Regular dental checkups are vital for overall health. Yet dental care in the United States is still excluded from medical health insurance coverage and usually not integrated with public health initiatives that promote preventative care. A new study from a researcher at Tufts University School of Dental Medicine found that nearly one in three young adults skipped visits to the dentist in the past year—and pointed to wider health and access problems that could affect the nation's future workforce and health systems.
Published recently in Frontiers in Oral Health, the study is the first to compare people's social and economic circumstances, access to dental care, and self-reported health challenges across different ages. The study builds on past research about cost and access barriers to dental care, but it provides new insights by showing that young adults are especially likely to miss out on care—and that factors like mental health and housing problems also play a role.
"Young adults, aged 18 to 35 years old, were the most likely to report not having visited a dentist within the past 12 months," says Yau-Hua Yu, the study's author and an associate professor of periodontology at the School of Dental Medicine. "This is very troubling."
Her earlier research suggested that poor oral health is linked to shortened life expectancy and other negative health outcomes.
For this study, Yu analyzed health, demographic, and dental-care data from nearly 128,000 adults in the National Institutes of Health's All of Us program, one of the world's largest biomedical databases. Yu used the data to examine how physical challenges and mental health issues reported by individuals from different socioeconomic backgrounds varied depending on three factors: whether they had visited a dentist in the past year, their income level, and their age.
"Across all ages, people generally managed to see a doctor," says Yu. "But those who skipped dental care most often pointed to cost and lack of insurance coverage." She says this finding reinforces the need to address the persistent policy gap in dental coverage, especially for those not covered by employer-based insurance or public programs.
Young adults who missed dental visits were also more likely to skip medical care, struggle with copays, rely on emergency care, and report poor mental health or memory problems. Yu found that this group of study participants were more likely to be renters, uninsured, and racially diverse—and that unstable housing added financial and emotional strain.
The study's age-based analysis revealed other important generational contrasts. While adults aged 66 years or older were more likely to have insurance and own a home, they also reported more disabilities. Individuals who reported difficulty walking, bathing, running errands, or concentrating were more likely to skip dental care, particularly among these older adults.
"Our findings show the urgent need to integrate dental care into overall health care," Yu says. "They also suggest that interventions must be tailored not only to income, but to life stage and cumulative disadvantage. The desperate need to bring routine preventative dental care to younger adults—who will be our prime source for societal productivity—should not be ignored."
This may include expanding public dental insurance and integrating oral health equity goals into public health surveillance and primary care frameworks, Yu says.
For older adults, barriers like transportation and mobility point to the need for home-based or mobile dental programs.
For young adults, Yu adds that community organizations and faith-based health systems could be key partners in expanding access, as they already offer models of integrated affordable dental care.
"When dental care is rooted in trusted community spaces, it feels more familiar and supportive," she says. "That lowers the barriers of fear, inconvenience, and cost uncertainty that may keep some young adults away—and it helps them shift from waiting until there's an emergency to hopefully seeking regular, preventive care."
