Effects of dental attendance frequency in heavy and low private care-using young adults

In Finland, adults born in 1961 or later were progressively entitled to subsidies for dental care from private practitioners during 1986-90, while at the same time having access to care in the Public Dental Service. The aim of this study was to compare the effects of attendance frequency of private dental care on treatment costs and treatment spectrum for the heaviest and lowest users over a period. Three separate cohorts of recipients of reimbursements were formed, using the Social Insurance Register. The highest and lowest cost groups in 1986, 1990, and 1994 were followed up to 1997. Initially, the mean numbers of visits were 1.2-1.3 and 5.2-5.6 and cost Euro 48-53 and Euro 358-379 among low users and heavy users, respectively, in all cohorts. Among the heavy users (the high-cost category) infrequent attendance was related to higher and frequent attendance to lower mean annual costs of care. Among the low users (the low-cost category) the opposite was true. Those who initially belonged to the high-cost category received in 1997 significantly more (P < 0.01) restorative treatment and, to a lesser extent, more (P < 0.01) preventive and periodontal treatment than those belonging to the low-cost category. Frequent dental care seemed to benefit those who received a lot of care. Frequency of attendance was not associated with being a low or a heavy user, indicating rigid check-up routines. The inclusion of simple oral health data would greatly improve the usefulness of the register as an evaluation tool for health-political decisions.     

The frequency of dental attendance of Scottish dentate adults between 1978 and 1988

The dental attendance of a sample of dentate adults (n = 702) within the National Health Service in Scotland was monitored longitudinally between 1978 and 1988. The attendance pattern of the sample appeared to be no different between 1983-88 than in the preceding 5 years, which suggests that the attendance behaviour of the sample has not changed significantly. National figures, available for the same period, show an increase in the number of courses of dental treatment provided. These figures were examined in detail, and the analysis suggested that only 40% of the increase in number of courses provided in 1988 compared with 1978 could be accounted for by an improvement in attendance patterns among Scottish adults as a whole. The remaining 60% could be attributed to a greater requirement for dental care to cater for the increased proportion of the Scottish population who retained their own teeth in 1988. Only 16% of the sample consistently attended for dental care within 2 years of a previous dental course (which is the criterion for remaining under continuing care in the new General Dental Service contract).     

Association between dental fear and dental attendance among adults in Finland

Objective. Our aim was to evaluate the association between dental attendance and dental fear while considering the simultaneous effects of perceived oral health and treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Material and methods. The two-stage stratified cluster sample (n=8028) represented Finnish adults aged 30 years and older. The response rate to this nationwide sample was 88%. Dental fear was measured with the question: “How afraid are you of visiting a dentist?” Multiple logistic regression analyses were used to determine the association between dental fear and dental attendance, including the following independent variables: perceived oral health, perceived treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Results. Among all ages, except 30 to 34-year-olds, irregular attenders were more likely to be very afraid of visiting a dentist than regular attenders were. The association was stronger the older the age group. Only age modified the association between dental fear and attendance. Irregular dental attendance can be attributed to high dental fear (etiologic fraction among exposed) in 41% of cases. Conclusion. Reducing dental fear would increase the number of regular attenders, especially among older age groups. Individuals for whom oral health services have been provided regularly since childhood seem to continue to use these services regularly despite high dental fear.     

Association between dental fear and dental attendance among adults in Finland

OBJECTIVE: Our aim was to evaluate the association between dental attendance and dental fear while considering the simultaneous effects of perceived oral health and treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. MATERIAL AND METHODS: The two-stage stratified cluster sample (n=8028) represented Finnish adults aged 30 years and older. The response rate to this nationwide sample was 88%. Dental fear was measured with the question: "How afraid are you of visiting a dentist?" Multiple logistic regression analyses were used to determine the association between dental fear and dental attendance, including the following independent variables: perceived oral health, perceived treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. RESULTS: Among all ages, except 30 to 34-year-olds, irregular attenders were more likely to be very afraid of visiting a dentist than regular attenders were. The association was stronger the older the age group. Only age modified the association between dental fear and attendance. Irregular dental attendance can be attributed to high dental fear (etiologic fraction among exposed) in 41% of cases. CONCLUSION: Reducing dental fear would increase the number of regular attenders, especially among older age groups. Individuals for whom oral health services have been provided regularly since childhood seem to continue to use these services regularly despite high dental fear.     

