A Cross-Sectional Analysis of Oral Health Spending Over the Lifespan in Commercial and Medicaid Insured Populations

Background Life course theory creates a better framework to understand how oral health needs and challenges align with specific phases of the lifespan, care models, social programs, and changes in policy. Methods Data are from the 2018 IBM Watson Multi-State Medicaid Marketscan Database (31 million claims) and the 2018 IBM Watson Dental Commercial and Medicare Supplemental Claims Database (45 million claims). Analysis compares per enrollee spending fee-for-service dental claims and medical spending on dental care from ages 0 to 89. Results Dental utilization and spending are lower during the first 4 years of life and in young adulthood than in other periods of life. Stark differences in the timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations. Conclusions This unique lifespan analysis of the U.S. multi-payer dental care system demonstrates the complexities of the current dental service environment and a lack of equitable access to oral healthcare. Practical Implications Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the lifespan.