Dental dilemma: escalating out-of-pocket expenditure trends

Sir,

The increase in global oral diseases is driven by urbanization, inadequate fluoride exposure, easy access to sugary foods, and limited oral health care. Aggressive marketing of sugary products and tobacco/alcohol further worsens the situation, impacting both oral health and overall well-being.¹ American Dental Association (ADA) report "oral health and well-being". It reveals that a sizeable fraction of the population 38% has lower life satisfaction as a result of oral health problems. one in five persons’ experience anxiety, and twenty-three percent feel embarrassed about the state of their mouths and teeth. This affects social relationships in addition to being an emotional burden, as shown by the 1 in 4 individuals who avoid smiling and the 22% of young adults who avoid social situations because they are self-conscious about their teeth.²

GLOBAL ORAL HEALTH: A CLOSER LOOK AT THE NUMBERS

Around 3.5 billion people worldwide are anticipated to be impacted by oral disorders, with three out of every four affected individuals residing in middle-income nations, according to the World Health Organization (WHO) global oral health status report (2022). There are an estimated 2 billion adults worldwide who have permanent tooth carries, including 514 million children who have primary tooth caries.¹ Low socioeconomic status people are more likely to have oral diseases and be ignorant about oral health due to a variety of factors, including limited financial resources, insufficient dental insurance coverage, transportation challenges to dental clinics, language barriers, and a lack of knowledge about the importance of oral health care.³

Private dental clinics are popping up increasingly frequently in India to assist patients with dental issues. However, because these facilities frequently charge a lot, patients wind up footing the bill for dental care in full. This additional dental care spending can be very taxing, particularly if it accounts for a sizable portion of a family's income. A family experiences catastrophic dental health expenditure (CDH) when the cost of dental treatment consumes a sizable portion of their income. Families may become so impoverished as to be below the poverty line as a result of this increased spending. Therefore, it's critical to provide basic dental care to avoid future expensive issues and to keep families from experiencing financial hardship.⁴

COST PERCEPTIONS

Among respondents, 58% with dental benefits find dentistry unaffordable, a figure that rises to 75% for those lacking benefits to defray costs. This underscores the significant impact of financial barriers on access to dental care, revealing a pressing need for broader affordability measures to ensure equitable oral health access for all.⁵ The high costs people see for dental care show we really need to make it easier and cheaper for everyone to get the care they need. We should focus on making basic dental care more available to help families with their finances and make sure everyone can afford to take care of their teeth. By doing this, we can make sure everyone has a fair chance to have healthy teeth and feel good about their smiles. Let's work together to make sure oral health care is fair and accessible to all.

REFERENCES

1. 1. World Health Organization. Sugars and dental caries. Available at: https://www.who.int/news-room/fact-sheets/detail/sugars-and-dental-caries. Accessed on 11 April 2024.
2. 2. College of Dentistry | University of Illinois Chicago. The Many Costs (Financial and Well-Being) of Poor Oral Health. Available at: https://dentistry.uic.edu/news-stories/the-many-costs-financial-and-well-being-of-poor-oral-health/. Accessed on 11 April 2024.
3. 3. World Health Organization. Oral health. Available at: https://www.who.int/news-room/fact-sheets/detail/oral-health. Accessed on 11 April 2024.
4. 4. Nobelika, Alice A, Simon, Arun K. An Observational Study to find the Patterns of Out-of-Pocket Expenditure for Oral Healthcare Among Sanitary Workers in Coimbatore, India. J Indian Assoc Public Health Dent. 2020;18(2):143-50.
5. 5. Henry K. The cost barrier: How out-of-pocket expenses are impacting dental care access. DrBicuspid.com. 2024. Available at: https://www.drbicuspid.com/dental-practice/office-management/practice-trends/article/15665031/carecredit-the-cost-barrier-how-outofpocket-expenses-are-impacting-dental-care-access. Accessed on 11 April 2024.