LITTLE ROCK —A report on oral health in Arkansas released Thursday by the Arkansas Center for Health Improvement finds that even before the COVID-19 pandemic, most Arkansans were not making regular visits to the dentist, even if they had dental insurance – and use of dental services dropped even more during the first year of the pandemic.
The report, released during Oral Health Month, also suggests a link between lack of preventive dental care and dental emergencies: Among Arkansans with dental insurance who sought treatment in emergency departments for dental problems in 2019, over 90 percent had not been to a dentist in the previous 12 months.
ACHI reviewed insurance claims data from the Arkansas All-Payer Claims Database, as well as hospital and emergency department discharge data from the Arkansas Healthcare Transparency Initiative, to study usage of dental services by Arkansans between January 2019 and December 2020. The report, funded by and developed in partnership with the Delta Dental of Arkansas Foundation, is available at achi.net/oralhealth.
Findings in the report include:
Fifty-four percent of Arkansans, or 1.6 million individuals, had evidence of dental insurance in 2019.
Only 30 percent, or about one in three, of Arkansas adults age 19 or older with dental insurance used any dental services in 2019. About 51 percent of Arkansas children age 18 or younger with dental insurance used any dental services in that year.
Among Arkansans with private, Medicaid or Medicare Advantage dental insurance who sought dental care in an emergency department in 2019, over 90 percent had not received any preventive dental care in the previous 12 months.
Use of dental services was lowest in rural parts of the state in 2019, with 37 percent of rural county residents visiting a dentist compared to 40 percent of urban county residents.
The pandemic had a major impact on use of dental services. Between March 2020 and May 2020, during which period the state Department of Health called on dentists to suspend non-urgent services to slow the spread of COVID-19, use of dental services by Arkansans with dental insurance decreased by 56 percent compared to the same period in 2019. Monthly utilization generally returned to pre-pandemic levels by the end of 2020.
The percentage of Arkansas adults with dental insurance who visited a dentist at any point in 2019 was 30 percent; in 2020, only 25 percent visited a dentist. Among children with dental insurance, 51 percent visited a dentist in 2019 and 44 percent visited a dentist in 2020.
Access to dentists is limited in some parts of the state. In 2019, 11 Arkansas counties had dental provider shortages, defined by the Health Research and Services Administration as a ratio of 5,000 or more residents per dentist. Those counties were Chicot, Cleveland, Lafayette, Lawrence, Lee, Little River, Newton, Pike, Prairie, Scott and Woodruff. Two of those counties, Cleveland and Lafayette, had no active dentist in 2019.
The percentage of dentists serving children enrolled in the ARKids First children’s insurance program varied greatly from county to county in 2019, ranging from 100 percent in some counties to zero in others. Statewide, 61 percent of dentists served ARKids enrollees in 2019.
Fluoride varnish application by dental and medical providers has trended upward and steadily increased since 2013, with the exception of 2020, during which overall levels of dental care utilization were lower than in previous years
“A visit to a dentist for preventive care one or twice a year is commonly recommended by dental care providers, but our report shows that even most Arkansans are not heeding that advice, even if they have dental insurance,” said ACHI Director of Analytics Mike Motley. “The report is intended to inform policy decisions that will promote better oral health in the state.”
“This report shows why preventive care is important,” said Dr. Susan Ward-Jones, CEO of East Arkansas Family Health Care Inc. “When Arkansans seek emergency dental care, an overwhelming percentage of them have not been to a dentist in over a year.”