BOSTON, US: In the US, dental care remains largely excluded from medical insurance and separated from public health initiatives that promote prevention. A new study from Tufts University School of Dental Medicine in Boston underscores the consequences of this gap, reporting that nearly one in three young adults did not visit a dentist in the past year. Beyond oral health, the findings point to broader issues of access and well-being that could impact the nation’s future workforce and healthcare systems.
The research is the first to compare individuals’ social and economic circumstances, access to dental care and self-reported health challenges across age groups. Building on previous findings about cost and access barriers, it found that young adults are particularly likely to miss out on care, and factors such as mental health and housing instability play a part.
“Young adults, aged 18 to 35 years old, were the most likely to report not having visited a dentist within the past 12 months. This is very troubling,” study author Dr Yau-Hua Yu, associate professor of periodontics at the university, said in a press release.
Dr Yu analysed health, demographic and dental care data from nearly 128,000 adults in the National Institutes of Health’s All of Us Research Program—which has one of the world’s largest biomedical databases. The data were examined to assess how physical and mental health challenges varied by income, age and dental visit patterns.
“Across all ages, people generally managed to see a doctor. But those who skipped dental care most often pointed to cost and lack of insurance coverage,” Dr Yu commented. She emphasised that this highlights a persistent policy gap in dental coverage, especially for those without employer-based insurance or access to public programmes.
The study also found that young adults who missed dental visits were more likely to skip medical care, be unable to afford co-payments, rely on emergency care, and report poor mental health or memory issues. The analysis showed that many in this group rented their homes, were racially and ethnically diverse, and experienced housing instability. Housing instability and lack of insurance were significantly associated with financial hardship and poorer mental health.
Age-based differences also emerged. While adults aged 66 years and older were more likely to have insurance and own homes, they reported more disabilities. Those with mobility or cognitive difficulties were especially prone to missing dental care.
“Our findings show the urgent need to integrate dental care into overall healthcare,” Dr Yu said. “They also suggest that interventions must be tailored not only to income but to life stage and cumulative disadvantage,” she added.
According to Dr Yu, expanding public dental insurance and incorporating oral health equity goals into public health and primary care systems could help address these challenges. For older adults, she recommended home-based or mobile dental services, and she suggested that for younger adults, partnerships with faith-based and community organisations may be particularly effective.
“When dental care is rooted in trusted community spaces, it feels more familiar and supportive,” Dr Yu said. “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,” she concluded.
The study, titled “Access to oral health care and its social determinants across the lifespan in the United States”, was published online on 11 September 2025 in Frontiers in Oral Health.