Dental Health Care Utilization Research Articles

Awareness and attitude towards dental coverage right affecting the dental service utilization among selected thais in Bangkok

Oral health problems are one of the most prevalent public health issues in Thailand. However, the rate of dental service utilization is relatively low despite having three major healthcare coverages provided for Thai citizens. Objectives: This study aims to investigate whether awareness about dental coverage affects the rate of dental care utilization and the attitude towards dental coverage compared across coverage types. Methods: A cross-sectional analytical study based on Bangkok, Thailand using a newly developed questionnaire to assess socio-demographic information, dental healthcare utilization, dental coverage, and attitude towards dental coverage. Convenience sampling was used. Population studied was Thai citizens of working age (above 15 years old). Paper-based questionnaire forms were handed out in public venues. Data was analyzed with chi-square analysis to assess whether the sociodemographic characteristics and awareness of dental coverage correlates with dental care service utilization. Logistic regression was used for multivariate analysis to determine which variables had more influence upon dental care utilization. ResultsA total of 315 participants were included for data analysis. Chi-square analysis showed that gender, age, occupation, education, income, and awareness of dental coverage and reported type of dental coverage were all significantly correlated to dental healthcare service utilization (p-value <0.05). Multivariate analysis revealed that gender, age, career, and income still affect utilization when put into a logistic regression model, while awareness was no longer significant in predicting utilization rate. ConclusionIn conclusion, sociodemographic factors that significantly affect dental care service utilization included age, gender, occupation, education and income. When weighted with other socioeconomic determinants of dental care utilization, awareness of dental coverage schemes did not have a significant prediction value.

Socioeconomic status is associated with dental healthcare utilization among Iranian breast cancer survivors

Background: Oral health conditions are a group of complications that are partially associated with breast cancer (BC) treatments. However, evidence on the sociodemographic risk factors of oral health conditions among BC patients is scarce. This study aimed to investigate the relationship between the socioeconomic status (SES) and dental health in a population of Iranian female BC patients in 2020. Methods: A cross-sectional study was conducted in Kerman, Iran. Indices of decayed, extracted, and filled teeth were measured based on clinical examination by a general dentist. Data were collected through structured face-to-face interviews, review of the patients’ medical records, and clinical examination for six months. Data were analyzed by applying univariate and multivariable generalized negative binomial regression (GNBReg). Data were analyzed using the Stata. Results: Data from 1760 BC patients were collected, 1707 of whom were included in the analysis. The mean age of the participants was 46.3±9.8 years. The mean of the total decayed, missing, and filled teeth, and the number of decayed teeth (DT), missing teeth (MT), and filled teeth (FT) were 12.8±5.8, 3.5±3.1, 4.6±5.2, and 4.6±4.4 teeth, respectively. Regarding SES, the number of participants with high, high-middle, low-middle, and low SES were 421, 432, 395 and 459, respectively. According to univariate analysis, there was no significant difference between different SES in mean DMFT (decayed, missing, and filled teeth), while SES was significantly associated with DT, MT and FT among the study participants. Conclusion: Female BC patients in Iran have lower levels of dental health regardless of their SES. As those from different socioeconomic classes are seeking different and mostly inadequate or unsuitable dental healthcare services, tailored interventional programs are needed to address the dental healthcare needs of patients in each socioeconomic class.

The impact of dental care programs on healthcare system and societal outcomes: a scoping review

BackgroundDental diseases have detrimental effects on healthcare systems and societies at large. Providing access to dental care can arguably improve health outcomes, reduce healthcare utilization costs, and improve several societal outcomes.ObjectivesOur objective was to review the literature to assess the impacts of dental care programs on healthcare and societal outcomes. Specifically, to identify the nature of such programs, including the type of services delivered, who was targeted, where services were delivered, and how access to dental care was enabled. Also, what kind of societal and healthcare outcomes have been attempted to be addressed through these programs were identified.MethodsWe conducted a scoping review by searching four databases, MEDLINE, EMBASE, CINAHL, and Sociological s. Relevant articles published in English language from January 2000 to February 2022 were screened by four reviewers to determine eligibility for inclusion.ResultsThe search resulted in 29,468 original articles, of which 25 were included in the data synthesis. We found minimal evidence that answers our proposed research question. The majority of identified programs have demonstrated effectiveness in reducing medical and dental healthcare utilization (especially for non-preventive services) and avert more invasive treatments, and to a lesser degree, resulting in cost-savings. Moreover, some promising but limited evidence about program impacts on societal outcomes such as reducing homelessness and improving employability was reported.ConclusionDespite the well-known societal and economic consequences of dental problem, there is a paucity of studies that address the impacts of dental care programs from the societal and healthcare system perspectives.MeSH termsDelivery of Health Care, Dental Care, Outcome assessment, Patient acceptance of Health Care.

