Are We Getting Any Better? A Critical Analysis of Selected Healthy People 2020 Oral Health Indicators in 1999-2004 and 2013-2016, USA.

Oral health disparities are prevalent in the American population and are influenced by various social determinants. This study aimed to analyze oral health disparities in the US between 1999-2004 and 2013-2016 according to sociodemographic characteristics. This analytic cross-sectional study analyzed five oral health indicators from Healthy People 2020. A binomial test was used to compare proportions between baseline and follow-up. Only the indicator for non-treated cavities among children reached its goal. White children had the greatest decrease (-15.4%; = 0.0428) in dental caries. Higher income determined better outcomes for adolescents (-27.54%; = 0.00032 dental caries) and adults (-15.96%; = 0.0143 tooth extractions). However, adults 35-44 years with the highest income had a significant increase (40.74%, = 0.0258) in decayed teeth. This study provides evidence to suggest that some progress has been made towards reducing oral health disparities in the US, primarily among children. However, trends for certain indicators remain disparate between different racial/ethnic and income groups. Applications for the findings of this study should address the intersectional nature of social determinants of health and should center on improving the equity of services offered by public oral healthcare.