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Dental health care status, use, and insurance coverage among adults with chronic conditions: Implications for medical-dental integration in the United States



Background:

The authors examined potential benefits and difficulties in integrating oral health care and medical care for adults with chronic conditions (CCs).


Methods:

The authors used National Health and Nutrition Examination Survey 2009-2016 data to estimate crude (age- and sex-standardized) and model-adjusted estimates to examine the association between dental disease (severe tooth loss, untreated caries) and chronic disease (≥ 3 CCs, fair or poor health) and Medical Expenditure Panel Survey 2014-2016 data to estimate crude estimates of past-year medical and dental use and financial access according to CC status. Reported differences are significant at P < .05.


Results:

National prevalences of reporting fair or poor health and 3 or more CCs were both approximately 15%. Standardized prevalence of dental disease was notably higher among adults reporting CCs than those not reporting. After controlling for covariates, the magnitude of the association was substantially lower, although the association remained significant. Adults with CCs were approximately 50% more likely to report having a past-year medical visit and no dental visit than those not reporting CCs. Among adults reporting CCs, prevalence of having no private dental insurance and low income was approximately 20% and 60% higher, respectively, than that among adults not reporting CCs.


Conclusions:

Adults with CCs had higher prevalence of dental disease, past-year medical visit and no dental visit, and limited financial access.


Practical implications:

Medical visits may be the only opportunity to provide dental education and referrals to adults with CCs. Improved medical-dental integration could improve oral health care access and oral health among these adults who are at higher risk of dental disease.


Keywords:

Medical and dental integration; caries; tooth loss.



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