America’s Oral Health

Twice as many Americans like dental coverage compared to medical coverage highlighting a neglected aspect of our health care system.

Fisher-Owens, et al. describe the state of dental care in the United States. Dental care represents a mere 7.5% of all health care expenditures. A startling figure is that although more than 47 million Americans lack health insurance; 108 million (about one in three) Americans lack dental insurance. Another interesting finding is that nearly one –third of all Americans have no access to fluorinated drinking water, one of public health’s greatest achievements in dental care.

As with many other conditions, disparities exist for the poor, the less educated, and racial or ethnic minorities. Exacerbating these disparities are relative shortages in the dental health care workforce such as limited availability of dental practices in typically underserved communities. Also complicating the picture is a lack of diversity in the dental workforce (only 13% of the workforce is from a minority background, less than half the percentage for the general population).

Possible solutions to America’s dental health problems offered by the authors include, federally mandating fluoridation in all American communities, expanding resources to train dental providers who will practice in underserved communities, and mandating coverage for the elderly and children in federal programs such as Medicare, Medicaid, and SCHIP.

Commentary:

Dental care in the United States is often overlooked but certainly important to the overall health of the nation. Solutions common to all health care reform, expanding access and training providers likely to practice in underserved areas are keys to improving the dental health of the nation.

Health Affairs, 27, no. 2 (2008): 404-412.

by

Cedric K. Dark, MD, MPH