The crisis of dental care under American capitalism
By
Esther Galen
11 January 2018
Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America, by Mary Otto, 2017, The New Press
Mary Otto sets out to paint a picture of the reality of poor dental health and lack of dental care that the working class and especially those living in poverty endure in the United States. She is well versed in the subject, as the oral topic leader for the Association of Health Care Journalists.
Her book, she says, “provides a look into the insular world of dental care in America. It examines the enduring tension between the need of Americans for dental services and the lack of services available to millions of us under the current system.”
Federal data show that tooth decay remains the most prevalent chronic disease of American children and adults. At the end of 2014, about one-third of Americans lacked dental benefits of any kind. The figure included millions of the elderly covered by Medicare, which has never offered dental benefits, and 68 million Americans under the age of 65.
The federal government estimates about 49 million Americans live in an area where there is a shortage of dentists. In addition, more than 114 million people lack either private or public dental benefits. The result is that many people delay getting needed dental care, at a heavy cost, in terms of both health and money. Twelve percent of adults who had unpaid medical bills reported that dental expenses made up the largest share of bills they struggled to pay. In addition, many patients may not be able to afford the antibiotics the dentist prescribes for tooth infections, instead only filling prescriptions for less expensive painkillers.
Under Medicaid, the federal-state health program…