52 FUTURE OFDENTISTRY

Financing of and Access

to Dental Services

CHAPTER

4

Most Americans today receive the oral health care services that they need and want. As noted in Chapter

2, the nation's overall oral health is improving. The inflation rate for dental services has been moderate, and

dental care accounts for a smaller proportion of overall economic resources compared to previous generations.

Indeed, the near-and long-term outlooks for the affordability and accessibility of dental care for the major-

ity of Americans remain excellent, a situation that owes in no small part to dentistry's outstanding record of

prevention, efficiency and cost-control. However, dental care has not reached every corner of American soci-

ety to the extent it has reached the majority of Americans.

Millions of children and adults from low-income families, people with disabilities, and the low- and fixed-

income elderly––especially those in nursing homes––among others, have difficulty obtaining dental care.

This is especially unfortunate because most oral disease is easily and economically prevented and treated.

Providing basic preventive and restorative care to these groups is achievable, provided that law- and policy-

makers at the state and federal levels are willing to work with the dental profession, other members of the

health community and other stakeholders toward that goal.

The market for dental services is a well-functioning, competitive market. The overall performance of the

general economy influences dentistry just as it does other sectors. Market conditions within and outside den-

tistry affect the amount and types of services provided, the geographical distribution of dentists, average

income levels of dentists and auxiliary personnel, the financial strength of dental practices, and the number

of applicants to and graduates from dental schools.

For the purposes of this discussion, access is viewed as the means of approaching and entering into the

use of dental services. The availability of dental care does not, in and of itself, constitute access. Rather,

access occurs when care is available and people are able and willing to utilize it. Access to dental services

in the United States is a matter of degree. Not surprisingly, people in middle and high-income groups, those

with extended education, and those who live in areas with abundant dental personnel have greater access to

care. For individuals with meager incomes, especially those who live in areas with few dental personnel,

access is more difficult. For individuals who have disabilities and other special problems, access to care can

be exceedingly difficult.

This chapter discusses the trends in dentistry, the status of dental health in America and identifies future

challenges for the financing of and access to dental care, including:

u Status of oral health in the United States;

uUnmet needs for dental services and the major barriers that prevent some people from receiving the

dental services that they need and want, and how these barriers can be reduced or eliminated;

uDemand for dental services, changes in demand in recent years, and future patterns of demand; and,

uHow people pay for dental services, important trends in the demand for dental prepayment, and how

changes in dental prepayment may impact use of dental services and access to dental services.

CHAPTER OVERVIEW