The perception that oral health is in some way less important than and separate from general health has been deeply ingrained in the American consciousness. Many Americans are unaware of ways to preserve oral health and may not recognize signs indicating they are in trouble. Poor oral health can contribute to various diseases including endocarditis, cardiovascular disease, diabetes, HIV/AIDS, osteoporosis, and Alzheimer’s disease.

Kentuckians often fair worse on a multitude of health measures, especially rural Kentuckians. According to the 2019 County Health Rankings data, when compared to US averages, Kentuckians are more likely to smoke (18% vs 23%), be obese (32% vs 36%), be physically inactive (26% vs 31%), have diabetes (12% vs 14%), and report higher instances of poor or fair health (17% vs 22%). Rural Kentuckians experience these conditions at an even higher rate: physical inactivity (32%), diabetes (15%), and 23% report having poor or fair health. Life expectancy also decreases from the US average (77.4 years) to Kentucky’s average (74.4 years) to rural Kentucky’s average (73.8). In fact, the bottom ten counties with the lowest life expectancy are in rural Kentucky: (Owsley (67.8), Perry (69.0), Powell (69.8), Whitley (70.2), Breathitt (70.4), Floyd (70.6), Harlan (70.7), Lee (70.8), Gallatin (70.8), and Leslie (71.0)). Furthermore, Owsley County ranks eleventh in lowest life expectancy among all counties in the US.

Social factors can contribute to a patient’s interest in or ability to seek oral health services which include: geography, socioeconomic conditions, oral health literacy, oral health preventive behaviors, and cultural preferences. Health behaviors including diet, smoking, and daily hygiene impact overall oral health. In addition, use of medications, abuse of substances, and genetic factors increase the likelihood of dental disease. Compounding health disparity problems is the lack of adequate reimbursement for oral care services in both public and private programs.

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