Utilization Of Dental Care Services Research Articles

Race, Ethnicity, and Other Barriers to Access Dental Care During Pregnancy.

Historically, women of color showed poorer oral health and lower dental service utilization in the USA. These barriers to dental care during pregnancy included dental coverage, primary language, dental provider availability, safety concerns, affordability of dental care, and perceived oral health benefits during pregnancy. The purpose of this study is to examine whether race/ethnicity modified the associations between barriers to accessing dental care and dental service utilization during pregnancy. This cross-sectional study sample included 62,189 women aged 20 and older with a recent birth history in 21 states from the Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2016 to 2019. We introduced a race/ethnicity by barrier interaction term to our multiple logistic regression models. After adjusting for other confounders, dental insurance during pregnancy and perceived oral health benefits were associated with 4.0- and 5.6-fold higher odds, respectively, of dental service utilization during pregnancy. Statistically significant effect modification by race/ethnicity was observed in crude and adjusted analyses of the relationship between dental service utilization for all barriers included in the interaction analyses with all adjusted p-values < 0.001. The interaction analysis found that racial/ethnic disparity in visiting dentists during pregnancy was significant among women who reported these dental barriers. In contrast, such racial/ethnic disparity was substantially attenuated among women who did not report such barriers. The observed racial/ethnic disparities could be mitigated by such supporting mechanisms: dental coverage, provider availability and willingness to treat pregnant women, oral health education on the safety of dental care during pregnancy, and affordable dental care costs.

Impact of income and financial subsidies on oral health care utilization among persons with disabilities in Singapore.

Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore. Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD. Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08-1.52), 1.48 (95% CI 1.14-1.92) and 1.36 (95% CI 1.09-1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies. Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.

Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors.

This study was undertaken with an aim to explore the influence of factors associated with anxiety and fear of dentistry on oral health behavior. A total of 84 patients aged 20-40 years visiting the dental institute for the management of gum diseases (gingivitis and periodontitis) and tooth decay (dental caries) were enrolled. Fear of dentistry and oral health behaviors were recorded employing a dental fear survey (DFS) and oral health behaviors checklist. Each of the 20-item scale of DFS was rated on a 5-point Likert scale. The oral health behavior checklist was based on oral hygiene habits, patterns of utilization of dental services, food habits, and use of tobacco products. Each of the 13-item checklist comprised a closed-ended statement with a high score corresponding to more positive oral health behavior. Domains of dental fear (avoidance of dentistry, physiological arousal, and fear of specific stimuli) and total dental fear did not predict oral hygiene habits and nutritional preferences (p > 0.05). Physiological arousal was a positive predictor of utilization of dental services (p = 0.009) and oral health behavior (p = 0.042). Oral health behaviors were found to be positively correlated with three factors of DFS. Anxiety and fear of dentistry are not found to influence personal preventive oral care with reference to oral hygiene habits. Avoidance of dentistry factor of DFS is positively correlated with oral health behavior. Dental fear and anxiety do not impact oral health behaviors adversely. In this era of youth and beauty, the utilization of professional dental care services is not affected by fear of invasive nature of dental procedures. Establishing the groundwork for knowledge regarding the scope of fear appeals in anxiety for dentistry may help to augment positive oral health behaviors for effective primary prevention of oral diseases. Interactions among personality characteristics, attitudes, emotions, and health behavior need further exploration. How to cite this article: Supriya, Singh R, Ahsan A. Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors. J Contemp Dent Pract 2024;25(3):280-288.

ORAL HEALTH AMONG FILIPINO OLDER ADULT IMMIGRANTS

Abstract Poor oral health has been associated with decreased quality of life, various non-communicable diseases, and a higher risk of mortality. There is also evidence that older immigrants and those who have been in the US for less than 5 years are more likely to have periodontitis, a serious gum disease and a common oral health condition. Despite this evidence, there is a paucity of studies investigating the influence of acculturation, immigration-related experiences, and resilience on oral health among older Filipino immigrants. To address this significant knowledge gap, a mixed methods study using a survey and focus group interviews was conducted among community-dwelling Filipino immigrants aged 60 years and older. This poster will present the results of the survey (N=103), which used a socio-demographic questionnaire, as well as valid and reliable instruments such as the Geriatric Oral Health Assessment Index, A Short Acculturation Scale for Filipino Americans, Everyday Discrimination Scale, and Connor-Davidson Resilience Scale. The results of the regression analysis revealed that the perception of discrimination and resilience were significantly associated with the perception of oral health among the participants surveyed [F(10,92) = 1.985, p &amp;lt; 0.05]; this regression model accounted for 18.6% of variance in the perception of oral health. The findings support the need for culturally sensitive interventions that could optimize oral health, including the utilization of dental care services for this underserved population.

