Dental prepayment: the past, present, and the future.

Insurance now pays for slightly less than 50% of America's dental bill. The explosive growth in dental insurance in the 1970s and 1980s is traced to the tax effect (coverage paid for with pre-tax dollars offsets fees up to a point) and the insurance effect (costs for care can be projected, although improvements in oral health status are leading to lower projected costs). An equilibrium point appears to have been reached. Dentists must weigh the trade-offs between discounted fees and increased number of patients, and carriers must weight the trade-offs between smaller discounts and wider participation by dentists. There are no market forces forecast that will substantially change this equilibrium in the near future.