Medical Expenditure Panel Survey 

Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #117

March 2006 

Children’s Dental Visits and Expenses, 

United States, 2003 Highlights 

 Slightly more than half of 

all U.S. children ages 2–

17, who were part of a 

civilian noninstitutionalized 

family, received dental 

services during 2003. 

 In 2003, white children 

were more likely to have at 

least one dental-related 

visit than black children, 

Hispanic children, and 

children in the other single 

race/multiple race 

category. 

 Among children using 

dental services in 2003 and 

with a dental expense, 

those children in high 

income families incurred 

higher dental costs than 

those children in low/ 

middle income and 

poor/near poor families. 

Erwin Brown, Jr. 

Introduction 

Regular dental care, beginning early in childhood, is an important 

component of health care. The American Academy of Pediatric 

Dentistry recommends that children begin having dental service 

visits at approximately age 1.1

 Tooth decay (dental caries) is one of 

the most common chronic infectious diseases among children in the 

United States. Tooth decay begins early. Among children ages 2–4, 

17 percent have already had tooth decay. By the age of 8, approximately 52 percent of children have experienced tooth decay, and by 

the age of 17, tooth decay affects 78 percent of children.2

 However, 

tooth decay is, to a large extent, preventable through regular dental 

cleanings and checkups, the use of sealants, and appropriate diet 

and oral health care.3 

This Statistical Brief presents estimates based on data from the 

Household Component of the 2003 Medical Expenditure Panel 

Survey (MEPS-HC) on the proportion of children age 17 and under 

who utilize dental services, by race/ethnicity, age, sex, income, and 

geographical region. In addition, the data presented in the brief 

include measures from Healthy People 2010, a set of health 

objectives to be attained in the U.S. by 2010. Only differences that 

are statistically significant at the 0.05 level are discussed in the text. 

Findings

In 2003, approximately 50.9 percent of children between the ages of 2 and 17 living in the civilian 

noninstitutionalized population had at least one dental-related visit (table 1). This translates into about 

33.5 million American children ages 2–17 obtaining at least one dental service visit during 2003. 

During 2003, a larger percentage of children ages 12–17 (55.4 percent) had a dental visit than children 

ages 2–11 (48.1 percent). Among all children, whites (59.6 percent) were more likely to have at least one 

dental visit than any other reported race/ethnic children’s group. 

1

 American Academy of Pediatric Dentistry. Guideline on Infant Oral Health Care. Available at aapd.org/media 

/Policies_Guidelines/G_InfantOralHealthCare.pdf. 

2 Preventing Dental Caries with Community Programs, Fact Sheet August 2005. CDC National Center for Chronic Disease 

Prevention and Health Promotion Division of Oral Health. Available at http://www.cdc.gov/oralhealth/publications/factsheets/dental_caries.htm. 3

 Kaste, L. M., Selwitz, R. H., Oldakowski, R. J., Brunelle, J. A., Winn, D. M., and Brown, L. J. (1996). Coronal Caries in the Primary 

and Permanent Dentition of Children and Adolescents 1–17 Years of Age: United States, 1988–1991. Journal of Dental Research, 

75, 631–641. Rockville, Md.: National Institutes of Health. National Institute of Dental Research, Division of Epidemiology and Oral 

Disease Prevention. 
Children residing in high income families (60.1 percent, or 24.2 million) were more likely to have a dental 

visit than children in low/middle income families (37.4 percent, or 4.0 million) and children in poor/near 

poor income families (35.8 percent, or 5.3 million). Children residing in the Northeast and Midwest regions 

(55.3 percent and 55.6 percent, respectively) were most likely to have at least one dental visit compared 

to children residing in the South (47.7 percent) and the West (48.3 percent) regions. 

In 2003, the average dental care expense for a child ages 2–17 with an expense and having at least one 

dental visit was $501 (table 2). For children between ages 12–17 with at least one dental visit, the 

average dental expense was $742 for the same period. This was more than twice the average annual 

dental expense of $327 for a child ages 2–11. These differences in expenditures reflect differences in use 

by age. Among children with a dental services visit in 2003, those children ages 2–11 averaged 2.0 visits 

per year while older children ages 12–17 averaged 3.4 visits per year. 

Among children with an expense, expenses incurred for white children and other single race/multiple race 

children ages 12–17 ($835 and $827, respectively) were significantly higher than those incurred for 

similar age Hispanic children ($472) and black children ($323). A significant difference in the average 

expenses for a dental services visit was also evident among children ages 2–11 with respect to 

race/ethnicity. White children ages 2–11 ($369) with a dental visit had significantly higher average dental 

expenses than black children ($228) and Hispanic children ($226) in the same age group in 2003. 

Among those with a dental visit and a dental expense in 2003, those children living in high income 

families had average dental expenses of $567. This compares with average expenses of $365 for 

children in low/middle income families and $302 for children living in poor/near poor families. 

Excluding orthodontic care from these estimates reduces the number of dental visits and the cost of 

dental care, especially for children between the ages of 12 and 17. When orthodontic care is excluded, 

the number of visits for all children drops from 2.6 to 1.8; and, for children between 12 and 17, the 

average number of visits drops from 3.4 to 1.8 (figure 1). Similarly, the average dental expenses for all 

children drop from $501 to $243; and, for children between 12 and 17, the average dental expense drops 

from $742 to $268 (figure 2). 

Data Source 

The estimates in this Statistical Brief are based on a sample from the dental public use data set of the 

2003 MEPS-HC (HC-077B: 2003 Dental Visits file). This data set contains 29,473 dental event records; of 

these records, 28,920 are associated with persons having a positive person-level weight. This file 

includes dental event records for all household survey respondents who resided in eligible responding 

households and reported at least one dental event. Each record represents one household-reported 

dental event that occurred during calendar year 2003. Dental visits known to have occurred before 

January 1, 2003 and after December 31, 2003 are not included in this brief. 

