Prevalence of and factors associated with unmet dental need among the U.S. adult population in 2016

Abstract

Objectives: Understanding and addressing contributing factors to unmet dental need is an important public health challenge. This study investigated the prevalence of, and factors associated with, self-reported unmet dental need using a nationally representative sample of US adults. Methods: This was a cross-sectional study using the Medical Expenditures Panel Survey (MEPS) from 2016. The weighted prevalence of unmet dental need was estimated among individuals aged 18 years or older. Chi-squared and multivariate logit regression with marginal effects (ie absolute risk differences) were used to measure the association of unmet dental need with respondent characteristics. Results: The prevalence of adults reporting unmet dental need was 6% (95% CI: 5.5 to 6.5). Adults with dental insurance were 1.7 percentage points (95% CI: -2.8 to -0.6) less likely to report unmet dental needs than adults without dental insurance. Those with middle income were 2.3 percentage points (95% CI: 1.2 to 3.4), those with low income were 3.3 percentage points (95% CI: 1.7 to 5.0), and those with poor/negative/near-poor income were 4.2 percentage points (95% CI: 2.7 to 5.7) more likely to report an unmet dental need than adults with high income. Both Hispanics (-1.7 percentage points [95% CI: -2.8 to -0.6]) and non-Hispanic Blacks (-1.1 percentage points [95% CI: -2.1 to -0.1]) were less likely to report an unmet dental need than whites. Smoking, education, general health status, chronic disease and marital status were also significantly associated with reporting an unmet dental need. Conclusions: Future policies should continue to address cost and coverage barriers to adult dental care, as these remain significant barriers to access, particularly for low-income adults. Future research should evaluate the reasons adults report unmet dental need and explore how adults' judgment of dental need compares to providers' clinical judgment. Additionally, research that explores how race and ethnicity affect perceptions of unmet dental need is warranted.