Demographic, health and lifestyle factors associated with dental service attendance by young adults

BACKGROUND: The aim of this study was to describe the demographic and health and lifestyle factors associated with dental service attendance in the previous 12 months by young Australian adults (18-24 years). METHODS: Population-based data from the 2001 Australian National Health Survey were analysed. Proportions and single associations between variables of interest and dental service attendance were calculated. A logistic regression analysis using significant single association variables was then conducted. RESULTS: Overall, 41 per cent of young adults in this study had visited a dental professional in the previous 12 months. Females, those in cities, those with private insurance, those who spoke languages other than English, those in the highest socioeconomic group and those with healthy behaviours were subgroups most likely to have visited a dental professional. With logistic regression, factors found to be associated with dental services attendance were being female, having private health insurance and low alcohol consumption. CONCLUSIONS: In this study, the proportion of young adults who had visited a dental professional in the previous 12 months was only 41 per cent. It is therefore suggested that oral health policy and promotion activities be encouraged for this group, paying attention to young adults in groups with low attendance.     

Dental anxiety and regularity of dental attendance in younger adults

Dental anxiety constitutes a major problem for patients and dental care providers alike. The aim of this study was to examine the relationship between dental anxiety and regularity of dental attendance among young adults. A random sample of 15 course directors (1:50) was asked to participate in the study. Of these, only 10 course-directors agreed to handout the 500 questionnaires. All undergraduate students who participated in this study were asked to complete a questionnaire modified from Dental Fear Survey (DFS) questionnaire and 368 (73.6%) filled forms were returned for statistical analysis. The results showed that only 20.9% were regular dental attendee while the majority (79.1%) were irregular attendee. The reasons given for irregular attendance were 'lack of time' (36%), 'treatment not needed' (34.1%), 'fear from dentist' (13.3%) and 'cost' (16.6%). The sight and sensation of the injection and sight, sound, and sensation of the drill were the most common fear-eliciting stimuli. Increased heart rate was the commonest reported physiological response. Females had higher mean ratings, therefore tended to be more anxious than males. Dental anxiety represented by the mean responses to the items, was found to be higher in irregular dental attendee than regular attendee. In conclusion, this suggests that dental anxiety may affect the seeking of dental care, therefore to be taken into account when training dental care providers.     

Fluoride sources and dental attendance habits among adults in communities with optimal and low water fluoride concentrations

The aim of this study was to obtain data on local fluoride supply, dental attendance, and dental care habits in two sociologically similar municipalities with optimal, 1.0 ppm, and low, 0.3 ppm, water fluoride concentrations, respectively. The participants in the study were 30- to 40-year-old lifetime residents in the two municipalities: 569 individuals from the 1-ppm fluoride community and 466 from the low-fluoride community. There were no intergroup differences in the fluoride mouthrinse utilization rate of 1%. Fluoride toothpaste was much more common in the low-fluoride area. In the 1-ppm fluoride area more people drank tea, and they went more regularly to the dentist. It is suggested that dental attendance habits and various fluoride sources should be taken into account in studies evaluating the effect of fluoride in drinking water.     

Dental care attendance and refrainment from dental care among adults

Objective: The aim of this study was to analyse dental care utilization, refrainment from self-perceived needed dental care and the association with socioeconomic indicators among adult individuals.

Materials and methods: This cross-sectional survey included 3500 randomly selected adult individuals. Telephone interviews were conducted and the participants answered a battery of questions regarding dental visiting habits, health, socioeconomic position (SEP), behavioural factors and lifestyle indicators.

