BACKGROUND: Disparities in dental health resulting from social and economic inequality are a pressing public health concern. Poor and vulnerable populations bear a higher burden of caries exacerbated by limited access to quality dental care. Recent publications have suggested a possible association between intellectual capability and caries risk, as well as lower compliance with publicly funded healthcare services among populations with lower educational levels. The objective of this study was to explore potential associations between severe dental caries treatment needs (root canal treatments and extractions), socioeconomic factors and intellectual capability. METHODS: Dental records of 21,052 soldiers recruited into Israeli military service between 2019 and 2021 were reviewed, and data on the need for root canal treatments and extractions were retrieved. Sociodemographic information, including age, sex, socioeconomic strata, intellectual capability scores, body mass index, and place of birth, were extracted and analyzed. RESULTS: The findings from the multivariate generalized linear model indicated that lower intellectual capability scores and socioeconomic strata were associated with a significantly greater requirement for root canal treatments and extractions (p < 0.001). The model also identified male gender and older age as predictors for higher treatment needs. Non-native Israelis were found to be at a greater risk for needing root canal treatments compared to native Israelis. Additionally, a significant positive correlation was observed between intellectual capability scores and socioeconomic strata (p < 0.001). CONCLUSIONS: Groups with lower intellectual capability scores and socioeconomic strata exhibited a greater need for dental treatments, including root canal treatments and extractions. Given their higher likelihood of requiring more invasive treatments, health policy should prioritize intervention plans aimed at improving attendance at preventive care services for these disadvantaged populations under the Israeli free dental care reform.
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