The association of social determinants of health with oral health status among patients of health resources and services administration funded health centers in the United States

OBJECTIVES: This study examined the association of social determinants of health (SDOH) domains on oral health status. METHODS: We used the nationally representative 2022 Health Center Patient Survey and the 2021-2022 Area Health Resource File. We constructed seven domains on burden of SDOH disadvantage: (1) oral health behavior, (2) dental service use and access, (3) general health service use and access, (4) social, (5) economic, (6) contextual or physical environment, and (7) health condition indicators, and calculated a score per domain. We assessed the association between SDOH domains and four oral health measures: (1) poor self-assessed oral health, (2) low functional dentition, (3) acute dental need, and (4) chronic symptoms in logistic regressions. RESULTS: SDOH domains had different degrees of association with outcomes. Oral health behavior, health condition, and economic indicators were positively associated with all outcomes. General health service use and access, and contextual or physical environment were positively associated with all outcomes except for low functional dentition. Dental service use and access indicators were associated with higher likelihood of poor oral health (7.3%) and low functional dentition (2.5%). Social indicators were associated with higher likelihood of poor oral health (3.1%). CONCLUSIONS: Findings highlight the importance of measuring the burden of SDOH disadvantage and including it in care provision. Findings indicate the need for more access through better integration of oral health within primary care, provision of nonclinical services to link patients with social services to promote oral health, and further support of these approaches by payer.