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Chartbook #17: Dental Use, Expenses, Dental Coverage, and Changes, 1996 and 2004



By Richard J. Manski, DDS, MBA, PhD
Erwin Brown, Jr., BS.


Contents

Executive Summary   Chapter 2. Children: Birth-Age 20
Foreword   Chapter 3. Adults: Age 21-64
Acknowledgments   Chapter 4. Older Adults: Age 65 and Over
Introduction   References
Source of Data   Definition of Terms
Chapter 1. Community Population      

The estimates in this report are based on the most recent data available from MEPS at the time the report was written. However, selected elements of MEPS data may be revised on the basis of additional analyses, which could result in slightly different estimates from those shown here. Please check the MEPS Web site (www.meps.ahrq.gov) for the most current file releases.

AHRQ is the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decision makers—patients and clinicians, health system leaders, and policymakers—make more informed decisions and improve the quality of health care services.

Executive Summary

Community Population

  • Forty-four percent of the community population had a dental visit in 2004. The average annual expense for persons with a visit was $560, and the average number of visits per person for persons with a visit was 2.5. (4)

  • Fifty-eight percent of persons from a high-income family had at least one dental visit during the year; only 30% of persons from a family with low income had at least one dental visit during the year. (7)

  • Black non-Hispanic and Hispanic persons were less likely to have a dental visit in 2004 than white non-Hispanic persons or persons of other race/ethnicity categories. (8)

  • While 57% of those with private dental coverage had a visit during 2004, 32% with public dental coverage only and 27% with no dental coverage had a visit. (13)

  • Overall, there was no change in the percentage of the population with a dental visit. The average number of dental visits per person for those with a dental visit decreased from 1996 to 2004. (16, 20)
  • The average dental expenses increased from $374 ($450 adjusted for inflation) in 1996 to $560 in 2004. For each age and income category, the average expense increased. (20, 24)

Children: Birth–Age 20

  • The likelihood of a visit varied by age, with approximately 25% of children under age 6 but 59% of children age 6-12 years old having a visit. (39)

  • Overall, high-income children were twice as likely to have a visit as poor children. (39)

  • Black non-Hispanic and Hispanic children were more likely to have public dental coverage and less likely to have private dental coverage in 2004 than white non-Hispanic children or children of other race/ethnicity categories. Overall, children with private dental coverage were twice as likely to have had a dental visit as children with no dental coverage. (44, 45)
  • The average annual expense for children with a visit was $635 for a child with private dental coverage and $272 for a child with public dental coverage only during 2004. (46)

  • Younger children, low-income children, black non- Hispanic children, Hispanic children, and children with public dental coverage only experienced an increase in the likelihood of a dental visit from 1996 to 2004. (50, 51, 52)

  • The percentage of children with public dental coverage only increased from 1996 to 2004. The percentage of children with no dental coverage decreased from 1996 to 2004. (64)

  • Poor, low-income, and middle-income children were much more likely to have public dental coverage only and less likely to have no dental coverage in 2004 than in 1996.(66)

Adults: Age 21–64

  • Among adults, the likelihood of having a dental visit varied by age, family income, race/ethnicity, and education. While 56% of adults with high income had a visit, only half as many (27%) with low income had at least one dental visit during 2004. (73, 74)

  • About 60% of adults (age 21-64) had private dental coverage, and 34% of adults had no dental coverage
    during 2004. (76)

  • Adults from a poor family were almost three times more likely to have no dental coverage as one from a high-income family, (59% and 21%, respectively). (77)

  • In 2004, 56% of the adult population with private dental coverage had a dental visit, 28% of the adult population with public dental coverage only had a dental visit, and 22% of adults without any dental coverage had a dental visit. (79)

  • Adults without dental coverage had a statistically significant decrease in the likelihood of having a dental visit from 1996 to 2004. (85)

  • Average dental expenses increased from $361 ($434 adjusted for inflation) in 1996 to $556 in 2004. (86)


Older Adults: Age 65 and Over

  • Among older adults, approximately 46% age 65- 74 and 39% age 75 and over had at least one dental visit. (105)

  • While 60% of older adults from a high-income family had at least one dental visit during the year, less than 31% of older adults from a poor or low-income family had at least one dental visit during the year. (105)

  • Approximately 70% of older adults did not have any dental coverage in 2004. (108)

  • Older adults with public dental coverage only were more likely to have a dental visit in 2004 than 1996. (117)

  • Average dental expenses increased from $438 ($527 adjusted for inflation) in 1996 to $620 in 2004. (118)

Return to Table of Contents

 

Foreword

The mission of the Agency for Healthcare Research and Quality (AHRQ) is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. The Medical Expenditure Panel Survey (MEPS) helps AHRQ fulfill its mission by providing information on health care use and expenses, health insurance, health status, and a variety of demographic, social, and economic characteristics. MEPS is a set of large-scale surveys of families and individuals, their medical providers, and employers across the United States.

MEPS provides various ways of accessing the data so that it can be most useful to you. The MEPS Web site (http://www.meps.ahrq.gov) has


• Online publications to read or download

• MEPS public use data files that you can review and download

• MEPSNet, which allows analysis of MEPS data using online statistical tools

• Tables showing MEPS data displayed by some of the most frequently used characteristics

AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more
information about access, cost, use, financing, and quality of health care in the United States. We also invite you to
tell us how you are using this chartbook and other MEPS data and tools and to share suggestions on how MEPS
products might be enhanced to further meet your needs.
Please e-mail us at mepsprojectdirector@ahrq.hhs.gov or send a letter to the address below:

Steven B. Cohen, Ph.D.
Director
Center for Financing, Access, and Cost Trends
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD 20850

Return to Table of Contents

 

Acknowledgments

We wish to thank Jessica Banthin, Karen Beauregard, Joel Cohen and Steven Cohen for their comments on an earlier draft; and Devi Katikineni and Zhengyi Fang of Social & Scientific Systems, Inc., Silver Spring, Maryland, who provided skillful computer programming support. We also wish to thank Burton L. Edelstein, DDS, MPH, Professor and Director, Division of Community Health, Columbia University School of Dental and Oral Surgery; A. Conan Davis, DMD, MPH, Chief Dental Officer, Centers for Medicare & Medicaid Services; and Donald A.
Schneider, DDS, MPH, Consultant in Health Policy and Dental Health, for their guidance in helping to construct a public dental coverage variable; and Tom Wall, MA, MBA, Manager Statistical Research, Health Policy Resource Center, American Dental Association; and William R. Maas, DDS, MPH, Director, Division of Oral Health, Centers for Disease Control and Prevention, for their very careful and thoughtful review and suggestions.

We wish to also thank the following individuals for their guidance and assistance: Albert H. Guay, Chief Policy Advisor, American Dental Association; Niva Haynes MA, Senior Project Assistant, Legislative & Regulatory Policy, American Dental Association; Janice Kupiec, Manager, Legislative & Regulatory Policy, American Dental Association; and Paul O'Connor, ADA State Legislative Liaison, American Dental Association.

 

Introduction

This chartbook presents data from the 1996 and 2004 Medical Expenditure Panel Survey (MEPS), which is sponsored by the Agency for Healthcare Research and Quality (AHRQ), on dental use and dental coverage for the U.S civilian noninstitutionalized (community) population. The chartbook is organized into four chapters each containing three sections. Chapter 1 presents data for the overall community population, chapter 2 restricts the presentation to children age birth to age 20, chapter 3 restricts the presentation to adults age 21 to age 64, and chapter 4 restricts the presentation to older adults age 65 and older. Each chapter is organized into three sections. Section 1 presents a summary of overall dental use, expenses, procedures, and providers; section 2 contains the prevalence of dental coverage and the relationship of dental coverage to use and expenses; and section 3 contains changes in dental use, dental coverage, and dental procedures from 1996 to 2004. See the Definitions of Terms section for information and definitions of the categories used throughout the chartbook.

This chartbook and other MEPS publications are available electronically on the MEPS Web site at http://www.meps.ahrq.gov/.

Return to Table of Contents

 

Source of Data

The estimates shown in this chartbook are drawn from analyses of the following public use files: 1996 Full Year Consolidated Data File HC-012, 2004 Full Year Consolidated Data File HC-089, 1996 Dental Visits File HC-010B, 2004 Dental Visits File HC-085B, and other information available on the MEPS Web site.

Only differences that are statistically significant at the 0.05 level are discussed in the text. In some cases, totals may not add precisely to 100% because of rounding.

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Chapter 1. Community Population

Section 1: Dental Use

 

What proportion of the community has a dental visit?

  • In 2004, there were about 294 million people in the community population of the United States.

  • Approximately 44% of the population had at least one dental visit during the year.

  • The average expense was $560 per year for persons with a dental visit, and the average number of visits was 2.5 visits per person for persons with a visit (data not shown).

Pie charts - Refer to text conversion table below for details.

U.S. community population
Dental visit 43.6%
No Dental visit 56.4%
Total population = 294 million

 

What procedures do people receive?

  • In 2004, approximately 128 million people with at least one dental visit received about 572 million dental procedures in the United States.

  • Approximately 86% of the population with at least one dental visit had at least one diagnostic procedure (examination or x-ray), and about 79% of the population had at least one preventive procedure (cleaning, fluoride, or sealant) during the year.
  • Together, approximately 73% of all procedures were diagnostic (42.5%) or preventive (30.4%) during 2004.

Bar charts - Refer to text conversion table below for details.

Percentage of population with at least one procedure
Diagnostic 85.8%
Preventive 79.3%
Restorative 22.2%
Prosthetic 13.8%
Oral surgery 10.9%
Periodontic 2.3%
Endodontic 4.6%
Orthodontic 6.6%
Other* 3.6%
Total population with a visit = 128 million

 

Pie charts - Refer to text conversion table below for details.
Distribution of procedures
Diagnostic 42.5%
Preventive 30.4%
Restorative 6.9%
Prosthetic 6.4%
Oral surgery 3.3%
Periodontic 0.9%
Endodontic 1.7%
Orthodontic 6.9%
Other* 1.0%
Total procedures = 572 million

 

*Other includes treatment for TMD or TMJ (jaw pain), bonding, whiting, or bleaching.

Return to Table of Contents

 

What dental providers do people visit?

  • In 2004, approximately 128 million people in the United States with at least one dental visit made about 316 million visits to a dental office.

  • Approximately 82% of all dental visits were to a general dentist, 2.7% of all visits were to an oral surgeon, and 13.2% of all visits were to an orthodontist.

  • Approximately 2.4% of dental visits were to other dental providers, including endodontists (dentists who perform root canals) and periodontists (dentists who treat gums).

  • About 34% of all dental visits included care by both a dentist and a non-dentist team member.*

Pie charts - Refer to text conversion table below for details.

Dentist provider visits
General dentist 81.6%
Oral surgeon 2.7%
Orthodontist 13.2%
Endodontist 0.9%
Periodontist 1.5%
Total visits = 316 million

 

*Non-dentist team members include dental hygienists, dental technicians, or other non-dentist dental specialists.

How are dental visits distributed across the population?

  • In 2004, the likelihood of having a dental visit varied by age, family income, race/ethnicity, and education.

  • Approximately 45% of children and adolescents (less than age 21) and 39% of young adults (21-44 year olds) had at least one dental visit during the year.

