Utilization Of Oral Health 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.

Perceived strengths, weaknesses, opportunities and threats related to the utilization of oral health services among pre-conceptive married women before their first pregnancy in Kalutara District

Introduction: Utilization of oral health services during pre-conce ptive period is important for a woman to accomplish a healthy oral environment prior to her pregnancy. Objectives: To describe the perceived strengths, weaknesses, oppor tunities and threats (SWOT) related to the utilization of oral health services among pre-conceptive married women before the ir first pregnancy in Kalutara District Methods: In-depth interviews among pre-conceptive married wome n before their first pregnancy in Kalutara District were conducted using semi-structured interview guide. Purposive sampli ng method was used to select 18 study participants. Data were analysed manually using the thematic analysis method. The i nductive method was used to identify and generate codes and themes from the data itself. The theoretical perspective of qua litative data analysis carried out in this study was the ‘grounded theory approach’. Results: Identified strength was knowledge on benefits of oral health for the pregnancy and quality of life of women. Identified weaknesses were lack of motivation regarding oral health care seeki ng, lack of awareness that the pre-conception period is a crucial period for the oral health promotion among married women, f ear for dental treatment, myths related to the oral health and barriers related to attending dental clinics due to personal-level factors. Identified opportunities were availability of oral health component in the Healthcare for Newly Wedded Programme (HNWP), provision of the oral health education by the medical officer of health (MOH) office staff at the HNWP session s, help and guidance from the MOH office staff at the HNWP sessions to clarify oral health related issues, satisfactory pro vision of the government dental services, dental clinics in the MOH office premises and favourable working hours of the priva te dental clinics. Identified threats were barriers related to attending dental clinics due to service-related factors and lack of information regarding the oral health component of the HNWP from peer groups. Conclusions &amp; Recommendations: Perceived SWOT related to t he oral health services among pre-conceptive married women were identified. These findings will be important to the poli cy makers and service providers to plan an effective oral health service for married women before their first pregnancy.

Patterns, barriers, and utilization of oral healthcare provided at primary health centers (PHCs) and its association with oral health status among rural population in Rohtak district, Haryana: A household cross-sectional study.

Access to oral healthcare is limited in rural areas, resulting in disparities in oral health services. Primary health centers (PHCs) are essential for providing integrated oral healthcare to rural populations. This study examines the patterns, barriers, and utilization of oral healthcare at PHCs in Rohtak district, Haryana. In this 6-month household cross-sectional study, data were collected from a sample of 600 participants residing in rural areas under the jurisdiction of three randomly selected PHCs in Rohtak district. The study employed multistage cluster systematic random sampling procedures. Data collection included structured questionnaires and clinical oral examinations following the type-III ADA classification. Participants' oral health status was evaluated using the WHO oral health assessment form for adults (2013). Descriptive and analytical statistics were used for data analysis. Dental caries and periodontal diseases were more common in older age groups. Barriers to oral healthcare among the elderly include fear of dental procedures and low dental literacy. Proximity to PHCs influenced dental service utilization, with higher rates among participants living near a PHC, that is, within 5 km of a PHC. Age, gender, proximity to PHCs, household size, and socioeconomic status play crucial roles in the utilization of oral health services among the rural population. Addressing these factors is essential for improving oral healthcare and overcoming barriers. It is crucial to enhance the accessibility, affordability, and availability of oral health services at PHCs to promote better oral health and overall well-being in rural areas.

Factors associated with oral health service utilization among young people in southern China

