The world health organization ranks oral disease as one of the top non-communicable diseases.
- Melissa Batchelor (01:19-01:23)
Have you ever wondered why Medicare doesn't have a dental benefit? Wonder why it's a longstanding problem? In this week's episode, Melissa Batchelor, together with her special guest, Taneika Duhaney, talks about the lack of dental coverage by medicare.
She's a dental hygienist and a healthcare administrator for the United States Navy. She was also a Health and Aging Policy Fellow and is interested in improving oral health for older adults. The term oral health refers to your mouth that's free of broken teeth, sores, and infections.
Part One of ‘Lack of Dental Coverage by Medicare
- Interview with Taneika Duhaney’
We've done a lot of things to improve our oral health. We've put fluoride in our water, we've developed the ability to put sealants on teeth. That has helped protect people from getting cavities and losing teeth. But as we age, we still see a lot of cavities, people losing teeth, a lot of gum disease. And the biggest reason for that is the lack of ability to pay for dental services.
Seniors and people with disabilities do not have access to dental services. They need to manage chronic conditions and support their oral health.
There are programs in place to help children go to the dentist and maintain their teeth, but why is it important for older adults? Why is it so important as we age?
The development of clinical practice guidelines is important to create age-friendly evidence-based care.
- Melissa Batchelor (05:45-05:51)
The World Health Organization ranks oral diseases as one of the top noncommunicable diseases, which means a disease that you get by infection. In the United States, many older adults have not seen a dentist in over a year because they would have to pay out-of-pocket for dental care due to a lack of insurance.
Ultimately, what this means is that a minor dental problem isn't taken care of early, so it become a major problem. This often leads to infections, needing to be hospitalized, and sometimes can result in death. Lack of dental care contributes to poorer health due to broken or fractured teeth. These problems can lead to nutritional deficiencies, oral pain, and even serious heart infection when the bacteria travels from the mouth to the heart.
The development of clinical practice guidelines is essential to create age-friendly evidence-based care and to improve health outcomes for older adults. If you are an older adult or a caregiver be sure you ask your doctor to look at your mouth. It just might save your life.
Part Two of ‘Lack of Dental Coverage by Medicare
- Interview with Taneika Duhaney’
There is legislation right now in Congress that supports adding dental benefits to Medicare. For example, there's S.22 Medicare Benefit Act of 2019 and H.R.4650 Medicare Dental Coverage Act of 2019. These bills would add coverage for certain dental items and services under to Part B of the Medicare program.
In adulthood, many American’s are offered dental benefits by their employer. Once you retire, dental benefits are not offered by Medicare. Medicare only covers dental are in very limited circumstances and this puts older adults at increased risk. Without a Medicare dental option, most older adults skip dental care due to high out of pocket expenses.
Seniors and people with disabilities need to manage chronic conditions and support their oral health.
- Melissa Batchelor (03:00-03:06)
Medicare currently only covers medically necessary procedures. For example, if an older adult needs an organ transplant or cancer treatment and has a dental problem, that procedure cannot happen until the individual is in good oral health because of the risk of high amounts of bacteria in their mouth that could potentially travel through their bloodstream during the procedure. Medicare does not pay for crowns, bridges, or preventive care.
Seniors can pay for an independent, supplemental dental benefit, but if they're not working, many are on limited incomes. They don't have the financial resources to pay for dental insurance or additional dental care due to out-of-pocket costs that can start at about a thousand dollars. That can be huge financial burden and cause many to choose between food, housing or prescriptions and dental care.
Older adults might be able to seek out community services, community clinics, or community care through local colleges that have dental clinics. Unfortunately, individuals to try to figure out and navigate what is available in their community, what care they are and aren't eligible to receive, which is the hardest part. The National Council on Aging, Administration for Community Living, and your local Area Agencies on Aging (AAA) can help seniors and their caregivers find dental care. Find out where your local AAA is using this link.
If you can't afford preventive care like having your teeth cleaned every six months, deal with a cavity or a broken tooth, some think it's just cheaper to extract the tooth. We commonly see older adults missing teeth. That is not a normal part of aging. Education programs can help us all to be more aware of the importance of dental care.
Dr. Melissa Batchelor earned her Bachelor of Science in Nursing (‘96) and Master of Science in Nursing (‘00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). She worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home and office visits) then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer.
She obtained her PhD in Nursing and a post-Master’s Certificate in Nursing Education from the Medical University of South Carolina College of Nursing (’11) and then joined the faculty at Duke University School of Nursing as an Assistant Professor. Her family moved to northern Virginia in 2015 and led to her joining the faculty at George Washington University (GW) School of Nursing in 2018 as an Associate Professor with tenure where she is also the Director of the GW Center for Aging, Health and Humanities.
Find out more about her work HERE.