Mobility Limitations and Self-Perceived Unmet Dental Needs Among Korean Adults: A Nationwide Multilevel Analysis for Integrated Care

TL;DR

Mobility limitations in older Korean adults are linked to higher unmet dental needs, suggesting a need for accessible dental care solutions.

Contribution

This study identifies mobility limitations as an independent barrier to dental care access, beyond socioeconomic and household factors.

Findings

Mobility limitations were associated with a 20% higher odds of unmet dental needs after adjustment.

Unmet medical needs, lack of regular dental scaling, and chewing difficulty were strongest predictors of unmet dental needs.

Between-district variation accounted for 2.3% of total variance in unmet dental needs.

Abstract

Self-perceived unmet dental needs reflect access barriers and inequities. In rapidly aging Korea, mobility limitations may exacerbate these barriers, yet evidence disentangling individual, household, and district-level influences is scarce. We examined the association between mobility limitations and self-perceived unmet dental needs and assessed contextual variation.

We analyzed nationally representative data from the 2024 Korea Community Health Survey (KCHS) for adults aged ≥45 years (n = 167,474). Multilevel logistic regression with district random intercepts estimated adjusted odds ratios (AORs) for self-perceived unmet dental needs, incorporating survey weights and z-standardised district covariates. Absolute differences and prevalence ratios were derived from weighted cross-tabulations, and the intraclass correlation coefficient (ICC) summarised random effects.

Mobility limitations were reported by 20.6%. Unmet needs were more common among those with limitations than without (17.3% vs 11.4%; difference = 5.9 points; prevalence ratio = 1.5). After adjustment, mobility limitations increased the odds of unmet need by about 20% (AOR = 1.2, 95% CI: 1.1-1.3). Need-related factors showed the strongest associations: unmet medical needs (AOR = 5.1), no regular scaling (AOR = 3.0), and chewing difficulty (AOR = 2.5). Between-district variation accounted for 2.3% of total variance (ICC = 0.023). Conventional supply indicators were not significant, while higher oral-health examination rates showed a modest positive association (per 1 SD, AOR = 1.1; p = .03).

Mobility limitations constitute an independent barrier beyond socioeconomic and household factors. Persistent unmet need appears driven more by detection–treatment linkage gaps and mobility-related obstacles than by nominal service supply.

Mobility-sensitive dental delivery—visiting dentistry, transport support, and assisted referral—may help reduce detection-to-treatment gaps for mobility-limited adults within community-based integrated care.

Figures