ObjectivesTo explore the factors associated with utilization of oral health services among Chinese adults and older adults according to the Andersen Behavior Model.MethodsData from the 4th National Oral Health Survey (2015‐2016) in China were used. A total of 7206 people (3669 adults aged 35‐44 years and 3537 older adults aged 65‐74 years) were included in our analysis. Oral health service utilization in the past 12 months was the outcome variable. Explanatory variables were selected according to the Andersen Behavior Model. Descriptive statistics and bivariate associations (chi‐square tests) were analysed, followed by hierarchical Poisson regression models, which were conducted to determine the factors associated with oral health service utilization.ResultsIn total, 21.4% (95% CI: 19.4%‐23.7%) of adults (35‐44 years old) and 20.7% (95% CI: 18.6%‐22.9%) of older adults (65‐74 years old) utilized oral health services in the past 12 months. Nearly 80% of adults (78.7%, 95% CI: 74.0%‐82.7%) and more than 90% of older adults (93.7%, 95% CI: 91.0%‐95.6%) visited a dentist for treatment. Adults aged 35‐44 years old who were female (IRR: 1.15, 95% CI: 1.00‐1.33, P = .047), had good oral health knowledge and attitudes (IRR: 1.30, 95% CI: 1.06‐1.59, P = .011), perceived their oral health status as fair (IRR:1.51, 95% CI:1.24‐1.85, P < .001) or poor/very poor (IRR:2.52, 95% CI:2.01‐3.18, P < .001) and had a decayed, missing and filled teeth (DMFT) index >0 (IRR: 1.52, 95% CI: 1.11‐2.09, P = .009) were more likely to report dental visits in the past 12 months. Older adults who utilized oral health services tended to be female (IRR: 1.32, 95% CI: 1.09‐1.59, P = .004); to be covered by Urban Resident Basic Medical Insurance (URBMI) (IRR: 1.56, 95% CI: 1.18‐2.05, P = .002), Urban Employee Basic Medical Insurance (UEBMI) (IRR: 1.69, 95% CI: 1.32‐2.16, P < .001) or government medical insurance (GMI) (IRR: 1.03, 95% CI:1.01‐2.16, P = .044); to have a high education level (IRR: 1.37, 95% CI: 1.08‐1.74, P = .010); to have an income level in the 2nd tertile (IRR: 1.44, 95% CI: 1.13‐1.84, P = .003) or 3rd tertile (IRR:1.52, 95% CI:1.18‐1.95, P = .001); and to perceive their oral health status as poor or very poor (IRR: 1.53, 95% CI: 1.21‐1.95, P = .001).ConclusionsSex and self‐perceived oral health status were associated with oral health utilization among Chinese population. Additionally, for older adults, education level, household income and insurance coverage were determinants of dental service use. These findings can aid in creating more targeted policies to increase the use of dental services by Chinese adults.

Background: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen's behavioural model to explore influencing factors, thereby providing a reference for future policy making.Methods: This study is a cross-sectional study. Data of 40,305 children aged 3-5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016. Patient data were collected using a questionnaire, which was answered by the child's parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchical logistic regression results were then analysed to find the factors associated with oral health service utilization.Results: The oral health service utilization prevalence during the prior 12 months were 9.5% (95%CI: 8.1-11.1%) among 3-year-old children, 12.1% (95%CI: 10.8-13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6-19.4%) among 5year-old children. "No dental diseases" (71.3%) and "dental disease was not severe" (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor's degree or higher (OR: 2.29, 95%CI: 1.97-2.67, p < 0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43-1.89, p < 0.001), annual per capital income more than 25,000 CNY (OR: 1.40, 95%CI: 1.18-1.65, p < 0.001), think their child have worse or bad oral health (OR: 3.54, 95%CI: 2.84-4.40, p < 0.001), and children who often have toothaches (OR: 9.72, 95%CI: 7.81-12.09, p < 0.001) were more likely to go to the dentist in the past year. Conclusion:The prevalence of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.

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