DataBank Indicator

Download Report

Among children lacking health insurance in 2012, more than 40 percent had not seen a dentist in the past year, and nearly a quarter needed dental care, but did not receive it because they could not afford the cost.

Importance

Children (and their parents) may avoid seeing a dentist for a number of reasons, including inadequate insurance coverage, lack of sufficient providers, and anxiety about dental care.

Untreated oral diseases can lead to problems in eating, speaking, and sleeping.[1] Poor oral health among children has been tied to poor performance in school and poor social relationships. For example, children with chronic dental pain may have difficulty concentrating, poor self-image, and problems completing schoolwork.[2] Children with early childhood dental problems also often weigh less.[3]

The American Academy of Pediatric Dentistry recommends that all children visit the dentist within six months of the eruption of their first primary tooth, or no later than their first birthday.[4]

Trends

82_fig1In 2012, six percent of children ages two to 17 had unmet dental needs, meaning they did not receive needed dental care in the past year due to financial constraints. This proportion has remained between six and eight percent since 1997. The percentage of children who had not seen a dentist within the past year was 27 percent in 1997, but had decreased to 18 percent by 2012. (Figure 1)

Differences by Race/Hispanic Origin[5]

82_fig2In 2012, Hispanic children were more likely than white or black children to have unmet dental needs (eight percent for Hispanic children, compared with five percent, each for black and white children). (Figure 2)

The percentage of children who had not been to the dentist within the past year followed a similar trend. White and black children were less likely than Hispanic children to have gone without care for that long, at 17 percent, each, compared with 19 percent for Hispanic children.  (Figure 2) Among Hispanic children, 20 percent of Mexican or Mexican-American children had not been to the dentist with the past year, a substantial improvement from a high of 45 percent in 1999. Among black children this rate has fallen by nearly 50 percent since 1999. (Appendix 2)

Differences by Poverty Status

82_fig3In 2012, seven percent of children in poor families, and eight percent of children in near-poor families, had unmet dental needs, compared with only four percent of children in non-poor families. Twenty-three percent of children from poor families, and 21 percent of children from near-poor families, had not been to the dentist within the past year in 2012, compared with 14 percent of children from non-poor families. (Figure 3)

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 of the threshold or greater.

Differences by Health Insurance Coverage

82_fig4In 2012, uninsured children were significantly more likely than children with Medicaid or other public or private insurance to have unmet dental needs (22 percent, compared with five and four percent, respectively). Forty-two percent of uninsured children had not been to the dentist within the past year, compared with 18 percent of children with Medicaid or other public health insurance, and 15 percent of children with private health insurance. (Figure 4)

Differences by Age

Children between the ages of two and four are much less likely than older children to have unmet dental needs (three percent in 2012, compared with five percent among children ages five to 11, and eight percent among those ages 12 to 17, in 2012). (Appendix 1) In 2012, 43 percent of children ages two to four, 11 percent of children ages five to 11, and 14 percent of adolescents ages 12 to 17 had not seen a dentist in the past year. (Appendix 2)

State and Local Estimates

2011/12 data by state for unmet dental needs and  dental care in the past year are available at the Data Resource Center for Child and Adolescent Health.

International Estimates

While there are no international estimates for unmet dental needs, country profiles including the prevalence of dental caries among twelve-year-olds (2011 data) are available from the World Health Organization.

National Goals

Through its Healthy People 2020 Initiative, the federal government has set several national goals to improve the oral health of children and youth. Among the goals are to increase the proportion of low-income children and adolescents who had preventive dental service in the past twelve months, from 26.7 percent in 2007 to 29.4 percent in 2020. Another goal is to increase the proportion of children, adolescents, and adults who used the oral health care system in the past 12 months. In addition, there are several goals regarding specific oral health issues for children.

More information is available here.

Related Indicators

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?”

Data Sources

National Center for Health Statistics. Summary health statistics for U.S. children: National Health Interview Survey. Vital and Health Statistics: Series 10. Data from the National Health Interview Survey. Available online at: http://www.cdc.gov/nchs/products/series/series10.htm

Raw Data Source

National Health Interview Survey

http://www.cdc.gov/nchs/nhis.htm

Appendix 1 – Percentage of Children, Ages Two to 17, with Unmet Dental Needs1: 1997-2012

