Objectives/Goals: Our objective is to evaluate how access to oral health care and tobacco use in patients with serious mental illness (SMI) impact their oral health outcomes identifying barriers and service utilization disparities affecting the prevalence and severity of oral diseases. Methods/Study Population: A secondary retrospective data analysis study will use records from the electronic database (All of Us). The study population includes individuals over 21 years old, diagnosed with SMI. Data will be collected focusing on their oral health status, access to oral health care (frequency of visits, availability of services, etc.), tobacco use, and social determinants of health. The study will evaluate the impact of access to oral health care on the prevalence of oral health outcomes (e.g., periodontal diseases and oral cancer), analyzing socioeconomic factors, mental health status, and tobacco use as independent variables. A quantitative, descriptive-correlational analysis will be performed to explore the study variables. Results/Anticipated Results: We anticipate that limited access to oral health care, influenced by socioeconomic factors, the presence of SMI, and tobacco use, will correlate with worse oral health outcomes in Hispanics. Disparities in access, such as financial limitations, transportation issues, and stigma, are expected to significantly hinder service utilization and increase the prevalence of oral diseases in patients with SMI who smoke. Discussion/Significance of Impact: This research highlights the need to address disparities in oral health access for Hispanic marginalized populations, particularly those with severe mental illness and tobacco use. It will contribute to reducing health inequalities and improving oral health outcomes through culturally adapted interventions that address these barriers.