What is the function of psychosocial factors in predicting length of time since last dental visit? A secondary data analysis

Abstract

Aim: To conduct a secondary analysis of the Adult Dental Health Survey, UK (ADHS.UK) data to investigate the function of psychosocial factors (costs, dental anxiety, communication) and whether their interaction mediates the relationship between perception of need and length of time since last dental visit. Materials and methods: The data used from the ADHS.UK interview questionnaires included demography, costs, perception of treatment need, communication, dental anxiety and reported dental attendance. The data were subjected to χ2‐analysis and hierarchical logistic regression analysis. Results: Time since last dental visit was significantly associated with all demographic and psychosocial variables. The hierarchical logistic regression analysis tested three models. Model 1 examined the demography and explained 2% of the variance. Model 2 showed that those in intermediate (e.g. clerical staff) and routine (e.g. agriculture workers) occupations and those who were unemployed/never worked had a greater likelihood of increased interval between dental visits, explaining an additional 2% of the variance of the time interval between dental visits. Model 3 provided an additional 10% of the variance, which included costs, perceived need, communication and dental anxiety. The interaction of the perception of need by extreme dental anxiety (OR = 0.52; 95% CI: 0.40, 0.69) improved the fit of the model [χ2 (df1) = 22.85, P < 0.001]. Conclusion: This study revealed that dental anxiety, communication and treatment costs acted as barriers to accessing dental care. Dental anxiety acted as a mediator in the relationship between perception of need and increased time interval between dental visits.

Disentangling a web of causation: An ethnographic study of interlinked patient barriers to planned dental visiting, and strategies to overcome them

“…These have been mainly cross‐sectional and often look to describe patients’ barriers to dental attendance. Most studies focus on specific groups, such as children, 11 older adults, 12 homeless people, 13 welfare recipients or people on low income, 14,15 and migrant or ethnic groups, 16,17 as well as the general adult population 18,19 . Barriers have been described as dental anxiety, 20,21 competing demands 22 including affordability of dental care, 18 relevance and meaning of oral health, 23‐25 embarrassment, 26 trust in dentists and dental services, 27,28 and accessibility and availability of dental care 12,29 .…”

Experience of Intravenous Sedation Increases Incidence of Caries in Patients With Dental Anxiety

“…Patient education is necessary for the continuation of treatment, and dentists should explain the negative effects of treatment interruptions, understand the patient's psychology, and employ an empathetic approach to help arrest any downward spiral of the disease [26]. Patient psychosocial factors (such as treatment costs, awareness of necessity for treatment, communication) are associated with the extension of interruption [27]. A good relationship between the patient and the dentist can lead to effective communication, which can reduce the patient's anxiety and fear toward dental treatment and maintain the motivation to undergo dental treatment [28][29][30].…”

Communication, Trust and Dental Anxiety: A Person-Centred Approach for Dental Attendance Behaviours

“…Later researchers supported Cohen's proposal and pointed to the role of dental anxiety, costs of care, and perception of need as important accessibility factors [4,5]. However, with regard to person-centred care, the significance of the dentist-patient interaction and the role of dental system drivers had not been fully explored [6].…”

“…The business context or system drivers of dental practice could further exacerbate the individual's dental anxiety together with feelings of shame [8,9]. The consequence is to reduce trust within the treatment alliance leading to lowered patient satisfaction and a delay in accessing dental care [5]. The role of such person-centred factors together with a lack of effective communication affected the role of social deprivation with regard to increasing or reducing access to regular dental attendance [4,5,10].…”