Predictors of dental care utilization in north‐central Appalachia in the USA

Abstract

Objectives: Dental utilization is an important determinant of oral health and wellbeing. The aim of this study was to evaluate potential associations between a variety of biopsychosocial factors and dental utilization in north-central Appalachia, USA, a region where oral health disparities are profound. Methods: This study used household-based data from the Center for Oral HealthResearch in Appalachia (COHRA1) study in north-central Appalachia, including 449 families with 868 adults. The generalized estimating equation (GEE) approach was used to determine the best-fitting predictor model for dental utilization among adult family members. Results:On average across West Virginia and Pennsylvania, having dental insurance was associated with greater dental utilization over a 3-year time period (OR = 2.20, 95% CI = 1.54, 3.14). When stratified by state, the association held for only West Virginia (OR = 2.41, 95% CI = 1.54, 3.79) and was nonsignificant for Pennsylvania residents (OR = 1.50, 95% CI = 0.80, 2.79). Individuals from Pennsylvania were more likely to utilize dental care and participants from West Virginia less so (2.31, 95% CI = 1.57, 3.40). Females from Pennsylvania were more likely than males to regularly

A Framework for Understanding the Role of Psychological Processes in Disease Development, Maintenance, and Treatment: The 3P-Disease Model

“…That is, some have demonstrated a predisposition toward pain sensitivity (e.g., MC1R gene) and its relation to poorer oral health (Randall et al, 2016, 2017a,b). Other long-standing factors such as SES, region, or access to dental insurance have been implicated in the utilization of dental services, which can influence oral health status (Chen et al, 2019). Others have shown the importance of familial transmission of dental care-related fear and anxiety (McNeil et al, 2019).…”

The role of psychosocial factors and treatment need in dental service use and oral health among adults in Norway

“…Why people do not regularly attend dental services is complex, and there is probably an interplay between psychosocial, material, cultural and behavioural aspects as well as the perceived need for treatment. Factors found to be associated with less use of dental health services are lower socioeconomic status (SES), dental fear, distant geographic location and distance to dental care services and fatalistic beliefs …”

Transmission of dental fear from parent to adolescent in an Appalachian sample in the USA

“…It is likely that the unique psychosocial factors related to living in isolated parts of Appalachia and other rural areas globally influence oral health care. For instance, geographic isolation, topographic and weather‐related travel barriers, economic issues, and a set of values emphasizing self‐reliance and non‐interference with others likely affect the development and manifestation of fear, anxiety, and ultimately health care utilization . Given that high dental fear/anxiety and phobia predict avoidance of oral health care, and that there are disproportionately high rates of oral health problems in Appalachian and other rural populations, it is particularly worthwhile to examine dental fears/anxieties in Appalachian families.…”