When was the last time you went to the dentist? If you’re now opening your calendar to check your last appointment, chances are it has been too long. There is no general rule on the regularity that will apply to all patients, not least because we all have different lifestyles. That said, if you are someone who consumes tobacco, drinks alcohol regularly, or if you are in doubt about whether your daily oral hygiene is up to standards, a good rule of thumb is to make a dentist appointment every six months.

For many Americans, the rudimentary costs of seeing a dentist for a routine checkup are manageable. Despite the fact that most dental plans cover 100% of the costs for preventive visits, many Americans appear to lack awareness of their benefits. Even though 80% Americans have access to dental benefits, nearly 35% of adults didn’t visit a dentist in 2019, according to the National Association of Dental Plans. For both the 20% of Americans who are either not employed or whose employer’s chosen insurance plan doesn’t cover dental care, and the existing insured patients, it would be important to increase competition through subscription models. My colleague Yaël Ossowski has explained the advantages of such subscriptions in the Boston Herald.

Improving America’s oral hygiene doesn’t just happen through the policy level of increasing competition or, as some argue, through getting the government more involved in the field of healthcare. First and foremost, oral hygiene happens at home through brushing and flossing. Unfortunately, that is where some Americans’ habits are falling short.

A 2021 study commissioned by the American Association of Endodontists showed that 21% of respondents failed to brush their teeth in the morning, 23% never floss, and 28% didn’t schedule a dental appointment the entire year. A 2016 analysis of 5,000 men and women had found that 32 percent of Americans never floss. This is all paired with headlines of less representative surveys showing that Americans mostly only brush once a day, if at all.

A factor that is underestimated by many is the effectiveness of chewing sugar-free gum. The American Dental Association says that while chewing sugar-free gum is no substitute for brushing your teeth, those gums sweetened by non-cavity-causing sweeteners such as aspartame, xylitol, sorbitol or mannitol can help prevent tooth decay. The saliva produced through chewing washes away food debris and neutralizes acids, and also carries with it more calcium and phosphate to help strengthen tooth enamel.

The European Food Safety Authority (EFSA), known for its cautious assessments of product claims, seconded the assessment that sugar-free gum improved tooth mineralization and thus has overall oral health benefits. It remains important to reiterate that sugar-free gum is in no way a substitute for regular oral hygiene; however, it is an adjunct to oral hygiene that makes it more than just a lifestyle but in fact, a wellness product.

Oral hygiene is an important factor in our daily lives. Tooth decay and lasting problems with teeth plague many Americans, burdening them with high dental costs. Both on a policy level and on an individual level, a lot remains to be done to improve the oral health of all citizens.

Originally published here

A new Senate bill seeks to take the hassle of dealing with healthcare companies away from patients and into the hands of insurance companies. Although it falls short of the mark, this bill is a step in the right direction toward sensible healthcare reform in Pennsylvania.

Regardless of your job, your income, or where you live, we’ve all had at least one nightmare scenario when it comes to health insurance.

There are forms, claims, reimbursement requests, schedules, and negotiations. Doctors, dentists, and health practitioners understand the burden, and often have to face their own bureaucratic tests of will before focusing on their patients. The growth of healthcare administration costs emphasizes this. And that’s for people with private plans.

The price inflation that comes with the amping up of health insurance plans in our entire system — not to mention the role of government subsidies — is a well-known phenomenon. Insurance becomes involved in every rudimentary doctor visit or procedure, leading to bad incentives for health providers, employers, and insurance companies. This process involves a middleman in what should essentially be a simple medical contract between patient and practitioner. 

The answer, however, is not in abandoning free exchange in healthcare, as Medicare For All proponents would have us believe, but rather it is in reckoning with insurance to make our system more competitive and fair.

In Pennsylvania, one particular bill is addressing the process of making insurance more accountable and lowering patient costs and headaches.

This session, State Sen. Judy Ward has introduced SB850 that would enact assignment of benefits reform, compelling insurance companies to follow a patient’s wish to directly pay healthcare providers rather than leaving them with the paperwork and negotiation. This would simplify life for patients by requiring insurers to pay providers directly.

One would think this is standard practice, but especially for dental insurance, there are additional steps and vetting that often leave patients responsible for paying their dentists only after the insurance company has paid out the claim.

Though only a small reform, and leagues from where we need to be to have a truly free market in healthcare decoupled from our employers, this bill would make the entire process simpler and better empower patients and consumers.

Since the Affordable Care Act and large Medicare reforms at the federal level, assignment of benefits is recognized in most medical insurance markets, but not yet for dental patients.

These reforms are complicated by the often cumbersome terms of dental insurance contracts: only portions of care or procedures can be covered by insurance, there are caps on the amounts one can reimburse in a single year, and dentists must navigate these steps to accurately bill their patients without producing a shocking bill. This balanced billing approach is necessary for any medical professional who wants to stay in business.

The answer, however, is not in abandoning free exchange in healthcare … but rather it is in reckoning with insurance to make our system more competitive and fair. 

But the status quo often makes it more complicated than it otherwise would be.

That is why price transparency remains an important principle for these debates, and why legislators should continue ensuring patients have choice and access to the information they need.

There are dozens of easy reforms state legislatures could follow that would help improve care: fostering innovation, reducing bureaucracy, giving incentives to patients to use direct-to-consumer options, and more.

By continuing to promote competition and transparency, patients and consumers can benefit from better care and lower costs. It is only a small degree of change we need, but it beats the alternative.

Originally published here