Much of the nation's proposed reform centers around preventive health services, health promotion and primary care, most of which have been neglected under our current system and in most insurance policies.
The proposed Clinton plan takes bold steps to achieve these ends, including preventive dental services for children.However, a void exists in the area of preventive dental care for adults. By failing to address this need, the plan does not meet its goal of comprehensive prevention.
Some 95 percent of Americans suffer from oral diseases that can result in pain and an inability to eat or speak properly. While 37 million Americans lack medical insurance, 150 million lack dental insurance and millions more are underinsured.
It is also estimated that half of the population has oral diseases, primarily tooth decay and periodontal disease (gum and bone disorders), which are absolutely preventable with regular dental care.
Oral cancer alone kills 8,000 Americans every year, with the highest incidence in adults and the elderly, who are underinsured and less likely to seek dental care. The five-year survival rate for oral cancer for all Americans is estimated to be 51 percent, and among blacks it is only 31 percent.
Early detection is crucial. Routine dental exams also provide valuable diagnostic information regarding an individual's overall health.
In monetary terms, for every $1 invested in preventive dentistry, $8 to $50 is saved. In the United States, the decline in dental decay has been attributed to increased fluoridation of water supplies and increased use of fluoride toothpastes. In Utah, preventive dental care is especially critical because of the lack of fluoride in community water supplies.
It is troublesome to note that in the three health-care options proposed by the Utah Health Care Policy Option Commission, only limited preventive dental services would be provided, but no restorative care.
This reality makes the early detection of decay imperative and support for regular checkups, fluoride treatments and sealants of critical importance.
We salute the Clinton administration's efforts in health-care reform, but it is now time to put money where the mouth is. If disease prevention is the desired outcome of the American health-care plan, the oral cavity cannot be left untreated.
Sarah Toevs
Professor and acting director
Dental Hygiene Program
Weber State University
Marilyn S. Harrington
Professor and dean
College of Health Professions
Weber State University
?