Older adults in the United States with lower education or incomes near the poverty line were substantially less likely to visit a dentist in 2022, according to a cross-sectional analysis of national survey data published in Frontiers in Oral Health. The study, based on the 2022 Medical Expenditure Panel Survey (MEPS), also found that private dental insurance was associated with both more frequent use and higher spending on dental services among adults aged 65 and older.
The research team, led by Maryam Alfayyadh of UNT Health Fort Worth with colleagues at Temple University, examined how five social determinants of health—education, poverty level, marital status, dental insurance coverage, and geographic region—related to dental care utilization and expenditures among noninstitutionalized older adults.
The analysis showed that 52.5 percent of older adults reported at least one dental visit in 2022, and average expenditure among those who used dental care was $1,016. The investigators used a two-part statistical model: multivariable logistic regression estimated the likelihood of any dental visit, while a generalized linear model with a log link and gamma distribution assessed total expenditures among users. Marginal effects were calculated to estimate the combined impact of each factor.
The socioeconomic gradients were pronounced. Older adults with lower education had 0.25 times the adjusted odds of a dental visit compared with their more educated counterparts (adjusted odds ratio 0.25; 95 percent confidence interval 0.18 to 0.35), and living in poverty was associated with 0.51 times the odds (95 percent CI 0.38 to 0.69). In expenditure terms, lower education was linked to $161 less in dental spending and poverty to $303 less among users.
Insurance coverage moved in the opposite direction. Private dental insurance was associated with higher utilization, with an adjusted odds ratio of 1.76 (95 percent CI 1.42 to 2.17), and with $157 greater expenditures among those who used care. The authors note that these cross-sectional associations describe differences between groups in a single year and cannot establish that any single factor causes the observed patterns.
The study’s scope carries important limitations. The MEPS sample covers only noninstitutionalized adults, so older adults in nursing homes or other institutions—populations with often severe unmet dental needs—are not represented. As an observational analysis of self-reported survey data, the findings reflect associations measured in 2022 rather than longitudinal changes over time, and unmeasured factors may contribute to the observed differences.
The authors conclude that structural socioeconomic factors remain strongly associated with dental care access and financial burden among older adults, and they argue the findings support policies that integrate oral health into Medicare and broader national strategies to improve access and outcomes. For the roughly half of older Americans who did not see a dentist in 2022, the data suggest that the divide runs along familiar socioeconomic lines.
Subject of Research: Social determinants of health and dental care utilization and expenditures among older adults in the United States
Article Title: The association of social determinants of health with dental care use and expenditures among older adults in the United States
Article References: Alfayyadh, M., Patel, J. S., Zanwar, P. P., & Sambamoorthi, U. (2026). The association of social determinants of health with dental care use and expenditures among older adults in the United States. Frontiers in Oral Health, 7, Article 1870576. https://doi.org/10.3389/froh.2026.1870576
Image Credits: AI Generated
DOI: 10.3389/froh.2026.1870576
Keywords: dental care utilization, older adults, social determinants of health, Medicare, dental insurance, health expenditures, health disparities, MEPS, oral health, United States, association, social
News Source: Courtney Benton. (October 29, 2026). Poverty and Low Education Linked to Lower Dental Care Use Among Older Americans. Scienmag.
