scholarly journals Social and Behavioral Factors, Oral Health, and Dental Care Utilization

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 799-800
Author(s):  
Bei Wu ◽  
Stephen Shuman ◽  
Elisa Ghezzi

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S606-S606
Author(s):  
Yanyan Wu ◽  
Wei Zhang ◽  
Bei Wu

Abstract Oral health is an essential part of staying healthy. Neglect of dental care may lead to tooth decay/ loss, poor nutrition, and affects individuals’ quality of life. Over the past decades, dental care utilization has risen considerably, however, racial/ethnic and socioeconomic disparities still persist in the U.S. Additionally, poor oral health is a contributing factor to, and a consequence of chronic diseases such as cognitive impairment, diabetes and cardiovascular disease. Faced with the complex and intertwined health and social challenges, it’s imperative to understand the disparities of dental care utilization and the relationships among oral health and chronic diseases so that effective policies and preventions can be implemented to improve quality of care. In this symposium, we present findings for older adults from diverse racial/ethnic populations in the U.S. We begin with results from two national-wide trend analyses: a 15-year review of dental care utilization and the evaluation of dental care performance over a 16-year period in nursing homes. The next study presents the barriers of dental care utilization in Hawaii. Finally, we present results of the negative effects of diabetes and poor oral health on cognitive function. Our studies address the disparities of dental care utilization among minority and under-represented ethnic groups as well as the connections between oral health and chronic conditions. Our results are helpful in educating policy makers and health practitioners about how to improve dental care and how dental care can be effectively integrated into chronic disease prevention and health promotion activities.


2020 ◽  
Author(s):  
Jin-Sun Choi ◽  
Se-Hwan Jung

Abstract Background: In Korea, the National Health Insurance Service (NHIS) began its coverage of dentures and dental implants for older people in 2012 and 2014, respectively. This study aimed to investigate the impact of these policies on dental care utilization among people aged 65 years or older according to their sociodemographic characteristics. Methods: Data was collected from the Korea Health Panel (KHP; years 2012 and 2015). The statistical significance of the relationships between sociodemographic characteristics and use of outpatient dental care, denture, and dental implant were analyzed. Results: Results showed an increase of 5.7%, 1.4%, and 2.8% for use of outpatient dental care, denture, and dental implant, respectively, over the course of three years. Including dentures increased its use by 2.5–3.7 times among people aged 70 years or older. Including dental implants alleviated the disparities among age groups and duration of education, except among uneducated people; however, it caused inequity according to household income. Conclusions: Thus, some Korean older adults remain neglected from the benefits of the expanded NHIS; the NHIS should aim for the provision of universal health coverage, and older adults’ access to dental care should be enhanced by the implementation of policies to promote oral health care utilization, Dental prosthetic services, Older adults, Insurance coverage


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S607-S607
Author(s):  
Bei Wu ◽  
Huabin Luo

Abstract This study examined the joint effects of diabetes and poor oral health on cognitive function among older adults aged 60 years or older in the U.S. We analyzed data of 2,937 participants from the National Health and Nutrition Examination Survey (2011-2014). We investigated the interaction effects between diabetes and significant tooth loss, i.e. differences among the following four groups: 1=neither of the two conditions, 2=non-diabetic but with tooth loss, 3=diabetic but no tooth loss, and 4=both conditions. Significant interaction effects were found in our study. Having either diabetes or significant tooth loss was associated with lower cognitive function. When the two conditions were both present, the negative effects were much stronger than the total effects from either one of the two conditions. The additional loss of cognitive function resulting from multiple health conditions illustrates the importance of improving access to dental care for older adults in the U.S.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 800-800
Author(s):  
Sam Li ◽  
Isaac Donkor ◽  
Liang Hong ◽  
Kevin Lu ◽  
Bei Wu

Abstract There is limited information on the impact of cognition function on dental care utilization and costs. This study used the Medicare current beneficiaries survey in 2016 and included 4,268 participants 65+. Dental care utilization and costs were measured by self-report and included preventive and treatment events. Negative binomial regression and generalized linear regression were used to examine the impact of Alzheimer’s disease (AD) and related dementia (RD) on dental care utilization and costs. We found that AD was not associated with dental care utilization, but RD was associated with a lower number of total treatment dental care visits (IRR: 0.60; 95% CI: 0.37~0.98). RD was not associated with dental care costs, but AD was associated with higher total dental care costs (estimate: 1.08; 95% CI: 0.14~2.01) and higher out-of-pocket costs (estimate: 1.25; 95% CI: 0.17~2.32). AD and RD had different impacts on different types of dental care utilization and costs. Part of a symposium sponsored by the Oral Health Interest Group.


