According to a new report by the journal Health Affairs, adults are skipping dental exams at alarming rates. So what’s behind this surprising new data? Mostly, it’s cost. According to the study, a staggering 88% of seniors don’t have dental insurance. The report revealed that seniors who rely solely upon Medicare for medical insurance have no preventative dental benefits whatsoever because Medicare does not provide dental coverage unless the procedure is performed as an emergency service, rendered while the patient is admitted to a hospital.
Dr. Stephen Hill of Allen, TX says the findings of the Health Affairs report are especially troubling, given the medical vulnerability of seniors. "Poor oral health can contribute to illnesses like periodontitis, tooth decay, and even pneumonia. In a highly vulnerable population like seniors, pneumonia can be extremely dangerous," says Hill. This is especially true for seniors in a nursing home setting because illnesses in these facilities can often spread quickly- and residents of residential care facilities are often already experiencing declining health.
Still, residing in a care facility shouldn’t necessarily be a factor in whether a senior gets dental care. In fact, a study recently published in Special Care in Dentistry found that in many nursing homes, dental care is readily available, but many seniors are simply not taking advantage of it. The study found that 90% of seniors admitted to care facilities declined dental care- even when that care was provided free of charge. Though at least some opted out of care due to short (two months or less) stays at these facilities, even among seniors who stayed longer than two years, only 55% were found to take advantage of on-site dental services.
But the lack of dental exams isn’t exclusive to the over-65 crowd. According to the Health Affairs study, lack of insurance across all age ranges is the number one reason adults are skipping dental exams. In fact, three times more adults are forgoing dental checkups due to lack of money than to fear of the dentist. Worse yet, the study found that just because a patient has insurance doesn’t mean they can afford to use it. Some respondents said despite having dental coverage, their out of pocket cost is still too high. Says Hill "The fact that people are forgoing dental exams even though they are supposedly covered by insurance says a lot about how badly the insurance industry is doing at providing adequate dental coverage. Especially with Medicare, it seems like dental care is treated like either a cosmetic procedure or an afterthought- and that needs to change."
Unfortunately, the cost to expand Medicare to add bare minimum dental coverage would cost upwards of $16 billion dollars a year- and that could be a hard sell for lawmakers. In the meantime, short of waiting until their teeth have gotten so bad they have no choice but to check into the ER, what can seniors and adults with little to no dental coverage do? Hill has a few suggestions. "Check out your local free clinic. Many have low or no cost dental programs. You can also check with your local medical school. Many schools conduct free or low-cost services, too." Hill also suggests if you’re in a residential care facility, take advantage of the free dental exams offered during your stay- and if all else fails and you’re experiencing any kind of discomfort in your mouth, "Go to the emergency room and take advantage of your Medicare Part An emergency coverage." Says Hill "It seems strange to go to the ER for a dental emergency- but maybe if enough Medicare claims are filed for emergency dentistry, lawmakers will get the hint that coverage should include preventative care."