Socioeconomic and Geographic Inequalities in Dental Care Utilization Among Thai Older Adults: Trends and Determinants, 2009–2021

Background Despite Thailand’s universal healthcare coverage, socioeconomic and geographic disparities in dental care utilization persist, particularly among older adults. This study examines the trends and determinants of inequality in dental care use among older adults in Thailand (aged 60 and above) during the country’s transition to an aging society (2009–2021). Methods Nationally representative data from the Thailand Health & Welfare Survey (2009, 2015, 2021) were analyzed (N = 52,825 older persons). Dental care utilization was assessed via self-reported use in the past 12 months. Logistic regression identified determinants of inequality across socioeconomic, geographic, and health insurance factors. Results Persistent inequalities were observed in the socioeconomic status in the wealthiest quartile, having 2.4 times higher utilization than the poorest (OR = 2.4, 95% CI: 2.0–2.9). Concerning education, those with tertiary education were 6 times more likely to use dental care than those without formal schooling (OR = 6.0, 95% CI: 4.3–8.3). Among geographic disparities, Bangkok residents had 3 times higher utilization than rural Northeast populations. Additionally, Civil Servant Medical Benefit Scheme (CSMBS) beneficiaries were twice as likely to access care as Universal Coverage Scheme (UCS) enrollees (OR = 2.0, 95% CI: 1.8–2.3). Conclusions Despite Thailand’s universal healthcare system, dental care access remains unequal, disproportionately affecting low-income, less-educated, and rural older adults. Policy reforms, such as expanding rural dental services, integrating oral health into primary care, and reducing insurance-based disparities, are urgently needed to achieve equitable aging-in-place.