Author(s):  
Jin-Sun Choi ◽  
Se-Hwan Jung

In South Korea, the National Health Insurance Service (NHIS) began its coverage of dentures and dental implants for older people in 2012 and 2014, respectively. This study aimed to investigate the impact of these policies on dental care utilization among people aged 65 years or older according to their sociodemographic characteristics. Data were collected from the Korea Health Panel Survey (KHP; years 2012 and 2015). The statistical significance of the relationships between sociodemographic characteristics and the use of outpatient dental care, denture, and dental implant were analyzed. Results showed an increase of 5.7%, 1.4%, and 2.8% in the use of outpatient dental care, denture, and dental implant, respectively, over the course of three years. Including dentures increased its use by 2.5–3.7 times among people aged 70 years or older. Including dental implants alleviated the disparities among older adults based on age groups and duration of education, except those among uneducated people; however, it caused inequity according to household income. Some Korean older adults remain neglected from the benefits of the expanded NHIS. Therefore, older adults’ access to dental care should be enhanced by the implementation of policies to promote oral health care utilization, dental prosthetic services, and older adults’ insurance coverage.


2020 ◽  
pp. 238008442092333
Author(s):  
A.A. Akinkugbe ◽  
S.E. Raskin ◽  
E.E. Donahue ◽  
M.E. Youngblood ◽  
N.N. Laniado ◽  
...  

Objectives: Access to routine dental services is important to maintaining good oral health. The aims of this study were to describe the dental care utilization patterns of a diverse group of Hispanic/Latino men and women and assess differences in dental care utilization by perceived need for dental care and proxy measures of acculturation. Methods: Data from 13,792 participants of the Hispanic Community Health Study were analyzed with SAS 9.4. Time since last dental visit was dichotomized into <1 and ≥1 y. Acculturation measures included the language and social subscales of the Short Acculturation Scale for Hispanics, the Multiethnic Study of Atherosclerosis nativity subscore, and immigrant generation. Survey logistic regression adjusted for demographic (age and sex) and health-related variables, estimated associations among perceived need for dental care, acculturation measures, and dental care utilization. Results: About a quarter (23%) of the participants were born in the 50 US states, excluding territories, while 77% were non–US born. Overall, 74% perceived a need for dental care. Upon covariate adjustment, perceiving a need for dental care was associated with reduced odds of reporting a past-year dental visit (odds ratio, 0.32; 95% CI, 0.28 to 0.37), while there appeared to be no meaningful association between proxy measures of acculturation and past-year dental visit. Having health insurance was significantly associated with a past-year dental visit (odds ratio, 2.23; 95% CI, 1.99 to 2.49) for all groups combined and among the different Hispanic/Latino background groups. Conclusions: Acculturation affects general health and contributes to general health disparities; however, its role in dental care utilization remains questionable. Given that acculturation is a process that occurs over several years, longitudinal studies that evaluate oral health trajectories along the acculturation continuum are needed. Knowledge Transfer Statement: The results of this study are valuable for dental public health program planning and implementation for minority groups, as it describes the varying patterns of dental care utilization among US-born and non–US born Hispanics/Latinos and identifies factors that may partly explain dental care utilization patterns, such as acculturation.


2020 ◽  
pp. 1-7
Author(s):  
B. Everaars ◽  
K. Jerković – Ćosić ◽  
N. Bleijenberg ◽  
N.J. de Wit ◽  
G.J.M.G. van der Heijden

Background: In frail older people with natural teeth factors like polypharmacy, reduced salivary flow, a decrease of oral self-care, general healthcare issues, and a decrease in dental care utilization contribute to an increased risk for oral complications. On the other hand, oral morbidity may have a negative impact on frailty. Objective: This study explored associations between oral health and two frailty measures in community-dwelling older people. Design: A cross-sectional study. Setting: The study was carried out in a Primary Healthcare Center (PHC) in The Netherlands. Participants: Of the 5,816 persons registered in the PHC, 1,814 persons were eligible for participation at the start of the study. Measurements: Two frailty measures were used: 1. Being at risk for frailty, using Electronical Medical Record (EMR) data, and: 2. Survey-based frailty using ‘The Groningen Frailty Indicator’ (GFI). For oral health measures, dental-record data (dental care utilization, dental status, and oral health information) and self-reported oral problems were recorded. Univariate regression analyses were applied to determine the association between oral health and frailty, followed by age- and sex-adjusted multivariate logistic regressions. Results: In total 1,202 community-dwelling older people were included in the study, 45% were male and the mean age was 73 years (SD=8). Of all participants, 53% was at risk for frailty (638/1,202), and 19% was frail based on the GFI (222/1,202). A dental emergency visit (Odds Ratio (OR)= 2.0, 95% Confidence Interval (CI)=1.33;3.02 and OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07;3.99), and making dietary adaptations (OR=2.66, 95% CI=1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01) were associated with being at risk for frailty and survey-based frailty respectively. Conclusions: A dental emergency visit and self-reported oral health problems are associated with frailty irrespective of the approach to its measurement. Healthcare professionals should be aware of the associations of oral health and frailty in daily practice.


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