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I've been saying what we actually need is universal dental care vs universal health care for over 15 years. Giving out universal health care without dental car

by dham 1y ago

I've been saying what we actually need is universal dental care vs universal health care for over 15 years. Giving out universal health care without dental care is like changing the oil in a car but failing to see the tires aren't even on. I heard horror stories from my mom who worked in a periodontist office (as receptionist) growing up. Really got me to care about oral health early on. Health really starts at the mouth. If you don't have a healthy mouth you'll never have a healthy body.

Wowfunhappy 1y ago
I find it completely strange that dental care isn't just considered part of standard healthcare. Like, so my employer's health care plan covers every part of my body except my mouth? Why does my mouth specifically need its own plan?
- wormius 1y ago
  Here's an article about the history of that: https://www.nbcnews.com/better/health/reason-your-dental-work-isn-t-covered-medical-insurance-ncna813666 https://www.nbcnews.com/better/health/reason-your-dental-wor...
- atombender 1y ago
  It's a really unfortunate historical accident, especially in the US. Dentistry evolved relatively late compared to regular medicine, and early oral procedures were mostly tooth extractions, which ended up being predominantly done by barbers, who would also do surgery (!). These procedures were often considered crude and beneath that of a trained doctor, and they were generally performed by self-trained practitioners. There were several attempts in the 1800s to integrate dentistry into mainstream medicine, but they failed, both because the doctors of the time didn't think of dentistry as being a real science, but also because, as dentistry started to legitimize itself, the dentists themselves preferred being separate. For some reason the same separation also evolved in the U.K., but it's more integrated in other countries. For example, basic dental coverage is part of national healthcare in Germany and Japan. In the U.S., dentists have their own schools and licensing boards and so on, which isn't the case in the rest of the world, where dentistry is usually accepted as a regular branch of medicine and taught at the same universities.
  - wkat4242 1y ago
    It's not just in the US. In all the EU countries I lived it was also excluded from standard health insurance and government programs except in cases of acute damage.
    - bad_haircut72 1y ago
      Australia, despite having basically universal medicare (otherwise) still considers teeth "luxury bones" in the sense that they're not really necessary to health care (else they would be covered by medicare)
  - marttt 1y ago
    I literally remember one of my elderly relatives pulling out a tooth at home with a thread tied around a door handle as if this was nothing special. DIY all the way! Early 1990s, former Soviet Union rural-or-so area. As of today, we have moved to a different situation where dental care in that same country is ample, but the price lists are rarely transparent, making many not-so-well-off people avoid going to dentists altogether. The health insurance system gives something like 60€ yearly to an adult for fixing teeth. Dental care for children up to 19yo is for free, though, which is great.
    - wil421 1y ago
      >I literally remember one of my elderly relatives pulling out a tooth at home with a thread tied around a door handle as if this was nothing special. DIY all the way! Early 1990s, former Soviet Union rural-or-so area. Some form of this type of tooth pulling was common for baby teeth in the 90s. I’m sure it still is today. I don’t know about recommending it for adult teeth.
      - SlightlyLeftPad 1y ago
        Yeah my kid asked me to do some form of this for a baby tooth because She didn’t want to wait for an appointment and it was really bothering her. It worked! Definitely not recommended for an adult tooth. Baby teeth are barely hanging on and don’t have deep roots really
- bluedevil2k 1y ago
  Nor your eyes for some reason either.
  - Wowfunhappy 1y ago
    Every health care plan I've had (US, New York specifically) has covered optometry, is that unusual?
    - adastra22 1y ago
      Yes, in the US at least.
    - lttlrck 1y ago
      Same for me. It's always an add-on but same provider and policy. This has been true with multiple providers on the east and west coast.
