Dentition status, dental care visits, and incremental expenditures in US adults, 2016-2018

Although edentulism prompts a continued need for professional care, related use and expenditures are not well characterized. The authors evaluated associations between dentition status and dental care visits and incremental expenditures among US adults.

Using 2016-2018 Medical Expenditure Panel Survey data and 2015-2017 National Health Interview Survey results, the authors categorized dental care visits as occurring within 12 months and dentition as edentate or dentate. Using Poisson regression, the authors estimated the association between dentition and visits, controlling for sociodemographic covariates. Using a 2-part model, they determined incremental expenditures adjusted to 2023 health care rates.

The sample of 66,639 adults represented 236 million people in the United States, 6.3% of whom were edentate. Lack of dental care visits in the previous 12 months was higher among edentate adults (81.2%) compared with dentate adults (55.2%). After controlling for covariates, edentate adults had significantly lower visit prevalence (20.1%) than dentate adults (44.5%; adjusted prevalence ratio, 0.45; 95% CI, 0.41 to 0.49). The adjusted mean expenditure was $359.70 for dentate adults and $276.00 for edentate adults. Edentate adults incurred $83.70 less per capita in adjusted incremental expenditures (P < .002).

Edentulism is associated with significantly fewer visits and lower expenditures despite the need linked to the natural aging of dental tissues.

The study results revealed a paradox; people with the highest potential oral health care needs are the least likely to access care. This differential access to oral health care could be due to socially framed circumstances, and integrating oral health care with primary and geriatric care can help address this in the most affected population groups.