I have been fortunate to have had healthy teeth all of my childhood and adult life, until now. As a child, my parents were diligent in making sure I had an annual oral checkup, and properly brushed my teeth. Cavities were filled and I never had a tooth ache. As an adult, I continued with similar maintenance, adding in semiannual hygienist visits. I never thought about cost because, even when I didn’t have dental insurance, maintenance was relatively inexpensive.
Now that I’m approaching Medicare age, I’m learning teeth don’t necessarily last forever, and I’m experiencing a bit of sticker shock on the cost of dental care for services beyond maintenance. When you start getting into crowns, bridges, implants, etc., even with dental coverage, the out of pocket costs are substantial.
million aged (65 or older) or disabled adults currently receive health insurance through Medicare. That number is expected to increase to over 70 million in the next 25 years as our population ages. Preventive personal care combined with seeing a dentist for annual maintenance are the most practical and least costly methods of preserving teeth and health. By catching early signs of infection or disease before they become more serious, you can avoid unnecessary physical discomfort as well as expenditures.
According to the National Health and Nutrition Examination Survey 2011-2012, of adults 65 and over, nearly
- 19 percent of adults 65 and over had untreated tooth decay
- 96 percent of all U.S. adults 65 and over with any permanent teeth had cavities (treated or untreated)
- 19 percent had lost all of their teeth
Poor oral health can lead to periodontal (gum) disease, caused by bacteria in plaque. Irritated, swollen and/or bleeding gums are all signs of developing gum disease. Untreated, deep pockets can form, where more food particles and plaque can collect. As the disease advances, the supporting gums, bone and ligaments around the teeth can pull apart and result in tooth loss.
Oral health is often an overlooked component that could have impacts on overall health and well-being. Periodontal disease has also been linked with diabetes, heart disease and stroke. In addition, many seniors experience more challenges with oral health due to medication reactions, such as dry mouth, a common cause of cavities in older adults.
Original Medicare currently doesn’t offer dental coverage. However, many Medicare Advantage (MA) plans offer the service. Currently, about 63 percent of beneficiaries are enrolled in original Medicare (and 37 percent in MA). With the evolving health care provisions under the new administration, it will be important to keep a close watch on this coverage for both plans.
Other affordable options for dental services may be available through Federally Qualified Health Centers, private insurance and discounted rates offered by some dentists which can be accessed through the American Dental Association’s website here
What can you do now? Follow the Centers for Disease Control and Prevention guidelines for maintaining Oral Health for Older Americans
to prevent serious issues.
What will I do next? I’m switching to an in-network dental provider and getting as much work done as I can while I still have coverage!
Take care of your teeth and follow a preventive care schedule diligently to prevent problems that can affect the rest of your body. Think of your body as a beautiful sports car — and, the only car you will have for your entire life. To keep the car running smoothly long-term and to prevent any problems with the vehicle, you would likely follow the manufacturer’s preventive care schedule diligently. Do the same with your teeth – you won’t regret it.
[i] Medicare Enrollment Dashboard and Data File, available at https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMSProgramStatistics/Dashboard.html, accessed 3/17/2018