Predictors of having a dentist among older adults in Iowa.
access
dental services research
geriatrics
Journal
Community dentistry and oral epidemiology
ISSN: 1600-0528
Titre abrégé: Community Dent Oral Epidemiol
Pays: Denmark
ID NLM: 0410263
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
10
06
2019
revised:
19
12
2019
accepted:
16
01
2020
pubmed:
12
2
2020
medline:
15
12
2020
entrez:
12
2
2020
Statut:
ppublish
Résumé
Oral health plays an important role in the general well-being of older adults, yet older adults experience unique barriers to dental care. In the United States, almost two-thirds of older adults are dentally uninsured - a reflection of the exclusion of dental benefits from Medicare. The aim of this study was to investigate potential predictors of having a dentist among older adults receiving services funded through the Iowa Department on Aging (IDA). This was a cross-sectional analysis on a convenience sample (n = 2692) of adults age 65+ who completed a required survey to determine eligibility to receive services from the IDA. Data from questionnaires completed between March and December 2017 were used to generate multivariable logistic regression models that identified predictors of having a dentist. The dependent variable, having a dentist, was gathered by self-report in the survey. Explanatory variables eligible for inclusion in the models included demographic and geographic factors, indicators of access to dental care, and factors related to activities of daily living. Fewer than half (46.2%) of the respondents reported having a dentist. In the final regression model, individuals with dental insurance were more than twice as likely to have a dentist than those without insurance. Conversely, individuals with a tooth/mouth problem and who need help with housekeeping and with transportation were significantly less likely to have a dentist than their counterparts. These results align with known insurance-related barriers and identify certain activities of daily living that might influence older adults' ability to access care. The finding that individuals with oral health problems were less likely to have a dentist underscores the need to reduce barriers to care for this population.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
240-247Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Wolrd Health Organization. World Report on Ageing and Health. Geneva: Wolrd Health Organization; 2015:260.
He W, Goodkind D, Kowal PUS. Census Bureau International Population Reports. An Aging World: 2015. Washington, DC: U.S. Government Publishing Office; 2016:175.
Dye BA, Weatherspoon DJ, Lopez MG. Tooth loss among older adults according to poverty status in the United States from 1999 through 2004 and 2009 through 2014. J Am Dent Assoc. 2019;150:9-23.e3.
Wall TP, Vujicic M, Nasseh K. Recent trends in the utilization of dental care in the United States. J Dent Educ. 2012;76:1020-1027.
Friedman PK, Kaufman LB, Karpas SL. Oral health disparity in older adults: dental decay and tooth loss. Dent Clin North Am. 2014;58:757-770.
Prince MJ, Wu F, Guo Y, et al. The burden of disease in older people and implications for health policy and practice. Lancet. 2015;385:549-562.
Scannapieco FA, Cantos A. Oral inflammation and infection, and chronic medical diseases: implications for the elderly. Periodontol 2000. 2016;72:153-175.
Hybels CF, Bennett JM, Landerman LR, Liang J, Plassman BL, Wu B. Trajectories of depressive symptoms and oral health outcomes in a community sample of older adults. Int J Geriatr Psychiatry. 2016;31:83-91.
Delwel S, Binnekade TT, Perez R, Hertogh C, Scherder EJA, Lobbezoo F. Oral hygiene and oral health in older people with dementia: a comprehensive review with focus on oral soft tissues. Clin Oral Investig. 2018;22:93-108.
Sugihara N, Tsuchiya K, Hosaka M, Osawa H, Yamane GY, Matsukubo T. Dental-care utilization patterns and factors associated with regular dental check-ups in elderly. Bull Tokyo Dent Coll. 2010;51:15-21.
Sanz M, Ceriello A, Buysschaert M, et al. Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol. 2018;45:138-149.
Lockhart PB, Bolger AF, Papapanou PN, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation. 2012;125:2520-2544.
van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. 2013;30:3-9.
Bomfim RA, de Souza LB, Corrente JE. Tooth loss and its relationship with protein intake by elderly Brazilians-A structural equation modelling approach. Gerodontology. 2018;35:51-58.
