Dental Service Utilization Patterns Research Articles

The effect of education on dental service utilization patterns in different sectors: A multiple mediation analysis.

The aim of this study was to investigate how education level affects dental service utilization patterns in the Australian adult population. This study tested how education level mediated these service patterns through behavioural mediators such as smoking, tooth brushing and oral health status and investigated these mediation effects in different dental service providers. Following the flexible mediation approach, the direct and indirect effects of education through behavioural mediators on dental service utilization patterns (time of last dental visit, reason for last dental visit and frequency of seeking dental care) were calculated for the South Australian population from the Dental Care and Oral Health Study. Participants with lower educational attainment were 33% (Odds Ratio: 0.67, 95% CI 0.56-0.78) and 38% (Odds Ratio: 0.62, 95% CI 0.53-0.74), less likely than their counterparts with higher education to visit a dentist or to receive dental care in the last 12 months, respectively. Low education was associated with a 23% increase in odds of receiving emergency and treatment services (Odds Ratio: 1.23, 95% CI 1.05-1.43) compared to routine dental check-ups or examinations. Low education, regardless of oral health behaviours and status, reduces the odds of dental service utilization in terms of frequency of seeking dental care and time of last dental visit. There is more tendency towards receiving emergency and treatment services compared to routine dental check-ups or examinations in participants with lower educational attainment.

Self-reported oral hygiene practice and utilization of dental services by dental technology students in Port Harcourt, Rivers State, Nigeria.

Dental technology students are Dental surgery technicians under training, trained to assist patients maintain good oral health. Hence, their oral hygiene is expected to be optimal. To determine the oral self-care practices and pattern of utilization of dental services among dental technology students. This was a descriptive, cross-sectional study, consisting of 109 participants. The questionnaire had three sections. Section A had questions on sociodemographic, section B was on self-reported oral hygiene practices and section C was on pattern of dental service utilization. Statistical analysis was done using the SPSS version 20.0. The mean age was 23.66 years; age range was 18 - 42 years. There were 20 males and 89 females, 95.41% of the participants used toothbrushes and paste, while 4.59% used both chewing sticks and toothbrushes. 22% used horizontal/scrub method of toothbrushing, 10.1% used modified bass method, whereas 5.0% do not know which method of toothbrushing they use. 81.3% of the participants had visited the dentist previously for routine dental check-up while 10.71% visited for dental pain. The self-reported oral hygiene practice of the dental technology students is commendable, however, further education on the importance of scaling and polishing is advocated.

THE RELATIONSHIP BETWEEN DENTAL HEALTH PERCEPTION AND DENTAL SERVICE UTILIZATION AMONG SCHOOL CHILDREN IN SOUTH JAKARTA

INTRODUCTION:The utilization of dental service is an important factor of oral health. The utilization of dental service is affected by the perception and the importance that the person gives to their oral health and needs. This study described the relationship between dental health perception and dental service utilization among school children in south Jakarta.OBJECTIVE:To analyze the relationship between perception of dental health and utilization of dental service. METHODS:A qualitative analytical cross-sectional study was conducted among 120 students of 12 elementary schools in south Jakarta, selected using proportional sampling method. A questionnaire was administered to elicit data on dental health perception and dental service utilization.RESULTS:Most students perceived their dental health as good and never had dental sickness.Almost half of the sample never utilized dental service and the utilization of dental service mostly for extracting and filling the teeth. Chi square test showed significant difference between the perception of the occurrence of dental sickness with the frequency and pattern of dental service utilization, and no significant difference between the perception of the health of teeth and oral soft tissue with the utilization of dental service. CONCLUSIONS: There were relationship between the perception of the occurrence of dental sickness with the frequency and with the pattern of dental service utilization. There were no relationship between the perception of the health of teeth and oral soft tissue with the utilization of dental service.

Maternal knowledge, dental service utilization and self-reported oral hygiene practices in relation to oral health of preschool children in Lagos, Nigeria

INTRODUCTION: Maternal oral health practices and perception about infant oral health are probable pointers to the status of an infant´s oral health. We aimed to evaluate maternal knowledge about infant oral health and oral hygiene practices. METHODS: a descriptive study was conducted among 334 mothers using a cluster sampling technique. A 32-item pretested validated, interviewer administered questionnaire obtained socio-demographic data, pattern of dental service utilization, maternal and child oral hygiene practices and to assess oral health related knowledge. Linear regression analysis was conducted to assess predictors of knowledge scores, p ≤ 0.05 was accepted as statistically significant. RESULTS: only 42 (12.6%) knew how a baby´s mouth should be cleaned while 127(38%) knew that cariogenic bacteria was transferrable. The mean knowledge score was 4.89 ± 1.72 out of 9. There was a moderate positive significant correlation (0.334; p<0.000) between maternal educational level and having good knowledge. Multiple linear regression analysis revealed that the knowledge score was significantly associated with mother´s oral hygiene practices (β=0.167; 95% CI; p<0.001), education level (β=0.321; p<0.000).

