America's dentists launch nationwide campaign to address U.S. dental crisis

Washington, May 15, 2013 – The nation’s leading organization of dentists today announced a nationwide campaign aimed at boldly addressing the dental health crisis in the U.S. The American Dental Association (ADA) campaign – Action for Dental Health: Dentists Making a Difference – aims to reduce the numbers of adults and children with untreated dental disease, through oral health education, prevention and providing treatment now to people in need of care.

The need is clear, according to new Harris Interactive data released today by the ADA. The study confirmed a disturbing dental divide in America:

• Nearly half of lower-income adults say they haven’t seen a dentist in a year or longer, while the vast majority of middle- and higher-income wage earners (70 percent) have.
• Lower-income adults 18 and older are more than two times as likely as middle- and higher-income adults to have had all of their teeth removed (7 percent vs. 3 percent).
• Nearly one in five (18 percent) lower-income adults have reported that they or a household member has sought treatment for dental pain in an emergency room at some point in their lives, compared to only seven percent of middle- and higher-income adults.
• Only six percent of those low-income adults who went to the ER reported that the problem was solved.
• Even though the Affordable Care Act offers little relief for adult Americans who lack dental coverage, 40% of lower-income adults believe that health care reform will help them obtain dental care.

The survey’s findings echo prior research from multiple sources. According to a new ADA Health Policy Resources Center analysis of 2010 MEPS and U.S. Census data, 181 million Americans did not visit the dentist in 2010. Nearly half of adults over age 30 suffer from some form of gum disease, according to the Centers for Disease Control (CDC), and nearly one in four children under the age of five already have cavities.

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Complex Problem Calls for a Coordinated National Action
Surgeon General David Satcher’s landmark 2000 report “Oral Health in America” identified a “silent epidemic” of untreated oral disease among some populations groups. A subsequent “National Call to Action” articulated an ambitious agenda for ending these disparities.

“We’ve made great progress, with each generation enjoying better dental health than the one before,” said ADA President Robert A. Faiella, D.M.D., M.M.Sc. “But there’s still a dangerous divide in America between those with good dental health and those without. Our mission is to close that divide. Good oral health isn’t a luxury. It’s essential.”

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The causes of the dental health crisis are varied and complex. However, dentists in America believe it can be solved, that it’s never too late to take on this challenge, both as individuals and as a nation. Action for Dental Health is national and coordinated in its scope and approach, and is designed to address the dental health crisis in three distinct areas:

1. Provide care now to people suffering with untreated disease
   • Reduce by 35 percent by 2020 the number of people who visit the emergency room for dental conditions, by referring them to community health centers, private dental practices or other settings, where they can receive proper dental care.
   • Implement in at least 10 states by 2015 a long-term care program to improve the oral health of nursing home residents.
   • Expand the ADA Give Kids A Smile local community programs to provide education, screening and treatment to underserved children in order to achieve the vision statement of Give Kids a Smile: the elimination of cavities in children under five by 2020.
2. Strengthen and expand the public/private safety net to provide more care to more Americans
   • Help provide more care to people by having private-practice dentists contract with Federally Qualified Health Centers, therefore increasing the number patients receiving oral health services 175% by 2020.
   • Fight for increased dental health protections and simplified administration under Medicaid by increasing by 10% the number of states that have streamlined their credentialing process to less than one month.
3. Bring dental health education and disease prevention into communities
   • Ensure that 80% of Americans on public water systems have access to optimally fluoridated drinking water by 2020.
   • Increase from seven to 15 the number of states where Community Dental Health Coordinators (CDHCs) are active by 2015. CDHCs provide dental education and prevention services to the community and help people navigate the dental health system.
     

“We need to remember that every infant is born cavity-free,” said Dr. Faiella. “The key for both kids and adults to maintain their dental health is effective prevention. That’s why we’re increasing our awareness efforts in schools and underserved communities. By working to ensure all Americans understand the connection between their dental and overall health, we can begin to solve this crisis.”

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Affordable Care Act Fails to Address Critical Dental Care for Adults
When it comes to access to routine dental care – a major determinant of oral health – the Affordable Care Act (ACA) falls well short in its goals of lowering costs, increasing access and improving health outcomes, according to a recent analysis by the American Dental Association. In a series of three research briefs, available at www.ada.org/1442.aspx, the association’s Health Policy Resources Center (HPRC) reports that under the ACA about 8.7 million children are expected to gain some form of dental benefit from the program, which will reduce by approximately 55 percent the number of children without dental benefits.

But for adults it’s a different story. Only an estimated 5.3 million adults are expected to gain extensive oral health coverage as a result of the ACA, almost all due to Medicaid expansion in the few states that provide extensive dental benefits. This will reduce the number of adults without dental benefits by about 5 percent, a negligible impact. Further, Medicaid-eligible adults may see few improvements in their ability to receive dental care, the HPRC analysis suggests.

“The ACA is a missed opportunity, and we have a long way to go in ensuring access to oral health for all Americans,” writes Dr. Marko Vujicic, managing vice president of the HPRC and co-author of the briefs. “This is especially true for adults, who have experienced greater financial barriers to dental care in recent years.”

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Harris Interactive Survey Methodology
The ADA Dental Divide in America Study was conducted online within the United States by Harris Interactive on behalf of the American Dental Association, between April 24-29, 2013 among 1,221 US adults age 18+, of whom 310 had a household income of less than $30K and 911 had a household income of $30K or more.

All sample surveys and polls, whether or not they use probability sampling, are subject to multiple sources of error which are most often not possible to quantify or estimate, including sampling error, coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey weighting and adjustments. Therefore, Harris Interactive avoids the words "margin of error" as they
are misleading. All that can be calculated are different possible sampling errors with different probabilities for pure, unweighted, random samples with 100% response rates. These are only theoretical because no published polls come close to this ideal.

Respondents for this survey were selected from among those who have agreed to participate in Harris Interactive surveys. The data have been weighted to reflect the composition of the adult population. Because the sample is based on those who agreed to participate in the Harris Interactive panel, no estimates of theoretical sampling error can be calculated.

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