Trends in Dental Treatment Patterns Among Older Adults in the Era of Long‐Term Care Insurance in Korea: An Analysis of the NHIS ‐Senior Database

OBJECTIVES: To compare dental utilization and treatment patterns among LTCI recipients and non-recipients over the 5-year period following the expansion of national dental coverage in South Korea. METHODS: Using the National Health Insurance Service-Senior 2.0 database (2015-2019), we performed propensity score matching (1:3) to balance sociodemographic covariates between LTCI recipients (n = 170,407) and non-recipients (n = 486,788). Annual dental utilization rates, frequency of visits, and seven individual dental treatment types were compared using the compound annual growth rate (CAGR). RESULTS: Dental utilization rates increased in both groups, but a persistent gap of 17% remained (LTCI recipients: 29.5% vs. non-recipients: 46.9% in 2019). Both groups exhibited a shift towards more complex, higher-cost prosthetic treatments, as evidenced by a sharp decline in resin-based dentures and a corresponding increase in metal-based complete dentures and dental implants. However, the absolute utilization rate of dental implants in 2019 was 1.7 times higher in non-recipients than in LTCI recipients (14.4% vs. 8.3%, p < 0.001), indicating persistent disparities in access to complex dental care. Meanwhile, partial denture and extraction rates remained stable without significant differences between the groups. Notably, the continuous decline in endodontic treatments despite stable extraction rates among LTCI recipients suggests potential silent unmet needs. CONCLUSIONS: Despite expanded coverage, LTCI recipients face significant, persistent disparities in quantitative and qualitative dental accessibility. The lower utilization of complex care suggests the need for home-visit dental services and prevention-oriented fee structures tailored to the frail older adults within the community integrated care framework.