Dental Care Among Adults Age 65 and Older: United States, 2022

NCHS Data Brief No. 500, April 2024

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Robin A. Cohen, Ph.D., and Lauren Bottoms-McClain, M.P.H.

Oral health is associated with overall health, especially in older adults (age 65 and older). Chronic conditions in older adults may affect oral health, and poor oral health may increase the risk of certain chronic conditions (1-3). Poor oral health has also been associated with increased cardiovascular disease risk (4). Several factors, including chronic conditions, health status, race, and income have been associated with reduced dental care use among older adults (5-9). This report describes the percentage of older adults who had a dental visit in the past 12 months by selected sociodemographic characteristics and chronic conditions using the 2022 National Health Interview Survey (NHIS).

Keywords: oral health,chronic conditions, National Health Interview Survey

Among adults age 65 and older, dental visits in the past 12 months varied by sex, age group, and race and Hispanic origin.

• In 2022, 63.7% of adults age 65 and older had a dental visit in the past 12 months (Figure 1, Table 1).
• Men (62.3%) were less likely than women (64.9%) to have had a dental visit.
• The percentage of older adults who had a dental visit decreased from 65.4% among those ages 65-74 and 63.6% among those ages 75-84 to 53.3% among those age 85 and older.
• The percentage of older adults who had a dental visit was highest among White non-Hispanic (subsequently, White) adults (68.1%) compared with Asian non-Hispanic (subsequently, Asian) adults (51.8%), Black non-Hispanic (subsequently, Black) adults (53.4%), other and multiple-race non-Hispanic (subsequently, other and multiple race) adults (48.8%), and Hispanic adults (48.0%). No other significant differences by race and ethnicity.

Figure 1. Percentage of adults age 65 and older who had a dental visit in the past 12 months, by sex, age group, and race and Hispanic origin: United States, 2022

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¹Significantly different from women (p < 0.05).
²Significant quadratic trend with age (p < 0.05).
³Significantly different from White non-Hispanic adults (p < 0.05).
⁴Significantly different from Other and multiple-race non-Hispanic adults (p < 0.05).
⁵Significantly different from Hispanic adults (p < 0.05).
NOTES: People of Hispanic origin may be of any race. Adults categorized as Asian non-Hispanic, Black non-Hispanic, or White non-Hispanic indicated one race only. Estimates are based on responses to the question, "About how long has it been since you last had a dental examination or cleaning?" A response of "within the past year (anytime less than 12 months ago)" was considered as having a dental visit in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2022.

Data table for Figure 1. Percentage of adults age 65 and older who had a dental visit in the past 12 months, by sex, age group, and race and Hispanic origin: United States, 2022

Among adults age 65 and older, dental visits increased with increasing family income and increasing education level.

• In 2022, the percentage of adults age 65 and older who had a dental visit in the past 12 months generally increased with increasing income as a percentage of the federal poverty level (FPL), ranging from 35.3% among those with incomes less than 100% FPL to 80.5% among those with incomes greater than 400% FPL (Figure 2, Table 2).
• The percentage of older adults who had a dental visit increased with increasing education level, from 33.3% among those with less than a high school diploma to 82.0% among those with a bachelor's degree or higher.

Figure 2. Percentage of adults age 65 and older who had a dental visit in the past 12 months, by family income level and education level: United States, 2022

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¹Significant quadratic trend with family income (p < 0.05).
²Significant linear increase with increasing education level (p < 0.05).
NOTES: Family income is based on a percentage of the federal poverty level (FPL). Estimates are based on responses to the question, "About how long has it been since you last had a dental examination or cleaning?" A response of "within the past year (anytime less than 12 months ago)" was considered as having a dental visit in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2022.