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Total 6.0 5.6 6.5 6.1 6.7 5.9 5.6 6.6 7.3 6.9 6.3 7.0 7.1 6.6 6.1 5.5
Gender
Male 6.0 5.3 6.4 5.7 5.8 5.3 5.4 7.3 7.3 6.2 5.5 7.1 7.5 6.4 5.9 4.8
Female 6.0 6.0 6.7 6.5 7.7 6.5 5.9 5.9 7.2 7.5 7.2 6.9 6.6 6.8 6.3 6.3
Age
2-4 years 3.2 2.5 4.9 3.1 3.9 2.5 2.2 3.3 3.8 3.5 2.1 3.9 4.4 4.0 4.1 2.8
5-17 years 6.7 6.4 6.9 6.8 7.3 6.6 6.4 7.4 8.1 7.7 7.3 7.8 7.7 7.2 6.6 6.1
5-11 years 6.2 5.9 6.5 6.1 6.7 6.4 5.7 6.3 6.9 6.5 6.4 7.5 6.2 6.5 5.7 4.9
12-17 years 7.3 6.9 7.4 7.6 8.1 7.0 7.3 8.5 9.3 8.9 8.4 8.0 9.5 8.0 7.6 7.6
Race/Hispanic origin2
White, non-Hispanic 5.6 4.9 5.9 5.6 6.3 5.5 4.9 6.2 6.0 6.0 6.5 5.6 6.0 5.6 5.3 5.0
Black, non-Hispanic 6.8 6.5 7.2 6.8 6.1 6.0 6.6 5.2 6.8 6.9 3.8 7.7 6.8 6.3 5.9 5.3
Hispanic 8.0 7.7 8.2 8.3 8.8 7.3 7.0 9.4 10.8 9.9 7.4 10.8 10.5 9.4 8.2 7.2
Mexican or Mexican American 8.0 8.5 9.2 9.2 9.3 8.1 7.8 9.3 11.7 10.9 8.5 11.7 11.1 9.8 9.0 8.0
Poverty status3
Poor 9.0 9.1 13.8 9.4 12.8 9.7 10.1 10.0 12.5 10.7 8.5 9.8 9.8 8.2 8.2 6.8
Near poor 11.9 10.9 12.5 11.6 11.7 10.5 9.5 10.5 10.9 11.2 11.2 12.2 10.7 10.3 8.4 8.3
Not poor 3.4 3.3 3.8 4.0 4.5 4.0 4.0 4.4 5.0 5.0 4.2 4.5 4.5 4.4 4.0 3.9
Health insurance coverage4
Private 3.8 3.7 4.0 3.9 4.5 4.0 3.3 4.2 4.3 4.2 4.1 4.2 4.4 4.1 4.5 3.8
Medicaid/other public 5.5 5.7 7.2 6.3 7.7 7.3 6.4 7.5 8.6 6.5 5.6 6.2 6.7 5.8 5.4 5.2
Other 3.8* 5.9 3.9 5.3 3.9* 2.8* 3.9* 5.2* 4.8* 6.9* 5.6* 3.8* 3.1* 6.8 4.9* 2.9*
Uninsured 18.2 16.2 21.1 18.5 19.6 15.2 19.2 21.3 23.3 23.0 24.3 27.9 27.8 26.6 22.0 21.9
* Has relative standard error greater than 30% and should be used with caution.1 Defined as those whose parents answered yes to 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)?”2 Persons 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.

3Poverty status is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. “Poor” persons are defined as below the poverty threshold. “Near poor” persons have incomes of 100% to less than 200% of the poverty threshold. “Not poor” persons have incomes that are 200% of the poverty threshold or greater.

4Classification of health insurance coverage is based on a hierarchy of mutually exclusive categories. Persons with more than one type of health insurance were assigned to the first appropriate category in the hierarchy. The category “Uninsured” includes persons who had no coverage as well as those who had only Indian Health Service coverage or had only a private plan that paid for one type of service such as accidents or dental care.

Sources: National Center for Health Statistics. Summary health statistics for U.S. children: National Health Interview Survey. Vital and Health Statistics: Series 10. Data from the National Health Interview Survey. Available online at: http://www.cdc.gov/nchs/products/series/series10.htm

 

Appendix 2 – Percentage of Children, Ages Two to 17, Who Have Not Seen a Dentist in the Past Year1: 1997-2012

