National data indicate that working-aged adults (20-64 years) are more likely to report
financial barriers to receiving needed oral health care relative to other age groups.
The aim of this study was to examine the burden of untreated caries (UC) and its association
with reporting an unmet oral health care need among working-aged adults.
The authors used National Health and Nutrition Examination Survey data from 2011 through
2016 for 10,286 dentate adults to examine the prevalence of mild to moderate (1-3
affected teeth) and severe (≥ 4 affected teeth) UC. The authors used multivariable
logistic regression to identify factors that were associated with reporting an unmet
oral health care need.
Low-income adults had mild to moderate UC (26.2%) 2 times more frequently and severe
UC (13.2%) 3 times more frequently than higher-income adults. After controlling for
covariates, the variables most strongly associated with reporting an unmet oral health
care need were UC, low income, fair or poor general health, smoking, and no private
health insurance. The model-adjusted prevalence of reporting an unmet oral health
care need among low-income adults with mild to moderate and severe UC were 35.7% and
The burden of UC among low-income adults is high; prevalence was approximately 40%
with approximately 3 affected teeth per person on average. Reporting an unmet oral
health care need appears to be capturing primarily differences in UC, health, and
financial access to oral health care.
Data on self-reported unmet oral health care need can have utility as a surveillance
tool for monitoring UC and targeting resources to decrease UC among low-income adults.