Predicting depression in old age: Combining life course data with machine learning

With ageing populations, understanding life course factors that raise the risk of depression in old age may help anticipate needs and reduce healthcare costs in the long run. We estimate the risk of depression in old age by combining adult life course trajectories and childhood conditions in supervised machine learning algorithms. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we implement and compare the performance of six alternative machine learning algorithms. We analyse the performance of the algorithms using different life-course data configurations. While we obtain similar predictive abilities between algorithms, we achieve the highest predictive performance when employing semi-structured representations of life courses using sequence data. We use the Shapley Additive Explanations method to extract the most decisive predictive patterns. Age, health, childhood conditions, and low education predict most depression risk later in life, but we identify new predictive patterns in indicators of life course instability and low utilization of dental care services.

A national sample of developmentally disabled adolescents with obesity and their utilization of preventive dental care services.

Previous literature indicates that adolescents with developmental disabilities and obesity may have more oral health complications than healthy adolescents. However, dental care utilization among adolescents with developmental disabilities (DDs) and obesity is unclear. We investigated the differences in the utilization of preventive dental services between this high-risk group of adolescents and those with no DDs or obesity. Parent-reported data of adolescents 10-17 years (n = 68,942) from the 2016 to 2019 National Survey of Children's Health was used. In addition to descriptive and bivariate statistics, we ran three multiple logistic regression models guided by Andersen's Behavioral Model of Health Services Use, predicting the use of dental cleanings, fluoride treatments, and dental sealants. Among adolescents with DDs and obesity, dental cleanings, fluoride treatments, and dental sealant utilization prevalence were 76%, 48%, and 21%, respectively. In comparison, adolescents with no DDs or obesity had a prevalence of 83%, 50%, and 19%, respectively. Multiple logistic regression analysis showed that adolescents with DDs and obesity did not significantly differ in their receipt of dental cleanings (p = .07), fluoride treatments (p = .55), and dental sealants (p = .23) compared to those with neither DDs nor obesity. Adolescents with DDs but no obesity were 22% and 30% more likely to receive fluoride treatments (p < .0001) and dental sealants (p < .0001), respectively. Fewer than half of adolescents with DDs and obesity utilized fluoride treatments, and less than one quarter utilized dental sealants but used all three preventive services at the same rate as those with no DDs or obesity. This study identified no differences in preventive dental care services utilization in adolescents with developmental disabilities (DDs) and obesity compared to those without DDs and obesity. However, the utilization of preventive dental services in this population is influenced by the federal poverty level and family background.

Impact of migration on oral health outcomes of children in multi-beneficial kindergartens in Nanning, Southern China: a cross-sectional study

ObjectiveTo explore the effect of children’s migration on their oral health outcomes in multi-beneficial kindergartens in Jiangnan District, Nanning, China, and to provide a basis for improving the oral health of migrant children.MethodsA cross-sectional study was conducted among 470 children aged 5 years in Jiangnan District, Nanning, Guangxi. A questionnaire was used to collect information on their demographic and socioeconomic background, migration experience, eating habits, oral hygiene behaviours and utilization of dental care services. Dental caries of primary teeth was examined using the decayed, missing, and filled teeth (dmft) index recommended by the World Health Organization. Dental caries experience and oral health-related behaviours were compared between migrant and resident children. The impact of children’s migration attributes on their oral health outcomes was examined by univariate and multivariate analyses.ResultsAmong the examined children, 52.3% were migrant children. The prevalence of caries among the children in multi-beneficial kindergartens was 78.3%, and the mean number of dmft was 5.73 ± 5.00. The prevalence of caries was 81.7% for migrant children and 74.6% for resident children (p = 0.060). No significant difference was found in the mean numbers of DMFT between migrant children and resident children (5.96 ± 4.81 vs. 5.47 ± 5.20, p = 0.139). There were significant differences in the frequency of tooth brushing (p = 0.023) and parental help with tooth brushing (p = 0.008), typical use of fluoride (p = 0.012), regular dental check-ups (p = 0.003) and experience of dental fillings for caries (p < 0.001) between migrant and resident children. The multivariate logistic regression analysis showed that among the children with caries, the proportion of resident children who had regular dental check-ups was 1.720 times higher than that of migrant children (95% CI = 1.155 ~ 2.560), and resident children were more likely to have caries filled than migrant children (OR = 3.313, 95% CI = 1.585 ~ 6.927).ConclusionOral health status and oral health behaviours were poor among children in multi-beneficial kindergartens in Nanning, China, and migration might be a significant predictive indicator for the poor utilization of dental care services by children. The government departments should make special policy to promote the children’s oral health in multi-beneficial kindergartens, and invest more to cover the migrant children’s utilization of oral health services.

