In just under twenty years—or about the time today's pre-dental students start exiting the "new dentist" membership category—the number of adults 65 years and older will outnumber those under 18, according to the U.S. Census Bureau. Fewer than half of adults over 65 have had a dental visit in the last year, with cost cited as the biggest barrier. The impact of these demographic shifts on the health of the public and the dental profession, both now and in the future, may be dramatic.

As a result, several diverse entities are promoting the addition of a dental benefit in Medicare. The coalitions engaged in this effort over the last three years include extremely influential consumer advocacy organizations like Families USA, Justice in Aging, AARP, The Gerontological Society of America, and Oral Health America, which represent a large number of voters and wield considerable influence in Washington D.C. The ADA is faced with the critical choice of either allowing these coalitions to drive the agenda and accepting the outcomes, or participating actively in the process to ensure that the dentist perspective is represented and understood.

ADA governance, with the leadership and participation of the Council on Dental Benefit Programs, the Council on Dental Practice, the Council on Access, Advocacy and Prevention, and the Council on Government Affairs, with input by the Board of Trustees, is studying this trend and the activities of these external organizations, and evaluating the long-term implication to oral health care for seniors. The advocacy groups are now requesting that the ADA have a clear, current policy on financing oral healthcare for seniors that takes into account the best interests of our members and the patients we serve.

We agree.

Currently, ADA's sense of urgency is being driven by the lack of early participation in this coalition, which appeared ready to advocate for a dental benefit design that would not be ideal. Due to ADA's recent involvement, this work has become even more thoughtful, and the coalition now believes that dentists' perspectives on a Medicare dental benefit are essential. There is a need for updated ADA policy regarding a Medicare dental benefit to more fully specify the ADA's advocacy position.

We believe unequivocally that the ADA should be fully engaged with these advocacy groups in a leading role in order to anticipate and influence potential changes ahead—including those to Medicare—if we are to have a voice in the implementation of changes in the future. We are cognizant of the challenges and the opportunities, the risks and the benefits, ahead for the profession as we move down this path. We pledge to share more information in the coming months as the Councils and Board continue their work leading up to the 2018 House of Delegates meeting in October.

In the meantime, you can learn more about how Medicare works, and the case that some organizations are making for a dental benefit in Medicare (New York Times, Oral Health America). Should you have questions, you can email dentalbenefits@ada.org.