December 27, 2004 08:29 PM
Dental Double Standards
Excerpt: Each year, Americans spend about $70 billion on dental services, ranging from basic checkups to sophisticated dental implants and new cosmetic whitening treatments. But for all that spending, what has evolved is a double standard of care, with the haves getting movie star smiles and the have-nots more likely to be living with mouths full of bad or missing teeth.
Among the nation's reservists, a common reason for not being sent to Iraq has been poor teeth. The military offers dental insurance to reservists and members of the National Guard, but for those who opt for it, the benefit of $1,200 a year does not cover many procedures and still requires reservists to pay as much as half the cost of the care.
The reservists are hardly alone. With dental costs rising and employers cutting dental coverage, an increasing number of working Americans cannot afford to see a dentist even for chronic problems.
Roughly a quarter of reservists in seven early-deploying Army units had dental problems that could require emergency attention within the next year, according to an analysis done last year by the Government Accountability Office. Similar problems surfaced in the first gulf war.
During the current Iraq war, some reservists and Guard members chose to have their teeth pulled so that they could be deployed, said Maj. Gen. Robert A. McIntosh, retired, the executive director for the Reserve Officers Association of the United States, in testimony before Congress in February.
"Although promised restorative dental work, their reward for their loyalty and patriotism will be dentures," he said. Dental implants, a better alternative to dentures, are not covered because they are more expensive.
In a nation where a person's smile is considered a sign of general well-being and an important factor in landing a job, dental care is becoming ever more unequal, policy specialists say. In 2000, the surgeon general issued a report describing the silent epidemic of dental and oral diseases affecting mainly the poor, but some specialists, including those working at community clinics, say the problem is becoming worse.
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