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By Dr. Kari Sakurai
Dentist
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America’s healthcare system is failing patients by treating oral health as separate from whole-body health.
Dentists and physicians must coordinate care, schools must prioritize prevention, and patients must demand accountability before preventable conditions become painful, expensive emergencies, or worse.
This is not a dental issue. It is a public health failure that costs Americans their health, working hours, and money.
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The science reinforces the urgency. The American Heart Association examined growing evidence linking periodontal disease with cardiovascular disease, including heart attack and stroke.
Researchers have not established that gum disease directly causes these conditions or that treating it prevents cardiovascular events. But uncertainty does not justify indifference.
Oral disease already causes infections, pain, difficulty eating, and lost school and work time. Why does our healthcare system continue treating the mouth as somebody else’s responsibility?
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The answer lies in a system designed around professional and financial divisions rather than patients as whole people.
Medical and dental schools largely educate students separately. Insurance systems divide coverage, while reimbursement rules can restrict access to preventive care.
Many dentists enter private practice without hospital-based training or established relationships with physicians.
Consequently, critical information gets lost between specialties, leaving patients to connect the dots themselves.
The consequences can be serious. For instance, as the ADA notes, certain osteoporosis medications are associated with medication-related osteonecrosis of the jaw, a potentially debilitating condition involving jawbone damage.
Other medications can affect decisions about dental anesthesia. A dentist lacking a patient’s medical history may miss an important risk; a physician unaware of an oral infection may overlook a relevant part of the patient’s condition.
Coordinated care should be standard practice, not a lucky exception.
Prevention is an Investment
The damage also reaches classrooms, workplaces, and household budgets. According to the Centers for Disease Control and Prevention, emergency dental care accounts for an estimated 34 million lost school hours annually, while untreated dental disease is associated with more than $45 billion in lost U.S. productivity, measured in 2015 dollars.
Behind those figures are children missing lessons, parents missing work obligations, and families facing bills that prevention might have reduced.
Women often bear a disproportionate share of this burden because they continue shouldering much of the responsibility for emergency childcare.
A child’s preventable dental crisis can mean lost wages, disrupted schedules, and another setback in a mother’s career.
Neglecting school-based oral health education does not eliminate these costs. It transfers them to families and employers, perpetuating avoidable suffering.
Prevention in schools is not an optional extra. It is an investment in children’s health, parents’ livelihoods, and the wider economy.
Action Now
We can choose a different future. Imagine a healthcare system in which dentists and physicians securely share relevant patient information, medication decisions account for oral health, and schools teach children that caring for their teeth is as routine as washing their hands.
Prevention would become a shared priority, reducing avoidable emergencies and allowing families to spend less time managing crises and more time living their lives.
Achieving that future requires action now, not another generation of promises. Medical and dental schools should integrate training, but existing practitioners also need cross-specialty education and professional networks.
Insurers and healthcare systems must reward prevention and coordination instead of treating them as administrative inconveniences. Schools must protect oral health education rather than sacrifice it when budgets tighten.
Patients have leverage, too. Tell every provider which medications you take. Ask whether a medical condition could change your dental treatment.
Stop Drawing Boundaries
When risks overlap, insist that your dentist and physician communicate directly. Parents should demand preventive education in schools, and consumers should favor providers who coordinate care.
These requests are not unreasonable demands for special treatment; they are basic expectations of a system entrusted with people’s health.
We need an understandable owner’s manual for the human body, empowering people to recognize risks and ask informed questions.
Technology can help clinicians share information, but patients must demand a culture in which collaboration is expected.
We cannot keep paying for fragmented care while pretending its consequences are inevitable. If healthcare is serious about protecting lives, it must stop drawing boundaries around the body and start treating the whole person.
Dr. Kari L. Sakurai is a California dentist and former president of the Academy for Excellence in Dentistry. All opinions are her own.
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