Abstract
The growing geriatric population is facing numerous economic challenges and oral health changes. This study explores the relationship between affordability of dental care and untreated root caries among older American adults, and whether that relationship is independent of ethnicity and socioeconomic factors. Data from 1776 adults (65 years or older) who participated in the National Health and Nutrition Examination Survey (NHANES) were analyzed. The association between affordability of dental care and untreated root caries was assessed using logistic regression models. Findings indicated that untreated root caries occurred in 42.5% of those who could not afford dental care, and 14% of those who could afford dental care. Inability to afford dental care remained a statistically significant predictor of untreated root caries in the fully adjusted regression model (odds ratio 2.79, 95% confidence interval: 1.78, 4.39). Other statistically significant predictors were gender (male), infrequent dental visits, and current smoking. The study concludes that the inability to afford dental care was the strongest predictor of untreated root caries among older Americans. The findings highlight the problems with access to and use of much needed dental services by older adults. Policy reform should facilitate access to oral healthcare by providing an alternative coverage for dental care, or by alleviating the financial barrier imposed on older adults.
Highlights
In the United States of America (USA), one in seven people are older than 65 years of age.By 2060, the proportion of older American adults, aged 65 and over, is projected to almost double, reaching 98 million [1]
Non-Hispanic Blacks had higher odds for untreated root caries
Females had lower odds for untreated root caries and in the semi-adjusted and fully adjusted models, respectively
Summary
In the United States of America (USA), one in seven people are older than 65 years of age. By 2060, the proportion of older American adults, aged 65 and over, is projected to almost double, reaching 98 million [1]. Increasing age is associated with health issues, including oral health changes. These changes include increased decayed, missing, or filled teeth (DMFT) [3], root caries [4], xerostomia [5], and limited access to oral health care [6]. Edentulism has significantly declined over the past decades, especially in economically developed countries, leading to older individuals retaining more of their teeth for longer; the trend of root caries remains ambiguous [5,7]
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