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Total 27.3 26.5 27.4 25.9 26.7 25.7 25.0 23.7 23.7 24.2 23.3 22.7 21.6 21.1 18.6 17.7
Gender
Male 27.7 28.1 27.6 26.3 27.3 26.2 25.9 24.9 24.5 25.0 23.5 23.2 22.4 21.7 18.7 17.2
Female 26.9 25.0 27.2 25.3 26.1 25.1 24.1 22.3 22.9 23.5 23.2 22.1 20.7 20.5 18.6 18.0
Age
2-4 years 55.3 55.2 60.2 55.8 57.7 59.3 53.5 53.4 51.9 54.4 53.0 49.1 44.5 47.7 42.4 42.8
5-17 years 20.8 20.0 20.1 19.3 19.7 17.8 18.3 16.6 17.3 17.1 16.3 16.1 16.0 14.6 12.7 12.0
5-11 years 19.3 19.9 19.2 18.9 19.3 17.2 18.4 15.9 16.2 17.0 15.4 16.0 14.9 13.5 11.1 10.7
12-17 years 22.6 20.1 21.3 19.7 20.2 19.2 18.6 17.6 18.4 17.1 17.5 16.3 17.1 15.9 14.6 13.5
Race/Hispanic origin2
White, non-Hispanic 23.6 23.0 23.0 21.4 22.3 20.7 20.6 19.1 19.7 20.4 20.6 19.8 18.5 19.1 17.4 16.7
Black, non-Hispanic 31.1 30.2 32.3 29.9 31.9 31.4 29.4 27.2 27.3 27.6 25.0 21.4 23.2 20.8 18.6 17.1
Hispanic 39.0 37.6 40.7 39.6 39.5 37.6 35.5 34.7 33.5 33.6 28.8 30.1 27.0 25.3 20.3 19.1
Mexican or Mexican American 44.3 43.2 44.8 42.3 43.5 40.7 37.6 36.1 34.6 36.9 31.3 30.9 28.3 25.1 19.9 19.5
Poverty status3
Poor 37.6 36.8 41.6 37.5 39.8 36.9 36.1 35.4 33.6 32.6 32.0 29.9 28.4 26.8 24.6 23.1
Near poor 38.4 38.9 38.4 34.7 36.8 33.5 35.1 31.6 32.2 32.4 30.7 29.6 24.4 25.7 22.3 21.2
Not poor 20.4 19.7 20.1 20.0 20.6 20.2 18.8 17.8 17.8 18.3 17.9 17.3 17.8 16.5 14.8 14.4
Health insurance coverage4
Private 21.6 21.3 21.6 20.3 21.0 20.1 19.9 17.8 17.9 17.6 17.8 17.4 16.8 16.9 14.9 14.7
Medicaid/other public 30.4 31.5 34.7 31.5 33.8 31.5 29.0 28.9 28.5 28.8 27.3 24.0 22.8 21.7 19.7 17.5
Other 26.8 22.1 22.7 24.6 24.1 22.5 17.7 21.9 18.6 20.1 19.9 23.3 23.0 20.0 16.2 19.5
Uninsured 53.2 50.7 53.1 49.3 50.6 49.7 48.9 51.0 50.5 51.2 48.2 51.9 48.1 48.0 41.9 42.2
* Has relative standard error greater than 30% and should be used with caution.1 Defined as those whose parents anything more than 12 months to the question: “About how long has it been since [child’s name] last saw or talked to a dentist? Include all types of dentists, such as orthodontists, oral surgeons, and all other dental specialists, as well as dental hygienists.”2 Persons 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.

3Poverty status is based on family income and family size using the Census Bureau’s poverty thresholds for the previous calendar year. “Poor” persons are defined as below the poverty threshold. “Near poor” persons have incomes of 100% to less than 200% of the poverty threshold. “Not poor” persons have incomes that are 200% of the poverty threshold or greater.

4Classification of health insurance coverage is based on a hierarchy of mutually exclusive categories. Persons with more than one type of health insurance were assigned to the first appropriate category in the hierarchy. The category “Uninsured” includes persons who had no coverage as well as those who had only Indian Health Service coverage or had only a private plan that paid for one type of service such as accidents or dental care.

Sources: National Center for Health Statistics. Summary health statistics for U.S. children: National Health Interview Survey. Vital and Health Statistics: Series 10. Data from the National Health Interview Survey. Available online at: http://www.cdc.gov/nchs/products/series/series10.htm. 

Endnotes


[1] U.S. Department of Health and Human Services. (2000).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. Available at: http://www2.nidcr.nih.gov/sgr/execsumm.htm

[2] 2003 Rhode Island Kids’ Count FactBook, Rhode Island Kids’ Count, Providence, Rhode Island, 2003. http://www.rikidscount.org/matriarch/

[3] National 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

[4] Council on Clinical Affairs, American Academy of Pediatric Dentistry. (2002). Clinical guideline on infant oral health, Reference Manual (2002): 54. Available at: http://www.aapd.org/members/referencemanual/pdfs/02-03/G_InfantOralHealth.pdf

[5] Hispanics may be any race. Estimates for whites and black in this report do not include Hispanics.

Suggested Citation:

Child Trends DataBank. (2015). Unmet dental needs. Available at: https://www.childtrends.org/?indicators=unmet-dental-needs

Last updated: March 2015

Subscribe to Child Trends

Short weekly updates of recent research on children and youth.