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Health Care Reform Must Include Dental Care

As the health care debate grows louder, a critical voice has yet to be heard.

Last month, President Barack Obama took the first step toward reforming the American health care system by convening a White House summit that brought together many of the top stakeholders in the health care community. An excellent start, to be sure, but there was a conspicuous absence at the summit — out of the 80 organizations present, not one represented dentistry.[IMGCAP(1)]

The American Dental Education Association strongly supports the president in his efforts to build a more equitable, cost-effective and robust American health care system — but any comprehensive reform of the U.S. health care system should provide universal coverage of and access to high-quality, cost-effective dental services for all Americans.

Oral health is often ignored or overlooked in the debate over health care reform, despite the fact that, as former Surgeon General C. Everett Koop noted, “You are not healthy without good oral health.—

Good oral health has proven to be essential to general health and well-being. Bacteria associated with dental plaque have been linked in studies to cardiovascular disease, diabetes, pneumonia, and pre-term, low-birth-weight deliveries. Mouth lesions may present as early signs of HIV infection. Bone loss in the lower jaws of post-menopausal women may occur before the skeletal bone loss associated with osteoporosis. Poor oral health directly affects an individual’s nutritional state.

Approximately 130 million American adults and children lack dental insurance coverage. There are almost no oral health care services covered under the nation’s Medicare system, and there are no guaranteed oral health care services for adults in the Medicaid program.

This lack of insurance coverage has real consequences for American families. A recent tragic example of untreated dental disease is the 2007 death of 12-year-old Deamonte Driver of Maryland. Deamonte’s death resulted from complications of an acute dental infection that spread to his brain — an infection that could have been avoided had Deamonte received proper preventive dental care. The cost of his hospitalization was estimated at $250,000. Had he gotten treatment earlier, the cost would have been closer to $80 — and he would have lived to see his 13th birthday.

Each year, millions of productive work hours are lost due to dental diseases. Dental disease is also one of the leading causes of school absenteeism for children:
• Children miss 51 million hours of school due to dental problems.
• Workers lose 164 million work hours because of dental disease.
• According to the Journal of Dental Education, oral-related illnesses account nationally for 3.6 million days of bed disability, 11.8 million days of restricted activity and 1 million lost school days.

Every American should receive the care necessary to promote good oral health. Most dental diseases are preventable, and early dental treatment has proven to be cost effective. In fact:
• Preventive care and early detection and treatment save $4 billion annually in the United States. (Delta Dental)
• Children who receive preventive dental care early in life have lifetime dental costs that are 40 percent lower than children who do not receive this care.
• The cost of providing preventive dental treatment is estimated to be 10 times less costly than managing symptoms of dental disease in a hospital emergency room.

Dental diseases are universal. Nearly every man, woman and child will experience some aspect of these diseases during their lifetimes. Most dental diseases will not heal without intervention. They are chronic, progressive and destructive over time. That’s why it is critical that individuals with unmet dental needs within the U.S. health care system obtain timely and cost-effective treatment. It will save lives. It will save money.

We urge President Obama, Members of Congress, and the health care community to make dental care an integral part of America’s health care system.

Charles N. Bertolami is the immediate past president of the American Dental Education Association and the Herman Robert Fox Dean of the New York University College of Dentistry.

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