Utilization of dental care services among adult Indian population: A meta-analysis of evidence from 2011–2022

Abstract

Background: This study aimed to generate a pooled national estimate on dental health care services utilization by the adult population in India from any public or private facility in an effort to highlight the demand and usage for oral health care. Methods: In this meta-analysis, PubMed, ScienceDirect, DOAJ, and Google Scholar were searched using a search strategy that combined MeSH headings and keywords (e.g., "Oral Health", "Dental Health Services", utilization, India, etc.) for articles on dental utilization among Indian adults, published between January 2011 and June 2022. Study quality was assessed using the NIH Quality assessment tool, and a random-effects inverse-variance method was used for pulling utilization proportions. Meta-regression and sub-group analyses were conducted to identify the sources of heterogeneity. Heterogeneity is reported as I2 . To examine publication bias, the funnel plot, egger’s test, and trim-and-fill analysis were performed. Results: From 4012 identified articles, 21 were eligible for inclusion. The pooled dental care utilization amongst Indian adults were found to be 23.96% (confidence interval [CI]: 16.81%– 31.11%, P<0.001, I2=98.93%), and the highest estimate was in South Zone (30.02%, CI: 19.14–40.90, P<0.01, I2=98.63%). Visual inspection of the funnel plot revealed the presence of publication bias (egger’s P value 0.02). A mild decrease in utilization estimate was noted through trim and fill analysis (adjusted estimate 17.65%, CI: 8.97–26.33, P=0.03). No significant subgroup effect was found for the variables study zone and conduction years (P value: 0.09 & 0.34 respectively). Conclusion: Future studies should be undertaken to focus on the demand and supply of oral health care services since an evidential gap has been identified due to the uneven distribution of studies available from various regions of India. The heterogeneity can be attributed to the diverse socioeconomic, literacy, and inherent health system performance status.

Oral health in emerging countries and suggestions for adjusted care strategies

“…Counselling by doctor´s and dentist´s combined with medication are further instruments to stop smoking. 124 The oral status of the Indian population, which ranked second in our study, is astonishing because the high prevalence of caries and the low level of treatment in all age groups (24% across all adult classes) 80 obviously do not inevitably produce the expected poor oral health results that dentistry would predict for such conditions. The explanation for this mystery is still unclear.…”

“…For example, in most of these countries. a) caries prevalence in deciduous teeth is very high (71%-88%), 55,79 b) caries prevalence in the adult population is often rampant (77%-94%), 9,55,79 c) most decayed teeth remain untreated (68%-89%), 9,6,32,36 d) if there is treatment, it is mostly extraction and prescription, 5,9 e) dental service utilisation is rudimentary (10%-31%), 34,[80][81][82] f) oral health literacy is at best 40% (MY) 81 , mostly lower (BR: 28.5%), 83 g) oral health awareness is hardly existent across large parts of the population, h) correct tooth brushing is extremely seldom (ID: 8.5%), 73 i) adequate nationwide dental facilities and workforces are widely lacking 84 everywhere, except in Brazil, where, on average, the dentists/population ratio is sufficiently high, but distribution is very uneven (mostly in urban areas) 85 and j) most people in rural and remote areas cannot afford or are unwilling to pay for dental services.…”

Impact of tobacco habits on poor oral health status among bone-factory workers in a low literacy city in India: A cross-sectional study

“…This condition could be because poor and uneducated workers have less access to and utilization of oral healthcare services in India. A systematic review done by Talukdar et al in 2022 reported that only 23% of the Indian population has utilized dental healthcare services in both the public and private sectors in the last decade [ 26 ].…”

Oral health status, treatment needs, and patterns of utilization of dental services among village volunteers in Andhra Pradesh: A cross-sectional multi-stage cluster survey

“…[ 15 , 16 , 17 , 18 , 19 ] The pooled dental service utilization among Indian adults was found to be 23.96% in a recent meta-analysis of data from 2011 to 2022. [ 20 ] Positive general health behaviors and attitudes are associated with better oral health in a dose-response association. These findings should design appropriate and tailored health promotion programs to achieve the targeted population's oral and general behavioral change.…”