Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Oral health is justice for all

Richard Rodriguez, DDS
Policy
May 15, 2022
24 Shares
Share
Tweet
Share

Recently, the New England Journal of Medicine published “Oral Health for All — Realizing the Promise of Science,” authored by some of the most respected officials in dentistry and medicine, including the U.S. Surgeon General. They declared the pressing need to address the “global public health threat” of inequitable dental care. With a surprisingly populist title, it was refreshing for a public health dentist to see a clear stance being taken and a call to action on such a prestigious platform.

Yet, two days prior to publication, President Joe Biden gave the State of the Union Address without mentioning dental health, even though adding dental coverage to Medicare was the top priority among voters during the final negotiations of the Build Back Better Agenda with more than 80 percent public support.

So, if the top medical and dental professionals of the country, the public at large, and many politicians acknowledge the issue, what or who keeps us from addressing it head-on?

A quick look into the past provides a bit of perspective. As the original legislation responsible for Medicare was being crafted, the American Dental Association (ADA) lobbied against its inclusion and has worked to maintain its autonomy from government-funded programs ever since.

Fifty years later in 2021, the ADA, coordinating with a group of allied organized dentistry groups, wrote in opposition of including dental care in Medicare Part B, specifically, and offered a counter-proposal, including a means-tested program to offer care to the lowest-income seniors. Despite this, more dental organizations than ever before lobbied in favor of the proposal, including the National Dental Association and Hispanic Dental Association.

The ADA’s counter-proposal of creating a separate plan that would serve seniors up to 300 percent above the federal poverty level sounds generous, but it would equate to about only $40,770 of yearly income, leaving millions still without crucial coverage. Oddly enough, one of the strongest complaints about the dental benefit in Plan B was that dentists are unwilling to work with administrative burdens; however, one of the most salient critiques of means testing is that it is more expensive and less effective than universal programs due to more of these burdens.

Throughout this lobbying spree, the ADA sent a litany of “Action Alert” emails asking its 161,000 members, myself included, to write to their legislators. However, six months later and after their victory of dental coverage being omitted from the final iteration of Build Back Better, my most recent email from the organization consisted of a list of “ADA endorsed” products ranging from waiting room TVs to luxury vehicles.

Not an advocacy email in sight.

Moving past the failure of the Build Back Better Agenda, there have been administrative steps made to acknowledge and explore ways to alleviate oral health disparities. In the past year, the Center for Medicaid and Medicare Services has hired its first-ever Chief Dental Officer, Natalia Chalmers DDS, PhD, to examine possible improvements of delivery of dental care through the agency.

Just a few months ago, The National Institute of Dental and Craniofacial Research, a division of the National Institutes of Health, released a monumental 800-page report titled “Oral Health in America: Advances and Challenges” outlining the current landscape and proposed policy suggestions. One of the proposals suggests using dental therapists. These mid-level providers can perform a limited number of low-risk dental procedures such as extractions, treatment of basic cavities, and cleanings to address the oral health needs of communities, particularly Black and Latinx communities.

The ADA has never gone on record supporting these providers.

To start the year of 2022, the American Medical Association Journal of Ethics released an issue titled, Inequity Along the Medical/Dental Divide edited by Lisa Simon, MD, DMD. In a note, she states that “the professionally entrenched view that what’s in patients’ mouths is somehow isolated from what’s going on in the rest of their bodies is one all clinicians need to resist, since this view can be a source of harm, particularly among vulnerable patients and communities.”

Not a week goes by where I scroll through my timeline on Twitter and see someone comment on this separation of the mouth from the body reflected in our health care system, and in most cases, it’s a young and financially struggling person of color expressing their valid concerns. Through posts like these, I am constantly reminded of the work that is required of us — dentists, policymakers, and advocates — to address this public health threat.

We must reframe the concept of oral health in American society. Routine care of our mouths should not be a luxury or an optional insurance add-on. More people are unable to afford dental care than other types of health care. Dentistry as a profession focuses entirely too much on the profits that can be made from aesthetic and implant dentistry. What good are the advances in the technology and services a dentist can offer if they’re only available to a select few?

The evidence base has been built now – there is no denying the importance of oral health to systemic health. It is time to reconsider our collective approach to improving access and understand the political and financial barriers we face to achieve our goals. The ADA, while some members and leaders of the organization share many of the same sentiments as local and state advocates, must step up to support marginalized communities. The mouth is undeniably a site for justice to be achieved, and the work is cut out for us all to create a more equitable dental care delivery system.

Richard Rodriguez is a dentist. 

Image credit: Shutterstock.com

Prev

Patient platforms should be intuitive in design and execution

May 15, 2022 Kevin 0
…
Next

Residency interviews and the inner muse [PODCAST]

May 15, 2022 Kevin 0
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Patient platforms should be intuitive in design and execution
Next Post >
Residency interviews and the inner muse [PODCAST]

Related Posts

  • Are negative news cycles and social media injurious to our health?

    Rabia Jalal, MD
  • How social media can help or hurt your health care career

    Health eCareers
  • Sharing mental health issues on social media

    Tarena Lofton
  • Why the health care industry must prioritize health equity

    George T. Mathew, MD, MBA
  • 3 ways to advance the credibility of online health information

    Robert Pearl, MD
  • Why this physician teaches health policy in medical school

    Kenneth Lin, MD

More in Policy

  • Unveiling the global pandemic threat: insights into risk factors and urgent measures for prevention

    Ton La, Jr., MD, JD
  • Why the WHO’s pandemic accord is critical for global health care

    Elizabeth Métraux
  • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

    Robert Pearl, MD
  • Unveiling the intricate link between housing costs and health care

    Harvey Castro, MD, MBA
  • Uncovering the truth about racial health inequities in America: a book review

    John Paul Mikhaiel, MD
  • Why affirmative action is crucial for health equity and social justice in medicine

    Katrina Gipson, MD, MPH
  • Most Popular

  • Past Week

    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions
    • Master the ABIM Certification exam with effective strategies: insider tips for success

      Farzana Hoque, MD | Education
    • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

      Arthur Lazarus, MD, MBA | Physician
    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
    • Fixing the system and prioritizing patient care [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • New Data in NSCLC Bolster Support for Perioperative Immunotherapy
  • Breathing Support Type Matters for Preventing Extubation Failure in the PICU
  • Second-Line Axi-Cel Bests Standard in Relapsed/Refractory Large B-Cell Lymphoma
  • New Agents for Relapsed/Refractory Myeloma Impress in Early-Stage Clinical Trials
  • Kratom Linked to Outsized Proarrhythmic Risks

Meeting Coverage

  • New Data in NSCLC Bolster Support for Perioperative Immunotherapy
  • Second-Line Axi-Cel Bests Standard in Relapsed/Refractory Large B-Cell Lymphoma
  • New Agents for Relapsed/Refractory Myeloma Impress in Early-Stage Clinical Trials
  • CAR-T Tops Standard Care in Heavily Pretreated Lenalidomide-Refractory Myeloma
  • T-DXd Proves Mettle in Multiple Solid Tumors
  • Most Popular

  • Past Week

    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions
    • Master the ABIM Certification exam with effective strategies: insider tips for success

      Farzana Hoque, MD | Education
    • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

      Arthur Lazarus, MD, MBA | Physician
    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
    • Fixing the system and prioritizing patient care [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Oral health is justice for all
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...