1. US Worker Dental Care Access and Unmet Dental Needs: The National Health Interview Survey 1997 to 2003 AJ Caban-Martinez MPH 1, DJ Lee PhD 1, LE Fleming MD PhD 1, WG LeBlanc PhD 1, K Arheart EdD 1, K Chung-Bridges MD MPH 1,2, SL Christ MS 3, T Pitman BS 1 Departments of Epidemiology & Public Health 1 & Family Medicine 2, University of Miami Miller School of Medicine; Odum Institute for Research in Social Science and Dept of Sociology 3, University of North Carolina at Chapel Hill Study Website www.rsmas.miami.edu/groups/niehs/nioshwww.rsmas.miami.edu/groups/niehs/niosh This study was funded in part through a grant from the National Institute of Occupational Safety and Health (NIOSH R01 OH03915) ABSTRACT Background: Healthy People 2010 Objectives call for an increase in the proportion of adults who annually use the oral health care system. The present study evaluated dental care utilization and the extent of unmet dental needs of US workers and their families. Methods: Gender-specific analyses by occupation were conducted on 135,004 US worker participants in 1997-2003 nationally representative National Health Interview Surveys (NHIS). Results: Reported lack of oral health care within prior year ranged from 18.9%-57.8% and 17.6%-50.0% among male and female workers, respectively. Gender-specific occupational groups with the highest rates of reported unmet dental needs included: male Health Service occupations (17.1%), and female Construction & extractive trade workers (26.8%). Conclusions: There is significant oral health care underutilization and high rates of unmet dental care needs among many US worker groups. Strategies to increase regular dental visits for US worker groups reporting low dental care access and high dental need are paramount. INTRODUCTION Poor oral health can have a profound effect on quality of life. Millions of Americans suffer from periodontal diseases and other oral conditions, including an estimated 17 million with all their teeth lost. In his 2000 Report on Oral Health, the US Surgeon General acknowledged the significant disparities in the oral health of Americans as a function of sociodemographic status, but did not detail the extent of these disparities in different worker groups. METHOD The National Health Interview Survey (NHIS) is a multistage probability area survey of the US civilian non-institutionalized population living at addressed dwellings. For survey years 1997-2003, the response rates were 70-80%. Participants were asked: “About how long has it been since you last saw or talked to a dentist? (including all types of dentists such as orthodontist, oral surgeons, and all other dental specialists as well as dental hygienists).” Participants were also asked: ‘‘During the past 12 months, was there any time when you needed dental care (including check-ups) but didn’t get it because you couldn’t afford it?’’ Due to complex sample survey design, analyses were completed with the SUDAAN package to take into account sample weights and design effects. CONCLUSIONS The present findings completed in a nationally representative sample of US adults, documented substantial variability in oral care utilization in different worker groups. Continued surveillance of unmet dental needs and oral health care utilization using the NHIS is needed to identify worker groups and other sub- groups of the US population who continue to fall well below Healthy People 2010 objectives for Oral Healthcare. Targeting strategic dental care access programs among identified US worker groups reporting dental care access deficits can improve oral health. RESULTS 66,616 male and 68,388 female NHIS workers (representing 68,293,862 and 58,676,455 US workers, respectively) Male workers more likely to report no dental visit within previous 12 months than female workers (38.5% vs 29.6%). No receipt of oral health care over prior 12 months ranged from 18.9%-57.8% (males), and 17.6% to 50.0% (females). Occupations with majority of male workers not seen a dentist in past year included: Forestry & fishing occupations; Construction laborers; Farm workers & agricultural workers; Food service workers; Freight & stock material handlers Occupations for female workers with reported highest rates of unmet dental needs: Construction & extractive trade workers; Construction laborers; Food service workers.