Dental care utilization: patterns and predictors in persons living with HIV in British Columbia, Canada.

To identify the predisposing, enabling, and need factors of the Andersen and Newman (A&N) model and their associations with the pattern of dental service utilization in a sample of people living with HIV (PLHIV) in British Columbia. Participants responded anonymously to a 40-item online questionnaire to explore the patterns of dental service utilization. Following the descriptive statistics, the associations between A&N model factors and main outcome variables (having a dental visit in the last year and reasons for the dental visit) were evaluated using simple and multiple logistic regression analyses. Out of 600 potential PLHIV participants, 210 responded to the survey and 186 met the inclusion criteria. The experience of being discriminated against by dental professionals (P = 0.005), having dental anxiety (P < 0.001), not having dental insurance (P = 0.001), and having living condition difficulties (P = 0.004) were significantly associated with nonemergency dental visits. In multiple logistic regression analysis, dental anxiety (OR = 0.1; 95 percent CI 0.0; 0.4), having a regular dentist (OR = 3.7; 95 percent CI 1.1; 12.6), and visiting a dental office in the last year (OR = 21.6; 95 percent CI 6.1; 76.5) were the strongest predictors of dental service utilization in this study. Several predisposing, enabling, and need factors from the A&N model were associated with dental service utilization by PLHIV. In addition to various psychosocial barriers, a significant number of respondents reported experiencing stigma and discrimination from their oral care providers.

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.

Higher experience of caries and lower income trajectory influence the quality of restorations: A multilevel analysis in a birth cohort

ObjectivesThis study aimed to evaluate the quality of posterior restorations (amalgam or composite) placed in adults from a birth cohort and its association with clinical and socioeconomic determinants experienced during their life course. MethodsA representative sample (n=539) of all 5914 births occurring in Pelotas (Brazil) in 1982 was prospectively investigated. Quality of posterior restorations (satisfactory or unsatisfactory) was assessed at 31 yrs-old, using modified USPHS criteria. Trained and calibrated dentists performed clinical examination. Explanatory variables included demographic and socioeconomic, oral health and dental service utilization patterns during the life course. Tooth related variables (type of tooth, material, size of cavity) were also analyzed. Untreated caries and socioeconomic status were assessed by group-based trajectories analyses. Multilevel Regression models were used to determine factors associated with restoration outcomes. ResultsIn total 2123 restorations (53% composite) were evaluated of which 107 (5%) were assessed as failed. The main reasons for failure were tooth/restoration fracture (50.5%) and secondary caries (30.7%). Failures in posterior restorations showed a significant association with socioeconomic aspects (lower tertile of income at age 30 – prevalence ratio (PR) 2.21 [95% CI 1.19–4.09]), clinical variables (trajectory of higher untreated caries – PR 2.11 [95% CI 1.23–3.61]) and also with tooth-related factors (Restorations involving three or more surfaces – PR 5.51 [95% CI 3.30–9.19]) after adjustment for each other. ConclusionsThese findings suggest that, although tooth-related variables have an important role in restoration longevity, patient-related factors, such as socioeconomic variables and untreated caries are also associated with failure and should be taken into account when evaluating longevity of posterior restorations. Clinical significanceThis was the first study assessing long-term trajectory of untreated caries, showing an association between higher experience of caries during the life-course and unsatisfactory restorations. The findings suggest that individual related factors should be considered when planning treatment and in future research evaluating the longevity of dental restorations.

Dental services and attitudes towards its regular utilization among civil servants in ibadan, Nigeria.

