title: Oral health and access to dental care - a comparison of elderly migrants and non-migrants in Germany.
abstract: To compare oral health, access barriers to dental care, oral health behavior and oral hygiene behavior of elderly German residents with and without immigration background.
  
  
  
  In this cross-sectional explorative study, a convenience sample (N = 112, age ≥ 60 years, 54% immigrants) was recruited in four dental practices in Hamburg, Germany. Oral health was assessed with Decayed/Missing/Filled Teeth (DMFT), Papillary Bleeding Index (PBI), and Approximal Plaque Index (API). Dental health was operationalized as number of decayed teeth, and poor oral hygiene based on a PBI ≥ 40%. Access barriers and oral health behavior were assessed with a standardized questionnaire.
  
  
  
  While caries experience was similar in migrants and non-migrants (DMFT mean: 24.8 vs. 23.4, n.s.), significantly more teeth were decayed (5.3 vs. 2.1, p < 0.001), and API (55.3% vs. 33.0%, p = 0.002) and PBI (46.3% vs. 30.5%, p = 0.016) were significantly higher in migrants. After adjusting for age, sex, income, education, and number of teeth, migrants still had on average 3 decayed teeth more than non-migrants. However, impact of migration background on poor oral health changed from OR = 3.61 (p = 0.007) to OR = 1.05 (n.s.) after adjusting for confounders, mainly due to lower income in migrants. Fewer migrants had visited a dentist within the past 12 months, and migrants were less likely to have a regular dentist that they visit and more often indicated language or cost barriers than non-migrants.
  
  
  
  Elderly German migrants have higher treatment needs than non-migrants. Likely causes are poorer oral hygiene and lower utilization of dental care services. Specific prevention programs targeting migrants are warranted to improve oral health in this disadvantaged group.
authors.affiliation: a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
authors.forename: Ghazal
authors.initials: G
authors.lastname: Aarabi
authors.affiliation: a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Reissmann
authors.affiliation: a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
authors.forename: Udo
authors.initials: U
authors.lastname: Seedorf
authors.affiliation: b Department of Medical Biometry and Epidemiology, Center for Experimental Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Becher
authors.affiliation: a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Heydecke
authors.affiliation: c Department of Medical Sociology, Center for Psychosocial Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kofahl
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003729:Dental Care / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000453:epidemiology; D003752:Dental Health Services; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D011795:Surveys and Questionnaires; D014171:Transients and Migrants
keywords: Oral health; dentistry; elderly; health care access; migrant