Social Determinants of Oral Health: State-Level Analysis of Edentulism in Older Adults

Background: The US has state variation in edentulism, commonly known as total tooth loss, in older adults. This paper identifies key social determinants of health (SDOH) associated with state differences in older adult edentulism that can be addressed with partnerships between dental providers and policymakers. Methods: Data was collected from three publicly available data sets, including County Health Rankings, provided by the University of Wisconsin Population Health Institute, the U.S. Centers for Disease Control and Prevention (CDC), and the Centers for Medicare and Medicaid Services (CMS). Results come from multiple regression analysis of panel data for all states and the District of Columbia for even years of 2012–2020. Results: A variety of SDOH, population health behaviors, and demographics are associated with older adult edentulism, with the largest effects for education and smoking. We have other variables of interest, and overall, our model explains over 80 percent of the variation. Conclusion: Policymaking in states should emphasize both education and smoking cessation programs for individuals. Future research may also consider the relationship between state-regulated dental insurance and dental practice location. States may also consider policies to encourage better dental professional training and incentives to address smoking cessation for patients.