This course summarizes the most up to date, comprehensive research on how various segments of the U.S. population use dental care, what they spend on dental care, their dental benefits coverage and how this is changing over time. The analysis demonstrates convincingly that profound changes are occurring and there are very divergent patterns of care and spending the past decade for children and adults, rich and poor Americans. State-specific analysis is presented as well. Research on the underlying drivers of these trends is discussed. The presentation ends with a forward looking discussion, including perspectives on how the Affordable Care Act, health care consumerism, and other forces could affect future patterns of dental care use, benefits, and spending.