Factors related to severe untreated tooth decay in rural adolescents: a case-control study for public health planning

In this case-control study of rural adolescents we identified factors to discriminate those who have high levels of tooth decay and receive treatment from those with similar levels who receive no treatment.

The sample was drawn from all 12-20-year-olds (n = 439) in a rural high school in Washington State, U.S. The criterion for being included was 5 or more decayed, missing or filled teeth. The questionnaire included structure, history, cognition and expectation variables based on a model by Grembowski, Andersen and Chen.

No structural variable was related to the dependent variable. Two of 10 history variables were related: perceived poor own dental health and perceived poor mother's dental health. Four of eight cognition variables were also predictive: negative beliefs about the dentist, not planning to go to a dentist even if having severe problems, not being in any club or playing on a sports team and not having a best friend. No relationship was found for the expectation variable 'usual source of care'.

These data are consistent with the hypothesis that untreated tooth decay is associated with avoidance of care and point to the importance of history and cognition variables in planning efforts to improve oral health of rural adolescents.