Dental treatment affordability and oral outcomes among U.S. adults: NHANES 2015-2018.
Level 4 - case-series / case-control
Cross-sectional analysis of national survey data (NHANES)
PubMed 40781615 · doi:10.1186/s12903-025-06685-w
What was done
This cross-sectional study analyzed data from 11,566 U.S. adult participants in the 2015–2018 National Health and Nutrition Examination Survey (NHANES). The authors evaluated the relationship between self-reported dental treatment affordability and oral health outcomes, including decayed, missing, and filled teeth (DMFT), untreated decayed teeth, missing teeth, and the presence of root caries. Negative binomial regression was used for count outcomes and logistic regression was used for binary outcomes, adjusting for NHANES sampling weights.
What was found
Among the participants, 14.17% reported being unable to afford dental treatment. Compared with those who could afford treatment, individuals unable to afford care had a significantly higher rate of untreated dental decay (mean ratio 3.27; 95% CI: 2.72–3.95; p < 0.01) and a higher DMFT score (mean ratio 1.24; 95% CI: 1.18–1.31; p < 0.01). They also had significantly higher odds of having root caries (odds ratio 4.46; 95% CI: 3.53–5.64; p < 0.01).
Why it matters
The findings document a substantial disparity in oral disease burden tied to financial barriers, highlighting the need for targeted policies to improve dental care affordability in the United States.
Limits
The cross-sectional design precludes establishing causality or temporal sequence. Dental treatment affordability was self-reported, and the abstract does not specify which sociodemographic or lifestyle confounders were controlled for in the regression models.
Cited by
- partial The average American has 12 dental fillings.