Economy and health. The combination always bounces back day after day, to the point of creating real indissoluble bonds that create real “red threads” between people’s well-being and financial resources. If we talk about dental care in older people, the topic appears even more important. And we must ensure that people have access to diagnoses and therapies for oral pathologies as soon as possible, given that not being able to afford treatments of this type translates into an increased risk of developing neurological and cardiovascular problems, starting from cognitive impairment and heart attack. This is according to research coordinated by Kendra Sims, carried out by experts from the Boston University School of Public Health (BUSPH), which appeared in The Journals of Gerontology, Series A.
How important is the economic factor?
The fact that there are relationships between oral health and chronic inflammation, with repercussions on heart and brain health, is nothing new. But the study is among the first to associate these conditions with the socio-economic reality of the people under study. As a note reports, in fact it is necessary to remember how much and how the cost of the service can become an obstacle to accessing care. Mabeline Velez, professor of health policy and health services research at BUSPH, reports this: as a consequence,
“People often put off essential care or accept available insurance coverage, which can result in more drastic measures, such as a tooth extraction that is not clinically indicated. Tooth loss, especially at a young age, can cause a variety of health problems in later life, including increased mortality.”
The study, in particular, analyzed data from a survey conducted among study participants over 55 All of Usan initiative launched in 2017 by the National Institutes of Health to develop a diverse database on a variety of health conditions. By analyzing electronic health records and survey responses, the team examined associations between unmet dental care needs due to cost and new diagnoses of heart failure, heart attacks, strokes, and dementia of any cause. A total of 88,496 people were analyzed for heart attacks, 86,593 for heart failure, 88,410 for strokes and 92,272 for dementia. The researchers found that people who skipped dental visits and treatments because they couldn’t afford them had a higher incidence of all the conditions mentioned above.
At a population level, eliminating economic barriers that prevent people from receiving dental care could prevent 2 to 4 percent of each of these conditions among older adults. Except for what was observed for strokes, the associations attenuated after researchers accounted for socioeconomic, behavioral and clinical factors. The researchers point out that this weakening of the correlation indicates a need for more data to understand and address the underlying or systemic causes of chronic diseases.
Can treatment be made more accessible?
Finding ways to make dental care more accessible to everyone is a preventative measure that can help individual well-being and healthcare overall. But we need to work on it. Certainly policies that facilitate access to preventive dental care could significantly reduce oral health problems, with benefits that also extend to cardiovascular health and cognitive functions.
If this is the situation on the other side of the ocean, where do we go from here? There are opportunities to help, confirms Corrado Bondi, National Vice President of ANDI (National Association of Italian Dentists).
“In Italy, the response to the economic barrier highlighted by the Boston research has a precise name: integrated category healthcare. The FAS, the Fund of the National Association of Italian Dentists, was created with the exact aim of separating the link between immediate financial availability and the right to health. While the US study confirms how giving up treatment increases the risk of heart attack and dementia, the FAS model operates on primary prevention. Through targeted health plans, the Fund allows patients to have regular access to check-ups and therapies, eliminating the obstacle of ‘out-of-pocket cost’ of the service. It is not just about reimbursing a fee, but about promoting a culture of health where therapeutic continuity is guaranteed. Making dental care accessible is not just a question of social equity, but a true health prevention measure access to preventive care could significantly reduce oral problems, with benefits that extend to cardiovascular health and cognitive functions, transforming what is currently a cost into an investment in longevity.”
