New research discovers growing issues in oral care access and utilization

Although the Affordable Care Act (ACA) has improved children's access to dental services, the situation for adults is getting worse, new research states.

An analysis by the ADA Health Policy Institute (HPI) shows no reversal of the past few years' decline in dental care use by adults, regardless of income or insurance status. This is a result, in part, of both Medicaid policy deprioritizing adult dental care and the ACA omitting adult dental as an essential benefit, according to the institute.

Two recent HPI studies - one on why adults forego dental care and another on how diverting dental emergency visits could save Maryland's Medicaid program $4 million per year - look into the causes, effects and solutions to the dental access problem.

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HPI found inability to pay for care and lack of perceived need are the top reasons adults do not intend to visit a dentist in the next 12 months. Other important reasons include lack of time, transportation problems, anxiety and difficulty finding a dental practice that accepts Medicaid.

The second study, in which HPI focused on Maryland's dental Medicaid program, found that since 2012, per-capita outpatient dental emergency department visits for dental problems have decreased in the state, especially among children and adults aged 21 to 40. The decrease in outpatient ER visits for dental pain among children is likely caused by reforms to Maryland's pediatric Medicaid program since 2007. The study authors concluded an effective statewide emergency department referral program - for both pediatric and adult patients - could save the Maryland Medicaid program up to $4 million per year.

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Emphasizing oral health education and developing strategies to get dental patients out of emergency rooms and into dental chairs are just two of the many initiatives of Action for Dental Health (ADH), the ADA's nationwide, community-based campaign to address the access and utilization problem facing low-income Americans. ADH is comprehensive in its approach and scope and is designed to address the dental health crisis in three distinct areas: providing care now to people who are suffering from untreated disease; strengthening the public/private safety net; and bringing dental health education and disease prevention into underserved communities.

For more information on these and other HPI studies, visit http://www.ada.org/en/science-research/health-policy-institute/publications/research-briefs.