Predictors of Unmet Dental Health Needs in US Adults in 2018: A Cross-Sectional Analysis

Abstract

Objective: To identify predictors of unmet dental needs for adults 18 y of age or older in the United States. Method: Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost any teeth using a national sample of 155,060 survey respondents. Results: Results showed that predisposing factors (age, race/ethnicity, gender, and educational attainment) and enabling factors (income and health insurance status) are important predictors for losing teeth due to decay or gum disease. Men, the elderly, and less educated and low-income residents were less likely to have seen a dentist within the past 5 y and more likely to have lost their permanent teeth. Compared to non-Hispanic White adults, Hispanics adults were more likely to have had a dental visit within the past 5 y. Unmet dental needs varied across states. People living in states with extensive Medicaid dental care benefit coverage were less likely to lose their teeth and more likely to have had a dental visit within the past 5 y. Conclusion: Efforts to improve oral health should address unmet dental needs of men and adults with low socioeconomic status. Studying the variation between state oral health care programs could further our understanding of how public policy can improve population oral health. Knowledge Transfer Statement: Men, non-Hispanic Blacks, mixed and other race minorities, and low socioeconomic status adults are most at risk of unmet dental needs. States can address these needs by expanding Medicaid coverage for adults.

Dental Care Utilization Among Adults Aged 18−64: United States, 2019 and 2020

“…A previous study reported several predictors of unmet dental need among adults in the United States (5). Therefore, the decline in dental visits between 2019 and 2020 may be attributable to other factors in addition to the impact of the COVID-19 pandemic.…”

“…Significantly different from non-Hispanic Asian adults for both 2019 and 2020 (p < 0.05) 4. Significantly different from non-Hispanic Black adults for both 2019 and 2020 (p < 0.05) 5. Significantly different from non-Hispanic other and multiple race adults for both 2019 and 2020 (p < 0.05).…”

“…Along with good oral hygiene, an important factor of oral health is regular dental care (3). However, about 35% of adults aged 18 and over did not have a dental visit in 2019 (4), and predictors such as age, race, sex, and socioeconomic status were associated with delayed dental care among adults in the United States (5). In 2020, many dental practices limited their hours and services in response to the COVID-19 pandemic (6,7).…”

Assessing inequities in unmet oral care needs among adults in Sweden: An intersectional approach

“…Low coverage of oral care remains a global problem affecting also high‐income countries 2 . Additionally, social inequities in oral health and care are consistently reported in several high‐income countries, even in Nordic countries where the financing and delivery of oral care are known to be a public responsibility 3–7 …”

Oral Health Care Access, Inequity, and Inequality

“…Beyond pregnancy, Gaskin et al (2022) describe predictors for unmet dental needs in >150,000 US adults, resulting from their analyses of the 2018 Behavioral Risk Factor Surveillance System. In addition to finding that predisposing and enabling factors predicted tooth loss, their results demonstrate that differences in unmet dental needs are modulated by the vitality of each state’s oral health policy, indicating that improvements in state and federal oral health programs could vastly improve oral health.…”