Unmet Dental Needs
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Headline

In 2004, more than 50 percent of children without health insurance had not seen a dentist in the past year, and more than one in five needed dental care but did not receive it for financial reasons. In contrast to children with insurance, 21 percent of uninsured children had unmet dental needs, compared with 4 percent of children covered by private insurance and 8 percent of those covered by public insurance (mostly Medicaid).¹ (See Figure 2)

Importance

Untreated oral diseases may lead to problems in eating, speaking, and sleeping.² Poor oral health among children has been tied to poor performance in school and poor social relationships. Children with chronic dental pain may have difficulty concentrating, poor self-image, and problems completing schoolwork.³ Children with early childhood dental problems also often weigh less.⁴ The American Academy of Pediatric Dentistry recommends that all children visit the dentist within six months of the eruption of the first primary tooth and no later than after the first birthday.⁵

Trends

In 2004, 7 percent of children ages two to 17 had unmet dental needs, meaning they did not receive dental care in the past year due to financial reasons. This proportion has wavered between 6 and 7 percent since 2000. (See Table 1) The percentage of children who had not seen a dentist within the past year was 27 percent in 1997 and was at 23 percent by 2004. (See Table 1)

Differences by Race/Ethnicity⁶

In 2004, non-Hispanic black children were less likely than Hispanic children to have unmet dental needs (6 percent versus 10 percent, respectively).

Twenty-three percent of non-Hispanic white children, 27 percent of non-Hispanic black children, and 34 percent of Hispanic children had not been to the dentist within the past year in 2004. (See Figure 1) Among Hispanic children, 36 percent of Mexican or Mexican American children had not been to the dentist with the past year.

Note: Estimates for 1999-2004 reflect the new Office of Management and Budget race definitions, and include only those who are identified with a single race. Hispanics may be of any race.

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Differences by Health Insurance Coverage

Fifty percent of uninsured children had not been to the dentist within the past year in 2004. Twenty-nine percent of children with Medicaid or other public health insurance and 18 percent of children with private health insurance had not been to the dentist in the past year. (See Table 1)

Differences by Poverty Status

Thirty-five percent of children from poor families, 31 percent of children from near-poor families, and 18 percent of children from non-poor families had not been to the dentist within the past year in 2004. (See Table 1)

Note: Children from poor families are defined as those living in families below the poverty threshold, based on family income and family size using the U.S. Census Bureau's poverty thresholds for the previous calendar year. Children from near-poor families are in families with incomes between 100 and 200 percent of the poverty threshold. Children from not-poor families are in families with incomes 200 percent or greater.

Differences by Age

In 2003, 53 percent of children ages two to four, 16 percent of children ages five to 11, and 17 percent of adolescents ages 12 to 17 had not seen a dentist in the past year.

Related Indicators

Health Care Coverage

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State and Local Estimates

None

International Estimates

While no international estimates exist for unmet dental needs, country profiles for dental caries among twelve-year olds are available from the World Health Organization.
http://www.whocollab.od.mah.se/countriesalphab.html

National Goals

Through its Healthy People 2010 Initiative, the federal government has set many national goals to improve the oral health of children and youth.

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What Works: Programs and Interventions that May Influence this Indicator

Click here to view examples of programs and interventions that research has evaluated for this indicator. View programs

Research References

¹Estimates for 2004 are provisional and may be revised.

²U.S. Department of Health and Human Services. Oral health in America: A report of the surgeon general- executive summary. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000. http://www.surgeongeneral.gov/library/oralhealth/

³2003 Rhode Island Kids' Count FactBook, Rhode Island Kids' Count, Providence, Rhode Island, 2003. http://www.rikidscount.org/matriarch/

⁴National Maternal and Child Oral Health Resource Center. Promoting awareness, preventing pain: Facts on early childhood caries. Washington, DC: Georgetown University, National Maternal and Child Oral Health Resource Center. http://www.mchoralhealth.org/PDFs/ECCFactSheet.pdf

⁵ Council on Clinical Affairs, American Academy of Pediatric Dentistry, "Clinical Guideline on Infant Oral Health," Reference Manual (2002): 54.
http://www.aapd.org/members/referencemanual/pdfs/02-03/G_InfantOralHealth.pdf

⁶Persons of Hispanic or Latino origin may be of any race or combination of races. In accordance with the new OMB race standards, white non-Hispanic only and black non-Hispanic only are limited to people who indicated only one race group.

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Definition

Unmet dental need is based on the question, "During the past 12 months, was there any time when [child's name] needed any of the following but didn't get it because you couldn't afford it: Dental care (including check-ups)?"

Having not seen a dentist in the past year is based on the question "About how long has it been since [child's name] last saw or talked to a dentist, including all types of dentists, orthodontists, oral surgeons, and all other dental specialists, as well as dental hygienists?"

Estimates for 1999-2003 by race have been revised to reflect the new OMB race definitions, and include only those who are identified with a single race. Hispanics may be of any race.

Children from poor families are defined as those living in families below the poverty threshold, based on family income and family size using the U.S. Census Bureau's poverty thresholds for the previous calendar year. Children from near-poor families are in families with incomes between 100 and 200 percent of the poverty threshold. Children from not-poor families are in families with incomes 200 percent or greater.

Data Sources

Data for 2004: National Center for Health Statistics. "Summary Health Statistics for U.S. Children: National Health Interview Survey, 2004." Vital Health Statistics 10(227). 2005. Available online at: http://www.cdc.gov/nchs/data/series/sr_10/sr10_227.pdf

Data for 2003: Dey, AN, Bloom B. Summary Health Statistics for U.S. Children: National Health Interview Survey, 2003. National Center for Health Statistics. Vital Health Statistics 10(223). 2005. Available online at: http://www.cdc.gov/nchs/data/series/sr_10/sr10_223.pdf

Data for 2002: Dey AN, Schiller JS, Tai DA. Summary Health Statistics for U.S. Children: National Health Interview Survey, 2002. National Center for Health Statistics. Vital Health Stat 10(221). 2004.
http://www.cdc.gov/nchs/data/series/sr_10/sr10_221.pdf

Data for 2001: Bloom, B, Cohen, RA, Vickerie, JL, & Wondimu, EA. Summary health statistics for U.S. Children: National Health Interview Survey, 2001. National Center for Health Statistics. Vital and Health Statistics, 10(216). 2003.
http://www.cdc.gov/nchs/data/series/sr_10/sr10_216.pdf

Raw Data Source

National Health Interview Survey.
http://www.cdc.gov/nchs/nhis.htm

Approximate Date of Next Update

2006

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