Medicare's exclusion of routine dental coverage causes a measurable 4.8 percentage-point spike in complete tooth loss at age 65

Traditional Medicare (Parts A and B) does not cover routine dental care -- cleanings, fillings, extractions, or dentures -- a gap that has existed since Medicare's creation in 1965. A study of 97,108 U.S. adults (representing 104.8 million people) published in Health Affairs found that complete edentulism (loss of all teeth) increases by 4.8 percentage points precisely at age 65, and the percentage of people receiving restorative dental care drops by 8.7 percentage points at Medicare enrollment. Only 63.7% of adults 65 and older had any dental visit in the past 12 months as of 2022. Why it matters: Seniors transitioning from employer-sponsored insurance to Medicare abruptly lose dental coverage, so many stop seeking preventive and restorative dental care due to cost, so existing dental conditions deteriorate rapidly without maintenance, so approximately 1 in 20 older adults experience new complete tooth loss during the transition period, so tooth loss impairs nutrition, speech, social engagement, and is associated with cognitive decline and increased risk of cardiovascular disease, so Medicare then pays far more for the downstream medical consequences of poor oral health than dental prevention would have cost. The structural root cause is that when Medicare was enacted in 1965, dental and medical care were considered separate domains, and Congress explicitly excluded dental coverage to control costs -- and despite multiple legislative attempts (including the Build Back Better Act in 2021), adding comprehensive dental benefits to Medicare has failed because the Congressional Budget Office scores it at $238 billion over 10 years, making it a persistent target for deficit hawks.