Results of largest survey of its kind indicate Americans rate oral health as critical, but that barriers to care persist

Two years after dental care was disrupted for millions of Americans, many are still not getting the dental care they need and disparities in oral health care persist, according to the results of an annual national survey from CareQuest Institute for Oral Health® — a leading national nonprofit focused on creating a more accessible, equitable, and integrated oral health system.

CareQuest Institute today released initial findings from the second annual State of Oral Health Equity in America survey, a nationally representative survey of adults’ knowledge, attitudes, experiences, and behaviors related to oral health. The survey is the largest and most comprehensive of its kind, with more than 5,000 participants and 170 questions. Its depth and breadth offer researchers the ability to uncover trends in oral health equity gaps for specific populations based on race/ethnicity, sexual orientation, income, insurance status, disability status, and social determinants of health. Providing timely and actionable insights into the state of oral health equity in the US allows for a deeper understanding among key consumer segments and historically underserved communities.

Some of the noteworthy findings from the 2022 survey include:

• More adults identified cost as a reason they are likely to avoid dental care in 2022 (43%) than in 2021 (38%).
• More than half of adults (55%) reported some type of oral health problem in 2022, similar to 2021 (56%). In both years, toothache, cracked or broken teeth, swollen or bleeding gums, and frequent dry mouth were the most frequently cited dental problems.
• 96% of adults know that there is a connection between the health of the mouth and the rest of the body.
• Nearly 7 out of 10 adults rate oral health about as important as physical health.
• White adults were least likely to experience discrimination in an oral health care setting (33%), as compared to Hispanic adults (49%), Asian adults (49%), and Black adults (48%).
• More than two-thirds of adults strongly agree that dental care should be covered by Medicaid (67%) and Medicare (70%).
• Nearly 6 in 10 (59%) of Black adults have lost one or more permanent teeth to decay or gum disease compared to 45% for all adults.
• 9% of Black adults and 6% of Hispanic adults reported visiting the emergency department or emergency room for a dental condition or pain/discomfort in their mouth in the last year, compared to 4% of all white adults.

“These findings offer powerful insights into the state of oral health equity in this country — insights that we hope will inform advocacy, policy, technology advancement, and clinical integration to increase access for oral health care, especially for historically marginalized populations,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health. “In part, this survey confirms what we already know — our system does not work for everyone and deep-rooted health inequity exists across our nation. Too often, we don’t have the oral health data we need to drive systemic change. A survey of this size and scope is critical to the development of actionable steps to help transform the oral health system into one that is more accessible, equitable, and integrated.”

This survey is a follow-up to a similar survey from 2021, which identified multiple troubling issues emerging during the early stages of the COVID-19 pandemic in the US. Findings from the 2022 survey reveal that while some aspects of oral health have rebounded since the earlier stages of the pandemic, inequities still exist within oral health care. While barriers to oral health care have been well recognized in the past, data from the survey provide new perspectives on inequities related to factors such as food insecurity, housing instability, discrimination experiences, and social determinants of health.

CareQuest Institute will be releasing a series of in-depth reports in the coming weeks and months analyzing the results of the survey focusing on topics including the impact of discrimination on oral health access; dental anxiety; the oral health of specific populations, including veterans, LGBTQIA+ individuals, people with intellectual and developmental disabilities, and American Indians and Alaska Natives; integration of medical and dental care; teledentistry utilization and experience; and more.

The first report in the series — “Americans Are Still Not Getting the Dental Care They Need” — indicates that two years after the start of the pandemic, oral health inequities persist due to cost of care, lack of insurance, dental anxiety, and lingering fears of COVID-19 exposure. The report recommends solutions to increase access to care, such as teledentistry and expanding the reach of the oral health care workforce.

This series of reports will allow health professionals, policymakers, and thought leaders to better understand the state of oral health equity in the US and drive progress in eliminating barriers to excellent health for everyone.

Survey methodology

The State of Oral Health Equity in America (2022) survey is a nationally representative survey of consumer and patient attitudes, experiences, and behaviors related to oral health. The study was designed by CareQuest Institute for Oral Health. Results were collected in January and February 2022 on adults 18 and older by NORC at the University of Chicago on the AmeriSpeak panel. AmeriSpeak is a probability-based panel designed to be representative of the US household population. Randomly selected US households were sampled using area probability and address-based sampling, with a known, non-zero probability of selection from NORC National Sample Frame. Sampled households were contacted by US mail, telephone, and field interviewers. A sampling unit of 17,603 was used, with a final sample size of 5,682 and a final weighted cumulative response rate of 4.0%. All data presented account for appropriate sample weights. The margin of error for the survey is 1.75%.

About CareQuest Institute for Oral Health®

CareQuest Institute for Oral Health® is a national nonprofit championing a more equitable future where every person can reach their full potential through excellent health. We do this through our work in grantmaking, research, health improvement programs, policy and advocacy, and education as well as our leadership in dental benefits and innovation advancements. We collaborate with thought leaders, health care providers, patients, and local, state, and federal stakeholders, to accelerate oral health care transformation and create a system designed for everyone. To learn more, visit carequest.org and follow us on Twitter, LinkedIn, Facebook, and Instagram.

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