Dental Benefits
Dental Benefits
In 1954 labor unions sought to add dental coverage as a “fringe benefit” and consulted with state dental societies in Washington, Oregon and California to develop a benefit where care would be delivered in the dentist’s office, creating prepaid plans. Source: Dental Insurance by Eric Bishop, McGraw Hill, ©1983.”
The architects and participants of prepaid dental learned a great deal from their experiences over the next 20 years as they pioneered this new niche in health care. “Part of the problem was that any who knew – or thought they knew – the medical business assumed they were automatically experts in the dental business; not so, they are significantly different in many fundamental ways,” Bishop noted.
In Dental Benefits: A Guide to Dental PPOs, HMOs and Other Managed Plans, Dr. Donald S. Mayes devoted an entire chapter highlighting significant differences between medical and dental benefits, which he summarized in Figure 3-1 as:
Because the dental benefits industry is still relatively young, data is not available for all time periods and categories.
Medical and Dental Practices
How Medical and Dental
Practice Differ
As the industry grew, understanding about the fundamental differences between dental and medical conditions and benefits increased and the market evolved to offer more options including Dental PPO and Dental Savings in addition to employers self-funded plans. The following industry milestones below highlight the evolution of the dental benefits industry.
| Medical | Dental | |
|---|---|---|
| Diseases treated | Myriad | Mainly two |
| Diagnostic complexity | Great | Small |
| Diagnostic cost | High | Low |
| Prevention: cost/effectiveness | Variable | High |
| Institutional based treatment | High | Low |
| Nature of disease | Acute/chronic | Chronic |
| Life threatening | Not uncommon | Rare |
| Audit Trail | Varies | Very Good |
| Covers low cost/high frequency | Not Standard | Standard |
| Covers high cost / low frequency | Yes | No |
Jump to Sections Below
1840 -1900
| Dental Benefits | Dentistry / Access to Care | Oral Health | Technology |
|---|---|---|---|
| 1840: Baltimore College of Dental Surgery founded, a turning point in field of U.S. dentistry | 1900: Caries (tooth decay) prevalent in U.S. Extraction most frequent treatment. Source: Centers for Disease Control (CDC) | 1895: Wilhelm Roentgen, a German physicist, discovers the x-ray. In 1896 prominent New Orleans dentist C. Edmond Kells takes the first dental x-ray of a living person in the U.S. Source: American Dental Association History of Dentistry. | |
| 1903: Charles Land devises the porcelain jacket crown. Source: American Dental Association History of Dentistry. | |||
| 1905: Alfred Einhorn, a German chemist, formulates the local anesthetic procain, later marketed under the trade name Novocain. Source: American Dental Association History of Dentistry. |
1901 -1969
| Dental Benefits | Dentistry / Access to Care | Oral Health | Technology |
|---|---|---|---|
| 1945: Water fluoridation introduced as Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems. Source: American Dental Association History of Dentistry | |||
| 1950: The first fluoride toothpastes are marketed. Source: American Dental Association History of Dentistry. | |||
| 1954: International Longshoreman’s & Warehousemen’s Union Pacific Maritime Association establish first dental program. Source: Dental Insurance by Eric Bishop, McGraw Hill, ©1983 1955: First Dental Service Organizations (DSC) formed in California Source: Dental Insurance by Eric Bishop, McGraw Hill, ©1983 | |||
| 1966: 2 million beneficiaries covered by prepaid dental (DHMO) Source: Dental Insurance by Eric Bishop, McGraw Hill, ©1983 | 1960: Average American over age 65 years had only seven of his or her original teeth. Source: CDC |
1970-1979
| Dental Benefits | Dentistry / Access to Care | Oral Health | Technology |
|---|---|---|---|
| 1970: 12 million beneficiaries covered by prepaid dental Source: Dental Insurance by Eric Bishop, McGraw Hill, ©1983 | |||
| 1974: United Auto Workers create first employer group dental program. Source: Dental Insurance by Eric Bishop, McGraw Hill, ©1983 | 1975: Dental Service Organization model introduced. Source: The ADSO. | ||
| 1979: DSC spreads to 17 states west of Mississippi Commercial insurers enter market |
1980-1989
| Dental Benefits | Dentistry / Access to Care | Oral Health | Technology |
|---|---|---|---|
| 1980: More than half of all people with dental benefits are covered by commercial prepaid plans. Source: Dental Insurance by Eric Bishop, McGraw Hill, ©1983 | |||
