Dental care isn’t part of most people’s health insurance plans, and this is a problem with a long history. In fact, it all goes back to the days of the barber surgeons – oral care, particularly dental extractions, were performed by the same people who gave haircuts and did amputations, and when medical education branched off to become its own specialty, dentistry became a separate field.
What this divergence overlooks, however, is that dental issues and overall health are deeply intertwined. You can’t have one without the other. As it turns out, though, without good oral health, people may suffer negative social outcomes too.
Like clean clothes, neat hair, and other basic attributes, teeth are at the fore of out self-presentation. Just as showing up for a job interview in dirty clothes makes it unlikely that you’ll be offered a position, having damaged teeth can be equally detrimental. That’s because having oral health problems is often viewed as a sign of being irresponsible, or even judged to be a character flaw. People, including employers, assume that if people brushed their teeth more often, their teeth would be fine, but the truth is much more complicated.
Rather than a direct line between basic care like brushing and flossing and picture perfect teeth, research shows that oral health problems are particularly common among people with certain health conditions, including cancer and HIV, those suffering from malnutrition, and even those experiencing hormonal changes. Add to that the inability to afford dental care, including preventative treatments like sealants, and the problem quickly escalates, impacting those suffering from the greatest degree of social and economic precarity the most.
A Cyclical Problem
Not only can social conditions, underlying health problems, and economic deprivation cause dental issues, but what’s even more worrisome is that it’s a cyclical problem. For example, malnutrition can cause tooth decay and cavities, and ultimately lead to tooth loss, which is unsightly. This, in turn, can lead to low self-esteem, difficulty finding employment, and trouble eating, worsening one’s health.
Pricy treatments like dental implants can improve appearance and nutrition, but they’re often out of reach of those who need them most.
How can individuals and dental care providers bridge the gap between dental care needs and services rendered? It won’t be easy. Many Americans travel hundreds of miles each year to visit free or low-cost dental clinics where established dentists offer treatment to underserved communities.
These services are extremely limited in what they can accomplish, however, forcing people to travel when they may have limited transport, unable to complete the full range of necessary treatments, and requiring those who do have jobs to take time off.
One strategy that could do more to bridge the dental care gap would be for employers to address internal bias in hiring. Research by the American Dental Association have the highest degree of untreated tooth decay among any group and 28% say their oral health undermines their ability to interview for jobs.
For individuals at the beginning of their professional lives, with no savings and limited insurance and earning ability, this is especially catastrophic. If employers make comprehensive dental insurance a priority and address discrimination against applicants due to oral health issues, they could do a lot to expand access.
Right now, oral health care – and especially cosmetic dental treatments – are primarily accessible to wealthy individuals who have the least need of them, but that’s hardly the biggest issue. If dental care providers don’t do more to treat oral health issues among young people now, it will compromise their overall health for years to come. This will mean mounting public health costs and great strain on healthcare providers. This isn’t just about how someone smiles, but about taking a comprehensive view of health.