A History Of Neglected Teeth, Ctd

A reader illustrates the really high stakes for some people lacking dental insurance:

The exclusion of dental from many medical plans – or the need to add it at significant cost – is completely foolhardy, especially given the links between poor oral health and heart disease.

While there doesn’t yet seem to be consensus about poor oral care causing heart disease, I know it can be fatal for at least one kind of very expensive heart patient. My boyfriend had a heart valve replacement when he was in his late 30s – the necessary outcome of a congenital birth defect that caused him to slowly develop heart disease through his first three decades. He lives a normal life now, though he’ll have at least one more valve replacement before the end of his life, hopefully about 15 years after the first.

What’s the thing that is most likely to send him in for a replacement on an earlier schedule? Bacterial endocarditis, which would attack the prosthetic tissue valve. The most likely thing to cause that? Oral bacteria entering his blood stream and causing an infection in his valve.

He takes massive doses of prophylactic antibiotics before he goes to the dentist. But he’s also one of those guys who had limited dentistry over the last few decades, because he’s self-employed and dental was too expensive in his self-purchased plan. So every time he goes to the dentist, it tends to be for more invasive processes than when I go, because I’ve gone every six months for my whole life, thanks to my insurance.

The cost for his valve replacement? Approximately $500,000 when he had it five years ago.