      - adastra22 1y ago
        Yes, but the point is it is an add-on. Administratively (and in terms of deductible, etc.) it is different from the medical plan.
  - Broken_Hippo 1y ago
    That line is Really fuzzy. They don't generally cover normal vision needs. Your regular glasses and/or contacts aren't covered. Eye injury or cancer, though? Usually covered. I honestly can't recall anyone getting denied for a possible scratch on the eye, either here in Norway or the US (Am from the US). Expenses for eye issues with MS or Diabetes? Usually covered. In these cases, you often go to a specialist MD instead of the normal eye doctor (if you see an MD at all). More is generally covered for eyes than teeth - if teeth were covered like eyes, it would be an improvement. A lot of acute care and infections and stuff would be covered.
    - Wowfunhappy 1y ago
      As a glasses wearer, not covering glasses feels reasonable to me, although I can't quite put my finger on why. I guess I see glasses at least partially as a fashion accessory--a necessary one for sure, but then so are shoes, and I don't expect those to be covered by insurance.
- ChrisMarshallNY 1y ago
  I remember reading a survey, where they determined that dentists are the most highly-compensated medical providers. Seems like the status quo is just fine for a whole bunch of folks that make enough to buy regulatory capture.
  - lithocarpus 1y ago
    True but the profits and regulatory capture lie more with pharma companies than with dentists. There's an incentive for pharma to want people not to take care of their teeth, I don't know if they ever act on this incentive but I wouldn't be surprised.
- dboreham 1y ago
  It's supposed to be insurance and most dental services don't cost enough to be worthwhile insuring as a risk. Everyone needs them, more or less, so any insurance would just be a (costly to run) payment plan. Proper civilized countries do provide free to the consumer dental services, at least for children and poor people.
- losvedir 1y ago
  It's not your employer's "health care" plan. It's an insurance plan. And dental care doesn't really fit the insurance model since the vast majority of spending is expected and regular (checkups, cleaning, etc).
jjtheblunt 1y ago
Are you thinking universal health care would help, with respect to this article, even if people can't remember to brush their teeth?
- mrtesthah 1y ago
  Yes, it would help to know that I could see a dentist who would inform me of cavities and gingivitis that I am (or am not, depending on genes), developing as a result of my brushing habits (and through that feedback help refine said habits), rather than merely hoping and doing nothing more for lack of funds. And many people will require regular teeth cleanings to avoid gum pockets and consequent gingivitis despite their best efforts at brushing and flossing. There are other situations where tooth infections can move to the brain in a matter of days, risking death if left untreated. Regular checkups reduce that risk considerably. The other side of your argument would imply that the existence of toothpaste renders the entire field of dentistry inessential.
  - jjtheblunt 1y ago
    That's a great point. (I didn't have an argument; I just wondered how the parent comment was thinking.)
- AngryData 1y ago
  It definitely would just by making sure cavities are taken care of earlier. They are caused by bacteria, and an active tooth infection is spreading and multiplying that bacteria at a much faster rate than it would be otherwise which exponentially increases the decay rate and number of cavities of all their other teeth.
tiahura 1y ago
You're proposing dental hygienists that do house calls and brush lazy people's teeth?
ChrisMarshallNY 1y ago
Cats can have systemic problems from dental issues. I had a cat die of kidney failure, precipitated by a gum infection. Friend of mine just spent a few grand for an operation on their cat, where they had to remove its teeth, because of a rare autoimmune problem.
vixen99 1y ago
We can agree on that but how about spreading more widely the simple advice - floss thoroughly & daily, clean your teeth twice a day and don't let sugars hang around in your mouth for extended periods. We know these pathogenic oral bugs can be related to heart disease (fibrosis for one) but maybe other dysfunction as well as prostate. A catchy meme might do the trick to remind us all.

