Objectives Oral health is an essential component of overall health. This study includes objective oral health screening and survey data to explore individual, psychosocial and community-level predictors of oral health status in a state-wide population of adults. Methods Data includes a representative sample of 1,453 adult Wisconsin residents who participated in the Survey of the Health of Wisconsin (SHOW) Oral Health Screening project, conducted with the Wisconsin Department of Health Services during 2010. Results Over 15% of participants had untreated cavities and 20% did not receive needed oral health care. Individuals self-reporting unmet need for dental care were four times more likely to have untreated cavities, controlling for sociodemographics and oral health behaviors. Significant disparities in oral health status were found across all individual, psychosocial and community level predictors. Conclusions Results suggest that costs are a primary predictor of access to care and poor oral health status. The results underscore the role that primary care in conjunction with dental health care providers can play in promoting oral health care particularly in reducing barriers such as costs associated with unmet dental care and promoting preventive health behaviors such as teeth brushing.

US children experiencing certain social risk factors, such as low family income, high school education or less, and poor maternal mental health, are likely to be at greater risk for poor dental health and low levels of dental-care seeking behavior. Children experiencing multiple social risks are at greater risk for poor oral outcomes than children who experience fewer social risks. An approach that involves the social determinants of health is needed to address these issues.