ObjectivesTo identify the patterns and influencing factors of oral health service utilization among college students, and further to provide scientific evidence for policy making on oral health education and behavioral interventions for the college population.MethodsThe study population was college students in Southern China. Totally 678 students participated in the survey. A self-designed questionnaire based on Anderson’s model (predisposing factors, enabling factors, need factors) was used to survey college students. Descriptive statistics, χ2 test, and logistic regression were used to analyze influence factors of oral health service utilization among college students.ResultsThe utilization rate of oral health service in the past 12 months was 30.2%. The primary type of oral health service was treatment (59.6%), and only 12.8% were for prevention. There were 39% of the participants having oral health diseases, of which dental caries (25.7%) and oral bleeding (22.2%) were the main problems. The results from logistic regression analysis revealed that students with better beliefs (OR = 1.84, 95% CI:=1.02–3.43), frequent consumption of sugary drinks (OR = 2.90, 95% CI:=1.90–4.47), teeth brushing frequency > = 2 times per day (OR = 2.09, 95% CI = 1.24–3.61), frequent floss utilization (OR = 2.63, 95% CI = 1.21–5.76), dental caries (OR = 2.07, 95% CI = 1.35–3.17) used oral health services higher, while those lived in rural areas (OR:0.52, 95% CI = 0.34–0.80), and had only a fair concern (OR = 0.48, 95% CI = 0.31–0.74) or no concern (OR = 0.26, 95% CI = 0.08–0.67) on oral health utilized oral health services lower.ConclusionsChinese college students demonstrate some knowledge and attitudes towards oral health. However, they tend to neglect oral hygiene and have limited understanding of their own oral issues. Furthermore, the utilization of oral services, such as treatment, remains remarkably low, despite the availability of long-term and favorable health insurance policies. The utilization of oral health services among college students is influenced by various factors, including residing in rural areas, consuming sugary beverages on a daily basis, brushing teeth at least twice a day, and practicing flossing.

Towards the integration of prevention and control of oral diseases within child primary healthcare: The case of Peru.

The Peruvian public health norm of primary healthcare (PHC) for growth and development medical check-ups (CRED, Spanish acronym) of children under 5 years of age was updated in 2017 with the inclusion of interdisciplinary prevention and control actions for oral diseases, such as dentist referral. The aim of this study was to explore the association between CRED and oral health services utilization (OHSU), throughout the heterogeneous Peruvian territory. A population-based cross sectional study was conducted using the 2021 Demographic and Family Health Survey of Peru and included data from 15 836 children aged 12-59 months. Poisson generalized linear models were used to evaluate the association between any CRED and OHSU, in the 6 months prior to the survey, including sociodemographic characteristics of the children and their mothers as confounding variables. A possible effect modification by natural region of residence (Metropolitan Lima/rest of the Coast/Highlands/Jungle) was evaluated. To examine the robustness of the regression model, a sensitivity analysis was performed using the cumulative number of CRED. Children who had at least one CRED were almost twice as likely to report OHSU (aPR: 1.95; 95% CI: 1.73-2.21), which was greater in the regions of rest of the Coast (aPR: 2.56; 95% CI: 2.00-3.17) and Jungle (aPR: 2.03; 95% CI: 1.64-2.56). The sensitivity analysis showed consistent results for the association CRED-OHSU. Nevertheless, within the last 6 months, attendance at CRED and OHSU were only achieved by 43.7% and 13.7% of the children respectively. Integrating oral health into Peruvian Child PHC seems to be a promising public health intervention to increase children's OHSU. For a greater scope, it is crucial to drive greater attendance at CRED and continuous monitoring and strengthening of CRED-based oral health promotion in all Peruvian natural regions with an equity-focused approach.

Decomposition Analysis of Socioeconomic Inequalities in Utilization of Oral Health Services: A Population-Based Study in Urban and Rural Households of Ahvaz.

Inequality in the use of dental services is a primary concern of global health, and few studies have been done in this field in Iran. Therefore, the present study aimed to conduct a decomposition analysis of socioeconomic inequalities in the utilization of oral health services. This was a cross-sectional study in which 715 households, including 2680 people living in Ahvaz, were included using a stratified-cluster sampling. Data were collected using a questionnaire. For data analysis and estimating the elasticity of the influencing factors, the logistic model and Stata software were used. The social and economic disparities in oral health variables were broken down into determinant components using the Van Doorslaer and Wagstaff technique. The key factors determining social and economic inequalities in the utilization of these services were insurance status, education level, income quintile, and occupation. Nearly 31% of utilization inequalities can be attributed to the insurance status of households. In addition, the education level of household members (about 28%) was the second factor of inequality. The variables of income quintile and occupation are also considered as the third factor, and the age of household members had a negative role in the socioeconomic inequality. The utilization of oral health services can be improved by improving economic and social variables in society. Therefore, including oral health services in insurance plans and primary health care services and supporting people with low-income levels can play an important role in reducing these inequalities.

