The Status of Children's Dental Health in Rural Appalachian West Virginia.

Introduction: Non-metro/rural Appalachian West Virginia (WV) residents have been stigmatized for poor oral health (OH), despite many advances. Purpose: The aims of this study were to examine current OH in children in WV, as compared to children in the greater United States (U.S.), and secondarily in subgroup non-metro/rural comparisons. Methods: This observational study involved the U.S. National Survey of Children's Health 2022-2023 data from parents/guardians who were asked about their child's previous 12-month OH. Rao-Scott Chi-square and logistic regression analyses were used. Results: Nationally, the mean age was 9.7 years; for WV children, it was 9.9 years. Nationally, 12.4% of children lived in non-metro/rural areas; in WV, 36.5% of children lived in non-metro/rural areas. Children from WV were similar or had slightly more positive outcomes of being more likely to see a dentist, have a dental prophylaxis, have a professional fluoride treatment, have sealant placement, and to have both preventive dental and medical care, as compared to children in the rest of the nation. Among non-metro/rural children, WV children were more likely to see a dentist and have ≥1 preventive dental visit(s), dental prophylaxis, oral hygiene instructions, fluoride, sealant(s), and to have both preventive dental and medical care. Implications: Children living in WV have similar or slightly better OH than children living in the U.S. overall. Similarly, children living in non-metro/rural WV have similar or slightly better OH than children living in non-metro/rural U.S. These positive results are often obscured by the previous health history in rural WV. Overall, there remains a need to continue to improve OH, particularly in improving the number of children who have preventive dental care.