May 24, 2021. By Christopher Lane.

Have you ever had a dream that your teeth were falling out? If so, you’re not alone. In a recent survey, nearly a third of Americans report recurring dreams of losing their teeth. Psychology experts say these dreams relate to personal feelings of insecurity, lack of control, and inadequacy. On the other hand, a healthy smile symbolizes confidence, strength, and hope for the future. So it goes to show that a bad day, a tough week, or a hard year can easily translate to nocturnal delusions of loose, rotten teeth in our heads. Thankfully, most of us wake up from those worrisome dreams to find our pearly whites intact and unchanged. But for many Americans, the nightmare of tooth loss is a daily reality.

Tooth loss (or edentulism, as we say in the dental world) is incredibly common. Current studies estimate that less than half (48%) of adult Americans aged 20-64 have a full set of permanent teeth. And as we age, our risk of tooth loss increases due to wear, tear, oral disease, and poor oral hygiene. By age 65, one in five Americans have lost all of their teeth.

We also know that tooth loss correlates with a variety of socio-economic and health factors. Adults who did not graduate high school are four times more likely to lose their teeth than those who did. Folks with lower incomes have three times greater risk of tooth loss than those with higher incomes. And smokers are four times more likely to lose their teeth than non-smokers. There is a clear pattern here that tooth loss disproportionately affects populations with limited resources and abilities.

As we discuss health policy on a state level, tooth loss is something we need to keep in mind. It is common and it is a devastating disease process. People with tooth loss overwhelmingly report poor professional advancement and job opportunities, limited ability to eat, lower self-esteem, and lower quality of life. These impacts have incalculable negative effects on the general health, nutrition, and well-being of people.  With tooth loss so prevalent among our more vulnerable populations, public health programs must address edentulism.

Currently, NC Medicaid provides coverage for complete and partial dentures for adults. However, it only covers one set of dentures every 10 years. If a denture loses proper fit, becomes damaged or misplaced, low-income citizens have little to no recourse at getting their smile and teeth back until their decade is up. The American Dental Association currently recommends replacing dentures every 5-7 years. By increasing frequency of coverage and replacement to 5 years or less for those with public insurance in North Carolina, we take a small but meaningful step towards improving the lives of those in our state suffering from tooth loss. 

Let’s take this step together and preserve the right to smile for so many deserving citizens of North Carolina!

Christopher Lane is a 2020-21 J. Bradley Wilson Schweitzer Fellow and a UNC Adams School of Dentistry student.