Mobility Limitations and Self-Perceived Unmet Dental Needs Among Korean Adults: A Nationwide Multilevel Analysis for Integrated Care.

INTRODUCTION AND AIMS: Self-perceived unmet dental needs reflect access barriers and inequities. In rapidly aging Korea, mobility limitations may exacerbate these barriers, yet evidence disentangling individual, household, and district-level influences is scarce. We examined the association between mobility limitations and self-perceived unmet dental needs and assessed contextual variation. METHODS: We analyzed nationally representative data from the 2024 Korea Community Health Survey (KCHS) for adults aged ≥45 years (n = 167,474). Multilevel logistic regression with district random intercepts estimated adjusted odds ratios (AORs) for self-perceived unmet dental needs, incorporating survey weights and z-standardised district covariates. Absolute differences and prevalence ratios were derived from weighted cross-tabulations, and the intraclass correlation coefficient (ICC) summarised random effects. RESULTS: Mobility limitations were reported by 20.6%. Unmet needs were more common among those with limitations than without (17.3% vs 11.4%; difference = 5.9 points; prevalence ratio = 1.5). After adjustment, mobility limitations increased the odds of unmet need by about 20% (AOR = 1.2, 95% CI: 1.1-1.3). Need-related factors showed the strongest associations: unmet medical needs (AOR = 5.1), no regular scaling (AOR = 3.0), and chewing difficulty (AOR = 2.5). Between-district variation accounted for 2.3% of total variance (ICC = 0.023). Conventional supply indicators were not significant, while higher oral-health examination rates showed a modest positive association (per 1 SD, AOR = 1.1; p = .03). CONCLUSION: Mobility limitations constitute an independent barrier beyond socioeconomic and household factors. Persistent unmet need appears driven more by detection-treatment linkage gaps and mobility-related obstacles than by nominal service supply. CLINICAL RELEVANCE: Mobility-sensitive dental delivery-visiting dentistry, transport support, and assisted referral-may help reduce detection-to-treatment gaps for mobility-limited adults within community-based integrated care.