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<b>Background:</b> Oral pathology (e.g. caries, periodontal disease, edentulism) contributes to poor overall health and negatively impacts quality of life. Ageing increases susceptibility to oral diseases and poor oral health is common among older adults. In contrast, dental attendance is low among this group. This descriptive study aims to examine dental utilisation patterns among older adults in Flanders, Belgium. <b>Methods:</b> The study included all members from the two largest Belgian healthcare insurance funds aged 65 and older, residing in Flanders (Belgium). Descriptive and bivariate analyses were performed with dental utilisation patterns as main outcome and socio-demographic data, care dependency and oral status as covariates. Statistical analysis was performed using chi-square tests, with effect sizes calculated using Cramér's V. <b>Results:</b> Data from 911,159 older adults were analysed. Between 2020 and 2022, preventive care was regularly received by 36.8% of the participants, 37.0% had no contact with an oral health professional and 21.9% only received curative care. Lower utilisation of preventive care was observed in the following groups: the oldest-old (Cramér's V = 0.136), individuals having an increased reimbursement (Cramér's V = 0.171), residents of long-term care facilities (Cramér's V = 0.090), recipients of domiciliary nursing care (Cramér's V = 0.121), and edentulous older adults (Cramér's V = 0.362). <b>Conclusion:</b> A significant proportion of older adults did not attend a dentist or only received curative care. Further research is needed to investigate whether health promotion campaigns and enhanced collaboration among health professionals can motivate these older adults to engage in preventive oral care.