Access to Care


October 1, 2013, marked the commencement of the Patient Protection and Affordable Care Act, enabling Americans to purchase health care through a national marketplace. Widely known as Obamacare, this new law entered amid controversy and confusion, with the goal of providing quality and accessible health insurance to more Americans and lowering the cost of health care for individuals and the government. Confusion accompanied the launch of this new law largely due to a branding problem. Many Americans do not realize that Obamacare and the Affordable Care Act are one and the same, and that this new law brings positive changes for the uninsured and disadvantaged.

As a dental specialist, I believe the Affordable Care Act (ACA) is a positive step toward remedying the oral health epidemic in America. With a recent New York Times article highlighting the serious and potentially fatal consequences of untreated dental problems, we have an obligation to focus less on expensive emergencies and shift our focus toward the children and adults who have fallen through a nonexistent safety net.

The Affordable Care Act is a law mandating all Americans be covered by some form of health insurance, whether through an employer, government subsidized program, private broker or the new health insurance marketplace. The ACA also prohibits insurers from denying coverage based on a preexisting condition, extends Medicaid benefits to millions of low-income Americans and requires most plans to offer essential health benefits.

Pediatric dental care is considered an essential health benefit. According to projections made by the American Dental Association, roughly 8.7 million children could gain extensive dental coverage through the ACA by 2018. The number of adults with dental coverage will improve as Medicaid coverage is extended, however most states only offer the bare minimum under Medicaid and have no intention of boosting coverage.

Why is access to affordable oral health care so critical? Most dental ailments are preventable, yet tragedy can strike when left untreated. Take the heartrending story of Deamonte Driver, the 12-year-old Maryland boy who passed away in 2007 after bacteria from an abscessed tooth made its way to his brain. Or Kyle Willis, a 24-year-old man from Cincinnati who died from a tooth infection in 2011 after not being able to afford the antibiotics the doctor prescribed for treatment. Access to care and affordable dental services could have resulted in a different outcome for both Deamonte and Kyle.

In 2012, a Pew Charitable Trust study estimated that 830,590 Americans visited the emergency room with a preventable dental condition as their chief complaint, a 16% increase from 2006. On a similar note, researchers in Boston found that the number of individuals hospitalized for dental abscesses increased by 40% from 2000 to 2008.

Hospital-based dental visits are neither favorable medically nor fiscally, as emergency rooms are seldom staffed with trained dentists and the cost of an ER visit is often astronomical. The most alarming fact about this data is that people are waiting until the last minute to seek treatment, when what was likely once a preventable dental ailment has magnified to a potentially life-threatening and expensive hospital visit. This type of situation is completely avoidable.

We must shift our philosophy on oral care from reactive to preventive: Don’t wait until it’s too late and get to problems when they are small and manageable. Eliminate problems before they occur with regular brushing and flossing, routine dental cleanings and a healthy diet. Educate yourself and your family on the new health-care options available under the Affordable Care Act and be proactive in seeking treatment. A routine dental cleaning can be a fraction of the cost of an ER visit, even for the uninsured.

If affordable dental coverage is still unattainable, contact an accredited dental education program, where reduced cost services are often offered or keep an eye out for community-based events providing free or subsidized health care.

The bottom line: Oral health in America will only improve if both sides step up to the plate. Individuals need to act preemptively and take care of issues when they initially arise. The government and insurance companies must continue to work toward improving access to quality and affordable dental insurance for both adults and children. With the inception of the Affordable Care Act, we’ve taken a small step in the right direction.