Thursday, March 01, 2007

for want of a dentist

The following heart-breaking news story, about a boy who died from a tooth abscess that spread to his brain, confirmed my worst fears:

which is that the lack of a link between dental health and medical health has some pretty severe consequences.

We have medical insurance. (Such that it is, HMO, better than nothing!) However, we do not have dental insurance. So all of our dental care, both for us and our kids, has to come 100% out of our pockets. Yet, dental offices don't care, they charge us the same inflated fees they charge the insurance companies. (In fact, having seen the way insurance companies work with the professional offices they are paying, I'd bet you even money that the insurance companies are paying LESS than we are.) As a result, we can only afford to care for our teeth when we obviously need to. In other words, when a dental problem gets bad enough to actually be threatening our health, we find a way to get it take care of. (ie, we put it on a credit card and make minimum payments for the rest of our life on it, or beg a loan out of a relative and then make minimum payments to them for the rest of their lives)

Of course, by the time we get to the "medically neccessary" stage, it costs about 10 times as much to take care of it as it would have if we'd just gone to the dentist in the first place. Problem is, it's pretty hard to predict which problems are going to "turn into something", and MOST problems that could have been fixed would have needed to be caught during the "6 month routine visit". And we just can't afford for any of us to go to the dentist for a "routine" visit on any sort of a regular basis.

All of which made me wonder -- what happens to the people in worse shape than us, the ones who can't afford ANY dental care, health-threatening or not? Do they just let their teeth rot out of their heads? Do they die from dental absesses?

Obviously, that question is yes. And it makes me sick. The point they make in the article has to do with access and Medicaid. My bigger concern is wondering WHEN the medical/insurance professions are going to recognize the obvious connection between dental health and medical health, in a tangible form rather than just as a theory. I mean, ask any doctor or dentist, they'll tell you there is a direct link. Yet my medical insurance wouldn't even look at my claim for periodontal disease. I would have had to let the infection spread to my heart and threaten my life (no doubt leaving myself with long-term damage even if I survived the episode) before my medical insurance would touch it, and even then, they'd only treat my heart problems, not my teeth. When Zoo Boy had major dental surgery a couple of years ago (he was born with no enamel on his teeth, and his teeth pretty much rotted right out of his head), our insurance covered his hospital expenses, but all the dental expenses (thousands of dollars) came directly out of our pocket.

And what does this seperation of medical and dental coverage really serve in the end? The boy in the article could have been saved by an $80 extraction and a $20 antibiotic prescription when his tooth abcess first began. Instead, the child has died, and the medical community is stuck with a $250, 000 bill that has no way of ever getting paid. Can no one see how insane this is? Simple math tells us that we could save 2500 children for the same cost to the profession/medicaid/society (whatever!) as was spent to let this one boy die. Even for those not morally horrified that this happened, they should at least be financially horrified.

And that's my soapbox rant for today.


At 8:38 AM, Anonymous Anonymous said...

I share your frustration! I'm a dental hygienist that wants to do more, but because we are regulated by the dentists, we are held back from doing more to provide access to care. I am very aware of the mouth/body connection and I don't understand why more is not being done!


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