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Best and Worst U.S. States for Dental Health

A recent investigation into the nation’s dental health by the personal finance website WalletHub revealed that some states are doing better than others when it comes to taking care of teeth.

Minnesota tops the chart as the best overall state for dental care with a 79.13 (of 100) ranking. Wisconsin and Connecticut follow at 76.30 and 75.33 respectively. Illinois and North Dakota come in at fourth and fifth place with 74.11 and 73.33.

States that fell at the bottom of the list include Montana at No. 47 with a score of 37.64 and West Virginia at 36.80. Alabama came in at 36.28, followed by Arkansas at 35.51. Mississippi was in last place at 34.01.

WalletHub measured all 50 states and the District of Columbia against each other using 25 distinct benchmarks of dental health, including the frequency of dental visits for adults and children, the costs of dental care, and the impact of negative oral health on individuals’ quality of life.

“Oral health care is not just about telling patients to brush their teeth twice a day. Many factors go into making sure the population has good oral health,” said Stefania Caracioni, D.D.S., L.V.I.F.

Caracioni is a dentist in Topeka, Kansas, the state that ranked 14 out of 50 in terms of dental care.

Other factors used during WalletHub’s analysis involved the number of dentists available per capita, the percentage of elderly patients missing teeth and the rates of sleep apnea, dry mouth and other conditions that have a negative impact on oral health.

One critical point used in the WalletHub analysis was the availability of fluoridated water. Currently, 75 percent of municipalities treat their water with fluoride. The U.S. Centers for Disease Control and Prevention estimates that by 2020, over 80 percent of the public water supply will be fluoridated.

“Adding fluoride to public water systems is regarded as one of the top 10 most important events in health care. Fluoride plays an important role in returning strength to tooth enamel damaged by tooth decay,” Caracioni said.

According to the CDC, over 35 percent of adults have gone more than a year without visiting a dentist. While some of these adults skip going to the dentist citing fear of the dentist or dental anxiety, many individuals go long periods without seeing the dentist because they cannot find one. Many also cannot afford a dental visit.

“One of the components of ensuring you have people with healthy teeth is providing access to dental care and that the care is affordable,” Caracioni said.

Skipping regular dental checkups has serious consequences and increases the risk of developing cavities or periodontitis, a serious form of gum disease.

“When tooth decay or gum disease goes without treatment, patients are at risk for painful complications and even more expensive treatments,” Caracioni said.

Limited access to dental care is a critical factor in the states that ranked at the bottom of the list, such as West Virginia, Arkansas, Alabama and Mississippi.

The WalletHub study also considered lifestyle factors that have negative effects on oral health, such as smoking and soft-drink consumption. Residents of Connecticut, which ranked No. 3 in the nation for positive oral health, consume fewer sugary beverages than individuals in West Virginia, Mississippi and Arkansas, three states rated as having poor oral health.

There are also fewer smokers in Connecticut than these three states, and people living in Connecticut have less dental pain and fewer complications than residents living in other places.

“Making positive lifestyle choices can reduce the risk of developing oral health issues,” Caracioni said.


WalletHub. 2018’s States with the Best & Worst Dental Health. 1 February 2018.

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