Odds are, your health insurance does not cover dental care. You (or your employer) has to purchase separate dental insurance. If you are a Medicare recipient, you know all too well that Medicare does not cover dental care, and you have been having to buy additional coverage, or forego dental care altogether. ACA plans and Medicare both cover at least basic medical care. But having to pay extra means what? Are teeth luxury items?

Many dentists bill themselves as aesthetic dentists: selling straight teeth and nice, white smiles. But healthy teeth represent more than a person’s vanity. Oral health is linked to overall health. And, in the arena of preventative care, dentists play a significant role. Poor oral health can contribute to conditions like endocarditis (where bacteria from a person’s mouth infects the inner lining of their heart), cardiovascular disease, premature birth or low birth weight (for pregnant mothers with oral health issues), and pneumonia (bacteria from a person’s mouth may be inhaled, causing infection). Dentists are often at the front line in identifying many head and neck cancers. Many oral cancers, starting as painless lesions in the mouth, are detected first by dental hygienists or dentists. And conditions like diabetes, HIV, and osteoporosis manifest early in oral and dental problems. Dental infections can, if untreated, progress to significant infections and even death, in rare occasions. And, missing or painful teeth can cause patients to avoid eating or change their diets for the worse.

Interestingly, it was the American Dental Association that vigorously opposed an inclusion of dental care in the original Medicare program. It was also not included when the Affordable Care Act was passed in 2010. Perhaps our aging population is incentivizing action now? Whether we see any significant expansion of Medicare would come as a surprise to me, given the partisan gridlock in Washington.

One thing we can all probably agree on, though, is that teeth should not be luxury items.