Data table for Figure 2. Percentage of adults age 65 and older who had a dental visit in the past 12 months, by family income level and education level: United States, 2022

Table 2

Characteristic	Percent (95% confidence interval)	Standard error
Family income
Less than 100% FPL	35.3 (31.0-39.8)	2.20
100% to less than 200% FPL	46.1 (43.1-49.0)	1.49
200% to 400% FPL	61.5 (59.1-63.8)	1.17
Greater than 400% FPL	80.5 (78.8-82.1)	0.88
Education level
Less than high school diploma or GED	33.3 (29.7-37.0)	1.83
High school diploma or GED	55.8 (53.4-58.1)	1.21
Some college	67.2 (65.0-69.4)	1.10
Bachelor's degree or higher	82.0 (80.3-83.5)	0.81

NOTES: Family income is based on a percentage of the federal poverty level (FPL). Estimates are based on responses to the question, "About how long has it
been since you last had a dental examination or cleaning?" A response of "within the past year (anytime less than 12 months ago)" was considered as having a
dental visit in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2022.

Dental visits among adults age 65 and older were higher among those with dental coverage.

• In 2022, among adults age 65 and older, those with dental coverage were more likely to have had a dental visit in the past 12 months (69.6%) compared with those without dental coverage (56.4%) (Figure 3, Table 3).

Figure 3. Percentage of adults age 65 and older who had a dental visit in the past 12 months, by dental coverage status: United States, 2022

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¹Significantly different from adults who have no dental coverage (p < 0.05).
NOTES: Estimates are based on responses to the question, "About how long has it been since you last had a dental examination or cleaning?" A response of "within the past year (anytime less than 12 months ago)" was considered as having a dental visit in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2022.

Data table for Figure 3. Percentage of adults age 65 and older who had a dental visit in the past 12 months, by dental coverage status: United States, 2022

Table 3

Dental coverage status	Percent (95% confidence interval)	Standard error
Has dental coverage	69.6 (67.9-71.3)	0.85
No dental coverage	56.4 (54.5-58.3)	0.97

NOTES: Estimates are based on responses to the question, "About how long has it been since you last had a dental examination or cleaning?" A response of "within the past year (anytime less than 12 months ago)" was considered as having a dental visit in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2022.

The percentage of adults age 65 and older who had a dental visit was lower among those in fair or poor health and those with diabetes or heart disease.

• In 2022, adults age 65 and older with fair or poor health (44.5%) were less likely than those in excellent, very good, or good health (69.5%) to have had a dental visit in the past 12 months (Figure 4, Table 4).
• Older adults with diabetes (55.1%) were less likely than those without diabetes (65.9%) to have had a dental visit.
• Older adults with heart disease (58.7%) were less likely than those without heart disease (64.7%) to have had a dental visit.

Figure 4. Percentage of adults age 65 and older who had a dental visit in the past 12 months, by selected health factors: United States, 2022

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¹Significantly different from adults in fair or poor health (p < 0.05).
²Significantly different from adults without diabetes (p < 0.05).
³Significantly different from adults without heart disease (p < 0.05).
NOTES: Estimates are based on responses to the question, "About how long has it been since you last had a dental examination or cleaning?" A response of "within the past year (anytime less than 12 months ago)" was considered as having a dental visit in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2022.

Data table for Figure 4. Percentage of adults age 65 and older who had a dental visit in the past 12 months, by selected health factors: United States, 2022

Table 4

Characteristic	Percent (95% confidence interval)	Standard error
Health status
Excellent, very good, or good health	69.5 (68.2-70.8)	0.67
Fair or poor health	44.5 (41.8-47.3)	1.39
Diabetes status
With diabetes	55.1 (52.1-58.1)	1.50
Without diabetes	65.9 (64.4-67.3)	0.73
Heart disease status
With heart disease	58.7 (55.4-61.9)	1.61
Without heart disease	64.7 (63.3-66.1)	0.72

NOTES: Estimates are based on responses to the question, "About how long has it been since you last had a dental examination or cleaning?" A response of "within the past year (anytime less than 12 months ago)" was considered as having had a dental visit in the past 12 months. Estimates are based on household interviews of a sample of the U.S. civilian noninstitutionalized population.
SOURCE: National Center for Health Statistics, National Health Interview Survey, 2022.

