Dental Visit - Women in California

California

Oral health is a vital component of overall health. Oral diseases such as dental caries (also known as cavities), gum disease, tooth decay and gingivitis are common and can contribute to severe health issues if left undiagnosed and untreated.

Poor oral health can negatively affect quality of life by causing pain and/or tooth loss, and affect the ability to chew, speak and engage socially. Further, inflammation associated with periodontal disease has been linked to several chronic diseases, including diabetes, heart disease, respiratory disease and oral cancer. More than 40% of adults in the United States reported feeling mouth pain in the past year, and 80% of adults have had at least one cavity by age 34.

Good oral health is particularly important during pregnancy, as physiological changes may put pregnant women at higher risk of new or exacerbated oral health problems. For example, increased inflammatory response to dental plaque during pregnancy can cause pregnancy-related gingivitis. Other oral health problems that commonly occur during pregnancy include tooth erosion, cavities and gum disease.

There are barriers to receiving routine dental care. The most common reasons cited for not seeking dental care are cost and lack of insurance, and more recently COVID-19. Although the prevalence of dental visits has largely rebounded from its steep decline during the early months of the pandemic, significant COVID-related barriers to oral health care remain. Nearly a quarter of Americans delayed dental care in 2022 due to COVID-19, and 19% have not seen a dental provider at all since the pandemic began. Furthermore, pandemic-related job losses, reductions in benefits and financial hardship continue to negatively impact access to dental insurance.

According to America’s Health Rankings analysis, the prevalence of annual dental visits is higher among:

• Women ages 18-24 and 35-44 compared with women ages 25-34.
• Asian, white and Black women compared with Hispanic women.
• Women with a college degree. The prevalence of annual dental visits increases with each increase in education level.
• Women with an annual household income of $75,000 or more. The prevalence of annual dental visits increases with each increase in income level.
• Women living in metropolitan areas compared with those in non-metropolitan areas.

Oral diseases are preventable through routine dental visits and proper oral hygiene. The U.S. Department of Health and Human Services Oral Health Strategic Framework outlines specific strategies and current government initiatives for improving access to oral health care.

Incorporating oral health counseling into prenatal and perinatal care can help prevent pregnancy-related oral health disease and encourage healthy oral hygiene habits during and after pregnancy. A 2022 study found that offering comprehensive dental benefits to Medicaid-enrolled pregnant women led to higher rates of dental insurance and increased dental care use.

Resources for finding affordable dental care include:

• The Find a Health Center tool, which locates community-based organizations that provide sliding-scale and free medical and dental services that meet the quality requirements of the Health Resources and Services Administration.
• The 211 helpline, accessible online and by phone 24/7, provides assistance with meeting basic needs and connects people with resources and services in their area, including medical and dental care.
• State and local dental organizations, which may have more information about local free or reduced-cost services and programs.

Increasing the proportion of adults who have used the oral health care system within the past year is a Healthy People 2030 leading health indicator. 

The Department of Health and Human Services identifies five key goals in their Oral Health Strategic Framework:

• Integrate oral health and primary health care.
• Prevent disease and promote oral health.
• Increase access to oral health care and eliminate disparities.
• Increase the dissemination of oral health information and improve health literacy.
• Advance oral health in public policy and research.

“ACOG Committee Opinion No. 569: Oral Health Care During Pregnancy and Through the Lifespan.” Obstetrics & Gynecology, no. 122 (August 2013): 417–22. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/08/oral-health-care-during-pregnancy-and-through-the-lifespan.

Adesanya, Margo R., William Bailey, Donald C. Belcher, Marco Beltran, Tracy Branch, Marcia K. Brand, Edwin M. Craft, et al. “U.S. Department of Health and Human Services Oral Health Strategic Framework, 2014–2017.” Public Health Reports 131, no. 2 (March 2016): 242–57. https://doi.org/10.1177/003335491613100208.

Choi, Sung Eun, Lisa Simon, Sanjay Basu, and Jane R. Barrow. “Changes in Dental Care Use Patterns Due to COVID-19 among Insured Patients in the United States.” The Journal of the American Dental Association 152, no. 12 (December 2021): 1033-1043.e3. https://doi.org/10.1016/j.adaj.2021.07.002.

Heaton, Lisa J., Adrianna C. Sonnek, Kelly Schroeder, and Eric P. Tranby. “Americans Are Still Not Getting the Dental Care They Need.” Research Report. The State of Oral Health Equity in America 2022. Boston, MA: CareQuest Institute for Oral Health, April 2022. https://doi.org/10.35565/CQI.2022.2020.

Naavaal, Shillpa, and David W. Harless. “Comprehensive Pregnancy Dental Benefits Improved Dental Coverage and Increased Dental Care Utilization among Medicaid-Enrolled Pregnant Women in Virginia.” Frontiers in Oral Health 3 (September 20, 2022): 989659. https://doi.org/10.3389/froh.2022.989659.

U.S. Department of Health and Human Services. “Oral Health in America: A Report of the Surgeon General.” Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000. https://www.nidcr.nih.gov/sites/default/files/2017-10/hck1ocv.%40www.surgeon.fullrpt.pdf.