Firearm Violence and Dental Health: A Neighborhood Analysis in 100 U.S. Cities, 2014-2022.

Abstract

This study examined the relationship between community-level firearm violence and dental health, focusing on dental care utilization and edentulism (i.e., total tooth loss) . The authors analyzed 20, 332 census tracts within the 100 largest U.S. cities from 2014 to 2022. Dental care utilization and edentulism rates were sourced from the Centers for Disease Control and Prevention's PLACES project. Firearm violence data was drawn from the American Violence Project. Lagged random intercept mixed-effects models estimated associations between firearm violence and dental outcomes, adjusting for neighborhood demographic and socioeconomic covariates. Analyses were performed in 2024. Increases in firearm violence were associated with lower dental care utilization and higher rates of edentulism. A 1-shooting increase corresponded to a 0.01% reduction in dental care utilization and a 0.06% increase in edentulism the following year. Neighborhoods experiencing higher levels of firearm violence face disparities in dental care and oral health, highlighting firearm violence as a social determinant of oral health. Interventions such as mobile dental clinics and integrating dental care into violence intervention programs could mitigate disparities in dental care access and oral health in communities affected by firearm violence.