Utilization of Dental Preventive and Treatment Services Among Older Adults with and without ADRD

Individuals with Alzheimer's disease and related dementias (ADRD) face substantial challenges in accessing dental care, yet the types of services received and how they compare with peers without ADRD remain understudied. This study compared dental service utilization and procedure types between older adults with and without ADRD.

A cross-sectional analysis was conducted in 2026 using 2017-2023 Medical Expenditure Panel Survey (MEPS) data for community-dwelling adults aged 65 years and older (N=35,538). Outcomes were any dental visit in the past year and receipt of preventive or treatment-based procedures among those with at least one visit. Survey-weighted logistic regression models estimated associations between ADRD status and each outcome. Blinder-Oaxaca decomposition partitioned the disparity in dental visits into an endowments component (the share explained by group differences in measured characteristics) and a coefficients component (the share reflecting differences in how those characteristics relate to care use).

Older adults with ADRD were less likely to have a dental visit (AOR=0.75, 95% CI: 0.64-0.88), and among those with a visit, less likely to receive preventive care (AOR=0.69, 95% CI: 0.50-0.95). No significant differences were observed in treatment-based procedures after adjustment. The disparity in dental visits (13 percentage points, p <0.001) was explained by both differences in characteristics (43.2%) and differences in coefficients (43.5%). Health status and education were the largest contributors to the explained component, while family income primarily drove the unexplained component. Disparities in preventive care were smaller (approximately 9 percentage points) and largely driven by the unexplained component.

Disparities in dental care for older adults with ADRD are associated with differences in individual characteristics as well as unexplained factors that may represent barriers to accessing dental care. Closing these gaps requires moving beyond financial coverage toward integrated, community-based delivery models. Such strategies are vital to shifting care from episodic treatment to sustainable prevention.