Mertz once referred to the snaggletoothed, gap-filled oral health care system \u2014 which isn\u2019t really a system at all \u2014 as \u201ca mess.\u201d<\/p>\n
But let me get back to my toothache, while I reach for some painkiller. It had been bothering me for a couple of weeks, so I went to see my dentist, hoping for the best and preparing for the worst, having had two extractions in less than two years.<\/p>\n
Let\u2019s make it a trifecta.<\/p>\n
My dentist said a molar needed to be yanked because of a cellular breakdown called resorption, and a periodontist in his office recommended a bone graft and probably an implant. The whole process would take several months and cost roughly the price of a swell vacation.<\/p>\n
I\u2019m lucky to have a great dentist and dental coverage through my employer, but as anyone with a private plan knows, dental insurance can barely be called insurance. It\u2019s fine for cleanings and basic preventive routines. But for more complicated and expensive procedures \u2014 which multiply as you age \u2014 you can be on the hook for half the cost, if you\u2019re covered at all, with annual payout caps in the $1,500 range.<\/p>\n
\u201cThe No. 1 reason for delayed dental care,\u201d said Mertz, \u201cis out-of-pocket costs.\u201d<\/p>\n
So I wondered if cost-wise, it would be better to dump my medical and dental coverage and switch to a Medicare plan that costs extra \u2014 Medicare Advantage \u2014 but includes dental care options. Almost in unison, my two dentists advised against that because Medicare supplemental plans can be so limited.<\/p>\n
Sorting it all out can be confusing and time-consuming, and nobody warns you in advance that aging itself is a job, the benefits are lousy, and the specialty care you\u2019ll need most \u2014 dental, vision, hearing and long-term care \u2014 are not covered in the basic package. It\u2019s as if Medicare was designed by pranksters, and we\u2019re paying the price now as the percentage of the 65-and-up population explodes.<\/a><\/p>\n So what are people supposed to do as they get older and their teeth get looser?<\/p>\n A retired friend told me that she and her husband don\u2019t have dental insurance because it costs too much and covers too little, and it turns out they\u2019re not alone. By some estimates,<\/a> half of U.S. residents 65 and older have no dental insurance.<\/p>\n That\u2019s actually not a bad option, said Mertz, given the cost of insurance premiums and co-pays, along with the caps. And even if you\u2019ve got insurance, a lot of dentists don\u2019t accept it because the reimbursements have stagnated as their costs have spiked.<\/p>\n But without insurance, a lot of people simply don\u2019t go to the dentist until they have to, and that can be dangerous.<\/p>\n \u201cDental problems are very clearly associated with diabetes,\u201d as well as heart problems and other health issues, said Paul Glassman,<\/a> associate dean of the California Northstate University dentistry school.<\/p>\n There is one other option, and Mertz referred to it as dental tourism, saying that Mexico and Costa Rica are popular destinations for U.S. residents.<\/p>\n \u201cYou can get a week\u2019s vacation and dental work and still come out ahead of what you\u2019d be paying in the U.S.,\u201d she said.<\/p>\n Tijuana dentist Dr. Oscar Ceballos<\/a> told me that roughly 80% of his patients are from north of the border, and come from as far away as Florida, Wisconsin and Alaska. He has patients in their 80s and 90s who have been returning for years because in the U.S. their insurance was expensive, the coverage was limited and out-of-pocket expenses were unaffordable.<\/p>\n \u201cFor example, a dental implant in California is around $3,000-$5,000,\u201d Ceballos said. At his office, depending on the specifics, the same service \u201cis like $1,500 to $2,500.\u201d The cost is lower because personnel, office rent and other overhead costs are cheaper than in the U.S., Ceballos said.<\/p>\n As we spoke by phone, Ceballos peeked into his waiting room and said three patients were from the U.S. He handed his cellphone to one of them, San Diegan John Lane, who said he\u2019s been going south of the border for nine years.<\/p>\n \u201cThe primary reason is the quality of the care,\u201d said Lane, who told me he refers to himself as 39, \u201cwith almost 40 years of additional\u201d time on the clock. <\/p>\n Ceballos is \u201cconscientious and he has facilities that are as clean and sterile and as medically up to date as anything you\u2019d find in the U.S.,\u201d said Lane, who had driven his wife down from San Diego for a new crown.<\/p>\n \u201cThe cost is 50% less than what it would be in the U.S.,\u201d said Lane, and sometimes the savings is even greater than that.<\/p>\n Come this summer, Lane may be seeing even more Californians in Ceballos\u2019 waiting room.<\/p>\n \u201cProposed funding cuts to the Medi-Cal Dental program<\/a> would have devastating impacts on our state\u2019s most vulnerable residents,\u201d said dentist Robert Hanlon, president of the California Dental Assn.<\/p>\n Dental student Somkene Okwuego smiles after completing her work on patient Jimmy Stewart, 83, who receives affordable dental work at the Ostrow School of Dentistry of USC on the USC campus in Los Angeles on February 26, 2026. <\/p>\n (Genaro Molina \/ Los Angeles Times)<\/p>\n Under Proposition 56\u2019s tobacco tax in 2016, supplemental reimbursements to dentists have been in place, but those increases could be wiped out under a budget-cutting proposal. Only about 40% of the state\u2019s dentists accept Medi-Cal payments as it is, and Hanlon told me a CDA survey indicates that half would stop accepting Medi-Cal patients and many others will accept fewer patients.<\/p>\n \u201cIt\u2019s appalling that when the cost of providing healthcare is at an all-time high, the state is considering cutting program funding back to 1990s levels,\u201d Hanlon said. \u201cThese cuts \u2026 will force patients to forgo or delay basic dental care, driving completely preventable emergencies into already overcrowded emergency departments.\u201d<\/p>\n![\"Dental](\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/02\/1772288408_868_.jpeg\")
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