back
|
 |
Elderly
Dental
Care
Falls
Through Gaps
By Cory Reiss, The
Lakeland
Ledger
October 14, 2003
A stroke sent Marcia Ball to a nursing
home, but her most recent brush with death may have come from a tooth
infection.
Louisiana's Medicaid program doesn't cover tooth extractions or other
procedures for most poor adults, so Ball, 64, was given antibiotics when
her face swelled with an abscess.
In July, Ball was taken to the emergency room with a fever and pneumonia.
Doctors discovered the infection in her face had become resistant to
antibiotics and decided on emergency surgery to drain it. Medicaid does
cover that.
The next day, while recovering, Ball's heart stopped.
Whether the tooth infection caused the heart attack or pneumonia is a
question that isn't broached in Ball's medical records. Ball's dentist,
however, is certain it did, and other experts said those are two of the
major health problems that have been linked to festering gums and tooth
decay, which can send bacteria into the bloodstream and lungs.
Ball survived, but the ordeal cost Medicaid thousands of dollars. She
still has the bad tooth. Pulling it would cost $70.
"I think I need every tooth in my head removed because they all have
the possibility of getting abscessed," Ball said with some difficulty
from her nursing-home bed in
Lafayette
,
La.
"I try not to think about it."
Ball, one of 1.7 million nursing home patients, is far from alone in
having aching teeth and no means to pay a dentist. And Medicaid, the
state-federal health program for the poor, isn't the only program full of
gaps. The elderly also are taking it in the teeth because Medicare, the
federal program for the elderly, generally doesn't cover dentistry unless
surgery or another covered condition, such as mouth cancer, is involved.
(In
Polk
County
, roughly 92,000 residents -- or about 20
percent of the population -- are covered by the Medicare insurance
program. Roughly 71,000 residents -- or 15 percent -- are covered by the
Medicaid insurance program.)
More Americans are keeping their teeth into old age, but that can mean a
mouthful of problems that doctors say contribute to heart disease,
pneumonia and diabetes complications. Mouth infections can delay
transplants and other surgical procedures.
Many seniors lose or drop costly dental insurance at retirement and go
without routine care, according to dentists with geriatrics experience.
With Medicare and Medicaid in the spotlight for other reasons, Congress is
just beginning to chew on the dental problem.
Dr. Teresa Dolan, dean of the
College
of
Dentistry
at the
University
of
Florida
in
Gainesville
, said public policy doesn't give the mouth its
due as a breeding ground for bacteria. Also, many seniors are preoccupied
with drug costs and other health issues.
"No one pays attention to it," she said.
Dr. Gregory Folse, a dentist who has treated Ball on rounds to
Lafayette-area nursing homes, wants Congress to require states to cover
routine dental care and procedures such as extractions for disabled adults
under Medicaid. Adult dental care is optional for state Medicaid programs,
which are required to cover children.
Folse, an activist with the advocacy group Special Care Dentistry whose
practice covers 13 nursing homes, said Ball's tooth would be removed
"when I come here and do it for free. I have 1,300 patients exactly
like her."
A 1999 report by the Centers for Disease Control and Prevention said 26
percent of people between the ages of 65 and 74 had private dental
insurance, and 20 percent of seniors 75 and older were covered.
The 77 million baby boomers driving the debate about adding a prescription
drug benefit to Medicare have yet to fully realize the problem, experts
say. They are used to regular dental care and will retire with more teeth
to protect than their parents did.
Sen. John Breaux, a Louisiana Democrat, is sounding alarms and recently
held a forum on the subject. He said dental coverage under Medicare should
be the goal but will take time. More immediately, he wants Congress to
require better Medicaid coverage for people like Ball.
"This is a horribly neglected area of health care that can lead to
far greater problems than losing your teeth," Breaux said.
Copyright
© 2002 Global Action on Aging
Terms of Use | Privacy
Policy | Contact Us
|
