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Dental care sector analysis finds key structural changes in progress

An environmental scan of the dental care sector shows that the climate is shifting and dentistry needs to adapt, a notion the ADA has been following and explaining for some time.

"A Profession in Transition: Key Forces Reshaping the Dental Landscape," is an analysis that's never been done before and one that shows the ADA has been on point in its assessment of the changes in dentistry. The environmental scan includes research from the ADA Health Policy Resources Center and Diringer and Associates, a consulting firm hired to help the ADA Board of Trustees' Strategic Planning Steering Committee develop a strategic plan for 2015-20, as well as other experts.

This is the first of three articles that will summarize the report, and it will focus on the first key finding: the dental care sector has recently experienced important structural changes. These changes are not related to the economic downturn or slow recovery—they're ones that have been happening for years, according to the scan.

Dental care use has declined among working age adults, particularly the young and poor, and it's a trend that emerged well before the recession, the scan said. But children's dental care use has been on the upswing, driven primarily by the expansion of public insurance programs.

Among some of the other findings in the environmental scan:

•Changes in dental benefit coverage for adults and children is a key driver of utilization trends. There has been a steady erosion of adult dental benefits coverage in the past decade, particularly for young and poor adults, the scan said. This is attributed to a combination of labor market factors, employer behavior and the elimination of adult dental benefits within Medicaid programs.

•More adults in all income groups are experiencing increased financial barriers to care, a trend that emerged in the early 2000s, well before the economic downturn. In 2011, nearly one in five young adults reported they could not get the dental care they needed because of cost, a statistic that has almost doubled since 2000, according to the scan.

•The trends in dental care use have affected total dental spending and dentists' earnings. Total dental spending in the United States slowed considerably in the early 2000s and has been flat since 2008, according to the report. Dentists' average net incomes flattened then declined considerably, starting in the mid-2000s. They have held steady since 2009 but have not rebounded, the scan said. Two out of five dentists indicate they are not busy enough and can see more patients, a significant increase over the past years.

To read the full environmental scan and to watch a video explaining the report, visit ADA.org/escan.