Dental service utilization by independently dwelling older adults in Manitoba, Canada.
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OBJECTIVES: The objectives of this study were to determine the rate of use of dental services by independently living older dentate and edentulous adults and the factors affecting utilization. METHODS: Data were derived from the cross-sectional Manitoba Study of Health and Aging. A personal interview included over 240 questions addressing sociodemographics, well-being, oral and general health, and health service utilization. Variables that were significantly associated with visitation on bivariate analysis were entered into separate logistic regressions for dentate and edentulous participants. The Anderson model of health service utilization was used to categorize variables with significant independent effects as predisposing, enabling and need factors. RESULTS: The 1,751 participants had a mean age of 76.2 years (standard deviation 7.1); 58.5% were women and 72.7% were edentulous. Only 383 participants (21.9%) reported having visited a dentist in the past 6 months. The visitation rate for dentate seniors (36.2%) was significantly higher (p < 0.001) than that for edentulous seniors (13.5%). Multiple logistic regression analysis revealed significant independent effects of 5 variables for each group. Predisposing factors predicting visitation for both groups were higher level of education and frequent use of professional services. For dentate adults, dental visitation was predicted by 3 enabling factors (main supporting person not a family member, fewer restrictions on activities of daily living and residence in a major urban centre) but no need factors. For edentulous participants, dental visitation was predicted by only 1 enabling factor (higher income) and 2 need factors (recent dental problems and longer duration of denture use). DISCUSSION: Regular dental visits are important in maintaining good health, for edentulous as well as dentate seniors. Despite this fact, older Manitobans, especially the edentulous, are not accessing care in an appropriate manner. One unexpected finding was that despite equivalent abilities, cognitive status and health problems, those who had a family member as their main supporting person were less likely to have a dental visit than those supported by non-family members. This may relate to resistance from family members to provide appropriate support for dental visits, an issue considered by some to be a form of elder abuse. CONCLUSION: Despite some common predisposing factors, the variables influencing dental utilization were different for dentate and edentulous participants, with enabling factors playing a bigger role for the dentate and need factors of greater importance for the edentulous. These findings seem to indicate that older dentate adults who visit the dentist do so because they can, while older edentulous adults who visit the dentist do so because they must. (+info)
Factors influencing the use of public dental services: an application of the Theory of Planned Behaviour.
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Racial differences in baseline treatment preference as predictors of receiving a dental extraction versus root canal therapy during 48 months of follow-up.
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Early childhood caries and access to dental care among children of Portuguese-speaking immigrants in the city of Toronto.
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OBJECTIVE: To determine the influence of accessibility of dental services and other factors on the development of early childhood caries (ECC) among Toronto children 48 months of age or younger with at least one Portuguese-speaking immigrant parent. METHODS: This population-based case-control study involved 52 ECC cases and 52 controls (i.e., without ECC) identified from community centres, churches and drop-in centres by a process of network sampling. Caries status (dmft/s) was assessed by clinical examination. Access to dental care and risk factors for ECC were determined through a structured interview with the Portuguese-speaking parent. RESULTS: Forty (77%) of the children with ECC but only 28 (54%) of controls had never visited a dentist. Thirty (58%) mothers of children with ECC but only 13 (25%) mothers of controls had not visited a dentist in the previous year. Bivariate analyses revealed that low family income, no family dentist, no dental insurance, breastfeeding, increased frequency of daily snacks and low parental knowledge about harmful child feeding habits were associated with ECC. Non-European-born parents and parents who had immigrated in their 20s or at an older age were 2 to 4 times more likely to have a child with ECC than European parents and those who had immigrated at a younger age. Lack of insurance, no family dentist and frequency of snacks were factors remaining in the final logistic regression model for ECC. CONCLUSIONS: The strongest predictors of ECC in this immigrant population, after adjustment for frequent snack consumption, were lack of dental care and lack of dental insurance. These findings support targeting resources to the prevention of ECC in children of new immigrants, who appear to experience barriers to accessing private dental care and who are exposed to many of the determinants of oral disease. (+info)
Use of patient self-report oral health outcome measures in assessment of dental treatment outcomes.
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Comparison of the effects of secondary prevention in schoolchildren between hospitals with and without mobile dental services in Southern Thailand.
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The aim of the present study was to compare the performance of hospital clinics with and without adjunct mobile services for the delivery of secondary prevention for caries in Thai schoolchildren. A dental survey was conducted in schools served by different dental services. 711 schoolchildren were selected from primary schools in Southern Thailand by multistage cluster random sampling. WHO basic oral health survey methods were employed to evaluate three outcomes of secondary prevention: 1) Coverage of secondary prevention - all filled teeth (FT+D(F)T) among caries experienced teeth (DMFT), 2) Effectiveness of secondary prevention - successfully filled teeth (FT) among all filled teeth (FT+D(F)T) and 3) Protective effect of secondary prevention- successfully filled teeth (FT) among caries experienced teeth (DMFT). The respective percentages were 74.3, 97.5 and 72.5 in the children served by hospital-only services, and 41.3, 97.2 and 40.2 in the other group. From clustered logistic regression modeling, only the first and third outcomes were significantly different between the two access groups. This study showed that adjunct mobile service may be less effective in secondary prevention. (+info)
Barriers to utilization of dental services during pregnancy: a qualitative analysis.
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PURPOSE: Dental services during pregnancy can improve maternal oral health, reduce mother-child transmission of cariogenic bacteria, and create opportunities for anticipatory guidance. The purpose of this study was to understand why low-income women did or did not utilize dental services in a pilot program to promote dental visits during pregnancy in Klamath County, Ore. METHODS: Women were selected randomly from the pilot program. 51 women were asked to participate in semistructured telephone interviews regarding utilization of dental services during pregnancy. 45 women (88%) utilized dental services and 6 did not. Transcripts were content analyzed using a mixed method qualitative approach--grounded theory and stages of change model--to identify themes. RESULTS: Most women overcame stress or dentally related barriers to obtain care. Stressors included poor domestic relationships, personal finances, and employment. Dentally related factors included perception of dental experience, attitude toward dental providers, importance/valuing of oral health, perceived ability to pay for care, time constraints, and dental providers' and office staff attitudes toward clients. CONCLUSIONS: Pregnancy stressors and dentally related issues were identified as barriers to utilizing dental services. Identifying barriers that prevent women from taking action to access dental care may provide essential information for enhancing programs to promote dental visits during pregnancy. (+info)