Abstract
Background
This study used the Anderson Behavioral Model to assess the socioeconomic inequalities in dental services utilization among adults in Saudi Arabia, along with other predictors of utilization, to inform future planning of dental care services.
Methods
In this cross-sectional study, we conducted secondary analysis using national data from the 2019 Kingdom of Saudi Arabia World Health Survey (KSAWHS). The survey consisted of two interviewer-administered questionnaires, one for the household and one individual interview. The questionnaires included questions covering predisposing factors (age, gender, marital status, nationality, education, employment), enabling factors (income, household wealth, area-based socioeconomic class, health insurance, eligibility for free governmental health care, transportation and region of residence) and self-reported need for dental treatment. The main outcome was dental utilization. The independent variables were the predisposing, enabling and need factors. Hierarchical logistic regression analyses identified significant predictors of dental utilization, applying survey weights to adjust for the complex survey design. Adjusted odds ratios with 95% confidence intervals and p values were reported in the final model.
Results
The final dataset included 8,535 adults (response rate = 95.4%). Twenty percent of adults visited the dentist at least once in the past year (95%CI: 18% -21%). The socioeconomic factors associated with the higher likelihood of dental service utilization in the final fully adjusted model were high household income (OR = 1.43, p = 0.043), second and middle household wealth status (OR = 1.51, p = 0.003 and OR = 1.57, p = 0.006) and access to free governmental health care (OR = 2.05, p = 0.004). In addition to self-reported oral problems (OR= 52.09, p < 0.001).
Conclusion
Socioeconomic inequalities in the utilization of dental services exist in Saudi Arabia. The main driver of dental services utilization in adults was the need for treatment suggesting predominantly symptomatic attendance. Increasing awareness about the importance of preventive dental visits rather than symptomatic attendance could be an important policy implication to improve oral health and optimize dental care expenditure. Further research should explore the drivers for adults to seek preventive care in the absence of any recognized dental problems.
Dental workforce availability and dental services utilization in Appalachia: a geospatial analysis
