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Income and age tied to lack of dental benefits, poor oral health

Children, minorities, and the elderly are among those with the worst oral health in the country, often because they lack dental insurance, says the first comprehensive government report on the issue.

About 108 million Americans do not have dental insurance, according to the "Surgeon General's Report on Oral Health," released on May 25, 2000.

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The report, which had been in progress since 1997, cites a striking disparity in dental disease based on income. Poor children, it says, suffer twice as many cavities as more affluent kids, and 25 percent of poor children have not visited a dentist before entering kindergarten.

Dental health is important to overall health, the report says. Recent research findings, for instance, have linked chronic oral infections to diabetes, heart and lung disease, stroke, and low-birth-weight babies. In addition, serious dental problems in children might undermine their self-esteem, lead to long term stress and depression, and interfere with normal physical functioning, such as breathing, swallowing, eating, and speaking.

One out of four children in America is born into poverty, and children living below the poverty line meaning annual income of $17,000 for a family of four have more severe and untreated tooth decay. Tooth decay is the single most common chronic childhood disease: five times more common than asthma and seven times more common than hay fever, the surgeon general's report says.

Public programs don't meet dental needs

Having medical insurance with dental benefits strongly influences whether consumers seek dental care, the report says. Uninsured children are 2.5 times less likely than insured children to receive dental care. Children from families without dental insurance are three times more likely to have dental needs than children with either public or private insurance. And for each child without medical insurance, there are at least 2.6 children without dental insurance.

Medicaid has not been able to fill the gap in providing dental care to poor children.

Medicaid has not been able to fill the gap in providing dental care to poor children, the report says. Fewer than one in five Medicaid-covered children received a single dental visit in a recent year-long study period. Although new programs, such as the Childrens Health Insurance Program (CHIP), might increase the number of insured children, many will still be left without effective dental coverage, it says.

In addition to children and minorities, the elderly are also at risk, since many of them lose private health insurance when they retire, and Medicare does not cover dental services.

The report was applauded by the Health Insurance Association of America, an industry trade group. "It recognizes the inexorable link that exists between coverage and increased access to dental services, and good oral health," the group says.

Delta Dental Plans Association echoed the surgeon general's report that oral diseases affecting certain populations amount to a "silent epidemic." Delta Dental, based in Oak Brook, Ill., is a national network of independently operated not-for-profit dental service corporations that provide dental benefits and community-outreach programs.

"We have the ability to drastically reduce some of our nation's most common dental diseases, like dental cavities and periodontal disease," says Dr. Roger C. Smith, chairman of Delta Dental's dental policy committee. "Legislators, educators, communities, and providers need to work together to focus on this important issue and continue improving our nation's oral health."

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