Access to Care

People with low incomes are more likely to obtain dental care outside of private dental practices than those with higher incomes

In recent years, many States have tightened eligibility criteria and restricted and/or eliminated adult dental benefits in their Medicaid programs. A new study found that people with low incomes are more likely than higher income individuals to use physicians' offices or hospital emergency rooms (ERs) instead of private dental practices to treat their dental problems.

During 2001, about 3 percent of the U.S. population had at least one dental problem taken care of outside of the traditional office-based dental system. Of these, 2.7 percent received care in a hospital ER and 7 percent received care in other medical settings, note Leonard A. Cohen, D.D.S., M.P.H., M.S., of the University of Maryland Dental School, and Richard J. Manski, D.D.S., M.B.A., Ph.D., of the Agency for Healthcare Research and Quality. A majority (68 percent) had contact with the formal health care system via a prescription associated with their dental problem. About 1 in 5 people did not seek any formal treatment for their problem. Low-income individuals were more likely not to seek formal dental care than were middle/high-income individuals (32.5 vs. 19.7 percent). Those experiencing dental problems were most likely to be in the 19 to 64 and 65 and over age categories.

Individuals with no dental visits during the year were more likely to have received no formal care than those who had at least one dental visit during the year (56.4 vs. 16.2 percent). Twenty percent of all individuals who had a dental problem outside the normal dental office system missed at least one day of school, stayed home from work, or stayed in bed as a result of their dental problem. The findings were based on analysis of 2001 data from the Household Component of the Medical Expenditure Panel Survey, a nationally representative health survey of the U.S. community-based population.

See "Visits to non-dentist health care providers for dental problems," by Drs. Cohen and Manski, in the September 2006 Family Medicine 38(8), pp. 556-564. Reprints (AHRQ Publication No. 07-R007) are available from the AHRQ Publications Clearinghouse.

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