title: Use of dental services by immigration status in the United States.
abstract: BACKGROUND
  There is limited research with mixed findings comparing differences in oral health outcomes and the use of dental services by immigration status. The authors conducted a study by reviewing nationally representative data to describe differences in dental care among noncitizens, naturalized citizens, and US-born citizens in the United States.
  
  
  METHODS
  The authors used nationally representative data from the 2008-2012 Medical Expenditure Panel Survey to examine dental care for US-born citizens, naturalized citizens, and noncitizens 18 years and older. Total analytical sample size was 98,107 adults. They used multivariate logistic regression to model dental service use adjusting for confounding factors.
  
  
  RESULTS
  Naturalized citizens and noncitizens were significantly less likely to have at least 1 dental visit within 12 months (39.5% and 23.1%, respectively) compared with US-born citizens (43.6%; P < .001). Among users, a smaller proportion of comprehensive examination visits were for naturalized citizens and noncitizens (75.9% and 71.4%, respectively) compared with US-born citizens (82.8%; P < .01). Noncitizen visits to dentists were also more likely to involve tooth extraction compared with those of US-born citizens (11.3% versus 8.8%; P < .01). Multivariate logistic regression suggests both non- and naturalized citizens had lower adjusted odds of having a comprehensive examination compared with US-born citizens during a visit (P < .01).
  
  
  CONCLUSIONS
  Noncitizens and naturalized citizens had a lower rate of dental service use, and noncitizens were more likely to have had tooth extraction compared with US-born citizens.
  
  
  CONCLUSIONS
  Increased outreach efforts tailored to noncitizens and naturalized citizens who are at high risk of experiencing dental problems are needed, particularly to address misperceptions on the necessity of preventive dental visits.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Wilson
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Jim P
authors.initials: JP
authors.lastname: Stimpson
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: McFarland
authors.forename: Karan P
authors.initials: KP
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003729:Dental Care / Q000706:statistics & numerical data*; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D014481:United States; D055815:Young Adult
keywords: Dental health services; dental care; dental care use; dental public health; health policy; minority groups; public health and community dentistry; public policy; vulnerable populations