Trends in dental care utilisation among the elderly using longitudinal data from 14 European countries: A multilevel analysis
Open accessAbstract
Background: The use of dental care among older people is low compared to other forms of health care, with significant health consequences. However, the evidence on the extent to which countries’ welfare systems and socio-economic factors influence the uptake of dental care by older people is limited. This study aimed to describe trends of dental care utilisation, and to compare use of dental care with other types of healthcare services among the elderly, considering different socio-economic factors and welfare systems in European countries. Methods: Multilevel logistic regression analysis was performed using longitudinal data from four waves (between Wave 5 and 8) of the Survey of Health, Ageing and Retirement in Europe database, with a follow-up period of 7 years. The study sample included 20,803 respondents aged 50 years or older from 14 European countries. Results: The annual dental care attendance was the highest in Scandinavian countries (85.7%), however, improving trends of dental attendance was recognized in Southern and Bismarckian countries (p<0.001). The difference in use of dental care services between socio-economic groups was expanding over time regarding low- and high-income level and residential area. A more marked difference was observed between social groups in dental care utilisation compared to other forms of care. Income level and unemployed status had significant effect on forgoing dental care due to cost and unavailability. Conclusion: The observed differences between socioeconomic groups may highlight the health consequences of the different organization and financing of dental care. The elderly population could benefit from adopting policies aiming to reduce the financial barriers to dental care usage, especially in Southern and Eastern European countries.
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Some people only visit a dentist when they have problems, and this is more likely among people from more disadvantaged backgrounds.
“However, some people only visit a dentist when they have problems, and this is more likely among people from more disadvantaged backgrounds [3–5].”
From Layering perspectives: a structured approach to meaningful patient and public involvement and engagement in the RETURN dental trial (2026) · cites this paper as [4]
The Results (page not available in our copy) associate lower income, lower education and unemployment with less dental attendance, supporting the socioeconomic-disadvantage part. The paper does not establish that these people visit a dentist only when they have problems; its attendance measure does not distinguish problem-driven visits from routine visits. (LLM, conf=0.85)
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- Authors
- Kovács, N., Liska, O., Idara-Umoren, E. O., Mahrouseh, N., & Varga, O.
- Affiliations
- University of Debrecen (HU)
- Corresponding author
- Kovács, Nóra
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2023-06-09
- Volume
- 18
- Issue
- 6
- Pages
- e0286192
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC10256212
- OpenAlex
- W4379980749
- Cited by
- 18
- References
- 62
- Citations by year
- 2026: 9 · 2025: 6 · 2024: 2 · 2023: 1
- FWCI
- 5.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Nemzeti Kutatási, Fejlesztési és Innovaciós Alap (FI17198)
- Topics
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
- Keywords
- dental care utilization, older adults, welfare system, dental care financing, financial barriers to care, European comparison, Bismarckian welfare state
- MeSH terms
- Aged, Aging, Dental Care, Europe, Humans, Income, Socioeconomic Factors, Multilevel Analysis
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