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Report: Dental crisis could create 'State of Decay'

Md. fares well in report

Jen Christensen | 10/9/2013, 9:25 a.m.

— Obamacare expands access to health insurance for tens of millions of people come January 1. Dental care for adults, however, is not included, and experts say we've got a potential oral health care crisis coming.

Studies show that people who have insurance are more likely to get regular dental care. But only about 2% of older Americans have dental insurance of any kind, according to a new report.

"Until we have an expansion of this kind of coverage, and until we have people really recognizing what this means for their overall health, I do believe we have an unimaginable tragedy on our hands," said Beth Truett, president and CEO of Oral Health America.

Truett's organization published the report "State of Decay: Are older Americans coming of age without oral health care?" which shows that baby boomers -- who have, for the most part, kept their natural teeth -- could be facing some serious oral health problems over the next decade. People with low income and racial and ethnic minorities are particularly vulnerable, according to the report.

"It's an issue that is particularly important that is not always talked about," said Ira Lamster, dean of the Columbia University College of Dental Medicine. "People in the United States are retaining their teeth, and as a result, teeth that have been in use for 50 or 60 or 70 years will have problems."

Neither Medicare nor the Affordable Care Act includes adult dental coverage, although some pediatric dental care is covered. Even the Medigap insurance that adults buy to expand their plans' benefits still won't cover dental procedures. Less than 1% of dental services are covered by Medicare.

And neglected dental health can turn into even bigger medical issues.

"For instance, if you have diabetes and you have gum disease, your metabolic control will be worse," Lamster said. "There is a lot of data showing that periodontal disease can increase your risk for heart attacks and strokes. There are so many ways this can impact your overall health. That is why regular access to care is so important."

The study put together by Oral Health America ranked states in terms of the oral care their populations receive. Seventeen states received a "poor" grade.

The states were evaluated on edentulism, which is the fancy word for total loss of teeth. Other factors included community water fluoridation, adult Medicaid coverage, access to dentists and a state oral health plan that addresses older adults.

Some states' Medicaid programs cover adult dental care. However, of the 17 states that received a "poor" grade for dental care, the majority are led by Republican governors who have refused or are leaning against expanding Medicaid under the Affordable Care Act.

Mississippi is ranked the worst. Tennessee and Alabama tied for second to last.

The other states rated as "poor" are Florida, Arizona, Louisiana, Delaware, Utah, Washington, Wyoming, Pennsylvania, Oregon, Montana, Kentucky, Maine, Virginia and California.

"Some of this 'poor' care is in direct relation to the economic changes our country has experienced," Truett said. "A lot of it, though, stems from the fact that some people see this as a tangential kind of medical care."