Poster #138 - Reducing Financial Burden in Dental Care: The Role of Insurance and Procedure Mix in the U.S.

• In Event: Friday Poster Reception

Abstract

Introduction/Background:Oral health is a critical component of overall health, yet dental care in the United States remains financially and structurally separated from medical care. This fragmentation contributes to underuse of preventive services and greater reliance on advanced, high-cost procedures, increasing financial burden for individuals and exacerbating inequities in access and outcomes.Purpose/Research Question:This study examines how dental procedure mix and provider type are associated with out-of-pocket (OOP) spending among U.S. adults, and how these relationships vary by insurance status, income, and chronic conditions.Data:We use quantitative data from the 2022 Medical Expenditure Panel Survey (MEPS) Full-Year Consolidated and Dental Event files, which provide nationally representative information on health care utilization, expenditures, insurance coverage, and demographic characteristics for the U.S. civilian noninstitutionalized population.Research Design and Methods:We conducted a cross-sectional analysis of adults aged 19–64. Dental procedures were categorized into mutually exclusive groups (preventive, restorative, surgical/periodontal, prosthodontic, orthodontic, and other), with a dominant procedure type assigned at the person level. Outcomes included annual OOP spending and indicators of high financial burden (>$500, >$1,000, and ≥5% of family income). Multivariable survey-weighted regression models were estimated, adjusting for predisposing, enabling, and need factors consistent with the Andersen Behavioral Model of Health Services Use.Results/Findings:Among 12,403 adults aged 19–34, 39% had a dental visit in 2022, with preventive care the most common (31%). Mean annual OOP spending was $146 (median $0), with 25% incurring no OOP costs. Compared to preventive care, restorative, surgical, prosthodontic, and orthodontic services were associated with significantly higher financial burden. Orthodontic services had the highest odds of exceeding $500 (OR 6.34, 95% CI 3.77–10.6) and $1,000 (OR 11.2, 95% CI 6.52–19.1). Uninsured individuals faced two- to three-fold higher odds of high OOP burden relative to those with private insurance, while public coverage provided partial protection. Specialist care was associated with the highest per-event OOP spending ($449).Conclusion/Implications:Financial burden in dental care is driven primarily by insurance coverage and procedure mix. Preventive care is associated with lower financial risk, while delayed care leading to restorative and surgical services shifts costs to patients. Expanding comprehensive dental coverage and reducing cost-sharing for essential services may improve access, reduce inequities, and mitigate downstream health system costs.

Author

• Victoria Wyant, University of Pittsburgh
  Presenting Author