| 1981: 82 million covered by prepaid dental plans. Source: Dental Insurance by Eric Bishop, McGraw Hill, ©1983 | 1988: Tooth decay affects 59 percent of children with permanent teeth, i.e. 12-19 years old. Source: CDC | ||
| 1989: National Association of Prepaid Dental Plans (NAPDP) incorporated |
1990-1999
| Dental Benefits | Dentistry / Access to Care | Oral Health | Technology |
|---|---|---|---|
| 1990:Referral (now known as Dental Savings Plans) introduced | 1990: New tooth-colored restorative materials plus increased usage of bleaching, veneers, and implants inaugurate an era of esthetic dentistry. Source: American Dental Association History of Dentistry. | ||
| Mid 90s: Dental Preferred Provider Organizations (DPPO) | |||
| 1994: NAPDP becomes NADP 113.6 million Americans have dental coverage. Source: NADP 1994 Dental Benefits Report: Enrollment. | 1994: Tele dentistry was first used in the U.S. Army's Total Dental Access Project at Fort Gordon. Source: Wikipedia. | ||
| 1995: Seniors over age 65 have an average of 18.90 remaining teeth. Source: National Institute of Dental and Craniofacial Research | |||
| 1997: CHIP created | |||
| 1999: 56% of U.S. population, 153 million, had some type of dental benefit. Source: NADP 1999 Dental Benefits Report: Enrollment |
2000-2009
| Dental Benefits | Dentistry / Access to Care | Oral Health | Technology |
|---|---|---|---|
| 2000: Oral Health in America: A Report of the Surgeon General alerts Americans “to the full meaning of oral health and its importance to general health and well-being.” | |||
| 2004: Federal Employee Dental and Vision Benefits Enhancement Act signed by President Bush. Act gives federal employees access to full dental and vision benefits. | |||
| 2005: $86 billion spent annually for dental care and dental benefits funded half of this total. Source: 2005 U.S. Census Bureau. Table 8.1. Health care and social assistance. | |||
| 2007: Individuals with dental coverage are: 49 percent more likely to have visited the dentist in the past 6 months and 17 percent more likely to rate their overall health as very good/excellent. Source: NADP 2007 Consumer Survey | 2007: 57% of covered individuals consider their dental health as very good or excellent – 2007 NADP Consumer Survey | ||
| 2008: Sealants covered at some level by all types of plans. Source: NADP Industry Snapshot: Sealants and Topical Fluoride Varnishes, 2008 Implants covered by most plans. Source: NADP 2008 Consumer White Paper | 2007: Dentists Participating in Networks 33,201 (DHMO) 91,781(DPP0) 59,185 (Discount) Source: 2008 NADP Dental Benefits Report: Network Statistics |
2010 - Present
| Dental Benefits | Dentistry / Access to Care | Oral Health | Technology |
|---|---|---|---|
| 2010: Pediatric dental coverage is included as an essential health benefit under the Affordable Care Act. | |||
| 2011: Dentists Participating in Networks 28,145 (DHMO) 158,079 (DPP0) 98,521 (Discount) Source: 2012 NADP Dental Benefits Report: Network Statistics | |||
| 2012: 60% of population has dental benefits. Source: NADP 2012 Dental Benefits Report: Enrollment | 2012: U.S. Bureau of Labor Statistics data indicated that there were 146,800 total dentists in U.S. | ||
| 2015: 66% of the population has dental benefits. Source: NADP 2012 Dental Benefits Report: Enrollment Two-thirdsnsumers with dental benefits have carried coverage continuously for more than 5 years. Source: NADP 2015 Consumer Survey: Dental Health and Benefits | 2015: Dentists Participating in Networks 49,822 (DHMO) 211,371 (DPP0) 96,208 (Discount) Source: 2016 NADP Dental Benefits Report: Network Statistics | 2015: Approximately two-thirds of the population indicate they brush at least twice daily and approximately one-third report to floss daily. Males, those younger and less educated, and those without dental benefits, are significantly less likely to engage in these positive oral health behaviors. 90% replace their toothbrush at least every six months. Source: NADP 2015 Consumer Survey: Dental Health and Benefits. | 2015: ADA issued specific guidelines on teledentistry. |
| 2016: NADP research reveals 77% of U.S. population have dental benefits. Large increase is because of market growth and additional data on public programs supplied by Centers for Medicare & Medicaid. | |||
| 2017: In China, a robot successfully performed the world's first fully automated dental implant with 3-D printed teeth. The robot automatically adjusted with the patient's movement. | |||
| 2018: ADA adds tele-dentistry Codes to CDT. |
Change in Premium (2012 - 2016)
