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Objectives To test the relationship of predisposing, enabling and need characteristics with dental services utilization and pattern of dental attendance among 12‐year‐old schoolchildren living in a socially deprived urban area. Methods A cross‐sectional study was carried out involving 358 children enrolled in public schools located in a deprived area of the city of Manaus, Brazil. Predisposing, enabling, and need characteristics were selected according to Andersen's behavioral conceptual model. Self‐completed questionnaires were used to collect the predisposing characteristics (child's gender, sense of coherence, self‐esteem, oral health beliefs). Parents or guardians provided data on enabling characteristics, including dental health insurance and socioeconomic status. Evaluated need characteristics included oral clinical status assessed through dental examinations conducted by five calibrated examiners. Structural equation modeling was used to test the predictors of dental services utilization and pattern of dental attendance. Results Predisposing characteristics, including male gender and low parents/guardians sense of coherence predicted poor dental services utilization and inadequate pattern of dental attendance, respectively. Low socioeconomic status and poor oral clinical status were linked to poor dental services utilization and worse children's pattern of dental attendance. Conclusions The present findings suggest that predisposing (child's gender and parental sense of coherence), enabling (socioeconomic conditions) and evaluated need characteristics (oral clinical status) are associated with dental services utilization among children.

O estudo avaliou o cumprimento das metas de desempenho dos Centros de Especialidades Odontológicas (CEO) do estado do Amazonas, utilizando dados secundários do SIA-SUS, considerando as variáveis estruturais dos estabelecimentos, cobertura da atenção básica e indicadores sociodemográficos dos municípios. Treze CEO foram avaliados. Um estabelecimento de Manaus e os de Maués e Parintins apresentaram melhor desempenho em relação ao Cumprimento Global das Metas. A cobertura das Equipes de Saúde Bucal na atenção básica parece não acompanhar o desempenho dos estabelecimentos. Os resultados sugerem que o desempenho dos CEO está relacionado às características sociodemográficas dos municípios.

Dental caries and malnutrition are costly public health problems affecting a large number of children worldwide. Both are multifactorial conditions that may share common risk factors, including inadequate diet and low socioeconomic background. 1 The relationship between dental caries and socioeconomic status, however, is still under debate, mainly in middle-income countries. 2 Malnutrition is a broad term characterized by the imbalance, deficiency, or excess between energy expenditure and nutrient intake. Harmful eating habits are crucial in determining malnutrition and related diseases. For instance, free sugars intake has a consistent dose-response relationship with dental caries. 3 Undernutrition and