medRxiv : the preprint server for health sciences · 2026
Trends in Dental Care Visits Across the Lifespan Before and During the COVID-19 Pandemic in the United States: Implications for Practice and Policy.
СтатьяПрепринтНазвание и аннотация: Перевод пока не подготовлен
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Zanwar Preeti Pushpalata, Zare Hossein, Mathur Kopal, Slashcheva Lyubov, Wu Bei
Аннотация
OBJECTIVE: Age-specific disparities in dental care use continue to exist in the United States. The COVID-19 pandemic led to widespread delays in non-urgent dental care. This study provides national estimates of dental care use and examines associated factors for dental visits in the United States population before and during the COVID-19 pandemic.
METHODS & DATA SOURCE: We used the nationally representative Medical Expenditure Panel Survey for the pre-COVID-19 years (2018-2019) and the COVID-19 years (2020-2021). We estimated yearly survey-weighted trends in the mean number of non-zero dental visits by age using an adapted Anderson Behavior and Dental Care Use conceptual model and Poisson regression, controlling for a comprehensive set of confounders across five domains of influence. Dental care visits were defined as visits to any dental care provider.
RESULTS: The overall analytic sample included non-institutionalized, community-living persons (unweighted n=6518, weighted N~320 million), grouped by age as 0-17, 18-44, 45-64, 65-74, and 75+, present in all four years. The prevalence ratio (PR) for dental visits was slightly higher for ages 75+ than for ages 65-74 across 2018-2021, increasing from 1.73 (95% CI: 1.4, 2.1) to 1.84 (95% CI: 1.5, 2.3) to 2.13 (95% CI: 1.7, 2.7) from 2018 to 2020, then rebounding to near pre-pandemic levels in 2021 to 1.66 (95% CI, 1.3, 2.0). Associated factors during the COVID-19 pandemic years 2020-2021 that increased dental visits included dental insurance, high income, and having a usual source of care (p<0.01).
CONCLUSIONS: Dental care use among older adults increased in 2021; however, it did not fully return to pre-pandemic levels.
CLINICAL IMPLICATIONS: Understanding disparities in associated factors for dental care use across all age groups is critical to improving dental practice, policy, and the provision of timely, high-quality care. Future research should investigate factors contributing to delays in dental care beyond the COVID-19 pandemic, including caries burden, decayed teeth, and tooth loss, particularly among older adults.
METHODS & DATA SOURCE: We used the nationally representative Medical Expenditure Panel Survey for the pre-COVID-19 years (2018-2019) and the COVID-19 years (2020-2021). We estimated yearly survey-weighted trends in the mean number of non-zero dental visits by age using an adapted Anderson Behavior and Dental Care Use conceptual model and Poisson regression, controlling for a comprehensive set of confounders across five domains of influence. Dental care visits were defined as visits to any dental care provider.
RESULTS: The overall analytic sample included non-institutionalized, community-living persons (unweighted n=6518, weighted N~320 million), grouped by age as 0-17, 18-44, 45-64, 65-74, and 75+, present in all four years. The prevalence ratio (PR) for dental visits was slightly higher for ages 75+ than for ages 65-74 across 2018-2021, increasing from 1.73 (95% CI: 1.4, 2.1) to 1.84 (95% CI: 1.5, 2.3) to 2.13 (95% CI: 1.7, 2.7) from 2018 to 2020, then rebounding to near pre-pandemic levels in 2021 to 1.66 (95% CI, 1.3, 2.0). Associated factors during the COVID-19 pandemic years 2020-2021 that increased dental visits included dental insurance, high income, and having a usual source of care (p<0.01).
CONCLUSIONS: Dental care use among older adults increased in 2021; however, it did not fully return to pre-pandemic levels.
CLINICAL IMPLICATIONS: Understanding disparities in associated factors for dental care use across all age groups is critical to improving dental practice, policy, and the provision of timely, high-quality care. Future research should investigate factors contributing to delays in dental care beyond the COVID-19 pandemic, including caries burden, decayed teeth, and tooth loss, particularly among older adults.