The Hidden Cost of Skipping the Dentist

Access to dental care remains a critical challenge for many Americans, with cost being a major barrier across age groups. The latest data reveals that 13% of all adults reported forgoing necessary dental care due to financial constraints in the past year. 

The issue is particularly pronounced among adults (17%) and seniors (11%), highlighting the gaps in coverage and affordability in the current insurance landscape. While medical and prescription drug costs also pose significant barriers, dental care consistently sees the highest levels of unmet need, underscoring the necessity for expanded insurance solutions and policy reforms.

For dental insurers, providers, and policymakers, these insights present both a challenge and an opportunity. As out-of-pocket expenses continue to deter access, the demand for comprehensive dental plans, employer-sponsored benefits, and public-private partnerships is rising. 

Understanding the demographic breakdown of cost barriers is crucial in shaping more inclusive, financially accessible insurance offerings that cater to the growing and aging population. The following analysis delves into the key trends shaping the dental insurance market and their implications for industry stakeholders.

Key takeaways from chart

• Dental Care Faces the Greatest Cost Barriers

  • 13% of all ages report skipping dental care due to cost, the highest among healthcare services.

  • The issue is particularly acute among adults (17%) and seniors (11%), highlighting affordability concerns.

• Children Have the Lowest Levels of Unmet Need

  • Only 3% of children reported missing dental care, compared to 17% of adults.

  • This suggests that pediatric dental coverage, often bundled with health insurance or public programs, is more effective than adult coverage.

• Medical and Prescription Barriers Are Lower but Still Significant

  • 5% of all respondents skipped medical care, while 4% skipped filling prescriptions due to cost.

  • The disparity between dental and medical coverage indicates that dental insurance still lags behind in comprehensiveness and accessibility.

• Seniors Face Unique Cost Challenges

  • 11% of seniors reported cost-related dental care avoidance, compared to 3% for medical services.

  • This reflects gaps in Medicare dental coverage, reinforcing the need for expanded senior dental benefits in supplemental plans.

• Implications for Insurers and Policymakers

  • Opportunity for insurers to expand affordable, flexible dental plans tailored to adults and seniors, who report the highest cost barriers.

  • Employers and benefits providers can address these gaps by enhancing workplace dental plans, particularly for part-time and gig workers.

  • Policy shifts, such as Medicare dental expansion, could significantly reduce unmet needs for aging populations.

The Rising Cost of Dental Insurance for U.S. Households

Household spending on dental insurance in the U.S. has steadily increased, reflecting growing demand for coverage and rising plan costs. Since 2017, the average annual expenditure per consumer unit has grown from $109 to $133 in 2023, marking a 22% increase over six years.

 While 2020 and 2021 saw only marginal growth, expenditures have remained consistently high, signaling that dental insurance is an essential and persistent expense for American households.

For insurers, employers, and policymakers, these trends emphasize the need for cost-effective dental coverage solutions. As premiums rise, consumers are increasingly looking for value-driven plans that provide comprehensive coverage without excessive out-of-pocket costs. 

Understanding consumer spending behaviors and pricing trends will be key to adapting plan structures, pricing models, and employer-sponsored offerings in a competitive market. The following analysis breaks down key insights from this expenditure trend and its implications for the dental insurance industry.

Key takeaways from chart

• Steady Growth in Household Spending

  • Dental insurance costs per household have increased 22% from $109 in 2017 to $133 in 2023.

  • The most significant jump occurred between 2017 and 2018, with a 15.6% increase in spending.

• Plateauing Growth in Recent Years

  • While 2020 saw a rise to $129, the past three years have shown minimal increases, stabilizing at $133 in 2022 and 2023.

  • This could indicate a leveling off of premium hikes or a shift in consumer choices toward more affordable plans.

• Impact of Economic Factors

  • The COVID-19 pandemic (2020-2021) had a modest effect on dental insurance spending, with no significant drops, indicating consistent demand for coverage.

  • Inflationary pressures and increased healthcare costs have likely contributed to sustained expenditure growth.

• Implications for the Insurance Market

  • Insurers must focus on affordability while maintaining comprehensive coverage, as consumers remain price-sensitive.

  • Employers may need to reassess benefits offerings to ensure dental plans remain competitive and attractive in workplace benefits packages.

  • The rise in dental spending presents opportunities for new plan structures, expanded coverage options, and value-driven pricing models to meet evolving consumer needs.

