Oral Health - Factors of Non-Adherence to Dental Vouchers: A Case-Control Study

Abstract

A dental voucher was created to facilitate the access to oral health care, however the use of these vouchers, by students aged 7, 10 and 13 with dental caries from state schools within the geodemographic area covered by the Community Health Center Group of Western Lisbon and Oeiras, had a low uptake (23%, school year 2014/2015) The aim of this study was to examine the factors associated with this non-use. A case-control study was carried out involving 270 students (135 cases and 135 controls) from 35 state schools who agreed to participate in the study. A descriptive analysis of the reasons for non-adhesion to the voucher, and a study associating the variables and the use/non-use of the dental vouchers using bivariate and multivariate statistical analysis was made adopting a significance of 0.05. The main reasons for non-use (n = 135) were the use of private dentists outside the dental voucher scheme (23.7%) and forgetting to use the vouchers or exceeding the expiry date (21.5%). The main factor associated with the non-use was students having a private dentist (OR adjusted 2.004, p = 0.012; IC 95%: 1.176 - 3.413) and the main factor associated with the use was having information of dentists accepting dental vouchers (OR adjusted 0.096, p = < 0.001; IC 95%: 0.047 - 0.198). Our findings highlight the need to improve the accessibility to dental vouchers. It is hoped that the identification of these factors will contribute in the planning of strategies and activities to improve the use of dental vouchers.