  • About 49% of adults (45-64 year olds) and 43% of older adults (age 65 and over) had at least one dental visit during the year.

  • Although 58% of persons from a high income family had at least one dental visit during the year, only 30% of persons from a family with low income had at least one dental visit during the year.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Age
Under 21 45.4%
21-44 38.7%
45-64 48.6%
65 and over 43.0%

Percentage with a dental visit

Family income
Poor 26.5%
Low income 29.9%
Middle income 41.9%
High income 57.9%

 

  • Black non-Hispanic and Hispanic persons were less likely to have a dental visit in 2004 than white non-Hispanic persons or persons of other race/ethnicity categories.

  • Persons with less than a high school education were less likely to have a dental visit in 2004 than college graduates or children with a college graduate caregiver.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Race/ethnicity
Black non-Hispanic 30.2%
Hispanic 28.9%
White non-Hispanic 49.4%
Other* 41.5%

Percentage with a dental visit

Education
Some or no school 21.9%
High school graduate 37.3%
College graduate 54.5%

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

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Section 2: Dental Coverage

What proportion of the community has dental coverage?

  • In 2004, approximately 158 million people, or 54% of the community population, had private dental coverage during the year.

  • Approximately 12% of the community population had public dental coverage only, and 35% of the community
    population had no dental coverage at all during the year.

Pie charts - Refer to text conversion table below for details.

Dental Coverage
Private dental coverage 53.9%
Public coverage only 11.5%
No dental coverage 34.6%

 

How is dental coverage distributed across the population?

  • In 2004, dental coverage varied by age, family income, race/ethnicity, and education.

  • About 61% of middle age adults (45-64 year olds) and 24% of older adults (age 65 and over) had private dental coverage during 2004.

  • Persons from lower income families were less likely to have private dental coverage in 2004 than persons from a family with higher income.

  • Children and adolescents (less than age 21), persons who were poor, and persons from a family with low income were more likely to have public dental coverage in 2004 than adults (age 45 and over) or persons from a family with middle or high income.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage

Age

  Private dental coverage Public dental coverage only No dental coverage
Under 21 53.9% 26.2% 19.9%
21-44 60.1% 5.7% 34.2%
45-64 60.9% 4.7% 34.3%
65 and over 23.8% 6.3% 69.9%
Percentage with dental coverage

Family income

  Private dental coverage Public dental coverage only No dental coverage
Poor 14.8% 43.8% 41.4%
Low income 32.6% 20.8% 46.6%
Middle income 58.2% 5.5% 36.3%
High income 74.4% 0.8% 24.7%

 

  • Black non-Hispanic and Hispanic persons were more likely to have public dental coverage and less likely to have private dental coverage in 2004 than white non-Hispanics or persons of other race/ethnicity categories.

  • Persons with some or no school were more likely to have no dental coverage, more likely to have public dental coverage, and less likely to have private dental coverage in 2004 than high school graduates or college graduates.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage

Race/ethnicity

  Private dental coverage Public dental coverage only No dental coverage
Black non-Hispanic 48.6% 22.0% 29.4%
Hispanic 35.3% 22.6% 42.1%
White non-Hispanic 58.7% 6.9% 34.3%
Other* 55.4% 14.3% 30.3%
Percentage with dental coverage

Education

  Private dental coverage Public dental coverage only No dental coverage
Some or no school 23.1% 25.6% 51.3%
High school graduate 48.1% 14.4% 37.6%
College graduate 67.2% 5.3% 27.4%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

Return to Table of Contents

 

Do dental care visits vary by dental coverage status?

  • In 2004, 57% of the population with private dental coverage had a dental visit, 32% of the population with public dental coverage only had a dental visit, and 27% of the population without any dental coverage had a dental visit.

  • Persons with public dental coverage only had fewer visits on average in 2004 than persons with private dental coverage or no dental coverage.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Overall 43.6%
Private dental coverage 56.9%
Public dental coverage only 31.9%
No dental coverage 26.9%

Average number of dental visits for persons with a visit

Overall 2.47%
Private dental coverage 2.54%
Public dental coverage only 2.06%
No dental coverage 2.39%

 

Do dental care expenses vary by dental coverage status?

  • In 2004, total dental expense for the community population of the United States was $72 billion.

  • The average annual expense for a person with a dental visit was $612 for a person with private dental coverage, $326 for a person with public dental coverage only and $482 for a person with no dental coverage during 2004.

Bar charts - Refer to text conversion table below for details.

Average annual dental expense for a person with a dental visit
Overall $560
Private dental coverage $612
Public dental coverage only $326
No dental coverage $482

 

Return to Table of Contents

 

Section 3: Changes from 1996 to 2004

How has the percentage of the population with a dental visit changed from 1996 to 2004?

  • There was no significant change in the percentage of the population with a dental visit from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
1996 42.9%
2004 43.6%

 

  • Children age 21 or less had a statistically significant increase in the likelihood of having a dental visit from 1996 to 2004.

  • Adults age 21-44 and individuals from a family with middle income had a statistically significant decrease in the likelihood of having a dental visit from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Age

  1996 2004
Under 21 42.2% 45.4%
21-44 41.2% 38.7%
45-64 48.8% 48.6%
65 and over 40.3% 43.0%
Percentage with a dental visit

Income

  1996 2004
Poor 26.2% 26.5%
Low Income 28.9% 29.9%
Middle Income 44.9% 41.9%
High Income 56.6% 57.9%

 

  • Black non-Hispanics had a statistically significant increase in the likelihood of having a dental visit from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Race/ethnicity

  1996 2004
Black non-Hispanic 26.1% 30.2%
Hispanic 28.5% 28.9%
White non-Hispanic 48.3% 49.4%
Other* 39.3% 41.5%
Percentage with a dental visit

Education

  1996 2004
Some or no school 23.9% 21.9%
High school graduate 39.3% 37.3%
College graduate 53.8% 54.5%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

  • Persons with public dental coverage only had a statistically significant increase in the likelihood of having a dental visit from 1996 to 2004.

  • No significant changes in the likelihood of a dental visit from 1996 to 2004 were found for people with private dental coverage or for persons without dental coverage.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
  1996 2004
Private dental coverage 56.0% 56.9%
Public dental coverage 28.3% 31.9%
No dental coverage 28.7% 26.9%

 

Return to Table of Contents

 

How have dental visits and dental expenses changed from 1996 to 2004?

  • The average number of dental visits per person for those with a dental visit decreased from 1996 to 2004.

  • Average dental expenses increased from $374 ($450 adjusted for inflation) in 1996 to $560 in 2004.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for persons with a visit
1996 2004
2.55 2.47
Average dental expense for persons with a dental visit
1996 $374
1996 adjusted for inflation $450
2004 $560

 

How have average visits per person for those with a dental visit changed from 1996 to 2004?

  • The average number of dental visits per person for those with a dental visit decreased for adults age 45-64 and for adults with low or middle income from 1996 to 2004.

 

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for persons with a visit

Age

  1996 2004
Under 21 2.70 2.64
21-44 2.20 2.12
45-64 2.70 2.53
65 and over 2.92 2.72
Average number of dental visits for person with a visit

Income

  1996 2004
Poor 2.11 2.19
Low Income 2.37 2.16
Middle Income 2.56 2.36
High Income 2.69 2.65

 

  • The average number of dental visits per person for those with a dental visit decreased for college graduates from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for persons with a visit

Race/ethnicity

  1996 2004
Black non-Hispanic 2.05 2.03
Hispanic 2.22 2.17
White non-Hispanic 2.63 2.57
Other* 2.54 2.28
Average number of dental visits for persons with a visit

Education

  1996 2004
Some or no school 2.33 2.19
High school graduate 2.44 2.35
College graduate 2.66 2.55

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

  • The average number of dental visits per person for those with a dental visit decreased for persons with private dental coverage from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for persons with a visit
  1996 2004
Private dental coverage 2.65 2.54
Public dental coverage only 1.97 2.06
No dental coverage 2.43 2.39

Return to Table of Contents

 

How has the average dental expense for those with a dental visit changed from 1996 to 2004?

  • For each age the average expense (adjusted for inflation) increased from 1996 to 2004.

  • For each income category except for middle income the average expense (adjusted for inflation) increased from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for persons with a dental visit

Age

  1996 1996 adjusted for inflation 2004
Under 21 $374 $450 $544
21-44 $318 $384 $488
45-64 $425 $512 $630
65 and over $438 $527 $620
Average dental expense for persons with a dental visit

Income

  1996 1996 adjusted for inflation 2004
Poor $268 $323 $427
Low Income $282 $340 $433
Middle Income $384 $462 $510
High Income $415 $500 $646

 

  • White non-Hispanics and Hispanics and persons of other race/ethnicity categories had a statistically significant increase in expenses from 1996 to 2004.

  • For each education category, the average expense (adjusted for inflation) increased from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average dental expense for persons with a dental visit

Race/ethnicity

  1996 1996 adjusted for inflation 2004
Black Non-Hispanic $299 $361 $367
Hispanic $317 $382 $430
White Non-Hispanic $384 $462 $599
Other* $417 $502 $555
Average dental expense for persons with a dental visit

Education

  1996 1996 adjusted for inflation 2004
Some or no school $330 $435 $524
High school graduate $370 $449 $540
College graduate $402 $495 $596

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

  • For each dental coverage category the average expense (adjusted for inflation) increased from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for those with a dental visit
  1996 1996 adjusted for inflation 2004
Private dental coverage $415 $500 $612
Public dental coverage only $204 $245 $326
No dental coverage $304 $366 $482

 

How has the likelihood of having at least one type of procedure changed from 1996 to 2004?

  • People were more likely to have at least one diagnostic or preventive procedure and less likely to have one restorative, prosthetic, surgical, or other procedure in 2004 than in 1996.

Bar charts - Refer to text conversion table below for details.

Percentage of the population with at least one procedure
  1996 2004
Diagnostic 82.7% 85.8%
Preventive 74.6% 79.3%
Restorative 24.2% 22.2%
Prosthetic 15.2% 13.8%
Oral surgery 12.5% 10.9%
Periodontic 2.6% 2.3%
Endodontic 5.1% 4.6%
Orthodontic 5.9% 6.6%
Other* 4.5% 3.6%

 

*Other includes treatment for TMD or TMJ (jaw pain), bonding, whiting, or bleaching.

 

How has the distribution of procedures changed from 1996 to 2004?

 

  • The total number of procedures increased from about 496 million in 1996 to about 572 million in 2004 (data not shown).

  • As a percentage of all procedures, diagnostic and preventive procedures increased while restorative, prosthetic, surgical, endodontic, and other procedures decreased from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Distribution of dental procedures
  1996 2004
Diagnostic 40.2% 42.5%
Preventive 29.0% 30.4%
Restorative 8.2% 6.9%
Prosthetic 7.3% 6.4%
Oral surgery 4.1% 3.3%
Periodontic 0.9% 0.9%
Endodontic 2.1% 1.7%
Orthodontic 6.8% 6.9%
Other* 1.5% 1.0%

 

*Other includes treatment for TMD or TMJ (jaw pain), bonding, whiting, or bleaching.

Return to Table of Contents

 

How have dental expenses changed from 1996 to 2004 by category of procedure?

