Dental care pathway of Quebecers after a broken filling

The objectives were to 1) describe the dental care pathway of adults after sustaining a broken filling, and particularly, the patient delay in seeking care as well as the continuity of care, and 2) identify factors associated with the decisions taken.

In 1998-99, 5,469 Quebec women aged 30 to 44 years completed a self-administered questionnaire in which they indicated whether they had experienced a dental problem in the previous 12 months. From then on, the questions identified the decisions they made during the process of consulting a dentist.

32.4% of the respondents had experienced a dental problem within the last 12 months. Among them, 38.0% reported a broken filling. 65.1% of those who identified a broken filling decided immediately to consult a dentist and 34.9% chose to wait and see. Patient delay was over one month in 44.0% of the cases. When asked by the dentist to come back in order to complete the treatment. 90.6% agreed, 3.2% decided to consult another dentist, and 6.21% chose not to consult. Logistic regression analyses show that patient delay was associated with low income, low degree of inconvenience (symptoms), low degree of perceived seriousness, and absence of a family dentist.

This study reveals important social disparities: after sustaining a broken filling, which remains an important problem in industrialised societies, patient delay, interruption of the dental care episode and extraction are more frequent in low-income groups. It also reveals that a wait-and-see attitude is more frequent than an interruption of the dental care episode after the first visit.