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Originally published Sunday, September 22, 2013 at 4:04 PM

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Guest: Expand Affordable Care Act to cover adult dental care

The Affordable Care Act should be expanded to include adult dental care, writes guest columnist Ron Inge.

Special to The Times

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BIG changes are coming to Washington health care in 2014. While much of the focus is currently on medical care, there are some important changes and strides happening on the dental front.

In the first phase of the Affordable Care Act in Washington, the state’s new health-insurance exchange will begin enrolling people Oct. 1, with coverage starting Jan. 1.

From a dental-coverage point of view, this will greatly increase access to oral care for previously uninsured children across the state. Unfortunately, adult dental care is not included in the Affordable Care Act.

Without coverage, oral care for adults will become a discretionary-income decision. Do we go on a family vacation or does Dad get his necessary root canal? For others without the cushion of discretionary income, the choice will be even harder.

Studies done by the National Association of Dental Plans show that those with dental coverage are 50 percent more likely to visit the dentist than those who don’t. They also reported that while more children are receiving dental care, fewer adults are visiting the dentist. The American Dental Association attributes the lack of care to fewer adults with dental coverage.

So the big question is, if adults don’t have coverage, what does their dental care ultimately cost the public?

A recent study by the Washington State Hospital Association indicated that there were 54,000 dental-related visits to the emergency room during an 18-month period, which cost our state more than $36 million. Patients who visit the ER with dental problems are often charged three to four times more. While given medication to lessen the pain, they often do not receive treatment to fix the problem.

Luckily, through the recent reinstatement of dental coverage to eligible Medicaid adults and the hard work of the Washington Dental Service Foundation, 250,000 Washingtonians will again have dental coverage beginning in 2014. As a former practicing dentist I’m excited by this change, but I’m concerned that many adults still won’t receive the dental care they need.

So, what is the solution?

U.S. Sen. Bernie Sanders, Ind-Vt., has introduced a bill to add adult dental care to the Affordable Care Act in 2015. I hope that the Washington state Congressional delegation will support the bill.

Providing dental care to more people could significantly reduce medical costs and provide lifesaving, preventive treatment. When the Affordable Care Act expands over the next few years, dental coverage should not and cannot be overlooked.

Providing dental care can significantly reduce medical costs, particularly for patients with diabetes.

A recent study done at the University of Pennsylvania found that providing dental treatment to people with diabetes reduced hospitalizations by more than 60 percent in the first year of treatment. This resulted in an average savings of $3,200 per person annually.

Based on the number of Medicaid-insured Washingtonians with diabetes, the Washington Dental Service Foundation staff projects that the state could save $24 million in medical costs by providing dental coverage.

If you are a Washingtonian who has dental insurance, use it, especially if you’re a parent. Parents who visit the dentist regularly are more likely to take their kids to the dentist. Also, the bacteria that cause dental disease are often passed from adults to children, so it is essential parents and expectant mothers have good oral health.

It’s critical that we understand just how important dental care is to our overall health. The mouth is the window to the body, and dentists are increasingly becoming the first line of detection for many systemic diseases including heart disease, diabetes and oral cancer. Unfortunately, most people don’t think about this until they are in tremendous pain and unable to eat properly or smile. It is a place no one wants to be.

Ron Inge is dental director and vice president for Washington Dental Service and executive director of the Institute for Oral Health. He has a degree in dental surgery.

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