Good dental care is about more than brushing your teeth and keeping an attractive smile. Teenager Dominique Allen of Petaluma, Calif., was rushed to the hospital in 2010 with a life-threatening infection. The cause? Bacteria from four rotting molars that had caused crippling pain for months had spread into her jaw and neck, triggering so much swelling she could barely breathe.
Allen’s case is not unique. Between 2000 and 2008, more than 60,000 Americans were hospitalized with abscessed teeth — a preventable problem — and 66 of them died. Researchers have also linked gum disease to heart disease and other serious illnesses. This guide will help you figure out how to get dental care for you and your family — and how you can keep your mouth healthier on your own. Plus, a special section on flouridation.
Finding affordable dental care is a challenge for Americans in every income bracket, but especially for poor and middle-class adults on a tight budget. Even if they could afford dental insurance, they might have trouble finding a plan. Private insurers, Medicaid, Medicare and the Affordable Care Act Marketplace, for example, don’t have to even offer dental care to adults. Employer health insurance policies may or may not include dental insurance. Here’s where to look for it.
Why Is Good Dental Insurance So Important?
A healthy mouth is an important part of a healthy body. So why isn’t everyone seeing the dentist?
One word: Money. Dental care is expensive. The 2014 ADA Health Policy Institute report Oral Health & Well-Being in the United States found that among all income and age groups surveyed, everyone — even people with the highest incomes — cited cost as a main reason for not seeking dental care.
One problem is that dental care “is excluded from most insurance plans for a bizarre and antiquated reason,” according to an article in The Atlantic: As a profession, dentistry and surgery grew out of hairdressing — barbers used to pull teeth, drain abscesses and even take care of wounds. Surgery and medicine were considered two very different fields, a bias that some experts say drove policymakers planning Medicaid in the 1960s to pay little attention to dental problems.
As Columbia University professor of dental medicine Burton Edelstein told the magazine, the division between medicine and dentistry has long been a “medically, morally, and ethically inappropriate separation.”
Indeed, when cost is taken care of, studies show dental care goes up dramatically. Researchers have seen improved dental health in children who are covered by Medicaid and the Children’s Health Insurance Program (CHIP), which together cover 40 percent of children in the United States.
What about the Affordable Care Act?
Wasn’t the Affordable Care Act supposed to guarantee our right to health care? Children have definitely benefited from its expansion of dental coverage. But according to some experts, dental insurance for adults fell through the cracks.
The Affordable Care Act of 2010 (ACA), sometimes called Obamacare, made dental care for children one of the ten essential health benefits. It’s credited with major improvements in childhood dental health. (See “If You Have Children Who Need Dental insurance or Dental Care.”) But it didn’t do much for adult dental care.
Even though ACA marketplace plans don’t have to offer dental coverage for adults, some do. If you decide you want dental coverage and your plan doesn’t offer it, you can buy and enroll in a separate, stand-alone dental plan. This government blog site has some good information about how the ACA works, who is eligible and how much subsidy support you may get.
The bottom line: Check whether dental coverage for adults through ACA programs are cost effective for you. The government Marketplace website has programs that allow you to check the costs and benefits, along with premiums and co-pays of stand-alone dental plans.
These vary state by state. Choose your state at Healthcare.gov to check plans available to you. Or call 800-318-2596 to speak to someone at the Marketplace. Note that many commercial organizations also have “marketplace” websites offering insurance. Be sure to check your options.