Socioeconomic Determinants of Oral Health

Since posting my initial research plan in the spring, further reading has convinced me to slightly adjust my topic. While I was originally set out to uncover the reasons why some people feel uncomfortable at the dentist, I stumbled upon a much larger and perhaps more obvious problem: it’s not that most individuals don’t want to go to the dentist, it’s that many of them cannot go to the dentist. According to a recent study of the National Health Interview Survey, the main cause for adults to avoid the dentist is cost: over 40% of the surveyed population could not afford treatment or had no insurance, whereas only 10% of adults cited fear as the reason they had no recent dental visit. Certain populations within the United States are facing a serious disparity in accessibility to quality oral healthcare; many individuals either lack dental insurance and cannot afford it or don’t have access to a health center offering affordable services.

Yet by forgoing primary dental care, patients are increasing the likelihood of developing more serious dental conditions that cause more pain, more disruption of daily activities, and are more costly to treat. Therefore, it is in the best interest of everyone to see a dentist sooner, rather than later. The million-dollar question, however, is how can we ensure that everyone is able to regularly see a general dentist for the necessary primary care and preventative treatments? With cost being the main obstacle to many in receiving oral healthcare, the next thing I looked into was dental insurance. According to the most recent Medical Expenditure Panel Survey (MEPS), 59% of Americans have private insurance, 29% have public insurance, and 12% are uninsured. Uninsured patients are likely to be facing a huge barrier in paying fees for service out of pocket, but even Medicaid-insured patients may face similar difficulties. A majority of American dental offices do not accept Medicaid plans for payment, so while an individual may have a public insurance plan, it may be difficult to even use it. Further data from the MEPS shows that adults with public health insurance are about 20% less likely to have a dental visit when compared to adults with private health insurance.

In this next week of my research I would like to explore some of the proposed solutions to this disparity in access to oral healthcare. Some of my sources have suggested increasing preventative procedures in public schools, expanding the dental workforce, and adjusting Medicaid policies. I plan to further investigate these methods as well as others, and find out if any have worked in the past. I would also like to use some more data specific to New Jersey to see how this problem ties into my home state.