Department of Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa.
Department of Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics, University of Iowa Public Policy Center, Iowa City, Iowa.
Community Dent Oral Epidemiol. 2020 Jun;48(3):240-247. doi: 10.1111/cdoe.12521. Epub 2020 Feb 10.
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.
口腔健康对老年人的整体健康起着重要作用，但老年人在获得牙科护理方面存在独特的障碍。在美国，近三分之二的老年人没有牙科保险——这反映了医疗保险不包括牙科福利。本研究旨在调查在美国爱荷华州老龄化部（IDA）接受服务的老年人中，有牙医的潜在预测因素。
这是一项对便利样本（n=2692）的横断面分析，该样本由 65 岁以上完成了一项确定是否有资格从 IDA 获得服务的要求性调查的成年人组成。使用 2017 年 3 月至 12 月间完成的问卷数据生成多变量逻辑回归模型，以确定有牙医的预测因素。依赖变量（有牙医）是通过调查中的自我报告收集的。纳入模型的解释变量包括人口统计学和地理因素、获得牙科护理的指标以及与日常生活活动相关的因素。
不到一半（46.2%）的受访者报告说有牙医。在最终的回归模型中，有牙科保险的人有牙医的可能性是没有保险的人的两倍多。相反，有牙齿/口腔问题且需要帮助做家务和需要交通帮助的人有牙医的可能性明显低于他们的同龄人。
这些结果与已知的与保险相关的障碍相一致，并确定了某些日常生活活动可能会影响老年人获得护理的能力。有口腔健康问题的人不太可能有牙医的发现强调了为这一人群减少护理障碍的必要性。