 

  • Average dental expenses increased from $115 ($139 adjusted for inflation) in 1996 to $172 and from $136 ($164 adjusted for inflation) in 1996 to $217 for preventive/ diagnostic procedures and restorative procedures, respectively, in 2004.

  • Expenses for other dental procedures (periodontic, orthodontic, prosthetic, endodontic, and oral surgery) increased from $213 ($257 adjusted for inflation) in 1996 to $354 in 2004.

Bar charts - Refer to text conversion table below for details.

Average dental expense per visit by procedure category
  1996 1996 adjusted for inflation 2004
Overall $147 $177 $288
Preventive/Diagnostic $115 $139 $172
Restorative $136 $164 $217
Other* $213 $257 $354

 

*Other includes periodontic (gums), orthodontic (braces), prosthetic (crown, bridges, and dentures), endodontic (root canals), oral surgery, treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

How has the percentage of people with dental coverage changed from 1996 to 2004?

  • The percentage of people with public dental coverage only increased from 1996 to 2004.

  • The percentage of people without any dental coverage decreased from 1996 to 2004.

  • No change was observed in private dental coverage.

 

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage
  1996 2004
Private dental coverage 52.2% 53.9%
Public dental coverage only 9.4% 11.5%
No dental coverage 38.4% 34.6%

 

How has distribution of dental coverage changed from 1996 to 2004?

 

  • Children were more likely to have public dental coverage only and less likely to have no dental coverage in 2004 than in 1996.

  • Adults age 45-64 were less likely to have no dental coverage in 2004 than in 1996.

Bar charts - Refer to text conversion table below for details.

Changes in coverage by age

Children age birth-20

  1996 2004
Private dental coverage 53.2% 53.9%
Public dental coverage only 18.0% 26.2%
No dental coverage 28.8% 19.9%
Changes in coverage by age

Adults age 21-44

  1996 2004
Private dental coverage 57.9% 60.1%
Public dental coverage only 5.8% 5.7%
No dental coverage 36.3% 34.2%
Changes in coverage by age

Adults age 45-64

  1996 2004
Private dental coverage 58.7% 60.9%
Public dental coverage only 3.9% 4.7%
No dental coverage 37.4% 34.3%
Changes in coverage by age

Older adults age 65 and above

  1996 2004
Private dental coverage 23.2% 23.8%
Public dental coverage only 7.9% 6.3%
No dental coverage 68.9% 69.9%

 

  • Persons from a family with low income were more likely to have public dental coverage only and less likely to have no dental coverage in 2004 than in 1996.

  • Persons from a family with middle income were more likely to have public dental coverage only in 2004 than in 1996.

  • Persons from a family with high income were more likely to have private dental coverage and less likely to have no dental coverage in 2004 than in 1996.

Bar charts - Refer to text conversion table below for details.

Changes in coverage by income

Poor

  1996 2004
Private dental coverage 16.0% 14.8%
Public dental coverage only 41.5% 43.8%
No dental coverage 42.5% 41.4%
Changes in coverage by income

Low family income

  1996 2004
Private dental coverage 34.3% 32.6%
Public dental coverage only 11.8% 20.8%
No dental coverage 53.8% 46.6%
Changes in coverage by income

Middle income family

  1996 2004
Private dental coverage 60.8% 58.2%
Public dental coverage only 2.5% 5.5%
No dental coverage 36.7% 36.3%
Changes in coverage by income

High family income

  1996 2004
Private dental coverage 70.0% 74.4%
Public dental coverage only 1.0% 0.8%
No dental coverage 29.0% 24.7%

 

  • Black non-Hispanics were less likely to have no dental coverage in 2004 than in 1996.

  • White non-Hispanics were more likely to have private or public dental coverage and less likely to have no dental coverage from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Changes in coverage by race/ethnicity

Black non-Hispanic

  1996 2004
Private dental coverage 43.8% 48.6%
Public dental coverage only 19.7% 22.0%
No dental coverage 36.5% 29.4%
Changes in coverage by race/ethnicity

Hispanic

  1996 2004
Private dental coverage 34.7% 35.3%
Public dental coverage only 21.9% 22.6%
No dental coverage 43.4% 42.1%
Changes in coverage by race/ethnicity

White non-Hispanic

  1996 2004
Private dental coverage 56.3% 58.7%
Public dental coverage only 5.4% 6.9%
No dental coverage 38.3% 34.3%
Changes in coverage by race/ethnicity

Other*

  1996 2004
Private dental coverage 53.4% 55.4%
Public dental coverage only 14.5% 14.3%
No dental coverage 32.1% 30.3%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

  • For each education category, people were more likely to have public dental coverage only and less likely to have no dental coverage in 2004 than in 1996.

 

Bar charts - Refer to text conversion table below for details.

Changes in coverage by education

Some or no school

  1996 2004
Private dental coverage 22.5% 23.1%
Public dental coverage only 22.4% 25.6%
No dental coverage 55.1% 51.3%
Changes in coverage by education

High school graduate

  1996 2004
Private dental coverage 49.7% 48.1%
Public dental coverage only 10.2% 14.4%
No dental coverage 40.0% 37.6%
Changes in coverage by education

College graduate

  1996 2004
Private dental coverage 66.8% 67.2%
Public dental coverage only 3.4% 5.3%
No dental coverage 29.9% 27.4%

Return to Table of Contents

 

Chapter 2. Children: Birth–Age 20

Section 1: Dental Use

What proportion of children has a dental visit?

  • In 2004, there were about 86 million children in the United States.

  • Approximately 45% of children had at least one dental visit during the year.

  • The average expense was $544 per year for children with a dental visit, and the average number of visits was 2.6 visits per child for children with a visit (data not shown).

 

Pie charts - Refer to text conversion table below for details.

What proportion of children has a dental visit?
Dental visit 45.4%
No dental visit 54.6%
Total child population = 86 million

 

What procedures do children receive?

  • In 2004, approximately 39 million children with at least one dental visit received about 186 million dental procedures in the United States.

  • Approximately, 88% of children receiving at least one dental visit had at least one diagnostic procedure (examination or x-ray), and about 82% of children had at least one preventive procedure (cleaning, fluoride, or sealant) during the year.

  • Together, approximately 72% of all procedures were diagnostic (39.1%) or preventive (33.1%) during 2004.

 

Bar charts - Refer to text conversion table below for details.

Percentage of children with at least one procedure
Diagnostic 88.0%
Preventive 82.0%
Restorative 20.4%
Prosthetic 2.4%
Oral surgery 8.5%
Orthodontic 17.6%
Other* 3.5%
Total population with a visit = 39 million

Pie charts - Refer to text conversion table below for details.

Distribution of procedures

Diagnostic 39.1%
Preventive 33.1%
Restorative 5.7%
Prosthetic 0.9%
Oral surgery 2.2%
Orthodontic 18.0%
Other* 1.0%
Total procedures = 186 million

 

*Other includes periodontics (gums), endodontics (root canals), treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

What dental providers do children visit?

  • In 2004, children made about 103 million visits to a dental office in the United States.

  • Approximately 63% of all children’s dental visits were to a General Dentist. While 2% of children’s dental visits were to an oral surgeon, 35% were to an orthodontist.

  • Less than 1% of all children’s dental visits were to other dental providers, including endodontists (dentists who perform root canals) and periodontists (dentists who treat gums).

  • About 29% of all dental visits included care by both a dentist and a non-dentist team member.*

 

Pie charts - Refer to text conversion table below for details.

Dentist provider visits

General dentist 62.9%
Oral surgeon 2.0%
Orthodontist 34.6%
Endodontist or Periodontist 0.5%
Total visits = 103 million

 

*Non-dentist team members include dental hygienists, dental technicians, or other non-dentist dental specialists.

 

How are dental visits distributed across the population?

  • In 2004, the likelihood of a child having a dental visit varied by age, family income, race/ethnicity, and education.

  • Approximately 48% of the adolescents age 13-20 and 59% of children age 6-12 had at least one dental visit during the year.

  • While 62% of children from a high-income family had at least one dental visit during the year, 34% of children from a family with low income had at least one dental visit during the year.

 

Bar charts - Refer to text conversion table below for details.

Percentage of children with a dental visit

Age

Under 6 25.1%
6 - 12 59.2%
13 - 20 47.9%
Percentage of children with a dental visit
Family Income
Poor 30.8%
Low income 33.9%
Middle income 46.5%
High income 61.8%

 

  • Black non-Hispanic and Hispanic children were less likely to have a dental visit in 2004 than white non-Hispanic children or children of other race/ethnicity categories.

  • Children with a caregiver with less than high school education were less likely to have a dental visit in 2004 than children with a high school graduate or college graduate caregiver.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Race/ethnicity

Black non-Hispanic 34.1%
Hispanic 32.9%
White non-Hispanic 52.5%
Other* 43.7%
Percentage with a dental visit

Caregiver education

Some or no school 25.2%
High school graduate 37.9%
College graduate 54.4%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

Return to Table of Contents

 

Section 2: Dental Coverage

 

What proportion of children has dental coverage?

 

  • In 2004, approximately 46 million children or 54% of children had private dental coverage during the year.

  • Approximately 26% of all children had public dental coverage only, and slightly less than 20% of all children had no dental coverage.

Pie charts - Refer to text conversion table below for details.

What proportion of children has dental coverage?

Private dental coverage 53.9%
Public dental coverage 26.2%
No dental coverage 19.9%

 

How is dental coverage distributed across the population?

  • In 2004, dental coverage varied by age, family income, race/e thnicity, and education.

  • Children from a family with lower income were less likely to have private dental coverage and more likely to have public dental coverage only in 20 04 than children from a family with higher income.

  • Children from a family with low or middle income were more likely to have no dental coverage compared with poor children or children from a family with high income.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage

Age

  Private dental coverage Public dental coverage only No dental coverage
Under 6 49.1% 33.1% 17.8%
6 - 12 55.9% 27.0% 17.1%
13 - 20 55.7% 20.7% 23.6%
Percentage with dental coverage

Family income

  Private dental coverage Public dental coverage only No dental coverage
Poor 13.9% 73.4% 12.7%
Low income 34.3% 40.9% 24.8%
Middle income 65.6% 11.8% 22.5%
High income 80.3% 1.9% 17.8%

 

  • Black non-Hispanic and Hispanic children were more likely to have public dental coverage and less likely to have private dental coverage in 2004 than white non-Hispanics or children of other race/ethnicity categories.

  • Children with a caregiver with some or no school were more likely to have public dental coverage and less likely to have private dental coverage in 2004 than children with high school graduate or college graduate caregivers.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage

Race/ethnicity

  Private dental coverage Public dental coverage only No dental coverage
Black non-Hispanic 43.5% 44.9% 11.6%
Hispanic 31.8% 42.9% 25.3%
White non-Hispanic 63.5% 16.2% 20.3%
Other* 55.3% 25.4% 19.3%
Percentage with dental coverage

Caregiver education

  Private dental coverage Public dental coverage only No dental coverage
Some or no school 16.8% 60.0% 23.2%
High school graduate 42.4% 37.3% 20.2%
College graduate 69.0% 12.1% 19.9%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

Do dental care visits vary by dental coverage status?

