A joint investigation with
Dollars and Dentists Preview(0:30) An investigation of the flaws in our dental care system and the proposals to fix them.

America’s Dental Care Crisis

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More than 100 million Americans don’t go to the dentist because they can’t afford it. Instead, they end up broke, in severe pain and struggling to get by. Sometimes they even die.

Our next film, Dollars and Dentists, a joint investigation by FRONTLINE and the Center for Public Integrity, examines the nation’s ruptured dental-care system, and some solutions to fix it. It airs Tuesday, June 26, and you can watch a preview of the film above.

New research released today from the Kaiser Family Foundation highlights just how dire our dental-care system has become. One in four children have untreated tooth decay, now the most common chronic illness among school-aged children. Adults fare no better. And one in four Medicare beneficiaries are missing all of their natural teeth — a problem that threatens not only among the elderly, but also the very poor. Low-income families and racial and ethnic minorities tend to be disproportionately affected because they tend to lack access to care, according to Kaiser.

Part of the problem is that many people don’t have dental insurance and can’t afford steep out-of-pocket costs for care. Medicare offers no dental coverage unless it’s connected to a medical procedure, Kaiser reports. Poor children are covered by Medicaid, but many dentists’ offices turn them away because the profit margins are so low. In 2009, according to the Kaiser data, 19 million children had no dental insurance — more than twice the number who went without health insurance. Low-income adults receive limited Medicaid benefits for dental care, but even those have been threatened by the economy: 13 states recently said they cut dental benefits for adults in 2011 or planned to do so this year.

With so many people without dental coverage, private companies have sprung up to offer care for those in need. But is it working? In the film, we look at two companies whose practices raised questions.

  • The dental chain Kool Smiles treats children on Medicaid who might not otherwise receive care. But critics say Kool Smiles takes advantage of some of its young patients. The company’s practices are under scrutiny by federal and state authorities.
  • Some chains, such as Aspen Dental, offer credit cards and payment plans to help people finance their procedures if they can’t afford it. But the cards, which are provided in the dentists’ offices, come with hefty financing rates. Aspen says it only offers financing when the care is absolutely necessary, but former employees tell FRONTLINE they were rewarded for getting patients to buy — and finance — as much dental care as possible. “Even if they had insurance, we were still required to push the finance options on them, and still proceed with the paperwork,” former Aspen employee Heather Haynes tells FRONTLINE.

Check your local listings to find out when Dollars and Dentists airs on your local PBS station, or you can watch it online here, starting at 10 p.m. EST on Tuesday, June. 26.

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