The cavity in the health-care debate

May 1, 2010
The national health-care debate cannot be complete unless we include dental care as part of the discourse.

By Gary Kadi, DDS

For more on this topic, go to and search using the following key words: health-care debate, cavity, dental coverage, electronic health record, benefits, Gary Kadi, DDS.

The national health-care debate cannot be complete unless we include dental care as part of the discourse. Dental care relates not only to teeth and gums, but also to our overall health. Researchers have discovered links between a healthy mouth and the prevention of heart disease, diabetes, liver and pancreatic cancer. The Mayo Clinic has published an article (“Oral health: A window to your overall health,” Mayo Foundation for Medical Education and Research, Feb. 7, 2009) that links oral health to other diseases such as cardiovascular disease, premature births, diabetes, HIV/AIDS, osteoporosis, certain cancers, and other conditions. In fact, dentists often locate and treat problems no one else can see, and that are often asymptomatic until an advanced stage.

The mouth’s primary function is to take in and process food and liquids for a healthy body. With a healthy mouth, people break down food properly and put less stress on the digestive system. Mouths also serve as a conduit for communication and expression. Without a full set of teeth, clear communication becomes difficult and problematic. Health declines because the body cannot process food that isn’t properly chewed.

On a base level good oral care means successful management and stabilization of the bacteria that lives in the mouth; without a healthy mouth overall health is threatened. This makes leaving dental care coverage out of the health-care debate a huge mistake, one that has been made before and is about to be repeated. Why is this?

Let’s face it — in our world dentists do not get the respect they deserve. They are not perceived to be “real” doctors. Shows on TV do not portray compassionate dentists who diagnose rare conditions accurately, saving lives not just episodically, but routinely. Perhaps the lack of sex appeal in dentistry is part of why dental coverage for everyone is an afterthought in the national health care conversation.

To reduce this argument to a businesslike bottom line, we aren’t getting remotely serious about health-care cost-containment until we examine the benefits of dental care for all Americans.

A validation of this thinking is the inclusion of dentistry in the recently mandated National Healthcare Information Infrastructure (NHII). The purpose of the NHII is to create an information network to facilitate the creation of an electric health record for all aspects of health care. The primary impetus is to achieve interoperability of health information technologies used in the mainstream delivery of health care.

This will enable an individual’s health care information to be shared by all the necessary health care parties in a secure manner, including dentistry. It will improve patient care and reduce the number of patients, currently 100,000 plus, who die each year due to a lack of accurate, complete, or timely information. The federal government estimates a cost savings of $85 billion to $100 billion per year with electronic health records.

Dentists and hygienists will play a vital role in this cost savings because people who go for regular cleanings will have their medical history updated in the shared system during each visit. In some cases, dental cleanings may be the only medical attention a person receives yearly.

Part of the reason the discourse on this issue is at the level it is, is because most of us have had no dental, vision, or mental health coverage for so long that we’ve come not to expect it. It is as if health insurance stops at the neck.

Today, people are lucky to have medical coverage. But any responsible medical doctor will confirm that having a healthy mouth in general is just as important, if not more important, than anything else we can do for our bodies. We have been trained not to ask about dental coverage from our employers, as if it’s a luxury akin to a private jet. Generally the reason given is “too expensive,” but what is the expense in the long-term for not supporting oral health care?

Dentists are widely perceived as working with archaic equipment, long needles, and cranky staffs, all of which add up to pain in your mouth and wallet. Dentists need to get the word out that the technology and overall patient experience today is radically different from a few years ago.

If you haven’t been to the dentist in the last few years, you’re not alone. Most people take better care of their cars than their teeth. This makes no sense, because it’s tough to eat corn with a Honda. More importantly, dentists now serve their patients with a stunning range of high-tech, cutting-edge technologies that minimize the pain and invasiveness of older dental practices, cutting down the time factor, the pain factor, and creating better, healthier results.

It’s time for Americans to realize that the dental community exists to keep our mouths healthy and clean, our bodies disease-free, and our kisses long and lingering.

Don’t get me wrong. Like most people who value a great smile, I’d rather be snorkeling in the Caribbean than getting a root canal. But it’s time we make a societal shift and recognize that dentistry is more than a punch line for a nightclub comic, and more than the negative stereotypes Madison Ave. uses again and again.

It’s time we recognize the value dentists provide. Dentists are real doctors and highly trained health-care professionals who truly care about patients. The services dentists offer make a huge difference to the overall health of people. As we seek to untangle our snarled health-care delivery system, let’s give dentists the respect they deserve. Let’s also include dentistry in the battle to provide America with fundamental health care. You can rinse now.

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