Nothing to Smile About

By:  Margot Sanger-Katz

The United States faces a shortage of dentists that is particularly acute in poor, rural regions. Huge pockets of the country have few (or no) providers. The federal government counts 4,503 mostly rural regions where more than 3,000 people share one dentist, making it tough for many residents to find someone to fix their teeth ...

Dental insurance is much less widespread than medical insurance; 130 million Americans lacked dental coverage in 2009, but only 50 million lacked medical coverage. And with most payouts capped at $1,000 to $2,000 per year, insurance can't cover much beyond basic services ...

Medicare does not pay for dental care at all-during its creation, dentists feared price-fixing and lobbied against inclusion-so 70 percent of seniors lack any dental coverage, according to an Institute of Medicine report. Medicaid, the government program that insures poor children (and a few adults), also fails to provide meaningful dental access for many of its beneficiaries ...

The result is a crisis. Dental disease is the largest unmet health need in the U.S. among both children and adults, according to the Pew Children's Dental Campaign. The worst-off are the poor, the young, the old, and those in rural America ...

"The people who are not getting dental care now are the most vulnerable people in this country," says Sen. Bernie Sanders, I-Vt., chairman of the Senate Subcommittee on Primary Health and Aging, which recently held a hearing on dental access ...

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