The Differences Between Dental and Medical Care: Implications for Dental Benefit Plan Design

Background: Dental benefit plans have grown since they were introduced in the 1960s. More than one-half of the American population is covered by a private dental benefit plan today. In general, these plans have been designed to mirror medical insurance plans, despite the fact that dental care is significantly different from medical care. The author discusses the differences and how they should influence dental benefit plan design.

Conclusions: The differences between dental care and medical care, how oral diseases are treated, the diseases' natural histories without treatment and the organization of the dental profession compared with that of the medical profession require that dental benefit plans be designed differently than medical insurance plans if they are to be effective. The operation of dental and medical plans requires different mind-sets.

Implications: If they are to be effective, dental benefit plans and attempts to control the costs of those plans must be designed with the specific nature of oral diseases and the organization of the dental profession in mind.