Without dental coverage, many American seniors on Medicare stop getting the fillings and crowns they may need, a new study finds.
The result isn't pretty.
"Without dental coverage for adults who are eligible [for] Medicare, we are seeing a rise in loss of teeth after age 65 among nearly 1 in 20 adults, which represents millions of Americans," said Dr. Lisa Simon, a resident in the Department of Medicine at Brigham and Women's Hospital in Boston.
"Older adults have the lowest rates of dental insurance in the U.S. and cost is a major barrier for many in seeking dental care," Simon said in a hospital news release. "We know that Medicare, by covering medical services, improves health outcomes and reduces racial health inequities among older adults, but it has the exact opposite effect for dental care."
Researchers examined changes in dental care and oral health for older adults who became eligible for Medicare using national data from the 2010-2019 Medical Expenditure Panel Surveys. Surveys included community-dwelling adults ages 50 to 85.
The traditional version of Medicare does not include dental coverage. Although Medicare Advantage plans can offer dental services, the extent of coverage varies.
Among more than 97,000 people, researchers found the number receiving restorative dental care dropped dramatically. The research team also found an almost 5 percentage point increase in the number who lost all their teeth after they turned 65 and became eligible for Medicare.
The total number of annual dental visits did not change. However, the number of visits for restorative procedures, such as fillings or crowns, decreased by nearly 9 percentage points.
Adults who lose their teeth are at higher risk of poor nutrition, lower quality of life and progression of mental impairment, according to the researchers.
"Loss of teeth can have a number of negative downstream effects," Simon said. "It's associated with many geriatric conditions, including frailty and cognitive function."
The study was not able to follow the seniors for long periods. Authors noted that the changes in dental care could also reflect other changes at age 65, including retirement or receiving Social Security income.
"Our findings capture the magnitude of the problem but also point to the opportunity to improve oral health care access and outcomes, should policymakers expand Medicare coverage to include dental services," Simon said.
The research was supported by the U.S. National Institute on Aging and the U.S. National Institutes of Health.
Study findings were published in the February 2023 issue of the journal Health Affairs.
The U.S. Centers for Disease Control and Prevention has more on dental health.
SOURCE: Brigham and Women's Hospital, news release, Feb. 7, 2023