Dental coverage, access & outcomes

Explore ADA Health Policy Institute findings on dental coverage, access and barriers to care and oral health outcomes.
Medicaid participation among dentists

Latest data on Medicaid reimbursement for adult and child services by state.

Medicaid reimbursement child adult dental services by state map infographic

Top publications

Explore dentist Medicaid participation and volume of patients by state.
How do privately and publicly insured patients compare in terms of dental procedures received?
See estimated cost of introducing an adult Medicaid dental benefit in all states that do not have one.

More research and insights

State fact sheets
Journal articles

FAQs about dental coverage, access and outcomes

What share of U.S. children and adults have dental benefits?
Dental benefits coverage varies by age. For children ages 2-18, 51.3 percent have private dental benefits, 38.5 percent have dental benefits through Medicaid or the Children’s Health Insurance Program (CHIP), and 10.3 percent do not have dental benefits. For adults ages 19-64, 59.0 percent have private dental benefits, 7.4 percent have dental benefits through Medicaid, and 33.6 percent do not have dental benefits.

Source: Dental Benefits Coverage in the U.S.  (PDF) (HPI Infographic).
Does my state’s Medicaid program cover dental services for adult enrollees?

Thirty-eight states and the District of Columbia provide at least limited dental benefits for adults.

SourceMaking the Case for Dental Coverage for Adults in All State Medicaid Programs (PDF) (HPI White Paper).

How many dentists accept Medicaid?
Dentist participation in Medicaid varies by state. There are many ways to measure dentist participation in Medicaid, such as by enrollment in the program or by volume of patients.

Source: Dentist Participation in Medicaid: How Should It Be Measured? Does It Matter? (PDF) (HPI Research Brief).
How does dental care utilization among Medicaid enrollees compare to dental care utilization among commercially insured individuals?

Children generally have higher dental utilization than adults. Individuals who have dental coverage, whether public of private, are more likely to visit the dentist than those who do not have coverage. However, the types of dental procedures obtained vary by patient benefit type and age group. 

The types of services that children covered by Medicaid received are comparable to the services received by privately insured children. Among adults, those with Medicaid benefits had higher shares of more invasive services, such as oral surgery procedures, while privately insured adults had higher shares of preventive services.

SourceComparative analysis of dental procedure mix in public and private dental benefits programs (JADA).

Dental Care Utilization in the U.S. (PDF) (HPI Infographic).

How many Medicaid patients have access to Medicaid dentists?

The Health Policy Institute has developed a tool for measuring access to dental care using geo-analytics for each state and the District of Columbia. Results report the percentage of publicly insured children living within a 15-minute travel time to at least one Medicaid/CHIP dentist per 2,000 publicly insured children as well as the percentage of overall population living within a 15-minute travel time to at least one dentist per 5,000 population. Data are as of 2015.

Source: Geographic Access to Dental Care (HPI State Fact Sheets).

Does dental care utilization vary by race and ethnicity?

Yes, there are racial disparities in dental care use. In general, White children, adults, and seniors have higher dental care use than Black and Hispanic children, adults and seniors. For all age groups, Hispanics and Blacks are most likely to face cost barriers to dental care.

Source: Cost Barriers to Dental Care Among the U.S. Population, by Race and Ethnicity (PDF) (HPI Infographic).
How many people have untreated caries in the United States?

Between 2011-2014, an estimated 18.2% of children ages 5-18 had untreated caries while 26.5% of adults ages 19-64 and 16.7% of seniors over age 65 had untreated caries. Results vary by income level and race/ethnicity.

Sources: Untreated Caries Rates Falling Among Low-Income Children (PDF) (HPI Infographic).
Racial Disparities in Untreated Caries Narrowing for Children (PDF) (HPI Infographic).

How many people have untreated gum disease in the United States?

An estimated 42% of adults over age 30 suffered from untreated periodontal disease between 2009-2014. Results vary by gender, education level, income, and other factors.

Source: Periodontitis in US Adults (JADA).