21st Century Aging

Living longer and better.

Live Longer, But Don't Expect Help Paying For It

The neglected importance of dental health

There is a lot we have to do to meet the guidleines of "optimal" self-care. Current recommendations include eating multiple fruits and vegetables, getting a lot of uninterrupted sleep, plenty of moderate exercise and not smoking or drinking alcohol (though alcohol guidelines vary from moderate use to not at all depending on the study). We also need to manage depression, anxiety and stress, as these contribute toward health risks. Now, added to this list, we need to be concerned about our mouths. Brushing our teeth, flossing, and managing periodontal (gum) disease is thought to increasingly protect us from the development of illness, lengthen our lifespans, and reduce the burden of disease.

As if we need something else to worry about.

Taking care of our teeth and gums is essential to overall health. Here’s just a few reasons why:

Periodontal disease can increase the risk of heart disease and perhaps cancer in men!  Additionally, according to The American Academy of Periodontology, diabetics are not only more prone to develop inflammed and infectious gums, periodontal disease can make it harder to control blood sugar, among those already struggling with diabetes.  All of these risks and consequences are assumed to be due to an increased inflammatory response, which wreaks havoc on many bodily systems. 

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The bottom line is, take care of your teeth and gums. This is important at all ages and may be more crucial among the elderly. 

Yet, who can afford to see a dentist twice a year? According to The Washington Post, about 85 million of us do not have dental insurance.  

I can’t help but think about the ways in which dental care is subject to the extremes of classism in medicine. Medicare does not cover visits to the dentist or hygenist.  The New York Times reports that dental care for children will be mandated under The Affordable Care Act, but even that implementation seems subject to wishful thinking.  

But before you get upset about Obamacare, most major insurance carriers still do not cover dental care. This is worrisome, especially given what we now understand about how important our mouths are to overall health.  

Is this just one more example of how the wealthy get to remain well and live longer? The priviledged can afford teeth cleanings and the exorbitant costs of periodontal care, such as gum grafting. But what about the majority of the population who cannot afford such care?

If dental care is so important and prolongs life, why then, are health insurance companies not providing coverage? Dental care has often been considered separate and split off from basic medical care. This would seem inappropriate given the current understanding of oral health.

Is adult dental hygeiene on the radar screen of insurance companies? And even all of us?  It should be.

Tamara McClintock Greenberg, Psy.D., M.S., is an Associate Clinical Professor of Psychiatry at the University of California, San Francisco.

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