  • In 2004, while 58% of children with private dental coverage had a dental visit, 34% of children with public dental coverage only had a dental visit, and 28% of children without any dental coverage had a dental visit.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
Overall 45.4%
Private dental coverage 57.5%
Public dental coverage only 34.1%
No dental coverage 27.5%
Average number of dental visits for children with a visit

Overall

2.64
Private dental coverage 2.85
Public dental coverage only 1.88
No dental coverage 2.71

 

Do dental care expenses vary by dental coverage status?

  • In 2004, the total dental expense for children in the United States was $21 billion.

  • The average annual expense for children with a visit was $635 for children with private dental coverage and $272 for children with public dental coverage only during 2004.

 

Bar charts - Refer to text conversion table below for details.

Average annual dental expense for children with a dental visit during 2004

Overall $544
Private dental coverage $635
Public dental coverage only $272
No dental coverage $470

 

  • The average annual orthodontic expense was $1,375, and the average annual non-orthodontic expense was $318 for children during 2004.

Bar charts - Refer to text conversion table below for details.

Average annual orthodontic dental expense
for children with an orthodontic visit during 2004
Overall $1,375
Private dental coverage $1,449
Public dental coverage only $1,233
No dental coverage $1,045
Average annual non-orthodontic dental expense
for children with an orthodontic visit during 2004

Overall

$318
Private dental coverage $358
Public dental coverage only $203
No dental coverage $275

 

Return to Table of Contents

 

Section 3: Changes from 1996 to 2004

 

How has the percentage of children with a dental visit changed from 1996 to 2004?

  • Children were more likely to have a dental visit in 2004 compared with 1996, which corresponds with the enactment of SCHIP (State Children’ s Health Insurance Program) an d public dental coverage only extensions among children.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

1996 42.2%
2004 45.4%

 

  • Children under age 6 , children age 6- 12, an d low-income children experienced an increase in the likelihood of a dental visit between 1996 and 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Age

  1996 2004
Under 6 21.1% 25.1%
6 - 12 54.4% 59.2%
13 - 20 47.6% 47.9%
Percentage with a dental visit

Income

  1996 2004
Poor 27.6% 30.8%
Low Income 27.4% 33.9%
Middle Income 49.4% 46.5%
High Income 58.9% 61.8%

 

  • Black non-Hispanic and Hispanic children had a statistically significant increase in the likelihood of having a dental visit from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Race/ethnicity

  1996 2004
Black non-Hispanic 25.5% 34.1%
Hispanic 28.6% 32.9%
White non-Hispanic 49.5% 52.5%
Other* 39.8% 43.7%
Percentage with a dental visit

Caregiver education

  1996 2004
Some or no school 24.5% 25.2%
High school graduate 37.7% 37.9%
College graduate 50.9% 54.4%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

  • Children with public dental coverage only had an increase in the likelihood of having a dental visit from 1996 to 2004.

  • No significant change in the likelihood of having a dental visit from 1996 to 2004 was found for children with private dental coverage or for children without dental coverage.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
  1996 2004
Private dental coverage 55.2% 57.5%
Public dental coverage only 28.4% 34.1%
No dental coverage 26.9% 27.5%

 

How have dental visits and dental expenses changed from 1996 to 2004?

 

  • There was no statistically significant change in the average number of dental visits per child for those with a dental visit from 1996 to 2004.

  • Average dental expenses increased from $374 ($450 adjusted for inflation) in 1996 to $544 in 2004.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for
children with a visit
1996 2.70
2004 2.64
Average dental expense for children
with a dental visit
1996 $374
1996 adjusted for inflation $450
2004 $544

 

  • The average dental orthodontic expense increased from $930 ($1,120 adjusted for inflation) in 1996 to $ 1,375 in 2004.

  • The average dental non-orthodontic expense increased from $229 ($275 adjusted for inflation) in 1996 to $318 in 2004.

Bar charts - Refer to text conversion table below for details.

Average orthodontic dental expense
for children with a dental visit
1996 $930
1996 adjusted for inflation $1,120
2004 $1,375
Average non-orthodontic dental expense
for children with a dental visit
1996 $229
1996 adjusted for inflation $275
2004 $318

 

How have average visits per child for those with a dental visit changed from 1996 to 2004?

 

  • There were no statistically significant changes in the average number of visits for children with a dental visit by age or income from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average number of dental visits
 for children with a visit

Age

  1996 2004
Under 6 1.54 1.60
6 - 12 2.47 2.40
13 - 20 3.33 3.26
Average number of dental visits
for children with a visit

Income

  1996 2004
Poor 2.01 1.84
Low Income 2.21 2.04
Middle Income 2.73 2.58
High Income 3.15 3.19

 

  • There were no statistically significant changes in the average number of visits by children with a dental visit by race/ethnicity or caregiver education from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits
for children with a visit

Race/ethnicity

  1996 2004
Black non-Hispanic 1.77 1.92
Hispanic 2.21 2.28
White non-Hispanic 2.85 2.86
Other* 3.12 2.31
Average number of dental visits
for children with a visit

Caregiver education

  1996 2004
Some or no school 2.28 1.91
High school graduate 2.27 2.33
College graduate 2.97 2.84

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • There were no significant changes by dental coverage status in the average number of visits for children with a dental visit from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for children with a visit
  1996 2004
Private dental coverage 2.88 2.85
Public dental coverage only 1.75 1.88
No dental coverage 2.61 2.71

 

How has the average dental expense for children with a dental visit changed from 1996 to 2004?

 

  • The average expense (adjusted for inflation) for children under age 6 and children age 6-12 increased from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for children with a dental visit

Age

  1996 1996 adjusted for inflation 2004
Under 6 $124 $149 $186
6 - 12 $327 $393 $490
13 - 20 $508 $612 $728
Average dental expense for children with a dental visit

Income

  1996 1996 adjusted for inflation 2004
Poor $226 $272 $277
Low family income $220 $264 $350
Middle family income $399 $481 $536
High family income $470 $566 $713

 

  • White non-Hispanic children and children with a college graduate caregiver had a statistically significant increase in average dental expenses (adjusted for inflation) from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average dental expense for children with a dental visit

Race/ethnicity

  1996 1996 adjusted for inflation 2004
Black Non-Hispanic $245 $295 $282
Hispanic $281 $338 $367
White Non-Hispanic $399 $480 $628
Other* $420 $506 $485
Average dental expense for children with a dental visit

Caregiver education

  1996 1996 adjusted for inflation 2004
Less than high school $223 $269 $348
High school graduate $345 $415 $420
College graduate $410 $493 $610

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • For children with private or public dental coverage only the average dental expense (adjusted for inflation) increased from 1996 to 2004.

  • No significant change (adjusted for inflation) was observed for children without dental coverage from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average dental expense for children with a dental visit
  1996 1996 adjusted for inflation 2004
Private dental coverage $433 $521 $635
Public dental coverage only $151 $182 $272
No dental coverage $295 $355 $470

 

How has the likelihood of having at least one type of procedure changed from 1996 to 2004?

 

  • Children were more likely to have at least one preventive procedure and less likely to have one oral surgery procedure in 2004 than in 1996.

Bar charts - Refer to text conversion table below for details.

Percentage of population with at least one procedure
  1996 2004
Diagnostic 85.9% 88.0%
Preventive 76.3% 82.0%
Restorative 19.8% 20.4%
Prosthetic 2.9% 2.4%
Oral surgery 10.4% 8.5%
Orthodontic 16.7% 17.6%
Other* 4.4% 3.5%

 

*Other includes periodontics (gums), endodoontics (root canals), treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

How has the distribution of procedures changed from 1996 to 2004?

 

  • The total number of procedures increased from about 156 million in 1996 to about 186 million in 2004 (data not shown).

  • As a percentage of all procedures, from 1996 to 2004 preventive procedures increased while oral surgery and other procedure types decreased.

 

Bar charts - Refer to text conversion table below for details.

Distribution of dental procedures
  1996 2004
Diagnostic 38.6% 39.1%
Preventive 30.7% 33.1%
Restorative 6.4% 5.7%
Prosthetic 1.0% 0.9%
Oral surgery 3.0% 2.2%
Orthodontic 18.9% 18.0%
Other* 1.4% 1.0%

 

*Other includes periodontics (gums), endodoontics (root canals), treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

How have dental expenses changed from 1996 to 2004 by category of procedure?

 

  • Average dental expenses increased from $108 ($130 adjusted for inflation) in 1996 to $163 and $129 ($155 adjusted for inflation) in 1996 to $216 for diagnostic/preventive procedures and restorative procedures, respectively, in 2004.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for children per visit by procedure
  1996 1996 adjusted for inflation 2004
Overall $138 $167 $206
Preventive/Diagnostic $108 $130 $163
Restorative $129 $155 $216
Other* $188 $227 $275

 

*Other includes periodontic (gums), orthodontic (braces), prosthetic (crown, bridges, and dentures), endodontic (root canals), oral surgery, treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

How has the percentage of children with dental coverage changed from 1996 to 2004?

 

  • The percentage of children with public dental coverage only increased from 1996 to 2004.

  • The percentage of children with no dental coverage decreased from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage of children with dental coverage
  1996 2004
Private dental coverage 53.2% 53.9%
Public dental coverage only 18.0% 26.2%
No dental coverage 28.8% 19.9%

 

How has distribution of dental coverage changed from 1996 to 2004?

 

  • While no significant changes by age in the percentage of children with private dental coverage from 1996 to 2004 were noted, children of all ages were much more likely to have public dental coverage only and less likely to have no dental coverage in 2004 than in 1996.

 

Bar charts - Refer to text conversion table below for details.

Changes in coverage by age

Children age birth-5

  1996 2004
Private dental coverage 48.8% 49.1%
Public dental coverage only 25.7% 33.1%
No dental coverage 25.4% 17.8%
Changes in coverage by age

Children age 6-12

  1996 2004
Private dental coverage 55.1% 55.9%
Public dental coverage only 17.9% 27.0%
No dental coverage 27.0% 17.1%
Changes in coverage by age

Children age 13-20

  1996 2004
Private dental coverage 55.0% 55.7%
Public dental coverage only 12.0% 20.7%
No dental coverage 33.1% 23.6%

 

  • Poor, low-income, and middle-income children were much more likely to have public dental coverage only and less likely to have no dental coverage in 2004 than in 1996.

  • Low-income and middle-income children were less likely to have private dental coverage in 2004 than in 1996.

  • High-income children were more likely to have private dental coverage and less likely to have no dental coverage in 1996 than in 2004.

 

Bar charts - Refer to text conversion table below for details.

Changes in coverage by income

Poor

  1996 2004
Private dental coverage 15.7% 13.9%
Public dental coverage only 59.8% 73.4%
No dental coverage 24.5% 12.7%
Changes in coverage by income

Low family income

  1996 2004
Private dental coverage 41.3% 34.3%
Public dental coverage only 18.0% 40.9%
No dental coverage 40.7% 24.8%
Changes in coverage by income

Middle family income

  1996 2004
Private dental coverage 70.2% 65.6%
Public dental coverage only 3.4% 11.8%
No dental coverage 26.4% 22.5%
Changes in coverage by income

High family income

  1996 2004
Private dental coverage 73.4% 80.3%
Public dental coverage only 1.8% 1.9%
No dental coverage 24.8% 17.8%

 

  • Black non-Hispanic, white non-Hispanic, and Hispanic children were much more likely to have public dental coverage only and less likely to have no dental coverage in 2004 than in 1996.

