Exploring the association between dental insurance coverage and dental care utilization and oral health among elderly Ontarians.

Abstract

Objectives: There has been an increasing interest in addressing the equity issue of accessing dental care for low-income elderly. This study aimed to estimate the marginal effects (ME) of dental insurance coverage for seniors on dental care utilization and oral health status outcomes. We also estimated the ME of dental insurance across income subgroups.

Methods: Data was sourced from the 2017/18 Canadian Community Health Survey (CCHS)-Annual component. The ME analysis included individuals aged ≥65 years residing in Ontario (n = 10,030). ME were derived from multivariate probit regression models for dental care utilization and oral health status outcomes.

Results: Dental insurance increased the likelihood of reporting excellent/very good oral health and never avoiding foods due to oral problems by 6.9% (ME:6.9, 95% CI: 5.4-8.3) and 3.5% (ME: 3.5, 95% CI: 1.9-5.1), respectively. Dental insurance increased the likelihood of dental visits within the past year by 11.3% (ME: 11.3, 95% CI: 9.8-12.8) and decreased the likelihood of dental visits only for emergencies by 11.2% (ME: -11.2, 95% CI: -12.5 to -9.9). Compared to low- and high-income groups, dental insurance had the highest ME for the middle-income groups for dental visits within the past year (ME middle: 13.1, 95% CI: 10.5-15.7) and dental visits only for emergencies (ME middle: -14.4, 95% CI: -16.0 to -12.8).

Conclusion: Dental insurance can improve the utilization of dental care and can help mitigate the negative effects of poor oral health in elderly populations.