Regular utilization of dental services is key to the attainment of optimal oral health state, an integral component of general health and well being needed for effective productivity by working personnel. This study assessed the rate and pattern of dental service utilization among civil servants and their attitudes towards its regular use. A multi-stage sampling technique was used to select participants from the Federal Secretariat in Ibadan, Nigeria. A structured, standardized, pretested and self-administered questionnaire was utilized to elicit responses on dental services and attitudes towards their regular utilization. Responses to knowledge and attitude questions were scored and categorized. Chi-squared test was used to test associations between variables at 5% level of significance. A total of 400 civil servants participated in the study. Their mean age was 44.0 ±7.3years. Many 291(72.8%) were well informed about dental health care and services, but few 156 (39%) had ever utilized it. Of the utilizers, 32 (20.5%) visited within the previous one year period, while others last visited in more than one year period. Few 17 (10.9%) of the utilizers visited for routine dental checks, 103 (66%) for acute pain relief, while the rest had other dental health care needs. The majority 312 (78.0%) showed positive attitude towards regular dental service utilization and this improved with higher educational attainment, improved level of income, being aware of dental services and having ever utilized it (all p<0.05). Despite the awareness and positive attitude towards regular dental service use, their utilization rate was relatively low, episodic and problem driven. Appropriate oral health promotion strategies to enhance utilization of preventive dental services are strongly recommended for them.

Treatment perception and utilization of dental services during pregnancy among sampled women in Riyadh, Saudi Arabia

To determine the access of dental care among a sample of pregnant women in Riyadh, Saudi Arabia and identify possible barriers for dental care during pregnancy. The target population in this cross-sectional study was female patients attending one private and two governmental hospitals in Riyadh, Saudi Arabia. The age range for these patients was limited to child bearing age (18–48 years old). The pregnant women were identified in obstetric and gynecology clinics. The control group of non-pregnant women was identified in dermatology clinics. A self-administered questionnaire was developed to assess the pattern of dental service utilization and attitude toward dental treatment during pregnancy. Personal information such as age, education, employment and number of live births were also collected. A total of 959 properly filled questionnaires out of 1176 (71% response rate) were used in the analysis. The mean age of the sampled subjects was 29.6 (±7.0) years. Only 22% of the sampled pregnant women indicated that they visited their dentists during their current pregnancy. Seventy-two percent of the sampled pregnant women indicated that they have experienced at least one dental problem that might need a dental intervention during their current pregnancy. The likelihood of visiting a dentist during pregnancy for pregnant women who visited the dentist before pregnancy was 20.4 times more compared to pregnant women who did not visit the dentist before pregnancy ( N = 510, OR = 20.4, 95% CI [11.9, 34.5]). A lack of knowledge of the importance and safety of dental treatment during pregnancy was reported by the majority of sampled women to be significant barriers for dental care during pregnancy. The majority of the sampled pregnant women did not visit the dentist during pregnancy and had major misconceptions about the need for and/or the safety of dental treatment during pregnancy.

Life-course Determinants of Need for Dental Prostheses at Age 24

This study aimed to assess the prevalence of use and need for dental prostheses (UNDP) by individuals at age 24 and their life-course determinants. A representative sample (n = 720) of all 5914 births occurring in Pelotas in 1982 were prospectively investigated, and the UNDP were assessed in 2006. Exploratory variables included demographic and socio-economic, oral health, and dental service utilization patterns during the life-course. The prevalence of UNDP was 2.1% and 29.7%, respectively. Multivariable Poisson regression analysis showed that low socio-economic status through the life-course [Prevalence Ratio (PR) = 1.56 (95% CI: 1.08-2.26)], lower maternal schooling in childhood [PR 2.79 (1.34-5.79)], no oral hygiene instruction by a dentist at age 15 [PR 1.64 (1.11-2.41)], and caries presence at age 15 (high DMFT tertile) [PR 2.90 (1.98-4.24)] were associated with prosthetic treatment needs. These results support the hypothesis that life-course socio-economic, behavioral, and clinical determinants are associated with the need for dental prostheses.

Oral health‐related quality of life among rural‐dwelling Indigenous Australians

There is limited information on the impact of poor oral health on Indigenous Australian quality of life. This study aimed to determine the prevalence, extent and severity of, and to calculate risk indicators for, poor oral health-related quality of life among a convenience sample of rural-dwelling Indigenous Australians. Participants (n = 468) completed a questionnaire that included socio-demographic, lifestyle, dental service utilization, dental self-care and oral health-related quality of life (OHIP-14) factors. The prevalence of having experienced one or more of OHIP-14 items 'fairly often' or 'very often' was 34.8%. The extent of OHIP-14 scores was 1.88, while the severity was 15.0. Risk indicators for having experienced one or more of OHIP-14 items 'fairly often' or 'very often' included problem-based dental attendance, avoiding dental care because of cost, difficulty paying a $100 dental bill and non-ownership of a toothbrush. An additional risk indicator for OHIP-14 extent was healthcare card ownership, while additional indicators for OHIP-14 severity were healthcare card ownership and having had 5+ teeth extracted. Risk indicators for poor oral health-related quality of life among this marginalized population included socio-economic factors, dentate status factors, dental service utilization patterns, financial factors and dental self-care factors.