  • Children of other race/ethnicity categories were less likely to have no dental coverage in 2004 than in 1996.

 

Bar charts - Refer to text conversion table below for details.

Changes in coverage by race/ethnicity

Black non-Hispanic

  1996 2004
Private dental coverage 39.5% 43.5%
Public dental coverage only 33.7% 44.9%
No dental coverage 26.8% 11.6%
Changes in coverage by race/ethnicity

Hispanic

  1996 2004
Private dental coverage 31.2% 31.8%
Public dental coverage only 35.0% 42.9%
No dental coverage 33.9% 25.3%
Changes in coverage by race/ethnicity

White non-Hispanic

  1996 2004
Private dental coverage 61.5% 63.5%
Public dental coverage only 10.1% 16.2%
No dental coverage 28.4% 20.3%
Changes in coverage by race/ethnicity

Other*

  1996 2004
Private dental coverage 53.1% 55.3%
Public dental coverage only 22.3% 25.4%
No dental coverage 24.5% 19.3%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • Children with a high school graduate caregiver had a statistically significant decrease in the likelihood of having private dental coverage from 1996 to 2004.

  • Children of caregivers of all levels of education were much more likely to have public dental coverage only and less likely to have no dental coverage in 2004 than in 1996.

Bar charts - Refer to text conversion table below for details.

Changes in coverage by caregiver education

Some or no school

  1996 2004
Private dental coverage 17.6% 16.8%
Public dental coverage only 48.1% 60.0%
No dental coverage 34.2% 23.2%
Changes in coverage by caregiver education

High school graduate

  1996 2004
Private dental coverage 47.9% 42.4%
Public dental coverage only 21.8% 37.3%
No dental coverage 30.3% 20.2%
Changes in coverage by caregiver education

College graduate

  1996 2004
Private dental coverage 67.7% 69.0%
Public dental coverage only 6.3% 12.1%
No dental coverage 26.0% 18.9%

Return to Table of Contents

 

Chapter 3. Adults: Age 21-64

Section 1: Dental Use

 

What proportion of adults has a dental visit?

 

  • In 2004, there were about 171 million adults (age 21-64) in the community population of the United States.

  • Approximately 43% of the adult population had at least one dental visit during the year.

  • The average expense was $556 per year for adults with a dental visit, and the average number of visits was 2.3 visits per adult for adults with a visit (data not shown).

Pie charts - Refer to text conversion table below for details.

What proportion of adults has a dental visit?
Dental visit 42.9%
No dental visit 57.1%
Total adult population = 171 million

 

What procedures do adults receive?

 

  • In 2004, approximately 73 million adults with at least one dental visit received about 312 million dental procedures in the United States.

  • Approximately 86% of the adult population with at least one dental visit had at least one diagnostic procedure (examination or x-ray), and about 79% of the adult population had at least one preventive procedure (cleaning, fluoride, or sealant) during the year.

  • Together, approximately 74% of all adult procedures were diagnostic (44.6%) or preventive (29.5%) during 2004.

 

Bar charts - Refer to text conversion table below for details.

Percentage of population with at least one procedure
Diagnostic 85.5%
Preventive 78.9%
Restorative 22.6%
Prosthetic 16.4%
Oral surgery 11.5%
Periodontic 3.2%
Endodontic 6.2%
Orthodontic 2.1%
Other* 4.4%
Total population with a visit = 73 million

Pie charts - Refer to text conversion table below for details.

Distribution of procedures
Diagnostic 44.6%
Preventive 29.5%
Restorative 7.5%
Prosthetic 7.8%
Oral surgery 3.8%
Periodontic 1.2%
Endodontic 2.5%
Orthodontic 1.8%
Other* 1.3%
Total procedures = 312 million

 

*Other includes treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

What dental providers do adults visit?

 

  • In 2004, approximately 73 million adults with at least one dental visit made about 170 million visits to a dental office in the United States.

  • Approximately 91% of adult dental visits were to a general dentist. While 2.9% of adult dental visits were to an oral surgeon, 3.4% were to an orthodontist.

  • Approximately 3.2% of adult dental visits were to other dental providers including endodontists (dentists who perform root canals) and periodontists (dentists who treat gums).

  • About 36% of all dental visits included care by both a dentist and a non-dentist team member.*

 

Pie charts - Refer to text conversion table below for details.

Dentist provider visits
General dentist 90.5%
Oral surgeon 2.9%
Orthodontist 3.4%
Periodontist 2.1%
Endodontist 1.1%
Total visits = 170 million

 

*Non-dentist team members include dental hygienists, dental technicians, or other non-dentist dental specialists.

 

How are dental visits distributed across the adult population?

 

  • In 2004, the likelihood of having a dental visit varied by age, family income, race/ethnicity, and education.

  • Approximately 39% of adults age 21-44 had at least one dental visit during the year, and 49% of adults age 45-64 had at least one dental visit during the year.

  • While 56% of adults from a high-income family had at least one dental visit during the year, only 27% of adults from a family with low income had at least one dental visit during the year.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Age

21-44 38.7%
45-64 48.6%
Percentage with a dental visit

Family income

Poor 22.7%
Low Income 26.9%
Middle Income 39.7%
High Income 56.2%

 

  • Black non-Hispanics and Hispanics were less likely to have a dental visit in 2004 than white non-Hispanic adults or adults of other race/ethnicity categories.

  • Adults with less than a high school education were less likely to have a dental visit in 2004 than college graduates.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Race/ethnicity

Black non-Hispanic 29.6%
Hispanic 26.8%
White non-Hispanic 48.7%
Other* 40.8%
Percentage with a dental visit

Education

Some or no school 20.8%
High school graduate 35.7%
College graduate 53.6%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

Return to Table of Contents

 

Section 2: Dental Coverage

 

What proportion of adults has dental coverage?

 

  • In 2004, approximately 103 million adults or 60% of the adult community population had private dental coverage during the year.

Pie charts - Refer to text conversion table below for details.

What proportion of adults has dental coverage?
Private dental insurance 60.4%
Public dental insurance 5.3%
No dental coverage 34.3%

 

How is dental coverage distributed across the adult population?

 

  • In 2004, dental coverage varied by age, family income, race/ethnicity, and education.

  • Adults from a family with lower income were less likely to have private dental coverage and more likely to have public coverage.

  • Poor adults and adults from a family with low income were more likely to have no dental coverage in 2004 than adults from a family with middle or high income.

 

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage

Age

  Private dental coverage Public dental coverage only No dental coverage
21-44 60.1% 5.7% 34.2%
45-64 60.9% 4.7% 34.3%
Percentage with dental coverage

Family income

  Private dental coverage Public dental coverage only No dental coverage
Poor 16.4% 24.5% 59.1%
Low income 38.1% 10.7% 51.2%
Middle income 62.5% 2.8% 34.8%
High income 78.3% 0.3% 21.4%

 

  • Black non-Hispanics and Hispanics were more likely to have no dental coverage in 2004 than white non-Hispanic adults or adults of other race/ethnicity categories.

  • Adults with less than a high school education were more likely to have no dental coverage in 2004 than high school or college graduates.

 

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage

Race/ethnicity

  Private dental coverage Public dental coverage only No dental coverage
Black non-Hispanic 55.9% 9.2% 35.0%
Hispanic 39.7% 8.9% 51.5%
White non-Hispanic 65.3% 3.8% 30.9%
Other* 61.9% 6.2% 31.9%
Percentage with dental coverage

Education

  Private dental coverage Public dental coverage only No dental coverage
Some or no school 30.6% 13.8% 55.6%
High school graduate 56.5% 6.6% 36.9%
College graduate 71.4% 2.1% 26.5%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

Do dental care visits vary by dental coverage status?

 

  • In 2004, 56% of the adult population with private dental coverage had a dental visit, 28% of the adult population with public dental coverage only had a dental visit, and 22% of adults without any dental coverage had a dental visit.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
Overall 42.9%
Private dental coverage 55.9%
Public dental coverage only 27.9%
No dental coverage 22.2%
Average number of dental visits for
persons with a visit

Overall

2.32
Private dental coverage 2.36
Public dental coverage only 2.39
No dental coverage 2.12

 

Do dental care expenses vary by dental coverage status?

 

  • In 2004, total dental expenses for the adult community population of the United States was $41 billion (data not shown).

Bar charts - Refer to text conversion table below for details.

Average annual dental expense for persons with a dental visit during 2004

Overall $556
Private dental coverage $582
Public dental coverage only $442
No dental coverage $466

Return to Table of Contents

 

Section 3: Changes from 1996 to 2004

 

How has the percentage of the adult population with a dental visit changed from 1996 to 2004?

 

  • There was no significant change in the percentage of adults with a dental visit from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
1996 43.9%
2004 42.9%

 

  • Younger and middle-income adults had a significant decrease in the likelihood of having a dental visit from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Age

  1996 2004
21-44 41.2% 38.7%
45-64 48.8% 48.6%
Percentage with a dental visit

Income

  1996 2004
Poor 25.4% 22.7%
Low Income 30.1% 26.9%
Middle Income 42.8% 39.7%
High Income 55.7% 56.2%

 

  • High school graduates had a significant decrease in the likelihood of having a dental visit from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Race/ethnicity

  1996 2004
Black non-Hispanic 27.8% 29.6%
Hispanic 28.8% 26.8%
White non-Hispanic 48.9% 48.7%
Other* 40.1% 40.8%
Percentage with a dental visit

Education

  1996 2004
Some or no school 23.7% 20.8%
High school graduate 38.9% 35.7%
College graduate 54.6% 53.6%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • Adults without dental coverage had a statistically significant decrease in the likelihood of having a dental visit from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
  1996 2004
Private dental coverage 55.7% 55.9%
Public dental coverage only 32.5% 27.9%
No dental coverage 26.8% 22.2%

 

How have dental visits and dental expenses changed from 1996 to 2004?

 

  • There was no statistically significant change in the average number of dental visits per adult for those with a dental visit from 1996 to 2004.

  • Average dental expenses increased from $361 ($434 adjusted for inflation) in 1996 to $556 in 2004.

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for
adults with a visit
1996 2.40
2004 2.32
Average dental expense for adults
with a dental visit
1996 $361
1996 adjusted for inflation $434
2004 $556

 

How have average visits per adult for those with a dental visit changed from 1996 to 2004?

 

  • Adults age 45-64 and adults in the low- or middle-income category had a significant decrease in the number of dental visits per year from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average number of dental visits
 for adults with a visit

Age

  1996 2004
21-44 2.20 2.12
45-64 2.70 2.53
Average number of dental visits
for adults with a visit

Income

  1996 2004
Poor 2.10 2.38
Low Income 2.38 2.08
Middle Income 2.33 2.18
High Income 2.49 2.42

 

  • There was no statistically significant change in the average number of dental visits per adult for those with a dental visit from 1996 to 2004, when considered by race/ethnicity or by educational attainment.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits
for adults with a visit

Race/ethnicity

  1996 2004
Black non-Hispanic 2.14 2.08
Hispanic 2.17 2.06
White non-Hispanic 2.45 2.38
Other* 2.23 2.25
Average number of dental visits
for adults with a visit

Education

  1996 2004
Some or no school 2.21 2.26
High school graduate 2.40 2.28
College graduate 2.43 2.34

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • Adults with private dental coverage had a significant decrease in the number of dental visits per year from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for adults with a visit
  1996 2004
Private dental coverage 2.47 2.36
Public dental coverage only 2.24 2.39
No dental coverage 2.19 2.12

 

How has the average dental expense for those with a dental visit changed from 1996 to 2004?