by dham 1y ago

Wowfunhappy 1y ago

I find it completely strange that dental care isn't just considered part of standard healthcare. Like, so my employer's health care plan covers every part of my body except my mouth? Why does my mouth specifically need its own plan?

wormius 1y ago
Here's an article about the history of that: https://www.nbcnews.com/better/health/reason-your-dental-work-isn-t-covered-medical-insurance-ncna813666 https://www.nbcnews.com/better/health/reason-your-dental-wor...
atombender 1y ago
It's a really unfortunate historical accident, especially in the US. Dentistry evolved relatively late compared to regular medicine, and early oral procedures were mostly tooth extractions, which ended up being predominantly done by barbers, who would also do surgery (!). These procedures were often considered crude and beneath that of a trained doctor, and they were generally performed by self-trained practitioners. There were several attempts in the 1800s to integrate dentistry into mainstream medicine, but they failed, both because the doctors of the time didn't think of dentistry as being a real science, but also because, as dentistry started to legitimize itself, the dentists themselves preferred being separate. For some reason the same separation also evolved in the U.K., but it's more integrated in other countries. For example, basic dental coverage is part of national healthcare in Germany and Japan. In the U.S., dentists have their own schools and licensing boards and so on, which isn't the case in the rest of the world, where dentistry is usually accepted as a regular branch of medicine and taught at the same universities.
- wkat4242 1y ago
  It's not just in the US. In all the EU countries I lived it was also excluded from standard health insurance and government programs except in cases of acute damage.
  - bad_haircut72 1y ago
    Australia, despite having basically universal medicare (otherwise) still considers teeth "luxury bones" in the sense that they're not really necessary to health care (else they would be covered by medicare)
- marttt 1y ago
  I literally remember one of my elderly relatives pulling out a tooth at home with a thread tied around a door handle as if this was nothing special. DIY all the way! Early 1990s, former Soviet Union rural-or-so area. As of today, we have moved to a different situation where dental care in that same country is ample, but the price lists are rarely transparent, making many not-so-well-off people avoid going to dentists altogether. The health insurance system gives something like 60€ yearly to an adult for fixing teeth. Dental care for children up to 19yo is for free, though, which is great.
  - wil421 1y ago
    >I literally remember one of my elderly relatives pulling out a tooth at home with a thread tied around a door handle as if this was nothing special. DIY all the way! Early 1990s, former Soviet Union rural-or-so area. Some form of this type of tooth pulling was common for baby teeth in the 90s. I’m sure it still is today. I don’t know about recommending it for adult teeth.
    - SlightlyLeftPad 1y ago
      Yeah my kid asked me to do some form of this for a baby tooth because She didn’t want to wait for an appointment and it was really bothering her. It worked! Definitely not recommended for an adult tooth. Baby teeth are barely hanging on and don’t have deep roots really
bluedevil2k 1y ago
Nor your eyes for some reason either.
- Wowfunhappy 1y ago
  Every health care plan I've had (US, New York specifically) has covered optometry, is that unusual?
  - adastra22 1y ago
    Yes, in the US at least.
  - lttlrck 1y ago
    Same for me. It's always an add-on but same provider and policy. This has been true with multiple providers on the east and west coast.
    - adastra22 1y ago
      Yes, but the point is it is an add-on. Administratively (and in terms of deductible, etc.) it is different from the medical plan.
- Broken_Hippo 1y ago
  That line is Really fuzzy. They don't generally cover normal vision needs. Your regular glasses and/or contacts aren't covered. Eye injury or cancer, though? Usually covered. I honestly can't recall anyone getting denied for a possible scratch on the eye, either here in Norway or the US (Am from the US). Expenses for eye issues with MS or Diabetes? Usually covered. In these cases, you often go to a specialist MD instead of the normal eye doctor (if you see an MD at all). More is generally covered for eyes than teeth - if teeth were covered like eyes, it would be an improvement. A lot of acute care and infections and stuff would be covered.
  - Wowfunhappy 1y ago
    As a glasses wearer, not covering glasses feels reasonable to me, although I can't quite put my finger on why. I guess I see glasses at least partially as a fashion accessory--a necessary one for sure, but then so are shoes, and I don't expect those to be covered by insurance.
ChrisMarshallNY 1y ago
I remember reading a survey, where they determined that dentists are the most highly-compensated medical providers. Seems like the status quo is just fine for a whole bunch of folks that make enough to buy regulatory capture.
- lithocarpus 1y ago
  True but the profits and regulatory capture lie more with pharma companies than with dentists. There's an incentive for pharma to want people not to take care of their teeth, I don't know if they ever act on this incentive but I wouldn't be surprised.
dboreham 1y ago
It's supposed to be insurance and most dental services don't cost enough to be worthwhile insuring as a risk. Everyone needs them, more or less, so any insurance would just be a (costly to run) payment plan. Proper civilized countries do provide free to the consumer dental services, at least for children and poor people.
losvedir 1y ago
It's not your employer's "health care" plan. It's an insurance plan. And dental care doesn't really fit the insurance model since the vast majority of spending is expected and regular (checkups, cleaning, etc).

jjtheblunt 1y ago

Are you thinking universal health care would help, with respect to this article, even if people can't remember to brush their teeth?

mrtesthah 1y ago
Yes, it would help to know that I could see a dentist who would inform me of cavities and gingivitis that I am (or am not, depending on genes), developing as a result of my brushing habits (and through that feedback help refine said habits), rather than merely hoping and doing nothing more for lack of funds. And many people will require regular teeth cleanings to avoid gum pockets and consequent gingivitis despite their best efforts at brushing and flossing. There are other situations where tooth infections can move to the brain in a matter of days, risking death if left untreated. Regular checkups reduce that risk considerably. The other side of your argument would imply that the existence of toothpaste renders the entire field of dentistry inessential.
- jjtheblunt 1y ago
  That's a great point. (I didn't have an argument; I just wondered how the parent comment was thinking.)
AngryData 1y ago
It definitely would just by making sure cavities are taken care of earlier. They are caused by bacteria, and an active tooth infection is spreading and multiplying that bacteria at a much faster rate than it would be otherwise which exponentially increases the decay rate and number of cavities of all their other teeth.

tiahura 1y ago

You're proposing dental hygienists that do house calls and brush lazy people's teeth?

ChrisMarshallNY 1y ago

Cats can have systemic problems from dental issues. I had a cat die of kidney failure, precipitated by a gum infection. Friend of mine just spent a few grand for an operation on their cat, where they had to remove its teeth, because of a rare autoimmune problem.

vixen99 1y ago

We can agree on that but how about spreading more widely the simple advice - floss thoroughly & daily, clean your teeth twice a day and don't let sugars hang around in your mouth for extended periods. We know these pathogenic oral bugs can be related to heart disease (fibrosis for one) but maybe other dysfunction as well as prostate. A catchy meme might do the trick to remind us all.