A new survey conducted by Gallup Healthways Well-Being has revealed the states where residents are most likely to visit the dentist — and which states are least likely to do so.

Mississippi placed among the latter group, coming in last for the number of dental visits among its residents, according to the Plymouth HamletHub.

Just a little more than half — 53% — of the state’s population has visited the dentist in the last 12 months. This is far below the national average of 64.7%.

Southern states rounded out the bottom 10 in the Gallup poll, with Oklahoma, Louisiana, Arkansas, Texas, West Virginia, Kentucky and Tennessee joining Mississippi as the worst offenders for skipping the dentist. Mississippi has ranked in the bottom 10 every year since 2008, according to the Plymouth HamletHub.

It’s recommended that an individual see his or her dentist for cleanings twice a year to help keep gum disease and tooth decay at bay. Both gum disease and tooth decay have been found to be responsible for tooth loss and more serious complications, including heart disease. 

Tooth loss is especially debilitating, making it difficult for an individual to bite and chew solid foods, which commonly leads to unhealthy dietary habits that in turn cause diabetes and obesity.

The Gallup poll suggested that a relationship between household income and frequency of trips to the dentist’s office exists. The states with residents who were less likely to visit the dentist also had a lower percentage of residents with enough income to pay for health and dental coverage.

For the poll, Gallup surveyed more than 178,000 people across America, asking respondents whether or not they visited their dentist in the last year.