While also the name of a hit pop song, blurred lines is an apt summary of the recommendations stemming from Health Forward’s recently released oral health assessment. Oral health has traditionally been siloed apart from physical health and, unfortunately this separation has greatly impacted the cost, quality and access to oral health services.
As changes in the Affordable Care Act have prompted the health delivery system to evolve at a breakneck pace, the integration of behavioral health and physical health is emerging as an important approach to tackle a patient’s holistic needs. However, any movement to integrate oral health into the delivery system seems decades behind.
Oral health and overall health are closely linked. Poor oral health is correlated with various cardiovascular diseases, stroke, premature birth, and even Alzheimer’s disease. Similarly, overall health heavily impacts oral health, with diabetic and HIV/AIDS patients suffering complex oral health issues. Despite this complex interaction between oral health and overall health, we continue to think about and treat oral health in an entirely different way.
This separation feeds the idea that oral health is less important or less necessary than overall health and is evidenced in many ways:
- Dental benefits are considered optional for adults in Medicaid.
- Medicare doesn’t include dental care.
- Only 58 percent of Americans have dental insurance, compared to 85 percent who have health insurance.
- Only 67.3 percent of Kansas adults and 61.8 percent of Missouri adults received dental care over the past year. By contrast, 82.1 percent of adults and 92.8 percent of children had contact with a health care professional in the past year.
Health Forward’s oral health assessment, which included consumer focus groups, interviews with key oral health leaders, and a survey of oral health providers, found that oral health is often not a top priority for low-income and uninsured consumers. While disappointing, this is hardly a surprising finding. Given that even public insurance systems and public health professionals continue to consider oral health as an “add-on” or auxiliary service, it’s no surprise to see that the public too places less importance on oral health.
The report highlighted many ways to further integrate oral health into the health delivery system, but I want to take this chance to spotlight just one: We must find a way to integrate oral health leaders into the larger public health dialogue and decision-making bodies.
I challenge oral health professionals to engage with nonprofit organizations and safety net clinics to ensure that oral health is not left behind in the move to integrated care. I also invite nonprofit organizations to actively seek board members and other leaders with backgrounds in oral health.
Until the public health community learns to “put the mouth back in the body,” we can’t expect our public policies or consumer attitudes to adequately address oral health.