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Updated: Sep 13, 2025

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Disparities in Dental Visits Among Participants of the Virginia Living Well Registry
April R Williams1, Maureen Wilson-Genderson1,2, Shillpa Naavaal3
1Department of Veterans Affairs, Million Veteran Program Coordinating Center, Boston, Massachusetts, USA.
Objectives:
Good oral health is integral to maintaining overall health. Yet little is known about the breadth of factors that affect dental visits. The objective of this study was to test for associations between reported dental visits and factors that may be related to dental visits: predisposing (demographics, educational attainment, marital status, employment and smoking status); enabling (income, insurance status, rurality, primary care and dental healthcare provider shortage areas (D-HPSA)) and need (overall health status and emotional wellbeing).
Methods:
Survey data were collected 2018-2020 for the Virginia Living Well (VALW) Registry, a convenience sample (n = 528) of largely rural (79.2%) panel of adult Virginians. Cross-sectional analyses included multilevel logistic regression models with the outcome of dental visits in the past 12 months that controlled for nesting of participants within geography.
Results:
Overall, 65% reported dental visits in the last 12 months. Models showed smoking (OR 0.51; 95% CI 0.29, 0.87), Medicaid coverage (OR 0.29; 95% CI 0.14-0.58), living in an area with a higher DHPSA score (OR 0.54; 95% CI 0.31-0.2) and lower overall health (OR 0.64; 95% CI 0.50-0.82) were associated with lower odds of having seen a dentist in the past 12 months.
Conclusions:
Health factors and healthcare provider shortages appeared to be associated with reported dental visits for Virginian participants of the VALW registry. Participants with Medicaid coverage and those living in a high D-HPSA coverage had lower reports of dental visits. More work is needed to improve equity in access to oral healthcare providers and coverage for dental care to align with recommended care guidelines.
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