In an era where technological advancements in medicine are rapidly growing, one may think that more people are receiving better healthcare. However, this is not the case since access to adequate healthcare is limited for many, especially the older generation. This is seen particularly in dental care, where a large portion of the elder population is still affected by dental problems due to limited access to preventive dental care. Approximately one in four seniors aged 65 and over have not visited a dentist in the past 5 years, according to the National Institute of Dental and Craniofacial Research. As a result, approximately 70% of elders aged sixty-five and older have developed periodontitis, or gum disease. In another ten years, approximately a quarter of the population will be older adults who are sixty five or older due to decreasing mortality rates as seen in the demographic transition. Therefore, this is a problem that needs to be addressed immediately since oral health has a direct correlation to one’s overall physical health, and our goal is to provide the best quality of life possible for older adults.
Gum disease increases the risk of developing certain chronic diseases, and it can also worsen the symptoms of preexisting chronic diseases. Gum disease is linked to diabetes, a significant chronic disease among elders, since it is harder to maintain healthy blood sugar levels with infected/damaged gums. Likewise, older people with gum disease eat foods that are easier to chew, but these foods have high saturated fats and cholesterol levels, which leads to obesity and risk of developing heart disease. Additionally, gum disease has been found to worsen brain function in those affected by Alzhimer’s, the leading chronic disease found amongst elders. Elders affected by periodontitis also have a higher risk of developing dementia.
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Greater access to dental care for elders will result in fewer cases of periodontitis among elders, and this will improve many aspects of life. This will have major economic benefits since good oral health can prevent/ reduce the medical costs associated with chronic diseases such as Alzhimer’s, diabetes, and heart disease. Also, as the younger generation, we have a responsibility to promote active aging and enhance the quality of life for the older generation. We are currently failing in this responsibility by not providing adequate dental care and allowing elders to easily develop periodontitis. Likewise, we are trying to compress morbidity, and this will become easier if we can prevent gum disease from developing in the first place through regular dental checkups. Even though gum disease itself is not deadly, as I mentioned before, it increases the risk of developing/worsening deadly chronic diseases that are prevalent among the older population such as diabetes, heart disease, and Alzhimer’s.
As of now, there are no health insurance programs or policies that address this issue. Only one third of those who qualify for Medicare have dental coverage. The other 60% of medicare recipients do not have dental coverage. This is an issue because approximately 50% of medicare recipients have at least three chronic diseases, which can become worse due to poor oral hygiene. Yet, Medicare Part B doesn’t cover dental benefits such as dental care, procedures, or dental devices that are necessary to maintain good oral hygiene and prevent oral diseases from developing due to a statutory exclusion in the Social Security Act. Medicare Part A only covers certain inpatient dental services. This includes emergency dental services, dental treatments needed for a patient preparing to undergo radiation treatment as a result of jaw related diseases, and dental checkups needed before kidney transplant or heart valve replacement. Some advantage plans offered under Medicare Part C offer dental coverage, but the benefits range based on the plan and you have to live in the plan’s service area to qualify.
Providing Dental benefits are optional for state Medicaid programs, but many states do provide dental benefits. Right now, 37 states offer dental benefits, but this varies each year depending on the amount of funding received. Also, many states place limits on how many times certain dental services will be covered in a year. Furthermore, only 38% of dentists accept Medicaid so access to dental care is still limited for Medicaid recipients even though many state Medicaid programs provide dental benefits.
Under the Affordable Care Act, insurers are not required to offer adult dental coverage but dental care is included in some marketplace health plans.. However, the dental expenses are only covered after you meet your deductible, and deductibles can range from approximately 6,000 - 12,000 dollars. You can also get dental care through stand alone plans, but you have to pay additional premium.
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