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 www.sanders.senate.gov.
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.
Who is going to pay for this? We are broke now. Want to borrow more money from China for it? I don’t.
The problem is that equipping dental offices is horrendously expensive. The walls have to be leaded and the new dental x-ray machines cost about $18,000 each – $9,000 for the wand they put in your mouth (and they need different sizes) and $9,000 for the machine they aim at your jaw. And then there are all the water supplies and drains needed. Most dentists out of school cannot afford to start out on their own because they are carrying heavy education debt and they cannot afford to buy in to another clinic until that huge school debt is paid off. Like the medical profession, it is no longer such an attractive career.
Another problem is that all the products needed to stock a dental office are very expensive. The manufacturers of everything from the equipment to the files used on root canals charge a big markup and they are the ones who are really making the money from this profession, and the medical profession.
The other problem with serving the poor who don’t have insurance is you have to hire extra help to treat them, clean their teeth, handle the Medicaid paperwork, and then you do not get reimbursed enough to cover those extra expenses. It’s a money-losing proposition for dentists (and doctors) and that’s why the poor can’t find dentists who will see them.
Help for the poor needs to start from the top down with manufacturers, salesman, and suppliers willing to stock Medicaid dental offices at a discount. Then they need to find altruistic dentists who will work there in exchange for a certain amount of debt forgiveness. These could be places where dental students intern or oral surgeons do residencies. They could also be an internship places for hygenists. I know it’s easier said than done, but there are already medical clinics for the poor, why not dental clinics?
Katie, Katie, Katie…. who do you think you are bluffing? Dentists have minimal government controls, unlike healthcare. Their noses are too high up in the air to care for the underpriviledged – most do not accept Medicaid patients. Medicaid (& Medicare) reimbursements to health care professionals & institutions have not been increased in 10 + years. Dentists refuse to take on under priviledged patients for this reason, while other health care fields must accept government payments { participating in the system } even though they are making a minimal profit from treating such. Equipment, supplies, & employees are costly for all healthcare providers, not just for the dental field ! Dentists need more government control – just like healthcare. The government decides what hospitals & doctors can charge a Medicare/Medicaid patient, so why not the field of Dentristy as well? That is why dental care is so out of control and extremely costly! The Cerro Gordo County free health clinic could use some dentists to provide certain oral care – free of charge – but why are dentists not volunteering at the free clinic? A penny for your thoughts on this one…..
Looks like Sen. Bernie Sanders is in the pocket of the dental health industry lobbyists. Can you imagine what dental health costs would be if insurance were expanded to cover it all? Costs would rise even more than they have.
But Senator Sanders has already gotten his.
Have a friend of mine that had braces put on her teeth. She had to have two teeth pulled to make it look right she had fake ones that she had to take out when she ate. It cost her 5000.00 yes 5000.00 dollars for her to have them put in permanently. It took her years to get the money to have it done. Matter of fact her husband surprised her. She thought she was going in for a regular cleaning and the next thing she new she was getting her new teeth!!! It’s crazy getting false teeth is so much cheaper than getting your real teeth fixed. I know this for a fact. She could have gotten a dentures for less than 500 where she lives.
Dental insurance has not kept pace with the cost of dental care. The amounts the insurance companies pay towards services have not changed for years, even though the cost of those services have risen dramatically.
Aren’t their programs available to new grads to work in impoverished areas that allow student loans to be forgiven??
No one can afford dental care anymore. They have priced themselves out of business. Who can afford $250 to have a tooth pulled or $950 for a root canel. It costs $500 to get your teeth cleaned and if you need dentures watch out. You are looking at $5,000. Very few people have that kind of money laying around. It means not paying your rent and car payments along with your food for at least a month. No says they shouldn’t make a decent living but this is stupid and people just can’t afford it. Even dental insurance just covers $1000.