Berg-Warman Ayelet, Kermel-Schiffman Ile, Zusman Shlomo Paul, Natapov Lena
Quintessence Int. 2023 Apr 11;54(4):344-352. doi: 10.3290/j.qi.b3819531.
Oral and dental health significantly impacts the quality of life and nutrition of the older population. While government action has been taken in Israel to reduce barriers to using dental care services by welfare recipients among older adults, there are still disparities associated with socioeconomic status in the older adult population. In 2019, a dental care reform for the older adults was implemented in Israel assuring dental Universal Health Coverage (UCH) for them. This has improved accessibility to dental services and reduced cost barriers. The aim of the present article was to explore the oral health disparities among the 65+ age group by their socioeconomic situation, and their additional barriers to using dental services at the start of the reform.
Telephone interviews were conducted with a representative sample of 512 older adults aged 65+ from February to April 2020.
The self-perceived oral health status was rated as better in the higher socioeconomic group (73.4% perceived their oral health status as good or very good), compared with the lower socioeconomic group (52.5%). In the lower socioeconomic group, 38.5% were edentulous, compared with 18.1% of the higher socioeconomic group. The latter group had four more natural teeth, on average, than the former. Regarding the prevalence of dental problems, double and triple gaps were also found, as well as loose, sore, and sensitive teeth, and difficulty chewing. Oral health behavior, as reflected in tooth brushing patterns and routine preventive check-ups, was found to be better in the higher socioeconomic group than in the lower socioeconomic group. Dental care costs were found to be a barrier to dental care, primarily in the lower socioeconomic group (18.2%, compared with 4.8% of the higher socioeconomic group, were faced with a financial barrier). At the same time, 66.7% of the higher socioeconomic group were aware of the inclusion of dental care services for the older adult population in the basket of health services provided by the health plans, compared with 27.8% of the lower socioeconomic group.
Lack of awareness to proper oral health behavior and to their legal rights were the main barriers to dental care in the lower socioeconomic groups. Dental practitioners play a vital role and have an opportunity to lower these barriers. Existing disparities and barriers should be monitored as a vital part of including dental care in Universal Health Coverage.
口腔和牙齿健康对老年人群的生活质量和营养状况有重大影响。尽管以色列已采取政府行动，以减少老年人中福利领取者使用牙科护理服务的障碍，但老年人群中仍存在与社会经济地位相关的差异。2019年，以色列实施了一项针对老年人的牙科护理改革，确保为他们提供牙科全民健康覆盖（UCH）。这改善了牙科服务的可及性并降低了成本障碍。本文的目的是按社会经济状况探讨65岁及以上年龄组人群的口腔健康差异，以及改革初期他们在使用牙科服务方面面临的其他障碍。
2020年2月至4月，对512名65岁及以上的老年人进行了电话访谈，该样本具有代表性。
与社会经济地位较低的群体（52.5%）相比，社会经济地位较高的群体自我感知的口腔健康状况更好（73.4%的人认为自己的口腔健康状况良好或非常好）。在社会经济地位较低的群体中，38.5%的人无牙，而社会经济地位较高的群体中这一比例为18.1%。后者平均比前者多四颗天然牙。关于牙科问题的患病率，也发现了双倍和三倍的差距，以及牙齿松动、疼痛、敏感和咀嚼困难的情况。从刷牙方式和常规预防性检查所反映的口腔健康行为来看，并发现社会经济地位较高的群体比社会经济地位较低的群体更好。牙科护理费用被发现是获得牙科护理的一个障碍，主要在社会经济地位较低的群体中（18.2%的人面临经济障碍，而社会经济地位较高的群体中这一比例为4.8%）。与此同时，66.7%的社会经济地位较高的群体知道健康计划提供的健康服务篮子中包括了针对老年人群体的牙科护理服务，而社会经济地位较低的群体中这一比例为27.8%。
社会经济地位较低的群体在获得牙科护理方面的主要障碍是对正确的口腔健康行为及其合法权利缺乏认识。牙科从业者发挥着至关重要的作用，并有机会降低这些障碍。作为将牙科护理纳入全民健康覆盖的重要组成部分，应监测现有的差异和障碍。
