Unmet dental need in community-dwelling adults with mental illness: results from the 2007 Medical Expenditure Panel Survey

Abstract

Background: Mental illness (MI) affects approximately one in five U.S. adults, and it is associated with oral disease and poor dental treatment outcomes. Little is known about dental care utilization or unmet dental need in this population.

Methods: The authors examined data regarding presence or absence of dental visits and unmet dental need in community-dwelling adults with MI from the 2007 Medical Expenditure Panel Survey. They tested differences between adults with and without MI by using multivariate logistic regression.

Results: Eighteen percent of adults (N = 19,368) had MI, and of these, 6.8 percent had unmet dental need. Although people with MI were not significantly more likely to have had a dental visit (46.3 percent) than were those without MI (42.2 percent; odds ratio [OR], 1.09; 95 percent confidence interval [CI], 0.97-1.23), they were significantly more likely to report unmet need (11.0 versus 5.3 percent; OR, 2.00; 95 percent CI, 1.67-2.41). Those with mood or anxiety disorders were most likely to report having an unmet dental need (P < .001 for all values).

Conclusions: Although people with MI did not visit the dentist significantly more often than did adults without MI, their higher level of unmet need suggests that current use of dental services is not addressing their needs adequately.

Practical implications: Dentists should be familiar with MI conditions as patients with MI may have greater unmet dental need.

Figure 1. Adjusted odds ratios* for unmet dental need by most frequently reported types of mental illness

*Adjusted for age, gender, race/ethnicity, education, income, employment, presence of dental and medical insurance. T-bars indicate standard 95 percent confidence intervals.