BMC Oral Health (May 2025)
Oral health and use of dental services in early adulthood and changes from adolescence - Fit Futures, a longitudinal cohort study
Abstract
Abstract Background The journey from adolescence to adulthood brings major life changes that can impact oral health and the utilisation of dental health services. Nevertheless, few longitudinal studies have followed oral health during this transition. This study aimed to evaluate key oral health parameters at young adulthood and how they have progressed from adolescence and identify predictors of self-reported dental health by young adulthood. Methods Data from the first and third Fit Futures (FF) studies that follow a cohort of Norwegians from the first year of upper secondary school (FF1 2010–2011, mean age 16.6 years) for ten years (FF3 2021–2022, mean age 26.9 years), were analysed. Participants answered questionnaires and underwent dental examinations. We included all FF3 participants younger than 32 years at FF3 examination (n = 698, 54.7% female), of whom 642 (92.0%) had also attended FF1 and 584 (83.7%) had data on dental health from both studies. Data were analysed with cross-tabulations, related-samples Wilcoxon Signed Rank Test and multivariate binominal logistic regressions. Results At age 16–17 (FF1) 53.0% and at age 26–27 (FF3) 46.0% of participants rated their dental health as very good or good (p = 0.002). Over the same period, the mean number of decayed teeth increased from 0.8 (SD 1.6) at age 16–17 to 1.4 (SD 2.1, p < 0.001) at age 26–27, with the largest increase among those reporting poor dental health. The proportion having four or more decayed teeth was 5.3% at age 16–17 and 14.4% at age 26–27 (p < 0.001). The mean number of filled teeth increased from 3.6 (SD 3.3) at age 16–17 to 4.8 (SD 3.7) at age 26–27 (p < 0.001), with the largest increase among those reporting good dental health. At age 26–27, 56.2% of the participants reported regular dental visits at least every second year, whereas 24.7% reported no or acute visits only. The primary barriers to regular dental visits were financial (30.6%), lack of priority (28.8%) or no subjective need (26.0%). Respondents with infrequent dental visits due to dental anxiety or finances reported especially poor dental health. Reporting moderate or poor dental health as a young adult was associated with male gender, having moderate or poor general health, caries experience and oral hygiene indicators in both longitudinal and cross-sectional regression analyses. Infrequent or irregular dental visits as a young adult was also associated with reporting moderate or poor dental health. Conclusions The transition from adolescence to adulthood appear to be a critical period for dental health. Interventions such as subsidised care may improve dental health for many but will not address everyone’s need. Clincal trial number Not applicable
Keywords
