Factors affecting the unmet dental care experience of people with a disability: using panel data

Objectives: To evaluate the effects of policies supporting oral health among people with a disability by examining recent trends in unmet dental care experiences, and to identify factors associated with unmet dental care to suggest directions for more targeted support policies.Methods: Panel data from 4,425 individuals who continuously participated in waves 1-6 (2018-2023) of the Disability and Life Dynamics Panel.Guided by Andersen's behavioral model, a correlated random-effects panel logistic regression was performed to determine overall unmet dental care, and multinomial models were generated to identify factors associated with unmet care.Analyses were performed using R software (ver.4.5.0). Results:The overall prevalence of unmet dental care experiences and the proportion of unmet dental care due to financial burden decreased over time, suggesting a possible association between oral health support policies for people with a disability and a reduction in unmet dental care.Household income level and health status were identified as significant factors associated with unmet dental care among people with a disability.In the analysis of factors associated with specific reasons for unmet care, age and means of transportation to healthcare facilities were significant determinants.Conclusions: These findings indicate that continuous implementation of oral health support policies for people with a disability is necessary to reduce unmet dental care, and that policy design should take into account the identified determinants of unmet dental care experiences to develop more detailed and tailored support measures.