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Health Econ. 2019 Sep;28(9):1151-1158. doi: 10.1002/hec.3921. Epub 2019 Jul 2.

The demand for preventive and restorative dental services among older adults.

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Department of Economics, Lehigh University, National Bureau of Economic Research, Cambridge, Massachusetts.
Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland.
Department of Economics, Lehigh University, Bethlehem, Pennsylvania.
University of Maryland School of Dentistry, Baltimore, Maryland.


Many older Americans have poor access to dental care, resulting in a high prevalence of oral health problems. Because traditional Medicare does not include dental care benefits, only older Americans who are employed, have post-retirement dental benefits or spousal coverage, or enroll in certain Medicare Advantage plans are able to obtain dental care coverage. We seek to determine the extent to which poor access to dental insurance and high out-of-pocket costs affect dental service use by the elderly. Using the 2007-2015 Medical Expenditure Panel Survey and supplemental data on dental care prices, we estimate a demand system for preventive dental services and basic and major restorative services. Selection into dental and medical insurance is addressed using a correlated random effects panel data specification. Consistent with prior studies of the nonelderly population, dental service use was not sensitive to out-of-pocket prices. However, private dental insurance increased preventive service use by 25%, and dental coverage through Medicaid increased basic and major service use by 23% and 36%, respectively. The use of services was more responsive to dental insurance for women than men. These estimates suggest that a Medicare dental benefit could significantly increase dental service use by older Americans.


Medicare; dental insurance; dental services; dual-eligible; health care demand

[Available on 2020-09-01]

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