Health Disparities
Dentition Status, Dental Visits, And Incremental Costs Among Adults In The U.S. McKing Amedari* McKing Amedari Amedari Amedari Amedari University of Mississippi Medical Center
Objective: Although edentulism may prompt a continued need for professional dental care, patterns of dental service utilization and associated expenditures are not well characterized. We evaluated the association between dentition status (edentulism), dental visits, and incremental costs among adults in the U.S.
Methods: We used data from the 2012-2016 Medical Expenditure Panel Survey, linked with the 2008-2015 National Health Interview Survey, for secondary data analysis. Dental visits were reported as at least one visit (≤12 months), and dentition status was determined as either completely edentulous or dentate. Using multivariable logistic regression, we estimated the association between dentition status and dental visits, controlling for socio-demographic variables and dental insurance. A two-part model was used to determine the incremental costs, adjusted to the 2023 Personal Consumption Expenditure (PCE) healthcare rates. All models were survey-weighted and accounted for complex survey designs.
Results: Our analytical sample was 66,639 adults representing 236 million Americans, of which 6.3% (95%CI: 6.0, 6.7) were completely edentulous, and 56.9% (95% CI: 56.0, 57.8) had no dental visits ≤12 months. Dentate adults had 72% greater odds for dental visits after controlling for covariates, including age, race, income, education, and dental insurance. The total annual expenditure for dental visits for dentate persons was $24.2 million, and $1.2 million for edentate adults. The average change (incremental costs) in expected dental expenditure was $87 greater per capita for dentate adults compared to edentate adults and statistically significant after controlling for covariates (p < 0.001).
Conclusion: Edentulism was associated with significantly fewer dental visits and lower dental expenditures. The disparities in dental visits and costs buttress the need to reduce access barriers through integrating oral care with primary care and geriatric care.
