America's great divide in dental care: 'The painful truth about teeth'

Rss@dailykos.com (dartagnan) · Saturday, May 13, 2017, 10:29 pm

A bolt of lightning shoots from your temple, through your tooth, around your jaw, down to your knee. As it goes through the tooth, an explosion occurs, filling your entire head with raw, concentrated agony.

Just as your brain begins to process this, a leg forgets its purpose. You barely realize you've dropped to the ground when a scream you didn't know was there forces your mouth back open, allowing the air pressure fluctuation to begin the cycle again. All you can see is white.

After a week-long hour or so, it ends. You can go about your day, but it will happen again. Probably tomorrow. Maybe today. It will happen with no warning, and it could happen at any moment. You are acutely aware of this, every second of every day, until you save up enough money to get it pulled out of your head.

The Washington Post examines one of the most overlooked aspects of inequality in this country—the high cost of obtaining even basic dental care. Dental care is a subset of health care, but historically separated out in the U.S. health care “market,” even though dental problems can quickly cascade into serious medical conditions. Those of us with decent dental coverage through our employers usually receive it through a plan separate from our health care coverage. And just like health insurance, the coverage provided in employer-based dental plans varies drastically.

But even meager coverage is better than no coverage at all. And no coverage is what millions of Americans—many working steady, full-time jobs—are forced to cope with:

As the distance between rich and poor grows in the United States, few consequences are so overlooked as the humiliating divide in dental care. High-end cosmetic dentistry is soaring, and better-off Americans spend well over $1 billion each year just to make their teeth a few shades whiter.

Millions of others rely on charity clinics and hospital emergency rooms to treat painful and neglected teeth. Unable to afford expensive root canals and crowns, many simply have them pulled. Nearly 1 in 5 Americans older than 65 do not have a single real tooth left.

More than a third of American adults have no dental coverage. Medicare does not cover dental issues—Medicare-eligible seniors must purchase separate dental insurance, which usually caps benefits at $1500 per year, even as dental costs have skyrocketed. Although states require coverage for children on Medicaid and CHIP, many non-eligible kids have to go without care because their parents can’t afford the plans offered through their work.  One of the benefits of the Affordable Care Act (and one of the measures callously repealed by the Republican House of Representatives last week) was a requirement that dental care be included in health insurance plans for those up to age 19.  Thanks to Donald Trump and the Republican Party, those benefits (and dental coverage for five million adults) are likely to be taken away.

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