Unmet Dental Research Articles

Cost-Associated Unmet Dental, Vision, And Hearing Needs Among Low-Income Medicare Advantage Beneficiaries.

Medicare Advantage (MA) supplemental benefits offered at no or low premiums are a key value proposition for low-income beneficiaries. Despite nearly $20billion in rebate payments to MA plans for funding supplemental benefits, their quality or enrollee access is not monitored. Using 2018-19 Medicare Current Beneficiary Survey data linked to MA plan data, we found that regardless of plan benefit generosity, low-income beneficiaries were more likely to report dental, vision, and hearing unmet needs because of cost. Enrollment in plans with higher corresponding-year (that is, the same year as unmet need measurement) star ratings was associated with lower dental unmet need. Income-related disparities in dental unmet needs were lower in the highest-rated plans. However, prior-year star ratings that determined plan payments were not associated with unmet needs or disparities in those needs. Policy makers should consider monitoring supplemental benefits for equity and access, and they should assess the value added by quality bonus payments to high-rated plans for beneficiaries' access.

Assessment of Caries-Prevalence, Unmet Dental Treatment Needs and Barriers to Care as Perceived by Parents of Private and Government Aided-School Children of Gandhinagar-An Epidemiological Study

Assessment of Caries-Prevalence, Unmet Dental Treatment Needs and Barriers to Care as Perceived by Parents of Private and Government Aided-School Children of Gandhinagar-An Epidemiological Study

Current Status and Related Factors of Unmet Dental Care among Korean Adults during the COVID-19 Epidemic

Current Status and Related Factors of Unmet Dental Care among Korean Adults during the COVID-19 Epidemic

The Effects of Health and Unmet Dental Care Needs on the Health-Related Quality of Life in Korea Older Adults: A Nationwide Study

Background: The purpose of this cross-sectional study was to assess the relationship between oral health, unmet dental needs and health-related quality of life in South Korea older adults. Methods: The present study used raw data from the 2019~2020 Korea National Health and Nutrition Examination Survey, and analyzed 4956 participants aged over 65 yr. Hierarchical multiple regression analysis was used for associations between oral health, unmet dental needs, and HRQoL. Results: The EQ-5D index differed according to tooth pain, chewing difficulty, speaking problem, subjective oral health status, oral examination, and unmet dental care needs (P<0.001). In the model 2, male, under 75 yr of age, high school graduate or higher, employed, living with a spouse, no stress, good subjective health status, no speaking problem, and no unmet dental care needs were associated with higher EQ-5D index (Adj R2 = 27.6%, P<0.001). Conclusion: To improve the HRQoL of older adults in South Korea, oral health problems need to be minimized through oral disease prevention and oral health education programs.

The Elderly's Limited Awareness of Advanced-Way Dental Procedures Hinders Access to Treatment, Resulting in Persistent Pain and Unmet Dental Needs in Pakistan.

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Unmet Dental Needs in Children Following Suspension of School-Based Oral Health Services Due to COVID-19.

Dental caries (tooth decay) is the world's most prevalent noncommunicable disease and can lead to pain, infection, and edentulism. Many children with caries lack access to traditional dental services. School-based caries prevention can increase access to care and reduce health inequities. Disruptions in school-based care due to pandemic control policies may result in children losing access to their primary dental care option. The CariedAway project was a school-based caries prevention program in operation from 2019 to 2023 in urban schools with a high proportion of low-income, minority students. Program operations were suspended for 2 years due to the COVID-19 pandemic. We estimated the prevalence of untreated decay, swelling, fistula, and pulpal involvement in participants at baseline and again after restrictions were lifted. A total of 2998 children between the ages of 5 and 13 years were enrolled and received preventive care prior to pandemic shutdowns, and 1398 (47%) completed a follow-up observation after 2 years. At baseline, approximately 30% had untreated caries on any dentition, 11% of children presented with evidence of dental sealants, and no participants had swelling, fistula, or pulpal involvement. After 24 months, 12% of participants had swelling fistula, or pulpal involvement that was not treated during the pandemic period. There are considerable unmet dental needs in high-risk children that may be further exacerbated by a lack of access to care during disease outbreaks.

Assessment of Oral Mucosal Lesions (OML), Periodontal Health Conditions, and Unmet Dental Treatment Needs in the Rural Adult Population of Jharkhand, North India.

