Fifty million Americans lack health insurance, a substantial portion of the U.S. population. But an even larger number of Americans have no dental insurance—130 million.

 

For many the problem stems from the fact that many employers don’t pay for dental coverage. In the case of seniors on Medicare, which does not include dental insurance because dentists lobbied against it, 70% of older Americans go without visiting the dentist regularly.

 

For those who have dental coverage, the amounts covered by insurers are often quite low ($1,000 to $2,000 per year), resulting in patients only getting basic services performed.

 

And then there are those living in rural areas, where just finding a dentist can be difficult. There are more than 4,500 mostly rural regions where 3,000 people share one dentist, according to the federal government, which also says that 47 million Americans live in “dental shortage areas.”

 

“The result is a crisis,” wrote Margot Sanger-Katz at National Journal. “Dental disease is the largest unmet health need in the U.S. among both children and adults, according to the Pew Children’s Dental Campaign. The worst-off are the poor, the young, the old, and those in rural America. Dental disease is among the most common reasons that children miss school. It’s the most common medical reason that soldiers can’t deploy. It is a leading cause of emergency-room visits in several states.”

 

Increasingly, people with dental emergencies have no choice but to go to hospital emergency rooms where doctors and nurses are not trained in dental care and are only able to give patients pain medication. The same limitations apply to many of the mobile non-profit dental programs that try to provide care for low-income and rural Americans.

 

Two states, Alaska and Minnesota, have begun certifying a new category of practitioners called dental therapists, who are licensed to provide preventative care and fill children’s cavities, but nothing else.

-Noel Brinkerhoff, David Wallechinsky