 

  • For each age and income category, the average expense (adjusted for inflation) increased from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average dental expense for those with a dental visit

Age

  1996 1996 adjusted for inflation 2004
21-44 $319 $384 $488
45-64 $425 $512 $630
Average dental expense for those with a dental visit

Income

  1996 1996 adjusted for inflation 2004
Poor $293 $352 $496
Low income $302 $364 $481
Middle income $345 $416 $485
High income $392 $472 $613

 

  • While black non-Hispanic and Hispanic adults and adults of other race/ethnicity categories did not have a statistically significant increase in expenses (adjusted for inflation) from 1996 to 2004, white non-Hispanic adults did.

  • For each education category, the average expense (adjusted for inflation) increased from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for those with a dental visit

Race/ethnicity

  1996 1996 adjusted for inflation 2004
Black Non-Hispanic $313 $377 $424
Hispanic $313 $377 $466
White Non-Hispanic $364 $438 $577
Other* $413 $497 $594
Average dental expense for those with a dental visit

Education

  1996 1996 adjusted for inflation 2004
Less than high school $300 $361 $584
High school graduate $355 $427 $571
College graduate $374 $450 $548

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • For adults with private or no dental coverage, the average expense (adjusted for inflation) increased from 1996 to 2004.

  • No significant change (adjusted for inflation) was observed for adults with public dental coverage only from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Average dental expense for those with a dental visit
  1996 1996 adjusted for inflation 2004
Private dental coverage $393 $473 $582
Public dental coverage only $254 $306 $442
No dental coverage $273 $329 $466

 

How has the likelihood of having at least one type of procedure changed from 1996 to 2004?

 

  • Adults were more likely to have at least one diagnostic, preventive, or orthodontic procedure and less likely to have at least one restorative or oral surgery procedure in 2004 than in 1996.

 

Bar charts - Refer to text conversion table below for details.

Percentage of population with at least one procedure
  1996 2004
Diagnostic 81.8% 85.5%
Preventive 74.3% 78.9%
Restorative 25.3% 22.6%
Prosthetic 17.9% 16.4%
Oral surgery 13.2% 11.5%
Periodontic 3.2% 3.2%
Endodontic 6.5% 6.2%
Orthodontic 1.4% 2.1%
Other* 5.1% 4.4%

 

*Other includes treatment for TMD or TMJ (jaw pain), bonding, whiting, or bleaching.

 

How has the distribution of procedures changed from 1996 to 2004?

 

  • The total number of procedures increased from about 276 million in 1996 to about 312 million in 2004 (data not shown).

  • As a percentage of all procedures, from 1996 to 2004 diagnostic procedures increased while restorative, prosthetic, oral surgery, and other procedure types decreased.

Bar charts - Refer to text conversion table below for details.

Distribution of dental procedures
  1996 2004
Diagnostic 41.6% 44.6%
Preventive 28.7% 29.5%
Restorative 8.9% 7.5%
Prosthetic 8.8% 7.8%
Oral surgery 4.6% 3.8%
Periodontic 1.2% 1.2%
Endodontic 2.9% 2.5%
Orthodontic 1.6% 1.8%
Other* 1.8% 1.3%

 

*Other includes treatment for TMD or TMJ (jaw pain), bonding, whiting, or bleaching.

 

How have dental expenses changed from 1996 to 2004 by category of procedure?

 

  • Average dental expenses increased from $115 ($138 adjusted for inflation) in 1996 to $181 and $142 ($171 adjusted for inflation) in 1996 to $225 for preventive/diagnostic procedures and restorative procedures, respectively, in 2004.

  • Expenses for other dental procedures (periodontic, orthodontic, prosthetic, endodontic, and oral surgery) increased from $239 ($288 adjusted for inflation) in 1996 to $411 ($288 adjusted for inflation) in 2004.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for adults per visit by procedure category
  1996 1996 adjusted for inflation 2004
Overall $151 $181 $241
Preventive/Diagnostic $115 $138 $181
Restorative $142 $171 $225
Other* $239 $288 $411

 

*Other includes periodontic (gums), orthodontic (braces), prosthetic (crown, bridges, and dentures), endodontic (root canals), oral surgery, treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

How has the percentage of adults with dental coverage changed from 1996 to 2004?

 

  • The percentage of adults with private dental coverage increased from 58% in 1996 to 60% in 2004. There was a decrease in the percentage of adults with no dental coverage from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage
  1996 2004
Private dental coverage 58.1% 60.4%
Public dental coverage only 5.1% 5.3%
No dental coverage 36.7% 34.3%

 

How has distribution of dental coverage changed from 1996 to 2004?

 

  • There was a decrease in the percentage of adults age 45-64 with no dental coverage from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Changes in coverage by age

Adults age 21-44

  1996 2004
Private dental coverage 57.9% 60.1%
Public dental coverage only 5.8% 5.7%
No dental coverage 36.3% 34.2%
Changes in coverage by age

Adults age 45-64

  1996 2004
Private dental coverage 58.7% 60.9%
Public dental coverage only 3.9% 4.7%
No dental coverage 37.4% 34.3%

 

  • Low- and middle-income adults had an increase in public dental coverage only from 1996 to 2004.

  • High-income adults had a significant increase in private dental coverage and a decrease in no dental coverage from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Changes in coverage by income

Poor

  1996 2004
Private dental coverage 17.3% 16.4%
Public dental coverage only 28.3% 24.5%
No dental coverage 54.4% 59.1%
Changes in coverage by income

Low family income

  1996 2004
Private dental coverage 38.3% 38.1%
Public dental coverage only 7.7% 10.7%
No dental coverage 54.0% 51.2%
Changes in coverage by income

Middle family income

  1996 2004
Private dental coverage 63.1% 62.5%
Public dental coverage only 1.5% 2.8%
No dental coverage 35.4% 34.8%
Changes in coverage by income

High family income

  1996 2004
Private dental coverage 73.7% 78.3%
Public dental coverage only 0.5% 0.3%
No dental coverage 25.8% 21.4%

 

  • No change is noted for Hispanics or black non-Hispanics and adults of other race categories, regardless of the type of dental coverage.

  • White non-Hispanic adults had an increase in private dental coverage and a decrease in no dental coverage from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Changes in coverage by race/ethnicity

Black non-Hispanic

  1996 2004
Private dental coverage 51.4% 55.9%
Public dental coverage only 10.0% 9.2%
No dental coverage 38.6% 35.0%
Changes in coverage by race/ethnicity

Hispanic

  1996 2004
Private dental coverage 39.4% 39.7%
Public dental coverage only 11.6% 8.9%
No dental coverage 49.0% 51.5%
Changes in coverage by race/ethnicity

White non-Hispanic

  1996 2004
Private dental coverage 62.0% 65.3%
Public dental coverage only 3.2% 3.8%
No dental coverage 34.8% 30.9%
Changes in coverage by race/ethnicity

Other*

  1996 2004
Private dental coverage 57.6% 61.9%
Public dental coverage only 7.6% 6.2%
No dental coverage 34.7% 31.9%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • There were no significant changes by education in the percentage of adults with private dental coverage from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Changes in coverage by education

School or no school

  1996 2004
Private dental coverage 29.6% 30.6%
Public dental coverage only 14.1% 13.8%
No dental coverage 56.4% 55.6%
Changes in coverage by education

High school graduate

  1996 2004
Private dental coverage 55.6% 56.5%
Public dental coverage only 5.4% 6.6%
No dental coverage 39.0% 36.9%
Changes in coverage by education

College graduate

  1996 2004
Private dental coverage 70.1% 71.4%
Public dental coverage only 1.8% 2.1%
No dental coverage 28.2% 26.5%

Return to Table of Contents

 

Chapter 4. Older Adults: Age 65 and Over

 

Section 1: Dental Use

 

What proportion of the older adult population has a dental visit?

 

  • In 2004, there were about 37 million older adults in the community population of the United States.

  • Approximately 43% of the older adult population had at least one dental visit during the year.

  • The average expense was $620 per year for older adults with a dental visit, and the average number of visits was 2.7 visits per older adult for older adults with a visit (data not shown).

 

Pie charts - Refer to text conversion table below for details.

What proportion of the older adult population has a dental visit?
Dental visit 43.0%
No dental visit 57.0%
Total older adult population = 37 million

 

What procedures do older adults receive?

 

  • In 2004, approximately 16 million older adults with at least one dental visit received about 74 million dental procedures in the United States.

  • Approximately 82% of the older adult population receiving at least one dental visit had at least one diagnostic procedure (examination or x-ray), and about 75% of the older adult population had at least one preventive procedure (cleaning, fluoride, or sealant) during the year.

  • Together, approximately 70% of all procedures were diagnostic (42.0%) or preventive (27.5%) during 2004.

 

Bar charts - Refer to text conversion table below for details.

Percentage of population with at least one procedure
Diagnostic 82.2%
Preventive 74.7%
Restorative 24.5%
Prosthetic 29.7%
Oral surgery 13.7%
Other* 11.8%
Total population with a visit = 16 million

Pie charts - Refer to text conversion table below for details.

Distribution of procedures
Diagnostic 42.0%
Preventive 27.5%
Restorative 7.5%
Prosthetic 14.5%
Oral surgery 3.9%
Other* 4.6%
Total procedures = 74 million

 

*Other includes periodontic (gums), endodontic (root canals), orthodontic (braces), treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

What dental providers do older adults visit?

 

  • In 2004, approximately 16 million older adults with at least one dental visit made about 43 million visits to a dental office in the United States.

  • Approximately 91% of older adult dental visits were to a general dentist.

  • While 3.6% of older adult dental visits were to an oral surgeon, 5.1% were to other dental providers including endodontists (dentists who perform root canals), periodontists (dentists who treat gums), or orthodontists (dentists who correct improper bites).

  • About 36% of all dental visits included care by both a dentist and a non-dentist team member.*

 

Pie charts - Refer to text conversion table below for details.

Dentist provider visits
General dentist 91.2%
Oral surgeon 3.6%
Orthodontist 0.7%+
Periodontist 2.6%
Endodontist 1.8%
Total visits = 43 million

 

*Non-dentist team members include dental hygienists, dental technicians, or other non-dentist dental specialists.
+Relative standard error greater than 30%

 

How are dental visits distributed across the older adult population?

 

  • In 2004, the likelihood of having a dental visit varied by age, family income, race/ethnicity, and education.

  • Approximately 46% of older adults age 65-74 and 39% of older adults age 75 and over had at least one dental visit during the year.

  • While 60% of older adults from a high-income family had at least one dental visit during the year, less than 31% of older adults from a poor- or low-income family had at least one dental visit during the year.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Age

65-74 46.4%
75 and over 39.3%
Percentage with a dental visit

Family income

Poor 28.2%
Low Income 30.5%
Middle Income 41.1%
High Income 59.9%

 

  • Black non-Hispanics and Hispanics were less likely to have a dental visit in 2004 than white non-Hispanic older adults or older adults of other race/ethnicity categories.

