Changes in Older Adults' Oral Health and Disparities: 1999 to 2004 and 2011 to 2016
- PMID: 30698819
- PMCID: PMC7962435
- DOI: 10.1111/jgs.15777
Changes in Older Adults' Oral Health and Disparities: 1999 to 2004 and 2011 to 2016
Abstract
Objectives: To examine changes in tooth loss and untreated tooth decay among older low-income and higher-income US adults and whether disparities have persisted.
Design: Sequential cross-sectional study using nationally representative data.
Setting: The 1999 to 2004 and 2011 to 2016 National Health and Nutrition Examination Survey.
Participants: Noninstitutionalized US adults, aged 65 years and older (N = 3539 for 1999-2004, and N = 3514 for 2011-2016).
Measurements: Differences in prevalence of tooth loss (having 19 teeth or fewer, 8 teeth or fewer, and no teeth) and untreated decay and mean number of decayed and missing teeth (DMT) between low- and high-income adults 65 years and older in each survey and changes between surveys. Adjusted prevalence and count outcomes were estimated with logistic and negative binomial regression models, respectively. Models controlled for sociodemographic characteristics and smoking status. Reported findings are significant at P < .05.
Results: In 2011 to 2016, unadjusted prevalence of having 19 teeth or fewer, 8 teeth or fewer, no teeth, and untreated decay among low-income adults 65 years and older was 50.6%, 42.0%, 28.6%, and 28.6%, respectively. Multivariate analyses indicated that although most tooth loss measures improved between surveys for both income groups, tooth loss among low-income adults remained at almost twice that among higher-income adults. The disparity in untreated decay prevalence in 2011 to 2016, 15.2 percentage points (26.1% vs 10.9% for low vs high income) was twice that in 1999 to 2004, 8.5 percentage points (22.9% vs 14.4% for low vs high income). DMT decreased for both groups, with lower-income adults having about five more affected teeth in both surveys.
Conclusion: Tooth loss is decreasing, but differential access to restorative care by income appears to have increased.
Keywords: disparities; oral health; tooth loss; untreated decay.
Published 2019. This article is a U.S. Government work and is in the public domain in the USA.
Conflict of interest statement
Comment in
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Reply to Changes in Institutionalized Older People's Dentition Status in Helsinki 2003 to 2017.J Am Geriatr Soc. 2020 Jan;68(1):223-224. doi: 10.1111/jgs.16229. Epub 2019 Oct 26. J Am Geriatr Soc. 2020. PMID: 31654524 Free PMC article. No abstract available.
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Changes in Institutionalized Older People's Dentition Status in Helsinki, 2003-2017.J Am Geriatr Soc. 2020 Jan;68(1):221-223. doi: 10.1111/jgs.16230. Epub 2019 Oct 26. J Am Geriatr Soc. 2020. PMID: 31654530 No abstract available.
References
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- Dye BA, Tan S, Smith V, et al. Trends in oral health status: United States, 1988—1994 and 1999—2004. Vital Health Stat. 2007;11(248):1–92. - PubMed
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- Manski RJ, Rohde F. Dental Services: Use, Expenses, Source of Payment, Coverage and Procedure Type, 1996–2015: Research Findings No. 38. Rockville, MD: Agency for Healthcare Research and Quality; November 2017. https://meps.ahrq.gov/data_files/publications/rf38/rf38.pdf Accessed June 13, 2018.
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