Oral Health Disparities and Dental Care Utilization among California Adolescents

Objective: To identify determinants of dental care utilization among adolescents in California with an emphasis on factors related to acculturation variables such as primary language spoken at home, years lived in the U.S., and citizenship status.

Method: This cross-sectional study is a secondary data analysis of the California Health Interview Survey (CHIS), the nation’s largest telephone health survey, with a focus on a subsample of 3,379 adolescents aged 12-17 in California from 2009.  To produce population estimates, weights were applied to the sample. Bivariate and multivariable logistic regression analyses were conducted to examine the relationship between sociodemographic variables and dental service use.  Jackknife repeated method was used to estimate the sampling variability of the statistics. Multicollinearity among independent variables were examined and the Allen-Cady modified backward selection model was used to fit a more parsimonious model. Pearson’s χ² test was utilized to test for independence among various categories.

Result: Overall, 10% of adolescents did not have a dental visit within the past year.   Black adolescents were significantly less likely than white adolescents to have had a prior year dental visit. Additionally, being a non-U.S.-citizen, born to parents who are not married, and not having a health insurance were significantly associated with lack of dental visits.  All p-values were 0.05 or less.  Languages spoken at home and years lived in the U.S. were not a significant predictor of having had a prior year dental visit.

Conclusion: Racial and economic disparities related to dental service utilization exist for California adolescents. In addition to these traditional sociodemographic factors, citizenship status remained a strong determinant of utilizing dental care. Focusing intervention efforts on California’s immigrant children could help reduce these oral health disparities and increase access to dental care.