Consensus Statements

Position Statement of The Santa Fe Group on Oral-Systemic Health

After decades of research and thousands of scientific papers, the relationships between oral health, especially periodontal health, and systemic health are well known. Moreover, during the past ten years, data analysis by health economists, and public statements and actions by several large, private dental insurers have identified additional benefits of oral health by revealing that insured individuals who receive treatment for periodontal disease show fewer hospitalizations and reduced cost of care for a number of systemic diseases including diabetes, cardiovascular disease, and stroke.

Therefore, the Santa Fe Group has concluded that sufficient evidence now exists that periodontal disease is a contributory cause to certain systemic diseases, and the public should benefit from this knowledge. Therefore, Medicare, Medicaid, and other public and private health insurance programs should incorporate oral health benefits as a component of comprehensive health insurance. These health benefits will not only improve oral health for its own sake, including speech, mastication and social acceptance, but will also produce substantial economic benefits and total health improvement for the public.

Community Statement on Medicare Coverage for Medically Necessary Oral and Dental Health Therapies

The undersigned organizations are proud to join in support of Medicare coverage for medically-necessary oral/dental health therapies.

It is well established that chronic diseases disproportionately impact Medicare beneficiaries and impose a substantial cost on the federal government.  It is also well established that untreated oral microbial infections are closely linked to a wide range of costly chronic conditions, including diabetes, heart disease, dementia, and stroke.  In addition, oral diseases have been documented by researchers and medical specialty societies as precluding, delaying, and even jeopardizing medical treatments such as organ and stem cell transplantation, heart valve repair or replacement, cancer chemotherapies, placement of orthopedic prostheses, and management of autoimmune diseases.

Despite these factors, most Medicare beneficiaries do not currently receive oral/dental care even when medically necessary for the treatment of Medicare-covered diseases. In fact, Medicare coverage extends to the treatment of all microbial infections except for those relating to the teeth and periodontium. There is simply no medical justification for this exclusion, especially in light of the broad agreement among medical specialists that such care is integral to the medical management of numerous diseases and medical conditions. Moreover, the lack of medically necessary oral/dental care heightens the risk of costly medical complications, increasing the financial burden on Medicare, beneficiaries, and taxpayers.

Some Medicare Advantage (MA) plans are providing coverage of medically necessary periodontal treatment to targeted enrollees with diabetes, heart disease or stroke. This is an important step forward, and medically necessary oral/dental healthcare including periodontal treatment should be provided in traditional Medicare as well. According to some reports, such plans have realized important benefits from oral/dental health coverage, including markedly lower hospitalization and emergency department admission rates as well as substantial cost reductions.

The Medicare program and all its beneficiaries should not be without the vital clinical and fiscal benefits of coverage for medically necessary oral/dental health therapies. Given the significant potential to improve health outcomes and reduce program costs, we urge Congress and the Administration to explore options, including utilization of existing authority, for extending such evidence-based coverage for all Medicare beneficiaries.

  • AARP
  • Acuity Specialists
  • American Academy of Maxillofacial Prosthetics
  • American Academy of Periodontology
  • American Association for Dental Research
  • American Association of Clinical Endocrinologists
  • American Association of Hip and Knee Surgeons
  • American Association of Kidney Patients
  • American Autoimmune Related Diseases
  • American College of Cardiology
  • American College of Emergency Physicians
  • American College of Gastroenterology
  • American College of Physicians
  • American College of Prosthodontists
  • American College of Rheumatology
  • American Dental Association
  • American Dental Education Association
  • American Dental Hygienists’ Association
  • American Diabetes Association
  • American Head and Neck Society
  • American Kidney Fund
  • American Liver Foundation
  • American Nurses Association
  • American Parkinson Disease Association
  • American Psychiatric Association
  • American Public Health Association
  • American Society for Radiation Oncology
  • American Society of Clinical Oncology
  • American Society of Nephrology
  • American Society of Transplant Surgeons
  • American Society of Transplantation
  • American Thoracic Society
  • Arthritis Foundation
  • Association of Dental Support Organizations
  • Association of State and Territorial Dental Directors
  • California Dental Association
  • Catholic Health Association of the United States
  • Center for Medicare Advocacy
  • Children’s Dental Health Project
  • Crohn’s and Colitis Foundation of America
  • Dental Lifeline Network
  • Dental Trade Alliance
  • Eating Disorders Coalition
  • Epilepsy Foundation
  • Families USA
  • Head and Neck Cancer Alliance
  • John A. Hartford Foundation
  • Justice in Aging
  • Leukemia and Lymphoma Society
  • Lupus Foundation of America
  • Medicare Rights Center
  • Mental Health America
  • National Alliance on Mental Illness
  • National Association of Area Agencies on Aging
  • National Association of Community Health Centers
  • National Association of Dental Plans
  • National Association of States United for Aging and Disabilities
  • National Committee to Preserve Social Security and Medicare
  • National Council for Behavioral Health
  • National Kidney Foundation
  • National Multiple Sclerosis Society
  • National Network for Oral Health Access
  • National Osteoporosis Foundation
  • National Rural Health Association
  • National Stroke Association
  • Oral Health America
  • Pacific Dental Services Foundation
  • Parkinson’s Foundation
  • PEW Dental Campaign
  • Renal Physicians Association
  • Santa Fe Group
  • School-Based Health Alliance
  • Society for Transplant Social Workers
  • Support for Persons with Oral, Head, and Neck Cancer
  • The Gerontological Society of America
  • The Michael J. Fox Foundation
  • The Society for Thoracic Surgeons