Document Type


Date of Degree

Fall 2016

Degree Name

MS (Master of Science)

Degree In

Dental Public Health

First Advisor

Daniel J. Caplan


OBJECTIVE: To establish baseline data of dental utilization and determine the predictors of receipt of dental procedures by Medicaid-enrolled senior adults who reside in Iowa nursing facilities.

METHODS: This was a longitudinal retrospective analysis of Iowa Medicaid claims data for SFY 2007-2014 of senior adults who were 68 years or older upon entry to a nursing facility and continuously enrolled (eligible 58 out of 60 months) in Medicaid for three years prior to and at least two years after admission.

RESULTS: Controlling for the subject and nursing facility level variables, the strongest predictor of dental utilization after entry was the receipt of a dental procedure before entry (p< 0.001). Subjects residing in a facility located in an urban area (p< 0.002) or in two regions of Iowa (p=0.035, p=0.019, respectively) also had increased odds of receiving a dental procedure.

CONCLUSION: Our results show that approximately 50% of the subjects never received a dental procedure in the 5-year study period. The strongest predictor of receipt of dental procedures in the 2 years after entry was the receipt of dental procedures in the 3 years before entry. It is important for Medicaid-enrolled senior adults to establish a dental home while community-dwelling.


dental utilization, frail elderly, preventive dental


xii, 87 pages


Includes bibliographical references (pages 80-87).


Copyright © 2016 Mary C. Kelly Grief