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Survey Shows U.S. Oral Health System is Failing


Dentists believe innovative practices––school-based dentistry, collaborative care teams, and services like transportation or child care––can overcome patient barriers to care.

Six in 10 U.S. adults rate oral health as fair or poor, and even more (67%) feel that it will either stay the same or get worse in the next five years, according to independent research conducted by KRC Research and commissioned by DentaQuest, an oral healthcare organization.

DentaQuest commissioned the survey to better understand the beliefs and attitudes of key stakeholders.

More than half of patients (51%) are concerned about their oral health, making it the top health concern over heart, eye, digestive, mental, and skin health. High costs and lack of coverage are significant barriers to getting oral healthcare, and many Americans view the dental system as scary, confusing, inconvenient, or ineffective.

The independent survey polled more than 2,300 Americans including dentists, physicians, patients, employee benefits administrators, and Medicaid dental administrators. The corresponding research report, "Reversible Decay: Oral Health is a Public Health Problem We Can Solve," gives a view of common concerns and potential solutions for America's oral healthcare challenges.

Here are some of the key findings:

America's oral health system is failing and unlikely to improve despite the connection between oral health and overall health.
Patients say oral healthcare is "expensive" (70%), "scary" (32%), "confusing" (28%), and "inconvenient" (27%). Sixty-six percent of dentists agree oral healthcare is too expensive for their patients and one in four dentists, physicians, and employers agree oral healthcare is confusing. Furthermore, eight in 10 physicians predict that Americans' oral health will either stay the same or get worse––and two in three dentists, patients, and employers agree.

Related: CMS Upgrades Medicare Plan Finder, Redesigns Website

Most Americans are misinformed or unsure about dental coverage under Medicaid and Medicare.
Most patients (74%) are either unsure if Medicaid includes dental benefits or believe it does. And 62% are either unsure if Medicare includes dental benefits, or believe it does. Plus, most patients believe Medicare (80%) and Medicaid (78%) should cover dental care. In reality, Medicare does not carry dental benefits, and state-based Medicaid programs include benefits to varying degrees, often only for children.

"An estimated 74 million Americans do not have access to oral healthcare, despite evidence linking oral health to overall health," says Steve Pollock, president and chief executive officer of DentaQuest. "As a result, many Americans forgo preventive dental care or seek treatment in ill-equipped emergency rooms, both of which contribute to rising overall health costs. But there is cause for optimism: patients, dentists, and physicians agree on what it will take to improve Americans' oral and overall health."

Key stakeholders agree on solutions.
Despite the many challenges facing the oral health system, most dentists (93%), physicians (86%), and employers (82%) agree greater collaboration across medical and dental providers would improve patient care. To that end, dentists believe innovative practices can be effective for overcoming patient barriers to care, such as, school-based dentistry (68%), collaborative care teams (64%), and wraparound services like transportation or child care (46%).

Plus, more than four in 10 employers are open to considering innovations in employee benefits. Innovations include providing medical screenings and associated referrals to health professionals and providing convenient access to urgent dental care.

Patients and employers support dental insurance models that emphasize value over volume.
Nearly half of patients (48%) think dental insurance should be based primarily on the impact the procedure will have on overall health, not on the procedure’s total cost. Most employers (87%) agree oral health benefits should prioritize healthy outcomes over volume of services delivered. And more than half of employers (51%) say their organizations would be interested in implementing a value-based care benefit design for dental coverage.

"This research underscores what DentaQuest has known for a long time––that our current oral health system is failing millions of Americans, despite the crucial role it plays in our overall health," Pollack says. "Fortunately, these survey findings demonstrate clear support from key stakeholders on how to improve the oral health system.”

Findings are based on independent public opinion research conducted by KRC Research through a July 2019 online survey.

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