Utilization of dental care service and associated factors among pre-school children in northwest China over the past decade

ObjectiveThe purpose of this study was to analyze the factors influencing the utilization of oral health care among 5 years old children.MethodsWe conducted two observational cross-sectional studies. The studies were conducted in 2005 and 2015 and included 5-year-old children who underwent dental examination by trained dentists and the caregivers of the children were requested to answer the questionnaire. Multi-level stratified sampling method was used. Chi-square tests were used to analyze the utilization of dental care and other socio-economic variables. Logistic regression models were employed to explore the primary factors influencing the use of dental care among pre-school children.ResultsIn 2005, a total of 399 and in 2015, 492 child-caregiver pairs were included. The majority of the caregivers in both surveys were females, comprising 68.2% and 74.8% of the caregivers in 2005 and 2015, respectively. 75.2% and 87.0% (p < 0.05) of the respondents had an education level of lesser than 9 years. The prevalence of caries was higher in 2015 (63.2%) (p < 0.05) than in 2005 (53.4%). In 2005 and 2015, the utilization of dental care services was 20.8% and 20.0%, respectively. A statistically significant association was observed between caries and dental care use in 5-year-olds over the past decade. After adjusting for confounders, dental service usage among children in urban areas was 1.62 times higher than that of rural areas in 2005 (95% CI 0.069–0.571), and the self-assessment of caregivers regarding their child’s oral health significantly improved oral health use in 2015.ConclusionThe utilization of dental care services over the past decade is insufficient among pre-school children in northwest China. Hence, with the decreasing gap about economic and health service resources, policymakers should place greater emphasis on raising awareness among caregivers about the oral health status of their children.

Characteristics of Hospitals Employing Dentists, and Utilization of Dental Care Services for Hospitalized Patients in Japan: A Nationwide Cross-Sectional Study.

Dental care for hospitalized patients can improve nutritional status and feeding function while reducing complications. However, such care in Japan is not uniformly provided. This investigation examined the presence and characteristics of hospitals where dentists work and the collaboration between medical and dental teams. This cross-sectional study involves 7205 hospitals using the administrative reports on the Hospital Bed Function of 2018. Indicators described were the proportion of hospitals employing dentists, those providing perioperative oral care, and those with a nutrition support team (NST) that included dentists. A two-level logistic regression model was performed using hospital-based and secondary medical area-based factors to identify factors associated with hospitals employing dentists and dental care services. Some hospitals had poor medical and dental collaboration, even those with dentists, and no-dentist hospitals had rare medical and dental collaboration. Factors positively associated with hospitals that employed dentists were diagnosis-procedure-combination-hospital types, the Japanese government-established hospitals compared with hospitals established by public organizations, among others. In conclusion, the present study found poor medical and dental collaboration was observed in some hospitals and that hospital type, region, and hospital founders were associated with the performance of collaborative medical and dental care.

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.

Socioeconomic-related inequality in dental care utilization among preschool children in China.