Silva JCM, Santos JFF, Marchini L. Factors influencing patients satisfaction with complete dentures: a qualitative study. Braz Dent Sci. 2014;17:83-88.
Kato H, Takahashi Y, Iseki C, et al. Tooth loss-associated cognitive impairment in the elderly: a community-based study in Japan. Intern Med. 2019;58:1411-1416.
Munoz-Torres FJ, Mukamal KJ, Pai JK, Willett W, Joshipura KJ. Relationship between tooth loss and peripheral arterial disease among women. J Clin Periodontol. 2017;44:989-995.
Koka S, Gupta A. Association between missing tooth count and mortality: a systematic review. J Prosthodont Res. 2018;62:134-151.
Almeida A, Nunes BP, Duro SMS, Facchini LA. Socioeconomic determinants of access to health services among older adults: a systematic review. Rev Saude Publica. 2017;51:50.
Maille G, Saliba-Serre B, Ferrandez AM, Ruquet M. Use of care and the oral health status of people aged 60 years and older in France: results from the National Health and Disability Survey. Clin Interv Aging. 2017;12:1159-1166.
Abdus S, Decker SL. Association between Medicaid adult nonemergency dental benefits and dental services use and expenditures. J Am Dent Assoc. 2019;150:24-33.
Nasseh K, Vujicic M. Dental benefits coverage increased for working-age adults in 2014. Health Policy Institute Research Brief. 2016. http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_1016_2.pdf. Accessed April 17, 2019.
Vujicic M, Buchmueller T, Klein R. Dental care presents the highest level of financial barriers, compared to other types of health care services. Health Aff (Millwood). 2016;35:2176-2182.
Boscato N, Schuch HS, Grasel CE, Goettems ML. Differences of oral health conditions between adults and older adults: a census in a Southern Brazilian city. Geriatr Gerontol Int. 2016;16:1014-1020.
Marchini L, Recker E, Hartshorn J, et al. Iowa nursing facility oral hygiene (INFOH) intervention: a clinical and microbiological pilot randomized trial. Spec Care Dentist. 2018;38:345-355.
Ornstein KA, DeCherrie L, Gluzman R, et al. Significant unmet oral health needs of homebound elderly adults. J Am Geriatr Soc. 2015;63:151-157.
Kelly MC, Caplan DJ, Bern-Klug M, et al. Preventive dental care among Medicaid-enrolled senior adults: from community to nursing facility residence. J Public Health Dent. 2017;78:86-92.
Nowak AJ, Casamassimo PS. The dental home: a primary care oral health concept. J Am Dent Assoc. 2002;133:93-98.
Davidson PL, Cunningham WE, Nakazono TT, Andersen RM. Evaluating the effect of usual source of dental care on access to dental services: comparisons among diverse populations. Med Care Res Rev. 1999;56:74-93.
Hosmer DW, Lemeshow S. Applied Logistic Regression (2nd ed.). New York, NY: John Wiley & Sons; 2000:383.
Jaffe S. Seeking dental care for older Americans. Health Aff (Millwood). 2016;35(12):2164-2167.
Gironda MW, Maida C, Marcus M, Wang Y, Liu H. Social support and dental visits. J Am Dent Assoc. 2013;144:188-194.
Willink A, Schoen C, Davis K. Dental care and medicare beneficiaries: access gaps, cost burdens, and policy options. Health Aff (Millwood). 2016;35:2241-2248.
Seo HY, Jeon JE, Chung WG, Kim NH. Activities of daily living and oral hygiene status of older Korean patients in a long-term care facility. Int J Dent Hyg. 2017;15:154-160.
Saintrain MVL, Saintrain SV, Sampaio EGM, et al. Older adults' dependence in activities of daily living: implications for oral health. Public Health Nurs. 2018;35:473-481.
Administration for Community Living. 2018 Profile of Older Americans. Washington, DC: Department of Health and Human Services; 2018:1-20.
Moss ME. Integrating oral health care services within medicare. N C Med J. 2017;78:402-405.