Urban-Rural Disparities in Dental Services Utilization Among Adults in China's Megacities

Abstract

Objective: China's dental care system is bifurcated between urban and rural areas. However, very few studies have examined the dental services utilization inequities in China's megacities, particularly in these urban and rural areas. This study aims to examine the urban-rural disparities in dental services utilization among adults living in China's megacities based on the Andersen dental services utilization model.Methods: This study used data from 4,049 residents aged 18–65 who participated in the “2019 New Era and Living Conditions in Megacities Survey.” Multivariate logistic regressions were employed to examine the associations between place of residence and dental services utilization for individuals from ten megacities in China. Predisposing variables (age, gender, marital status, living arrangement, and education), enabling variables (socioeconomic status, occupational status, income, insurance coverage, health attitude, and health behavior), and need variables (self-rated health, oral health status, gum bleeding) were controlled for.Results: The mean age of the 4,049 adults was 45.2 (standard deviation = 13.0), and 30.4% (n = 1,232) had no dental visits at all. Adults who resided in urban areas were more likely to use dental services [odds ratio (OR) = 1.57, 95% confidence interval (CI) = 1.30 to 1.91] than those residing in rural areas after controlling for key covariates. Factors associated with higher odds of visiting dentists include having a higher income (OR = 1.44, P < 0.001), higher education level (OR = 1.53, P = 0.042), being covered by insurance for urban residents/employees (OR = 1.49, P = 0.031), having a positive attitude toward healthy diets (OR = 1.43, P < 0.001), attending regular physical examination (OR = 1.66, P < 0.001), having more tooth loss (OR = 1.05, P < 0.001), and having frequent gum bleeding (OR = 2.29, P < 0.001).Conclusion: The findings confirm that place of residence is associated with dental services utilization while adjusting for key covariates. Despite rapid economic development in China, many adults had never visited dentists at all. More efforts should be taken to encourage widespread dental care, such as providing more dental coverage and better access to dental care services.

Periodontal Inflamed Surface Area Is Associated With Increased Gestational Blood Pressure and Uric Acid Levels Among Pregnant Women From Rural North China

“…Periodontal disease can be highly prevalent among pre-conception women in some regions of China ( 24 ), compounded by low levels of oral health awareness and utilization of dental services in rural areas ( 25 ). Periodontal disease has been reported to have a high prevalence among rural pregnant women in China ( 26 ).…”

“…In addition, a large-scale retrospective study showed an increased risk of hypertension was associated with periodontal disease in the Chinese population ( 27 ), further highlighting the necessity of investigating periodontal disease as an exposure in the context of gestational blood pressure in Chinese populations. Higher prevalence of both periodontitis ( 24 , 25 ) and hypertensive disorders during pregnancy ( 1 ) in populations in underserved regions of North China begets further investigations into their association.…”

Translation and Validation of the Short Form of the Fear of Dental Pain Questionnaire in China

“…This is similar to previous findings exploring dental service utilisation in China. For example, 30% of respondents in the “2019 New Era and Living Conditions in Megacities Survey” reported that they had never attended the dentist ( Qi et al, 2021 ). It is interesting that so many individuals in our sample have never experienced the specific procedures included in the scale, yet still report a considerable level of FDP.…”

“…Thus, dental visits tend to be treatment-oriented, which means that people do not seek dental care unless they have acute symptoms, such as severe toothache or periodontal symptoms ( Liu L. et al, 2015 ). Dental attendance rates are low with 30% of respondents in the “2019 New Era and Living Conditions in Megacities Survey” ( Qi et al, 2021 ) (NELCMS) reporting that they had never attended the dentist.…”

Health Behaviors and Self-Reported Oral Health among Centenarians in Nanjing, China: A Cross-Sectional Study

“…For older adults, dental care is challenging due to their lower socioeconomic status, disadvantageous physical health, and socio-cultural reasons. On the one hand, limited mobility and financial ability of older adults reduce their access to dental care, and the current dental care system is undeveloped, resulting in the lack of dental care services and nursing staff in rural areas, townships, and communities [46,47]. On the other hand, Chinese older adults are less likely to use preventative dental utilization owing to traditional beliefs and a lack of oral health knowledge [48].…”