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Dentistry has been ‘siloed off’

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Writing for Vox, Emily Stewart says the American medical system “doesn’t really consider dental care an essential service, despite mounds of evidence linking a healthy mouth to the well-being of the rest of the body, from better pregnancy outcomes to a healthier heart . . . Dentistry has always been siloed off.” She also observes that even if an individual does have dental benefits, “they’re often less than beneficial . . . Insurers may cover 100% of a cleaning or a checkup, but once you get into other more complicated services, they start to cover less, so patients have to pick up some or much of the cost. Plans have annual maximums ranging between, say, $1,000 to $2,000, after which the insurance covers nothing.” Marko Vujicic, chief economist and vice president of the Health Policy Institute at the American Dental Association, says:  “When you look at the dental insurance model, it doesn’t protect the patient from financial risk. It’s the opposite . . . Once the benefit runs out, the $1,400 or whatever it is, all of that financial burden is on the patient. So it protects the insurer, they’re limited on their exposure.” Lisa Simon, a dentist and physician at Brigham and Women’s Hospital and Harvard Medical School, says: “Organized dentistry itself has actively and expensively campaigned to keep things the way they are . . . there have been plenty of opportunities for dental insurance to be, more recently, integrated into Medicare and Medicaid in various ways, and those who have been vociferously opposed by many dentists.” Simon notes that many dentists still work in private practice with their own offices and tend to accept public insurance at low rates, if at all. “[They] tend to be very reactionary in any attempts to update the insurance industry,” she claims. “As an association, we’re not against it, it’s a question of how it’s structured,” responds Mark A. Vitale, dentist based in New Jersey and the former chair of the council of government affairs at the American Dental Association.

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