Changes in Older Adults' Oral Health and Disparities: 1999 to 2004 and 2011 to 2016

• Published in: Journal of the American Geriatrics Society (JAGS) 2019-06, Vol.67 (6), p.1152-1157
• Main Authors: Griffin, Susan O., Griffin, Paul M., Li, Chien‐Hsun, Bailey, William D., Brunson, Diane, Jones, Judith A.
• Format: Article
• Language: English
• Subjects: Aged; Cross-Sectional Studies; Dental Caries - epidemiology; disparities; Female; Healthcare Disparities; Humans; Male; Nutrition Surveys; Older people; oral health; Oral Health - statistics & numerical data; Oral Health - trends; Poverty; Prevalence; Regression analysis; Smoking; Surveys and Questionnaires; Teeth; tooth loss; Tooth Loss - epidemiology; United States - epidemiology; untreated decay
• ISSN: 0002-8614; 1532-5415; 1532-5415
• DOI: 10.1111/jgs.15777

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.