Background Dental diseases like caries, periodontal diseases, and oral mucosal lesions (OML) are common findings in rural adult populations that greatly impact their quality of life. Aim To assess OML, periodontal health conditions, and unmet dental treatment needs in the rural adult population in Jharkhand. Methodology A total of 700 permanent residents of Bero Block, Jharkhand, North India, in the age group of 35-44 years, participated in this cross-sectional study. Both men and women were equally represented. Their socio-demographic characteristics and previous dental visits were collected using standardized proforma. An assessment of periodontal health conditions, OML, and unmet dental treatment needs was done using the World Health Organization (WHO) Oral Health Assessment Proforma of 1997. Results It was found that over half (54.3%) of the studypopulation had the adverse habit of smoking and chewingpaan. Males were more likely to experience leukoplakia (18.87%), whereas females were more likely to experience abscesses (9.43%). The majority of males and females had a community periodontal index (CPI) score and loss of attachment (LOA) score greater than two, which indicated poor periodontal health as assessed by the periodontal index. Both males and females needed extraction of the diseased teethas their primary treatment. Conclusion The rural adult population residing in the Bero block of Jharkhand showed poor periodontal health and high unmet dental treatment needs. These people need effective oral health promotion policies and dental health education to improve their oral health.

HPR73 Underfunding of Public Health System and Unmet Dental Needs Among the European Elderly Population

HPR73 Underfunding of Public Health System and Unmet Dental Needs Among the European Elderly Population

Determinants of Dental Care Utilization, Unmet Dental Care Need, and Barriers among Women of Reproductive Age in the United States

Introduction: Dental care is integral to general health but is often isolated from the healthcare system nor discussed as part of overall health. The barriers to accessing needed dental care vary among socioeconomic and demographic groups. This study examined the disparities in dental care access and identified the socioeconomic and demographic factors associated with dental health needs among United States women. Methods: Using data from the 2017-2020 National Health and Nutrition Examination Surveys (NHANES), we conducted a Chi-square to assess the differences in the proportions of women who reported not getting their needed dental care and computed a weighted multivariate logistic regression to examine the factors associated with access to dental care use, unmet dental-care need, and reported reasons for unmet need. Results: Race, income, and education played a significant role in surveyed participants regarding dental care use and unmet dental care needs. Non-Hispanic Blacks and other minority racial-ethnic groups, including multi-racial groups, were likelier to have never used dental care than non-Hispanic Whites. Furthermore, non-Hispanic Whites with less than a high school education were likelier to have never used dental care than those with a high school education. Groups more likely to report an unmet need were women with PIR < 1.00. Moreover, between 1.00 and 1.99 compared to PIR ≥ 2.00 and women without health insurance compared to those with health insurance. Conclusion: Expanding insurance coverage for dental care and improving access for women with poor health may improve racial-ethnic and education-level disparities, specifically in African American women's unmet dental care needs.

Analysis of the Effects of Unmet Dental Care on Dental Treatment Needs: Based on the 8th Korea National Health and Nutrition Examination Survey (2019)

Analysis of the Effects of Unmet Dental Care on Dental Treatment Needs: Based on the 8th Korea National Health and Nutrition Examination Survey (2019)

Relationship between Precarious Employment and Unmet Dental Care Needs among Korean Workers: A Longitudinal Panel Study.

Background and Objectives: Precarious workers experience certain conditions, such as low income, instability in employment, and lack of social security. Precarious employment has increased barriers to the use of dental care services, resulting in more unmet dental care needs. The aim of this study was to identify unmet dental care needs among precarious workers in Korea's labor market, using data from the Korea Health Panel Survey (2011-2017). Materials and Methods: Based on job and income security criteria, four groups were formed: Group A (individuals with job and income security), Group B (individuals reporting job security with income insecurity), Group C (individuals reporting job insecurity with income security), and Group D (individuals with job and income insecurity). We measured self-reported unmet dental need or the inability to receive necessary dental care owing to the past economic burdens. Panel logistic regression analyses were performed to determine the effect of precarious employment on unmet dental care needs for all participants. Results: Approximately 16% of the respondents reported having unmet dental care needs. Unmet dental care needs owing to economic reasons were higher among male workers in groups C and D than among male workers in Group A. In particular, male workers aged 50 years and above in Group B were 3.36 times more likely to have unmet dental care needs than those in Group A. In Group D, female workers showed a high probability of having dental care needs owing to economic reasons. Moreover, female workers aged 18-49 years witnessed an increase in unmet dental care needs. Conclusions: Korean workers with unstable employment and/or income are at a higher risk of having unmet dental care needs owing to financial factors. The findings suggest an urgent need to implement robust national health insurance policies to improve efforts aimed at reducing unmet dental care needs that potentially decreases the disparity in oral health among precariously employed workers. Furthermore, it is necessary to implement comprehensive labor market policies such as sickness benefits for those in precarious employment.

Factors Associated with Unmet Dental Care Needs among Korean Adult Cancer Survivors: Cross-Sectional Analysis of the 2016-2018 KNHANES.

