The Cost of Delay: State Dental Policies Fail One in Five Children

Feb 23, 2010

An estimated one in five children go without dental care each year. States play a key role in ensuring that low-income children have access to basic, preventive dental care. A new report, The Cost of Delay: State Dental Policies Fail One in Five Children, (Adobe PDF) finds that two-thirds of states are doing a poor job. The report was produced by the Pew Center on the States with support from the W.K. Kellogg Foundation and the DentaQuest Foundation.

Pew assessed and graded states and the District of Columbia on eight proven policy solutions that ensure dental health and access to care. A 50-state report card shows that just six states earned an “A” and that 36 states received a “C” or lower.

Download the report (PDF) or view the state fact sheets.  

Read a Q&A with Shelly Gehshan, director of the campaign, where she discusses the crisis in children’s dental health and policy solutions within states’ reach.

Learn more about the eight policy benchmarks. 

Solutions Within States’ Reach    

Unlike so many of America’s other health care dilemmas, the challenge of ensuring disadvantaged children’s dental health and access to care is one that can be overcome. Americans are expected to spend $106 billion on dental care in 2010, which includes restorative treatments like fillings and root canals.  These expensive treatments could have been mitigated or avoided altogether with earlier, easier and less costly ways of ensuring adequate dental care when they were children.

Policy makers have a variety of solutions that can be achieved at relatively little cost and with a significant return on investment for children and taxpayers.

Four approaches stand out:

  • • school-based sealant programs and
  • • community water fluoridation, both of which are cost-effective ways to help prevent problems from occurring in the first place;
  • • Medicaid improvements that enable and motivate more dentists to treat low-income kids; and
  • • innovative workforce models that expand the number of qualified dental providers, including medical personnel, hygienists and new primary care dental professionals, who can provide care when dentists are unavailable.

Learn more about how these four approaches are being implemented by states. 

Capitol Hill Briefing on State Dental Policies

Pew hosted a briefing on February 23 to review findings from the report and showcase promising federal, state and local efforts to improve children’s dental health.View video highlights of the event below:


Shelly Gehshan, director of the Pew Children’s Dental Campaign, highlights the grades states received in Pew’s analysis and the results of model programs and policies featured in the report. (WMV, 31 MB)




Maryland Congressman Elijah Cummings reacts to Pew’s report and calls for greater federal leadership to help ensure that all children receive quality dental care. (WMV, 28 MB)




Sara Rich, with Maryland’s Choptank Community Health System, shares a story illustrating the obstacles many children and families face when seeking dental care and the role of community-based programs in reducing these barriers. (WMV, 32 MB)




Cindy Mann, director of the Center for Medicaid and State Operations, discusses her agency’s goals and plans to help low-income children with Medicaid insurance get the dental care they deserve. (WMV, 21 MB)



Media Inquiries

If you are with the media and would like additional information on The Cost of Delay: State Dental Policies Fail One in Five Children, contact Matt Jacob at 202.540.6310.

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