{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T01:34:38Z","timestamp":1787794478403,"version":"build-2784847793"},"posted":{"date-parts":[[2026,2,9]]},"group-title":"Health Economics","reference-count":48,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"award":["Award P30AG066619"],"award-info":[{"award-number":["Award P30AG066619"]}],"id":[{"id":"https:\/\/ror.org\/049v75w11","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,17]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Age-specific disparities in dental care use continue to exist in the United States. The COVID-19 pandemic led to widespread delays in non-urgent dental care. This study provides national estimates of dental care use and examines associated factors for dental visits in the United States population before and during the COVID-19 pandemic.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods &amp; Data Source<\/jats:title>\n                  <jats:p>We used the nationally representative Medical Expenditure Panel Survey for the pre-COVID-19 years (2018-2019) and the COVID-19 years (2020-2021). We estimated yearly survey-weighted trends in the mean number of non-zero dental visits by age using an adapted Anderson Behavior and Dental Care Use conceptual model and Poisson regression, controlling for a comprehensive set of confounders across five domains of influence. Dental care visits were defined as visits to any dental care provider.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall analytic sample included non-institutionalized, community-living persons (unweighted n=6518, weighted N\u223c320 million), grouped by age as 0-17, 18-44, 45-64, 65-74, and 75+, present in all four years. The prevalence ratio (PR) for dental visits was slightly higher for ages 75+ than for ages 65-74 across 2018-2021, increasing from 1.73 (95% CI: 1.4, 2.1) to 1.84 (95% CI: 1.5, 2.3) to 2.13 (95% CI: 1.7, 2.7) from 2018 to 2020, then rebounding to near pre-pandemic levels in 2021 to 1.66 (95% CI, 1.3, 2.0). Associated factors during the COVID-19 pandemic years 2020-2021 that increased dental visits included dental insurance, high income, and having a usual source of care (p&lt;0.01).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Dental care use among older adults increased in 2021; however, it did not fully return to pre-pandemic levels.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Understanding disparities in associated factors for dental care use across all age groups is critical to improving dental practice, policy, and the provision of timely, high-quality care. Future research should investigate factors contributing to delays in dental care beyond the COVID-19 pandemic, including caries burden, decayed teeth, and tooth loss, particularly among older adults.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.02.07.26345812","type":"posted-content","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T03:00:10Z","timestamp":1770692410000},"source":"Crossref","is-referenced-by-count":2,"title":["Trends in Dental Care Visits Across the Lifespan Before and During the COVID-19 Pandemic in the United States: Implications for Practice and Policy"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1521-9809","authenticated-orcid":false,"given":"Preeti Pushpalata","family":"Zanwar","sequence":"first","affiliation":[{"name":"Center for Healthy Aging Behaviors and Longitudinal Investigations (CHABLIS), The University of Chicago, 5801 S Ellis Ave, Chicago IL 60637"},{"name":"Hopkins Economics of Alzheimer\u2019s Disease & Related Dementias, John Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Zare","sequence":"additional","affiliation":[{"name":"Health Policy and Management, John Hopkins Bloomberg School of Public Health, 750 E Pratt St., Baltimore, MD 21202"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kopal","family":"Mathur","sequence":"additional","affiliation":[{"name":"Center for Health and the Social Sciences (CHeSS), University of Chicago, 5841 S. Maryland Ave. Chicago IL 60637"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7392-8569","authenticated-orcid":false,"given":"Lyubov","family":"Slashcheva","sequence":"additional","affiliation":[{"name":"Apple Tree Dental, 2201 26th Ave NW, MN 55112"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6891-244X","authenticated-orcid":false,"given":"Bei","family":"Wu","sequence":"additional","affiliation":[{"name":"NYU Shanghai, & Ashman Department of Periodontology & Implant Dentistry; New York University, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026072103500740000_2026.02.07.26345812v2.1","unstructured":"American Dental Association. Aging and dental health. 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