{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:05:30Z","timestamp":1779253530248,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Community Dental Health"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    This study examines variations in access to dental care and oral health outcomes by residence for children and adolescents in the United States (US).\n                    <jats:bold>Methods:<\/jats:bold>\n                    This cross-sectional study of 50,277 children and adolescents derived child residence, child and caregiver demographic characteristics, as well as access to dental care and oral health from the 2021\u20132022 National Survey of Children\u2019s Health. Access measures include dental care receipt, preventive dental visit, forgone dental care, and fluoride treatment; oral health outcomes include teeth condition, oral health problems, and tooth decay status. All descriptive, bivariate and multivariate analyses consider sampling weights for population-based estimates.\n                    <jats:bold>Results:<\/jats:bold>\n                    Rural versus urban children had lower rates of reporting excellent\/very good teeth condition (71.1% vs 74.4%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0015), higher rates of one or more oral health problems (18.7% vs 15.6%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0009) and tooth decay (16.6% vs 13.5%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0008), and lower rates of receiving fluoride treatment (18.3% vs 15.5%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0043). Regarding access to dental care, in the unadjusted analysis, rural children were less likely to receive preventive dental care (81.7% vs 84.5%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0012) and more likely to forgo needed dental care than urban children (2.6% vs 1.6%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0082). After adjusting for other child and caregiver characteristics, there was no significant difference between residence and preventive dental care.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This study provides updated and timely information for policymakers and community partners and shows that rural US children were both more likely to experience oral health problems and less likely to receive needed dental care.\n                  <\/jats:p>","DOI":"10.1177\/0265539x251400503","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:33:07Z","timestamp":1763461987000},"page":"144-151","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Geographic disparities in children\u2019s oral health in the United States"],"prefix":"10.1177","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5380-8391","authenticated-orcid":false,"given":"Elizabeth","family":"Crouch","sequence":"first","affiliation":[{"name":"Department of Health Services Policy & Management, University of South Carolina Rural Health Research Center Arnold School of Public Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joni","family":"Nelson","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peiyin","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Health Services Policy & Management, University of South Carolina Rural Health Research Center Arnold School of Public Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Boswell","sequence":"additional","affiliation":[{"name":"Department of Health Services Policy & Management, University of South Carolina Rural Health Research Center Arnold School of Public Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassie","family":"Odahowski","sequence":"additional","affiliation":[{"name":"Department of Health Services Policy & Management, University of South Carolina Rural Health Research Center Arnold School of Public Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Martin","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"issue":"2","key":"e_1_3_5_2_1","first-page":"111","article-title":"Relationship between caregivers\u2019 oral health literacy and their child\u2019s caries experience","volume":"36","author":"Baskaradoss JK","year":"2019","unstructured":"Baskaradoss JK, AlThunayan MF, Alessa JA, et al. (2019) Relationship between caregivers\u2019 oral health literacy and their child\u2019s caries experience. Community Dental Health 36(2): 111\u2013117.","journal-title":"Community Dental Health"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd21.230315"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12501"},{"key":"e_1_3_5_5_1","volume-title":"Third Quarter of Fiscal Year 2023 Designated HPSA Quarterly Summary","author":"Bureau of Health Workforce, Health Resources and Services Administration","year":"2023","unstructured":"Bureau of Health Workforce, Health Resources and Services Administration (2023) Third Quarter of Fiscal Year 2023 Designated HPSA Quarterly Summary. Rockville, Maryland: US Department of Health and Human Services."},{"key":"e_1_3_5_6_1","unstructured":"Centers for Disease Control and Prevention (2019) Oral health surveillance report: trends in dental caries and sealants tooth retention and edentulism United States 1999\u20132004 to 2011\u20132016. Available at: https:\/\/stacks.cdc.gov\/view\/cdc\/82756\/cdc_82756_DS1.pdf (accessed 23 July 2025)."},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphd.12444"},{"key":"e_1_3_5_8_1","unstructured":"Data Resource Center for Child and Adolescent Health (2022) National survey of children\u2019s health child and adolescent health measurement initiative; 2021-2022 national survey of children\u2019s health. 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(2017) Medicaid in Small Towns and Rural America: A Lifeline for Children, Families, and Communities. Chapel Hill, NC: Georgetown University Center for Children and Families and the University of North Carolina NC Rural Health Research Program."},{"key":"e_1_3_5_14_1","first-page":"114","article-title":"Early childhood caries and caries experience in permanent dentition: a 15-year cohort study","volume":"126","author":"Jordan AR","year":"2016","unstructured":"Jordan AR, Becker N, J\u00f6hren HP, et al. (2016) Early childhood caries and caries experience in permanent dentition: a 15-year cohort study. 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