Examination of rural–urban disparities in utilization of preventive dental procedures in the US pediatric population: A cross-sectional study

Purpose

To determine the extent to which there were disparities in access to recommended preventive oral services between US-based children living in rural versus urban areas.

Methods

The study used cross-sectional, parent-reported National Survey of Children's Health data from 2022, which is the most current year of publicly available data when analyses were performed. Inclusion criteria included all children from the ages of 2 through 17. The US Census Bureau definition of rural was used to guide the analyses. Survey procedures within Stata were used to build the multiple regression models. To test the association between the main predictor variable (i.e., rural–urban designation) and outcome variable (i.e., percentage of those receiving five recommended preventive dental services), five sets of multiple logistic regressions were used, which controlled for the effects of all the other covariates. The STROBE checklist for cross-sectional studies was used for reporting purposes in this manuscript.

Findings

Controlling for the effects of covariates, there was no association of living in an urban area (as opposed to a rural area) and children receiving any of the five recommended services, including comprehensive oral examination, prophylaxis, sealants, radiographs, and fluoride treatments (p > 0.01).

Conclusions

Our study demonstrated the lack of disparities in utilization of preventive dental procedures among US-based children, which may be attributable to factors such as innovative service delivery models integrating telehealth and community-based management in rural communities, COVID-19, and public insurance expansion. Future studies should be conducted to track whether the trend of eroding disparities remains consistent.