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Accessible Primary Care
Americans are more likely to visit a primary care provider than a dentist, making the primary care setting a more reliable source of preventive oral health care. In 2012, 82% of adults and 93% of children made at least one visit to a physician or other ambulatory care provider. By comparison, only 61% of adults visited a dentist, with significantly lower visit rates for uninsured, unemployed, low-income, Hispanic, and African-American adults, as well as adults with Medicare or Medicaid coverage. Among children with commercial insurance, 58% received dental care at least once per year. Rates were lower for children with Medicaid coverage (44%), particularly for the very young. The regularity and frequency of contact with primary care offers particular benefits for at least three high-risk/high-need groups: children, pregnant women, and people with diabetes.
• Children: The vast majority of children, especially young children, see their primary care provider on a routine basis for well-child care visits and other preventive services, such as immunizations. Offering preventive oral health care as a standard component of routine well-child care expands access, including the opportunity for referral, for nearly all children and adolescents.
• Pregnant women face barriers to accessing dental care, regardless of income or insurance status.
Only 50% of pregnant women with a dental problem visit a dentist during their pregnancy. Many dentists mistakenly believe that dental care could put pregnant patients at risk, and convey the message that dental care should be delayed until after delivery; despite evidence showing that dental care, including radiographs, local anesthesia, and oral pain medication is safe throughout pregnancy. Nearly 75% of pregnant women receive prenatal care in the first trimester of pregnancy (and an additional 20% receive prenatal care beginning in the second trimester) from a primary care provider, midwife, or physician specialist, yielding an important access opportunity.