Wellness That Matters: Black Health News & Community Care
- Delaying dental care worsens conditions, undermines preventative care, causes pain and infections, and often leads to emergency room visits.
- Affordability and access are primary barriers; know what your Medicare or employer plan covers and limits.
- Dr. Jimerson notes dental fear, rooted in historical trauma, keeps many from care; compassionate communication and trust building are essential.
- Know your coverage, find an in-network dentist, request prior approval, and use dental schools, mobile clinics, or American Dental Association resources.
Have you ever had a nagging tooth ache or bleeding gums, and just put off going to the dentist until it stops? You are not the only one. Black adults have the highest rates of tooth decay and major dental issues of all Americans, according to Community Dentistry and Oral Epidemiology. Dental debt makes up nearly 40 percent of the over $194 billion in medical debt in the U.S.
The most pressing reasons according to the Centers for Disease Control and Prevention (CDC) of lack affordability and access to dental care. There is no question that dental care can be expensive and even if you have some kind of health care insurance coverage, it may not pay for going to the dentist, or limit what it will pay. Paying for dental care is a significant obstacle.
Oral Issues Escalate When You Put Off Going to the Dentist
But putting a visit to the dentist off for months or years, doesn’t make your problems go away. The problems often become worse, more complicated and more expensive. Often the emergency room is the hub for uninsured and underinsured patients. In fact, Blacks are twice as likely to have to go to the emergency room for care because they don’t have a dentist.
And it can be even more difficult and surprising for those who are retired and over 65. After years of having dental coverage through employer-sponsored insurance plans, many people age 65 and older are often surprised to learn upon retirement that Medicare does not pay for most dental work.
Fear Play a Significant Role for Many of Us
While affordability and access are at the top of the list of reasons why Black Americans put off dental care, they aren’t the only ones. “Many people are simply terrified of going to the dentist, even for the most basic of preventative care, like cleanings or x-rays,” says Ruthie Jimerson, DDS and associate professor at Meharry School of Dentistry, in Nashville. “We know that a fear of the dentist can go back for generations because of the historical trauma of slavery,” says Dr. Jimerson says.
“When they were in excruciating tooth and mouth pain, and couldn’t work, the enslaved were treated with chisels, hammers and other tools without any anesthesia,” she says. And while there have been significant advances in how all dentistry has been practiced over the decades, Dr. Jimerson says that same fear and trauma have been passed from generation to generation of Blacks, leaving them afraid to go in for regular preventative care and treatment even now.
Lack of oral health preventative care can literally be a killer. The National Cancer Institute data suggests notes that oral cancer mortality rates for Blacks due to a lack of preventative care and screenings. According to the Journal of Evidence-Based Dental Practice, most oral cancer cases are detected when they have already reached an advanced stage.
Do Your Homework
If you have employer-sponsored health care coverage that includes dental care or Medicaid/Medicare, make sure you know what your plan will pay for and how much it will pay.
As an example, most standard Medicare plans do not pay for dental work. But ask about the Medicare Advantage plans available to you. Most offer some coverage but are limited in what they pay.
Find a dentist that is covered under your specific plan. And remember, not all dentists take all subsidized coverage. Also, in this current Federal administration, there may be cuts in coverage that could impact your dental care.
Communication is Key
There is also a shortage of dental care providers, especially in communities or color, that can cause obstacles to oral health care.
Find a dentist and get a baseline preventative screening which will probably include cleaning, x-rays and an examination. Even if you have dental insurance, this is an important step. Even if you select a dentist, you are not considered a patient until you go in for that first visit. If you wait until you have a major issue, it may be months before you can get an appointment to be seen.
In that first visit talk to your provider about what you can pay or the limits in your coverage before you have the recommended procedure.
Make sure you ask your dental team to get prior approval for all procedures. Knowing what you will have to pay will help you avoid financial surprises and major debt later. And often your provider can help you figure out an affordable treatment plan or a payment plan.
Check out dental schools and community college programs where dental students provide care under the supervision of practicing dentists. Dr. Jimerson says schools like Meharry have teaching practice partnerships with the communities they serve. Many community colleges that have dental hygienist programs are another option for those who need the basics of preventative care. The American Dental Association has a list of programs around the country.
Keep an eye out for free or low-cost mobile vans and community service options. There are many that come into low-income neighborhoods, schools and churches with volunteer dentists to provide cleanings and preventative screenings.
Oral health is a key part of overall health and wellness. Ignoring it can cause significant pain, systematic infections and a loss of teeth. But you have the opportunity to make your oral health a priority moving forward.
Resources
Community Dentistry and Oral Epidemiology
CDC: Health Disparities in Oral Health
Journal of Evidence-Based Oral Practice
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