Monday, May 15, 2017

Rich-poor divide in oral health forces low-income folks to choose extraction over costly repairs

The rich-poor divide is causing many impoverished rural residents to forgo dental health care, or resort to having teeth pulled rather than pay for costly fixes, Mary Jordan and Kevin Sullivan report for The Washington Post. The rate of Americans who have lost all their natural teeth is higher in rural areas in every age group, and 20 percent of all Americans over 65 do not have a single real tooth remaining. (CDC graphic: National Health Survey 2010-12 results of of people who have lost all their natural teeth)
Toothless rates among those 65 and older are especially high in the South. According to Kaiser Family Foundation data from 2014, 33.6 percent of West Virginia residents 65 and older have had all their natural teeth extracted. Second is Kentucky, at 23.9 percent, followed by Mississippi and Oklahoma (22.5), Tennessee (22.4), Alabama (22.2), Arkansas (22) and Louisiana (20.5). (CDC graphic: Where people 65 and older have lost all their teeth, by region)
More than 50 million Americans "live in areas officially designated by the federal government as Dental Health Professional Shortage Areas," reports the Post. "A great many of them are working poor. In these rural areas, even the water can work against people." Many people rely on well water that is not fluoridated, which helps reduce tooth decay. The Centers for Disease Control and Prevention says 25 percent of Americans are not connected to a fluoridated water system. Another problem in rural areas is a shortage of dentists.

While rich people can afford the luxuries of the best oral health care, poor people often resort to standing in line at free clinics, reports the Post. "High-end cosmetic dentistry is soaring, and better-off Americans spend well over $1 billion each year just to make their teeth a few shades whiter. Millions of others rely on charity clinics and hospital emergency rooms to treat painful and neglected teeth." The problem is that emergency rooms are not typically equipped to fix dental problems. That means they prescribe painkillers, which can lead to addiction, which destroys teeth, and dry mouth, which leads to more cavities.

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