Visits to the dentist drop significantly after the age of 80, according to researchers at New York University’s Rory Meyers College of Nursing and the University of Hawaii at Manoa who also note disparities in dental visits for adults in the United States by race and country of birth, with immigrants and racial and ethnic minorities less likely to access care.
Barriers to oral healthcare for older adults include a lack of access to quality dental care, a lack of awareness of the importance of oral health, and dental insurance coverage. Medicare does not cover most dental care, and only 12% of its beneficiaries report having at least some dental insurance from another source to help pay dental expenses, the researchers report. Racial and ethnic minorities and immigrants also face discrimination and language barriers.
“To promote oral health and close racial and ethnic gaps in oral health disparities, seeing a dentist regularly is critical,” said Wei Zhang, professor and chair of the Department of Sociology at the University of Hawaii at Manoa and first author of the study. “Failure to engage in preventive dental care may lead to serious consequences such as tooth decay, pain, tooth loss, and inflammation.”
The study examined how often people see a dentist as they age, focusing on adults in the United States age 51 and older, and explored variations by race and country of birth. While previous studies have looked at recent trends of dental care utilization among adults in the United States, this study extended those efforts by using longitudinal data to focus on middle-aged and older adults across an extended period of time.
The researchers used data from the University of Michigan’s Health and Retirement Study, which interviewed a national sample of middle-aged and older adults. They analyzed rates of dental care utilization, measured by whether someone had seen a dentist in the previous two years, for 20,488 study participants of different races and ethnicities, including 17,661 US-born and 2,827 foreign-born individuals.
According to the study, 70% of adults had visited a dentist in the previous two years, but this rate decreased significantly beginning around age 80. US-born adults of all races and ethnicities were more likely to see a dentist (71%) than immigrants (62%). Also, the gap in care between US-born adults and immigrants shrunk as people aged, suggesting that age and acculturation may play a role in decreasing oral health disparities over time.
The researchers additionally found that white adults had higher rates of service utilization than black and Hispanic adults. Plus, while the rates of service utilization decreased with age for all groups, the rates of decline for whites were slower than others.
“Our study went beyond prior research by confirming that racial and ethnic disparities were substantial and persistent as people became older, regardless of their birthplace and while adjusting for a wide range of factors,” said Bei Wu, PhD, Dean’s Professor in Global Health at the Rory Meyers College of Nursing, codirector of the NYU Aging Incubator, and the study’s senior author.
“This finding is alarming as it indicates that some unmeasured factors beyond the scope of this study, such as oral health literacy, perception of need, barriers to access, and dissatisfaction with dental care, could play important roles in explaining the disparities in dental care as people age,” said Wu.
The study, “Racial/Ethnic Disparities in Dental Service Utilization for Foreign-Born and US-Born Middle-Aged and Older Adults,” was published by Research on Aging.
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