The Reality of US Dental Healthcare


As dentists, we tend to be well aware of many of the problems that exist within dental healthcare across the country.

One of the key issues is accessibility to care. This doesn’t necessarily mean how close the person lives to a good dentist, but factors in whether or not they can afford the care they need. The lines winding around free health fairs around the country point to a fundamental lack of accessibility to affordable care.

From a dentist’s perspective, it’s not that we’re gold-plating our services or expecting unrealistic fees. We’re dealing with often stagnant revenue, increased overheads, and fee suppression put in place by insurance companies. When you combine that with the very real economic woes of our patients, it can leave both unhappy.

Are there solutions that will work for all of us? Let’s take a look:

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Oral Health: The Facts

The grim reality is that our oral health statistics don’t paint a rosy picture. Here are a couple of facts gleaned from the CDC:

  • Only 64% of adults aged between 18 and 64 visited their dentist in the last year. This drops to 62.5% for people over 65.
  • 31.6% of adults aged 20-44 have untreated dental caries. For kids aged 5-19 years, this figure is 18.6%

The American Dental Association has also been closely monitoring the state of our healthcare and produces oral healthcare statistics for each state (you can check yours out here). What they have found is that while some gains have been made, with children on Medicare starting to catch up to those with access to private benefits, adult treatment has been going backwards.

Even among adults with access to private dental benefits, dental care use has declined in most states. The gap between Medicare adults and those with private benefits is even wider for adults than it is for children.

Across the US population, wages have remained relatively stagnant for several years while costs continue to rise (the same problem dental practices are having!). People are forced to cut right back to bare essentials, so often dental care doesn’t make the cut if they’re also deciding on paying for housing, schooling, or simply to eat.

The Personal Stories

Stepping back from the bare facts, it’s important to recognize the very personal stories of how accessibility to good dental care is impacting people. After all, “healthcare” is about people and meeting the needs of individuals, not a numbers game.

Healthcare is about meeting the needs of individuals, not a numbers game. Click To Tweet

Anecdotally, we’re seeing individual stories that you’d think would have come out of a developing country, not a country with the wealth of the United States. There’s the 30-year-old guy lining up at a free health fair to have 18 teeth pulled. He hadn’t seen a dentist in 20 years. In this case, a group that was originally set up to provide healthcare within the world’s poorest countries was there providing it within one of the richest.

From Maryland, there is the sad story of a 12-year-old boy who died from an infection caused by an untreated decaying tooth. In our home state of Illinois, there’s the lines of thousands of patients lining up for two days for free Mission of Mercy clinics that operate one weekend every two years. Each person has their own story—often with pain, shame, and self-consciousness due to the poor state of their oral health.

The point is this is personal. Dental health has long been known to have a strong impact on the overall health of the body, yet it is still not afforded the importance of mainstream healthcare. People are suffering with treatable oral conditions that end up impacting their health as a whole.

What matters to your patients?

Let me tell you a quick story about something I experienced. One day an assisted living facility near us had a health fair, where we had set up a table where we could talk to attendees. We assumed that, as we were talking to retirees, they’d be interested in chatting about dental implants and other treatments common in this age group.

You know what we found? The hot topic at our table was insurance. We assumed people wanted to know about specific treatments, but in reality they wanted to talk to us about insurance, about losing it upon retiring, about benefits changing, and about the unaffordable cost in general to individuals trying to buy their own policy.

There is a fundamental lack of understanding about what people are actually getting when they buy dental coverage. We found that overwhelmingly, the public tends to be clueless about how to make simple, cheap, affordable health their goal. Where do they begin to get there? How will they maintain it once they have it?

Dental insurance was designed to be purchased by large groups, such as through a larger employer. There are plenty of groups of people who fall outside of this, including;

  • Retirees
  • People without work benefits
  • Self-employed individuals

When you happen to fall into one of those groups, as most of our health fair attendees did, you find that your options are limited by an insurance system that demands high policy premiums, low annual maximums, “fine print” exclusions, and long wait times for individuals. Once again, human beings are reduced to numbers and statistics, a system where the only winners seem to be the insurance companies themselves.

It matters to our patients that we’re addressing the issues that are meaningful to them. It’s a stretch for someone to be thinking about dental implants when they can’t even see a way to have regular hygiene appointments. How will you help patients to attain the goal of getting to good health in a way that they can afford?

Health Assurance Plans

That afternoon at the health fair, we soon abandoned the idea of talking about dental implants—it just wasn’t what people were immediately interested in. As we chatted with people about their experiences with dental insurance, we found that most people were interested in finding a good alternative.

How could they reach good health affordably?

Health Assurance Plan became the big topic of interest to the fair attendees. Was it really possible for them to join an affordable plan and have transparency around the care that it covers?

As dentists, we make a lot of assumptions about what people are interested in, but often nothing is as important as basic accessibility to dental care. Our patients are sick of putting off needed treatment due to lack of funds. In fact, many of them are sick as a result.

We might not see an end to the lines at free health fairs any time soon, but we do have an answer that will be affordable to more patients. Health Assurance Plans allow dental practices to offer customized options to patients that they just can’t get through insurance. Patients enjoy transparency over costs and coverage and finally have an affordable option to receive ongoing care.

Why go for subscription plans? Get our quick guide here.

Final Thoughts

It’s time to get personal about dental healthcare. The overall picture in the United States is sadly lacking for a wealthy country, but at the heart of those statistics are individuals, each with their own story.

As dental practices, we want to be part of the story that brings solutions for the many problems people face under the current system. How can we bring accessible, affordable, transparent options for care?

Consider offering Health Assurance Plans in your own dental practice. You may not be able to meet the needs of everyone, but you sure can offer some customized solutions that will provide accessibility to more people. Together, we’re hoping to see those individual stories transform.


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