The association of social determinants of health with dental care use and expenditures among older adults in the United States
5 affiliations
- 1Department of Biomedical Sciences, University of North Texas Health, Fort Worth, TX, United States
- 2Department of Oral Health Sciences, Center for Artificial Intelligence, Data Science, and Informatics, Temple University Kornberg School of Dentistry, Philadelphia, PA, United States
- 3NIA Funded Center on Healthy Aging Behaviors & Longitudinal Investigations, University of Chicago, Chicago, IL, United States
- 4College of Pharmacy, University of North Texas Health Science Center, Fort Worth, TX, United States
- 5Department of Pharmacy Practice, Temple University School of Pharmacy, Philadelphia, PA, United States
Abstract
BackgroundOral health is a critical component of overall health, yet older adults in the United States continue to face persistent disparities in dental care access and utilization, largely shaped by social determinants of health (SDOH).ObjectiveThis study examined the influence of key SDOH factors on dental care utilization and expenditures among noninstitutionalized adults aged 65 years and older using cross-sectional data from the 2022 Medical Expenditure Panel Survey (MEPS).MethodsEducation, poverty level, marital status, dental insurance coverage, and geographic region were evaluated as primary SDOH variables. Dental care use and expenditures were modeled using a two-part approach in which multivariable logistic regression estimated the likelihood of any dental care utilization and a generalized linear model with log link and gamma distribution assessed total expenditures among users, with marginal effects calculated to estimate combined impacts.ResultsIn 2022, 52.5% of older adults reported at least one dental visit, and the average expenditure among users was 1,016. Lower education (adjusted odds ratio [aOR] = 0.25; 95% CI: 0.18, 0.35) and poverty (aOR = 0.51; 95% CI: 0.38, 0.69) were associated with lower dental care use and reduced expenditures (−161 and −303, respectively), whereas private dental insurance was associated with higher utilization (aOR = 1.76; 95% CI: 1.42, 2.17) and greater expenditures (+157).ConclusionsThese findings indicate that structural socioeconomic factors remain strongly associated with dental care access and financial burden among older adults and support the need for policies that integrate oral health into Medicare and broader national strategies to improve access and outcomes.
Related
- Association between dental checkup frequency and longitudinal changes in total healthcare expenditures: a longitudinal cohort study
- Social Determinants of Health and Dental Rehabilitation After Mandibular Reconstruction: A Scoping Review of an Evidence Gap
- The mediating role of social determinants of health in the association between adverse childhood experiences and later-life cardiovascular disease
- Life course social mobility, race and tooth loss in adulthood: The role of dental health services
- Social determinants of health associated with newly documented opioid‐related postpartum readmissions
BibTeX
@article{alfayyadh2026association,
title = {{The association of social determinants of health with dental care use and expenditures among older adults in the United States}},
author = {Maryam Alfayyadh and Jay Sureshbhai Patel and Preeti Pushpalata Zanwar and Usha Sambamoorthi and Usha Sambamoorthi},
journal = {Frontiers in Oral Health},
year = {2026},
month = oct,
doi = {10.3389/froh.2026.1870576},
url = {https://doi.org/10.3389/froh.2026.1870576},
note = {CC BY},
}
RIS
TY - JOUR
TI - The association of social determinants of health with dental care use and expenditures among older adults in the United States
AU - Maryam Alfayyadh
AU - Jay Sureshbhai Patel
AU - Preeti Pushpalata Zanwar
AU - Usha Sambamoorthi
AU - Usha Sambamoorthi
PY - 2026
DA - 2026/10/29
JO - Frontiers in Oral Health
DO - 10.3389/froh.2026.1870576
UR - https://doi.org/10.3389/froh.2026.1870576
AB - BackgroundOral health is a critical component of overall health, yet older adults in the United States continue to face persistent disparities in dental care access and utilization, largely shaped by social determinants of health (SDOH).ObjectiveThis study examined the influence of key SDOH factors on dental care utilization and expenditures among noninstitutionalized adults aged 65 years and older using cross-sectional data from the 2022 Medical Expenditure Panel Survey (MEPS).MethodsEducation, poverty level, marital status, dental insurance coverage, and geographic region were evaluated as primary SDOH variables. Dental care use and expenditures were modeled using a two-part approach in which multivariable logistic regression estimated the likelihood of any dental care utilization and a generalized linear model with log link and gamma distribution assessed total expenditures among users, with marginal effects calculated to estimate combined impacts.ResultsIn 2022, 52.5% of older adults reported at least one dental visit, and the average expenditure among users was 1,016. Lower education (adjusted odds ratio [aOR] = 0.25; 95% CI: 0.18, 0.35) and poverty (aOR = 0.51; 95% CI: 0.38, 0.69) were associated with lower dental care use and reduced expenditures (−161 and −303, respectively), whereas private dental insurance was associated with higher utilization (aOR = 1.76; 95% CI: 1.42, 2.17) and greater expenditures (+157).ConclusionsThese findings indicate that structural socioeconomic factors remain strongly associated with dental care access and financial burden among older adults and support the need for policies that integrate oral health into Medicare and broader national strategies to improve access and outcomes.
SN - 2673-4842
ER -