Many Americans make annual visits to the dentist, hoping their appointment will only entail a cleaning and perhaps a reminder that they need to floss more.
But millions of others go for years without seeing a dentist, which can affect not just their oral health, but their overall health.
“Many people in this country have a fear of dentists, but it’s not of the drill,” Rep. Debbie Dingell (D-MI) said during WTOP’s The Health Care Agenda: Real Policies for Real People. “It’s how much the visit is going to cost, and it keeps them from even making an appointment or going to the dentist.”
Dingell said it’s estimated that more than 70 million adults and nearly 8 million children don’t have any type of dental insurance.
And yet the mouth is the gateway to the whole body and therefore often plays a critical role in ensuring overall health, she said.
Dingell views it as important to help all Americans be able to go to a dentist when they need to, especially since oral health issues can be linked to broader health problems.
She pointed to her own experience, which included a bone infection in her jaw from an implant. It ended up being so serious that she eventually had to go to the hospital for surgery.
But Dingell also acknowledged that she’s more fortunate than many people because she had access to oral health care and so was able to have the problem addressed immediately.
Oral health is health
Sarah Chavarria, CEO and president of Delta Dental of California and affiliates (Delta Dental), shared during the WTOP event that her organization similarly believes in the need to make affordable dental care readily available.
The purpose-driven organization provides dental benefit plans to more than 31 million Americans in 15 states, including Maryland, and the District of Columbia.
Delta Dental seeks to improve health by providing access to quality care, Chavarria said. In addition to serving employees of its commercial clients, the company also provides benefits to veterans, military retirees, federal government civilian employees, retired federal annuitants and family members through its federal dental programs.
“What we’re striving to drive in this transformation that we’ve undertaken is to really connect for everyone that oral health is health and that a visit to the dentist’s office is more than a cleaning,” she said.
Chavarria noted that the company is developing an “innovation engine” to explore opportunities to integrate medical and oral health care. Among other initiatives, the effort aims to enable dentists and physicians to easily share health information and strengthen care coordination, ultimately improving overall health.
Going to see the dentist is a part of preventative care and taking care of overall health, she said.
She added that an estimated 27 million Americans forego their visit to their primary care physician each year but still visit a dentist.
“They have an opportunity to talk to a health care provider about whatever it is that’s going on with their body,” Chavarria said. “And that gets to be very important.”
She pointed out, by way of example, that there are links between periodontal disease and broader health issues, such as diabetes and cardiovascular health.
Chavarria said that during a recent dinner with friends she spoke to a woman who said her husband was told by his dentist that he needed to see his cardiologist.
The husband followed his dentist’s advice and was in the operating room within two months. Without that visit to the dentist, he might not have known about a serious health issue.
Delta Dental wants to work with providers to make insights like these a common part of a typical dental visit. More broadly, Chavarria said, the company is working to help Americans understand the correlation between oral health to overall health. That includes educating patients about the relationship between conditions like gum disease and heart health.
The company is also working with its provider network to expand the scope of the screenings and services offered by dentists to improve overall health, she said.
Ensuring the aging population has access to dental services
Dingell said more than 70 percent of older Americans have some type of periodontal disease, which as Chavarria noted, can sometimes be linked to more extensive health problems.
But millions of seniors never get dental care.
“We need to do something to help every American be able to go to the dentist when they need it and not have the first thing they think about be how they are going to pay,” Dingell said.
She shared that she had spoken to a dentist who tells patients they need to try to set aside money for dental care when they retire. The dentist recommends, if possible, that people try to save $50,000 — just for dental needs as they get older.
On a positive note, Chavarria said most aging baby boomers understand the link between oral care and overall health. A survey found that 91% of adults believe there’s a connection between the two, but only half visit the dentist for a preventative cleaning twice a year.
Delta Dental has made senior oral health a top priority. Through its philanthropic arm, the Delta Dental Community Care Foundation, the company is building coalitions with community partners that specifically serve seniors.
The first community partnership involving the Community Care Foundation was with the Howard University College of Dentistry and Mary’s Center in Washington, D.C.
Chavarria said the partnerships — as well as two others added in California — have helped provide care to thousands of seniors since the program’s launch in 2022.
“Our plan is to just replicate that model,” she said. “Because if we can, through our Community Care Foundation work, engage our community partners to help us deliver on our strategic priority … to ensure access to quality care for our older Americans, we think that is incredible work.”
The Community Care Foundation has committed $15 million to these three partnerships since 2022. The company has also supported senior oral health through its annual Access to Care Grants Program, which has issued more than $170 million in grants to hundreds of nonprofits since 2012.
Legislation related to dental care
Dingell is a sponsor of legislation that would try to make it easier for people to get dental insurance.
She notes that many people are currently prohibited from buying dental insurance if they don’t also buy overall health insurance.
“It would eliminate the prohibition and create more competition in the marketplace, which is obviously one of the issues that’s contributing to higher [retail] dental prices,” she said of her bill.
Chavarria said Delta Dental also wants to expand access to oral care. The organization supports the ability of people to make independent purchases on the public exchanges.
“This is very important because it would not require that someone buy a medical plan to get the dental benefit,” Chavarria said. “It would allow them to buy the dental benefit standalone.”
In D.C., people are now able to purchase standalone dental plans from several insurers. Close to a third of the dental plans are purchased independently.
“That’s a great testament to what we would like to see, which is to continue to allow for that to be separate,” she said.
A proposal to facilitate independent purchase of dental coverage — H.R. 1671 in the House and S. 2771 in the Senate — has gained bipartisan support and a Congressional Budget Office score finding that the measure would reduce federal health care costs by $3 million over the next 10 years.
Dingell is a lead sponsor of the measure in the House, joined by Rep. John Curtis (R-UT), and by Sens. Maggie Hassan (D-NH) and Roger Marshall (R-KS) in the Senate, along with a growing bipartisan list of co-sponsors in both chambers.
Dingell is also a sponsor of the Comprehensive Dental Care Reform Act of 2024, which would expand dental coverage under Medicare, Medicaid and the Affordable Care Act and through the Veterans Affairs Department.
The reform bill would extend dental insurance to millions of Americans who currently don’t have it, she said.
“It ensures that there are more places for people to go to get access to qualified oral health care professionals, to get the care that they need,” Dingell said. “But it would also increase funding for health clinics and school-based dental services.”
While there is still work to be done, both Dingell and Chavarria said they are encouraged by the increased attention to oral health.
“You see a growing respect and a growing acknowledgement by people that we have to do something,” Dingell said. “And I’m not going to stop until we get this done.”
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