1. Utilization and Expenditures for Dental Services Among the Elderly Larry Meskin Jack Brown Santa Fe Group, June 28, 2007

2. Note: The percentages are of the total population. Populations with Significant Barriers to Access to Dental Care are in Red Boxes

3. Size of the Elderly Population

4. U.S. Elderly by Age, 1900-2030 (in Millions) 65+ in the United States, 2005, U.S. Depts. of HHS & Commerce 3.1 3.9 4.9 6.6 9.0 12.3 16.6 20.1 25.6 31.2 35.0 40.2 54.6 71.5

5. Number (in Millions) & Percent of Total Population By Race/Ethnicity, 2000 & 2030 White-NHBlack-NHAll Other RacesAsianHispanic (Any Race) 2000 2030

6. Number (in Millions) & Percent of Total Elderly By Race/Ethnicity, 2000 & 2030 White-NHBlack-NHAll Other RacesAsianHispanic (Any Race) 2000 2030

7. Economic Status of the Elderly

8. Percent of Elderly Below Federal Poverty Level, Gender and Race/Ethnicity, 2003 U.S. Census Bureau

9. Net Worth With and Without Home Equity, by Age, 2000 65-6970-7475+ Overall Median Median Net Worth $114,050$120,000$100,100 Excluding Home Equity $27,588$31,400$19,025 Bottom Quintile Median Net Worth $32,000$43,230$46,266 Excluding Home Equity $2,900$2,885$4,000 Top Quintile Median Net Worth $449,800$452,992$569,000 Excluding Home Equity $237,925$272,681$414,369 U.S. Census Bureau

10. General Health and Living Arrangements Among the Elderly

11. Living Arrangements of the Non-Institutionized Elderly, by Race/Ethnicity and Gender, 2000 Men Women SpouseRelativesNon-relativesAloneLiving with

12. Number and Percent of Elderly Living in Nursing Homes, 1990 & 2000 19902000 Number of Elderly 1,772,0321,720,500 Percent of Elderly 5.7%4.9% Percent of U.S. Population 0.71%0.61%

13. Percent of Elderly in Nursing Homes, by Age and Gender, 1999 National Health and Nutrition Examination Survey, 2004

14. Trends in DMFT Among the Elderly

15. Change in DMFT by Age and Gender, 1971-74 & 1999-2004 3.8 7.8 10.5 12.9 14.5 14.8 15.4 15.8 16.4 17.5 18.0 18.6 1.01.1 4.3 8.7 11.1 13.7 15.4 16.7 16.5 17.1 17.8 17.7 19.5 18.4

16. Edentulism Among the Elderly

17. Percent Edentulous Among Elderly (65+), by Race/Ethnicity, 1999-2004 National Health and Nutrition Examination Survey, 2004

18. Percent Edentulous, by Age and Income, 1999-2004 National Health and Nutrition Examination Survey, 2004

19. Utilization of and Expenditures for Dental Services Among the Elderly

20. DMFS Versus Fluoridated Communities* 2 3 4 5 6 7 8 1967197119751979198319871991199519992003 DMFS 20% 30% 40% 50% 60% 70% 80% %Fl Baby Boom Gen X Gen Y * Decayed, Missing or Filled Surfaces, Children aged 5-17, NIDCR; Percent of population residing in fluoridated communities, ADA

21. Percent with a Visit to a Dentist During the Previous Year, By Age and Race NCHS, Health Interview Survey, 2005

22. Percent with a Visit to a Dentist During the Previous Year, By Hispanic NCHS, Health Interview Survey, 2005

23. Percent with a Visit to a Dentist During the Previous Year, By Income NCHS, Health Interview Survey, 2005

24. Multivariate Analysis of Utilization of Dental Services by the Elderly

25. Percent with a Visit During the Previous Year, By Selected Factors - Dentists & Physicians Ins No Yes Gender MMMM Age 75-84 Inc High Educ S Coll Race B-NHW W Dentate YYNA No Yes MMMM 75-84 Poor S HS B-NHW W YYNA

26. Percent with a Visit During the Previous Year, By Selected Factors - Dentists & Physicians Ins No Yes Gender MMMM Age 75-84 Inc Hi Educ S Coll Race WWWW Dentate NYNA No Yes MMMM 75-84 Poor S HS WWWW NYNA

27. Percent with a Visit During the Previous Year, By Selected Factors - Dentists & Physicians Ins No Yes Gender MMMM Age 75-84 Inc PoorHighPoorHigh Educ No HSS CollNo HSS Coll Race B-NH Dentate NYNA No Yes MMMM 75-84 PoorHighPoorHigh No HSS CollNo HSS Coll W-NH NYNA

28. Types of Dental Services Received by the Elderly

29. Distribution of Dental Services: All Ages, 2005-06

30. Distribution of Dental Services: 65-74 Year-olds, 2005-06

31. Distribution of Dental Services: Aged 75+, 2005-06

32. Percentage of Various Services Received by Elderly, Aged 65+, 2005-2006

33. Percent with a Visit by Type of Procedure By High, Middle, Low Incomes, 65 + MEPS 2004

34. Percent with Dental Visit by Type of Procedure, All Ages and Elderly MEPS 2004

35. Percent with a Visit by Type of Procedure Black/Hispanic 65 + -- 1996 & 2004 MEPS 1996 & 2004

36. Expenditures & Source of Payment for Dental Services Among the Elderly

37. Percentage Distribution of Expenditures, By Type of Procedure, 2005-2006 - All Ages

38. Percent of Expenditures and Procedures, By Type of Procedure, 2005-2006 – 65+

39. Total Real Charges (2004$) for Dental Services, By Age and Source of Payment, 1996 & 2004 $669 $760 $693 $674 55-64 65+ Medical Expenditure Panel Surveys