A new report warns that the rising cost of dental services is forcing many Maryland residents to delay oral care for years, deepening what researchers describe as a growing “dental divide” between financially stable households and those struggling to meet basic needs.
The report, ALICE and the Dental Divide in Maryland, found that nearly 10% of financially vulnerable adults in the state have not visited a dentist or dental clinic in five years or more. Dental care was identified as the most frequently skipped form of medical care due to cost, while financially stable adults were far more likely to maintain routine dental visits.
Produced by United For ALICE in partnership with United Way of Central Maryland, the research focuses on ALICE households—those who are employed but earn too little to afford essentials such as housing, food, child care, transportation, health care and taxes, while often earning too much to qualify for public assistance.
In 2023, ALICE households combined with households living in poverty accounted for 39% of all Maryland households, or 934,715 households statewide, according to the report.
Researchers also highlighted broader consequences of delayed dental care, linking poor oral health to reduced overall well-being and long-term health outcomes.
“Oral health is a window into our overall health and well-being,” said Franklyn Baker, president and CEO of United Way of Central Maryland. “When people put off dental visits, it can affect their confidence, ability to work and quality of life. Basic dental care should be a necessity, not a luxury.”
The report identified several disparities tied to financial hardship. Adults below the ALICE Threshold were nearly twice as likely as financially stable adults to have lost six or more teeth due to decay or gum disease. About 29% of households facing hardship lived in communities without nearby dental services in 2023.
The gap also begins early. Across the South Census Region, 72% of parents below the ALICE Threshold reported their children received dental care in the previous year, compared with 83% of parents above the threshold.
Limited insurance coverage further compounds the problem. The report found that about 24% of adults statewide lacked dental insurance last year, leaving many without access to preventive care.
“This research offers more than statistics—it provides a roadmap,” said Stephanie Hoopes, Ph.D., national director of United For ALICE. “By identifying where access breaks down, policymakers and providers can develop targeted solutions to close the dental care gap.”