Abstract
BackgroundPrompt dental service utilisation (DSU) is needed for the prevention and treatment of oral diseases, and it is therefore important to determine the facilitators and barriers of DSU. There is, however, scarce information available on DSU in Sudan. Therefore, this study aimed to investigate the prevalence and associated factors of DSU in a general population-based survey among 18–69 year-old persons in Sudan.MethodsCross-sectional nationally representative data of 7,722 18–69 year-old persons (36 years median age) from the 2016 Sudan Stepwise approach to surveillance (STEPS) survey were analysed. Using questionnaire, anthropometric and biochemical measures, predisposing, enabling and health and lifestyle factors of DSU were assessed. Multinomial logistic regression was conducted to estimate the predictors of DSU (> 12 months and past 12 months, with never DSU as the reference category).ResultsAbout two-thirds of the participants (64.6%) had never DSU, 22.0% had more than 12-month DSU, and 13.4% had past 12- month DSU. Among those who had ever DSU, the main reason for the last DSU was pain or trouble with teeth, gums, or mouth (66.9%), treatment or follow-up treatment 22.3%, and routine check-up treatment 5.0%. In adjusted multinomial logistic regression analysis, higher education (p < 0.001), urban residence (p < 0.001), screened for blood pressure (p < 0.001), raised total cholesterol (p < 0.05), poor SROH (p < 0.001), pain in teeth or mouth (p < 0.001), and not working because of teeth or mouth (p < 0.01) were positively and not knowing their household income (p < 0.01), high physical activity (p < 0.05), and having 20 or more teeth (p < 0.001), were negatively associated with both > 12 months and past 12 months DSU. Higher household income (p < 0.001), overweight/obesity (p < 0.05), using tooth paste (p < 0.001), and difficulty chewing (p < 0.001), were positively, and male sex (p < 0.01), and teeth cleaning twice or more times a day (p < 0.05), were negatively associated with > 12 months or past 12 months DSU.ConclusionMore than one in ten participants had past 12 months DSU and several factors were detected which could be targeted in intervention activities. Study findings suggest to improve oral health awareness, in particular stressing the relevance of regular dental check-ups, by using different modalities of oral health promotion.
Highlights
Oral diseases pose a major health burden globally causing pain, discomfort, disfigurement and even death, and are increasing in low- and middle-income countries [1]
About two-thirds of the participants (64.6%) had never dental service utilisation (DSU), 22.0% had more than 12-month DSU, and 13.4% had past 12- month DSU
Consistent with a number of previous research studies [14,15,16, 19, 22, 25], this study found a positive association between poor self-rated oral health (SROH), pain in teeth or mouth, oral health impact and DSU
Summary
Oral diseases pose a major health burden globally causing pain, discomfort, disfigurement and even death, and are increasing in low- and middle-income countries [1]. Other factors which influence dental attendance in Sudan include the lack of public funding for oral healthcare and dental insurance schemes to ameliorate the cost of care.” [2]. The National Health Insurance Fund (NHIF) covered 43.8% of the Sudanese population at the end of 2016 [8]. People who are not covered by health insurance have to pay user fees in public sector health facilities in Sudan [7]. The “utilization of outpatient dental healthcare is 63% higher for insured people than for the non-insured” in Sudan [7]. This study aimed to investigate the prevalence and associated factors of DSU in a general population-based survey among 18–69 year-old persons in Sudan
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