According to a University of Michigan poll on aging, an overwhelming 98% of senior patients say their oral health is important to them. That’s excellent news since keeping teeth healthy becomes ever more challenging with age, as receding gums and bone loss make teeth less stable. Even more importantly, 98% of those surveyed were also aware that oral health problems can cause other health problems, from malnutrition to cardiovascular issues.

It’s clear that the majority of senior patients are ready and eager to benefit from better oral healthcare—they just need the opportunity. As a dental practitioner partnered with Sterngold Dental, you can achieve a sizable cost savings on your restorative treatments that can be passed on to the edentulous patient.

The Realities of Dental Care for Those 65 and Above

With 54.1 million Americans now over the age of 65, the population of aging Americans not receiving dental care represents a huge opportunity for dentists to gain more market share.

As a patient ages, their prognosis for dental problems, lack of care, and the potential for edentulism, increases. And yet, while they are most at risk, senior patients over age 80 are among the most likely to forgo dental care. Often this is due to obstacles involving lack of transportation and cognitive decline.

Even sliding scale-fee health centers often prove just a band-aid. These clinics can help a limited number of seniors living in their service areas; however, since they are not widely available, it’s not enough to help the growing number of patients as the country ages.

Other Medical Issues and Quality of Life

A lack of dental care also exacerbates pressing concerns regarding a senior’s overall healthcare. Oral hygiene problems can lead to increased risk for stroke, cardiovascular disease, and diabetes. Other milder problems among untreated senior patients can include dry mouth, infections, inflammation, and mouth sores. Gum disease can also loosen teeth, allowing bacteria to enter the body.

There’s also the embarrassment and social factor. Teeth are important for eating, smiling, speaking, and kissing. Problems with oral health can also lead to depression and anxiety for the edentulous patient. These are all factors that lead to a lower quality of life and increased health care costs.

The Medicare Coverage Debate

Despite an increased need for diligent dental care, people over the age of 65 often struggle to obtain insurance. Currently, dental insurance is not part of Medicare. In fact, around two out of three Medicare recipients (nearly 37 million people) do not have access to dental care.

Overall, only 53% of older adults report having dental coverage, and cost is the leading factor for those who don’t have insurance. That 53% who are covered? A good portion of them get their coverage through a current (or former) employer or their spouse’s employer. Those who don’t have access to coverage via this avenue are stuck footing the bill on their own, and living on fixed income, the average Medicare beneficiary only has about $26,200 in annual income. Allocating money for dental insurance is frequently set aside for more pressing problems.

As a result of these disparities, 93% of Americans aged 65-80 are in favor of adding dental to federally-offered Medicare benefits (though the number decreases to a still-robust 59% when asked if they’d be willing to pay more accordingly).

Lawmakers will likely debate adding dental coverage to Medicare again soon. Already this year, the Biden Administration has endorsed increasing access to dental coverage in the 2022 federal budget. However, the opposing political party has unanimously objected to the expansion of federally funded dental coverage.

The issue remains controversial among healthcare professionals, with the American Dental Association (ADA) urging lawmakers not to support Medicare dental care. They argue that any Medicare coverage would be far too little to make any kind of notable impact. In contrast, both the National Dental Association and the AARP are in favor of adding dental care to Medicare.

Dental Insurance Options for Older Patients

If a senior can afford dental health insurance, these plans can address many of the issues associated with oral hygiene and aging. For example, most senior plans will cover 100% of preventative and diagnostic care, including exams and x-rays.

But overall the plans often don’t cover enough for the aging or endentulous patient. Dentures, fillings, root canals, extractions, and oral surgery are usually not included. On top of that, most plans have an annual maximum benefit.

For a higher cost, more comprehensive plans including coverage for services like fillings and orthodontics are available. But depending on the level of care needed, the edentulous patient may still feel burdened by other out-of-pocket costs.

Different Types of Coverage Plans

senior dental insurance

Dental coverage, like any medical plan package, can take a variety of forms, each with their own stipulations.

  • Preferred Provider Organization (PPO). In a PPO plan, seniors save money when they see a network of dentists that provide services for a set fee. In contrast, using an out-of-network dentist results in higher fees.
  • Dental Health Maintenance Organization (DHMO). Under a DMHO, participants can see dentists within network at little or no cost per service. Dentists participate in the plan in exchange for a set fee per patient, per month.
  • Direct Reimbursement Plan. In a direct reimbursement plan, patients can see any dentist they choose. Participants pay a dentist directly, then submit a receipt to the insurance company for reimbursement. As such, these prove less viable for those who cannot afford an upfront out-of-pocket fee.
  • Discount Plans. Not technically dental insurance, participants who opt for this coverage can receive dental care at a discounted rate from select dentists who agree to reduce fees. With no need to file a claim, patients will pay a dentist the discounted rate directly.
  • Schedule of Allowances Plan. Under this type of plan, the insurance company will pay a set amount for each type of dental work. After that, the patient must pay the difference between the insurance amount and what the dentist charges.

In addition to the generic plans through insurance providers listed above, additional Medicare coverage is available for purchase. A Medicare Advantage plan offers options to pick up dental, vision, and hearing coverage. Unfortunately, however, the reality remains no matter what plan seniors choose, serious care is likely to develop into a problematic expense.

Sterngold Total Smile™: Your Total Solution for the Edentulous Patient

No matter what insurance plan they have—if fortunate enough to have any—the fact remains that dental care costs are prohibitive for many seniors. In recent years, 19% of Medicare beneficiaries spent more than $1,000 on out-of-pocket dental care costs. This may be a significant portion of their limited earnings, given that most of those individuals are living on a fixed income.

As a dental health care provider, you can help provide a remedy to these cost barriers. With the affordable solutions under Sterngold Total Smile™, dentists can positively impact the quality of life for aging Americans with very limited insurance coverage, to none at all.

edentulous patient quality of life

Sterngold has combined its implant and attachment selections with the advanced capabilities of digital dentures to offer the Sterngold Total Smile™ package. Reduce costs and create a natural-looking smile for patients by ordering the best materials available, from a single source.

A winning solution for all, STS™ can help dental practices reduce fees by reducing the cost of acquisition for a combination of products to many treatment modalities, allowing them to pass savings down to an edentulous patient struggling to afford care, whether they have insurance or not.

Providers also bolster their professional credibility for patient care and concern. With one partner for all your related restorative needs, your practice can avoid negotiating with multiple suppliers. Instead, you’ll find what you need all in one reliable, quality-controlled, convenient place.

Enhance your patients’ quality of life by helping them afford that confidence building smile and supporting a still active and healthy lifestyle. Ask about Sterngold Total Smile™: Reach out to Sterngold today or download the information here.