Association between chronic conditions and oral health services utilization in older Peruvian adults: A pooled analysis of the Demographic and Health Survey 2015-2017

Abstract

Objectives. To investigate the association between chronic conditions (CCs) and oral health services utilization (OHSU) within the previous six months in older Peruvian adults (defined as a person 60 years of age or more according to Peruvian Law). Methods. An analytical cross-sectional study was performed based on the 2015-2017 Peruvian Demographic and Family Health Survey (ENDES). Pooled dat a from 13,699 older adults were analyzed. A logistic regression model was used to analyze the association between OHSU (dependent variable) and CCs (independent variable). Tobacco consumption, obesity, educational level, age, sex, welfare quintile, area of residence, having health insurance and natural region of residence were included as covariates in the analysis. Results. The frequency of OHSU in old r adults was 18.5% (95% CI 17.8%-19.3%). The highest percentage point differences with regards to O SU were found between extreme categories of educational level (higher education vs. none or elementary school: +24.8) and welfare quintile (richest vs. poorest: +24.0). In the crude model, OHSU was associated with diabetes (OR 1.46; 95% CI: 1.26-1.69), but this association disappeared after adjustment for covariates. Meanwhile, depression decreased the likelihood of OHSU (OR 0.82; 95% CI: 0.72-0.95) in the adjusted model. Conclusions. The frequency of OHSU is low in older Peruvian adults. Regarding CCs, we found that depression independently decreased the likelihood of OHSU in the adjusted model of analysis. Our results may be useful for the development of policies aimed at achieving greater OHSU in older adults with CCs, especially in those with depression.

Impact of the COVID-19 pandemic on the timing of dental care in elderly peruvians

“…It should also be considered that there is a gradient associated to receiving oral health care according to socioeconomic level, where older adults with lower purchasing power have a low probability of receiving dental services, as reported by Carbajal-Rodriguez et al 10 . Similarly, Azañedo et al reported that at national level, the use of dental health services decreased with age, which could be due to complications related to aging, such as difficulties in mobility, functional dependence and possible compromise of social skills for communication 17 . That is why, with the aim of contributing to improving the comprehensive health and quality of life of people aged 60 years and older, the Peruvian Ministry of Health designed the "Peru Smiles” plan, whose implementation period is from 2019 to 2022, to provide oral rehabilitation through complete dental prostheses for older adult beneficiaras 18 .…”

“…Similarly, an investigation with secondary information on Peruvian adults aged 60 years and older indicated a low frequency of dental care for this age group, noting that the Wealth Index factor determined differences in its use. Likewise, it is mentioned that at national level, oral rehabilitation treatments are not included in programs such as Universal Health Insurance 26 , 17 . Scientific evidence suggests that oral health is deficient in older adults, who have high prevalence of caries, periodontal disease and high number of missing teeth, leading to complications in the functions of the oral cavity, as well as contributing directly to worsening comorbidities 27 .…”

Oral Health Status of Older Adults in the Americas

“…The earliest oral health evaluation among older adults in Latin America (81) reported 25% utilization rates across the region. Two decades later, a study in Peru (2015-2017) among adults 60 years and older reported a lower rate (18.5%) but within a six-month time frame (82).…”

Situación de la salud bucodental de las personas mayores en la Región de las Américas

“…En la primera evaluación de salud bucodental en personas mayores de América Latina (81) se encontraron tasas de utilización del 25% en toda la región. Dos décadas más tarde, en un estudio sobre el período 2015-2017 realizado en las personas de 60 años o más en Perú, se encontró una tasa más baja, del 18,5%, pero en un plazo de seis meses (82). En este estudio, se encontró una asociación entre un mayor nivel de educación y las consultas odontológicas.…”