Economic Fears Affect Dental Care

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Regular checkups and cleaning can save money in the end by heading off problems early. Nevertheless, when times get tough and people start losing their jobs, preventive dental care can be one of the first things to go.

However, the correlation between rising unemployment and a drop in preventive dental care is not necessarily due to people being short of cash, according to a new study appearing in the online edition of Health Services Research.

"We see that high community-level unemployment exacts a psychological toll on individuals," said lead study author Brian Quinn. "Even for people who are working, or who have a working partner or spouse, there might be an impact if they're stressed about themselves or their significant others losing their jobs."

Quinn, a program officer for the Robert Wood Johnson Foundation, said the distraction of worrying about not having a job could make dental care drop off a person's radar. "During stressful periods, those things that don't seem as urgent may be ignored," he said.

The researchers analyzed 10 years of information about visits to dentists' offices in metropolitan Seattle and Spokane from Washington Dental Services, the largest dental insurer in the state, which covers roughly one-third of its residents. They compared this information to unemployment data from the Bureau of Labor Statistics and Washington's Employment Security Department, and ruled out other possible explanations for a correlation.

In the Seattle area, for every 10,000 people who lost their jobs, there was a 1.2 percent decrease in visits to dentists for checkups. The drop was higher in the Spokane area, where the same increase in unemployment was associated with a 5.95 percent decrease in preventive visits. This is notable as the study looked at people who had dental insurance that covered routine care.

Dental care is way down at the bottom of the list of essentials for many people, said Gene Sekiguchi, associate dean of legislative affairs for the University of Southern California School of Dentistry. "When the economy gets tough, you'll start eliminating the last items on the list and work your way up," said Sekiguchi, who had no affiliation with the study.

Sekiguchi said that oral hygiene is important for overall health; for example, gum disease can lead to heart disease and diabetes.

Because preventive care is usually cheaper than tooth repairs, dental plan administrators and public health policy makers might want to promote cleaning and checkups during periods of high unemployment, the study authors say.