Abstract
ObjectivesWe investigated the factors associated with no dental visit within the last two years by adolescents in the state of São Paulo, Brazil, by using data from the Oral Health Conditions of São Paulo state population Project (SBSP-2015) conducted in 2015.MethodsThis was a cross-sectional epidemiological study with a representative sample of adolescents aged 15 to higher years residing in São Paulo State. The examiners were calibrated and dental visits were measured categorically as 1- Less than 1 year, 2- One to two years, 3 - Three years or more, 4- I have never visited the dentist. Based on the literature we dichotomized the outcome in two groups: response 1 plus 2 against response 3 plus 4. Then, Multilevel Poisson Regression (MPR) was used to estimate the prevalence ratios of last dental visit three years or had never been to a dentist by adolescents compared with those who had visited the dentist within the past two years, with contextual variables as the distal level; sociodemographic variables, mesial; and individual variables, proximal level.ResultsA high percentage of adolescents (84.9%) reported visiting the dentist in the last 2 years. Whereas, 626 (11.6%) had not visited the dentist for over 3 years and 188 (3.4%) had never been. A significantly higher proportion of females than males reported visiting the dentist in the past 2 years (p = 0.003). The oral and dental condition was reported as satisfactory by 4,350 respondents (80.6%), and when they accessed the health service, 2,286 (42.3%) went to the public service. Lower mean family income (1.62PR;95%CI;1.36–1.94); ≥ 1,000 inhabitant/Dental Surgeons (1.25PR;95%IC;1.03–1.56);male (1.26PR;95%CI; 1.11–1.43) non-Caucasian ethnicity (Mulatto:1.30PR;95%CI;1.13–1.50 and Black:1.58PR;95%CI;1.29–1.93); dissatisfaction with the oral health condition (1.20PR;95%CI;1.01–1.45),last visit to the public service versus private service (2.26PR; 95%CI;1.91–2.65) and presenting with periodontal disease in the form of dental calculus as the worst situation (1.38PR; 95%CI; 1.16–1.53) were associated with last visit to the dentist.ConclusionsA high proportion of adolescents had visited the dentist in the last two years. No dental visit within the last two years by adolescents were associated with contextual, health care system, sociodemographic, personal and oral health status, demonstrating that this is a complex phenomenon. Actions to promote regular dental visits by adolescents in Brazil should take these factors into consideration.
Highlights
Oral health is a basic human right and an important public health issue but is a neglected area of international health [1]
No dental visit within the last two years by adolescents were associated with contextual, health care system, sociodemographic, personal and oral health status, demonstrating that this is a complex phenomenon
Actions to promote regular dental visits by adolescents in Brazil should take these factors into consideration
Summary
Oral health is a basic human right and an important public health issue but is a neglected area of international health [1]. Studies have demonstrated that delaying visit to oral health services increases the risk of poor oral health outcomes [2,3,4,5]. Socioeconomic conditions, cost, and a number of individual factors have been identified as potential barriers to accessing dental care [6]. Dental health care services differ greatly among countries in terms of organization, accessibility, availability, and cost. Full dental health services are readily available through private or public systems [2]. In Brazil, the state offers universal coverage of health services, organized around providing a health care package to all citizens, without suffering financial hardship when paying for them [7]. Public health care is not one-size-fits-all and this fact is a barrier to the use of public oral health care services worldwide [7]
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