A major study found that adults without teeth visit dentists 81% less often and spend significantly less on dental care despite having greater oral health needs, revealing a paradox where those most needing professional care are least likely to seek it.
- Adults without teeth had an 81% rate of no dental visits in the past year compared to 55% for those with teeth.
- Edentulous adults spent $83.70 less annually on dental care despite greater professional care needs.
- The study analyzed 66,639 U.S. adults, with about 6% lacking natural teeth.
- After adjusting for other factors, toothless adults had 55% fewer dental visits than those with teeth.
- Researchers recommend integrating oral healthcare into primary and geriatric care to address this gap.
Tooth loss in the U.S. may be significantly linked to visiting the dentist less often, as well as lower dental care expenditures, according to a large study published on August 28 in the Journal of the American Dental Association.
Integrating oral healthcare into primary and geriatric care may help address this problem in the most affected population groups, the authors wrote.
“The study results revealed a paradox; people with the highest potential oral health care needs are the least likely to access care,” wrote the study's lead author, McKing Amedari, MPH, of the John D. Bower School of Population Health at the University of Mississippi Medical Center in Jackson, MS.
Although tooth loss triggers an ongoing need for professional care, related use and spending are not well characterized. To better understand this, researchers investigated correlations between tooth status and dental care visits and incremental expenditures among adults in the U.S.
To conduct the study, 2016-2018 Medical Expenditure Panel Survey data and 2015-2017 National Health Interview Survey results were used. Dental care visits were characterized as occurring within one year, and patients had teeth or were toothless. The Poisson regression analysis was used to estimate the link between teeth and dental visits. Incremental expenditures adjusted to 2023 healthcare rates were determined using a two-part model, according to the study.
The study included 66,639 adults in the U.S. Of those, about 6% didn’t have teeth, the authors wrote. In the previous 12 months, lack of dental care visits was higher (81%) among adults without teeth compared to 55% with teeth. After controlling for covariates, edentulous adults had significantly lower visit prevalence (20%) than adults with teeth (44.5%; adjusted prevalence ratio, 0.45; 95% confidence interval, 0.41 to 0.49), they wrote.
Additionally, the adjusted mean expenditure was $359.70 for adults with teeth and $276 for edentulous adults. Adults without teeth accrued $83.70 less per capita in adjusted incremental expenditures (p < .002), the authors wrote.
Though the study had strengths, it also had limitations. Causation could not be established with the researchers’ cross-sectional analysis, which was due to the outcome and exposure being collected at the same time, the authors wrote.
“Edentulism is associated with significantly fewer visits and lower expenditures despite the need linked to the natural aging of dental tissues,” Bower and colleagues wrote.