This study aimed to investigate socioeconomic-related inequality in dental care service utilization in the past 12months among Chinese preschool children and to explore the contribution of various factors to this inequality. A total of 40305 children aged 3-5years from 372 kindergartens who participated in the Fourth National Oral Health Survey in China were included in the final analysis. The method of data weighting in complex sampling was adopted to make the samples more representative. Erreygers-corrected concentration index (EI) was used to measure socioeconomic-related inequality in dental care service utilization. The horizontal inequality index (HI) was employed to analyse horizontal inequality. Decomposition analyses were conducted to explore the contributions of income level, need variables (dmft, caregiver-evaluated oral health status and toothache experience) and nonneed variables (caregiver education level, residential location, age, and sex) to the inequality of health service utilization. The utilization of oral health services within the past 12months among the high-, middle- and low-income groups was 17.4% (95% CI: 15.6-19.3), 13.6% (95% CI: 12.2-15.1) and 9.4% (95% CI: 8.1-11.0) respectively. The concentration curve was below the line of equality, and the EI and HI were 0.072 and 0.078, respectively, indicating that dental care utilization in children aged 3-5years was concentrated in those who were better off. The contribution of the need variables to socioeconomic-related inequality in dental services was minimal, and most dental care utilization inequality could be explained by household income, caregiver education attainment and urban-rural disparities, accounting for 32.0%, 49.4% and 20.4% respectively. This study reveals the existence of pro-rich inequality in dental care utilization among preschool children in China. The decomposition analysis suggests that income, caregiver education background and urban-rural disparities are the main factors contributing to this outcome. Equity-oriented policies and programmes are needed to achieve equitable dental care utilization.

Recency of immigration and utilization of dental care services in Canada

To investigate the association between recency of immigration to Canada and the utilization of dental health services. The cross-sectional study sample (n=2137) was drawn from the 2015-2016 Canadian Community Health Survey (CCHS). It consisted of Canadian residents aged 12years and older who resided in the two provinces and one territory who opted into the optional dental module and gave valid responses to the questions 'How often do you usually see a dental professional, such as a dentist, a dental hygienist or a denturologist?' and 'Length of time since immigration to Canada?' for the outcome and independent variable, respectively. Multinomial logistic regression was used to analyse the data, and all statistics were weighted using sampling weights provided by Statistics Canada. The adjusted odds ratios were lower for recent immigrants than for established immigrants and for visits more than once per year (OR=0.35; 95% CI 0.14, 0.92), about once per year (OR=0.34; 95% CI 0.13, 0.90) and for less than once per year (OR=0.22; 95% CI 0.07, 0.64) than for those who never visited a dental professional. Recent immigrants, males, individuals aged 70years or more and those with a low household income were less likely to visit a dental professional than established immigrants, females, younger age groups or those with higher incomes. Better policies are needed to address the dental health concerns of recent immigrants who may suffer from poorer dental health, to ensure that they receive the care they require.

Dental Diseases and Factors Defining Utilization of Dental Care Services among Rural Children Aged 12 Years in Nellore District, Andhra Pradesh: A Community-Based Study.

Background:Rural children are predisposed to variety of dental problems, which may influence their overall health and well-being. Despite relentless efforts and achievements in oral health promotion by authorities, its impact seems limited in rural areas of developing countries.Aim:To generate data on the prevalence of dental caries and gingivitis, among 12-year-old rural children of Nellore district, Andhra Pradesh and factors facilitating or impeding uptake of dental care services.Methods:A cross-sectional, house-to-house survey was conducted in Kavali revenue division of Nellore district by random selection. A cluster sampling methodology was followed, and a total of 169 adolescents were involved in the study. Dental caries detection was performed according to the World Health Organization dentition status criteria and gingivitis according to modified Community Periodontal Index as gingivitis present or absent. Descriptive statistics were calculated.Results:Overall prevalence of dental caries and gingivitis was 39% and 35%, respectively, with <15% utilization of oral health care services. The main hurdle for this notably low utilization of oral health care services was that dental issues were not fatal or life-threatening.Conclusion:The prevalence of dental caries and gingivitis was high and poor utilization of oral health services was an importunate finding in this study. Understanding the trends of common oral diseases and hurdles in uptake of oral health care services could provide a basis for further research and improvement in accessibility to oral health care services in rural areas of developing nations.

