Near-congruence of dental utilization and voting patterns: The need for a multi-disciplinary approach by public health professionals

Educational efforts are likely to be more effective and more economical in increasing dental utilization than graduating more dentists or building more dental treatment facilities.

Utilization by adults ages 18-64 enrolled in employer-sponsored dental plans, primarily in upstate New York, was analyzed. Years examined were 1988, 1992, 1996, 2000, and 2004. The smallest number of eligible individuals was 31,166 in 2004. All plans covered diagnostic and preventive services in full, and all eligible individuals lived and/or worked near a dentist. The fraction of eligible adults who sought dental care during a given year ranged from 56% to 63%, the mean was 59%.

For comparison, Census Bureau statistics enumerating citizens ages 18-64 who voted in the five most recent U.S. presidential elections were examined. The fraction voting in a given election ranged from 56% to 67%; the mean was 61%.

2004 data (dental utilization and voting) were analyzed by age cohort: 18-24, 25-34, 35-44, 45-54, and 55-64. Whereas the fraction of citizens who voted in presidential elections increased with age (from 47% of the youngest cohort to 72% of the oldest), the fraction who sought dental care during presidential election years decreased with age (from 66% to 52%).

Fractions voting and fractions seeking dental care are nearly congruent. Both seem reflective more of sociologic than economic factors. The likelihood of increasing voter turnout by creating more voting booths is small, and politicians work to increase voter interest to affect “voter utilization.” Even with access to care – care that is free -- dental utilization is lower than target levels and much lower than 100%. Therefore, to increase dental utilization, emphasis should be on changing care-seeking behavior rather than building dental infrastructure. Dental health professionals and health educators should be encouraged to collaborate to develop programs for increasing dental patient “turnout.”