Shifts in U.S. Dental Insurance Coverage Trends

Over the past decade, the distribution of dental insurance coverage in the U.S. has remained relatively stable, with private insurance consistently covering around two-thirds of patients. However, public assistance programs and uninsured rates have fluctuated, reflecting policy changes, economic conditions, and accessibility challenges.

As of 2023, 67% of dental patients were covered by private insurance, the highest rate in the observed period. Meanwhile, public assistance coverage (8%) and the uninsured rate (25%) indicate that access gaps persist, especially for vulnerable populations.

For insurers, healthcare providers, and policymakers, understanding these shifts is crucial to addressing coverage gaps and designing more inclusive plans. While private insurance remains dominant, the slight declines in uninsured rates signal progress, likely driven by Medicaid expansion and employer-sponsored benefits.

The following analysis breaks down the key trends, challenges, and opportunities shaping the U.S. dental insurance landscape.

Key takeaways from chart

• Private Insurance Continues to Dominate

  • 67% of dental patients were covered by private insurance in 2023, the highest in over a decade.

  • Coverage fluctuated slightly over the years, dipping to 63% in 2016-2017 before rebounding.

• Public Assistance Coverage Has Increased but Remains Limited

  • Public assistance coverage rose from 7% in 2011 to a peak of 11% in 2016, before stabilizing around 8-9% in recent years.

  • The highest spikes occurred during economic downturns or policy expansions, suggesting Medicaid and CHIP influence coverage rates.

• Uninsured Rates Are Declining but Still Significant

  • In 2011, 28% of dental patients lacked insurance; by 2023, this dropped to 25%.

  • Despite improvement, 1 in 4 dental patients still lack coverage, highlighting cost and accessibility barriers.

• Implications for Insurers and Policymakers

  • The rise in private insurance coverage underscores a growing demand for employer-sponsored and individual dental plans.

  • Public program expansion (such as Medicaid) can further reduce uninsured rates, particularly for lower-income populations.

  • Insurers must adapt plan structures to affordability concerns, ensuring that out-of-pocket costs don’t deter care utilization.

The Coverage Gap Between Health and Dental Insurance

Despite being a critical component of overall well-being, dental insurance coverage continues to lag behind health insurance in the U.S. While 90% of adults had health insurance in 2021 and 2022, only 70% had dental insurance, leaving a significant gap in access to oral healthcare. 

Although dental coverage improved slightly to 73% in 2023, it remains well below health insurance rates, highlighting a systemic divide in how insurance coverage is structured and prioritized.

For insurers, policymakers, and employers, these figures emphasize the urgent need to expand dental coverage accessibility. As healthcare costs rise and preventative oral health gains recognition as a key driver of overall health outcomes, bridging the gap between medical and dental insurance will be essential. 

The following analysis outlines the key trends and implications for the dental insurance industry.

Key takeaways from chart

• Consistent Health Insurance Coverage, Slow Growth in Dental

  • 90% of adults had health insurance in both 2021 and 2022, rising slightly to 91% in 2023.

  • Dental insurance coverage increased from 70% in 2021-2022 to 73% in 2023, signaling a modest but positive shift.

• The Persistent Gap in Coverage

  • Despite improvements, 18% more adults have health insurance than dental insurance.

  • This suggests that dental insurance remains secondary or optional for many consumers, often not included in standard employer-sponsored plans.

• Implications for the Insurance Market

  • Insurers must innovate to make dental plans more accessible, affordable, and appealing, particularly for lower-income populations.

  • Employers have an opportunity to enhance benefits offerings, ensuring that dental coverage is bundled effectively with health insurance.

  • Policy changes could further support dental coverage expansion, particularly through Medicare, Medicaid, and ACA marketplace adjustments.

With dental insurance slowly gaining ground but still lagging far behind health coverage, addressing these disparities is critical for improving access to preventative and essential oral healthcare in the coming years. ​

Sources & References

Statista. Consumer spending on dental insurance. https://www.statista.com/statistics/1052356/us-consumer-spending-on-dental-insurance/

ADA. Health policy institute coverage. https://www.ada.org/resources/research/health-policy-institute/coverage-access-outcomes

Carequest. Uninsured and in-need. https://www.carequest.org/system/files/CareQuest_Institute_Uninsured-and-in-Need_8.17.23.pdf

ODPHP. Health care access and quality. https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality/increase-proportion-people-dental-insurance-ahs-02/data?group=None&from=2019&to=2022&tab=data-table&state=United%20States&populations=#edit-submit