Utilization of dental services by older adults in four Ontario communities

The elderly tend to use dental services less than most younger age groups. While the elderly's utilization rates may be rising, very low utilization by edentulous people depresses the overall rate for the group. We use data from the Ontario Study of the Oral Health of Older Adults to identify the variations in the use of dental services in the four study sites of Toronto, North York, Simcoe County and Sudbury and District. We reached 3,033 subjects by telephone and conducted dental examinations and a multi-item personal interview with 907 of them. The 907 subjects ranged in age from 50 to 87 years, 57 percent were female and two-thirds were born in Canada. Overall, 60.5 percent had seen a dentist or denturist in the previous year, but this was much lower among the edentulous (17 percent) when compared to the dentate (72 percent) (Chi-square test; p less than .0001). Of the 357 who did not visit a dentist or denturist in the previous year, nearly half (48 percent) felt they had nothing wrong and 20 percent reported they could not afford care. A high proportion (94 percent) of the edentulous reported visiting only for pain or trouble compared to 26 percent of the dentate (Chi-square test; p less than .0001). Using logistic regression, we found dental status (edentulous), community of residence (Sudbury), income (up to $20,000) and dental insurance coverage (none) were important factors in not making a dental visit in the last year. These same factors, plus education (elementary) were important where subjects reported visiting a dentist or denturist only when there was pain or trouble.