Results: The outcome ‘dental visits’ was significantly correlated with SEP, especially with monetary dimensions, such as income and economic resources for unforeseen expenditures. However, educational level was not a significant predictor in the tested statistical models. Furthermore, other covariates that contributed significantly to the models were ethnicity, dental anxiety and lifestyle factors, albeit with a different pattern of impact on the two outcome dimensions. Important features of the SEP variables were the stepwise gradient relative to the outcomes, implicating that the lower the SEP status, the greater the risk of reporting irregular dental visiting habits and refraining from dental care due to financial problems.

Conclusions: Dental care utilization and refraining from dental care for financial reasons clearly reveal associations with socioeconomic positions among adult individuals.     

Mothers' dental attendance patterns and their children's dental attendance and dental health

Two hundred and ten 10-11-year-olds were selected at random from those attending schools in the Tameside and Glossop Health District. One hundred and eighty-eight were examined for caries, and the mothers of 177 of these children completed a questionnaire on their own and their child's dental attendance. Claimed attendance was subsequently checked with the dentist concerned. Sixty-one percent of mothers had attended a general dental practitioner during the previous 12 months and 89% of these mothers took their children with them. Of the non-attending mothers, 38% took their child to the GDS, 36% to the CDS, while 26% did not take their child to a dentist. The DMFT of the children was 1.72, and the differences in DMFT between the three attendance groups were not significant. However, there were significant differences in the decayed and missing components. The study demonstrates that the CDS and the GDS treat different populations of children by virtue of the mothers' attendance patterns. The methods developed for this study provide a basis for ongoing evaluation within a district of the implementation of the Department of Health's policy for the provision of dental treatment by the CDS.     

Effects of fluoride and regular dental care on personal dental expenditures of young adults in Finland

Abstract This paper analyzes the relationship among presence of fluoride in the drinking water, oral health and dental expenditures in four towns in Finland. A two-stage least-squares model is used to determine the effect of fluoridated water and other independent variables on the number of missing teeth and per capita annual dental service expenditures for 555 adults. The results show that regularity of dental visits is the only significant factor explaining per capita expenditures. In contrast, many factors affect the number of missing teeth; most importantly, the number of dentists per capita, level of fluoride, age, education, use of services and smoking habits. These findings suggest I hat fluoride significantly improves oral health status but does not reduce adult per capita dental expenditures.     

A strong sense of coherence promotes regular dental attendance in adults

OBJECTIVE: To investigate the relationship between the sense of coherence (SOC) and dental attendance pattern. It was hypothesised that the subjects with a stronger SOC have a more regular dental attendance. BASIC RESEARCH DESIGN: In the nationally representative sample including 8,028 persons aged 30, or more, 88% were surveyed. The questionnaire and home interview included information about socio-economic and demographic factors, behavioural and attitudinal variables, such as oral health behaviours (i.e. dental attendance pattern), and the SOC scale (12-item). Chi-square test, unadjusted and adjusted logistic regression models were used in the data analysis. PARTICIPANTS: The sample for this study consisted of 4,263, 30- to 64-year-old dentate, adults. RESULTS: Regular dental attendance was more common among those with a stronger SOC. Gender, education, family income and marital status, but not age, were related with dental attendance. The gender- and age-adjusted associations between the SOC and dental attendance pattern were found to be significantly stronger among those having high-, or middle level of education compared with those having a low education level. CONCLUSION: A stronger SOC is associated with regular dental attendance. This raises the possibility of achieving long-term positive effects on dental attendance in adulthood, if the SOC could be strengthened during adolescence.     

Use of public and private dental services by adults in Finland

Abstract – The aim of this study was to analyze the factors that affected the choice between public and private dental services in 1979, when 9% of adults had received their dental services in a public health center. In September 1979 the National Board of Health conducted a telephone interview among Finnish adults over 15 yr old. When a representative sample of 1992 adults was drawn, the response rate was 90.4%. All subjects over 17 yr of age who had used dental services within the last 5 yr were included in the study, making a final sample of 1368. According to the logistic function, the greatest differences were between rural and urban areas. Of the subjects living in urban areas, 18% had visited public health centers; and of those living in rural areas, 45% had visited health centers. Of the adults living in an urban selling, 70% and in rural areas 49% visited private dentists. Of the subjects who had used private dental services, nearly half were managers and upper white-collar workers; while of those using communal services, less than one third worked in such jobs. In urban areas managers and upper white-collar workers used private services twice as often as they used public services. In an urban setting, subjects who had visited a dentist during the last 2 yr had received treatment mainly in the private sector; and in a rural setting, subjects had been treated mainly in health centers.     

