Oral Health Disparities Among the 65+ Age Group.

Abstract

Oral and dental health significantly impacts the quality of life and nutrition of the older population. While government action has been taken in Israel to reduce barriers to using dental care services by welfare recipients among the older adults, there are still disparities associated with socioeconomic status in the older adult population. In 2019, a dental care reform for the older adults was implemented in Israel assuring dental Universal Health Coverage (UCH) for them. This improves accessibility to dental services and reduce cost barriers. To explore the oral health disparities among 65+ age group by their economic situation and their additional barriers to using dental services at the start of the reform. Telephone interviews were conducted with a representative sample of 512 older adults aged 65+ from February to April 2020. The self-perceived oral health status was rated as better in the higher socioeconomic group (73.4% perceived their oral health status as good or very good), compared with the lower socioeconomic group (52.5%). In the lower socioeconomic group, 38.5% were edentulous, compared with 18.1% of the higher socioeconomic group. The latter had 4 more natural teeth, on the average, than the former. Double and triple gaps were also found in the prevalence of dental problems - loose, sore, and sensitive teeth, and difficulty chewing. Oral health behavior - as reflected in tooth brushing patterns and routine preventive check-ups - was found to be better in the higher socioeconomic group than that in the lower socioeconomic group. Dental care costs were found to be a barrier to dental care, primarily in the lower socioeconomic group (18.2%, compared with 4.8% of the higher socioeconomic group, were faced with a financial barrier). At the same time, (66.7% of the higher socioeconomic group were aware of the inclusion of dental care services for the older adult population in the basket of health services provided by the health plans, compared with 27.8% of the lower socioeconomic group. Lack of awareness to proper oral health behavior and to the legal rights are main barriers to dental care in the lower SEG. The dental practitioners have a vital role and an excellent opportunity to lower these barriers. Still existing disparities and barriers should be monitored as vital part of including dental care in UHC.