U.S. yuck mouth crisis: Which states are best, worst for oral health?

Nobody can deny the power of a great smile.

And for those who won’t flash a smile even when happy because of dental problems, it’s very stigmatizing.

What’s worse, it’s an extraordinarily un-level playing field when it comes to who is getting quality dental care in America.

Where I live – Illinois – lands at a respectable number four on a brand-new WalletHub ranking. Iowa, right across the Mississippi River from me, ranks 13th.

The top five oral health-friendly states: Minnesota, Wisconsin, Connecticut, Illinois, North Dakota.

And the least oral health-friendly states? Montana, West Virginia, Alabama, Arkansas and Mississippi.

You can view the full list for yourself by clicking here.

Medicaid programs (or lack thereof), lifestyle choices impact dental care

How did WalletHub arrive at its ranking? It measured access and affordability to dental care across 25 key metrics. Those metrics included:

  • Dentists Supply-Demand Ratio by 2025
  • Sugar-Sweetened Beverage Consumption Among Adolescents
  • Share of Adult Smokers
  • Share of People Who Receive Fluoridated Water Through PWSs (Public Water Systems)
  • Presence of State Oral Health Plan
  • Medicaid Dental Benefits for Adults
  • Status of Older Adult Basic Screening Survey
    Note: This metric measures the status of a state’s Older Adult Basic Screening Survey (BSS) administration — more specifically, whether the state has completed (and how long ago) or is planning an Older Adult BSS. According to Oral Health America, a BSS “a surveillance of the oral health conditions of seniors in community and long-term-care settings of older adults.”
  • Oral Health
  • Share of Elderly Population with No Natural Teeth
  • Pain Due to Oral Condition
  • Sleeping Problems Due to Oral Condition
  • Reduced Life Satisfaction Due to Oral Condition
  • Reduced Social Participation Due to Oral Condition
  • Work Absence Due to Oral Condition

Elderly, low-income people often can’t access dental care

The state of dental care in America is something I have written about several times in the past few years. In a 2014 piece I wrote for Healthline headlined, “The sorry state of dental care in the U.S.,” I focused on why dental care isn’t more accessible, even with the passage of the Affordable Care Act.

From the piece:

Why does something as basic as dental care continue to take a back seat, even with the new emphasis on preventive medicine? 

“The failure to value oral health and understand that the mouth is the gateway to the body has for too long impeded people’s ability to achieve good overall health,” Maxine Feinberg, a Cranford, New Jersey dentist, told Healthline. “

This failure can negatively affect anyone, but it is particularly devastating to low-income people who lack dental coverage or who for other reasons don’t seek or receive regular care.” 

According to the U.S. Centers for Disease Control and Prevention (CDC), about one-quarter of Americans 65 and older have lost their teeth. One-third have untreated tooth decay, even though poor dental health is linked to heart problems and other health concerns seniors already face, such as diabetes. Medicare, the federal program intended to keep seniors healthy, has never covered teeth cleanings, fillings, dental X-rays, or exams.

You can check out the complete Healthline article by clicking here.

Watching my dad suffer from dental pain was excruciating

On a personal level, I watched my father experience excruciating dental pain in the final years of his life.

This is a PTSD trigger for me.

From a piece I wrote for Caregiver Relief which is now hosted on my own site:

I can tell you right now that my dad is embarrassed that he has no teeth, especially as he is trying to make friends in the new nursing home. “Whether caring for natural teeth or dentures, daily oral hygiene can mean older adults will be free of oral pain, can maintain a well-balanced diet, and will enjoy interpersonal relationships and a positive self-image,” the AOA site states.

The poor guy has been sitting in the dining room by himself, which is why I’ve gone up there and had at least one meal with him every day. When I’m not there, an employee has been sitting with him. When old ladies wheel past, my dad lifts his hand and feebly says, “Hi.” Can you imagine what this is like for him? It’s got to be like the first day of high school freshman year in the lunchroom. Not having his teeth is a blow to this little Casanova.

I did end up getting my dad fitted for new dentures. He was dead less than two weeks later, before the dentures even were made.

From my Healthline story:

The Administration on Aging, part of the HHS, acknowledges the barriers to dental care that older Americans face and has several initiatives aimed at improving the situation. It operates a website intended to help seniors access dental services.

Earlier this year, the ADA Policy Institute produced a study that shows which states offer adult dental benefits and how extensive the benefits are.

Among ideas a panel of experts tied to the WalletHub study offered as a solution to America’s dental health crisis? Create the equivalent of an LPN in dentistry. These mid-level dentists could assist fully degreed dentists in common procedures and also perform some dentistry on their own, thereby increasing the availability of dental care at an affordable price.

It’s a model already being used among physician care.

Until next time.

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