Dental Benefits History

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MultiTrack Dental Benefits Industry History

INTRODUCTION

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.


How Medical and Dental Practice Differ

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

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 highlight the evolution of the dental benefits industry.


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

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.


2012- 2016