title: Dental service mix among older adults aged 65 and over, United States, 1999 and 2009.
abstract: OBJECTIVE
  The oral health of older Americans will assume increasing importance because of their increasing numbers and the evolving connections between oral health and general health. To establish a baseline and provide data for oral health workforce models, this report describes the types of dental procedures received by US adults 65 years and older in 2009 and looks at trends since 1999.
  
  
  METHODS
  Data for this analysis came from the 1999 and 2009 Medical Expenditure Panel Survey. The primary outcome variable represented the types of dental procedures that were received during a dental visit in the preceding year. Descriptive variables included dental insurance and poverty status. Analysis was restricted to adults aged 65 and over.
  
  
  RESULTS
  In 2009, diagnostic and preventive procedures accounted for almost three-quarters of all services. Compared with services received by those with private insurance, there were significantly fewer diagnostic and endodontic procedures among those with public coverage. Between 1999 and 2009, the proportion of preventive services significantly increased, whereas the proportion of restorative and endodontic services significantly decreased. Also, the likelihood of receiving preventive procedures increased, whereas the probability of receiving restorative or endodontic services decreased.
  
  
  CONCLUSIONS
  Findings point to a shift in the mix of dental services received by older adults during the two periods. The predominance of diagnostic and preventive procedures has important access and workforce implications. An expanded role for dental hygienists in helping to meet the oral health needs of older adults is possible given a hygienist's current scope of practice.
authors.affiliation: Dental Public Health, University of Maryland School of Dentistry, Baltimore, MD, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Manski
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Cohen
authors.forename: Erwin
authors.initials: E
authors.lastname: Brown
authors.forename: Kelly V
authors.initials: KV
authors.lastname: Carper
authors.forename: Clemencia
authors.initials: C
authors.lastname: Vargas
authors.forename: Mark D
authors.initials: MD
authors.lastname: Macek
mesh_terms: D000368:Aged; D003752:Dental Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007347:Insurance, Dental; D011203:Poverty; D014481:United States
keywords: United States; dental care; dental insurance; health-care surveys; older adult; poverty