A Comparative Evaluation of Self-Reported Oral Hygiene Practices Among Medical and Engineering University Students with Access to Health-promotive Dental Care

This study was conducted to test the null hypothesis that no difference exists in the oral hygiene knowledge and practices of university students in different courses when they have equal opportunity to access health-promotive dental care. The study was conducted using 120 students each from the medical and engineering colleges at the University of Manipal Academy of Higher Education who had easy access to the dental college within the campus which provides health-promotive dental care to all its patients. A self-administered structured questionnaire consisting of questions on demographic data, oral hygiene knowledge and practices, and dental service utilization patterns was distributed among the students. The data collected was analyzed using SPSS 10 version. Statistically significant differences were found between the two groups with respect to the knowledge of fluoridated toothpastes, frequency of toothbrush renewal, use of dental floss, and a tongue cleaner (p < 0.001). The groups were similar in all other practices including the utilization of dental services. There were no significant differences between the self-reported oral hygiene knowledge and practices among medical and engineering university students, but the knowledge levels of the students were considerably lower than expected.

Predictors of oral health behaviors among elderly Japanese Americans.

As part of a series of studies on oral health behaviors of older persons, 81 elderly Japanese Americans were interviewed regarding their dental service utilization patterns, oral health attitudes, and dental status. The sample consisted of 35 Issei (first generation) and 46 Nisei (second generation) Japanese Americans. Because of the significant age difference between the Issei and Nisei, it was difficult to examine generational differences between the two groups. When age differences were controlled, there was no difference between the two generations in interval since their last dental visit. However, reasons for dental visits differed between the two groups, with the Issei more likely to seek help with dentures or general restorative work while the Nisei were more likely to schedule appointments for dental check-ups and cleaning. The best predictors of dental service utilization for the entire sample were the use of complete dentures, age, and education (R2 = .38), but when the respondent's perceived importance of oral health was entered into the equation, this variable accounted for more variance than age or education. The combination of complete dentures, importance, and age accounted for 41% of the variance in recency of dental service utilization. Locus of control, the belief component of attitudes, and overall attitude scores did not add significantly to the prediction of dental utilization.

Recent advances in behavioral research in geriatric dentistry.

This paper examines recent studies in behavioral science and health services aspects of geriatric dentistry. With the increased focus on special needs of older patients, researchers have become concerned with psychological and sociocultural factors that influence older people's oral health status, behavior, and attitudes. Studies of dental service utilization patterns among subgroups of the elderly, including those in long‐term care settings, will be reviewed. Research on methods to improve oral health care behaviors will be discussed, with their implications for developing oral health promotion and service delivery programs. The special oral health needs of cognitively impaired and frail elderly will be reviewed. Studies of clinical decision‐making in geriatric dentistry have been conducted. These studies have revealed significant gaps in dental professionals' knowledge and attention to the special needs of older patients. This and other aspects of behavioral research suggest the need for better methods to disseminate research findings in geriatric dentistry to clinical practice in this field. The presentation will discuss ways of improving dissemination and transfer of research findings to the clinical management of aged patients.

Utilization of dental services and its relation to the periodontal status in a group of South Australian employees.

The pattern of dental service utilization, the perception of periodontal disease, and the oral hygiene habits among 642 industrial employees were evaluated using a self-administered questionnaire against background variables of age, sex, and socioeconomic strata. Of the study population, 50.5% had their most recent dental visit within the previous 12 months and 42.5% claimed to seek regular check ups. There was no significant association between time intervals since the last dental visit and age, sex, occupation, income or education. Regular visits were made more often by subjects in the higher occupation and income level. Multivariate analyses of the number of missing teeth simultaneously considering age, sex, socioeconomic level, regularity and frequency of dental visits revealed that except for age and sex, no other factors were significant. The most common reason for not seeing a dentist in the previous 12 months was an assumption that "nothing was wrong". A large majority of the group surveyed were unaware of the presence of periodontal disease or the need for its treatment, despite the high prevalence in all subgroups. Periodontal status was not significantly associated with sex, socioeconomic levels, regularity of frequency of dental visits, but there was a significant regression on age. The study population's pattern of service utilization was found to be similar to that reported for the general population, and it was anticipated that the hygiene habits of the group was representative of the total community. If that assumption is true the high prevalence of periodontal disease of the study population probably exists in the general community.