Research finds low-income adults face higher rates of tooth loss, pain and dentures

A new RIVM report shows that adults with lower incomes and less education in the Netherlands experience far worse oral health than wealthier and higher-educated groups. The Monitor Mondgezondheid 2025, released Tuesday, is the first national study to clearly document these disparities.

The findings show that 14 percent of low-income adults wear dentures, compared with 4 percent among high-income groups. Among people with the lowest education levels, one in five relies on a dental prosthesis. Tooth pain is also more common: 18 percent of lower-income adults report tooth or molar pain, versus 15 percent in higher-income groups.

Tooth loss presents one of the sharpest gaps. Twenty-six percent of the lowest-income group have fewer than 20 natural teeth — the minimum needed for proper function — while the rate is 11 percent among higher earners. The report notes that extractions are often chosen because they cost less than procedures that save a tooth.

Self-reported oral health follows the same pattern. Sixty-seven percent of people with low incomes rate their oral health as good or very good, compared with 75 percent among higher-income adults. Only 63 percent of the lowest-education group report good oral health, compared with 78 percent at the HBO level or higher.

In the past year, 76 percent of lower-income adults saw a dental professional, versus 87 percent among higher-income adults. One in five low-income respondents said dental care is “too expensive,” compared with 12 percent in higher-income households.

Lower-income adults also brush less often. Seventy-one percent brush at least twice a day, compared with 78 percent in higher-income groups.

RIVM project leader Babette Everaars said the results align with existing research. “People with lower incomes often show less healthy behavior and may have poorer access to care,” she said, adding that the study did not establish causal links.