Trends in dental visits among US adults from 1997 through 2019: Implications for policy reform.

BACKGROUND:Examination of serial cross-sectional national surveys from a representative sample of the population can identify patterns and help support policy development. METHODS:The authors used data from the National Health Interview Survey on US adults reporting a dental visit in the past 12 months to examine trends from 1997 through 2019. Groups analyzed were based on sociodemographic factors including residence in a metropolitan statistical area, race and ethnicity, family income level, and geographic region. RESULTS:Over the 23-year period, the authors found differences for family income level, living in a rural (nonmetropolitan vs metropolitan) area, race and ethnicity, and geographic region (P < .0001). When stratified by family income, racial disparities have diminished. Gaps in dental service use are long-standing for rural nonmetropolitan communities. CONCLUSIONS:Relative to urban locales, rural communities experienced persistent disparities in the use of the oral health care delivery system throughout the 23 years measured. Strategies to create innovative models of care are needed to address oral health needs in underserved rural communities. PRACTICAL IMPLICATIONS:Policy is needed to foster a shift toward population health that will incentivize a health care system that reduces financial barriers and enhances health outcomes for adult oral health, especially for rural areas.