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  • Writer's pictureMark Roberts

Smile Care is Health Care

Updated: Oct 18, 2023

October is National Dental Hygiene Month. Did you know that an estimated 68.5 million adults in the United States do not have dental insurance, according to new data released last month in September, 2023 by CareQuest Institute for Oral Health!?! What's worse, is that there are an additional 8.9 million household members may have lost dental insurance in the last year due to loss of coverage in a household, as many family and household members receive dental coverage through a single member of the household.


Furthermore, there are an estimated 14 million adults in the US who stand to lose their Medicaid dental insurance coverage with the public health emergency expiration. This results in as many as 91.4 million individuals without dental insurance by the end of this calendar year - over 27% of the US population. The 2023 survey results show the oral health challenges faced by many throughout the country, including:

  • The portion of the population without dental insurance (27%) is almost 3x as high as those without health insurance (9.3%).

  • Adults living in rural areas (34%) were more likely to lack dental insurance compared to adults living in suburban (24%) or urban (29%) areas.

  • Hispanic individuals were two times more likely to have lost dental insurance in the last year compared with white non-Hispanic individuals.

  • Approximately one-third of both Medicare and Medicaid participants do not have dental coverage.

  • Adults with lower incomes were significantly more likely than those with higher incomes to report cost as a barrier to seeing a dentist in the last two years.

Oral health is critical to your overall health. Normally the body's natural defenses and good oral health care, such as daily brushing and flossing, keep bacteria under control. However, without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease. According to the Mayo Clinic (https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475#), your oral health might contribute to various diseases and conditions, including:

  • Endocarditis. This infection of the inner lining of your heart chambers or valves (endocardium) typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to certain areas in your heart.

  • Cardiovascular disease. Although the connection is not fully understood, some research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause.

  • Pregnancy and birth complications. Periodontitis has been linked to premature birth and low birth weight.

  • Pneumonia. Certain bacteria in your mouth can be pulled into your lungs, causing pneumonia and other respiratory diseases.

Certain conditions also might affect your oral health, including:

  • Diabetes. By reducing the body's resistance to infection, diabetes puts your gums at risk. Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels. Regular periodontal care can improve diabetes control.

  • HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.

  • Osteoporosis. This bone-weakening disease is linked with periodontal bone loss and tooth loss. Certain drugs used to treat osteoporosis carry a small risk of damage to the bones of the jaw.

  • Alzheimer's disease. Worsening oral health is seen as Alzheimer's disease progresses.

Oral health affects your ability to eat, speak, smile, and show emotions according to the Centers for Disease Control (CDC). Oral health also affects a person’s self-esteem, school performance, and attendance at work or school. Oral diseases—which range from cavities and gum disease to oral cancer—cause pain and disability for millions of Americans and cost taxpayers billions of dollars each year. From childhood through senior adulthood, each age demographic faces its own set of dental care challenges (https://www.cdc.gov/oralhealth/basics/index.html).


Your dental health professionals include:

  • Dentist

  • Dental Hygienist

Dental specialists provide additional oral health care:

  • Periodontist

  • Orthodontist

  • Oral and Maxillofacial Surge​​o​ns

Finding someone who you trust to help you manage your dental health needs is an important step in developing a solid regimen to maintain healthy teeth and gums. Visit your dentist for routine check-ups and professional cleaning.

  • If you are at a high risk for tooth decay (for example, if you have a dry mouth because of medicines you take), your dentist or dental hygienist may give you a fluoride treatment, such as a varnish or foam during the office visit. Or, the dentist may recommend a fluoride gel or mouth rinse for home use.

  • If you are at higher risk for gum disease because of a medical condition (for example, diabetes), your dentist may want to see you more frequently.

According to the National Institute of Dental and Craniofacial Research (https://www.nidcr.nih.gov/health-info/oral-hygiene), if you protect your oral health with good oral hygiene practices (brushing and flossing), the odds are in your favor you can keep your teeth for a lifetime.


