Abstract
OBJECTIVES: To provide policy-relevant evidence to reduce oral health disparities and improve dental care accessibility by considering characteristics of urban and rural areas. BACKGROUND: Individual and regional factors influence dental care access. Regional poverty and limited dental resources among older adults may contribute to unmet dental care needs due to cost. MATERIALS AND METHODS: A multilevel logistic regression analysis was conducted to examine the association between regional factors (regional deprivation, number of dentists per 10,000 and number of dental offices per 100,000) and unmet dental care needs due to cost. The analysis was adjusted for individual factors, such as sex, education, marital status, household income, subjective health status, chewing difficulty and limited daily activities, as determined by the 2021 Korean Community Health Survey (KCHS; n = 47,802). RESULTS: The prevalence of unmet dental care needs due to cost was 4.94% in urban and 4.80% in rural older adults. Individuals who lived in higher regional deprivation (poorer regions) were less likely to experience unmet dental care needs due to cost (OR = 0.66, 95% CI = 0.47-0.94) only in rural areas. Individuals residing in areas with a higher number of dentists per 10,000 were more likely to experience unmet dental care needs due to cost in urban (OR = 2.19, 95% CI = 1.01-4.73) and rural (OR = 1.97; 95% CI = 1.16-3.34). Household income and oral health status were the strongest predictors of unmet dental care needs due to cost. CONCLUSIONS: The influence of regional poverty, dentist distribution and individual factors should be considered in developing policies to reduce the unmet dental care needs of older Koreans.