Predisposing, enabling, and need characteristics of dental services utilization among socially deprived schoolchildren

Abstract

Objectives To test the relationship of predisposing, enabling and need characteristics with dental services utilization and pattern of dental attendance among 12‐year‐old schoolchildren living in a socially deprived urban area. Methods A cross‐sectional study was carried out involving 358 children enrolled in public schools located in a deprived area of the city of Manaus, Brazil. Predisposing, enabling, and need characteristics were selected according to Andersen's behavioral conceptual model. Self‐completed questionnaires were used to collect the predisposing characteristics (child's gender, sense of coherence, self‐esteem, oral health beliefs). Parents or guardians provided data on enabling characteristics, including dental health insurance and socioeconomic status. Evaluated need characteristics included oral clinical status assessed through dental examinations conducted by five calibrated examiners. Structural equation modeling was used to test the predictors of dental services utilization and pattern of dental attendance. Results Predisposing characteristics, including male gender and low parents/guardians sense of coherence predicted poor dental services utilization and inadequate pattern of dental attendance, respectively. Low socioeconomic status and poor oral clinical status were linked to poor dental services utilization and worse children's pattern of dental attendance. Conclusions The present findings suggest that predisposing (child's gender and parental sense of coherence), enabling (socioeconomic conditions) and evaluated need characteristics (oral clinical status) are associated with dental services utilization among children.

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].…”

“…Children/adolescents. 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].…”

“…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.…”