This study aimed to identify the factors associated with unmet dental care needs among Korean adult cancer survivors. This cross-sectional study used data from the seventh (2016–2018) Korea National Health and Examination Survey. It included 339 adult cancer survivors. Participants’ experience of unmet dental care needs was assessed using a health questionnaire survey. Moreover, the subjective oral health status (i.e., toothache) and behavior (i.e., toothbrushing and oral examination) were assessed through oral health interviews. The data were analyzed using descriptive statistics, chi-squared test, and logistic regression analysis. The rate of experience of unmet dental care needs among cancer survivors was 29.5%. Cancer survivors with limitations in performing daily activities of living were more likely to experience unmet dental care needs than cancer survivors without activity limitations ([aOR] = 2.14, [95%CI] = 1.04–4.40). Moreover, cancer survivors who did undergo oral examination within the past year were more likely to experience unmet dental care needs than cancer survivors who underwent oral examination ([aOR] = 2.49, [95%CI] = 1.22–5.07). Korean cancer survivors experienced unmet dental care needs when they did not receive an oral examination or had activity limitations. This study’s findings provide insight into social and behavioral factors associated with unmet dental care needs among Korean cancer survivors.

Assessment of Parental Perceptions of Socio-Psychological Factors, Unmet Dental Needs, and Barriers to Utilise Oral Health Care in Autistic Children.

Introduction: Parents' participation is crucial in the dental health intervention of children with autism spectrum disorder (ASD). Parenting children with ASD is extremely stressful and challenging. Parents and other caregivers have a responsibility to care for and raise children with ASD. Parental perception of the condition, situational adaptation, and attitude towards the issue are significant indicators of how they will respond and eventually adapt to it.Methodology: A comparative, descriptive study was done on parents of 154 autistic children and 235 normal children. An 11-variable questionnaire eliciting various details of socio-psychological factors affecting the utilisation of oral health care was designed and validated. The questionnaire also included parameters regarding barriers to accessing dental services. The dental caries and oral hygiene status of all children were examined using the Basic Oral Health Survey 2013 proforma. Chi-square and independent t-tests were applied to find significant differences between the groups.Results: A greater number of male children (61.0%) were observed among autistic children. Parental perception regarding socio-psychological concerns with raising an autistic child showed significant differences for all variables between the groups except for assistance in the child’s task with 90.2% as against 55% of the parents with non-autistic children. Parents of autistic children were more receptive to the idea of focus group discussion. Decayed teeth were significantly found to be higher in autistic cohorts (2.554 ± 1.616 versus 1.779 ± 1.841). Oral hygiene status was also statistically significant amongst autism-affected children than those who were not at p =0.000.Conclusion: The present study explored various socio-psychological factors of parental perception of autistic children. A better outcome can be suggested when parents gained awareness regarding various strategies and treatment options available for their child's oral health. Furthermore, dental health can be improved by bringing in certain environmental modifications in which the autistic child is groomed.

Medical-Dental Integration: A Promising Approach To Address Unmet Dental Needs of Children and Youth With Special Health Care Needs

Background: This review presents strategies on how medical-dental integration and a patient-centered approach may address the unmet dental needs of children and youth with special health care needs (CYSHCN).Methods: Programs, strategies and frameworks to implement medical-dental integration to improve the overall quality of life of CYSHCN were reviewed. The authors propose a patient-centered health home (PCHH) as a step toward a patient-centered approach to medical-dental integration for CYSHCN.Results: Many federal, state and local organizations have emphasized the importance of medical-dental integration. Models and frameworks to implement integrated care in multiple settings have been developed and can be applied for CYSHCN. The proposed PCHH model includes integrated education, improved clinical collaboration, integrated health information technology and integrated financing. Ravenswood clinic is an example of an organization that has developed an integrated care model that serves children and adults with special health care needs.Conclusion: CYSHCN often seek services from multiple specialties that may or may not integrate care with a patient-centered approach. It is imperative to develop care systems that make oral health an inseparable part of general health and well-being.Practical implications: The PCHH is a promising approach to improve the overall health of CYSHCN. Incorporating oral health competencies for primary care providers and increasing the skills of dental providers to care for CYSHCN are important steps. Improved communication and clinical collaboration between dental and primary care providers to increase preventive dental services to CYSHCN will reduce the burden on the health care system. However, PCHH can only be practical by reforming the health care financing system.

Unmet Dental Needs Among Mid-to-Older Deaf and Hard of Hearing Women in the U.S.

