abstract: 'Introduction: Untreated dental caries (UC), although preventable, is the

  most prevalent disease in the United States. UC diminishes quality of

  life and lowers productivity for millions of Americans and is notably

  higher among lower-income compared to higher-income persons. Objective:

  This study examines changes in disparities by income in past-year dental

  use (DU) and UC in 4 life stages (2-5, 6-19, 20-64, and >= 65 y) between

  1999-2004 and 2011-2016. We also examined changes in dental safety net

  policies during this time. Methods: We obtained data on dependent

  variables, UC and DU, from cross-sectional, nationally representative

  surveys for 1999-2004 and 2011-2016. We used multivariable regression

  models with 3 main-effect explanatory variables: income (<200\% or >=

  200\% federal poverty level), life stage, and survey period (1999-2004

  or 2011-2016) and sociodemographic variables. We included 2-way

  interaction terms among main-effect variables to test whether

  disparities had changed over time in each life stage and a 3-way term to

  test changes in disparities differed across life stages. Results:

  Model-adjusted disparities in DU decreased for both preschool-age and

  school-age children, and disparities in UC decreased for school-age

  children. Changes in DU and UC disparities were not detectable for

  working-age adults and increased for retirement-age adults. Changes in

  DU and UC among preschool and school-age children were not significantly

  different from one another and were significantly different from changes

  among retirement-age adults. Compared to working-age adults, changes in

  disparities for DU and UC were significantly different for school-age

  children, and changes in DU were significantly different for

  preschool-age children. Between surveys, the dental safety net was

  expanded for youth but remained largely unchanged for adults.

  Conclusions: Expanding the dental safety net for youth could have

  contributed to increased access to dental care among children relative

  to adults and contributed to the decrease in disparities in DU and UC

  among youth. Knowledge Transfer Statement:Between 1999-2004 and

  2011-2016, the dental safety net was expanded for youth but remained

  largely unchanged for adults. Using national survey data to compare

  changes in disparities in past-year dental use and untreated dental

  caries by income between adults and youth sheds light on the potential

  impact of expanding the dental safety net.'
affiliation: 'Griffin, SO (Corresponding Author), Ctr Dis Control \& Prevent, Div
  Oral Hlth, Atlanta, GA 30333 USA.

  Griffin, SO (Corresponding Author), CDC, Div Oral Hlth, Natl Ctr Chron Dis Prevent
  \& Hlth Promot, 4770 Bufford Hwy,MSF 10, Atlanta, GA 30341 USA.

  Griffin, S. O.; Thornton-Evans, G., Ctr Dis Control \& Prevent, Div Oral Hlth, Atlanta,
  GA 30333 USA.

  Wei, L., DB Consulting Grp Inc, Atlanta, GA USA.

  Griffin, P. M., Purdue Univ, Regenstrief Ctr Healthcare Engn, W Lafayette, IN 47907
  USA.'
article-number: '2380084420934746'
author: Griffin, S. O. and Thornton-Evans, G. and Wei, L. and Griffin, P. M.
author-email: sig1@cdc.gov
author_list:
- family: Griffin
  given: S. O.
- family: Thornton-Evans
  given: G.
- family: Wei
  given: L.
- family: Griffin
  given: P. M.
da: '2023-09-28'
doi: 10.1177/2380084420934746
earlyaccessdate: JUN 2020
eissn: 2380-0852
files: []
issn: 2380-0844
journal: JDR CLINICAL \& TRANSLATIONAL RESEARCH
keywords: 'health care disparities; dentists'' practice patterns; public policies;

  dental caries; Medicaid; Medicare'
keywords-plus: ORAL-HEALTH; CHILDREN
language: English
month: APR
number: '2'
number-of-cited-references: '31'
pages: 234-241
papis_id: 67be3ae683788524606fc8e91121183a
ref: Griffin2021disparitiesdental
times-cited: '7'
title: Disparities in Dental Use and Untreated Caries Prevalence by Income
type: Article
unique-id: WOS:000546097700001
usage-count-last-180-days: '0'
usage-count-since-2013: '2'
volume: '6'
web-of-science-categories: Dentistry, Oral Surgery \& Medicine
year: '2021'