Our teeth are making us sick

As Americans debate medical coverage, the problem of our teeth has remained almost entirely unaddressed. About 114 million Americans don’t have insurance coverage for their teeth – more than twice the number of people who didn’t have health insurance before the Affordable Care Act.

Lots of people (including politicians) think of dental care as a luxury – pleasant, sure, but not vital. But that’s just not true, experts say. Gum disease can increase the risk of heart disease and diabetes, and among pregnant women it is correlated with lower birth weights for their babies.

“It’s a lot more than just having a pretty smile,” said IHPI member, Peter Polverini, a dean emeritus at the U-M School of Dentistry. “It’s not uncommon that you wind up with people being hospitalized because they can’t afford care.” Emergency room visits for dental problems – when teeth are often too ruined to save — cost the U.S. health care system an estimated $1.6 billion a year.

It’s virtually an accident of history that dental care isn’t considered part of medical care. The medieval barber-surgeon used to attend to all the human ailments that required a knife: bloodletting, tooth extraction, shaving. In the 1840s in the United States, the heirs to the tradition wanted to become professionals; they didn’t want to keep wandering from town to town selling their services. They asked physicians at the Medical College at the University of Maryland if they would include dentistry in the medical coursework, but the physicians refused. Soon after the dentists opened a separate dental school nearby.

This “historic rebuff,” as some historians have called it, is the creation myth of modern dentistry. The central tension in the tale – the separation between doctors and dentists (and the health of the mouth and the health of the body) – continues to plague patients today.