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Let’s address the dental crisis in America

MCT FORUM, By Sen. Bernie Sanders –

The United States is in the midst of a major dental crisis. There are 130 million Americans who have no dental insurance. One-fourth of adults age 65 or older have lost all their teeth. Only 45 percent of Americans age 2 and older had a dental visit in the last 12 months, and more than 16 million low-income children go each year without seeing a dentist.

Lack of dental access is a national problem but those who are most impacted are people who are low-income, racial or ethnic minorities, pregnant women, older adults, those with special needs, and those who live in rural communities. Simply put, the groups that need care the most are the least likely to get it. As chair of the Subcommittee on Primary Health and Aging, we released a report at a recent hearing on the dental crisis in America. This report is available at

What the report shows is that access to dental care is about more than a pretty smile. People with dental problems can be forced to live with extreme pain, and a mouth without teeth often makes it difficult to find and keep a job. Dental problems can have a significant impact on overall health and can increase the risk of diabetes, heart disease, digestive problems and poor birth outcomes. In some cases, dental conditions can result in death, including the well-publicized tragedy of 12-year-old Deamonte Driver of Maryland, who died five years ago.

In order to address the dental crisis facing millions of Americans, the U.S. Congress must take strong action now. Here are some of the things we have to do:

First, the United States needs more dental providers to serve those in need. The unfortunate reality is that dental schools are graduating fewer dentists than the number needed to replace those who retire each year. We also need to expand the dental workforce to include allied dental providers such as dental therapists in order to extend the capacity of dental practices and reach underserved populations.

Second, not only do we need more dentists but dentists must start serving more low-income people. Only 20 percent of the nation’s practicing dentists provide care to people with Medicaid and only an extremely small percentage devote a substantial part of their practice to caring for those who are underserved. Raising the Medicaid reimbursement rates could help, but dentists need to change their attitude toward the low-income community.

Third, we need to expand Medicaid and other dental insurance coverage. One-third of Americans do not have dental coverage. Traditional Medicare does not cover dental services for the elderly, and states can choose whether their Medicaid programs provide coverage for dental care for low-income adults. Children with Medicaid or CHIP are required to have coverage for dental services, but insurance alone does not guarantee access. Only 38 percent of children with Medicaid in the U.S. see a dentist during a year. Sadly, while dental pain is one of the major causes of school absenteeism, many families cannot find a dentist to treat their children.

Finally, we are seeing improved access through the growth of Federally Qualified Health Centers, which now provide dental services to more than 3.5 million people across the country, regardless of their ability to pay. These clinics must be expanded. There is also great potential in bringing dental care right into schools, a concept that has proved to be very effective.

Addressing access to dental care will not only help to relieve pain and improve health for millions, but it will save money too. The Pew Center on the States recently released a report that said that there were 830,000 visits to emergency rooms across the country for preventable dental conditions in 2009, a 16 percent increase from 2006. Emergency room care is extremely expensive. Access to dental care can cut back on these visits and save significant sums of money.

Over the last few months, I have asked people across the country to tell me what a lack of access to dental care has meant to their lives. I’ve received more than 1,200 comments. Many of these stories are heartbreaking. Peoples’ lives are being disrupted because of chronic tooth aches, yet they are unable to find affordable dental care for themselves or their children.

This is the United States of America. We can do better. We must do better.

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