Broken smiles: The impact of untreated dental caries and missing anterior teeth on employment

Abstract

Objectives We aimed to quantify the impact of dental caries and missing anterior teeth on employment, estimate the impact of a routine dental visit on the health of anterior teeth, and the benefits of expanding dental coverage for nonelderly adults. Methods We used the 2013–2014 Continuous National Health and Nutritional Examination Survey to develop a dental problem index (DPI) using tooth counts and tooth surface conditions. We estimated the impact of DPI on employment with logistic regression, controlling for seven demographic and socioeconomic covariates. We used a routine dental visit within 6 months as a proxy for access to dental services, and a linear regression to predict the DPI score for an average individual with and without a recent routine dental visit. We then computed the incremental probability of employment associated with a recent routine dental visit. Finally, we estimated the additional number of working age adults who might become employed due to improved access to dental services. Results The probability of being employed was negatively associated with poor oral health: a one‐point increase in DPI decreased the odds of being employed by 7.70 percent (CI: 5.15–10.19%). Having a routine dental visit had a negative and statistically significant impact on DPI [−0.41 (CI: −0.68 to −0.14)]. The incremental probability of employment associated with a routine dental visit was 0.62 percent (CI: 0.21–1.03%). Conclusions Oral health in the United States is worse among minorities and poor than among other residents. The benefits associated with access to dental care should justify expanding dental services.

Predictors of tooth loss: A machine learning approach

“…Studies have suggested that poor dentition is, indeed, a predictor of low SES, e.g. because individuals with "poor oral health" are less likely to be selected at job interviews [35,36]. However this type of reverse causation is less likely for education, since missing teeth is less likely to affect educational attainment.…”

School academic climate and oral health (tooth loss) in adolescents

“…Prevalence of tooth loss increases gradually with age [1] and in adolescents is associated with a number of deleterious outcomes including poor self-esteem [2], low quality of life [3], impact on daily performance [4], as well as impacts on social relations, and labor market outcomes (employability) [5]. It is worth noting that tooth loss before age 35 may be a risk factor for Alzheimer's disease at 65 years or over [6].…”

Time is on the side of change in dentistry

“…COVID‐19 has exacerbated persistent socioeconomic disparities in health outcomes and social risk factors at a time when health agencies are anticipating less revenue and increasing Medicaid enrollees. The ramifications of undervaluing oral health undermine overall health, economics, gainful employment, mental health, school and work performance, and socialization 8–10 . In order to reinforce the value of oral health care and its integral influence on overall health, we propose three domains of oral health investments and care advancements for financial viability and improved population health.…”

“…The ramifications of undervaluing oral health undermine overall health, economics, gainful employment, mental health, school and work performance, and socialization. [8][9][10] In order to reinforce the value of oral health care and its integral influence on overall health, we propose three domains of oral health investments and care advancements for financial viability and improved population health. The interventions within this domain framework can advance patient and provider well-being while reducing the cost burdens associated with poor quality of life due to oral disease.…”