Effect of the healthcare for newly wedded programme on the utilization of oral health services among married women before their first pregnancy in Kalutara District, Sri Lanka

Introduction: Oral health denotes an important perspective of health for women. The Healthcare for Newly Wedded Programme (HNWP) has a major role on improving oral health among married women before their first pregnancy.Objectives: To assess the utilization of oral health services and effect of the HNWP on the utilization of oral health services among married women before their first pregnancy in Kalutara District.Methods: A community-based cross-sectional study was done among 820 married women before their first pregnancy in Kalutara District. The sample was obtained by two-stage cluster sampling method based on probability-proportionate-tosize technique. An interviewer-administered questionnaire and an oral health assessment form were used for data collection. Categorical data were presented as percentages with 95% confidence intervals (CI). Bivariate analysis was done for comparisons and multivariate analysis was done to adjust for confounders.Results: Only 21.5% of the participants had utilized oral health care services after marriage and 38.5% of women who had perceived dental treatment needs, utilized oral health services. In this context, the most frequent reason for non-attendance was thinking that there was no need for treatment. Participation in the HNWP was significantly associated with the utilization of oral health services (p&lt;0.001), screened for oral diseases (p&lt;0.001) and free of oral diseases (p=0.003). Being referred to a dental clinic was significantly associated with the utilization of oral health services (p=&lt;0.001), screened for oral diseases (p=0.001) and free of oral diseases (p=0.001).Conclusions &amp; Recommendations: Utilization of oral health services among married women prior to their first pregnancy remained at an unsatisfactory level. The results of the present study indicated that the HNWP is effective in improving utilization of oral health services among them. Therefore, utilization of oral health services among married women before their first pregnancy should be improved through the HNWP.

Trends in maternal oral health services at primary healthcare centers in Saudi Arabia: a cross-sectional study

BackgroundDuring pregnancy, many complex physiological changes and increased levels of pregnancy hormones are associated with adverse oral health and increased prevalence of periodontal disease. Our study aimed to assess the oral health needs of pregnant women and describe the patterns of dental services provided to them before, during, and after pregnancy. Assessing the oral health needs of pregnant women and understanding the patterns of dental services provided to them are important to facilitate efficient utilization of oral health services to promote better health outcomes for the mother and baby.MethodsOur study utilized a cross-sectional design to examine the prevalence of dental problems and use of dental services among a sample of postpartum women who visited primary healthcare centers (PHCs) in Jeddah for antenatal care, between 2018 and 2019. A link to a questionnaire adapted from the Pregnancy Risk Assessment Monitoring System (PRAMS) was sent to participants via the WhatsApp messaging platform. A total of 1350 postpartum women responded to the online survey. We estimated the prevalence of dental problems among women before and during pregnancy and assessed the association between their dental problems and their respective demographic characteristics. We calculated the prevalence of each dental service received before, during, and after pregnancy and examined the trends in dental services over these three periods. All bivariate associations were tested using Pearson’s chi-squared test.ResultsWe found that significantly fewer women visited a dental clinic during pregnancy (31.0%) compared to pre-pregnancy (38.2%) and post-pregnancy (47.3%). The prevalence of toothache, dental caries, gum disease, and dental extraction need before pregnancy was 45.9%, 57.0%, 27.3%, and 40.0%, respectively. These percentages remained the same during pregnancy, except for the need for dental extraction, which significantly decreased to 35.3%. Check-up dental visits increased significantly to 70.6% during pregnancy compared to pre-pregnancy (51.7%) and post-pregnancy (59.9%).ConclusionIncreasing women’s awareness of the importance and safety of oral healthcare during pregnancy, training dental students and primary healthcare dentists in the practice guidelines for the dental management of pregnant women, and developing and monitoring key performance indicators for maternal oral healthcare are the starting steps for improving the oral health and well-being of women and their children.

The prevalence and common risk indicators of root caries and oral health service utilization pattern among adults, a cross-sectional study.