  • Adults with less than a high school education were less likely to have a dental visit in 2004 than college graduates.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Race/ethnicity

Black non-Hispanic 18.1%
Hispanic 22.7%
White non-Hispanic 47.3%
Other 38.7%
Percentage with a dental visit

Education

Some or no school 20.4%
High school graduate 43.4%
College graduate 60.0%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

Return to Table of Contents

 

Section 2: Dental Coverage

 

What proportion of older adults has dental coverage?

 

  • In 2004, approximately 9 million older adults or 24% of the older adult community population had private dental coverage during the year.

  • Approximately 70% of all older adults did not have any dental coverage.

Pie charts - Refer to text conversion table below for details.

What proportion of older adults has dental coverage?
Private dental insurance 23.8%
Public dental insurance 6.3%
No dental coverage 69.9%

 

How is dental coverage distributed across the older adult population?

 

  • In 2004, dental coverage varied by age, family income, race/ethnicity and education.

  • About 29% of 65-74 year olds and 18% of older adults age 75 and over had private dental coverage during 2004.

  • Older adults from a poor family or from a family with low or middle income were less likely to have private dental coverage and more likely to have no dental coverage in 2004 than older adults from a family with higher income.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage

Age

  Private dental coverage Public dental coverage only No dental coverage
65-74 29.2% 6.1% 64.6%
75 and over 17.8% 6.5% 75.7%
Percentage with dental coverage

Family income

  Private dental coverage Public dental coverage only No dental coverage
Poor 10.6% 18.0% 71.3%
Low income 15.2% 10.9% 73.9%
Middle income 19.3% 3.1% 77.6%
High income 39.3% 1.8% 58.8%

 

  • Hispanic older adults were less likely to have private dental coverage in 2004 than black non-Hispanic older adults or white non-Hispanic older adults.

  • Older adults with less than a high school education were less likely to have private dental coverage in 2004 than college graduates.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage

Race/ethnicity

  Private dental coverage Public dental coverage only No dental coverage
Black non-Hispanic 22.5% 12.6% 64.9%
Hispanic 16.0% 18.3% 65.7%
White non-Hispanic 25.2% 3.4% 71.4%
Other* 10.8% 31.1% 58.1%
Percentage with dental coverage

Education

  Private dental coverage Public dental coverage only No dental coverage
Some or no school 12.0% 13.6% 74.4%
High school graduate 23.0% 3.8% 73.2%
College graduate 33.6% 3.0% 63.4%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

Do dental care visits vary by dental coverage status?

 

  • In 2004, while 65% of the older adult population with private dental coverage had a dental visit, 26% of the older adult population with public dental coverage only had a dental visit and 37% of the older adult population without any dental coverage had a dental visit.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
Overall 43.0%
Private dental coverage 65.0%
Public dental coverage only 26.3%
No dental coverage 37.0%
Average number of dental visits for
persons with a visit

Overall

2.72
Private dental coverage 2.89
Public dental coverage only 2.95
No dental coverage 2.60

 

Do dental care expenses vary by dental coverage status?

 

  • In 2004, the total dental expense for the older adult community population of the United States was $10 billion (data not shown).

  • The average annual expense was $620 for older adults with a dental visit during 2004.

Bar charts - Refer to text conversion table below for details.

Average annual dental expense for persons with a dental visit

Overall $620
Private dental coverage $824
Public dental coverage only $535
No dental coverage $528

Return to Table of Contents

 

Section 3: Changes from 1996 to 2004

 

How has the percentage of the older adult population with a dental visit changed from 1996 to 2004?

 

  • There was no significant change in the percentage of the older adult population with a dental visit from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit
1996 40.3%
2004 43.0%

 

  • Adults age 75 and older were more likely to have a dental visit in 2004 than in 1996.

 

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Age

  1996 2004
65-74 46.9% 46.4%
75 and over 32.2% 39.3%
Percentage with a dental visit

Income

  1996 2004
Poor 24.0% 28.2%
Low Income 28.6% 30.5%
Middle Income 43.6% 41.1%
High Income 57.8% 59.9%

 

  • No significant changes by race/ethnicity or education in the percentage of older adults with a dental visit from 1996 to 2004 were noted.

Bar charts - Refer to text conversion table below for details.

Percentage with a dental visit

Race/ethnicity

  1996 2004
Black non-Hispanic 16.7% 18.0%
Hispanic 25.1% 22.7%
White non-Hispanic 43.6% 47.3%
Other* 31.8% 38.7%
Percentage with a dental visit

Education

  1996 2004
Some or no school 23.7% 20.4%
High school graduate 45.2% 43.4%
College graduate 61.4% 60.0%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • Older adults with public dental coverage only were more likely to have a dental visit in 2004 than in 1996.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage
  1996 2004
Private dental coverage 64.8% 65.0%
Public dental coverage only 15.4% 26.3%
No dental coverage 34.9% 37.0%

 

How have dental visits and dental expenses changed from 1996 to 2004?

 

  • There was no statistically significant change in the average number of dental visits per older adult for those with a dental visit from 1996 to 2004.

  • Average dental expenses increased from $438 ($527 adjusted for inflation) in 1996 to $620 in 2004.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for
older adults with a visit
1996 2.92
2004 2.72
Average dental expense for older
adults with a dental visit
1996 $438
1996 adjusted for inflation $527
2004 $620

 

How have average visits per older adult for those with a dental visit changed from 1996 to 2004?

 

  • There were no statistically significant changes by age or income in the number of visits by older adults with a dental visit from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits
 for older adults with a visit

Age

  1996 2004
65-74 3.03 2.74
75 and over 2.73 2.69
Average number of dental visits
for older adults with a visit

Income

  1996 2004
Poor 2.63 2.96
Low Income 2.62 2.55
Middle Income 3.04 2.61
High Income 3.03 2.82

 

  • No significant changes by race/ethnicity or education in the average number of visits for older adults with a dental visit from 1996 to 2004 were noted.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits
for older adults with a visit

Race/ethnicity

  1996 2004
Black non-Hispanic 3.01 2.27
Hispanic 2.79 2.40
White non-Hispanic 2.93 2.76
Other* 2.54 2.41
Average number of dental visits
for older adults with a visit

Education

  1996 2004
Some or no school 2.59 2.40
High school graduate 2.97 2.64
College graduate 3.11 2.84

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

  • No significant changes by dental coverage status in the average number of visits by older adults with a dental visit from 1996 to 2004 were noted.

 

Bar charts - Refer to text conversion table below for details.

Average number of dental visits for older adults with a visit
  1996 2004
Private dental coverage 3.24 2.89
Public dental coverage only 2.56 2.95
No dental coverage 2.74 2.60

 

How has the average dental expense for those with a dental visit changed from 1996 to 2004?

 

  • For high-income older adults, the average expense (adjusted for inflation) increased from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for those with a dental visit

Age

  1996 1996 adjusted for inflation 2004
65-74 $454 $547 $636
75 and over $409 $493 $601
Average dental expense for those with a dental visit

Income

  1996 1996 adjusted for inflation 2004
Poor $360 $434 $822
Low income $339 $409 $491
Middle income $508 $612 $550
High income $441 $532 $691

 

  • For white non-Hispanics and college graduates, the average expense (adjusted for inflation) increased from 1996 to 2004.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for those with a dental visit

Race/ethnicity

  1996 1996 adjusted for inflation 2004
Black Non-Hispanic $534 $643 $407
Hispanic $335 $403 $656
White Non-Hispanic $438 $527 $630
Other* $435 $524 $557
Average dental expense for those with a dental visit

Education

  1996 1996 adjusted for inflation 2004
Less than high school $452 $544 $549
High school graduate $414 $498 $552
College graduate $459 $553 $684

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • No significant change (adjusted for inflation) was observed from 1996 to 2004 in average dental expense for older adults with a dental visit, regardless of type of dental coverage.

 

Bar charts - Refer to text conversion table below for details.

Average dental expense for those with a dental visit
  1996 1996 adjusted for inflation 2004
Private dental coverage $552 $664 $817
Public dental coverage only $432 $520 $518
No dental coverage $367 $442 $510

 

How has the likelihood of having at least one type of procedure changed from 1996 to 2004?

 

  • Older adults were less likely to have at least one restorative or other procedure in 2004 than in 1996.

Bar charts - Refer to text conversion table below for details.

Percentage of population with at least one procedure
  1996 2004
Diagnostic 78.8% 82.2%
Preventive 71.4% 74.7%
Restorative 29.8% 24.5%
Prosthetic 33.4% 29.7%
Oral surgery 14.0% 13.7%
Other* 15.9% 11.8%

 

*Other includes periodontic (gums), endodontic (root canals), orthodontic (braces), treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

How has the distribution of procedures changed from 1996 to 2004?

 

  • For older adults, the total number of procedures increased from about 64 million in 1996 to about 74 million in 2004 (data not shown).

  • As a percentage of all procedures, from 1996 to 2004 diagnostic procedures increased while restorative procedure types decreased.

Bar charts - Refer to text conversion table below for details.

Distribution of dental procedures
  1996 2004
Diagnostic 38.3% 42.0%
Preventive 25.7% 27.5%
Restorative 9.6% 7.5%
Prosthetic 16.1% 14.5%
Oral surgery 4.8% 3.9%
Other* 5.6% 4.6%

 

*Other includes periodontic (gums), endodontic (root canals), orthodontic (braces), treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

How have dental expenses changed from 1996 to 2004 by category of procedure?

 

  • For older adults, average dental expenses increased from $124 ($149 adjusted for inflation) in 1996 to $184 for restorative procedures in 2004.

  • Expenses for other dental procedures (periodontic, orthodontic, prosthetic, endodontic, and oral surgery) increased from $194 ($233 adjusted for inflation) in 1996 to $403 in 2004.

Bar charts - Refer to text conversion table below for details.

Average dental expense for older adults per visit by procedure category
  1996 1996 adjusted for inflation 2004
Overall $150 $181 $230
Preventive/Diagnostic $134 $161 $156
Restorative $124 $149 $184
Other* $194 $233 $403

 

*Other includes periodontic (gums), endodontic (root canals), prosthetic (crown, bridges, and dentures), orthodontic (braces), oral surgery, treatment for TMD or TMJ (jaw pain), and bonding, whiting, or bleaching.

 

How has the percentage of older adults with dental coverage changed from 1996 to 2004?

  • There were no significant changes in the percentage of older adults with private, public only, or no dental coverage from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Percentage with dental coverage
  1996 2004
Private dental coverage 23.2% 23.8%
Public dental coverage only 7.9% 6.3%
No dental coverage 68.9% 69.9%

 

How has distribution of dental coverage changed from 1996 to 2004?

 

  • No significant changes by age in the percentage of older adults with private dental coverage from 1996 to 2004 were noted.

Bar charts - Refer to text conversion table below for details.

Changes in coverage by age

Adults age 65-74

  1996 2004
Private dental coverage 28.6% 29.2%
Public dental coverage only 8.0% 6.1%
No dental coverage 63.4% 64.6%
Changes in coverage by age

Adults age 75 and above

  1996 2004
Private dental coverage 16.7% 17.8%
Public dental coverage only 7.8% 6.5%
No dental coverage 75.5% 75.7%

 

  • Older adults from a middle-income family were less likely to have private dental coverage and more likely to have no dental coverage than older adults from a family with either lower or higher income in 2004 than in 1996.