PERCEIVED ORAL HEALTH NEEDS AND DENTAL CARE UTILIZATION AMONG PREGNANT WOMEN ATTENDING FAMILY HEALTH FACILITIES IN ALEXANDRIA

Introduction: Pregnant women are usually subjected to various hormonal and vascular changes that make them vulnerable to poor oral health. Scientific evidence has shown an association between periodontal health during pregnancy and adverse outcomes of labor such as low birth weight (LBW) and premature births. Hence, assessment of the self-perceived oral health status and needs along with the pattern of utilization of dental care during pregnancy is important. Objectives: The aim was to assess the self-perceived oral health status and needs along with rate of dental care service utilization among pregnant women attending the family health facilities, in Alexandria Governorate. Materials and methods: a cross-sectional analytical survey using a structured interview questionnaire was conducted on a simple random sample of 381 pregnant women attending family health care facilities in Alexandria governorate. Data was collected by a single, trained, examiner who interviewed the participants. A total of 3 facilities in each district were visited, till the required sample size was obtained (a total of 48 women from each district). The collected data were analyzed using IBM SPSS software package version 20.0. Results:More than half of the participants (66.93%) perceived their oral health status as excellent. Individual self-perception was affected by factors mainly; age, health status and number of children. The rate of dental service utilization was 56.96%, with the main influencing factors; age, pregnancy trimester, overall health status and prenatal care payment system, knowledge score and behavior score. Conclusions: Pregnant women lack sufficient knowledge about the importance of oral health and how it may affect their babies. Rate of dental service utilization is influenced by the lack of perceived need.

The impact of pregnancy on women\u2019s oral health-related quality of life: a qualitative investigation

BackgroundComplex psychological and physiological changes occur in women’s body during pregnancy. These changes affect both oral health status and oral health-related quality of life (OHRQoL). In almost all of the previous cross-sectional design studies on pregnant women, generic OHRQoL instruments have been used to measure OHRQoL. While such instruments may be reliable, they may not be appropriate to evaluate the OHRQoL in special populations like pregnant women. The purpose of this study was to investigate the self-perceived factors affecting the OHRQoL among pregnant women.MethodsIn this qualitative descriptive study, twenty- seven pregnant women were recruited from four healthcare centers located in Isfahan city, Iran. The interpretative phenomenological analysis was used to collect and analyze the data. Four criteria of credibility, dependability, transferability, and confirmability were implemented through established procedures to confirm the study rigor.ResultsThree major themes and six sub-themes capturing the impacts of pregnancy on women’s OHRQoL were identified. They covered all areas of life, including daily life, psychological well-being, social life, physical impact, and also barriers to utilization of dental care services. Some new domains such as “dentists’ refusal to treat pregnant women”, “negative feelings about pregnancy” and “concerns about fetal health” were found as important factors which could influence the OHRQoL during pregnancy.ConclusionThe findings help to better understand the oral health issues impacting women during pregnancy and to achieve person-centered care and improved oral health outcomes in pregnant women. The conceptual framework created based on the results of this study may help health care workers and policy makers for improving the health of pregnant women.

Perceived need and utilization of dental health care services in Indonesia: A secondary analysis using the national socioeconomic data

Background: Perceived needs and utilization of oral health services are important to ensure improvements in oral health outcomes and to allocate resources for the continuous provision of the services. This study aimed to determine the factors influencing the perceived needs and utilization of oral health services in Indonesia. Methods: Secondary data from the 2013 Indonesian National Socioeconomic Survey (n = 260,925) was used. Descriptive analysis and logistic regression were employed to describe the relationship between perceived needs and utilization of oral health services. Results: The proportions of Indonesians who had a perceived need for oral health services and utilized the services in 2013 were 1.64% and 2.30%, respectively. A higher probability of perceived need and utilization of dental health care services was observed in the respondents who wereold, females, unmarried, and living in rural areas and in those who had a higher level of education and health insurance. Conclusion: The proportions of individuals who presented with perceived needs and utilization of dental health care services were low and were associated with age, gender, marital status, geographic location, level of education, and insurance status. Appropriate strategies and policies are warranted to improve oral health in Indonesia.

COVID-19 affected patients' utilization of dental care service.

The novel coronavirus disease 2019 (COVID-19), characterized by symptoms of fever and pneumonia, was reported in Wuhan, China at the end of 2019 (Phelan, Katz, & Gostin, 2020). Given the likely transmission of COVID-19 via droplets and aerosols during dental clinical procedures, dental practitioners are at a high risk of COVID-19 infections (Ather, Patel, Ruparel, Diogenes, & Hargreaves, 2020). According to the guidelines of the Chinese Stomatological Association (CSA), dental clinics in China suspended the routine dental services and only provided emergency dental care between January and April 2020 (CSA, 2020). The objective of the study was to investigate the influence of COVID-19 on patients' utilization of dental services during the COVID-19 pandemic.

