Socioeconomic Inequalities in the Utilization of Dental Services Among Adults in Saudi Arabia

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.

Urban-Rural Disparities in Dental Services Utilization Among Adults in China's Megacities

Objective: China's dental care system is bifurcated between urban and rural areas. However, very few studies have examined the dental services utilization inequities in China's megacities, particularly in these urban and rural areas. This study aims to examine the urban-rural disparities in dental services utilization among adults living in China's megacities based on the Andersen dental services utilization model.Methods: This study used data from 4,049 residents aged 18–65 who participated in the “2019 New Era and Living Conditions in Megacities Survey.” Multivariate logistic regressions were employed to examine the associations between place of residence and dental services utilization for individuals from ten megacities in China. Predisposing variables (age, gender, marital status, living arrangement, and education), enabling variables (socioeconomic status, occupational status, income, insurance coverage, health attitude, and health behavior), and need variables (self-rated health, oral health status, gum bleeding) were controlled for.Results: The mean age of the 4,049 adults was 45.2 (standard deviation = 13.0), and 30.4% (n = 1,232) had no dental visits at all. Adults who resided in urban areas were more likely to use dental services [odds ratio (OR) = 1.57, 95% confidence interval (CI) = 1.30 to 1.91] than those residing in rural areas after controlling for key covariates. Factors associated with higher odds of visiting dentists include having a higher income (OR = 1.44, P &lt; 0.001), higher education level (OR = 1.53, P = 0.042), being covered by insurance for urban residents/employees (OR = 1.49, P = 0.031), having a positive attitude toward healthy diets (OR = 1.43, P &lt; 0.001), attending regular physical examination (OR = 1.66, P &lt; 0.001), having more tooth loss (OR = 1.05, P &lt; 0.001), and having frequent gum bleeding (OR = 2.29, P &lt; 0.001).Conclusion: The findings confirm that place of residence is associated with dental services utilization while adjusting for key covariates. Despite rapid economic development in China, many adults had never visited dentists at all. More efforts should be taken to encourage widespread dental care, such as providing more dental coverage and better access to dental care services.

Parents View About Oral Health Status, Oral Hygiene Behaviors, and Dental Services Utilization of Their Children With Hearing Impairment Attending Special Schools

Objectives: Parents are the principal decision-makers regarding their child’s health. Awareness of parents’ views regarding their children's health, particularly with special health care needs, is essential for health care providers. Therefore, the present study aimed to assess the parents' view about oral health status, oral hygiene practices, and dental services utilization of their children with hearing impairment attending special schools.Results: 57.4% of the parents rated their children's oral health status as very good or good, 27.9% as moderate, and 9.0% as poor. About half of the parents (49.2%) stated that their children used toothbrush once daily, and 15% use dental floss. Also, 54% of the children visited the dentist before this survey's conduct. The twice brush or more a day was significantly associated with the oral health status (OR: 22.16; CI 95%), and other factors did not show a significant association.

Awareness, perceptions and dental services utilization by patients a tertiary care centre during COVID-19 pandemic

BACKGROUND. COVID -19 pandemic has imposed multiple questions and consideration in the minds of the patients and dental professionals. The understanding of patient’s perceptions and dental services utilization can aid in modifying the pre-existing dental practices. The aim of the present study was to assess the awareness, perceptions and dental services utilization by patients visiting a tertiary care centre during COVID-19. METHODOLOGY. A cross-sectional study on 437 patients was carried using a validated questionnaire consisting of 22 questions on three domains. Strict sterilization protocol and infection control measures were practiced to avoid any contact between the investigator and the patient. RESULTS. Patients were aware of COVID -19 pandemic and were willing (76.7%) to inculcate preventive practices even post-pandemic. Concerns regarding the spread of infection (37.3%) and hygiene/cleanliness (28.6%) were most commonly reported. Patients visited the dental centre primarily for emergency management and preferred their queries being solved on the phone. CONCLUSION. Patients had a positive outlook towards visiting the dental centre for treatment in the near future and did not report any anxiety before visiting a dental centre.