Access to dental care remains unequal among older adults, particularly those with limited income. This study examined the impact of dental insurance coverage on both dental service utilization and self-reported oral health in seniors. The analysis also explored how these effects differed by income level. Data were drawn from the 2017/18 Canadian Community Health Survey (CCHS) Annual Component, including 10,030 individuals aged 65 and above living in Ontario. Marginal effects were estimated using multivariate probit regression models to quantify the influence of dental insurance on dental visits and oral health indicators. Seniors with dental coverage were 6.9% more likely to report excellent or very good oral health (ME: 6.9, 95% CI: 5.4–8.3) and 3.5% more likely to report no dietary restrictions due to oral problems (ME: 3.5, 95% CI: 1.9–5.1). The likelihood of visiting a dentist within the last year increased by 11.3% (ME: 11.3, 95% CI: 9.8–12.8), while the probability of seeking dental care only for emergencies decreased by 11.2% (ME: −11.2, 95% CI: −12.5 to −9.9). Across income categories, middle-income seniors experienced the largest changes, with a 13.1% higher probability of annual dental visits (ME: 13.1, 95% CI: 10.5–15.7) and a 14.4% reduction in emergency-only visits (ME: −14.4, 95% CI: −16.0 to −12.8). Dental insurance coverage is associated with increased dental service use and improved oral health outcomes among older adults. Policy interventions expanding coverage could reduce oral health disparities in this population.
