Barriers and Facilitators of Dental Care in African-American Seniors: A Qualitative Study of Consumers’ Perspective

Abstract

Objective: To identify African-American seniors’ perceptions of the barriers and facilitators to their dental care. Materials and Methods: In this cross-sectional qualitative study, we conducted in-depth interviews with 16 community-based, self-identified African-American seniors from March 2017 to August 2017 in Oregon. We coded data in ATLAS.ti and used thematic analysis to identify emergent themes within the social ecological framework and a cross-case comparative analysis to explore variation by participant characteristics. Results: Regardless of dental insurance status, cost and perceived urgency of treatment were the primary drivers of participant’s ability and interest in seeking dental care. Participants identified four solutions to improve oral health care in African-American seniors: affordable/free care and vouchers for dental work, better oral health education at a younger age, onsite community dental services, and navigators who can educate patients about insurance and dental providers who see low-income patients. Conclusions: Oral health decisions by African-American seniors were primarily driven by cost and perceived urgency irrespective of insurance coverage. Affordable dental care, early intervention, on-site services, and navigation may help to address key barriers and reduce oral health disparities faced by African-Americans.

Use of oral health care services among older home care clients in the context of an intervention study

“…Bakker et al [50] reported that among 1622 community-dwelling older persons aged ≥75 reporting oral pain, the robust ones mainly visited the dentist independently, while the frail and those with more complex care needs often required external support. Further, there are still many barriers to oral health care services, such as means of transportation, treatment costs, underestimation of dental health problems and challenges in accessing non-urgent dental treatment, such as the waiting time for comprehensive treatment [51][52][53][54][55].…”