A Claims-Based Study of Utilization of Dental Services among Adults 65 and Older

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Recorded On: 10/01/2020

Although adults age 65 and older spend more on dental care than other age groups, 70 percent lack dental coverage, and many lose their dental insurance after retirement. Furthermore, Medicare does not cover or reimburse most routine dental services. As a result, high out-of-pocket costs and a lack of price transparency impede timely dental care for older adults: In 2018, over half of adults age 65 and over in the United States reported that they had not visited the dentist in the past year, owing primarily to financial barriers. Without routine preventive dental services (e.g., dental cleanings), older adults can experience poor oral health and, concomitantly, poor general health. Untreated dental issues likewise can lead to increased usage of emergency departments (EDs); over two million individuals visit the ED for dental pain each year.

Drawing on the nation’s largest repository of private healthcare claims data, this session will present a claims-based analysis of utilization of dental services among adults 65 and older. The analysis will:

  • Examine trends in the utilization of preventive dental services and treatments (e.g., root canals, tooth extractions, scaling and root planing) among adults and compare them to those age 65 and older;
  • Identify trends in ED visits pertaining to dental diagnoses among this population compared to other age cohorts;
  • Explore trends in the dental claims data for older adults by gender and location; and
  • Analyze the rise of teledentistry services by region and gender.

Additionally, the session will illuminate the decline in dental service utilization during the COVID-19 pandemic in adults age 65 and older, and compare it to the decline in younger age cohorts. Individuals at risk of severe cases of COVID-19 were targeted for emergency dental care only, not preventive care, and those 65 and older were considered at risk.

FAIR Health looks forward to sharing our recent findings regarding older adults’ utilization of dental services, particularly amid the COVID-19 pandemic.

Robin Gelburd, JD


FAIR Health

Robin Gelburd, JD, is the president of FAIR Health, a national, independent nonprofit organization with the mission of bringing transparency to healthcare costs and insurance reimbursement. FAIR Health possesses the nation’s largest collection of private medical and dental claims data, which includes over 32 billion claim records contributed by payors and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. FAIR Health licenses data and data products to payors, providers, government agencies, researchers and others. The company also uses its database to power a free, award-winning website that enables consumers to estimate and plan for their healthcare expenditures, as well as learn more about healthcare reimbursement. Ms. Gelburd is a nationally recognized expert on healthcare policy, data and transparency.

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A Claims-Based Study of Utilization of Dental Services among Adults 65 and Older