American Diabetes Association
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Incremental Dental Expenditures Associated With Diabetes Among Noninstitutionalized U.S. Adults Aged ≥18 Years Old in 2016–2017

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posted on 2021-04-26, 22:56 authored by Yu Chen, Ping Zhang, Elizabeth T. Luman, Susan O. Griffin, Deborah B. Rolka

Diabetes is associated with poor oral health, but incremental expenditures for dental care associated with diabetes in the U.S. are unknown. We aimed to quantify these incremental expenditures per person and for the nation.


We analyzed data from 46,633 non-institutionalized adults aged ≥18 years old who participated in the 2016–2017 Medical Expenditures Panel Survey. We used two-part models to estimate dental expenditures per person in total, by payment source, and by dental service type, controlling for sociodemographic characteristics, health status, and geographic variables. Incremental expenditure was the difference in predicted expenditure for dental care between adults with and without diabetes. The total expenditure for the US was the expenditure per person multiplied by the estimated number of people with diabetes. Expenditures were adjusted to 2017 US dollars.


The mean adjusted annual diabetes-associated incremental dental expenditure was $77 per person and $1.9 billion for the nation. Fifty-one percent ($40) and 39% ($30) of this incremental expenditure were paid out-of-pocket and by private insurance; 69% ($53) of the incremental expenditure was for restorative/prosthetic/surgical services; and adults with diabetes had lower expenditure for preventive services than those without (incremental -$7). Incremental expenditures were higher in older adults, non-Hispanic whites, and people with higher levels of income and education.


Diabetes is associated with higher dental expenditures. These results fill a gap in the estimates of total medical expenditures associated with diabetes in the US and highlight the importance of preventive dental care among people with diabetes.