Dental access remains a stubborn fault line in U.S. health care. Fresh federal surveillance data show 66.0% of adults reported a past-year dental visit in 2022, leaving roughly one in three without a checkup that could catch problems early [1]. Cost and coverage design loom large: an estimated 70 million adults lack dental insurance [3]. And one in five adults report unmet dental needs due to cost—even some with insurance—because dental benefits are frequently sold separately from medical coverage [4].

Key Takeaways

– shows 66.0% of U.S. adults had a dental visit in 2022, leaving 34.0%—about one in three—without preventive care [1] – reveals about 70 million adults lack dental insurance, limiting appointments, affordability, and routine care continuity across employer and marketplace plans [3] – demonstrates one in five adults report unmet dental need due to cost, even when they have some form of insurance [4] – indicates 83% of 2023 dental visits were preventive, yet cost and coverage barriers still discourage timely checkups and early detection [5] – suggests integrating oral and primary care—via payment alignment and interoperable IT—can narrow access gaps; FQHCs already lead such models [2]

The state of dental access by the numbers

The CDC’s National Oral Health Surveillance System (NOHSS) reports that 66.0% of adults had a dental visit in the prior year in 2022, a core indicator of preventive care access in the United States. By implication, about 34.0% of adults did not receive routine care, a gap with consequences for decay, periodontal disease, and missed early detection of related systemic risks [1].

Within that national average, the CDC highlights persistent disparities by income, educational attainment, and race and ethnicity, reflecting uneven coverage, transportation, and provider distribution. Communities with lower incomes and less education are less likely to receive timely exams and cleanings, reinforcing cycles of delayed care and higher long‑term costs that compound over time [1].

These indicators matter because routine dental visits are a frontline screen. CDC experts emphasize that regular dental care supports early detection of oral disease and potential systemic health issues—benefits that are difficult to realize when a third of adults forego annual visits [1].

Why coverage design limits dental access

In the United States, dental benefits are typically structured and sold separately from medical insurance, and many employer plans either exclude or limit adult dental coverage. That separation helps explain why a nationally representative survey found one in five adults had unmet dental needs due to cost, including people with insurance who could not afford out‑of‑pocket expenses or lacked adequate benefits [4].

The financing gap is large: CareQuest estimates roughly 70 million adults have no dental insurance at all, limiting appointments, preventive checkups, and continuity of care that could avert costly procedures down the line [3].

Policy window: how ACA’s 2024 rule could expand dental access

A new federal rule finalized in May 2024 opens a pathway for states to designate adult dental services as essential health benefits under the Affordable Care Act. If states adopt it, premium subsidies could apply to comprehensive medical‑dental plans, potentially bringing millions of adults into insured preventive and restorative care [3].

The policy is not automatic: states must act to define and benchmark adult dental benefits, adjust market rules, and align plan offerings. The scale of impact will depend on the number of states that choose to move, the scope of benefits they include, and how carriers price and market integrated plans [3].

Integrating care to close gaps and improve outcomes

Coverage alone is not the only lever. Health policy experts argue that integrating oral and primary care—through interprofessional training, aligned payment models, and interoperable health IT—can make it easier for patients to receive preventive assessments and referrals in both settings. Federally Qualified Health Centers, which frequently co‑locate services, are cited as leaders that demonstrate how integration can reduce barriers [2].

The integration case is strengthened by need: roughly one in five Americans report unmet dental needs largely due to cost, and siloed financing and technology compound the problem. Authors call for policy changes that support team‑based workflows, care coordination, and data sharing to scale models that work beyond safety‑net settings [2].

What motivates preventive care when dental access improves

Recent consumer data underscore the upside potential. In Delta Dental’s 2024 State of America’s Oral Health and Wellness report, 9 in 10 adults said a dental visit is as important as an annual physical, 83% of 2023 dental visits were preventive, and 47% of adults expressed interest in teledentistry options. The report also notes that having dental insurance strongly motivates preventive visits [5].

Those attitudes suggest that if coverage expands and is better integrated with primary care, many patients—especially younger adults—will act on their intentions and schedule routine cleanings and exams, improving early detection and lowering downstream costs [5].

The cost of inaction for young adults

For young adults navigating entry‑level jobs or gig work, the coverage fissures are acute. One in five adults cite cost as a reason they could not get needed dental care, a barrier that can derail routine cleanings and early interventions when budgets are tight [4]. An estimated 70 million adults lack dental insurance, leaving many young adults without affordable entry points to preventive care [3].

Meanwhile, at a population level, only 66.0% of adults reported a dental visit in the past year, meaning roughly one in three missed preventive care that can flag oral disease early [1]. The CDC underscores that routine dental visits enable early detection of oral conditions and systemic risks—benefits that become harder to realize when cost and coverage keep people away [1].

What to watch in 2025: state decisions and dental access metrics

The next 12 months will test whether states seize the ACA opportunity to add adult dental services as essential health benefits. Watch for regulatory proposals and benchmark plan updates, as well as whether carriers create combined medical‑dental offerings that leverage premium subsidies to lower consumer costs [3].

On the measurement side, track the CDC’s NOHSS adult indicators for changes in past‑year dental visit rates and disparities [1]. And watch integration pilots—especially in FQHCs—for evidence on reducing unmet need and improving continuity of care [2].

Sources:

[1] Centers for Disease Control and Prevention (CDC) – Adult Indicators | Oral Health Data Systems: www.cdc.gov/oral-health-data-systems/about_oral_health_data/adult-indicators.html” target=”_blank” rel=”nofollow noopener noreferrer”>https://www.cdc.gov/oral-health-data-systems/about_oral_health_data/adult-indicators.html

[2] Health Affairs Forefront – Bridging The Dental Divide: Overcoming Barriers To Integrating Oral Health And Primary Care: https://www.healthaffairs.org/content/forefront/bridging-dental-divide-overcoming-barriers-integrating-oral-health-and-primary-care [3] Health Affairs Forefront – New ACA Policy Expands Access To Dental Care. Now, States Need To Act: www.healthaffairs.org/content/forefront/new-aca-policy-expands-access-dental-care-now-states-need-act” target=”_blank” rel=”nofollow noopener noreferrer”>https://www.healthaffairs.org/content/forefront/new-aca-policy-expands-access-dental-care-now-states-need-act

[4] KFF Health News – Adults With Insurance Often Still Have Unmet Dental Needs, Survey Finds: https://kffhealthnews.org/news/adults-with-insurance-often-still-have-unmet-dental-needs-survey-finds/ [5] Delta Dental Plans Association – New Delta Dental report: 9 in 10 adults believe their dental visit is as important as an annual physical: https://www.deltadental.com/us/en/about-us/press-center/2024-press-releases/new-delta-dental-report-9-in-10-adults-believe-their-dental-visit-is-as-important-as-an-annual-physical.html

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