Racial/ethnic and family income related differences in dental radiographic utilization among a national representative sample of U.S. children and adolescents

Background: For dental care professionals to accurately diagnose and prevent dental conditions, radiographic imaging is essential. However, the variation in dental radiograph use across different populations remains unclear. We examined national data on dental x-ray utilization and explored how racial/ethnic and family income related factors were associated among children and adolescents in the U.S. Methods: We conducted an observational cross-sectional analysis study of the National Survey of Children's Health (2016-2022) of children aged 1-17 years. The primary outcome variable indicates whether the child received a dental x-ray during the preventive dental visit in the past 12 months. We produced weighted estimates and fit survey-weighted adjusted logistic regression to estimate adjusted odds ratios (aORs) for dental x-ray receipt. Results: Out of 279,546 children, 56% received x-rays. Non-Hispanic Black children (aOR 0.55; 95% CI, 0.51-0.60), Hispanic children (aOR 0.90; 95% CI, 0.83-0.98), and children from other races/ethnicities (aOR 0.75; 95% CI, 0.70-0.80) were less likely to receive x-rays than non-Hispanic White children. Children from families with incomes below 200% FPL (aOR: 0.81, 95% CI: 0.75-0.88), and those earning between 200%-400% of the FPL (aOR: 0.92, 95% CI: 0.86-0.98) had a lower likelihood of receiving x-rays compared to families with incomes above 400% FPL. Conclusions: Dental radiography is commonly used during preventive visits, but its use in children depends on clinical need and age. In our study, we found significant disparities in dental radiograph utilization by race/ethnicity and family income.