Explaining public dental service utilization: A theoretical model

Area of Science:

• Public Health
• Health Services Research
• Dental Public Health

Background:

• Understanding the determinants of dental service utilization is crucial for developing equitable health policies.
• Socioeconomic factors significantly influence access to and use of healthcare services, including dental care.
• Existing models often lack a comprehensive examination of the interplay between socioeconomic status, oral health, and public dental service utilization.

Purpose of the Study:

• To construct and validate a theoretical model explaining the relationships between dental service utilization and key socioeconomic and health indicators.
• To identify specific socioeconomic characteristics associated with the use of public dental services.
• To provide an evidence base for enhancing the equity and effectiveness of public oral health policies.

Main Methods:

• Development of a theoretical-conceptual model based on existing literature.
• Validation of the model using Partial Least Squares Structural Equation Modeling (PLS-SEM).
• Analysis of data from the 2019 Brazilian National Health Survey (n=41,664, aged 15+).

Main Results:

• A theoretical model for public dental services utilization was successfully established.
• Socioeconomic status showed a negative association with oral health status (β = -0.376), primary care enrollment (β = -0.254), and public dental consultation use (β = -0.251).
• Minority ethnic groups (Black, Indigenous) and rural populations exhibited lower socioeconomic status and higher public dental service utilization.

Conclusions:

• The validated model elucidates the systematic relationships influencing public dental service use.
• Findings underscore the impact of public access policies on oral health equity.
• The study supports the development of more effective and equitable public health policies for oral healthcare.