FAQs
HEAD & NECK CANCER:
Teeth Not Included
By Dwight David Johnson
GENERAL QUESTIONS
Q: What is this booklet about?
A: This is a survivor’s journey through cancer treatment—and the dental destruction left behind. It exposes how Medicare, cancer centers, and treatment protocols routinely ignore oral injury, even when it’s foreseeable and billable. The mouth isn’t included. This booklet demands it should be.
Q: Is this a memoir or a policy guide?
A: Both. It’s a lived case file wrapped in system critique. Johnson merges personal experience with documented evidence to spotlight a neglected crisis in survivorship care.
Q: Who should read this?
A: Survivors, caregivers, oral health professionals, oncology providers, hospital administrators, Medicare contractors, and anyone who believes a patient’s mouth shouldn’t be excluded from their care plan.
MEDICARE & POLICY
Q: What is CMS Transmittal 13029?
A: It’s a 2023 Medicare policy update that expands dental coverage for patients whose oral injury is medically linked—like cancer survivors who need dental care due to radiation or chemo damage. It allows for coverage of root canals, crowns, and more when medically necessary.
Q: Why don’t hospitals or dentists know about this?
A: Because they haven’t been told. Medicare didn’t launch an awareness campaign. Most billing departments and providers are unaware the coverage exists—despite it being active and public.
Q: How can I get Medicare to pay for my post-treatment dental work?
A: The booklet outlines a billing strategy using ICD/CPT codes and HBOT precedents. Success requires documentation of medical necessity, coordination between oncology and dentistry, and providers willing to file under medical—not dental—coverage.
DENTAL & ONCOLOGY QUESTIONS
Q: Why does radiation therapy damage the teeth and jaw?
A: Head and neck radiation affects salivary glands, blood supply, and bone vitality—creating long-term risk for decay, infection, and jaw collapse. Chemo adds compounding effects.
Q: Why wasn’t I warned this could happen?
A: Many cancer centers lack integrated oral care. Dentists are excluded from treatment teams. Patients are told to “see a dentist” but receive no surveillance, referrals, or support.
Q: Why didn’t my dental insurance help?
A: Most dental insurance plans cap coverage between $1,000–$2,000/year. That doesn’t touch the real cost of injury from cancer care. This is why Medicare’s policy shift is so vital—it opens a pathway for full restorative coverage under medical necessity.
BOOK STRUCTURE & USE
Q: Is this book clinical? Political? Personal?
A: It’s all three. Clinical neglect, personal injury, and systemic silence are interwoven throughout. The goal is not blame—but change.
Q: What’s in the appendices?
A: Three appendices cover:
A summary of the Medicare policy (with codes)
Johnson’s personal timeline and care gaps
A historical overview of how dentistry was structurally excluded from medicine
Q: What if I want to share this with my provider?
A: You can. A printable summary of the Medicare policy and a provider-facing briefing guide are in development. Join the mailing list to receive updates.
SYSTEMIC QUESTIONS
Q: How do we get hospitals to act?
A: The final chapter proposes 10 bold reforms—from EHR integration to oral oncology hiring mandates. These are implementable, financially viable, and overdue.
Q: Is this just about teeth?
A: No. It’s about dignity, survivorship, and systemic accountability. “Teeth Not Included” is the symptom. The root issue is fragmentation in care.
Q: What comes next?
A: More booklets are planned, covering other ignored injuries: brain damage, thyroid loss, fatigue syndromes. The model is the same: reveal the harm, track the silence, follow the billing.