Summary

In 2022, 63.7% of U.S. adults age 65 and older had a dental visit in the past 12 months. Women, White adults, and adults ages 65-74 and 75-84 were more likely to have had a dental visit than their counterparts. Dental visits increased with increasing family income and education level. Also, older adults with dental coverage were more likely to have had a dental visit than those without dental coverage. Older adults with diabetes, heart disease, or those in fair or poor health were less likely to have had a dental visit than their counterparts. A previous report on dental care among older adults using the 2017 NHIS showed similar percentages of dental care use between men and women and decreasing visits with increasing age (10). However, it is important to note that NHIS was resigned in 2019 and the question wording for dental care was slightly changed, so estimates from NHIS data before 2019 may not be consistent with those from 2019 and later (10,11).

Definitions

Dental visit in the past 12 months: Estimates are based on responses to the question, "About how long has it been since you last had a dental examination or cleaning?" A response of "within the past year (anytime less than 12 months ago)" was considered as having had a dental visit in the past 12 months. NHIS did not collect data on edentulism (toothlessness) in 2022, so older adults who do not have teeth are included in this measure.

Dental coverage: Adults were considered to have dental coverage if, at the time of interview, they had coverage through either a single-service plan, a private health insurance plan, or a Medicare Advantage plan. Adults covered by Medicaid living in a state where Medicaid provides comprehensive dental coverage were also considered to have dental coverage.

Family income as a percentage of the federal poverty level: Calculated from the family's income in the previous calendar year and family size using the U.S. Census Bureau's poverty thresholds (12). The 2022 NHIS imputed income file was used to create the poverty levels (13).

Race and Hispanic origin: Adults categorized as Hispanic may be any race or combination of races. Adults categorized as non-Hispanic Asian, non-Hispanic Black, or non-Hispanic White indicated one race only. Other and multiple races includes those who did not identify as Asian, Black, Hispanic, or White or who identified as more than one race. Analyses were limited to the race and Hispanic-origin groups for which data were reliable and had a large enough sample to make group comparisons.

Data source and methods

This analysis was based on the 2022 NHIS. Estimates were based on a sample of 14,020 adults age 65 and older. NHIS is a nationally representative household survey of the U.S. civilian noninstitutionalized population. It is conducted continuously throughout the year by the National Center for Health Statistics. Interviews are typically conducted in respondents' homes, but follow-ups to complete interviews may be conducted over the telephone. Because of the COVID-19 pandemic, interviewing procedures were disrupted, and 55.7% of the 2022 Sample Adult interviews were conducted at least partially by telephone (14). For more information about the NHIS, visit: https://www.cdc.gov/nchs/nhis.htm.

Point estimates and their corresponding variances were calculated using SAS-callable SUDAAN software (15) to account for the complex sample design of NHIS. Differences between percentages were evaluated using two-sided significance t tests at the 0.05 level. Test for trends were evaluated using logistic regression. All estimates in this report met National Center for Health Statistics standards of reliability (16).

About the authors

Robin A. Cohen and Lauren Bottoms-McClain are with the National Center for Health Statistics, Division of Health Interview Statistics.

References

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11. National Center for Health Statistics. National Health Interview Survey: 2019 survey description. 2020.
12. U.S. Census Bureau. Poverty thresholds.
13. National Center for Health Statistics. Multiple imputation of family income in 2022 National Health Interview Survey: Methods. 2023.
14. National Center for Health Statistics. National Health Interview Survey: 2022 survey description. 2023.
15. RTI International. SUDAAN (Release 11.0.3) [computer software]. 2018.
16. Parker JD, Talih M, Malec DJ, Beresovsky B, Carroll M, Gonzalez JF Jr., et al. National Center for Health Statistics data presentation standards for proportions. National Center for Health Statistics. Vital Health Stat 2(175). 2017.

Suggested citation

Cohen RA, Bottoms-McClain L. Dental care among adults age 65 and older: United States, 2022. NCHS Data Brief, no 500. Hyattsville, MD: National Center for Health Statistics. 2024. DOI: https://dx.doi.org/10.15620/cdc/151928.

Copyright information

All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

National Center for Health Statistics

Brian C. Moyer, Ph.D., Director
Amy M. Branum, Ph.D., Associate Director for Science

Division of Health Interview Statistics

Stephen J. Blumberg, Ph.D., Director
Anjel Vahratian, Ph.D., M.P.H., Associate Director for Science