Title: 0355 - African American Seniors’ Perspectives on Dental Care: A Qualitative Study


Richie Kohli (Presenter)
Oregon Health & Science University

Sonya Howk, Oregon Health & Science University
Melinda Davis, Oregon Health & Science University


Objectives: To identify African American seniors’ perspectives on barriers and facilitators to their dental care.

Methods: In this cross-sectional qualitative study, we conducted in-depth interviews with 16 community-based, self-identified African-American seniors from March 2017-August 2017 in Oregon. We 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: Mean participant age was 70.8 years and 75% (n=12) were female. Mean annual income was $32,000. All participants had Medicare health insurance. Nine participants (56%) had no dental insurance; seven participants with dental insurance had coverage through Medicaid (n = 4, 25%) or private plans (n = 3, 19%). Ten themes emerged that shaped dental seeking behavior and obtaining dental care for African American seniors within two broad clusters: 1) individual and relational/community factors included presence of dental emergency; attitudes towards dental health; delaying treatment; past dental experiences; source of dental education; previous exposure to preventive oral health programs; and 2) macro-environment factors included bureaucracy of insurance; understanding of payment mechanisms; cost driving dental care decisions; dental provider characteristics. 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: dentists provide affordable or free (reduced cost) services; better oral health education at a younger age; onsite community dental services for seniors; and navigators to educate about insurance payment options and to connect with dental providers who see low-income patients.

Conclusions: Oral health decisions by African-American seniors are primarily driven by cost and perceived urgency. Early intervention, affordable dental care, on-site services and navigation support solutions proposed by African Americans may help to reduce their oral health disparities.

This abstract is based on research that was funded entirely or partially by an outside source:
Medical Research Foundation

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: None