Delayed oral health care due to cost among US adults with diabetes, 2018-2019

Although untreated periodontitis increases the risk of developing diabetic complications, people with diabetes are less likely to use dental services. The authors estimated the prevalence of reporting delayed needed oral health care due to cost and associated risk indicators by diabetes status.

The authors analyzed data for 43,291 adults who participated in the 2018 and 2019 Medical Expenditure Panel Surveys. The authors used t tests to compare crude estimates of delayed oral health care by diabetes status. Adjusted estimates were obtained from logistic regression models that controlled for sociodemographic, medical and dental insurance, health status, and geographic variables. Multivariable logistic regression models were run separately for adults with and without diabetes to identify factors that were associated with delayed oral health care.

After controlling for covariates, the difference in delayed oral health care prevalence between adults with diabetes (18%) and without diabetes (16%) remained significant. Lack of medical insurance and fair or poor self-rated health status were the highest predictors of delayed oral health care among those with diabetes.

Despite guidelines, factors other than biology and perceived need may impede access to oral health care for people with diabetes.

For uninsured adults, policies should prioritize enhancing access to regular ambulatory care and promoting awareness about the importance of preventing and treating dental conditions. In addition, addressing the medical and psychosocial aspects of diabetes in affected patients could affect positively their overall sense of well-being and self-rated health status, potentially encouraging greater use of oral health care services.