The authors conducted a study to assess recent trends in dental care provider mix
(type of dental professionals visited) and service mix (types of dental procedures)
use in the United States and to assess rural-urban disparities.
Data were from the 2000 through 2016 Medical Expenditure Panel Survey. The sample
was limited to respondents who reported at least 1 dental visit to a dental professional
in the survey year (N = 138,734 adults ≥ 18 years). The authors estimated rates of
visiting 3 dental professionals and undergoing 5 dental procedures and assessed the
time trends by rural-urban residence and variation within rural areas. Multiple logistic
regression was used to assess the association between rural and urban residence and
service and provider mix.
A decreasing trend was observed in visiting a general dentist, and an increasing trend
was observed in visiting a dental hygienist for both urban and rural residents (trend
P values < .001). An increasing trend in having preventive procedures and a decreasing
trend in having restorative and oral surgery procedures were observed only for urban
P values < .001). The combined data for 2000 through 2016 showed that rural residents
were less likely to receive diagnostic services (adjusted odds ratio [AOR], 0.82;
95% confidence interval [CI], 0.72 to 0.93) and preventive services (AOR, 0.87; 95%
CI, 0.78 to 0.96), and more likely to receive restorative (AOR, 1.11; 95% CI, 1.02
to 1.21) and oral surgery services (AOR, 1.23; 95% CI, 1.11 to 1.37).
Although preventive dental services increased while surgical procedures decreased
from 2000 through 2016 in the United States, significant oral health care disparities
were found between rural and urban residents.
These results of this study may help inform future initiatives to improve oral health
in underserved communities. By understanding the types of providers visited and dental
services received, US dentists will be better positioned to meet their patients’ oral