 

Bar charts - Refer to text conversion table below for details.

Changes in coverage by income

Poor

  1996 2004
Private dental coverage 11.9% 10.6%
Public dental coverage only 20.0% 18.0%
No dental coverage 68.1% 71.3%
Changes in coverage by income

Low family income

  1996 2004
Private dental coverage 12.3% 15.2%
Public dental coverage only 10.8% 10.9%
No dental coverage 77.0% 73.9%
Changes in coverage by income

Middle family income

  1996 2004
Private dental coverage 28.5% 19.3%
Public dental coverage only 4.5% 3.1%
No dental coverage 67.0% 77.6%
Changes in coverage by income

High family income

  1996 2004
Private dental coverage 34.8% 39.3%
Public dental coverage only 3.3% 1.8%
No dental coverage 61.9% 58.8%

 

  • Black non-Hispanic older adults had a significant increase in the likelihood of having private dental coverage from 1996 to 2004.

  • White non-Hispanic older adults had a significant decrease in the likelihood of having public dental coverage only from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Changes in coverage by race/ethnicity

Black non-Hispanic

  1996 2004
Private dental coverage 12.5% 22.5%
Public dental coverage only 18.4% 12.6%
No dental coverage 69.2% 64.9%
Changes in coverage by race/ethnicity

Hispanic

  1996 2004
Private dental coverage 14.4% 16.0%
Public dental coverage only 26.1% 18.2%
No dental coverage 59.5% 65.7%
Changes in coverage by race/ethnicity

White non-Hispanic

  1996 2004
Private dental coverage 24.6% 25.2%
Public dental coverage only 5.1% 3.4%
No dental coverage 70.3% 71.4%
Changes in coverage by race/ethnicity

Other*

  1996 2004
Private dental coverage 25.4% 10.8%
Public dental coverage only 32.2% 31.1%
No dental coverage 42.4% 58.1%

 

*Other includes non-Hispanics who reported to be of single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

 

  • There were no statistically significant changes by education in the percentage of older adults with private dental coverage from 1996 to 2004.

Bar charts - Refer to text conversion table below for details.

Changes in coverage by education

Some or no school

  1996 2004
Private dental coverage 14.1% 12.0%
Public dental coverage only 13.4% 13.6%
No dental coverage 72.4% 74.4%
Changes in coverage by education

High school graduate

  1996 2004
Private dental coverage 26.4% 23.0%
Public dental coverage only 5.0% 3.8%
No dental coverage 68.6% 73.2%
Changes in coverage by education

College graduate

  1996 2004
Private dental coverage 34.0% 33.6%
Public dental coverage only 3.1% 3.0%
No dental coverage 62.9% 63.4%

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References

Cohen J. Design and methods of the Medical Expenditure Panel Survey Household Component. Rockville (MD): Agency for Health Care Policy and Research; 1997. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026.

Cohen S. Sample design of the 1996 Medical Expenditure Panel Survey Household Component. Rockville (MD): Agency for Health Care Policy and Research; 1997. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027.

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, July 2003: 41(7) Supplement: lll-5- lll-12.

Brown E, Manski R. Dental services: use, expenses, and sources of payment, using data from the 1996-2000. Rockville(MD): Agency for Healthcare Research and Quality; 2003. MEPS Research Findings 20. AHRQ Pub. No. 04-0018.

Monheit AC, Wilson R, Arnett RH. Informing American health care policy: the dynamics of medical expenditure and insurance surveys, 1977-1996. San Francisco: Jossey-Bass, 1999.

Please consult the MEPS Web site (http://www.meps.ahrq.gov) for an updated publications list and other information from MEPS. For additional information, contact the MEPS project director at mepsprojectdirector@ahrq.hhs.gov.

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Definition of Terms

Dental Visit
This refers to care by or visits to any type of dental care provider, including general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists.

Dental Coverage Variables
Respondents were asked if they were covered by a private health insurance plan that included at least some dental coverage for each round of 1996 and 2004. This information was elicited from a pick-list,code-all-that-apply question that asked what type of health insurance the person obtained through an establishment. The list included hospital and physician benefits, including coverage through an HMO, Medigap coverage, vision coverage, dental, and prescription drugs. It is possible that some dental coverage provided by hospital and physician plans was not independently enumerated in this question. Persons with missing information on dental benefits for all reported private plans and those who reported that they did not have dental coverage for one or more plans but had missing information on other plans are coded as not having private dental coverage. Respondents who reported dental coverage from at least one reported private plan were coded as having private dental coverage.

The variable for dental coverage indicates if a participant was eligible to receive and/or actually received payments on their behalf for dental care obtained during 1996 and 2004. More specifically, an individual is considered to have dental coverage with a self or proxy report of dental coverage at any time during 1996 or 2004. An individual may or may not have full year coverage. An individual is also considered to have dental coverage with a self or proxy report of an insurance payment for dental care received.

While Medicaid/SCHIP provides medical care coverage for all enrolled children, Medicaid/SCHIP dental coverage often varies in scope or reimbursement level among the different states. The variable for Medicaid/SCHIP dental coverage indicates if a participant was enrolled (eligible and enrolled) to receive dental Medicaid/SCHIP coverage and/or actually received Medicaid/SCHIP payments on their behalf for dental care obtained during 1996 and 2004. Specifically, for 1996 an individual is considered to have Medicaid dental coverage with a self or proxy report of Medicaid coverage at any time during 1996 consistent with 1989 OBRA and state regulations and state eligibility expansions. For instance, pregnant women in families with a poverty status up to 133% of the Federal poverty level (FPL), children up to age 6 in families with a poverty status at least up to 133% FPL, and children up to age 14 in families with a poverty status at least up to 100% FPL are considered to have Medicaid dental coverage if they have a report of Medicaid coverage. Additionally, persons residing in states that expanded Medicaid eligibility beyond these minimum income requirements are considered Medicaid covered if they reside in an “expansion state” and report Medicaid coverage. Expansion states for 1996 include California, Connecticut, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, North Dakota, Pennsylvania, Washington, and Wisconsin. Persons who qualify as Medicaid covered at any of the three MEPS interviews are considered to be covered.

For 2004, an individual is considered to have Medicaid/SCHIP dental coverage with a self or proxy report of Medicaid/SCHIP coverage at any time during 2004 consistent with state regulations and state eligibility expansions. An individual may or may not have full-year coverage. In some states, dental SCHIP coverage was limited or absent during 2004. Persons residing in states that excluded dental SCHIP are considered to have no public coverage if not eligible for Medicaid. Delaware and Texas are SCHIP dental excluded states. Persons who qualify as Medicaid/SCHIP covered at any of the three MEPS interviews are considered to be covered. Additionally, persons residing in states that expanded Medicaid eligibility beyond these minimum income requirements are considered Medicaid covered if they reside in an “expansion state” and report Medicaid coverage. Expansion states for 2004 include California, Connecticut, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania,  Rhode Island, South Dakota, Vermont, Washington, and Wisconsin.

For 2004, an individual is considered to have no dental coverage if an individual has no report of private or public dental coverage at any time during the year.

Education
Education* is expressed in terms of years or formal education. In this chartbook, the following classification was used:

  • Some or no school—Less than 12 years of formal education

  • High school graduate —12 years of formal education

  • College graduate—More than 12 years of formal education

*For children 20 years of age and younger, education refers to a caregiver’s (parent or guardian) education.

Expenses
Dental expenditures (expenses). In this report, expenditures are the amount actually paid for dental services. More specifically, in MEPS, expenditures are defined as the sum of payments for care received, including out-of-pocket payments and payments made by private insurance, Medicaid, Medicare, and other sources.

This definition of expenditures differs somewhat from the definition used in predecessor surveys, the 1987 National Medical Expenditure Survey (NMES) and the 1977 National Medical Care Expenditure Survey, in which charges rather than payments were used to measure medical expenditures. Users who wish to compare the expenditure data presented in this report with data from the 1987 and/or 1977 surveys should consult Monheit, Wilson, and Arnett (1999). AHRQ has developed factors to apply to the 1987 NMCES expenditure data to facilitate longitudinal analysis. These can be accessed via the AHRQ Data Center; for information on applying to the AHRQ Data Center see http://www.meps.ahrq.gov/mepsweb/data_stats/onsite_datacenter.jsp. Details on the editing and imputation methodology used to develop the dental expenditure variables presented in this report can be found in the documentation for the dental event files. See http://www.meps.ahrq.gov/mepsweb/data_stats/download_data/pufs/h85b/h85bdoc.shtml for the 2004 dental event file link.

It should also be noted that it is common for several dental visits to be included in a single fee. These “flat fees” are particularly common for orthodontia and some types of dental reconstruction and surgery. The flat fee groups may cross calendar years. For flat fees, expenses for the entire episode are placed on the initial event. For comparison purposes, an expenditure amount adjusted for inflation is provided. Specifically, 1996 expenditures are adjusted to 2004 using a Bureau of Labor Statistics derived factor of 1.20 (our adjustment was calculated as follows: the CPI is 156.9 for 1996 and 188.9 for 2004; so the adjustment factor is 188.9/156.9=1.204).

Income
Income is expressed in terms of poverty status, the ratio of the family’s income to the Federal poverty thresholds, which control for the size of the family and the age of the head of the family (see the 2004 U.S. Department of Health and Human Services Poverty Guidelines at http://aspe.hhs.gov/poverty/04poverty.shtml for more details). In this chartbook, the following classification was used:

Poor—Persons in families with income less than or equal to 100% of the poverty line are considered poor. Some of these persons are in families reporting negative income.
Low income—Persons in families with income over 100% through 200% of the poverty line are considered low income.
Middle income—Persons in families with income over 200% through 400% of the poverty line are considered middle income.
High income—Persons in families with income over 400% of the poverty line are considered high income.

Procedures
Procedures refer to at least one procedure type per visit. Multiple procedures of the same type at the same visit are not included. Other service types not identified by respondents are not included.

Diagnostic = Includes examinations and x-rays
Preventive = Includes cleanings, fluoride, sealants and recall visits
Restorative = Fillings and inlays
Prosthetic = Crowns, bridges, dentures, repairs and implants
Periodontic = Periodontic services only
Endodontic = Endodontic services only
Orthodontic = Orthodontic services only
Other = Any other dental service not included above

Population Characteristics
In general, population characteristics were measured as of December 31st of the year of study (1996 or 2004), or the last date that the sample person was part of the civilian noninstitutionalized (community) population living in the United States prior to December 31st of that year.

Comparisons by race/ethnicity in this chartbook are based on the following four race/ethnicity groups: black non-Hispanic, white non-Hispanic, Hispanic, and other. Other includes non-Hispanics who reported being of a single race other than white or black (i.e., American Indian/Alaska Native, Asian, or Native Hawaiian/ Pacific Islander) as well as non-Hispanics who reported to be of multiple races (possibly including black).

Caution should be used when drawing conclusions based on comparisons of race/ethnicity groups for 2004 versus 1996 because the true racial composition of each of the identified race/ethnicity groups cannot be guaranteed to be the same across these years.

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Suggested Citation:
Manski, R. J. and Brown, E. Dental Use, Expenses, Private Dental Coverage, and Changes, 1996 and 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/data_files/publications/cb17/cb17.shtml