Join ADAMember Log In




Baby boomers may boost dental economy

As a whole, Americans aren't spending any more on dental care than they were five years ago but baby boomers may alter that.

After decades of steady growth, national dental expenditures began to slow in the early 2000s, years before the economy soured. Once the Great Recession hit in 2008, national dental expenditures leveled off and has remained flat ever since. These changes are being driven by fewer adults visiting the dentist.

This is according to the ADA Health Policy Resources Center, which published the research brief "National Dental Expenditure Flat Since 2008, Began to Slow in 2002." But a subsequent brief shows that between 2000 and 2010, spending among those who visited the dentist increased among the elderly and those in higher income brackets.

"As a result of the aging baby boomers, the elderly population is projected to increase from 48 million in 2015 to 92 million in 2060," according to the brief "Per-patient Dental Expenditure Rising, Driven by Baby Boomers." "The rising proportion of those over 65 years old combined with relatively high per-patient dental expenditures among the elderly could significantly increase the dental expenditures among adults with a visit, buoying up the dental economy for years to come."

As outlined in previous research briefs, as a whole, fewer adults are visiting the dentist—a trend that started well before the recession. But because fewer seniors are requiring dentures and retaining their teeth, they remain subject to oral diseases and disorders.

"In general, retired boomers will require more dental services than previous senior cohorts and purchase more intensive services than younger patients," according to the brief, which was authored by Tom Wall, Kamyar Nasseh, Ph.D., and Marko Vujicic, Ph.D.

Dr. Vujicic is the managing vice president of HPRC. Dr. Nasseh, a health economist in HPRC, is leading the effort to model the impact of population aging on dental spending through 2040.

Among adults 65 and older, real annual dental expenditures in the 2000s increased from $655 to $796 per person. For adults 21 to 64 in that same time period, the per-patient expense rose from $557 to $664. Average real per-patient dental expenditures rose from $600 in 2000 to $653 in 2010, according to HPRC.

While there was an increase in individual dental spending among older patients, nationwide, the average remained flat. In 2011, national dental expenditure was $108 billion, slightly up from $107 billion in 2010 (in inflation-adjusted 2011 dollars). In 2011, dental expenditures accounted for 4 percent of overall national health care spending, down from 4.5 percent of national health expenditure in 2000.

There are a number of factors that may have contributed to a slowness in dental spending but the main one is declining dental care utilization among adults, according to HPRC.

On the flip side, on average, more children, particularly low-income children, are visiting the dentist, but their care is typically less costly, according to HPRC. Combine those facts with statistics on fewer adults visiting the dentist and it explains why national dental expenditures have remained flat the past five years.

In 2013, HPRC has published a series of research briefs related to utilization rates, dentists' income and expenditures. All promote the same idea that the recession is not the cause of the decline in spending and utilization—something shifted years before the economic downturn.

"Taken together, our results suggest very strongly that the dental economy is in a major transition. Dental spending has not rebounded since the end of the Great Recession and has been stagnant, on a per capita basis, since 2008," wrote Dr. Vujicic, managing vice president of HPRC, in the brief "National Dental Expenditure Flat Since 2008, Began to Slow in 2002." "More importantly, in our view, our analysis shows convincingly that the dental economy began to slow well before the onset of the recent economic downturn. While overall health spending also began to slow in the early 2000s, the slowdown in dentistry is far more pronounced."

Dentists have entered a new reality in their profession. ADA leaders are trying to make sense of the data and figure out how to help dentists adjust.

"What this research shows is how dramatically dental care utilization and spending are shifting in the United States," Dr. Vujicic said. "HPRC is taking a hard look at this data to help the ADA get a sense of the big picture moving forward. The intent is for the ADA to be guided by reliable data and evidence in its strategic discussions about how we can help ensure the success of our members in a changing environment."

Read the full research briefs here.