title: Use of dental services  throughout middle and early old  ages: a prospective cohort study.
abstract: OBJECTIVE
  Focusing on a Swedish 1942 birth cohort, this study describes the trend of dental health care utilization between age 50 and 65 and identifies major determinants of dental visiting habits using Andersen's model as adapted for dentistry as a theoretical framework.
  
  
  METHODS
  In 1992, a census of 50 year olds in two counties of Sweden was invited to participate in a longitudinal questionnaire survey. Of the total population of 8888 subjects, 6346 responded (71%). Of the 6346 subjects who completed the 1992 survey, 4143 (65%) completed postal follow ups in 1997, 2002 and 2007.
  
  
  RESULTS
  83.3% and 3.2% of the cohort remained stable with respect to use and nonuse of regular dental care. Cochran's Q test revealed that the proportions reporting regular use decreased from 93% at age 50-87% at age 65 (P < 0.001). Generalized estimated equations revealed the following covariates; gender (females), country of birth (native born), marital status (married), perceived quality of dental care (good perceptions), dental care utilization as a child, remaining teeth and perceived oral problems. The influence of the variable time, functioning as a measure of period/ageing, maintained a statistically significant relationship with regular utilization after adjusting for all covariates in the model.
  
  
  CONCLUSIONS
  Regular use of dental health care services decreased slightly but statistically significantly from age 50 to 65 and was most prevalent in socio-economically advantaged groups, among those with remaining own teeth, subjects who perceived oral problems and reported high quality dental care. The results have implications for planning of elderly dental health care and required dental workforce in Sweden and countries with similar welfare systems.
authors.forename: Anne N
authors.initials: AN
authors.lastname: Astrom
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ekback
authors.forename: Elwalid
authors.initials: E
authors.lastname: Nasir
authors.forename: Sven
authors.initials: S
authors.lastname: Ordell
authors.forename: Lennart
authors.initials: L
authors.lastname: Unell
mesh_terms: D000367:Age Factors; D000368:Aged; D003729:Dental Care / Q000592:standards / Q000706:statistics & numerical data*; D016321:Dental Care for Aged / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology