The Price We Pay for Poor Oral Health

Lack of regular dental care is a significant factor in the economic consequences of poor oral health in the United States. Barriers to accessing dental care exist not only in underserved communities; It affects Americans of all socioeconomic statuses because coverage for all dental services is not guaranteed by Medicaid or private insurance plans.

These gaps in care make us wonder how the U.S. health care system, specifically dental health, got to this point.

Data tells us that approximately 67 million Americans do not have dental insurance, according to the National Institute of Oral Health at the National Institutes of Health. Since February 1, 2024, more than 16 million Medicaid beneficiaries have been eliminated due to the withdrawal of public health emergency funds, according to current data cited by the Kaiser Family Foundation. Although data are limited, children accounted for about four-in-ten (38%) of Medicaid disenrollments among the 21 states reporting age breakthroughs.

A lack of oral health can have a surprisingly negative impact on a person's financial well-being. According to the National Institutes of Health (NIH), per capita dental costs are 30% higher than they were 20 years ago, so it's no surprise that many Americans are unable to afford dental care.

To avoid the worsening economic impact and rising costs of neglect of oral health in the United States, we must work with policymakers and state governments to expand coverage of routine dental care and increase dental insurance availability and service coverage scope.

tooth gap

As the CEO of a dental care and orthodontic organization committed to providing quality care to more than 100 underserved communities, I have seen firsthand the difficulties of health care and dental care operating in silos. This dental divide is at the heart of many of the financial challenges faced by patients and institutions in healthcare. A study by Synchrony shows that as many as 58% of consumers believe dental insurance is unaffordable, and 75% of uninsured patients believe dental insurance is too expensive. This divide also results in the nation's health care system bearing the majority of the costs of poor oral health in communities across the country.

With high prices preventing many families from seeking routine dental care, 92% of adults say they have considered postponing dental care due to cost. The study also found that 27% of adults put off dental care because they can't afford it. To make matters worse, the National Institute on Minority Health and Health Disparities revealed that the financial stress of health disparities in the United States is increasing. Racial and ethnic health disparities cost $451 billion in 2018, a 41% increase from $320 billion in 2014, not only impacting health outcomes but also taking a heavy toll on the economy. The same study also shows that barriers to education come at a huge cost. For people without a college degree, the related medical cost burden in the United States, excluding dental costs, was $978 billion in 2018, twice the annual growth rate of the U.S. economy that year.

High costs ultimately lead to delays in treatment, causing those with severe toothache to turn to emergency rooms and placing a care burden on our hospitals and health systems. For reference, there were 2.1 million emergency department (ED) visits for dental disease in 2017, at a cost of $2.7 billion. 69%. The disconnect between health care and dental health makes it difficult to motivate changes in health care or dental care.

Dental Health Affects Whole Person Care

Many people must realize that oral health plays an important role in overall health. If left untreated, dental problems can have significant medical and indirect costs, negatively impacting other areas of people's lives.

There are many diseases and health complications associated with oral health, including heart disease, diabetes, cancer, osteoporosis, dementia, Alzheimer’s, and more, which can lead to expensive treatments in the long run Cost and disruptive effects. Poor oral health also limits labor force participation, harming economic productivity. In 2015, oral disease-related productivity losses in the United States totaled approximately $45.9 billion. That's higher than the amount of job losses in 195 other countries, according to the National Institutes of Health.

In addition to the substantial financial costs associated with delayed dental care, there are also hidden costs that are difficult to quantify. From toothache to the pain of missing teeth, every experience can have an emotional impact on a child's ability to learn, communicate and socialize. It is estimated that children miss 34 million hours of school due to dental problems. Children who neglect their oral health are three times more likely to miss school than their peers, and their toothaches are linked to poorer academic performance, a study shows.

Resolution: Build a dental home

What can healthcare providers and dentists do together to bridge the dental divide and help patients?

Primary care providers (PCPs) and clinicians across the continuum of care should join forces to help families establish a dental home—an ongoing relationship that the child or family develops with their dental provider just like they would with their primary care physician. For patients with or without insurance, PCPs, emergency physicians, or urgent care clinicians should recommend that patients visit their local dental office before the first year of life to maintain oral and dental health through regular dental visits. Providing patients with dental care outreach resources is the first step in equipping them with the knowledge to contact a dental provider before their treatment needs escalate into an urgent care visit.

Patients will benefit from developing a relationship with a hygienist who can perform dental cleanings and educate them on how to maintain a healthy smile. Routine cleanings are a preventative service that also provides tips on using fluoride or sealants and focuses on nutritional counseling at a much lower cost than remedial procedures.

For patients who do not have dental insurance and need to pay out of pocket, the cost of a routine cleaning depends on the dental provider; however, the average price in the United States is $104, according to the American Dental Association Health Policy Institute. Given the high cost of medical visits, low-income families may choose to buy groceries for their family instead of getting their teeth cleaned.

Click here for resources for healthcare services for Medicaid or Children's Health Insurance Program (CHIP) patients to confirm if their state plan offers dental coverage.

By working together, health care providers and dentists can improve health outcomes and reduce related costs for children and adults by preventing the early onset of dental disease.

Bryan Carey is the CEO of Benevis, a leading dental healthcare delivery organization dedicated to providing life-changing oral care and orthodontic services to underserved communities. He has spent more than 20 years improving and simplifying health care for providers and patients, ultimately making health care more equitable and accessible to those who need it most. Carey holds a BA in Applied Economics from Georgetown University and an MBA from the Wharton School.

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