By Mary Otto
Adults with incomes below 100 percent of the federal poverty level (FPL) are three times more likely to have untreated tooth decay than adults with incomes above 400 percent of the FPL.
More than one third of poor elders have lost all their teeth – compared with 16 percent of those with incomes at or above 200 percent of the FPL.
These and other facts come as reminders that poor oral health places a disproportionate burden upon poor adults in the United States, the nonpartisan Medicaid and CHIP Access and Payment Commission (MACPAC) concluded in a report to Congress on the status of adult Medicaid benefits around the country.
We’ve reported that it would cost at least $1.4 billion to expand Medicaid dental programs in the 22 states where options for adults are currently limited or nonexistent, according to a research brief from the American Dental Association’s Health Policy Institute (HPI).
The resulting lack of dental services can take a heavy toll upon poor adults. Access to routine preventive and restorative dental care can help people stay healthy and employable – and may prevent expensive and painful dental emergencies from occurring in the first place.
The MACPAC website includes a trove of useful reports and data on Medicaid and the Children’s Health Insurance Program.
The agency stresses the importance of more fully integrating oral health services into the health care system and promotes innovative approaches to expanding dental care to underserved Medicaid populations.
Another good source for timely reporting on state Medicaid dental programs is the Kaiser Family Foundation which recently offered a useful issue brief: “Access to Dental Care in Medicaid: Spotlight on Nonelderly Adults.”
The report offers a concise look at adult tooth decay rates across income and race. It also offers a good history of state cuts to adult Medicaid benefits over recent years, and provides a new look at how Medicaid expansion has affected the demand for dental care in some states.
The sky-rocking number of patients turning to hospital emergency rooms for toothaches and other preventable dental emergencies has been examined in a number of reports and studies, including “A Costly Dental Destination” by the Pew Charitable Trusts. The Pew report examines the impact of these visits on stressed state budgets.
It concludes that few of the hundreds of thousands of patients who turn to emergency rooms for dental needs in a typical year receive the level of care that would address their problems. Pew has also compiled a number of reports with a specific focus on children’s dental health policy.
Medicare, the nation’s health program for seniors, does not include coverage for routine dental services. In periodic “State of Decay” reports, the nonprofit Oral Health America provides a state-by-state analysis of factors – including adult Medicaid coverage and the availability of dental providers – that can directly impact the oral health of older adults. In the most recent report, the authors note:
“While improvements in oral health across the lifespan have been observed in the last half century, long-term concern may be warranted for the 10,000 Americans retiring daily, as it is estimated that only 9.8 percent of older adults retire with dental benefits,1 and 23 percent of older adults have not seen a dental provider in five years or more.”
