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Keep Boomers Smiling (With Their Own Teeth)

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Boomers should expect more from their teeth.

Financial services professionals who work with baby boomers ought to make sure that boomer clients get a chance to chew on that message, according to John Foley, vice president of group dental insurance at Guardian Life Insurance Company of America, New York.

Many affluent boomers already understand the importance of oral health and act on that knowledge, but “we’re looking to come up with messages that we can use to educate brokers,” Foley says.

When researchers at Guardian commissioned a survey of 1,000 U.S. consumers ages 18 and older in September 2006, they found that only 48% of the participants in the 45-54 age group, who were all boomers, said they expect to have most or all of their own teeth at age 80. Only 42% of the participants in the 35-44 age group, which included many younger boomers, said they thought they would have most of their teeth at age 80.

The researchers who conducted a National Health Interview Survey found in 2004, the latest year for which detailed statistics are available, that about 21% of the participants in the 65-74 age group and about 31% of participants ages 75 and up were “edentulous,” or “missing all natural teeth.”

But improvements in dental care, nutrition and overall medical care already are starting to reduce the ranks of the edentulous.

The percentage of U.S. adults ages 65 and older who are without natural teeth has fallen to about 28% in 2003, from 46% in the early 1970s, according to Health, United States, 2006, a report published by the National Center for Health Statistics.

Although low-income, uninsured adults are more likely than other adults to lack teeth, about 21% of adults who were “not poor” were edentulous in 2003, according to an NCHS report on the health of older adults published in April 2006.

In 1999, a more detailed “behavioral risk” report found that 7.7% of the adults in the 65-74 age group with annual incomes over $50,000 had no teeth, and 13% of the adults in that age group with annual incomes of $35,000 to $49,999 had no teeth.

For now, “there’s no causal proof” that improving dental health improves overall physical health, Foley says.

Many of the studies that seem to show that improvements in dental health correlate with improvements in conditions such as diabetes focus on groups of patients who start with lower incomes and less access to dental care than the typical financial professional’s boomer client.

But Guardian researchers found that 89% of the participants in the dental coverage survey agreed that there is a connection between oral health and overall health.

A University of Maryland study published in the January 2003 Journal of the American Dietetic Association concludes that adults with full dentures or other forms of dental impairment are far less likely than other adults to get enough Vitamin C, Vitamin A and folic acid, and far more likely to eat too much salt and cholesterol.

A Swedish study published in the July 2006 Journal of Periodontology suggests that the number of teeth that a patient has lost correlates with the likelihood that a patient will suffer a heart attack.

A University of North Carolina study published in the first 2007 issue of Blood Purification reports that elevated levels of antibodies to gum disease bacteria are associated with decreased levels of kidney function.

This year, experts say, dental health is becoming a bit of a hot topic, due in part to the evidence that modest efforts to improve dental health can lead to big improvements in overall health and growing awareness of the gaps in dental insurance menus for older Americans.

Boomers who do not get dental insurance through their employers can buy individual coverage from a variety of carriers in most states, but they may find that offerings are more limited four years from now, when they start turning 65.

AARP, Washington, for example, offers an insured dental insurance program administered by Delta Dental Insurance Company, San Francisco; and Security Life Insurance Company of America, Minnetonka, Minn., sells a vigorously promoted dental insurance program for adults over age 65.

But dental insurance for older adults continues to be a niche product, and federal officials have estimated that only about 25% of U.S. residents over age 65 have private dental coverage.

The cost of removing all of a patient’s teeth and replacing the teeth with dentures is relatively low, while the major work needed to save many problem teeth can cost tens of thousands of dollars.

A unit of Capital One Financial Corp., McLean, Va., a bank holding company with a large consumer finance unit, notes, for example, that it can provide up to $25,000 in financing per patient, and that it assumes that some borrowers will pay for procedures with a combination of Capital One financing and other resources.

Although dental plans can offer steep discounts off of the retail price of care, they may cover just $1,000 to $3,000 of the “repriced” bill, experts warn.

Seniors and others who need extensive work may have to rely on loans, rather than insurance, and even moderately affluent seniors may find that financial considerations push them toward accepting dentures.

But, in many cases, financial advisors who make any effort to talk to boomer clients about post-retirement health planning focus on the cost of long term care and filling gaps in Medicare, and they may leave dental care out of the conversation entirely, Foley says.

In the future, he adds, dental “has to be part of the equation.”