Root caries is a prevalent oral health concern among adults, yet there remains a need for a comprehensive understanding of its occurrence and associated risk indicators. The present study was aimed to investigate the prevalence of root caries and to determine significantly associated indicators with it among adults. The residents aged 35-74 years old were enrolled in a cross-sectional study in which dental examination were taken and structured questionnaires were collected in Zhejiang Province, China. All data were recorded in an electronic system and analyzed. The prevalence of decayed and filled root caries in 1,076 respondents was 31.9%. Elder age, greater attachment loss, and exposed root surface were associated with higher odds of incidence for decayed/filled roots and decayed roots. In the last 12 months, 27.4% of adults with decayed or filled roots and 23.2% of others utilized oral health services. Carious adults who had a very poor/poor oral health status were 2.905 times likely to report dental visits. People with sound roots who were female (OR = 2.103, P < 0.001), perceived their oral health status as moderate (OR = 1.802, P = 0.015), or poor/very poor (OR = 4.103, P < 0.001) were more likely to visit a dentist in the past 12 months. Age, attachment loss and root exposure were most significantly associated with the prevalence of root caries. Individuals who recognize their poor or very poor oral health status should feel encouraged to make use of oral health services.

A Scoping Review of Oral Health Outcomes and Oral Health Service Utilization of 2SLGBTQ+ People

Background: Oral health is an integral aspect of overall well-being and quality of life. Population groups such as two-spirit, lesbian, gay, bisexual, transgender, and queer, including other sexual and gender minorities (2SLGBTQ+), have reported poor oral health outcomes. Therefore, the aim of this review was to investigate the extent and scope of the literature describing 2SLGBTQ+ oral health outcomes, including unmet oral health needs and patterns of oral health care service utilization, as well as the risk factors affecting both. Methods: A comprehensive search strategy was developed to review the scope of the literature pertinent to unmet oral health needs and factors affecting access to oral health care among 2SLGBTQ+ members, globally. In total, 6 databases were searched with a combination of keywords relevant to 2SLGBTQ+ oral health status and oral health care utilization. Results: Our review identified 10 studies that met the eligibility criteria. Five out of 10 studies were based in India, 4 in the United States, and 1 in Brazil. Two studies reported poorer oral health outcomes among transgender people as compared with cisgender people, while 2 studies reported similar patterns of dental service utilization between their transgender and cisgender participants. Five studies explored the personal and structural risk factors associated with poor oral health outcomes, including financial affordability and income level and perceived discrimination, including instances of misgendering in health care settings. However, further comprehensive studies must be conducted to validate the trends and findings reported by the studies in the review and to generate data from diverse regional contexts. Conclusions: Our review identified that the extent of the literature in this research area is sparse and scarce. The evidence indicates poorer oral health status among 2SLGBTQ+ communities. Wider studies with diverse, representative samples are required to gain a comprehensive understanding of 2SLGBTQ+ oral health outcomes. Knowledge Transfer Statement: The results of this review will undoubtedly be important for many years to come as 2SLGBTQ+ oral health equity is prioritized by experts in public health dentistry. This review will allow other researchers to understand and fill literature gaps regarding 2SLGBTQ+ oral health outcomes, furthering this area of research.

Oral Health Beliefs, Perceptions and Utilisation of Oral Health Care Services among the Indigenous People (Orang Asli) in Pahang, Malaysia: A Qualitative Study

Introduction: Orang Asli refers to the indigenous people of Peninsular Malaysia, representing 0.6% of the Malaysian population. Vast inequality was observed regarding oral health beliefs, behaviour, and utilisation of oral health services between the Orang Asli and non-Orang Asli. The aim of the study was to explore the oral health beliefs, perceptions, and oral health service utilization behaviour among Orang Asli in the district of Bera, Pahang, Malaysia. Methods: Orang Asli’s oral health beliefs and perceptions of oral healthcare service were ascertained through four FGDs. Nineteen participants from Bera’s semi-urban and rural Orang Asli communities were convened. Emerging themes from the qualitative data were analyzed using thematic analysis. Results: Orang Asli believed that oral health is essential for an individual’s function and aesthetics. They are also aware that inadequate oral hygiene care will result in tooth decay and gum disease. Most of the Orang Asli that chewed betel nuts believed that limestone paste could cause oral cancer. The main barriers to Orang Asli accessing oral healthcare services were time constraints and distance to the nearby clinic. Conclusion: The Orang Asli believed oral health care is essential in ensuring a healthy oral condition. Despite their generational belief towards traditional healers and medication, Orang Asli in Bera had a perceived positive acceptance towards oral healthcare services.

