Multiple perceived oral health measures might be useful for service planning, as the changes in the three separate measures used in this longitudinal study were various and thus measured different aspects of perceived oral health. Research including both self-perceived and clinical indicators is needed to understand need for care as a whole.

Objectives: Our aim was to evaluate changes in and pathways between different measures of perceived oral health (POH) and regular oral health service use between the years 2000 and 2011 among Finnish adults. POH was measured by means of oral health-related quality of life (OHRQoL) and subjective oral health (SOH). Methods:The study was based on a longitudinal sample (n = 5525) of adults having participated both in the Health 2000 and 2011 Surveys (BRIF 8901). OHRQoL was measured with the Oral Health Impact Profile 14-item questionnaire and SOH with a single question. Path analyses were used to determine whether SOH or OHRQoL affected service use or vice versa, grouped by age groups and self-assessed treatment need. Results:The path analyses indicate that good OHRQoL leads to regular service use and regular service use leads to better SOH. The first path was stronger among the elderly (0.10) and the second among the younger age group (0.07). Both paths were stronger (0.12 and 0.06) among those who reported no treatment need in 2000.Conclusions: Good OHRQoL, indicated by a lack of perceived problems or symptoms, leads to regular service use. Our findings indicate that poor OHRQoL leads to nonregular service use, and nonregular service use leads to poor SOH.

Objectives Our aim was to describe the nature and determinants of the changes in unmet treatment need between the years 2000 and 2011 after a major oral healthcare reform and a wider supply of subsidized care. Methods The study used a longitudinal sample (n = 3838) of adults who had participated in both the Health 2000 and 2011 surveys (BRIF 8901). Those reporting self‐assessed treatment need without having visited a dentist in the previous 12 months were categorized as having unmet treatment need. Two logistic regression models were applied to determine the effects of predisposing and enabling factors on change in unmet treatment need. Model 1 was conducted among those who reported unmet treatment need in 2000 and evaluated the determinants for improvement. Model 2 was conducted among those who did not have unmet treatment need in 2000 to evaluate the risk factors for having unmet treatment need by 2011. Results Unmet treatment need was reported by 25% of the participants in 2000 and by 20% in 2011. Those with unmet treatment need in 2000 were less likely to report improvement by 2011 if they had poor subjective oral health, basic or intermediate education level, or poor perceived economic situation in 2000. Those who did not have unmet treatment need in 2000 were more likely to have it in 2011 if they were males or from northern Finland and less likely to if they came from central Finland or were older. Conclusions The wider supply of subsidized oral health care during the study years did not lead to complete elimination of treatment need. The determinants of unmet treatment need, such as low or intermediate education level and perceived economic difficulties, should be used in targeting the services at those with treatment need to achieve better oral health outcomes.

Objectives: A freedom of choice pilot provided access to private oral health care services without queuing and with fixed public service-fees for participants in Tampere region, Finland in 2018-2019. The aim of this study was to investigate how use of oral health care services differed by demographics, socioeconomic status, dental fear, and self-reported oral health in this pilot.Material and methods: SMS-messages including a link to online questionnaire were sent to participants who had booked an appointment, and to those who had not booked an appointment despite registering to pilot. We categorized participants to (1) those who had booked their first appointment before receiving SMS (visitors), ( 2) those who booked an appointment after receiving the SMS-message (late-visitors), and (3) those who had not booked an appointment during pilot (nonvisitors). We used regression analysis to estimate the association of age, gender, dental fear, economic situation, Oral Health Impact Profile-14-severity (oral health-related quality of life [OHRQoL]), self-reported oral health and need for oral health care (exposures) with oral health care service use during the pilot (outcome).Results: Out of 2300 participants, 636 (28%) responded. Late-visitors were more likely older and reported more likely need for oral health care, poorer oral health and OHRQoL than visitors or nonvisitors. Nonvisitors were younger and had better OHRQoL than the others. The differences in the service use by gender, economic situation, and dental fear were small. Conclusions: Service use during the pilot depended on the subjective oral health.Our findings highlight the potential of reminders in increasing care use among those with perceived need for services.