Dental care utilization: patterns and predictors in persons living with HIV in British Columbia, Canada

Abstract

Objectives To identify the predisposing, enabling, and need factors of the Andersen and Newman (A&N) model and their associations with the pattern of dental service utilization in a sample of people living with HIV (PLHIV) in British Columbia. Methods Participants responded anonymously to a 40‐item online questionnaire to explore the patterns of dental service utilization. Following the descriptive statistics, the associations between A&N model factors and main outcome variables (having a dental visit in the last year and reasons for the dental visit) were evaluated using simple and multiple logistic regression analyses. Results Out of 600 potential PLHIV participants, 210 responded to the survey and 186 met the inclusion criteria. The experience of being discriminated against by dental professionals (P = 0.005), having dental anxiety (P < 0.001), not having dental insurance (P = 0.001), and having living condition difficulties (P = 0.004) were significantly associated with nonemergency dental visits. In multiple logistic regression analysis, dental anxiety (OR = 0.1; 95 percent CI 0.0; 0.4), having a regular dentist (OR = 3.7; 95 percent CI 1.1; 12.6), and visiting a dental office in the last year (OR = 21.6; 95 percent CI 6.1; 76.5) were the strongest predictors of dental service utilization in this study. Conclusions Several predisposing, enabling, and need factors from the A&N model were associated with dental service utilization by PLHIV. In addition to various psychosocial barriers, a significant number of respondents reported experiencing stigma and discrimination from their oral care providers.

Oral Health Status and Patterns of Dental Service Utilization of Adolescents in Lesotho, Southern Africa

“…We utilized the A&N model of health service utilization to identify the strongest predictors of self-reported oral health and dental service utilization as employed in our previous studies. [31,32,33] For predisposing factors, we found that adolescents who reported receiving some oral health education were more likely to have visited a dental professional within the last year, which corroborates the ndings from Jessani et al in 2016, and Jessani et al in 2019. [32,31] However, 80% of adolescents had not been exposed to any form of oral health education.…”

“…[31,32,33] For predisposing factors, we found that adolescents who reported receiving some oral health education were more likely to have visited a dental professional within the last year, which corroborates the ndings from Jessani et al in 2016, and Jessani et al in 2019. [32,31] However, 80% of adolescents had not been exposed to any form of oral health education. This is concerning as adolescents are in a developmental stage during which they establish lifelong habits, attitudes, and beliefs.…”

“…It has been shown that having social supports such as transportation, housing, and employment, can lead to better oral health and dental service utilization. [31] This social support can result in a better quality of life that can be positively related to a better perception of oral health, as reported in this study. We also found that avoiding dental treatment due to cost was signi cantly associated with irregular dental visits, as nancial constraints remain the most important barrier preventing access to dental care.…”

“…[24] Having access to a regular medical doctor and a regular dentist were positively related to having had a dental visit within the last year, as was also found by Jessani et al in 2020. [31] In fact, our multivariate analysis revealed the lack of availability of medical doctors within their neighbourhood increased the odds of irregular dental visits by seven times. Participants who were unable to access a medical doctor were also less likely to visit a dental professional within the last year.…”

“…and 2020. [31,33] Adolescents who reported fair/poor oral health were more likely to also report fair/poor general health and quality of life. A study in Yemen found out that people who perceived their general health as very good/excellent were also likely to perceive their oral health as very good/excellent.…”