Disparities in Oral Health Among Middle and Old Ages in the United States: The Association of Minority and Immigrant Status

Objectives This paper explores the joint effects of minority and immigrant status on dentist visits and missing teeth among adults aged 45 years and older in the United States. Methods This is a cross-sectional study with data from National Health and Nutrition Examination Surveys (NHANES) 2011–2018. Five racial/ethnic groups were included: whites, blacks, Mexican Americans, other Hispanic Americans, and Asian Americans. Interaction effects were included to estimate the heterogeneity of minority and immigrant status. A series of ordinal logistic regression was employed to analyze the association on missing teeth. Coefficient tests were used to examine the effect size of slope difference between whites and minorities. Results Irregular dentist visits were associated with markedly higher odds of tooth loss for whites than for minorities. Being foreign-born indicates more missing teeth for Non-Mexican Hispanic Americans (OR = 1.538, 95%CI = 1.202–1.968) and Asian Americans (OR = 1.653, 95%CI = 1.237–2.209), but is associated with lower odds of irregular dentist visits for whites (OR = 0.539, 95%CI = 0.387–0.751) and Mexican Americans (OR = 0.655, 95%CI = 0.457–0.940). Non-U.S. citizen was associated with lower odds of irregular dentist visits for blacks (OR = 0.569, 95%CI = 0.379–0.816) and less missing teeth for blacks (OR = 0.361, 95%CI = 0.219–0.597). Discussion Racial disparities persist in middle and old age in dentist visits and missing teeth. Whether being foreign-born or using a non-English language in daily life is a risk or protective factor depends on the racial/ethnic group