Association between untreated caries and age, gender and dental attendance in adults

Abstract – The aim of the study was to examine the association between untreated caries on the crown and root of the tooth with the age, gender and dental attendance in a group of adult. Six general practitioners in the Greater Manchester area agreed to take part. Over a 6-week period they collected clinical and personal data on 270 of their adult patients. No association was found between the mean number of coronal surfaces with caries and age; however, there was more root caries in people over 55 yr. More recurrent caries associated with a restoration was diagnosed than primary caries. There were proportionally more female than male regular attenders, and once attendance has been taken into account there were no gender differences for either coronal or root caries. Both coronal and root caries were associated with attendance, with irregular attenders experiencing more. Irregular attenders were three and a half times more likely to have caries on the root surfaces than regular attenders.     

Periodontal awareness and knowledge,and pattern of dental attendance among adults in Jordan

AIMS: To provide baseline data on periodontal awareness and health knowledge, and to assess patterns of dental attendance behaviours among 20 to 60 year-old Jordanian adults. METHODS: A questionnaire incorporating items related to personal and socio-demographic data, periodontal awareness and health knowledge, and self-reported dental attendance behaviours. One-thousand questionnaires were distributed among adults attending dental clinics. RESULTS: 743 questionnaires were completed and statistically analysed. About one-quarter of adults reported 'gum bleeding' on brushing, but more subjects (40.4%) believed that they had periodontal disease. Also, 47% of the participants thought that they had a 'rough tooth surface', 16% had 'gum irritation' and 25% had 'bad breath'. There were no statistically significant differences between genders with regard to responses on periodontal awareness (P >0.05). The majority of adults incorrectly defined the meaning of dental plaque and did not know its role in the aetiology of gingival disease. Conversely, the majority of participants (60.8%) were aware that gingival bleeding upon brushing indicated the presence of periodontal disease that can be prevented by brushing and flossing (63.4%), mainly before going to bed (73.9%). The overwhelming majority of subjects (81.4%) were irregular attenders. 'Treatment not necessary' and 'cost' were found to be the common barriers for regular dental attendance. The most common treatment received by the subjects at their last visit was restorative therapy. CONCLUSION: Knowledge and awareness concerning periodontal disease is still poor in Jordan, therefore, more dental health education is needed to improve oral health.     

A study of the reasons for irregular dental attendance in a private dental college in a rural setup.

The mouth is regarded as a mirror and the gateway to health. Integration is required between the dental practitioner and the patient, if good dental health is to be attained. Various treatment modalities of late frequently require appointments, which are more than one in number for completion of the entire treatment program. This study was taken up to determine the impact of reported dental attendance patterns of patients on the oral health and treatment quality in teaching hospitals and also on the quality of life in rural areas. AIMS AND OBJECTIVES: 1. To assess the reasons for irregular dental care in the patients attending the clinics in teaching hospitals. 2. To assess the satisfaction of the patient as regards the treatment rendered in the teaching institutes. 3. To correlate the gender of the patient with the regularity in the recall attendance. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted using a systematic random sampling method and every alternate subject was selected from the patients attending the OPD of Department of Periodontics and Community Dentistry. The data was collected using the interview method with the help of a structured, pretested questionnaire. RESULTS AND CONCLUSION: Out of 288 patients, 94 failed to attend the recall appointments. In these 94 patients, various reasons for not attending recall were assessed and lack of time was found to be the most common reason for non-attendance. Relationship between age and reasons for not reporting was found to be significant (P < 0.01). Patient satisfaction survey showed that 51.54% of the patients were satisfied with the dental treatment rendered. The present study also showed that males are more prompt in attending recall appointments as compared to females. A positive and significant correlation between literacy and patient reporting status was found (P< 0.01).