Dental Health Utilization in the Republic of Palau: A Survey to Determine Feasibility of an Oral Cancer Screening Program

PURPOSE Oral cancer is the 5th most common cancer in Palau. Betel nut use is a highly prevalent cultural tradition in Palau and also a carcinogen, whose effect may be synergistic with the addition of smokeless tobacco in betel quid in the development of oral cancer. Prognosis can be improved with early detection. The purpose of this study is to assess the feasibility of an oral cancer screening program using existing dental health infrastructure with mixed methods assessment of utilization of dental health resources by adults in Palau. METHODS An Internet-based survey was used. Both quantitative and qualitative assessments of dental health care utilization were explored. Quantitative analyses of survey responses were done using descriptive and analytical statistical functions. Open-ended survey questions were coded and analyzed for emergent themes to develop recommendations for the proposed intervention. RESULTS The survey was available (Facebook Ads) for 9 days. There were 223 completed surveys, age range was 18-75 (mean = 42.7 years), 177 (80.1%) identified as female, 60.4% reside on Koror, and 60.4% have some university/college level education. Dental care was seen to be important (mean score 82.27). Most felt there were no major barriers to seeing a dentist (n = 164, 72.5%). Themes pertaining to barriers to access focused on lack of availability of appointments and cost. Themes pertaining to facilitators included multilevel resources and services provided by dental clinics. CONCLUSION Dental care is important to Palauans, and most would prefer to have this occur in a clinic setting. The themes generated suggest that while there are important facilitators that are in place to promote seeking and obtaining dental care, the existing infrastructure and access to dental care currently do not support an oral cancer screening program. However, these data do provide important areas to address the delays associated with dental care that can improve access and support the implementation of oral cancer screening in the future.

Factors associated with women's autonomy regarding dental health care utilization in Bengaluru - A cross sectional study

Background: Preventive dental care benefits people of all ages and genders' oral health. Among many conceptual implications, autonomy suggests the power to alter one's fate and environment, among other things. Little is known about women's autonomy and factors influencing dental health-care utilization in India. This study was designed to assess knowledge, attitude, and oral hygiene practices and its association with women's autonomy and dental care utilization. Materials and Methods: A cross-sectional study was conducted among 400 women aged 18 years or older in Bengaluru Urban District. Questionnaires were employed to assess women's autonomy, knowledge, attitude, oral hygiene practices, and dental care service utilization. Descriptive statistics and bivariate and regression analyses were carried out. The P < 0.05 was considered statistically significant. Results: More than half of the women (61.3%) had a high level of autonomy. Women with a high level of autonomy had more knowledge, a more positive attitude, and better dental hygiene habits. Autonomy, knowledge, and attitude were all significant independent predictors of women's use of dental care services. Conclusions: Women's autonomy was found to influence knowledge, attitude, and oral hygiene practices which in turn are associated with dental health-care service utilization.

Are maternal factors predictors of a child's first dental visit? A birth cohort study in Brazil.

The purpose of this study was to investigate the association between maternal factors and dental visits of children within their first year of life. This study used data from the 2015 Pelotas Birth Cohort and included pregnant women and their children at 12 months of age, followed-up between May 2014 and December 2015. Socioeconomic and demographic data, information on the use of dental services during the last year, and information on dental fear were collected by interviewing the mothers. Information regarding dental caries and periodontal disease were collected during the mother's clinical examination. The date of each child's first visit to the dentist was recorded. Crude and adjusted Poisson regression models with robust variance were used. The sample comprised 2,287 mother-child dyads, of which 10.1% of children visited the dentist during the first year of life. Children whose mothers visited the dentist within the last year for preventive reasons (RR: 1.51; 95%CI: 1.12-2.03) or curative reasons (RR: 1.47; 95%CI: 1.08-2.01) were more likely to have visited the dentist during the first year of life compared to those whose mothers had not used dental services during this period. Maternal tooth loss was inversely associated with a child's visit to the dentist during the first year of life (RR: 0.69; 95%CI: 0.54-0.89). Considering the mother's history of using dental services, as well as their dental caries history, is necessary to understand and improve patterns of dental health care utilization and implement public oral health policies for young children.

