ObjectivesTo explore the factors associated with utilization of oral health services among Chinese adults and older adults according to the Andersen Behavior Model.MethodsData from the 4th National Oral Health Survey (2015‐2016) in China were used. A total of 7206 people (3669 adults aged 35‐44 years and 3537 older adults aged 65‐74 years) were included in our analysis. Oral health service utilization in the past 12 months was the outcome variable. Explanatory variables were selected according to the Andersen Behavior Model. Descriptive statistics and bivariate associations (chi‐square tests) were analysed, followed by hierarchical Poisson regression models, which were conducted to determine the factors associated with oral health service utilization.ResultsIn total, 21.4% (95% CI: 19.4%‐23.7%) of adults (35‐44 years old) and 20.7% (95% CI: 18.6%‐22.9%) of older adults (65‐74 years old) utilized oral health services in the past 12 months. Nearly 80% of adults (78.7%, 95% CI: 74.0%‐82.7%) and more than 90% of older adults (93.7%, 95% CI: 91.0%‐95.6%) visited a dentist for treatment. Adults aged 35‐44 years old who were female (IRR: 1.15, 95% CI: 1.00‐1.33, P = .047), had good oral health knowledge and attitudes (IRR: 1.30, 95% CI: 1.06‐1.59, P = .011), perceived their oral health status as fair (IRR:1.51, 95% CI:1.24‐1.85, P < .001) or poor/very poor (IRR:2.52, 95% CI:2.01‐3.18, P < .001) and had a decayed, missing and filled teeth (DMFT) index >0 (IRR: 1.52, 95% CI: 1.11‐2.09, P = .009) were more likely to report dental visits in the past 12 months. Older adults who utilized oral health services tended to be female (IRR: 1.32, 95% CI: 1.09‐1.59, P = .004); to be covered by Urban Resident Basic Medical Insurance (URBMI) (IRR: 1.56, 95% CI: 1.18‐2.05, P = .002), Urban Employee Basic Medical Insurance (UEBMI) (IRR: 1.69, 95% CI: 1.32‐2.16, P < .001) or government medical insurance (GMI) (IRR: 1.03, 95% CI:1.01‐2.16, P = .044); to have a high education level (IRR: 1.37, 95% CI: 1.08‐1.74, P = .010); to have an income level in the 2nd tertile (IRR: 1.44, 95% CI: 1.13‐1.84, P = .003) or 3rd tertile (IRR:1.52, 95% CI:1.18‐1.95, P = .001); and to perceive their oral health status as poor or very poor (IRR: 1.53, 95% CI: 1.21‐1.95, P = .001).ConclusionsSex and self‐perceived oral health status were associated with oral health utilization among Chinese population. Additionally, for older adults, education level, household income and insurance coverage were determinants of dental service use. These findings can aid in creating more targeted policies to increase the use of dental services by Chinese adults.

BackgroundThe utilization of oral health services in children remains at a relatively low level in China. However, little is known about the utilization patterns and related factors. The objective of this study was to explore the patterns of oral health service utilization and to determine the related factors among preschool children in Beijing, China, based on the Andersen behavioral model.MethodsA cross-sectional study of 1425 preschool children aged 2 to 6 years was carried out in five kindergartens in Beijing, China. A questionnaire investigation of parents/caregivers was performed to collect information on oral health service utilization. Oral health needs were evaluated through oral health examinations. Chi-square tests, t-tests, multivariate logistic regression and negative binomial regression were used in this study to identify the variables associated with oral health service utilization.ResultsIn total, 648 (45.5%) children had utilized oral health services in the past 12 months, while 24.3% had utilized preventive oral health services. Routine checkups and receiving preventive measures accounted for 63.2% of the children who utilized oral health services in the past 12 months. Children were more likely to have utilized oral health services in the past 12 months if they attended kindergartens with regular oral health care resources, if their oral health status as perceived by their parents/parents was “fair” or “poor”, if they had more decayed, missing and filled teeth (dmft) and if they had experienced more dental pain. In addition, children with more dental pain and more access to oral health services, whose oral health status was perceived by parents/caregivers as worse tended to have utilized oral health services more frequently in the past 12 months.ConclusionsIn conclusion, we found a strong association between access to regular oral health care resources and oral health service utilization among preschool children. Children whose oral health status was perceived by parents/caregivers as worse and who had more dental pain were more likely to have utilized oral health services in China.Electronic supplementary materialThe online version of this article (10.1186/s12903-018-0494-6) contains supplementary material, which is available to authorized users.

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