Abstract
BackgroundThe Affordable Care Act of 2010 increased dental coverage for children in the United States, (U.S.) but not for adults. Few studies in current scholarship make use of up-to-date, nationally representative data to examine oral health disparities in the U.S. population. The purpose of this study is to use nationally representative data to determine the prevalence of untreated caries among children and adults of different socioeconomic and racial/ethnic groups and to examine the factors associated with untreated caries among children and adults.MethodsThis study used the 2011–2014 National Health and Nutrition Examination Survey (NHANES) demographic, oral health questionnaire, and oral health dentition examination data (n = 7008 for children; n = 9673 for adults). Participants that had a standardized oral health examination and at least one natural primary or permanent tooth considering 28 tooth spaces were included in this study. Our main outcome measure was untreated coronal caries defined as decay on the crown or enamel surface of a tooth that had not been treated or filled. Population estimates were calculated to determine the prevalence of untreated caries among children and adults in the United States. Frequencies and Pearson’s chi-square tests were used to compare those with and without untreated caries. Multivariate logistic regression models were used to evaluate the factors associated with untreated caries. We conducted analyses among children and adults separately.ResultsFrom 2011 to 2014, 12.4 million children and 57.6 million adults in the United States had untreated caries. Age, family income level, recent dental visit, and financial and non-financial barriers were significantly associated with untreated caries in both children and adults. Race/ethnicity, gender and education level were also significantly associated with untreated caries among adults. The odds of untreated caries associated with financial barriers were 2.06 for children and 2.84 for adults while the odds of untreated caries associated with non-financial barriers were 2.86 for children and 1.67 for adults.ConclusionsDemographic and socio-economic disparities in untreated caries exist among children and adults.
Highlights
The Affordable Care Act of 2010 increased dental coverage for children in the United States, (U.S.) but not for adults
Evidence continues to suggest that oral health is linked to overall health, and dental care utilization may lead to health care cost savings among children and adults [1, 2]
Oral health services are considered essential for children under the Affordable Care Act (ACA), and Medicaid and the Children’s Health Insurance Program (CHIP) have been
Summary
The Affordable Care Act of 2010 increased dental coverage for children in the United States, (U.S.) but not for adults. Oral health services are considered essential for children under the Affordable Care Act (ACA), and Medicaid and the Children’s Health Insurance Program (CHIP) have been required to cover dental benefits for children since 2010 [3]. Expanded coverage has led to increased dental care utilization among children under 19 years of age [4]. Despite this progress, about 11% of children forgo dental benefits coverage [5] and about 5% are unable to access dental services due to cost. Untreated caries can lead to significant pain and infection that require
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