Utilization of dental care and dentate status in diabetic and nondiabetic patients across US states: An analysis using the 2020 Behavioral Risk Factor Surveillance System

Muath Aldosari; Hannah R Archer; Fahad T Almutairi; Saud H Alzuhair; Mohammad A Aldosari; Erinne Kennedy

doi:10.1111/jphd.12613

Utilization of dental care and dentate status in diabetic and nondiabetic patients across US states: An analysis using the 2020 Behavioral Risk Factor Surveillance System

J Public Health Dent. 2024 Apr 10. doi: 10.1111/jphd.12613. Online ahead of print.

Authors

Muath Aldosari^{1

2

3}, Hannah R Archer⁴, Fahad T Almutairi¹, Saud H Alzuhair¹, Mohammad A Aldosari¹, Erinne Kennedy^{2

5}

Affiliations

¹ College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
² Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
³ Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA.
⁴ Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁵ College of Dental Medicine, Kansas City University, Joplin, Missouri, USA.

PMID: 38599647
DOI: 10.1111/jphd.12613

Abstract

Objective: This study examines the differences, by state, in dental care utilization and tooth retention between adults with and without diabetes mellitus (DM).

Methods: We conducted a secondary analysis of data from the 2020 Behavioral Risk Factor Surveillance System, an annual, state-based, random telephone survey of noninstitutionalized US civilian adults. The predictor variable was DM status. The outcome variables were time since the last dental appointment and tooth loss. We utilized multiple multinomial logistic regression models followed by postestimation procedures to determine state-level adjusted proportions for dental visits within the last year and complete teeth retention among DM and non-DM adults.

Results: Among adults with DM, 60.0% reported dentist visits within a year of survey participation, while 53.6% had complete tooth retention. As education and income levels increased, dental attendance and tooth retention increased among adults with DM. Most Southern states had a higher prevalence of DM, a lower proportion of dentist visits, and worse tooth retention among DM adults. Nationally, DM individuals were 4.3 percentage points less likely to visit a dentist and were 7 percent less likely to have complete teeth retention than non-DM adults. Compared with the national average, 25/50 states had greater disparities in dental visits between DM and non-DM adults, and 27/50 states had greater disparities in tooth loss between DM and non-DM adults.

Conclusion: State-level variations indicate geographical and dental coverage influences on DM and dental outcomes. There is a need for state-specific interventions to improve dental access and outcomes for adults with DM.

Keywords: dental care utilization; dental outcomes; diabetes mellitus; interventions; oral health disparities; social determinants of health; tooth loss.