Impact on Dental Economics and Dental Healthcare Utilization in COVID-19: An Exploratory Study

Aim: The current exploratory research establishes a correlation between the general unemployment rate due to COVID-19 and its effect on dental healthcare service utilization, workforce, and education attainments. Materials and methods: The conceptual model utilized in the study is the circular flow diagram explaining economy organization. The study is an exploratory research review. PRISMA guidelines are followed for the review of articles. The literature data for the current review study is obtained from Web of Science, Statista, Grey Literature like, the Federal Bank St. Louis, American Dental Association (ADA), Health Policy Institute, to justify the economic impact in the dental industry sector. The search terms employed to search for literature from the Web of Science database are “Dental” and “COVID-19.” Only research articles published in the past one year in English language are included as the final sample of literature review. Statista, Federal Bank, and ADA are utilized to take into consideration evolving economic impact data due to COVID-19. Results: Much less of research has been performed on the impact of COVID-19 on dental economics, and this study is one of the insights of projections about COVID-19 impact in the dental healthcare sector. The projected hardships of the economy during and post pandemic demand for timely measures in place. The dental regulating bodies must undertake those protocols to save the dental healthcare industry. Conclusions: Unlike other healthcare sectors, the impact of COVID-19 will disproportionately affect the dental healthcare sector for several reasons. Given dental healthcare services aid in generating nation’s revenue like any other sector, it demands urgent actions from regulating authorities.

The Swedish dental health register - validation study of remaining and intact teeth

BackgroundSweden has a long tradition of nationwide registers enabling population-based research of high quality and validity. We aimed to describe the content and validity of reported number of remaining and intact teeth in the Swedish Dental Health Register and report some descriptive data on dental health care utilization.MethodsThe Swedish Dental Health Register was initiated in July 1st 2008 and contains individual data on dental health care to the whole adult population of Sweden. The dental care given freely to children and young adults is not included. Descriptive data on remaining, intact teeth and dental health care utilization is presented by proportion of the population stratified by sex and age. We conducted a validation study, by manual review of randomly sampled 1500 dental health visits records, to assess reported number of teeth to the register with what was actually recorded in the dental health care record (gold standard), analyzed by positive predictive value (PPV) and Bland-Altman plots.ResultsOf the Swedish adult population 2014, 2.6 million (69%) men and 2.9 million (76%) women had at least one visit to a dentist during a two-year period 2013 to 2014. More than half of the population up to age 64 have all remaining teeth (28 teeth or more). Of the 1500 requested dental records 1131 (75%) were received. The positive predictive value for patients reported to the register as having at least 1 tooth up to 31 intact teeth was 91.5% (95% confidence interval 89.0–93.5, 567 manually reviewed to be correct out of 620 reported).ConclusionsFor patients coded as having less than 32 intact teeth but not being edentulous the reported number of remaining and intact teeth is to a very high degree correct. However, the correctness for those coded as edentulous or having 32 remaining intact teeth is low and varies substantially by age.

Gender Differences towards Dental Health Knowledge, Attitude and Utilization of Dental Care

Understanding the effect of gender on oral health would facilitate the development of successful attitude and behavior modification approach towards sustainable oral health. This study assessed the behavior, knowledge, rate, and pattern of dental service utilization of the students and workers of Adventist University of the Philippines (AUP). It also tested the widely documented hypothesis that women have better oral health behavior, oral hygiene, and periodontal status but higher dental caries rates than men. Further, it determined what dental procedure is mostly utilized by the patients. The data were based on annual dental records of AUP Dental Department and oral interviews. From the dental record of the year 2017, a total of 2,472 patients visited the dental clinic for the following procedures: oral prophylaxis (40%), tooth extraction (13%), tooth restoration (14%), prosthodontics (7%) and orthodontics (25%). Among the dental procedures, women are always higher in number compared to men. In terms of gender, 960 or 39% of men and 1,512 or 69% of women visited the clinic revealing that women have dental visits more often than men. Oral prophylaxis and orthodontic are two of the most availed dental procedure while prosthodontics is the least. Despite AUP Clinic’s promotion for health care and health care services, dental health care utilization remains very low relating to the whole university population. Women are more concerned with oral health than men, contrary to other researches that males have higher oral health knowledge score than females. Gender differences have no significance in terms of dental care utilization. Participants’ oral health knowledge is at least average and they showed positive attitude towards dental treatment. It is recommended that more oral or dental health campaign be done; utilization of dental service fee among students be promoted; and the importance of oral health be taught.

