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Retire Better: Older adults lose teeth at a shocking rate — dental care is an overlooked and increasingly expensive part of healthcare


You know the old saying that “an ounce of prevention is worth a pound of cure”? Look at this stunning data from the Centers for Disease Control and Prevention:   

26% of adults 65 or older have eight or fewer teeth

17% of adults 65 or older have lost all of their teeth

The CDC also notes that losing teeth correlates with lower income, and lower educated (defined as less than a high school education) citizens, and/or current cigarette smokers. People who fall into these categories “are more than three times as likely to have lost all their teeth as the comparison groups,” it adds.

This is disastrous. Tooth loss, the CDC points out, “impacts the ability to eat meats, fruits, and vegetables, and presents yet another challenge to having a healthy diet.” Even worse: tooth loss is linked to major killers like heart disease, cancers, diabetes and more. 

This isn’t rocket science. We all know that things like brushing our teeth and flossing should be part of our everyday routines, and that such basic maintenance of our choppers goes a long way toward staying healthy and preventing long-term, even life-threatening, problems. 

The problem though is that we should also go to the dentist for a routine checkup and professional cleaning, at least once a year. Twice is even better. But this costs money. 

Without dental insurance, a routine cleaning can average around $125. Doesn’t sound like much, but for a retiree living on an inflexible income, and battered by inflation, that can be daunting. As I’ve noted before, even before inflation took off in the past year, seniors have been forced to make difficult and dangerous choices with their money, like food vs. meds vs. the electric bill. To this, we can add dental care.

Americans who are in, or approaching retirement, are often surprised to learn that Medicare doesn’t cover dental care. Want a routine, preventive, teeth cleaning? Sorry, that’s not covered. Need a filling? Nope. More complex and expensive procedures like tooth extractions, dentures, or dental plates? You’re on your own. 

What about Medicaid? That depends on which state you live in. Notes “States have flexibility to determine what dental benefits are provided to adult Medicaid enrollees. While most states provide at least emergency dental services for adults, less than half of the states currently provide comprehensive dental care. There are no minimum requirements for adult dental coverage.”

At least a dozen states, according to the Commonwealth Fund, have not expanded Medicaid, meaning you’re probably out of luck in terms of dental care. Not to get political about it, but most of them are red states, including big ones like Texas and Florida. Many of these same states, incidentally, rank poorly in terms of overall healthcare for their residents.  

Status of Medicaid expansion

Commonwealth Fund

So what to do? Given that dental care is a must, millions of Americans usually have to buy dental insurance, or enroll in a Medicare Advantage Plan (also known as Medicare Part C), which includes dental coverage. But buyer beware: aside from ensuring you get the coverage you need, the usual premiums, copays and deductibles are a tricky minefield to navigate. The fact that so many Americans, according to the above CDC data, have allowed their teeth to simply fall out, suggests that dental insurance is an insurmountable obstacle.  

Meanwhile, here’s another angle to dental care that’s interesting, and it concerns the water in your home. We’ve all heard about water problems in Jackson, Miss., Flint, Mich., and elsewhere. The CDC says bad water systems around the country also contribute to dental problems. Politicians and municipalities may think it’s penny-wise to skimp on water systems—which no one thinks about until something goes wrong. But it’s pound-foolish. The CDC says, for example, that “communities served by fluoridated water save an average of $32 per person a year by avoiding treatment for cavities,” and that “communities of 1,000 or more people see an average estimated return on investment of $20 for every $1 spent on water fluoridation.”

Here too, it seems that an ounce of prevention is worth a pound of cure. 

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