Dental Care in Ethnic Populations Over 65

Dental Care in Ethnic Populations Over 65

Borrell, L.N., Burt, B.A., and Neighbors, H.W. (2004, May). Social Factors and Periodontitis in an Older Population. American Journal Public Health. 94(5), 748 -- 754. PMCID: PMC1448332

This article discusses the relationship between age, ethnicity, socio-economic status, and educational level with respect to oral dental health and particularly focuses on periodontitis. Research and conventional wisdom have long pointed to poorer health outcomes for people with lower socioeconomic status than for people with higher socioeconomic status.

Studies on the differences in received dental care for older individuals -- particularly those aged 65 and older -- indicate that oral health is poorer and dental care less frequent for this population. In this article, the authors evaluate various characteristic for blacks, Hispanics (Mexican-Americans), and whites in these age groups: 50-59 years; 60-69 years, and >70 years. The indicator "Time since last dental visit" is telling: 47.7% of the blacks over 70 years of age had gone over one year since their last dental visit; and 43.5% of the Hispanics (Mexican-Americans) had not seen a dentist in over a year. This compares to a figure of 18.2% for whites. Considering the same indicator, the figures for blacks, Hispanics (Mexican-Americans), and whites aged 60-69 years were 20.7%, 20.8%, and 16.9%, respectively.

An interesting point that emerged from the study is that, independent of high income or education, blacks exhibited the highest prevalence of periodontitis; the authors attributed this fact to the higher stress levels of blacks, which they surmised could be attributed to the social conditions resulting from racial inequality). Interestingly, regardless of education or income, Hispanics (Mexican-Americans) exhibited the lowest prevalence of periodontitis.

The topic was interesting to me as it underscored the impact that stress can have with respect to health, including dental health. Although people may think that getting older reduces stress, particularly as people leave the workforce and potentially benefit from a greater sense of self and competence, considerable stress is related to aging. Since the relationship between stress and health -- and dental health -- has been established, it is important to consider how the social situations and general milieu in which patients live their lives impact their need for oral dental care and routine dental visits. It was discouraging to see how firmly entrenched -- still -- racial inequality exists in society. While having medical and dental insurance is of tremendous importance in efforts to address these disparities, insurance is not sufficient to correct these social differences. This is apparent when examining the figures for the indicator "Time since last dental visit" with the figures for the indicator "Presence of health insurance." It is surprising that the when 92.4% of blacks, 87.8% of Hispanics (Mexican-Americans), and 97.9% of whites have health insurance, yet exhibit long times between dental visits.