Aging teeth and gums can lead to big dental bills, ones that aren't
often covered by Medicare
by Michelle Crouch, AARP,
September 26, 2018
When Jo Calk,
70, of Lincoln City, Ore., broke a tooth last year, she never considered seeing
a dentist. Instead, she took matters into her own hands. “The sharp points of
the still-intact metal fillings were painfully ripping into my tongue, so I
borrowed a diamond file from a friend and sawed off the edges,” she says. “At
least it doesn’t poke me anymore.”
Like many
seniors, Calk says she had to give up dental care in order to get by on her
fixed income. If you’re over age 65, maybe you can relate. In surveys, more
than half of older Americans say they have not been to the dentist in the past
year, and they cite cost as the top reason.
Calk went to
the dentist faithfully twice a year for most of her adult life, when she was
covered by employer-sponsored health insurance. She says she was shocked when
she retired and learned she had to start paying those costs herself. She gave
up going to the dentist about a year after she retired, when she realized she
was going through her savings too quickly.
Medicare has
never covered most routine dental care, and Medicaid offers extremely limited
coverage that varies by state. A few Medicare Advantage plans do offer dental
benefits, but most don’t even come close to covering the cost of expensive
procedures such as root canals, gum surgery and implants.
The unfortunate
irony is that older Americans lose their dental coverage precisely at the time
when they need it most. Aging takes a toll on teeth. Gum tissue naturally
recedes as you age, exposing roots to decay, and a lifetime of crunching and
grinding wears away tooth enamel. In addition, many medications cause dry
mouth, which raises your risk of gum disease, tooth decay and infection.
About 1 in 5
Americans age 65 or older have untreated cavities, and 2 in 3 have gum disease,
according to the National Center for Health Statistics.
Forgoing dental
care can have serious long-term consequences, says Stephen Shuman, a dentist at
the University of Minnesota School of Dentistry who leads the Gerontological
Society of America’s oral health group. Poor oral health affects your ability
to speak, eat healthy foods and feel confident in how you look. More importantly,
perhaps, taking good care of your teeth can decrease your risk of serious
problems such as heart attack, stroke and poorly controlled diabetes.
Amber Willink,
a health services researcher at Johns Hopkins Bloomberg School of Public
Health, has analyzed the economic impacts of the lack of dental coverage for
seniors. She says putting off care will likely cost you money — and pain — down
the road. “Chances are, you are going to end up in the ER in absolute
pain or dealing with an infection,” she says.
How to hold on to your smile on a budget
Before giving
up on dental care altogether, consider the following cost-cutting strategies:
Ask for a discount
If your dentist
recommends a particularly expensive treatment, negotiate on cost before you get
the work done. Many dentists will reduce your bill if you pay up front, says
Matt Messina, a spokesperson for the American Dental Association. He recommends
being honest with your dentist about your financial situation: “Have a thorough
exam and have us put a plan together for you. Or we may be able to treat you in
steps and phases so you have time to save up.”
Visit a dental school clinic
Dental
students, supervised by a licensed dentist, get hands-on experience, and you
save 20 to 70 percent off most procedures. Search for a program in your area on
the American Dental Association website.
See a dental hygienist
Forty-two
states now allow dental hygienists to treat patients without the specific
authorization or presence of a dentist, and the cost savings can be
significant. Check the specifics of how and what they can treat in your state.
Use free or low-cost dental providers
Some nonprofits
and government-funded health clinics provide free or reduced-cost dental
services (often based on income). Their services are in high demand, so expect
a wait. Your local health department or United Way can connect you to programs
in your area. Or try the Find Care tool at ToothWisdom.org,
a nonprofit dedicated to connecting people to affordable dental clinics.
Sign up for a dental savings plan
These
non-insurance dental plans negotiate discounts of from 10 to 60 percent on
dental costs. You pay a small monthly fee to join, and you get the discounts as
long as you use a dentist that accepts the plan. Search for plans in your area
at DentalPlans.com.
Shop around
Prices for
dental services can vary by hundreds of dollars, even in the same community.
Look up average prices in your area at FAIR Health, a national nonprofit dedicated to
bringing transparency to health costs, and then call a few dentists for quotes.
If you live in a community with a high cost of living, driving to a less
expensive area can boost your savings.
Search for coupons or deals
Some dentists
offer specials for new customers on daily deal websites like Groupon or through
direct-mail coupon packs. A typical deal may include an exam, cleaning and
X-rays for $40 to $60, a fraction of the typical cost.
Practice prevention
Taking care of
your teeth daily — and yes, seeing a dentist on a regular basis — is the most
cost-effective way to reduce your dental care costs. “The earlier we catch
something, the less expensive it is,” Messina says. “The cheapest cavity is the
one you never get, and the next cheapest is the one we catch early.” Seeing a
dentist for regular cleanings and checkups can save you money in the long run —
and it may just save your smile.
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