Background Older adults with functional disabilities experience challenges accessing dental care, yet the role of sex as an effect modifier of disability-related access barriers remains underexamined in Canada. The implementation of the Canadian Dental Care Plan (CDCP) creates an urgent need for pre-policy baseline evidence to guide targeting and evaluation. Methods This cross-sectional study investigates whether sex affects the relationship between functional difficulty (used here as a broad proxy for disability) and three aspects of dental care access among Canadian adults 65+: cost-related visit and treatment avoidance, and emergency-only or no dental visits. Analyzing 23,967 Canadian Community Health Survey (CCHS) 2022 participants, disability was defined as having at least some difficulty in one or more functional domains. Survey-weighted logistic regression estimated adjusted odds ratios, controlling for income, dental insurance, Indigenous identity, and immigration. Functional difficulty-by-sex interactions were tested, and predicted probabilities calculated using marginal means. Results Functional difficulty was linked to higher odds of access barriers: dental visit avoidance due to cost (OR 1.58), dental treatment avoidance due to cost (OR 1.59), and emergency-only or no dental visits (OR 1.60), all p 0.001, even after adjusting for income and insurance. No significant functional difficulty-by-sex interactions were detected, with a consistent 7–8 percentage point disability gap in cost-related avoidance for both sexes. Women had lower odds of emergency-only or no dental visits (OR 0.68, p 0.001). Dental insurance was the strongest protective factor, and immigration increased cost-related visit and treatment avoidance (OR 1.58 and 1.39, respectively). Conclusion Functional difficulty was linked to reduced access across all three outcomes, with little evidence of differences between male and female groups. These findings support inclusive accommodation strategies within the CDCP and suggest monitoring sex-related differences in emergency-only or no dental visits during implementation and evaluation.
Menon et al. (Tue,) studied this question.