Frequency, inequalities and spatial distribution of oral health services utilization in Peruvian children under twelve years of age: a population-based comparative analysis of the years 2017 and 2021

BackgroundOral diseases pose a significant public health challenge among Peruvian children. However, oral health services utilization among them is marked by inequalities, which may have been exacerbated by the COVID-19 pandemic. The objective was to compare the frequency, inequalities, determinants of inequality, and spatial distribution in oral health services utilization in Peruvian children under 12 years of age in 2017 and 2021.MethodsComparative secondary data analysis from the Demographic and Family Health Survey (ENDES) for the years 2017 (38,787 minors) and 2021 (36,729 minors). Age-adjusted prevalence ratios (PR) with 95% confidence intervals (CI) were calculated to assess the change in oral health services utilization in the last 12 months between the years 2017 and 2021, stratifying by demographic and socioeconomic covariates. Inequality was assessed by decomposing the Erreygers Concentration Index (ECI) and calculating the percentage contribution to inequality of the independent variables. Spatial analysis was performed using spatial autocorrelation methods, Hot Spot Analysis, Cluster and Outlier analysis, Inverse Distance Weighting, ordinary Kriging, and Kulldorff analysis.ResultsThe probability of Peruvian children under 12 years of age using oral health services in the last 12 months was reduced by 45% in 2021 compared to 2017. The ECI identified a significant reduction in oral health services utilization inequalities at the national level (Diff: -0.0963; p < 0.001). The main contributor to inequality was higher tutor education level (55.2% in 2017 and 82.7% in 2021). In the comparison of spatial distribution, there was a greater dispersion of the conglomerates in which the use of oral health services is concentrated in 2021.ConclusionsThe frequency of oral health services utilization in the Peruvian children under 12 years of age was halved between 2017 and 2021. This problem is transversal to the entire population at the demographic and socioeconomic level. The key factor contributing to inequalities in the utilization of oral health services was the higher educational attainment of caregivers or guardians. Despite the improvement observed in inequalities and spatial distribution of the concentration of oral health services utilization, it is necessary to keep monitoring these patterns to guide decision-making.

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.

Analisis Determinan Pemanfaatan Pelayanan Kesehatan Gigi dan Mulut di Kota Depok pada Masa Pandemi Covid-19

During the Covid-19 pandemic, starting from 2019, there was a 62.78% gap in dental and oral care patient visits at the Depok City Health Center. Data from the Depok City Health Department indicates a decrease in patient visits at the Depok City Health Center in 2018 by 90,366, in 2019 by 90,979, in 2020 by 33,861, and in 2021 by 29,455. The purpose of this study is to determine the factors associated with the utilization and selection of dental and oral healthcare providers in Depok City during the Covid-19 pandemic. It is a cross-sectional study conducted on the population of Depok City in 2021, with respondents who are willing to fill out online questionnaires, understand the Indonesian language, are able to read, write, communicate, and have a smartphone. The sample size is 580 people, and multivariate analysis with multinomial regression is used. The research results show that during the Covid-19 pandemic, 26.7% of the population utilized government services, 11.6% utilized private services, and 61.7% did not utilize any services. The multivariate analysis results indicate that age, marital status, medical history, insurance, and perception of needs have a significant relationship with the prediction of choosing to utilize dental and oral health examinations provided by the government and private sectors. The determinant factors associated with the utilization of dental and oral health services during the Covid-19 pandemic are age, having a medical history, having insurance, and having a perception of needs.&#x0D; &#x0D;

Utilization of dental services and encountered barriers among rural population of Rewari district

Objectives: The aim of the study was to assess the level of utilization of dental services and barriers to utilization of oral health services among rural population of Rewari district, Haryana. Materials and Methods: A descriptive and cross-sectional survey was conducted among 150 participants in Rewari District. Oral health was assessed using 28-item and 22-item self-administered, closed ended, and structured questionnaires for adults and children, respectively based on oral health assessment proforma by the World Health Organization. Descriptive statistics were used to summarize the results. Binary logistic regression analysis was performed using questions related to the last dental visit as dependent variables. Results: A total of 150 subjects participated in this questionnaire study. Utilization of dental services was limited to emergency and curative procedures. Only 34% of children and 19% of adults had visited the dentist in the past 1 year. Whereas, 30% of children and 34% of adults had never received dental services. The most commonly reported reasons for the last visit to dentist in 48.5% of children and 51.5% of adults is the pain or trouble with teeth, gums or mouth, followed by routine check-ups in 25.7% and 31.8% in children and adults, respectively, and results were found to be highly significant (P = 0.011). Conclusion: Majority of population assumes that visiting the dentist is simply for pain treatment. People were unaware of their dental problems and the number of self-reported dental issues was low.

