Time for Dental Care to Be Considered Essential in US Health Care Policy

Abstract

Training, service delivery, and financing are done separately in dentistry and general health care, which has influenced reimbursement structures, access to services, and outcomes. This article considers how medical and dental separation exacerbates health inequity and canvasses data demonstrating that oral health and dental services are the least affordable health services. This article also proposes how dental and general medical care coverage can be meaningfully integrated through better health policy to motivate health equity. DividedDental care services have a long history of being financed and delivered separately from medical care services. 1,2 In the mid-1800s, dental schools and associations were established independently of medical schools and associations. 1 Several important US health care reform milestones have reinforced this separation-most recently, the Affordable Care Act (ACA) of 2010. Under the ACA, dental care for adults was not included as an essential health benefit, and, while dental care for children was included and lowered total financial outlays, 3,4 the increase in stand-alone dental plans between 2014 and 2016 reinforced the separation of dental and medical insurance. 4 In this article, we summarize the implications of financing and delivering dental care separately from medical care, focusing on trends in outcomes and in affordability and utilization of dental care services and highlighting disparities by income, age, and race. We also pose some key questions for policymakers seeking to address these issues.

Stressful life events, oral health, and barriers to dental care during pregnancy

“…Accordingly, organizations such as The American College of Obstetricians and Gynecologists recommend good oral hygiene and dental care utilization throughout pregnancy [4]. Even so, dental care services are not considered essential in U.S. health insurance plans, including for pregnant women [5]. As a means to improve prenatal oral health, it is vital to understand the proximal risk factors-including life stressors that occur during the prenatal period-for oral health problems and challenges accessing dental care services during pregnancy.…”

A Decentralized Architecture for Semantic Interoperability of Personal Dental Data Based on FHIR

“…The particularities of odontology mean it is being treated in the USA as an independent area of medicine, due to the existing differences in terms of training, services provided, and financing concerning general medicine (Vujicic, 2022). In the field of odontology, 91% of active dentists worked in private practice settings and 46% of them were in solo practice (Fellows et al, 2022).…”

The Impact of the Affordable Care Act (ACA) on Oral Health in Low-Income Individuals

“…The ACA was planned to mainly benefit low-income individuals by expanding health care coverage and to be more comprehensive under Medicaid. The mandatory dental insurance coverage benefit guaranteed by the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requires that the Medicaid program and the Children's Health Insurance Program (CHIP) provide comprehensive, medically necessary dental services to all children under age 21 from low-income families enrolled in Medicaid (Vujicic & Fosse, 2022). This study reviews recently published scientific papers to explore whether expanding health care coverage under Medicaid through the ACA leads to better oral health for low-income individuals and their families.…”