title: Functional health and dental service use among older adults.
abstract: BACKGROUND
  Although socioeconomic barriers to receiving adequate dental care have been well documented, physical frailty as a risk factor for not visiting the dentist has not been fully explored. This study prospectively examines the relationship between functional health and dental service use, taking into account sociodemographic characteristics, general and dental health status, and prior dental utilization behavior.
  
  
  METHODS
  Data from a randomized trial of a comprehensive geriatric assessment and prevention program in community-dwelling adults age 75+ years living in Santa Monica, CA, collected between 1988 and 1993, were analyzed. A series of discrete-time proportional hazards models were used to assess the effects of functional status, sociodemographic characteristics, and general health and dental health measures on dental service use.
  
  
  RESULTS
  Functional status was negatively associated with dental service use, and the conditional probability of a first visit to the dentist after baseline decreased over time. When additional measures of general health, dental health, and socioeconomic status were introduced, the effect of functional status was mitigated but remained significant. In the most fully specified model, which took dental visitation behavior prior to the beginning of the study into account, the effect of functional limitation remained significant.
  
  
  CONCLUSIONS
  Even in this relatively well-educated group of older persons with higher than average dental service use, impaired functional status was associated with lower levels of dental service use over time.
authors.affiliation: Department of Community Dentistry, University of Florida College of Dentistry, Gainesville 32610-0405, USA. tdolan@dental.ufl.edu
authors.forename: T A
authors.initials: TA
authors.lastname: Dolan
authors.forename: C W
authors.initials: CW
authors.lastname: Peek
authors.forename: A E
authors.initials: AE
authors.lastname: Stuck
authors.forename: J C
authors.initials: JC
authors.lastname: Beck
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D003729:Dental Care / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010352:Patient Dropouts; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic