Best strategy for Senior dental care?

 

The New York Times has recently published an article titled "On Medicare and Need Dental Work? Beware a Big Bill". The article pointed out correctly that standard Medicare plans don't cover most patient dental procedures, unless they are related to the treatment of an ongoing medical problem. It also correctly explained that Medicare Advantage policies may cover some dentistry, but  max out quickly if a patient has the type of significant expenses involved with more extensive treatment plans involving implants. 

The truth is that seniors are often on fixed incomes and are loath to spend savings they have on large dental expenditures. I have some personal experience with this subject since a very high percentage of my patients are over 65 and most of those are either retired or planning on retiring in the near future. While I participate in two dental plans ( Cigna PPO & Delta Premier) most seniors who retire are uninsured.  They often complain about the cost of dental treatments since they have not been able to retain the dental insurance they had while they were employed. 

Being uninsured means that they often have to pay "full fare" even though most dentists  are listed as providers on a  dental insurance plans that offer a significant discounted fee as a prerequisite to their participation. Since Seniors may be uninsured, they often don't benefit from any insurance discount. 

My office manager does encourage our patients to participate in a Delta Dental PPO offered by AARP since this will often allow them a discount. For our uninsured Senior patients we often offer a 10% discount on our services. It is only a small gesture but at least it feels like the right thing to do, especially since most of these patients have been under our care for twenty or more years.

So what should seniors do who are worried about incurring significant expenses. In my opinion," an ounce of prevention is worth a pound of cure". Accordingly we often recommend three or four month recall schedules for our senior patients. My hygienist is trained to look for small new carious lesions that tend to crop up for an older population that may be suffering with a dry mouth. "Dry mouth" is often experienced by seniors, since their saliva production ( which helps prevent cavities) can greatly diminish over time. We  encourage them to use an Oral B rechargeable tooth brush and clean between their teeth with a small interproximal brush or to use Johnson and Johnson Stimudents.

In my experience Seniors who follow these recommendations do better and lose fewer teeth and need less extensive dental treatment plans. Unfortunately some seniors, who have extremely tight budgets choose to cut back on dental cleanings and exams. They figure they will wait until something is bothering them to schedule an appointment with their dentist. While this strategy may initially save money, in the long run it can lead to more tooth loss and necessitate more extensive and expensive solutions.

Many people, myself included, wish that Medicare will include dentistry in the future and hopefully if this comes to pass these dental benefits will allow several cleanings and check ups each year, since this will tend to greatly improve our seniors  dental health, as well as their over all health, and may even save money on the medical side.