Aging population means dental care access issues becoming more acute

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo: lawrence_baulch via Flickr

As America’s population ages, the shortage of dental care for the nation’s elders presents a growing problem.

Many seniors lack public or private coverage that would help defray the cost of dental services, according to a new fact sheet from the Pew Charitable Trusts.

“Perhaps the single greatest barrier is the inability to afford care,” Pew noted in its brief. “Seniors with dental insurance are 2.5 times more likely than those without coverage to visit a dentist and about half of seniors lacked insurance in 2015.”

Medicare, the federal health benefit program that covers 55 million older and disabled Americans has never included routine dental benefits.

Meanwhile, dental benefits for adults are considered optional under Medicaid, the federal-state program that provides health care benefits to poor Americans, including millions of poor elders.

In some states, dental services are extremely limited and a shortage of Medicaid dentists exacerbates access problems. The number of dentists who reported treating any patients on public programs declined from 44 percent to 35 percent between 1990 and 2013, according to Pew.

Americans age 65 or older comprised 15 percent of the population in 2014; a share that is expected to nearly double by 2060, the Pew report noted. The philanthropy is not alone in attempting to raise awareness about the growing ranks of seniors in need of dental care. In its latest series of State of Decay report cards, the nonprofit Oral Health America recently offered its own grim assessment of the shortage of care for elders.

“One of the most critical challenges for seniors is paying for care, thus we need to advocate for financially viable, publicly-funded dental benefits through Medicaid and Medicare,” noted State of Decay authors.

A bill proposed by U.S. Rep. Jim McDermott that would add dental, vision and hearing benefits to Medicare has been given no chance of passage in the current Congress.

Minority elders are disproportionately burdened by untreated disease, research has shown.

A large federal study released last year found that overall, 19 percent of adults age 65 and older had untreated tooth decay in 2011-2012. An estimated 41 percent of black seniors, 27 percent of Hispanic, 27 percent of Asian seniors had untreated decay, compared with 16 percent of white seniors.

Untreated tooth decay can cause pain and tooth loss, which in turn contribute to poor nutrition and other problems. Gum disease which is prevalent among older Americans, can also cause pain and tooth loss and may have much wider systemic implications as well. Research aimed at getting a better understanding of the connections between gum disease and diabetes and the potential links between gum disease and conditions such as heart disease and stroke are ongoing.

Leave a Reply