Association between Dental Caries and Unemployment among U.S. Adults with a history of Illicit Drugs

Objectives This study aims to explore the relationship between dental caries and unemployment among U.S. adults who have engaged in illicit drug use, such as cocaine, heroin, and methamphetamine. Methods The National Health and Nutrition Examination Survey (2015-2018) data were analyzed. The independent variable was severe dental caries (defined as DMFT >13.99), and the dependent variable was employment status. The sample was categorized into non-users, current users (used in the past year), and former users (used prior to the past year). Covariates included age, education, race, gender, smoking status, family income-to-federal poverty level ratio, and health insurance status. Logistic regression with survey weights was applied to assess associations between severe dental caries and employment status. Results The total sample (n=5,476) represented 131,848,604 U.S. adults aged 18-59 years, with 4% current users and 12% former users of the specified drugs. Among current users, those with severe caries had higher odds of unemployment (OR = 2.6, p = 0.025) compared to those without severe caries. No significant association was found between severe caries and employment status among former users after controlling for covariates. Conclusions The study underscores a significant association between severe dental caries and unemployment among U.S. adults who have used illicit drugs in the past year. These findings suggest a potential need for targeted oral health interventions in this population to improve economic well-being. Future research should focus on longitudinal studies to establish causality and explore mechanisms through which dental health may impact employment prospects.