Dental Visit in United States

United States

Oral health is a vital component of overall health. Oral diseases such as tooth decay, dental caries (cavities) and periodontal (gum) disease are common and can cause pain, tooth loss and oral infection if left undiagnosed or untreated. Poor oral health can also result in additional complications for individuals with chronic conditions such as diabetes. One in 5 adults ages 20-64 in the United States has untreated cavities. 

Cost of care is the most common reason reported for not having visited the dentist within the past year, even among adults with private dental insurance.

According to America’s Health Rankings analysis, populations that have a higher prevalence of annual dental visits include:

• Women compared with men.
• Adults age 65 and older compared with adults ages 18-64.
• White and Asian adults compared with Hispanic, American Indian/Alaska Native, multiracial and Black adults.
• College graduates compared with adults who have less than a high school education.
• Adults with an annual household income of $150,000 or more compared with those who have incomes less than $25,000. The prevalence of having a dental visit significantly increases with each increase in income.
• Adults without a disability compared with adults who have difficulty with self-care.
• Adults living in metropolitan areas compared with adults in nonmetropolitan areas.
• Straight adults compared with lesbian, gay, bisexual and queer (LGBQ+) adults. 
• Adults who have served in the U.S. armed forces compared with adults who have not served. 

Moreover, adults who are uninsured or underinsured are less likely to receive necessary dental care than those with adequate dental insurance.

Some states have passed legislation expanding the role of mid-level dental professionals, such as dental therapists, so more dental professionals can provide routine preventive and restorative treatment typically only performed by dentists. Such expansions of the dental workforce have increased access to cost-effective essential services, particularly among underserved populations.

• Meeting America’s underserved dental health needs means integrating oral health care as an essential part of overall health care and increasing access, largely by decreasing financial barriers to dental care and expanding the dental workforce. Strategies include:
• Supporting dental students of diverse backgrounds, including minority, low-income and rural students.
• Increasing Medicaid reimbursement rates to dental care providers.
• Training dental care providers in cultural sensitivity and providing interpretation services to remove cultural and language barriers. 

School-based cavity prevention programs can also effectively increase dental care access for children. These programs offer multicomponent cavity prevention provided by dental hygienists at schools.

Healthy People 2030 has several oral health objectives, including increasing the proportion of children, adolescents and adults who have used the oral health care system in the past year.

Institute of Medicine and National Research Council of the National Academies, eds. Improving Access to Oral Health Care for Vulnerable and Underserved Populations. Washington, D.C.: National Academies Press, 2011. https://doi.org/10.17226/13116.

Koppelman, Jane, Kelly Vitzthum, and Lisa Simon. “Expanding Where Dental Therapists Can Practice Could Increase Americans’ Access To Cost-Efficient Care.” Health Affairs 35, no. 12 (December 1, 2016): 2200–2206. https://doi.org/10.1377/hlthaff.2016.0844.

Northridge, Mary E., Anjali Kumar, and Raghbir Kaur. “Disparities in Access to Oral Health Care.” Annual Review of Public Health 41, no. 1 (April 2, 2020): 513–35. https://doi.org/10.1146/annurev-publhealth-040119-094318.

Starr, Jacqueline R., Ryan R. Ruff, Joseph Palmisano, J. Max Goodson, Omair M. Bukhari, and Richard Niederman. “Longitudinal Caries Prevalence in a Comprehensive, Multicomponent, School-Based Prevention Program.” The Journal of the American Dental Association 152, no. 3 (March 1, 2021): 224-233.e11. https://doi.org/10.1016/j.adaj.2020.12.005.

Vujicic, Marko, Thomas Buchmueller, and Rachel Klein. “Dental Care Presents The Highest Level Of Financial Barriers, Compared To Other Types Of Health Care Services.” Health Affairs 35, no. 12 (December 2016): 2176–82.https://doi.org/10.1377/hlthaff.2016.0800.