IntroductionDespite the significant number of deaf and hard of hearing (DHH) people living in the U.S., oral health research on DHH people who use American Sign Language (ASL) is virtually nonexistent. This study aims to investigate dental needs among mid-to-older DHH women and identify social determinants of health that may place them at higher risk for unmet dental health needs as the primary outcome.MethodsThis cross-sectional study uses data drawn from Communication Health domain in the PROMIS-DHH Profile and oral health data from the National Health and Nutrition Examination Survey. Both measures were administered in ASL and English between November 2019 and March 2020. Univariate and bivariate analysis included only complete data, and multivariable logistic regression analyses were conducted on multiply imputed data.ResultsOut of 197 DHH women (41 to 71+ years old) who answered the dental visit question, 48 had unmet dental needs and 149 had met dental needs. Adjusting for sociodemographic variables, disparity in dental needs was observed across education [OR (95% CI): 0.45(0.15, 1.370)] and communication health [0.95 (0.90, 1.01)].DiscussionOur study is the first to describe DHH mid-to-older women's access to oral health care. DHH women who do not have a college degree may be impacted. Further research is needed to elucidate the particular risk factors, including cultural, to which DHH individuals from marginalized racial groups are susceptible to unmet oral health needs.ConclusionsEvidence shows that DHH ASL users who have less years of education or are single experience barriers in accessing dental care.

Evaluation of Self-reported Unmet Dental Needs in Primary Health Care in Jazan, Saudi Arabia: A Cross-sectional Survey

Evaluation of Self-reported Unmet Dental Needs in Primary Health Care in Jazan, Saudi Arabia: A Cross-sectional Survey

Positive Parenting Styles Tied to Less Unmet Dental Needs in Children with Developmental Disabilities.

This study aimed to identify factors, particularly positive parenting styles, associated with unmet dental needs, defined as no dental visit for the past 12months, in children with developmental disabilities (DD). Participants included 263 primary caregivers of children with DD. Children exposed to less positive parenting styles were more than two times (aOR, 2.19, 95%CI, 1.12-4.32) more likely to have unmet dental needs. Children who were male (aOR, 1.88, 95%CI, 1.04-3.41), aged < 4years (aOR, 2.95, 95%CI, 1.2-7.27) or aged ≥ 11years (aOR, 2.65, 95%CI, 1.25-5.64), had higher illness severity (aOR, 2.04, 95%CI, 1.09-3.81), had primary caregivers with less than or equal to high school education (aOR, 2.45, 95%CI, 1.13-5.30) were also more likely to have unmet dental needs.

Unmet Dental Treatment Needs and Barriers to Dental Care of Patients with Special Needs Attending a Dental Teaching Hospital

Objectives: This work attempted to determine the unmet dental treatment needs and self-reported barriers to continued care, in patients with special needs, attending a dental teaching hospital in the English-speaking Caribbean. Methods: A chart audit of patients who were planned for comprehensive treatment for the period from August 1, 2015 to July 31, 2017 was used to determine the types of treatment required for the sample of patients. Treatment was classified as either urgent, preventive, or restorative. Restorative treatment was further divided into operative, endodontic, periodontic, and prosthodontic treatment. Reasons for not returning to the clinic to complete planned treatment care were ascertained via a telephone interview. A non-parametric McNemar change test for related samples at an alpha level of 0.05 was used to compare planned treatment with completed treatment. Results: 34% of patients with special needs had comprehensive treatment plans developed for the period under investigation. Preventive dental treatment was included in most comprehensive plans (96.1%). Large proportions of patients also required care for periodontal disease (65.7%) and operative management of caries (52.9%). While there was no significant difference between preventive treatment planned and received, there were significant differences in treatment planned and received for all types of restorative care. Major identified barriers included cost, accessibility, and psychosocial issues. Conclusions: There was an unmet need for restorative and periodontal treatment. Major self-reported barriers to dental care included cost, accessibility to care in terms of transportation issues, and psychosocial issues.

Comprehensive, School-Based Preventive Dentistry: Program Details and Students' Unmet Dental Needs.

In this paper, we describe the design, program details, and baseline demographics and oral health of participants in ForsythKids, a regional, comprehensive, school-based mobile caries prevention program. We solicited all Massachusetts elementary schools with greater than 50% of students receiving free or reduced-price meals. Six schools initially elected to participate, ultimately followed by over 50 schools. Interventions were based on systematic reviews and randomized controlled caries prevention trials. Participating students received semiannual dental examinations, followed by comprehensive preventive care. Summary statistics regarding oral health indicators were derived from individual tooth- and surface-level data. Over a 6-year period, data were collected on 6927 children. The number of students per school ranged from 58 to 681. The overall participation rate was 15%, ranging from 10% to 29%. Overall, 57% of the children were younger than 8 years at baseline. Approximately, 54% of children experienced dental decay on any tooth at baseline; 32% had untreated decay on any tooth, 29% had untreated decay on primary teeth, and 10% untreated decay on permanent teeth. Untreated dental decay was double the national average, even in schools within several blocks of community dental clinics. These data demonstrate the need for caries prevention beyond the traditional dental practice.

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

To identify predictors of unmet dental needs for adults 18 y of age or older in the United States. 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 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. 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. 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.