Social Capital and Dental Service Utilisation Among Japanese Older Adults: A Multilevel Longitudinal Study Using the Japan Gerontological Evaluation Study ( JAGES ) Data

INTRODUCTION: Social capital is an important social determinant of health linked to oral health and health-related behaviours. Several studies assessed its association with dental service utilisation; however, findings remain inconsistent. This study aimed to examine the association between individual- and community-level social capital and dental service utilisation within the past 12 months among Japanese older adults. METHODS: This longitudinal study utilised self-report data from the Japan Gerontological Evaluation Study in 2019 and 2022. Individual-level civic participation, social cohesion, and reciprocity were assessed and aggregated to community-level using factor analysis. The outcome was dental service utilisation (preventive, treatment, and overall dental visits). Multilevel Poisson regression analysis was used to examine their associations. RESULTS: The mean age of 11,642 participants from 48 municipalities was 73.8 years (range: 65-95), and 51.4% were female. Participation in three or more civic groups was associated with 22%, 12%, and 16% higher likelihood of preventive (prevalence ratio [PR] = 1.22, 95% confidence interval [CI] = 1.15-1.30), treatment (PR = 1.12, 95% CI = 1.06-1.18), and overall visits (PR = 1.16, 95% CI = 1.10-1.22), respectively. Higher community-level civic participation was positively associated with preventive (PR for the highest tertile group = 1.20, 95% CI = 1.02-1.42), treatment (PR = 1.11, 95% CI = 1.02-1.21), and overall visits (PR = 1.13, 95% CI = 1.03-1.24). CONCLUSION: Individual- and community-level civic participation was positively associated with dental visits. Promoting civic participation could improve utilisation of dental care by older adults.