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Updated: Jan 6, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Willingness to pay and its determinants for missing tooth replacement among older adults: A cross-sectional study in
Sakura Kiuchi1, Taro Kusama2, Jun Aida3
1Assistant Professor, Department of Dental Public Health, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan; and Adjunct Researcher, Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan.
Statement Of Problem:
Understanding the determinants of willingness to pay (WTP) for missing tooth replacement is essential for promoting oral health.
Purpose:
This study aimed to examine the factors associated with both the WTP and WTP amount for replacing missing anterior and posterior teeth among older Japanese adults.
Material And Methods:
This cross-sectional study used data from the Japan Gerontological Evaluation Study (JAGES) conducted in 2022, which targeted independent adults aged ≥65 years. Thirty-two explanatory variables were used, including demographic, socioeconomic, oral health-related, and general health indicators, and 2 primary outcome variables for both anterior and posterior teeth: whether participants were willing to pay for missing tooth replacement and the amount they were willing to pay. Dominance analysis was used to determine the relative importance of all candidate variables.
Results:
A total of 4616 participants were included (men: 57.9%). The mean ±standard deviation age was 71.9 ±4.8 years. Of the participants, 95.6% and 94.9% expressed WTP to replace missing anterior and posterior teeth. The mean WTP amounts for anterior and posterior teeth were 71 300 Japanese Yen (JPY) and 61 100 JPY (544 and 466 USD). Dominance analysis showed that the absence of depressive symptoms was the strongest positive predictor of WTP (18.3% of the total explained variance for anterior teeth and 22.4% for posterior teeth). Wealth was the most influential factor in WTP amount (21.3% for anterior teeth and 19.2% for posterior teeth). Other key predictors included educational level, preventive dental visit, income, population density, and frequency of meeting friends.
Conclusions:
While the absence of depressive symptoms emerged as the strongest predictor of whether individuals expressed WTP to replace missing teeth among older adults, wealth emerged as the most influential factor in determining the amount they were willing to pay for both anterior and posterior teeth. WTP is largely explained by economic, psychological, and social factors. These findings suggest that promoting oral health may require integrated strategies addressing financial barriers, mental health support, and social engagement.
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