Disparities in dental healthcare utilization in China.

The goal of this study was to investigate inequality in dental service utilization in Chinese middle-aged and senior adults and changes in inequality over time and to determine the sources of inequality. The data included 17 648 individuals aged 45 years and older in 2013 and 15 450 individuals in 2015 who participated in the China Health and Retirement Longitudinal Study (CHARLS). The concentration index was used to quantify the degree of inequality. A decomposition method was employed to determine the sources of inequality, including need variables (demographic characteristics, self-reported health status, and presence of chronic diseases), living standard (measured by household consumption expenditure per capita), other non-need variables (education level, marital status, region of residence, urban-rural difference and type of health insurance plans). The better-off not only had a higher likelihood of using dental care services than did the worse-off but also used them more often than the worse-off. The concentration index for probability of dental care utilization increased from 0.074 to 0.112 between 2013 and 2015, and the concentration index for total number of dental visits increased from 0.085 to 0.127. Living standard, education, health insurance plans and urban-rural disparities showed a pro-rich contribution to the inequality. The living standard contributed about 70% to the pro-rich inequality. Dental care utilization in the Chinese middle-aged and older adults was concentrated in the better-off. Inequality in dental care utilization widened from 2013 to 2015. Achieving equity in dental care utilization remains a challenge for the healthcare system in China.

Exploring the association of dental care utilization with oral impacts on daily performances (OIDP) – a prospective study of ageing people in Norway and Sweden

Objectives: To explore the association of dental health care utilization with oral impacts on daily performances (OIDP) across time focusing ageing Norwegian and Swedish adults adjusting for predisposing, enabling, and need related-factors as defined by Andersen’s model.Methods: Data were based on Norwegian and Swedish 1942 birth-cohorts conducted in 2007 (age 65) and 2012 (age 70). In Norway, the response rates ranged from 54% to 58%. Corresponding figures in Sweden were from 72% to 73%. Self-administered questionnaires assessed OIDP, dental care utilization and predisposing, enabling and need related factors. Logistic regression with robust variance estimation was used to adjust for clustering in repeated data.Results: Significant covariates of OIDP were satisfaction with dental services, dental care avoidance due to financial constraints, frightening experience with dental care during childhood and patient initiated dental visiting. Frequency and regularity of dental attendance were associated with OIDP in the Swedish cohort, only.Conclusions: In spite of country differences in the public co-financing of dental care, dental care utilization indicators were associated with OIDP across time in both cohorts. Encouraging regular and dentist initiated visiting patterns and strengthening beliefs in keeping own teeth could be useful in attempts to reduce poor oral health related quality of life in ageing people.

Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

Zum Stand der Mundgesundheitsaufklärung bei Eltern von Kindern mit frühkindlicher Karies

IntroductionThe overall incidence of tooth decay in children is decreasing in Germany. However, the reduction is less pronounced in primary teeth than in the adolescent permanent dentition. One reason is the increasing early childhood caries (ECC) prevalence within the age group reviewed. Early childhood caries progresses rapidly in the primary dentition and is caused by very frequent consumption of sugary beverages from baby bottles in combination with insufficient oral hygiene. Additional risk factors are insufficient oral health care and a lack of knowledge about development and avoidance of dental caries among parents. The aim of the present study is therefore to ascertain whether the current concepts for prophylaxis and early recognition of ECC are effective.Material and methodsIn a pediatric dental practice, 40 caregivers of children with ECC were asked via questionnaires about their level of understanding of caries prevention and their dental health care utilization during and following pregnancy.ResultsOver 70 % of the respondents stated that, during pregnancy, neither the gynecologist nor the midwife provided information about nurturing dental health for themselves or their child. Those who were counselled received information about the correlation of periodontitis and preterm birth (5 %), transmission of caries-producing microorganisms (7 %) and about dental prophylactic measures such as oral hygiene, nutrition and preventive examination (10 %). Half of the respondents were counselled on dental health by the pediatrician. They mainly received information about dental-awareness and nutrition as well as tablet fluoridation.ConclusionThe results of the present study show that current concepts for early dental health promotion in children are not effective enough. For prophylaxis and early recognition of ECC to be effective, interdisciplinary cooperation between gynecologists, pediatricians and dentists have to be improved. Beyond that, specific pre-ventative care must be provided by qualified personnel within high-risk groups.

