Title: Prevalence of Selected Dental Outcomes Among Older Adults by Health Insurance Status—United States, 2011-2014
Eleanor Fleming (Presenter)
Woosung Sohn, Boston University
Objectives: Older adults often have medical insurance but lack dental insurance. Dental is not an essential benefit in Medicaid nor are dental benefits included in Medicare. We determined the prevalence of selected dental outcomes among older adults in the United States by health insurance status.
Methods: Data from the NHANES 2011-2014 were analyzed for 2,423 non-institutionalized adults ≥ age 65 years who received an oral health examination. Health insurance, but no dental insurance, was determined from an interview question. Selected dental outcomes obtained from the oral health examination included untreated caries, edentulism, and missing six or more teeth. Analyses were weighted and accounted for complex survey design. Prevalence and odds ratios were calculated for selected dental outcomes.
Results: Overall, 77.7% of older adults had Medicare, 12.3% other insurance which included private insurance, 7.3% Medicaid or Medi-Gap, and 2.3% were uninsured. Among adults who reported their last dental visit was more than a year ago, 57.7% had Medicaid or Medi-Gap, 42.1% Medicare, 34.1% other insurance, and 58.2% of them were uninsured. For all dental outcomes, African Americans, of low poverty status, of less than high school education, tobacco users, those diagnosed with diabetes, those with no dental visit within last year showed higher disease prevalence. While those with Medicare showed significantly lower disease prevalence than those with Medicaid and uninsured, after controlling for confounding, Medicare-Medicaid difference remain significant only for edentulism. Adults with Medicare had significantly lower prevalence and number of untreated decay, missing six or more teeth than those with Medicaid or no insurance (p<0.01) after controlling for confounding.
Conclusions: The results suggest that there are significant disparities in dental care utilization and oral health among community dwelling older adults. Additional research is needed to understand these disparities and the effects that health insurance may have in these disparities.