Adults over the age of 65 are the largest and fastest growing demographic of the American population. They’re also the population most at risk when it comes to dental outcomes and health issues caused by poor oral health.
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Even though the Affordable Care Act (ACA) reformed healthcare for younger citizens, it did little to improve healthcare for seniors. According to Oral Health America, only about two percent of seniors have dental insurance through a prior employer. For many, it’s a serious health concern.
As we age our dental health needs change dramatically. The Center for Disease Control (CDC) warns that foregoing regular oral hygiene care by a dentist or oral hygienist leads to serious health problems, including tooth loss. One in four seniors will loose all of their teeth due to lack of professional care.
The CDC claims:
Older Americans with the poorest oral health are those who are economically disadvantaged, lack insurance, and are members of racial and ethnic minorities. Being disabled, homebound, or institutionalized also increases the risk of poor oral health.
Many older Americans do not have dental insurance. Often these benefits are lost when they retire. The situation may be worse for older women, who generally have lower incomes and may never have had dental insurance.
Oral health professionals understand that seniors in all demographics are susceptible to:
- Gum disease
- Root decay
- Uneven jawbone caused by tooth loss
- Thrush (overgrowth of fungus in the mouth)
- Attrition (loss of tooth structure)
- Tissue inflammation caused by dentures
- Dry mouth
These oral health conditions often lead to additional problems that impact a senior’s quality of life and their ability to stay healthy. Issues as simple as chewing and eating, due to mouth and gum pain (i.e., irritation caused by dentures, implants, missing teeth, cavities, tooth decay, etc.) lead to more serious health problems, including malnutrition.
Gum Disease and Heart Disease: Are They Linked?
For a number of years researchers have tried to connect gum disease to heart health. As yet, there’s no conclusive evidence. However, WebMD says, “Experts do agree that there are plausible reasons why dental health and heart health may be intertwined. For example, inflammation is a common problem in both diseases… Hardening of the arteries, or atherosclerosis, has a strong component of inflammation.” Gum disease also has an inflammation component.
Experts in periodontology and cardiology analyzed 120 published studies and position papers on the link between heart and dental health. Their consensus report, published in the Journal of Periodontology and the American Journal of Cardiology, makes the following points:
- A review of several published studies finds that gum disease is, by itself, a risk factor for coronary artery disease.
- Analysis of the large National Health and Nutrition Examination Survey (NHANES) found that gum disease is an important risk factor for diseases of the blood vessels and the arteries that supply the brain, especially strokes involving insufficient blood or oxygen to the brain.
- Data from another study of more than 50,000 people found that those with fewer teeth and more gum disease had a higher risk of stroke.
- However, other studies have uncovered no association between gum disease and stroke.
- Other research found a direct link between clogged arteries in the legs and gum disease.
So, as yet, there’s no conclusive data to suggest that gum disease and other oral health issues are a direct contributor to coronary heart disease or the risk of stroke. This remains the defining reason that oral healthcare is not provided to seniors with Medicare or Medicaid benefits.
Under the ACA, stand-alone dental insurance policies are available through healthcare.gov, but only with the purchase of a medical insurance plan from the Marketplace. This excludes access to these plans by most seniors.
Even for the poorest among us, Medicaid does not cover dental work for seniors. While state Medicaid programs are required to provide comprehensive dental care for children, coverage for adults is optional, based on federal rules. Only 21 states offer dental care for seniors with Medicaid benefits. In most cases, seniors are on their own for dental care, regardless of their economic situation.
Many seniors with dental health problems purchase a stand-alone dental insurance policy. They are later surprised to discover that the plan does not cover preexisting conditions. Likewise, most plans won’t pay to replace teeth that were lost prior to purchasing the coverage.
Limitations in traditional dental insurance for seniors on Medicare have caused many to seek alternatives that offer the opportunity to obtain affordable treatment for existing oral health problems. One such product is a dental savings plan (DSP).
For most seniors, dental savings plans are a smart, sensible alternative. For a low annual fee, members receive access to a large, growing network of dentists offering discounted rates to seniors. Savings are in the range of 30 to 60%. It all depends on the dentist and the services you need.
One of the best features of a DSP is that there are no claims to file. You simply pay your dentist the discounted rate when you receive the service. Plus, unlike most dental plans, there’s no annual limit (cap) on your coverage. That means you get the care you need when you need it without limitations.