The utilization of dental care services results from the interaction of biological determinants with sociocultural, family and community variables, as well as from some characteristics of health systems. The objective of this study was to assess the individual factors associated with the use of dental care services among low-income adult and elderly individuals living in the catchment area of the Family Health Strategy, in Ponta Grossa, PR. The sample included 246 individuals, aged 35 years or over, who answered a questionnaire on socioeconomic conditions, perceived needs, and access to dental care services. Data analysis was performed according to a conceptual framework based on Andersen's Behavioral Model. Non-recent use of dental care services was considered as the dependent variable in the logistic regression analysis models. There were high prevalences of self-reported oral health diseases and teeth loss. About 40% of the adults and 67% of the elderly had not made any dental visit in the past 3 years. Individuals without ownership of the family home, with inadequate oral hygiene habits and who wore complete dentures had higher odds of having gone to the dentist longer ago. The fact of having a regular source of dental care was identified as a protective factor in the analysis. The conceptual framework confirmed the presence of social and psychosocial inequalities in the use of dental services among low-income adult and elderly individuals.
The conceptual framework has confirmed the presence of social and psychosocial inequalities on the utilization pattern of dental services for low-income children. The individual determinants seem to be important predictors of access.
OBJECTIVE: To describe the prevalence of oral health impact on quality of life and its association with the dental condition and sociodemographic factors of homeless people. METHODS: The sample was composed of 116 adults, temporarily attended by a public institution in the municipality of Goiânia, state of Goiás. Interviews were carried out including the Oral Impact on Daily Performance instrument and sociodemographic aspects. Clinical examinations were done by a trained examiner considering criteria of the World Health Organization. We evaluated dental caries (DMFT index) and use or need to use some type of prosthesis. For the statistical analysis of data, we used Pearson’s Chi-square and Fisher’s exact tests and Poisson regression with robust variance. RESULTS: Of the total respondents, 81.9% had at least one daily performance affected by dental problems in the six months prior the survey. The most prevalent dental conditions were: need for lower arch (76.7%) and upper arch prosthesis (69.0%); untreated caries (75.9%); and high DMFT (57.8%). In bivariate analysis, only the need for upper prosthesis variable was associated with the impact (high Oral Impact on Daily Performance). In the regression model, adjusted for time in the institution, age, and sex, this association remained significant (p = 0.015). Individuals without need for upper prosthesis had prevalence of high impact on daily performance 55% lower than those in need of this type of prosthesis (p = 0.018). CONCLUSIONS: The prevalence of oral health impact on quality of life of homeless people was high and higher than that verified in the overall Brazilian population. The impact was associated with the need for upper prosthesis, regardless of sociodemographic characteristics of the individuals.
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