It's Time for Dentistry and Medicine to Join (free issue)
There's no reason for them to be as separate as they are
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Dental health and the rest-of-your-body health are so closely connected that it makes no sense at all that medical and insurance systems separate them. There have been calls over the years to fix this, and yet nothing has been done. Medical insurance often doesn’t include any dental care; if it does, it’s bare-bones coverage. Dental care, from basic cleaning and examination to extensive work like root canals, is very expensive. It’s often unaffordable to people without dental insurance.
But it’s not just the insurance. Dentists and medical doctors don’t work together either. Have you ever seen dentists and doctors practicing in the same clinic? I know that some do work together; I’ve just never seen it.
History of dentistry vs medicine
Oral health has a significant role in overall health, so why and how did the divide between oral health and the rest of the body occur? After all, we have specialties in everything else, like podiatrists for feet, dermatologists for skin, and so many more. How did the mouth get left out?
Back in ancient Greece, Hippocrates and Aristotle wrote about dental health and treating decaying teeth.
It’s not that people didn’t recognize the importance of the mouth. Back in ancient Greece, Hippocrates and Aristotle wrote about dental health and treating decaying teeth. According to this Forbes article, “The Greek scholar Hippocrates, known as the “Father of Medicine,” didn’t hesitate to write extensively about dentistry. In his scrolls, he focused on subjects like tooth decay and gum disease, which he saw as being as elemental to medicine as lung disease, fractures and wounds.”
In 1530, Artzney Buchlein wrote a book called The Little Medicinal Book for All Kinds of Diseases and Infirmities of the Teeth. An English textbook, Operator for Teeth, was written by Charles Allen in 1685. And yet, it would take centuries before dentistry was considered a professional or licensed trade. Anyone could become a dentist.
Finally, the world’s first dental school was established in 1840, the Baltimore College of Dental Surgery, and graduates obtained a Doctor of Dental Surgery degree. Still, it was only in 1941 that Alabama became the first state to regulate dentistry, making the state’s medical board responsible for granting licenses to practicing dentists. The act was never enforced.
Compare this to the world’s first medical school, the University of Montpellier, established in France in 1221. The first medical school in the U.S., the University of Pennsylvania School of Medicine, welcomed its initial students in the fall of 1765—when the country was not yet independent from British rule.
Medical vs dental insurance
If there was hope of marrying the two professions in the early 1900s, this was dashed with the advent of medical insurance. While I am focusing on U.S. medical insurance today, the same holds for countries like Canada and the United Kingdom with standardized healthcare (some oral care is available for lower-income people, but it is limited).
…when money is tight, it’s easier to eliminate the dental policy than the medical one.
In 1932, there was a push to include dentistry in medical insurance, but the medical system opposed it. So now there are two separate insurance policies that people have to carry. And, when money is tight, it’s easier to eliminate the dental policy than the medical one.
Dental care is expensive. If you don’t have insurance, it can be out of reach. But without dental care, you could end up in the hospital with severe medical complications, like endocarditis. Bacteria in your mouth could enter the bloodstream and settle in the heart’s lining or on the heart valves. This could cause a stroke, heart failure, blood clots, pneumonia, and many other complications.
But there is more.
Dentists can detect diseases that might otherwise be missed. They might notice something in your mouth that could be a sign of
Oral cancer
Anemia
Gastroesophageal reflux (GERD)
Diabetes
Heart disease
And more
Having teeth that hurt, too few teeth (or none at all), or ill-fitting dentures can result in other issues that affect your life, such as nutrition. You can’t eat well if it hurts too much or you can’t chew. People who are self-conscious about their teeth may withdraw so as not to be judged by others. The appearance of rotting or missing teeth can affect job opportunities – and no job in the U.S. means limited access to health insurance.
How can we fix this? How can we get dentistry and medicine to not only acknowledge each other but to work together?
What do you think? Leave your comment below. Let’s get a conversation going.
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I don't see this getting fixed anytime soon, at least not in the U.S. There's money to be made by keeping them separate. And THAT is typically the factor that decides how care is offered & covered here.