Improve Oral Health

Dental Benefits Improve Oral Health

Oral health has improved dramatically in the United States between 1970, when fewer than six million Americans had dental coverage, and today, when more than 161 million Americans are covered. The National Institute of Dental Research (NIDR), in a joint 1992study with the University of Connecticut, reported the number of cavities found in children ages 5 to 17 decreased from seven in the early 1970s to three by 1987. The same study reported significant reductions in tooth loss among working adults, with increased access to preventive services cited as one of the major factors for these improvements, along with wider use of fluorides and better oral hygiene practices.1 These findings echo those of many other studies, including one by the Institute of Medicine, which found that regular dental care has resulted in a dramatic reduction in dental diseases, saving patients an estimated $4 billion a year.2

Total dental expenditures climbed from $2 billion in 1960 to an estimated $61 billion by 2000, according to the U.S. Health Care Financing Administration (HCFA).3 Yet even as utilization of dental services grew over this period, a shift in the kinds of services provided -- from major restorative to more preventive-oriented services -- bears testament to the progress made by the dental profession in controlling oral disease, promoting oral hygiene and encouraging routine, professional dental care. The American Dental Association estimates that periodic oral exams increased by 12.1 percent just since 1979, while the number of metal fillings decreased by 51.7 %, plastic restorations by 5.7 %, and simple extractions by 41.2 %.4

The importance of access to dental care to oral health as provided by dental benefits is further documented in a Rand study, which concluded that Americans in poor oral health are less likely to have used dental services in the past or to have access to them in the future. Conversely, the Rand study showed those in good oral health are more likely to have had previous dental care and good access to future care.5

Having dental coverage is the single greatest factor in determining whether a person sees a dentist, according to statistics compiled by the Nation Health Center for Statistics. The Center's National Health Interview Survey revealed that people with dental benefits coverage are almost twice as likely to visit a dentist in any given year (2.6 vs. 1.7 visits per year), are far more likely to have multiple dental visits in a year (45% vs. 28%), and are more likely to have had a checkup during their last visit rather than require treatment for a specific problem (48% vs. 30%).6

The motivational effect of dental coverage on encouraging utilization of dental services is most evident when looking at the behavior of older Americans and lower income Americans. Covered adults over 75, for instance, average 4.3 dental visits annually, while those without coverage average only 1.4. Similarly, Americans with dental coverage earning under $10,000 annually average 2.9 dental visits a year compared with only 1.2 for those without.

All of these increased dental office visits translate to better oral health for millions of Americans as they gain access to a host of preventive and basic restorative services. Dental expenditures paid for by private insurance programs grew from $10 million in 1960 (10% of all expenditures), to $24 billion in 1997 (50%).7

Despite the tremendous growth in dental coverage and insurer-paid dental expenditures, overall spending on dental services actually declined as a percentage of total healthcare spending, from 7.4% in 1960 to a projected 4.7% in 2000.8 Many researchers attribute this to the success of dental benefits in improving oral health. As more Americans gained access to dental care , a corresponding improvement in oral health greatly limited the number of expensive, more costly procedures performed on Americans.9


  1. HHS News, Public Health Service, National Institutes of Health, July 1992.
  2. Soto, MA, Behrens, R, and Rosemont, C, eds., "Healthy People 2000: National Health Promotion ad Disease Prevention Objectives," Institute of Medicine, Washington, 1987.
  3. Data from Health Care Financing Administration, Office of the Actuary, Office of National Health Statistics Group.
  4. American Dental Association, Bureau of Economic and Behavioral Research. "Survey of Dental Fees," 1990.
  5. Davies AR et al. "Explaining dental utilization behavior." Santa Monica, CA: Rand, publ. no. R3528-NCHSR, Aug. 1987.
  6. Waldman, HB, "Who is Paying for Dental Care?" Compendium of Continuing Education, Vol. 13, No. 7.
  7. Waldman, HB, "Who is Paying for Dental Care?" Compendium of Continuing Education, Vol. 13, No. 7.
  8. Office of National Cost Estimates, Office of the Actuary, Health Care Financing Administration, US Department of Health and Human Services, US Public Health Service.
  9. Levit, KR, Lazenby, HC, Cowan, CA, and Letsch, SW, "National Health Expenditures, 1990," Health Care Financing Review Fall, Fall 1990 Vol. 13, No. 1. 1991 Data from Health Care Financing Administration, Office of the Actuary, based on data from Office of National Health Statistics.
  10. Survey conducted by Market Facts, Inc., conducted Feb. 5-7, 1993 for Delta Dental Plans Association.
  11. Alexander Consulting Group, July 1993 National Survey of Employer Groups
  12. Cooper, H, staff reporter for Wall Street Journal, quoting Frank McArdle, consultant from Hewitt Associates. "Employees' Cherished Dental Plans Will Feel the Bite," WSJ, 9/23/93, page B 11.
  13. Calculations from Delta Dental and HCFA Office of the Actuary data.
  14. Foster & Higgins Annual Benefit Survey, 1989, 1992.