Utilization of Dental Care and Oral Health Outcomes in the United States: Results from the National Health and Nutrition Examination Survey (2017-2020)

Purpose: This analysis aims to evaluate the association between the time since and reason for a patient's last dental ap-pointment across clinical oral health outcomes. Materials and Methods: We used data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES), a cross-sectional, nationally-representative survey of noninstitutionalized US adults. The predictors were the time since and the reason for the last dental appointment (routine vs. urgent). We examined the presence and number of missing teeth and teeth with untreated coronal and root caries. Multivariable regression models with interaction were used to as-sess the association between the time since the last dental appointment and clinical oral health outcomes among routine and urgent users separately.Results: Two-thirds of the US population had a dental appointment within a year, while nearly 44 million individuals did not visit a dentist for the last three years. The odds of having teeth with untreated coronal or root caries increased with the length of time since the last appointment, and urgent users had worse dental outcomes compared to routine users. Compared to those who had a dental appointment within a year, individuals who had their last dental appointment more than 3 years ago had 2.94 times the average number of teeth with untreated caries among routine users (95%CI=2.39, 3.62) and 1.60 times the average among urgent users (95%CI=1.05, 2.43). Conclusions: Recent, routine dental appointments are associated with improved oral health outcomes. The outcomes re-iterate how social determinants of health impact access to oral health care and oral health outcomes.