Socioeconomic Inequalities in Dental-Care Access and Utilization among Young Adult Students in the United States: Evidence from the 2024 Medical Expenditure Panel Survey
Using 2024 MEPS data, this study reveals that young adult students in the U.S. face significant disparities in dental care access and utilization driven primarily by lack of insurance and racial/ethnic inequalities rather than a simple poverty gradient.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Oral health is a vital part of overall well-being, yet in the United States, the ability to see a dentist is not distributed equally. For decades, researchers have known that people with lower incomes, those without insurance, and racial or ethnic minorities often face greater hurdles in getting dental care. These barriers are not just about money; they involve a complex mix of where people live, what they know about health, and the systems designed to help them. While much attention has been paid to children and older adults, a specific group often gets lost in the statistics: young adults who are currently enrolled in school. This is a critical time in life when people transition from relying on their parents for health decisions to managing their own care, often while juggling tuition, part-time jobs, and uncertain futures. Understanding whether this specific group faces unique challenges in accessing dental care is essential for building a healthier society.
A new study published in 2026 sheds light on this exact issue by examining the dental habits of young adult students across the United States. The researchers turned to a massive, nationally representative database known as the Medical Expenditure Panel Survey, which tracks how Americans use health services and pay for them. They focused specifically on 792 students who were enrolled full-time or part-time in 2024. By linking this data with records of actual dental visits, the team could see not only who went to the dentist but also who tried to go but was stopped by cost. The goal was to understand how family income, health insurance, and race influenced whether a student could get the care they needed.
The results reveal a picture of significant inequality. In 2024, fewer than half of these young adult students—about 46 percent—had visited a dentist at least once. This means that a majority of students in the study went an entire year without professional dental care. When the researchers looked at why, they found that money played a central role, but not in the simple way one might expect. While family income mattered, the presence or absence of specific dental insurance was an even stronger predictor of whether a student could get care. Students without dental insurance were nearly three times more likely to report that they delayed or skipped dental care because they could not afford it. This suggests that having general health insurance is not enough; without a specific plan that covers teeth, young adults remain financially exposed.
The study also uncovered deep racial disparities that persisted even after accounting for income and insurance status. Non-Hispanic Black students were significantly less likely to visit a dentist compared to their non-Hispanic White peers. Furthermore, Black students were much more likely to face cost-related barriers, such as being unable to pay for a visit or having to postpone treatment. These differences remained even when the researchers compared students of the same income level and insurance coverage, indicating that factors beyond simple economics are at play. The data suggests that structural and social conditions continue to create unequal access to oral health for Black students, regardless of their financial standing.
Interestingly, the relationship between income and dental visits was not a straight line. The researchers did not find a smooth, predictable pattern where the poorest students had the least access and the richest had the most. Instead, the middle-income group showed a notable drop in visits compared to the highest-income group, while the poorest categories showed more varied results. This complexity hints that for students, who often rely on family support or public programs, the rules of access are different than for the general adult population. The study also noted that as students got slightly older within this young adult range, they were less likely to visit the dentist, perhaps signaling a disconnect from routine care as they move further into adulthood.
Among the students who did manage to see a dentist, the most common procedures were routine checkups, cleanings, and X-rays, followed by treatments like fillings and orthodontic work. This indicates that those who can access care are generally receiving preventive services. However, because the data only captures those who actually made it to the chair, it cannot show the unmet needs of the students who never made it through the door. The researchers emphasize that the students who do not visit the dentist are not necessarily the same as those who say they cannot afford it; many may skip care due to other reasons like lack of time, transportation issues, or simply not feeling the need.
Ultimately, this research highlights that dental care inequality among young adult students is a multidimensional problem. It is not solved by income alone, nor is it fixed by general health insurance. The findings point to a clear need for policies that provide specific financial protection for dental care and address the broader structural barriers that prevent students from getting the help they need. Without targeted interventions, the transition from student to independent adult may continue to be a period where oral health disparities widen, leaving a significant portion of the population without the care necessary for a healthy life.
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