Going to the dentist can be expensive. Out of pocket costs without having a dental plan or dental insurance may be prohibitive for most people. Going through insurance can help reduce dental care costs. Dental plans or dental insurance can save you thousands of dollars a year, depending on the policy and type of dental work.

How does dental insurance work?

Most medical plans don’t include dental work, so dental insurance is sold separately as a stand alone product whether through your employer group plan or as individual insurance. Dental insurance works similarly to health insurance (though it’s usually much less expensive). You pay a premium in exchange for a certain amount of coverage. Components of dental insurance costs include:

  • Deductible: Your deductible, which is typically annual, is the amount of money you pay before your insurance pays for dental services. For instance, if you have a $50 dental insurance deductible, the company will pay a dental claim minus that $50 amount. That means the insurer will pay $250 for a $300 dental bill.

  • Annual maximum: The annual maximum is the most your dental insurance policy will pay in a year for services. This could be $1,000, $2,000 or a different amount. Some policies have annual and lifetime maximum amounts for certain dental services, such as braces. Once you reach your maximum, you pay for the rest of the covered dental services.

  • Copay: This is a fixed amount you pay at the time of treatment.

  • Coinsurance: Once your deductible has been met, you’re responsible for paying a fixed percentage of the total amount charged for a service covered by insurance. The exact percentage depends on the policy and type of dental work. For instance, dental plans often cover 100% of preventive care costs, 80% of basic care like fillings and 50% of major care like crowns. You pick up the rest of the costs.

Make sure to read the fine print to see exactly how much your policy covers. Though dental insurance typically covers 80% of basic services and 50% of major services, policies may offer less or more generous coverage. Dental insurance policies don’t typically cover purely cosmetic procedures, such as teeth whitening. Orthodontic procedures, such as braces, may also be excluded from a dental insurance plan or may only be limited to children.


Some dental care items may be considered a medical procedure rather than a dental procedure. Certain types of oral surgery, for instance, may need to be billed to your health insurance. What is covered and by which type of insurance can vary on a case-by-case basis. That’s why it’s a good idea to talk to your dentist before undergoing a major procedure. You’ll want to know exactly what’s covered and what your out-of-pocket expenses will be so you can budget for them as needed.


For older adults who may have lost dental coverage due to retirement or other situations, original Medicare does not include dental care except for medically necessary procedures. As well, many Medicare plans do not include a dental component as an extra benefit. Seniors typically spend a lot of money on dental care because of a lack of insurance as well as having significant oral health needs as they get older. Seniors often lose their employer-provided dental insurance at a time when their dental needs and costs are increasing.


Consider these statistics from the Centers for Disease Control and Prevention (CDC):

  • About two out of three adults 65 and older have gum disease.

  • One in five adults 65 and older have untreated tooth decay.

  • One in five adults aged 65 and older have lost all of their teeth.

At the same time according to MarketWatch (https://www.marketwatch.com/guides/insurance-services/dental-insurance-for-seniors-are-these-plans-worth-it/), more than half of seniors (53%) say they’ve had to delay dental care due to the high cost, and 23% of Medicare enrollees say they’ve delayed or gone without dental care, according to statistics from the Kaiser Family Foundation. Seniors need to have affordable dental care and practice good oral health.


The Holidays are coming soon. You'll want to make sure to get your dental needs taken care of before all the parties and other end of year celebrations start kicking in to high gear. It pays to have your dental visit completed before your dentist gets too busy to see you. Appointments book quickly starting this time of year. Finding time to see your dentist is going to become more of a challenge as the Holidays approach.


At the end of the day, your overall health is heavily dependent upon good oral health. Keeping a beautiful smile takes time, care and resources. As a licensed health agent, I can provide you multiple options for affordable dental plans or dental insurance through major national brands. Check out my website for more information (https://www.careingdentalgroup.com/choose-your-dental-plan). Then, let's have a conversation about how you can save money on your dental care.



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