Aging
Understanding the variations in oral health issues and access to dental care among Canadian adults across age groups, household income, and self-rated oral health status: a descriptive analysis using the CLSA Chau* Chau Huynh Annie Sun Amy Hsu Serena Chen Shehreen Hossain Therese Chan Heidi Sveistrup
Background and Objectives: Oral health is integral to overall quality of life and physical well-being. Despite the evidence on the cumulative effects of poor oral health, access to dental care remains inequitable among equity-deserving groups. Considering the roll-out of the Canadian Dental Benefit plan in 2024, we sought to examine trends in dental health status, prevalence of dental issues, and access to services by age and household income.
Methods: We conducted descriptive analyses using prospective cohort data from the Canadian Longitudinal Study of Aging at baseline (2011-2015) and three-year follow-up (2015-2018). T-tests and chi-squared tests were used to examine differences in access to care and dental issues by age (under and over 65 years), household income (<50k, 50-100k, >100k), oral health status (poor, fair, good, very good, excellent), and changes in oral health status between baseline and at the three-year follow-up.
Results: Our study comprised 44,817 Canadian adults. Respondents with a household income of <$50k had the lowest self-rated oral status of ‘fair’ and ‘poor’ and had a higher proportion of dental issues (0.5-25%), e.g., swelling, dry mouth, tooth decay, compared to all other income groups (p<.0001). Most participants in the low-income category did not have any dental insurance (54.0% in those under 65 years; 69.8% in those over 65 years), while most participants in the higher income categories had private dental insurance (71.2% in those under 65 years; 50.2% in those over 65 years). Persons under 65 years with a lower income experienced the largest increase (11.5%) in other oral health issues between baseline and follow-up and had the fewest annual dental visits (p<.0001).
Conclusion: Barriers to accessing preventative care and treatment increases the risk of adverse oral health outcomes and chronic morbidities. Reframing policies to meet the needs of vulnerable groups are critical to quality of life and reducing healthcare costs.