Survey: Cost keeps Americans from visiting dentists

Three-quarters of American adults say they have good or very good oral health.

The news is not so good for the other 25 percent, according to newly released statistics from the Centers for Disease Control and Prevention.

Mary OttoMary Otto, AHCJ’s topic leader on oral health, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care. If you have questions or suggestions for future resources on the topic, please send them to

Seventeen percent report their oral health is only fair and 7 percent say they have poor oral health. The findings, contained in a new report, were gathered as part of the 2008 annual National Health Interview Survey, based upon face-to-face interviews with more than 17,000 men and women aged 18 to 64.

According to the survey findings, adults with Medicaid (21 percent) were almost twice as likely as adults overall (12 percent) to have not had a dental visit in more than five years.

The main reason for forgoing a dental visit for an oral health problem in the past six months was cost, respondents said. A full 42 percent told interviewers they could not afford treatment or did not have insurance.

Adults with Medicaid were almost five times as likely as adults with private health insurance to report poor oral health. And this was in 2008. As the effects of the recession wore on, Medicaid enrollment swelled. To contain costs, many states began cutting even the often meager adult dental benefits they carried, the Kaiser Commission on Medicaid and the Uninsured found.

While they often don’t get it, children are entitled to dental care under Medicaid. But adult dental benefits are considered optional and are often among the first benefits to be cut when state economies tank.

The CDC report also revealed ethnic and racial disparities in oral health status.

Only 25 percent of Hispanic adults and 26 percent of non-Hispanic black adults reported having very good oral health, compared with 37 percent of non-Hispanic whites and 37 percent of non-Hispanic Asians.

The supplemental questions on dental visits, toothache pain, broken or missing teeth and other issues were included in the survey in response to calls by federal officials for more information about oral health, an often overlooked aspect of the larger national health care picture.

Among other interesting findings included in the report:

  • Level of education is positively associated with having better comparative oral health status.
  • Adults with diabetes (29 percent) are almost twice as likely as adults without diabetes (16 percent) to have worse oral health status than others the same age.
  • Adults in poor families (28 percent) are more than twice as likely as adults in families that are not poor (13 percent) to have worse oral health status than others the same age.
  • Former drinkers are about twice as likely as lifetime abstainers and one and one-half times as likely as current drinkers to have experienced bad breath, dry mouth or difficulty eating or chewing.
  • One out of ten adults said fear was the reason they did not visit the dentist for an oral health problem.

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