Matthew Wall’s medical odyssey has had a happy ending. But many similar stories don’t.

MATTHEW WALL, who lives a few miles from Benco Dental’s home office in Pennsylvania, was diagnosed with an aggressive form of leukemia in 2004. Over the following decade, his chemotherapy treatments slowed the spread of the disease but didn’t stop it. They also weakened his gums and teeth.

When doctors determined that Wall, who is in his thirties, needed a bone- marrow transplant, he was lucky enough to find a donor match. His luck ran out, though, when the doctors decided his teeth needed to be extracted. The transplant would require substantially suppressing his immune system, likely transforming his existing dental problems into a life-threatening systemic infection—and Medicare wouldn’t cover the extractions.

In dentistry, we often say that oral health is integral to overall health. The mouth is the gateway to the body. For the neediest among us who depend on Medicare for health insurance, however, that connection is broken because the federally funded program doesn’t cover dental care, even when a procedure is integral to an overall medical treatment plan.

Dentistry required as part of distinct treatment for a number of other diseases is called medically necessary dental care. Wall’s surgery would cost $4,000, and he and his fiancée faced an untenable choice: take out a loan to complete the needed dental work, or go without the bone-marrow transplant.

Wall’s happy ending came courtesy of Dental Lifeline Network’s Pennsylvania chapter, which identified a local oral surgeon, Dr. Justin Burns, who volunteered to complete the extractions in time for Wall to receive the marrow transplant. Following his recovery from that, another volunteer, Dr. Samuel M. Prisco, donated the fabrication of full upper and lower dentures to restore Wall’s ability to maintain the proper nutrition so vital to his long-term health.

Needless to say, though, we can’t depend on volunteer dentists to treat every patient who requires dental care in order to complete procedures such as immunosuppressive chemotherapy, organ transplants, orthopedic surgery or heart-valve repair. (Donations certainly help, though; see page 22 for a message to that end from Dental Lifeline Network.) It’s past time for Medicare to fix this serious flaw and cover medically necessary dental work.

Three U.S. Senators—Kentucky Republican Rand Paul (an ophthalmologist by trade) and Democrats Debbie Stabenow of Michigan and Benjamin Cardin of Maryland—have teamed up to request that the Center for Medicare and Medicaid Services (CMS) change the reimbursement rules. (You can see a copy of their missive at dentallifeline .org/reimbursementletter.) Please get involved by contacting your own Congressional representatives and asking them to support this change.

Our annual 40 Under 40 honorees represent some of dentistry’s best, brightest and most enthusiastic, and they always inspire us to look for ways to make our profession better. Please reach out with ideas; we’d love to hear from you,