{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T08:09:41Z","timestamp":1773734981427,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Public Health Dent"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the association between rural\/urban status, adverse childhood experiences (ACEs), and oral health outcomes, specifically focusing on inadequate dental visits and significant tooth loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), including 79,571\u2009U.S adults from 12 states, was analyzed. Inadequate dental visits were defined as having last visited a dentist more than one year ago. Significant tooth loss was defined as the loss of six or more permanent teeth due to decay or gum disease. Multivariable logistic regression models were applied to assess the effects of rural\/urban status and ACEs on both outcomes, adjusting for sociodemographic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rural residents had higher odds of reporting inadequate dental visits (AOR: 1.17, 95% CI: 1.07\u20131.29) and significant tooth loss (AOR: 1.36, 95% CI: 1.21\u20131.53) compared to urban residents. ACEs were significantly associated with both outcomes, with individuals reporting 4 or more ACEs showing the highest prevalence of inadequate dental visits and significant tooth loss. Although no statistically significant interaction between rural\/urban status and ACEs was found, rural residents generally had worse oral health outcomes than their urban counterparts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both rural\/urban status and ACEs independently contribute to oral health disparities, with rural populations facing greater challenges in maintaining oral health. The findings emphasize the need for targeted interventions that address geographic and psychosocial determinants, particularly in rural areas, and highlight the importance of trauma\u2010informed care in dental practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jphd.70019","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T04:30:33Z","timestamp":1762489833000},"page":"473-481","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Oral Health Disparities in the\n                    <scp>2022 BRFSS<\/scp>\n                    : The Impact of Rural\/Urban Status and Adverse Childhood Experiences"],"prefix":"10.1111","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3087-1571","authenticated-orcid":false,"given":"Jihee","family":"Song","sequence":"first","affiliation":[{"name":"Florida Department of Children and Families  Tallahassee Florida USA"},{"name":"Department of Family, Youth, and Community Sciences University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong Nam","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Microbiology Pusan National University  Busan Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Centers for Disease Control and Prevention (CDC) \u201cOral Health Health Disparities in Oral Health \u201d2024 https:\/\/www.cdc.gov\/oral\u2010health\/health\u2010equity\/index.html."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12344"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12334"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.2014.1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0800"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12500"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-6590-y"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12271"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/00333549221128336"},{"key":"e_1_2_9_11_1","unstructured":"Center for Disease Control and Prevention (CDC) \u201cAdverse Childhood Experiences (ACEs) About Adverse Childhood Experiences \u201d2024 https:\/\/www.cdc.gov\/aces\/about\/index.html."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0469"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2663"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2380084418810218"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12564"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0886260519883872"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12137"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-020-1028-6"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12274"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182312313"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12366"},{"key":"e_1_2_9_22_1","unstructured":"J.Talbot D.Szlosek andE.Ziller \u201cAdverse Childhood Experiences in Rural and Urban Contexts [Internet] \u201dUniversity of Southern Maine Muskie School of Public Service Maine Rural Health Research Center; 2016. Report No.: PB\u201064 https:\/\/digitalcommons.usm.maine.edu\/behavioral_health\/31."},{"key":"e_1_2_9_23_1","article-title":"Rural\u2013Urban Differences in Exposure to Adverse Childhood Experiences Among South Carolina Adults","volume":"18","author":"Radcliff E.","year":"2018","journal-title":"Rural and Remote Health"},{"key":"e_1_2_9_24_1","volume-title":"The Health and Well\u2010Being of Children in Rural Areas: A Portrait of the Nation 2011\u20132012","author":"US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau","year":"2015"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10935-011-0233-0"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-7325.2010.00178.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.2003.tb00572.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2003.0199"},{"key":"e_1_2_9_29_1","unstructured":"\u201cBRFSS Overview [Internet] \u201d2025 https:\/\/www.cdc.gov\/brfss\/annual_data\/2022\/pdf\/Overview_2022\u2010508.pdf."},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00017-8"},{"key":"e_1_2_9_31_1","doi-asserted-by":"crossref","unstructured":"E. 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