Dental coverage, access & outcomes

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).

Dental coverage for adults enrolled in Medicaid varies drastically from state to state. The Medicaid Adult Dental Coverage Checker identifies where each state’s Medicaid adult dental benefits package falls on a continuum from "no dental benefits" to "extensive benefits".

Source: Medicaid Adult Dental Coverage Checker (CareQuest Institute for Oral Health).

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).

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.

Source: Comparative Analysis of Dental Procedure Mix in Public and Private Dental Benefits Programs (JADA).

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).

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).

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: Disparities in Untreated Caries Among Children and Adults (BMC Oral Health).

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).