Letter: What about dental care?

In all the discussion about Obamacare, MassHealth, Medicare, etc., I’ve seen virtually no mention of the problem of dental care. Compared with surgery, insurance coverage for dental services is minimal or nonexistent. I happen to be on a Medicare Advantage insurance plan I purchased from Health New England, but I think the same situation holds for virtually all publicly managed medical insurance.

Dentistry is expensive, very expensive. By shopping around, I recently had a root canal procedure done for $720, but it required two trips to Albany, over a two-hour drive each way. The going rate closer by is well over $1,000. Crowns and caps are typically about the same and implants or bridgework are several times that. Most people require those procedures eventually, and not just one of them. Semiannual cleanings and X-rays run a couple of hundred annually.

Given those costs, you might think that dental care is optional — a luxury reserved for those who can easily afford it. Not so, as any physician will tell you. Dental problems affect the whole body. Those expensive procedures are as critical for your health as organ surgery. If a tooth is compromised and requires a crown, there’s no cheaper alternative.

Employer-provided health insurance often provides dental coverage. Government-financed health insurance or even privately purchased health insurance doesn’t. Obamacare provides no help. And in all the whoop-de-do about Obamacare, pro or con, I’ve seen no discussion of the necessity of insurance coverage for dental care as complete as the coverage of surgery for other parts of the body.

I think this situation arose because of the historic division between dentistry and medicine. Dental and medical schools are distinct institutions and a DDS is not equivalent to (nor inferior to) an MD. The American Medical Association and the American Dental Association are parallel organizations. Dentistry is not just a medical specialty like orthopedics or cardiology. As a result, the dental community has not been involved in the arguments over health care in the same way that the medical community has.



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