An Examination of Dental Health Among Metropolitan and Appalachian Adolescents in Ohio

Background: Poor dental health is a common chronic condition among youth. Appalachian versus metropolitan residence, socioeconomic status, and health behaviors contribute to poor dental health. Limited research has directly compared dental health and risk factors for poor dental health among Appalachian and metropolitan youth. We examined the association between dental health and residence among adolescent boys and explored socioeconomic and behavioral factors that may contribute to differences in dental health. Methods: Adolescent males from metropolitan and rural Appalachian Ohio (n = 1220, age 11-16 years) reported their diet and tobacco use. Parents or guardians reported when boys had last visited the dentist and rated their dental health (excellent/very good/good versus fair/poor). Unadjusted logistic regression modeled the association between fair/poor dental health and residence (metropolitan versus Appalachian). Adjusted analyses controlled for race, household income, dental visits, diet, and tobacco use. Results: Appalachian (versus metropolitan) boys were more likely to have used tobacco in the past 30 days and consumed fewer fruit and vegetables, more added sugar, and more sugary beverages. The relation between dental health and Appalachian versus metropolitan residence did not reach statistical significance, and adjusting for behavioral factors did little to change the observed association. Conclusion: Our findings suggest that some of the urban/rural disparities in dental health observed in other studies may be related to behavioral factors like tobacco use and diet, but much remains unexplained. We provide support for behavioral interventions to address these issues in the Appalachian community.