ADA.org: Future of Dentistry Full Report

FUTURE OFDENTISTRY

RACE & ETHNICITY

As shown in Table 4.3, over time, dental visits have
increased for both the White and African American
population. Throughout the time period of 1983-1998,
a higher percentage of the White population visited the
dentist compared to the African American population.
However, the difference has narrowed from 15.2 per-
centage points in 1983 to 8.5 percentage points in

1998. As for dental expenditures, Table 4.2 shows that
      Whites who visited a dentist spent more, on average,
      than African Americans in both 1987 and 1996.
      Again, this difference was smaller in 1996.
      Non-Hispanics are more likely to visit a dentist
      than Hispanics. In contrast to racial patterns, this dif-
      ference has not decreased over time. As for dental ex-
      penditures, non-Hispanics spend more than Hispanics
      and the gap does not appear to have diminished.

POVERTY LEVEL

The percentage of people who
visited the dentist has increased
for both those below poverty and
those at or above poverty.
However, there is approximately
a 20 percentage point difference
in the likelihood of a visit between
these two groups. This difference
is consistent for 1989-1998.
There has been a substantial
increase in the percentage of chil-
dren that visited the dentist between
1989 and 1998 (see Table 4.4). For
children two to four years old
below the poverty level, the likeli-
hood of visiting a dentist increased
by 21.9 percentage points, from
26.4% to 48.3%. For children 5-
17 years old below the poverty level, the likelihood of
visiting a dentist increased by 15.7 percentage points,
from 51.1% to 66.8%.
Among children two to four years old, living
above the poverty level, the percentage of those who
visited the dentist increased by 9.2 percentage
points, from 34.7% to 43.9%. For children 5-17
years old, living above the poverty level, the increase
among those who visited the dentist was 6.8 per-
centage points, from 74.9% to 81.7%. The differ-

ence in the percentages visiting a dentist between

children who are above and below poverty levels

narrowed to one-half of the earlier percentage dif-

ference. Both pre-school and school-age children

demonstrated this improvement. By 1998, pre-

school children living below the poverty level exhib-

ited as high a likelihood of visiting a dentist as those

above poverty. This finding comes as a surprise and

has not been seen before. Confirmation from other

sources is necessary before it can be assumed that

the poverty gap in utilization of dental services in

this age group has vanished.

Among adults, the increase in the likelihood of a

visit was smaller than that for children (see Table

4.4). Across all age groups, persons living below the

national poverty level were less likely to see a den-

tist than those above the poverty level. However,

both groups exhibited substantial improvement in

the likelihood of a visit between 1989 and 1998.

Unlike the experience of children, however, among

adults the differences observed between poverty and

non-poverty groups did not appear to narrow over

this time period.

As might be expected, dental expenditures

increased with the level of income (i.e., percent

of poverty level) between 1987 and 1996. However, dif-

ferences between individuals at the highest and lowest

income levels narrowed by almost 60%, from $236

($607 - $371) to $96 ($516 - $420) in 1996.

Financing of and Access to Dental Services

Percentage Distribution of Persons Two Years of Age and Older who

Visited the Dentist within the Past Year, by Poverty and Age Group^7

Source: National Center for Health Statistics, National Health Interview Survey (1989 and 1998).

26.4

51.1

48.0

33.6

27.2

22.6

48.3^8

66.8

52.3

41.7

32.0

32.7

Below Poverty At or Above Poverty

T A B LE 4.4

2 - 4

5 - 17

18 - 34

35 - 54

55 - 64

65 and over

1989

Age

Group (^1998)
34.7

74. 9

60.1

65.2

58.4

47.4

43. 98

81.7

63.1

71.2

66.4

58.4

1989 1998

(^7) Data derived by ADA staff using public use data files available from NCHS.
(^8) The difference in these two means - the 48.3% utilization rate for 2-4-year-olds below poverty and the 43.9% utilization rate for 2-4-year-
olds above poverty - is not statistically significant.