Need for dental care drives utilisation of dental services among children in Saudi Arabia

Abstract

Objectives: This study used Andersen's predisposing, enabling and need behavioural model to predict factors that influence utilisation of oral health services for children in Saudi Arabia. Methods: The model was tested in a random sample of parents of third-and eighth-grade children in Jeddah (n = 1,668) using the access to care questionnaire adapted from the Basic Screening Survey. Predisposing (sex, parent education, nationality); enabling (school type, family income, government financial support, health insurance); and need for dental care (examined or perceived) were modelled to assess children's use of dental services. Univariate and multivariate logistic regression models were conducted. Significant findings were reported at P ≤ 0.05. Results: About 84% of parents responded to our questionnaire (n = 1,397). One in four children have never visited a dentist. Our findings indicate that need and predisposing factors explained oral health services' use among younger children, whereas need, predisposing and enabling factors predicted use of services among older children. Perceived barriers to dental care for children who never went to a dentist and for those who needed dental care and could not get it included oral health illiteracy (82.3%, 49.7%), dentist-related (19.9%, 42.1%), financial (22.8%, 37.1%) and transportation (9.8%, 20.8%), respectively. Conclusions: The need for dental care, predominantly for illness-related dental care, drives utilisation of dental health services among children in Saudi Arabia. Enhancing oral health literacy and mitigating organisational and financial barriers to dental care for families will increase children's access to quality oral healthcare, and promote better oral health practices and outcomes.

Factors Associated with Dental Service Use Based on the Andersen Model: A Systematic Review

“…The process of study selection is shown in Figure 1 (flow chart [21]). In sum, n = 41 studies were included in our final synthesis (ten studies investigating children/adolescents [22][23][24][25][26][27][28][29][30][31] and 31 studies investigating adults ). We will present an overview of included studies by age group (children/adolescents; adults) in the next two sections.…”

“…Four [23,25,27,31] out of the six studies which examined age found a positive association with dental service use, whereas two studies did not identify such a link [29,30]. While two studies [22,26] found a link between being female and increased dental service use, five studies did not find a significant association between gender and dental service use [23,[28][29][30][31]. Other predisposing characteristics were only examined in a few studies.…”

“…Children/adolescents. In sum, n = 10 studies examined predisposing characteristics [22][23][24][25][26][27][28][29][30][31]. Four [23,25,27,31] out of the six studies which examined age found a positive association with dental service use, whereas two studies did not identify such a link [29,30].…”

“…In sum, n = 9 studies examined enabling resources [22][23][24][25][26][27][28][29][30]. Higher family income was associated with increased dental service use in four studies [23,27,29,30], whereas one study did not identify a significant link between these factors [22]. Other enabling resources were only examined in a few studies.…”

“…The period of dental service use ranged from six months [23,29] to ever visiting a dentist in one's lifetime (in Saudi Arabia [22] and Brazil [24,25]). While all studies examined predisposing characteristics, nine out of the ten studies examined enabling resources [22][23][24][25][26][27][28][29][30], eight out of the ten studies examined need factors [22,[24][25][26][27][28]30,31] and one study examined psychosocial factors [30]. The studies included covered all age groups in childhood/adolescence.…”