Oral care disparities and treatment choices in a sample of low Socio-economic adults living in Southern Nevada

Objective: The purpose of this study was to compare the types of procedures selected by patients of low socio-economic status (SES) treated at a dental clinic in Southern Nevada.

Methods: This retrospective observational study included a sample (n=457) from a population of 1716 patients who received treatment between June and December 2007. SES was defined using zip codes correlated with median annual household incomes less than or equal to $32,999, and used to identify the low SES patient sample. A total of 97 (21.2%) had insurance versus 360 (78.8%) with no insurance. Dental procedures selected included simple extractions vs. single and double amalgam and composite restorations. A comparison of the type of procedure selected and covariables (insurance and treatment location) were evaluated.

Results: Patients of lower SES were more likely to choose extractions (83.2%; n=380) over restorations (16.8%; n=77). Of those choosing extractions, 4.2% (n=16) were treated at the Medicaid clinic; 37.4% (n=142) were treated at the emergency clinic, and greater than half (58.4%; n=222) were treated in the main clinic. Of those with insurance, 64.9% (n=63) chose extractions over restorations (17.5%, n=17).

Conclusion: Oral health disparities regarding type of treatment exist regardless of SES, insurance status or location of treatment. Further research is required to investigate reasons for these discrepancies. There is a need to develop an individualized oral care model that includes patient education, oral disease prevention, and access to oral care addressing low SES population needs.