FAIR Health Presents at Virtual NADP CONVERGE

On October 1, FAIR Health President Robin Gelburd presented remotely to an audience of dental benefit industry leaders and decision makers at CONVERGE, the annual conference of the National Association of Dental Plans (NADP), held virtually this year. Entitled “A Claims-Based Study of Utilization of Dental Services among Adults 65 and Older,” Ms. Gelburd’s presentation used FAIR Health data to analyze the utilization of dental services in the older population, with emphasis on how the COVID-19 pandemic had affected dental utilization.

Tooth Extractions
Ms. Gelburd compared recent trends in common dental procedures by age, as well as by other variables such as gender and rural/urban location. Tooth extractions, for example, declined 35 percent overall as a percentage of all dental claim lines from 2009 to 2019, perhaps as a result of advances in periodontology and other areas of dental care designed to prevent tooth removal. But the decline was greater in adults under age 65 (42 percent) than those 65 and older (28 percent).

In the 65 and older age group, men consistently had more tooth extractions than women from 2009 to 2019, even as the percentage of tooth extractions declined for both (30 percent for men, 23 percent for women). In rural areas, patients 65 and older had more tooth extractions in this period than in urban areas, and the decline in tooth extractions among patients 65 and older was greater in urban areas (30 percent) than rural areas (19 percent).

Dental Cleanings
Similarly, Ms. Gelburd presented findings on age-related trends in root canals, scaling and root planing, periodontal maintenance, bitewings and periapicals, caries risk assessments, dental cleanings and emergency department services due to dental issues. For example, in every year from 2015 to 2019, adults 65 and older were closer, on average, to the recommended two dental cleanings per year than adults under 65. In 2019, adults 65 and older had an average of 1.53 cleanings compared to 1.38 for adults under 65. It may be that adults under 65 are still working and may not have time for dental appointments, whereas retired adults 65 and older have more free time. In addition, younger people who consider themselves “healthy” may believe they do not need to see the dentist twice per year, while older people, because of dental issues, may be more conscious of the need for dental maintenance.

Presenting results from the FAIR Health brief Dental Services and the Impact of COVID-19: An Analysis of Private Claims, as well as other findings based on FAIR Health data, Ms. Gelburd discussed the impact of the COVID-19 pandemic on dental utilization. Notably, in March and April 2020, there was a sharp decline in dental service utilization in comparison to March and April 2019: a decrease of 75 percent in March 2020 and 79.5 percent in April 2020. The same months saw a surge in teledentistry.

Age was a factor in dental service utilization, particularly as dental practices opened up again in May and June 2020 after having been closed in March and April due to the pandemic. In May, patients 65 years and older were more likely than younger patients to receive diagnostic and preventive dental services, receiving them at 87.7 percent of the May 2019 volume, compared to those under 65, who received them at only 74.8 percent of the May 2019 rate.

In June 2020, compared to the same month in 2019, adults 65 and older had the largest increase in dental service utilization of all age groups—15 percent. By comparison, individuals aged 45 to 54 had a decrease of 8.3 percent. The only age groups with an increase close to that of adults 65 and older were the two youngest ones. Patients younger than 14 had an increase of 8.6 percent, and those 14 to 22 an increase of 11.9 percent.