Socioeconomic-Related Inequalities in Dental Care Utilization in Northwestern Iran.

IntroductionThere have been multiple studies on socioeconomic-related inequalities in the use of dental services in Iran, but the evidence is still limited. This study measured inequality in dental care utilization by socioeconomic status and examined factors explaining this inequality among households in Ardabil, Iran in 2019.MethodsA total of 436 household heads participated in this cross-sectional study. Using a validated questionnaire, face-to-face interviews were conducted to collect data on dental care utilization, unmet needs, sociodemographic characteristics, economic status, health insurance, and oral health status of the participants. We used the concentration curve and relative concentration index (RCI) to visualize and quantify the level of inequality in dental care utilization by income. Regression-based decomposition was also applied to understand the causes of inequality.ResultsAbout 59.2% (95% CI 54.4%–63.7%) and 14.7% (95% CI 11.6%–18.4%) of participants had visited a dentist for dental treatment in the previous 12 months and for 6-month dental checkups, respectively. The RCI for the probability of visiting a dentist in the last 12 months was 0.243 (95% CI 0.140–0.346). This suggests that dental care utilization was more concentrated among the rich. The RCI for unmet dental care needs was negative, which indicates more prevalence among the poor. Monthly household income (20.9%), self-rated oral health (6.9%), regular brushing (3.2%), and dental health insurance (2.5%) were the main factors in socioeconomic inequality in dental care utilization.ConclusionThis study reveals that dental care–service utilization did not match the need for dental care, due to differences in socioeconomic status in Ardabil, Iran. Policies could be implemented to increase the coverage of dental care services among socioeconomically disadvantaged groups to tackle socioeconomic-related inequality in dental care utilization.

Barriers to utilisation of dental care services among children with special needs: A systematic review.

Disabled population accounts for 2.86 Crore of total Indian population. Among these 27.4% of population consists of children within age group of age 0 to 19 years. Studies have shown oral health status of children with special needs is lower than children without special needs. Though there are various attributing factors, access to dental care delivery and difficulties faced during dental treatment delivery are of major concern. Therefore the aim of this systematic review was set to assess the barriers faced by children with special needs during utilization of dental services; through caregiver's perception. For this review MEDLINE, EBSCO, COCHRANE, EMBASE and Google Scholar were the electronic data bases searched based on the PICO. PRISMA guidelines were followed for final inclusion of articles. The search generated a total of 259 articles from five different electronic bases: PUBMED, EMBASE, EBSCO, COCHRANE and GOOGLE SCHOLAR. Based on inclusion criteria, 7 articles made it to final analysis. All the 7 studies reported that dentist were unwilling to treat children with special needs as a major barrier followed by fear towards dentist by the children with special needs. The cross sectional studies of this review were assessed for quality using a modified Newcastle Ottawa Scale, proposed by Egger et al. in 2003. Even though the available literature forms a lower standard of evidence, further evaluation of barriers are recommended using better designed studies to substantiate the in equal access to healthcare facilities by these marginalized population.

Oral health status of children with epilepsy in Hong Kong.

This study assessed and compared the oral health status, dental trauma experience and oral health habits of children with and without epilepsy. Thirty-five children with epilepsy aged 3-18years old were recruited from the pediatric neurology clinics of 2 university-affiliated district hospitals. A sample of 35 age- and gender-matched healthy children was recruited as controls. Clinical data on caries, gingival health, oral hygiene level and dental trauma were collected and compared between the groups. Information about children's oral health habits and reported dental trauma experience were obtained by structured questionnaire. Children with epilepsy had significantly poorer gingival health than healthy controls. No significant differences in dental caries experience, oral hygiene level, dental trauma experience, oral health habits and dental care service utilization were observed between the children with and without epilepsy. Among the children with epilepsy, those taking more than 1 antiepileptic drug had a greater prevalence of dental caries when compared with those receiving mono-antiepileptic drug therapy. The presence of gingival hyperplasia indicated poorer gingival health in epileptic children. The study shows that children with epilepsy had poorer oral health status in terms of gingival health than those without epilepsy.