Definitions 

Dental services/visit 

Dental services/visit refers to care by or visits to any type of dental care provider, including general 

dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and 

periodontists. 

Dental expenses 

Expenses are the amount actually paid for dental services. More specifically, in MEPS, 

expenses/expenditures are defined as the sum of payments for care received, including out-of-pocket 

payments, and made by private insurance, Medicaid, and other sources. 

Race/ethnicity 

Race/ethnicity is coded hierarchically into the following codes: White single race, black single race, 

Hispanic or Latino, and other single race/multiple race. 

 
Poverty status

Income is expressed in terms of poverty status, the ratio of the family’s income to the Federal poverty 

thresholds, which control for the size of the family and the age of the head of the family (see the 2002 

U.S. Department of Health and Human Services Poverty Guidelines at http://aspe.hhs.gov/poverty/ 

02poverty.htm for more details). In this Statistical Brief, the following classifications were used: 

– Poor: Persons in families at or below the poverty line. 

– Near poor: Persons in families over the poverty line through 125 percent of the poverty line. 

– Low income: Persons in families with income from 125 percent to less than 200 percent of the poverty 

line. 

– Middle income: Persons in families with income from 200 percent to less than 400 percent of the 

poverty line. 

– High income: Persons in families with income at or over 400 percent of the poverty line. 

Region of residence 

Each MEPS sampled person was classified as living in one the following four regions as defined by the 

U.S. Census Bureau: 

– Northeast: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, 

New Jersey, and Pennsylvania. 

– Midwest: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, South Dakota, North 

Dakota, Nebraska, and Kansas. 

– South: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South 

Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana,

Oklahoma, and Texas. 

– West: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, 

California, Alaska, and Hawaii.

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr1/mr1.pdf 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. http://www.meps.ahrq.gov/mepsweb/data_files/publications/mr2/mr2.pdf

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Brown, E., Jr. Children’s Dental Visits and Expenses, United States, 2003. Statistical Brief #117. March 

2006. Agency for Healthcare Research and Quality, Rockville, Md. 

http://meps.ahrq.gov/mepsweb/data_files/publications/st117/stat117.pdf 
∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Table 1. Percentage of children ages 2–17 with at least one dental care visit, 2003 

Population characteristic 

Total population 

(in thousands) 

(age 2–17) 

Percentage with 

at least a visit 

(age 2–17) 

Percentage with at 

least a visit 

(age 2–11) 

Percentage with at 

least a visit 

(age 12–17) 

Total 65,868 50.9% 48.1% 55.4% 

Race/ethnicity 

Hispanic 12,253 36.7% 36.1% 37.9% 

White single race 39,262 59.6% 56.1% 65.0% 

Black single race 10,042 36.8% 37.1% 36.3% 

Other single race/multiple race 4,311 45.3% 39.5% 55.1% 

Gender 

Male 33,745 49.5% 47.6% 52.4% 

Female 32,123 52.5% 48.6% 58.7% 

Income 

Poor/near poor 14,888 35.8% 37.0% 33.7% 

Low/middle income 10,664 37.4% 34.8% 42.4% 

High income 40,315 60.1% 56.6% 65.2% 

Census region 

Northeast 11,613 55.3% 52.7% 59.4% 

Midwest 14,569 55.6% 51.9% 61.4% 

South 23,835 47.7% 44.9% 52.3% 

West 15,851 48.3% 46.3% 51.5% 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel 

Survey, 2003 
Table 2. Number of dental care visits and expenses for children ages 2–17 with at least one visit, 2003 

Population characteristic 

Total 

population 

(in thousands) 

(age 2–17) 

Average 

visit with a 

visit 

(age 2–17) 

Average 

expense 

with a visit 

(age 2–17) 

Average 

visit with a 

visit 

(age 2–11) 

Average 

expense with 

a visit 

(age 2–11) 

Average 

visit with a 

visit 

(age 12–17) 

Average 

expense with 

a visit 

(age 12–17) 

Total 65,868 2.6 $501 2.0 $327 3.4 $742 

Race/ethnicity 

Hispanic 12,253 2.1 $313 1.8 $226 2.6 $472 

White single race 39,262 2.8 $571 2.2 $369 3.7 $835 

Black single race 10,042 1.8 $265 1.6 $228 2.0 $323 

Other single race/multiple race 4,311 2.6 $538 1.9 $295 3.4 $827 

Gender 

Male 33,745 2.5 $516 2.0 $340 3.2 $767 

Female 32,123 2.7 $486 2.0 $314 3.5 $717 

Income 

Poor/near poor 14,888 1.9 $302 1.7 $213 2.4 $484 

Low/middle income 10,664 2.3 $365 2.0 $289 2.8 $483 

High income 40,315 2.8 $567 2.1 $365 3.6 $821 

Census region 

Northeast 11,613 2.8 $610 2.1 $357 3.7 $960 

Midwest 14,569 2.7 $433 2.0 $272 3.6 $641 

South 23,835 2.5 $429 2.0 $308 3.1 $600 

West 15,851 2.5 $587 2.0 $386 3.2 $884 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2003 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2003

Figure 1. Average number of dental visits for children 

ages 2–17 with a visit, United States, 2003

2.0

3.4

2.6

1.8 1.8 1.7

0

1

2

3

4

Ages 2-17 Ages 2-11 Ages 12-17

All dental visits Excluding orthodontist visits

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2003

Figure 2. Average expense per child with a dental visit and

expense for children ages 2–17, United States, 2003

327

742

501

268

226 243

0

200

400

600

800

Ages 2-17 Ages 2-11 Ages 12-17

All dental visits Excluding orthodontist visits

D

ollars