Oral healthcare is a fundamental aspect of good health, supporting communication, self-confidence and social well-being. It is integral to general health, particularly in children and older people, and is key to preventing many costly health conditions and disabilities. Oral diseases disproportionately affect the most vulnerable and disadvantaged groups, with socioeconomic status affecting a person’s oral health throughout their lifetime.
In addition to reducing dental problems such as tooth decay and gum disease, routine dental care can lower medical costs. In addition, there is evidence that poor oral health increases the risk of some diseases and health conditions. For example, a person with diabetes who neglects their teeth is at higher risk of developing periodontal (gum) disease. This can lead to complications such as heart disease and increased health care costs. The National Institute of Dental and Craniofacial Research estimates that untreated periodontal disease adds to the cost of treating diabetes by 4.6 times more than preventive dental care. Untreated oral disease also leads to a lack of self-confidence, reduced quality of life and decreased ability to work, study or interact with others.
The good news is that oral health is a vital part of overall wellbeing, and most oral health problems can be prevented with regular care and treatment. But for those with limited incomes or access to dental care, the barriers to receiving appropriate oral health care are formidable. Many dental problems – such as rotting teeth, gum disease and bone loss – can be avoided with regular visits to the dentist.
Unfortunately, many people are missing out on this essential preventive care. In the United States, a large proportion of adults do not have access to affordable dental services and are at high risk of developing serious and disabling oral health problems. This is largely due to a combination of factors including state and federal policies that influence the distribution of oral health professionals, reimbursement policies of public insurance programs, and incentives for private dental plans.
For example, the lack of a comprehensive dental benefit in Medicare leaves many adults with only emergency dental care coverage and often at a financial disadvantage. Likewise, Medicaid coverage for adults varies from state to state and may exclude most dental services, while employer-sponsored retiree and individual-purchased private dental insurance often fails to adequately address the dental care needs of older individuals.
There are a number of steps that can be taken at the local level to promote and encourage better oral health, especially among those who have low incomes or little or no access to dental care. This includes ensuring that dental care is included in personalised care plans for people who use health and social care services, encouraging a wider range of providers to offer dentistry, and making sure that advice on maintaining oral health is easily accessible to those living in care settings and their carers. It is also important that health and social care regulators and providers consider oral health in their inspections of hospitals and residential homes.