Welcome to The Leftist Review

Please join our discussion community.

You must log in to your account to leave comments. If you do not have an account, simply register and begin posting comments on articles now. To register, you will need to create a user name and provide a valid email address. Your privacy is guaranteed--your email and information will never be shared. Your password will be sent to your registered email. Thank you!

Member Login
Lost your password?
Not a member yet? Sign Up!

Obamacare: What About Dental Health?

December 3, 2013

In the words of the American Dental Association:

Taking care of your teeth and gums isn’t just about preventing cavities or bad breath. The mouth is a gateway into your body’s overall health. And since gum disease and other health problems may be linked, brushing and flossing are more important than ever. See your dentist regularly to keep your smile, and yourself, healthy.

So why didn’t the ADA fight to be part of the Affordable Care Act? Some say that ADA lobbyists fought hard to keep most dentists out of the government program, with only children ending up with some dental coverage through Obamacare. Some plans include pediatric dental care (18 and younger), other plans may offer it as an option, and all plans include an oral health risk assessment for children 10 years and younger.

But what about adults?

For the middle-class the cost of dental care has become so prohibitive that many are forgoing routine care while others are in debt to their dentists for recurrent costly procedures like root canal treatment, the placement of crowns, or periodontal work. Some of my own patients report to me that they borrowed money or are late paying other bills because they were charged several thousand dollars for treatment of their teeth.

My colleagues and I are now seeing patients with rotting teeth, with infectious endocarditis (a bacterial infection of a heart valve) caused by poor dentition, and people in chronic pain from old caries. When one considers how commonplace these conditions are, one can understand how chronically poor dental care contributes to locking many into chronic poverty. Heart surgeons are doing careful dental exams because they are concerned that patients have smoldering gum and tooth infections that could result in an infection of their newly inserted valve. Therefore, many patients having heart surgery are first having a number of teeth urgently removed. But under Obamacare the patient’s surgery will be covered, the heart surgeon will be paid about $2,300 (CPT code 33403) for his work, that includes all his postoperative care and visits, and the patient will likely be billed thousands of dollars, by the dentist. Under ACA, patients having life-saving heart surgery will have more out of pocket expense for that dental bill than for the heart surgery!

Without affordable dental care many will forgo seeing a dentist because they just cannot afford to. Others will lose their savings to pay-off their dentist. But dentists remain immune to government control, immune to being paid whatever government feels is reasonable to pay them. Why would a dentist, including an oral surgeon, wish to be part of a program that could reimburse them a few hundred dollars for a procedure for which they now charge a thousand dollars or more, like root canal? And while physicians are now asked to contact insurers to get approval for a test or procedure (I must say that this is necessary because too many doctors would perform every test and procedure possible if they could) dentists just need the approval of their patient, something that I suspect is an invitation for the most duplicitous types to perform unnecessary and costly dental work.

So if the American Dental Association tells us that “The mouth is a gateway into your body’s overall health,” then why isn’t that gateway to our overall health part of Obamacare? Did the lobbyists for the ADA convince the Obama administration to exclude affordable dental care? Is the Obama administration willing to allow millions to become sick because of diseases of the mouth and carries?

Once again those running this country have really screwed up. If President Obama believes we all deserve affordable health care then why isn’t dental care part of the Affordable Care Act? I just can’t imagine how government can provide care for the feet, eyes, and skin but neglect dental care.


About the author: Dr. Evan S. Levine is a cardiologist in New York and a Clinical Assistant Professor of Medicine at Montefiore Medical Center – Albert Einstein College of Medicine. He is also the author of the book “What Your Doctor Won’t (or can’t) Tell You”. He lives in Connecticut with his wife and children.

7 Responses to Obamacare: What About Dental Health?

  1. NicoleSullivan on April 1, 2014 at 7:03 am

    Other than cost,the myth about dental care(that it is not a serious problem) is other reason why people pay less attention to dental care and isolate it from the general health issues. Government then supports them by paying less attention and deny to provide concession on dental services.Oral health services will be provided to each person only when it is treated like other health issues.

  2. Yahoo Groups on March 11, 2014 at 11:10 pm


  3. David Cox on December 10, 2013 at 7:09 am

    Thank you Dr. Levine, as usual, a wonderful article. Richard Nixon’s 1972 health care program, similar to ACA because it pushed people into HMO’s and private insurance did offer a full dental plan. It also offered free wellness care for all children up to age thirteen, eye care, dental care and psychiatric care. It is telling indeed, that the ACA comes in second, to a plan designed by Nixon and Kissinger

  4. globalcitizen on December 5, 2013 at 11:47 pm

    Healthcare should mean human health in its entirety: vision, dental, medical, mental. Why is the Right so dedicated to defending a system which rewards the children of the rich while punishing the children of the poor? And then they have the hubris to imagine it’s a meritocracy. I have seen too many poor people suffering from a lack of dental and healthcare to not see it as a national shame. We need to go far beyond Obamacare.

    • Yahoo Groups on March 11, 2014 at 11:16 pm

      The right (aka the WRONG) especially doesn’t like the idea of “human” health being used to cover those they don’t consider human. Women are chattel; blacks are slaves; “Mexicans” are cockroaches and gays are demons. T-Boogers see no reason why health insurance should cover “infant sacrifice” (reproductive care), “sodomy” (AIDS treatments and spousal coverage for same-sex partners), or “bestiality” (health coverage for non-white people, which in their warped minds comes under veterinary care).

      I SOOOOOOOOO want the SPLC to declare the Tea Farty a hate group already. They bring nothing good to the table and only spew venom from their rabid, foaming mouths. The whole of the GOP should be consigned to the fringes like their buddies at Westboro Batsh*t Church and the Ameriklan Shamily Association.

  5. SteveH on December 4, 2013 at 1:45 pm

    Too many people go without dental care for one reason: cost. How long will it take the regressive party that fronts for big business to get out of the way and start actually helping the People? I have no doubt that Obama would have included dental if there had been the slightest possibility of getting that concession from the Republicans.

    • Yahoo Groups on March 11, 2014 at 11:17 pm

      They see no reason why dental care is a big deal. Most of their voting base is toothless to begin with. Clearly they don’t believe in evolution because it left them behind.

Leave a Reply