앤더슨 모형을 적용한 산업체 근로자 직업유형에 따른 구강보건행위와 치과이용에 영향을 미치는 요인

Objectives: The purpose of the study is to investigate the oral health and oral health beliefs in industrial workers and to analyze the influencing factors on dental health care utilization. Methods: The subjects were 280 adults from 16 to 64 years old in Seoul and Gyeonggi from June 20 to July 31, 2014, A self-reported questionnaire was completed after receiving informed consent. The independent variables consisted of predisposing, enabling, and need factors. The predisposing factors included gender, age, residence area, number of family. The enabling variables included monthly income, education, occupation, type of employment. The need factors included subjective oral health recognition and oral health belief model. These three variables had a direct and indirect influence on dental clinic use. The types of occupation were classified into desk duties, merchandizing and service duties technology and others by KSCO-6. Results: The relating factors to dental health care utilization were sex, oral health beliefs perceived benefits, perceived barriers, and self-efficacy. Female tended to have the higher oral health beliefs perceived benefits, perceived barriers(p<0.01), self-efficacy(p<0.05). Conclusions: Those who received frequent oral examination and health instruction tended to have a favorable impact on maintenance of oral health status and improvement in quality of life.

Use of dental services throughout middle and early old ages: a prospective cohort study

Focusing on a Swedish 1942 birth cohort, this study describes the trend of dental health care utilization between age 50 and 65 and identifies major determinants of dental visiting habits using Andersen's model as adapted for dentistry as a theoretical framework. In 1992, a census of 50 year olds in two counties of Sweden was invited to participate in a longitudinal questionnaire survey. Of the total population of 8888 subjects, 6346 responded (71%). Of the 6346 subjects who completed the 1992 survey, 4143 (65%) completed postal follow ups in 1997, 2002 and 2007. 83.3% and 3.2% of the cohort remained stable with respect to use and nonuse of regular dental care. Cochran's Q test revealed that the proportions reporting regular use decreased from 93% at age 50-87% at age 65 (P < 0.001). Generalized estimated equations revealed the following covariates; gender (females), country of birth (native born), marital status (married), perceived quality of dental care (good perceptions), dental care utilization as a child, remaining teeth and perceived oral problems. The influence of the variable time, functioning as a measure of period/ageing, maintained a statistically significant relationship with regular utilization after adjusting for all covariates in the model. Regular use of dental health care services decreased slightly but statistically significantly from age 50 to 65 and was most prevalent in socio-economically advantaged groups, among those with remaining own teeth, subjects who perceived oral problems and reported high quality dental care. The results have implications for planning of elderly dental health care and required dental workforce in Sweden and countries with similar welfare systems.

A Comparison of Medical and Dental Outcomes for Medicaid-Insured and Uninsured Medicaid-eligible Children: A U.S. Population–Based Study

In a population-based study of Medicaid-eligible children, the authors described and compared sociodemographic attributes, medical and dental health care utilization, and health status between Medicaid-insured and uninsured Medicaid-eligible children. The authors analyzed data from 2,491 poor Medicaid-eligible children 2 to 16 years of age who participated in the 1999-2004 National Health and Nutrition Examination Survey. They quantified the association of medical and dental health care utilization, health status and treatment needs with Medicaid insurance status by using multivariable logistic regression modeling, taking into account the complex survey design and sample weights. Approximately 40 percent of Medicaid-eligible children were uninsured. Medicaid-insured children were more likely to have an annual physician visit but no more or less likely to have good general or oral health, asthma or dental caries, or treatment needs than were uninsured Medicaid-eligible children. Medicaid-insured older children (9-16 years old) were more likely to have an annual dentist visit than were uninsured Medicaid-eligible older children. Children with Medicaid coverage were more likely to use health care services but no more or less likely to have good general health, good oral health, asthma treatment needs or dental treatment needs. To improve health care use, more poor children need to be enrolled in Medicaid.