Income-related inequalities in dental service utilization by Europeans aged 50+

The purpose of this study was to describe income-related inequalities in dental service utilization by the elderly populations residing in different European countries. We used data from the Survey of Health, Ageing, and Retirement in Europe (SHARE Wave 2), which contains information on utilization of dental services by 33,358 individuals aged 50+ years from 14 different countries. We assessed income-related inequalities in dental attendance and preventive and/or operative dental treatment by means of Concentration Indices (CI) and Slope Indices of Inequality (SII). We could identify a disproportionate concentration of access to treatment among the rich elderly populations in all 14 countries (relative inequality according to CI), as well as significantly higher access to treatment by individuals located in the highest in relation to the lowest income group for all countries except Italy and the Czech Republic (absolute inequality according to SII). Such differential utilization appears mainly attributable to inequalities in preventive dental visits, either alone or in combination with operative treatment. Persons' oral health status explains substantial proportions of absolute but not of relative inequalities. Overall, there is considerable income-related inequality in dental service utilization by several elderly populations residing in Europe. More research is needed to identify the exact causes of such disparities.