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What Should Dental Health Care Look Like in a Reformed Health System?

As government leaders set out to overhaul the nation’s health care system, one hopes that Hippocrates’ words, “First, do no harm,” will guide their decisions.

While Congress wrestles with some intractable problems — chief among them 46 million uninsured and skyrocketing costs — our lawmakers should take note of the fact that one component of our health care system works relatively well: the delivery of oral health care. In fact, the mouth can tell us a lot in the health care reform debate.

Oral Health Is Vital

As a society, we have come to recognize that good oral health means more than bright white teeth and an attractive smile. Poor oral health, a lack of dental care and untreated oral diseases can adversely affect an individual’s ability to speak, smile, kiss, chew, maintain proper nutrition, attend school or go to work. In addition, the mouth is as important to overall health status as any other part of the body. Several systemic diseases, including diabetes, cancer, cardiovascular and chronic kidney disease, and HIV/AIDS manifest symptoms that can be detected during an oral exam. That means a dentist may be the first to spot warning signs during a regular checkup.

Over the past 25 to 30 years, we have gone from a nation where most Americans could expect to lose their teeth by the time they reached middle age to one where the average number of dental cavities has declined among most age groups. In recent years, in fact, we have seen major increases in the number of children ages 5-17 who have never had a cavity in their permanent teeth. The improvements we’ve seen stem from three sources: more widespread community water fluoridation, improved treatments such as dental sealants and greater access to dental insurance coverage.

While science gives us the tools to prevent and treat dental disease, dental insurance coverage affords 173 million Americans the means to access that care. As a matter of record, dental insurance is prevention-oriented, relatively inexpensive (the average dental policy costs $30 per month) and highly cost-efficient — all of the qualities Congress and the public would like to see in our health care system.

As we seek to expand the benefits of dental coverage to the more than 130 million Americans who do not enjoy it — as Congress should — we must be vigilant against reversing the progress that’s been made.

Taxing Dental Benefits a Step Backward

The vast majority of these individuals receive dental insurance coverage through their jobs, in large part because the federal government does not tax the value of health benefits offered through employment. Yes, that’s right, this is a government policy that’s working as it should to promote health insurance coverage.

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