Cost-related avoidance of oral health service utilization among lesbian, gay, and bisexual individuals in Canada.

This study estimates the frequency of cost-related oral health service avoidance (CROHSA) among lesbian, gay, and bisexual (LGB) individuals in Canada relative to heterosexual persons. Heterosexual and sexual minority individuals in Canada were compared using the national probability-based Canadian Community Health Survey 2017-2018. Logistic regression was used to quantify associations between LGB status and CROHSA. Mediators were tested following Andersen's behavioral model of health service utilization and included partnership status, oral health status, presence of dental pain, educational attainment, insurance status, smoking status, general health status, and personal income. From our sample of 103,216 individuals, 34.8% of LGB individuals reported avoiding oral health care due to cost compared to 22.7% of heterosexual persons. Disparities were most pronounced among bisexual individuals (odds ratio [OR] 2.29 95% confidence interval [CI] 1.42, 3.49). Disparities persisted despite adjustment for confounding using age, gender/sex, and ethnicity (OR 2.23 95% CI 1.42, 3.49). Disparities were fully mediated by eight hypothesized mediators namely, educational attainment, smoking status, partnership status, income, insurance status, oral health status, and the presence of dental pain (OR 1.69 95% CI 0.94, 3.03). In contrast, lesbian/gay individuals did not have elevated odds of experiencing CROHSA compared to heterosexual individuals (OR 1.27 95% CI 0.84, 1.92). CROHSA is elevated for bisexual individuals relative to heterosexual individuals. Targeted interventions should be explored to improve oral healthcare access among this population. Future research should assess the role of minority stress and social safety on oral health inequities among sexual minority groups.

Utilisation of Oral Health Services and Associated Factors in a Sub-Urban Population in Western Uganda

Aim: To determine the prevalence and factors affecting the level of utilization of oral health services in a sub urban adult population in Ishaka-Western Uganda. Methods: A community-based cross-sectional study was conducted among 384 study participants. Data was collected using pre-tested and structured questionnaires. Data was entered in Epi-info computer software version 3.5.1 and exported to STATA Version 14.0 for analysis. Univariate analysis and modified Poisson regression were done to identify factors associated with utilization of oral health services. Crude prevalence ratios with 95% confidence interval were used to determine the level of significance at bivariate meanwhile adjusted prevalence ratios were calculated at multivariate analysis to establish independent significant factors. Results: The mean age of the study participants was 30.22 ± 9.97. It was observed that 36.72% of the study participants had utilized oral health services. Factors affecting utilization of oral health services that were statistically significant were level of education (tertiary level of education versus none) (P&lt;0.001), average monthly income of &gt;1,000,0000 Shilings (about $300) versus &lt;501,000 ( about $150) (P&lt;0.001), no phobia for dental procedures (P=0.035), perception that oral health visits are important (P=0.017) and positive attitude of attending health workers ( P=0.028). Conclusion: This study has shown that the level of utilization of oral health services in the studied suburban adult population was poor. The level of education, income and phobia for dental procedures were associated with the utilization of oral health services. It is recommended that oral health promotion strategies be deployed in order to increase awareness and access to oral health care. Keywords: Oral health services, community-based cross-sectional study, Uganda

Oral health behavior and oral health service utilization among cancer patients in China: A multicenter cross-sectional study.

Oral health plays an important role in overall health. But there is scarce information available on oral health behavior and oral health service utilization among cancer patients. This study aimed to evaluate oral health behavior and oral health service utilization among different population groups of cancer patients in China. A multicenter cross-sectional study in three tertiary hospitals was conducted to explore the oral health behaviors and oral health service utilization of 162 cancer patients in China. We investigated a total of 162 cancer patients, 81 from urban and rural areas, respectively. The participant's ages ranged from 18 and 82 years, mean age was 44.62 years (SD = 15.72). Overall, cancer patients have poor oral health behaviors and limited oral health service utilization. There were statistically significant differences (p < 0.05) between urban and rural cancer patients in terms of oral health behaviors, including brushing methods, the use of fluoride toothpaste, the use of dental floss, dental caries, and bleeding gums while brushing teeth. As for oral health service utilization, there were significant differences (p < 0.05) between urban and rural cancer patients on regular dental cleaning, the reasons for visiting a dental clinic, and whether they took the initiative to learn about oral health. The study findings suggest that cancer patients had poor oral health behaviors and limited oral health service utilization, and rural patients perform poorer than their urban counterparts. Oral health education should be provided to cancer patients to improve their oral health behaviors and oral health service utilization.

