2011 Survey of Dental Care Affordability and Accessibility: Highlights from the Nationally Representative Survey

August 2011

Prof. David Neal, Ph.D. Empirica Research & The University of Southern California

Cassandra Govan, Ph.D. Empirica Research

Funding for the 2011 survey was provided by Brighter.com, which works to increase Americans access to quality, affordable dental healthcare. 1

Dental healthcare in America today

Substantial economic and practical barriers to quality dental healthcare persist in America today. Approximately 50% of Americans lack dental insurance and, in 2010, dental premiums increased at a higher rate than medical insurance premiums (NADP). The US Surgeon General described the barriers to quality, affordable care as a silent epidemic, leading to 164 million hours of lost productivity annually. Individuals without dental insurance are dramatically less likely to get recommended care and thus are more likely to develop the major health conditions (e.g., diabetes, heart disease, stroke) linked with poor oral health.

2011 Survey Highlights.

The Annual Survey of Dental Care Affordability and Accessibility is a nationally representative study conducted to gauge the current state of Americans access to dental care, with a special emphasis on the 50% of the population without dental coverage.

This document provides an executive summary of the 2011 survey, including details of the survey methodology and key findings. The research was conducted in May-June 2011 by EmpiricaResearch.com.au in collaboration with Professor David Neal, Ph.D at the University of Southern California. The annual survey is supported by funding from Brighter.com, whose mission emphasizes reducing disparities in Americans access to high quality, affordable dental care.

Survey Methodology.
The survey research was conducted in May 2011 with a nationally representative sample of 1000 American adults. The research was conducted by the international research firm EmpiricaResearch.com.au in conjunction with Dr. David Neal, Professor of Psychology at the University of Southern California. Quota sampling and weighting were employed ensure sample demographics that match the US population defined by the latest Census data.

Survey Content.
The annual survey gathers data on three key areas of Americans dental health care behaviors and attitudes: 1. Demographics: Whether respondents currently have any dental coverage (i.e., insurance, finance, discount plan); income; ethnicity; age; gender; marital status; children.

2. Dental Healthcare Behavior: Frequency of visits to the dentist; visits for preventive vs. reactive care; rates of delayed care due to cost; rates of delayed care due to access problems (e.g., finding reliable information about dentists); rates of compliance with Surgeon Generals recommended bi-annual visits. 3. Attitudes and Opinions about Dental Healthcare: Major factors keeping Americans from more regular dental visits (e.g., fear of pain, price, difficulty getting reliable information about dentists etc); intentions to visit the dentist in the future; self-rated dental health; (mis)perceptions about the cost of care.

Key Findings from the 2011 Survey.

1. Uninsured Americans are falling dramatically short of the Surgeon Generals recommended levels of dental care (2 visits per year). 74% of Americans without dental coverage report going to the dentist only when they believe there is a problem with their teeth; only 26% get preventative care. o Among those who have dental coverage, 68% get preventative care and only 32% wait until there is something wrong with their teeth. More than a quarter (28%) of Americans without dental coverage say they have been to the dentist only once (11%) or not at all (17%) in the last 10 years. o This is four times the rate among Americans with dental coverage (7%). On average, those without dental coverage report going to the dentist once every 3 years, or 6 times less frequently than the Surgeon General recommends. o Those with dental coverage report, on average, going around once per year. On average, those without dental coverage predict it will be between 18 months and 3 years until their next visit. o Those with dental coverage predict it will be between 6 month and 1 year until their next visit. 0nly one in six (17%) of those without dental coverage go to the dentist every six months, as recommended by the Surgeon General. o Almost one in two (46%) Americans with dental coverage report getting to the dentist every six months, as recommended. 1 in 5 (21%) Americans without dental coverage predict they wont go to the dentist in the next five years. o Only 3% of those with dental coverage make that prediction. Those without dental coverage are 4.3 times more likely to rate their teeth and gums as very unhealthy than those with dental coverage.

Figure 1: Disparities In dental care for Americans with and without coverage

2. High cost and low transparency are the major barriers to access for the uninsured

The number one reason for delaying dental care is high cost, followed by lack of transparency about costs, and then difficulty in finding a good dentist. 77% of those without dental coverage have delayed regular dental care due to the high cost of care. o Only 50% of those with coverage have delayed care due to high costs of care.

73% of those without dental coverage have delayed regular dental care due simply to not knowing what the costs of treatment would be. o Only 46% of those with coverage have delayed care due to not knowing what the cost of care would be.

Figure 2: High cost and low transparency drive deferred care, especially for Americans without coverage

3. Disparities are most evident for children, retirees, and low-income earners. Children. 47% of parents without dental coverage report having delayed their childrens regular dental check-ups due to high dental care costs. o This figure is 30% among parents with coverage. Retired Americans. Almost 1 in 3 retired Americans who lack dental coverage say they probably wont go to the dentist in the next 5 years. High cost is the top factor keeping these retired Americans from visiting the dentist. Low income Americans. Personal income is a strong predictor of frequency of dental visits. This relationship is especially strong for those lacking any dental coverage. Among those earning less than $40,000 per year and lacking dental coverage, almost one in three (31%) have been to the dentist only once or not at all in the past 10 years. Among those earning over $40,000, this figure falls to 18%.

For more information regarding the 2011 Survey of Dental Care Affordability Accessibility, please contact the study authors or Brighter.com: Study authors: Dr. David Neal, Ph.D. d.neal@usc.edu 213.300.5957 Dr. Cassandra Govan Ph.D. Empirica Research cassie@empiricaresearch.com.au Brighter.com contact: Lacey Trejo JCUTLER media group Lacey@Jcutlermedia.com 818.981.3023

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