J Am Dent Assoc. 2021 Jul;152(7):551-559.e1. doi: 10.1016/j.adaj.2021.03.010.
Older adults are keeping their natural teeth longer, spurring calls for dental coverage under Medicare. Although Medicare dental coverage would benefit all older adults, the poorest among them are already eligible for dental benefits through Medicaid. The authors examine the association between states' Medicaid adult dental benefits and dental care use and tooth loss among low-income older adults.
Using the Behavioral Risk Factor Surveillance System data from 2014, 2016, and 2018, the authors examined adults 65 years or older. The outcomes examined included annual dental visit and partial and complete tooth loss. Poisson regressions were used to obtain risk ratios after adjusting for covariates.
States' Medicaid adult dental benefits were significantly associated with dental care use, with low-income older adults in states with no coverage having the lowest probability of visiting a dentist (risk ratio [RR], 0.83; 95% CI, 0.74 to 0.94), followed by emergency-only coverage (RR, 0.91; 95% CI, 0.84 to 0.98) and limited benefits (RR, 0.91; 95% CI, 0.85 to 0.98) relative to states with extensive benefits. There were no significant differences in either partial or complete tooth loss.
States' Medicaid adult dental benefits are significantly associated with dental visits among low-income seniors. Providing comprehensive dental benefits under Medicaid can improve access to dental care among low-income older adults.
As the older adult patient population grows, the poorest older adults may face barriers to dental care in the absence of dental coverage. Dental professionals must engage in advocating for comprehensive dental coverage, especially for vulnerable populations.
老年人保留自然牙齿的时间更长,这促使人们呼吁将牙科纳入医疗保险范围。尽管医疗保险的牙科覆盖范围将使所有老年人受益,但其中最贫困的老年人已经通过医疗补助获得了牙科福利。作者研究了各州医疗补助成人牙科福利与低收入老年人的牙科护理使用和牙齿缺失之间的关系。
作者使用 2014 年、2016 年和 2018 年的行为风险因素监测系统数据,研究了 65 岁及以上的成年人。检查的结果包括每年的牙科就诊和部分及全部牙齿缺失。在调整了协变量后,使用泊松回归获得风险比。
各州的医疗补助成人牙科福利与牙科护理使用显著相关,没有覆盖范围的低收入老年人去看牙医的可能性最低(风险比 [RR],0.83;95%置信区间 [CI],0.74 至 0.94),其次是仅急诊覆盖(RR,0.91;95% CI,0.84 至 0.98)和有限福利(RR,0.91;95% CI,0.85 至 0.98),与广泛福利的州相比。在部分或全部牙齿缺失方面没有显著差异。
各州的医疗补助成人牙科福利与低收入老年人的牙科就诊显著相关。在医疗补助计划下提供全面的牙科福利可以改善低收入老年人获得牙科护理的机会。
随着老年患者群体的增长,最贫困的老年人在没有牙科覆盖的情况下可能面临牙科护理的障碍。牙科专业人员必须参与倡导全面的牙科覆盖,特别是针对弱势群体。