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Trends in Why Americans Delayed Dental Care From Pre-COVID-19 to the COVID-19 Era: Implications for Oral Public Health

Zanwar, P. P. P.; Patel, J. S.; Shen, C.

2026-08-23 public and global health
10.64898/2026.08.22.26361060 medRxiv
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Objectives: To describe age-group differences in inability to afford dental treatment and cost related dental delay, among the US community-dwelling population. Study design: Descriptive analysis of nationally representative survey data. Methods: Using nationally representative Medical Expenditure Panel Survey data (2018-2021), we examined trends in inability to afford dental treatment and cost-related dental treatment delays across four age groups (2-17, 18-39, 40-64, [&ge;]65 years). Weighted analyses accounted for the complex survey design; statistical significance was set at p<0.001. Results: Cost-related delays declined modestly from 2018 to 2021 but remained most prevalent among adults aged 40-64 (4.8% for ages 40-64, 3.4% for ages 18- 64, 2.2% for ages>65 in 2021; p<0.001). Conclusion: Middle-aged adults seem to experience delays due to cost, underscoring the need for dental coverage to expand dental coverage for this group and to reduce their out-of-pocket costs.

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