Most people’s days start and end the same way- brushing their teeth. Twice a year you schlep your way to the dentist for a cleaning. And for flossing? Maybe twice a week. Your mom always booked your appointments 6 months in advance at the practice around the corner, but now you have to find one closer to campus. You avoid candy but sometimes fall victim to those night munchies. By now, you know the drill. As simple as this sounds, dental care and oral health is way out of reach for some Americans. 

About 74 million Americans do not have any form of dental insurance, private or public. Almost half of insured adults have skipped dental visits or recommended procedures because their insurance didn’t cover enough of the costs. Millions of children aged 2-11 have never been to the dentist leading to 40% having at least one cavity by the time they reach kindergarten. Unsurprisingly, people with a lower socioeconomic status experience these aches and pains at a much higher rate. 

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The most common problems, cavities, gum disease, and jaw disorders, are all preventable with regular dental care. Unfortunately, most of these issues aren’t accompanied by any pain. People aren’t inclined to seek help if nothing seems wrong. Also, people are unaware of how serious these issues can be.

In regard to children, oral health inequalities are even more concerning. Pediatric oral health is a good indication for oral and overall health later on in life, so early oral health is a necessity. Oral health is significantly affected by social determinants of health.

These social determinants of health include age, gender, education level, income, race and ethnicity, insurance, and location. Addressing these determinants is key in reducing oral health disparities and improving overall health.

Children of color are much less likely to go to the dentist for preventative check-ups than white children. Asian, black, and hispanic children are less likely than their white peers to have sealants on their teeth. Children of color are also more likely to have untreated tooth decay. 

Dental schools, where our country’s leading institutions are expected to produce educated, caring public servants, are actually doing the opposite. A recent literature review found that dental students and residents have an overall negative attitude towards patients in poverty. These attitudes were the same towards Medicaid patients. The study also revealed that the social determinants of health were rarely a topic of instruction in dental school curriculum. Students are graduating with a prestigious degree, but without skills necessary to combat the largest problem facing oral health today.  

​Medicare is seen as the gold standard in American insurance. Try to cut it and risk getting your teeth knocked out. Even though our boomers think Medicare is all that, there are substantial gaps in coverage for oral health. 

According to a study published in Health Affairs, in a given year, three-quarters of low-income Medicare beneficiaries do not receive any dental care at all. Among higher-income beneficiaries, the figure is about one-quarter. Almost half of Medicare beneficiaries have some periodontal disease, or infection of the teeth or surrounding tissues. Bacteria from periodontal disease has been linked to heart disease and strokes. 

The oral health gap in the US is only going to grow worse if the government doesn’t take action. People are suffering from health issues stemming from poor oral health that could have been prevented. The rising costs of private dental insurance and procedures coupled with Medicare’s disregard to oral health have created a cavity that needs to be filled.

Everyone is entitled to dental care regardless of where they live or how much money they make. The US needs to prioritize oral health and preventative care the same it does with the rest of the body. This could save some real toothaches in the future.