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Oral Health in Maryland: Key Findings

Below is the "Oral Health in Maryland: Key Findings" section of the Maryland Oral Health Plan, 2026-2030.  Click here to download the full Maryland Oral Health Plan

Oral Health in Maryland: Key Findings

The following themes emerged from the evaluation of measurable data, state reports and through discussions with a network of partners composed of clinical and nonclinical professionals, nonprofit organizations, managed care organizations, county and state governments, academic institutions, social service agencies, area health education centers, philanthropic organizations and Maryland consumers.

Oral Health Strengths

  1. Medicaid dental utilization in Maryland continues to outpace national averages. In the last few years, the Maryland Healthy Smiles Dental Program has seen an increase in dentist participation and member utilization of oral health care. In 2023, the state established comprehensive dental coverage for adults who are fully enrolled in Maryland Medicaid, expanding access to care for hundreds of thousands of Maryland residents. In 2023, 19.9% (155,167) of enrolled adults received at least one dental service, up from 16.2% (93,988) in 2019.
  2. Maryland has comprehensive adult coverage in Medicaid. The CareQuest Institute for Oral Health’s Medicaid Dental Coverage Checker gives Maryland a score of 26 out of 31, with only 16 states ranking higher.
  3. Maryland has been a national leader in children’s oral health. Over the last decade, a strong foundation was established through implementation of the Dental Action Committee’s recommendations. The recommendations can be viewed here.
  4. More pregnant and postpartum individuals are receiving oral health care. As of August 2024, at least 13,700 additional pregnant individuals in Maryland have gained access to dental coverage through the Healthy Babies Equity Act. The program covers legal residents who have been in the U.S. for less than five years and are noncitizen pregnant women who would qualify for Medicaid but for their immigration status and their children up to the age of 1 year.
  5. More Maryland adolescents have completed the whole series of the HPV vaccine. As of 2023, an estimated 67% of males and females ages 13 to 17 are fully vaccinated, compared to 58% in 2018. The rate in Maryland (67%) is higher than the national rate, which is 61% for the same age group. HPV vaccinations reduce one’s risk of multiple cancers, including mouth, throat and cervical cancers.
  6. Community water fluoridation rates are top 10 in the country. In 2022, 93.2% of Marylanders on community water systems had fluoridated drinking water. Community water fluoridation has been proven to prevent tooth decay and promote good oral health, especially for children.
  7. Maryland has seen an increase in enrollment of adults in standalone dental plans through the Maryland Health Benefit Exchange. Between 2018 and 2023, dental plan enrollment increased by 66% from 39,334 to 65,393. The growth in dental plan enrollment is likely among individuals who were already purchasing health insurance through the Health Benefit Exchange.

Oral Health Challenges

  1. Some Maryland regions and communities experience barriers to oral health. Stark disparities between groups exist related to access to and use of oral health care and oral health outcomes. Black and Hispanic Marylanders have worse oral health outcomes compared to other racial groups. For example, according to 2022 data, 44% of Black and 49% of Hispanic Marylanders have had a permanent tooth extracted compared to 37% of White Marylanders and 34% of Asian Marylanders. People who live in rural areas of Maryland and Baltimore City do not have the same access to oral health care as people in other regions.
  2. Dental provider shortages are a barrier to accessing oral health care. The ratio of dentists and dental hygienists per 100,000 population in Maryland is decreasing and provider shortage areas are increasing.
  3. Lack of oral health surveillance data at state and local levels. Ongoing collection of oral health data for surveillance purposes is critical to focus efforts where they are needed most. Additionally, Maryland data specific to racial and ethnic groups, geography, gender, LGTBQ+, immigration status and income level are necessary to further identify oral health inequities.
  4. More children have experienced tooth decay and children’s utilization of preventive oral health care under Medicaid has declined. During the 2022-2023 school year, 43% of children experienced tooth decay compared to 36% in 2015-2016. During the COVID-19 pandemic, children did not receive preventive treatments through schools, like dental sealants and fluoride treatments, and only 48% of children enrolled in Medicaid received a preventive oral health service. In 2023, this percentage had increased to 56% but had not fully rebounded to the previous high of 64% in 2015.
  5. Incidence of mouth and throat cancer has increased. From 2000 to 2022, the incidence rate for mouth and throat cancer has been increasing with an 0.8% annual percent change for women and 0.7% for men. Fewer adults report being screened for oral cancer. Oral cancer screenings reduce oral cancer rates at advanced stages and reduce deaths from this type of cancer. In 2018, 21.6% of adults reported having an oral cancer exam in the past year.47 This was a decrease from 2012, when 24% of Maryland adults reported having an oral cancer screening in the past 12 months.
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