Title: Dental Care Utilization Among US Elderly With Chronic Medical Conditions
eman aljoghaiman (Presenter)
Woosung Sohn, Boston University
Elizabeth Kaye, Boston University
Thayer Scott, boston university
Objectives: To investigate whether comorbidity of systemic health conditions is a barrier to dental care utilization among the elderly.
Methods: Data on dental care status and systemic diseases from the National Health and Nutrition Examination Survey (NHANES 2013–2014) for 1004 elderly subjects (>65 years) were analyzed. The main outcome was utilization of dental care, defined as having a dental examination within the past year. The main predictor variables were the presence and number of multiple diseases including hypertension, diabetes, hepatitis, asthma, arthritis, congestive heart failure, coronary heart disease, chronic obstructive pulmonary disorder, cancer, and osteoporosis. Confounding factors included in the analysis were race, age (65–75 or ≥75 years), sex, income (<$45,000, $45,000–$74,999, ≥$75,000), and education (less than high school, high school diploma, associate or college degree). Chi-square test and multiple logistic regression analysis were conducted using SAS (version 9.4). SAS Survey Procedures with sampling weights were used to estimate correct variance accounting for the complex sampling of the NHANES study.
Results: 91.2% had at least one comorbidity; the most prevalent was hypertension (73.4%). Patients with chronic obstructive pulmonary disorder (COPD) were significantly less likely to have utilized dental care in the past year (OR 0.42; 95% CI 0.19–0.93). Patients with three or more and four or more comorbidities (20.57% and 7,46% of the participants, respectively), but not those with two or fewer, were significantly less likely to have utilized dental care after controlling for all confounding factors (OR 0.56, 95% CI 0.35–0.89 and OR 0.38, 95% CI 0.20-0.74).
Conclusions: Elderly people with COPD or with three or more systemic diseases are more likely to underutilize dental care. Future programs and/or policy to increase dental care utilization among the elderly should consider interventions that focus on those burdened by several systemic diseases.