UC San Diego

Background: Mexican-Americans experience a high burden of oral diseases. Oral health behaviors (annual dental visits, daily toothbrushing and flossing) can reduce disease risk. Methods: All three chapters utilized survey data from 340 Mexican-identifying Californians aged 21-40 years. In Chapter 1, logistic regression examined differences in past year dental utilization by health literacy (HL), stratified by birthplace. In Chapter 2, logistic regression assessed dental attendance (a composite of time since last dental visit and reason for visit) by three psychosocial factors (dental anxiety, participant-reported quality of provider interactions, and perceived social support). Chapter 3 used negative binomial regression to examine associations of predisposing, enabling and needs factors with reported one-week frequency of toothbrushing and flossing. Results: In Chapter 1, mean HL was significantly higher among those with a past year dental visit (Odds Ratio [OR]=1.41, 95% Confidence Interval [CI]=1.05-1.93). In a significant birthplace-language preference interaction, US-born individuals preferring Spanish had higher odds (OR= 3.30, CI=1.56-6.97) of reporting a past year dental visit than US-born individuals preferring English. In Chapter 2, we factors associated with poor dental attendance (dental visit one or more years ago or urgent/emergency dental problem). 58% had poor dental attendance. Those with high dental anxiety and those who perceived that their providers did not explain their oral health status or treatments well had higher odds of reporting poor dental attendance (OR= 2.01, CI=1.03-4.17) (OR=2.02, CI=1.09-3.72) respectively. In Chapter 3, weekly toothbrushing frequency was higher among US-born (Incidence rate ratio [IRR]=1.16, CI=1.03-1.28) than foreign-born adults, increased with each unit increase in perceived oral health importance (IRR=1.04, CI=1.01-1.06), and was higher among adults with a past year dental visit (IRR=1.15, CI=1.03-1.28) versus more than one year ago. Adults with a past year dental visit (IRR=1.79, CI=1.37-2.33) versus more than one year ago had a greater frequency of weekly flossing. Conclusion: Overall, results indicate that higher HL, being US-born, and a preference for Spanish are important factors in dental care utilization. Higher perceived importance of oral health and past-year dental visit are crucial for maintaining frequent toothbrushing and flossing. Conversely, high dental anxiety and poor patient-provider interactions negatively impact dental attendance.