Dental Health in the United States

The American dental care delivery system leaves millions of people struggling to find care, especially residents of rural areas, people of color, those with disabilities, low-income families, and the uninsured. Left untreated, dental health issues can cause pain and tooth loss, impair children’s growth and social development, impede productivity and job opportunities, and complicate chronic conditions. And when dental pain becomes too severe to ignore, many people—more than 2 million in 2012—resort to emergency room visits, which provide no treatment for underlying oral health problems but are costly for patients and taxpayers: $1.6 billion in 2012, with Medicaid’s share totaling $520 million.

Problems With Dental Care Access

One of the greatest issues affecting Americans’ access to dental care is the shortage of providers available to offer preventive and routine restorative care. More than 48 million people in the United States live in areas with dentist shortages. Access to care is also limited for the 72 million children and adults who rely on Medicaid and the Children’s Health Insurance Program: Only about one-third of U.S. dentists accept public insurance.

What Can Be Done?

Pew’s dental campaign works to close gaps in dental care access by increasing the number of available providers through the addition of midlevel practitioners such as dental therapists and expansion of school-based sealant programs to reach low-income children, who are at the greatest risk for dental decay.

Dental therapy: Dental therapists are midlevel providers, similar to physician assistants in medicine, who help to extend care to more patients, expand dental practices, and provide treatment to underserved populations in community settings such as schools or nursing homes, under the supervision of a dentist. Dental therapists provide preventive and routine restorative services, including filling cavities, placing temporary crowns, and extracting severely diseased or loose teeth.

Dental sealant programs: Sealants—plastic coatings that are placed over the chewing surfaces of teeth to protect them from cavities—are among the most effective interventions for preventing tooth decay.  School sealant programs are an optimal, research-based way to deliver sealants to children who might not have regular access to dental care.