Inequalities in Dental Implants Provision in the United States

Objectives: Treatment options for the replacement of tooth loss have been expanded to include the placement of endosteal dental implants as the standard of care. It is unclear whether implants represent a standard treatment option for the average American with tooth loss. However, to date there are no studies that have reported on the provision of dental implants in adults from a nationally representative sample in the United States. The study aim was to estimate the proportion of adults who had dental implants placed and to compare their socio-demographic profile: (a) with those with any missing teeth and, (b) to non-tobacco users with ≤ 3 missing teeth.

Methods: We analyzed data from the Medical Expenditure Panel Survey (MEPS) and National Health and Nutrition Examination Survey (NHANES) for 1999 to 2004.

Results: On average, 0.3% of adults (511,700 individuals per year), had dental implants placed within the study period. Mostly middle (23.7%) to high (60%) income adults received dental implants. Asian-Americans (45.8%) and whites (42.4%) accounted for a higher percentage of adults receiving dental implants. While Hispanics and African-American comprise 24.6% of adults with tooth loss, they only account for 8.1% and 2.1 % of adults with dental implants. In addition, Hispanics and African-Americans represent 20.2% and 13.5% of non-tobacco users with ≤ 3 missing teeth.

Conclusion: An income driven disparity in the provision of dental implants among adults was identified. Given that dental implants are not covered by most dental insurance plans, this suggests that either they should be, or that costs need to be lowered for it to be considered a standard of care.