Adolescents and oral health service utilization in Canterbury, New Zealand: A geospatial cross-sectional study.

Non-utilization of dental care during adolescence can result in poorer oral health and subsequently higher expenditures on dental services. This study examined the geospatial and epidemiological factors associated with utilization of the publicly funded Adolescent Oral Health Services (AOHS) in Canterbury, Aotearoa New Zealand (NZ). A secondary analysis of prospectively collected routine data from AOHS visits of adolescents in school Year 9 (13-14 years) for the financial year 2019-2020. Geographic information systems examined distance from home to dental practices. Multilevel mixed-effects Poisson regression models investigated associations between geospatial, demographic and clinical factors and non-utilization of dental services. Models were adjusted for sex, ethnicity, area-level deprivation, rural/urban classification, previous caries experience and the distance from home address to dental practice referred. Dental practices were concentrated in large urban areas and in the least deprived neighbourhoods, with several service area gaps identified. Rural areas and the most deprived areas of Christchurch City had the highest non-utilization rates. After adjustment, adolescents residing in the most deprived areas had a higher risk of non-utilization (adjusted risk ratio [aRR] = 1.38; 95% CI 1.26-1.51) compared to adolescents in the least deprived areas. Adolescents in remote areas also had an increased risk of non-utilization (aRR = 1.36; 95% CI 1.20-1.54) compared to adolescents in urban core areas. Finally, Māori (aRR = 1.37; 95% CI 1.29-1.46) and Pasifika (aRR = 1.46; 95% CI 1.35-1.59) adolescents had significantly higher risks of non-utilization compared to their NZ European counterparts. Inequitable utilization of dental services exists among adolescents in Canterbury, NZ, and is associated with Māori, Pasifika and those living in rural and most deprived areas. Adolescents at the greatest oral health risk are geographically underserved by current oral health services. The current health system should also explore the possibility of partnering with Māori and Pasifika communities to provide services within culturally appropriate settings.

The impact of oral health literacy on dental anxiety and utilization of oral health services among dental patients: a cross sectional study

BackgroundLow oral health literacy levels and deficient oral health knowledge jeopardize the communication between dentists and patients in different communities. This study aimed to examine the impact and association of oral health literacy with patients’ levels of dental anxiety and their utilization of dental health services.MethodsThis cross-sectional study was conducted at the Misr International University (MIU) dental clinics. The study utilized a structured, interview led questionnaire that was administered by second year dental students, over the period of two successive academic years 2018–2019 and 2019–2020. A total of 440 student interviewed a convenience sample of 440 dental patients: including 269 females (61.1%) and 171 males (38.9%). The questionnaire consisted of four sections; a demographic section, a modified Arabic Rapid Estimate of Adult Literacy (ARELAD-30) Tool that measures the ability of the participants to read 30 commonly used dental terms. This questionnaire was modified by the authors to measure the participants’ knowledge by asking them to choose the most accurate meaning for each word based on their previous knowledge. Scoring was dependent on the participant’s immediate correct pronunciation, as well as comprehension of each word. The Arabic Modified Dental Anxiety Scale (AMDAS) was used to measure the level of dental anxiety, and the dental health service utilization was measured using the Utilization of oral health services questionnaire.ResultsOne quarter (24.1%) of the participants read the 30 items of the A-REALD correctly. The average percentage of correct responses to the meaning of the dental terms was 71.2%. There was no statistically significant association between A-REALD and knowledge scores (Spearman’s Correlation coefficient ρ = -0.008, p-value = 0.872). There was a statistically significant inverse correlation between age and MDAS (Correlation coefficient ρ = -0.146, p-value = 0.002). A-REALD scores were inversely correlated with time since last visit (Regression coefficient = -0.027, p-value = 0.036, with 95% CI: -0.052 – -0.002).ConclusionWithin the limitations of this study, it can be concluded that oral health literacy is significantly associated to dental health services utilization, while, dental anxiety is related to other variables, such as age and gender.