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Background: A systematic review synthesizing studies examining the determinants of dental service use drawing on the (extended) Andersen model is lacking. Hence, our purpose was to fill this knowledge gap; Methods: Three established electronic databases (PubMed, PsycInfo, as well as CINAHL) were searched. Observational studies focusing on the determinants of dental service use drawing on the Andersen model were included; Results: In sum, 41 studies have been included (ten studies investigating children/adolescents and 31 studies investigating adults). Among children, particularly higher age (predisposing characteristic), higher income (enabling resource) and more oral health problems (need factor) were associated with increased dental service use. Among adults, findings are, in general, less consistent. However, it should be noted that one half of the studies found an association between increased education (predisposing characteristic) and increased dental service. In general, study quality was rather high. However, it should be noted that most studies did not report how they dealt with missing data; Conclusions: Our systematic review revealed that all components (i.e., predisposing characteristics, enabling resources and need factors) of the Andersen model tend to be associated with dental service use among children, whereas the findings are more mixed among adults. In conclusion, beyond need factors, dental service use also tend to be driven by other factors. This may indicate over—or, more likely—underuse of dental services and could enrich the inequality discussion in dental services research.

The US Department of Health and Human Services (HHS) is committed to advancing the oral health and general well-being of all populations across the lifespan. The HHS Oral Health Strategic Framework 2014-2017 (hereinafter, the Framework) reflects the collective deliberations and next steps proposed by HHS and other federal partners to realize the department's oral health vision and eliminate oral health disparities. The Framework builds upon and outlines a strategic alignment of HHS operating and staff divisions' resources, programs, and leadership commitments to improve oral health with activities of other federal partners. Here, the goals of HHS Oral Health Strategic Framework are detailed.

Background Utilization of oral health services on a regular basis is essential for addressing any oral health problem and preventing the development of more serious concerns. However, there exist some barriers that directly impact utilization of dental services, like cost, lack of awareness, anxiety or dental fear, accessibility and availability of dental services. Therefore, this study was conducted to determine dental service utilization and perceived barriers among adults residing in Jiri, Nepal. Methods A cross-sectional study was conducted among 725 adult residents of Jiri who were interviewed with the help of a validated and pre-tested questionnaire. Data were analyzed in SPSS version 24. Mean and standard deviation were computed for continuous data like age. Frequency and percentage were calculated for categorical variables regarding dental service utilization and perceived barriers. Chi square test was used to determine association between demographic factors and their dental services utilization status. Results Out of 725 study participants, 595 (82.1%) did not visit a dentist in the past one year. Very few (87, 12%), utilized dental services in the past six months. Dental pain was the major reason for their visit to the dentist. Many aged 65 years and above (109, 87.2%) did not visit dentist in the past one year which was significantly higher than other age groups ( P  = 0.033). Similarly, most of the unemployed residents of Jiri (331, 86.9%) had not utilized dental services than employed or self-employed residents ( P  = 0.001).The major barrier for dental service utilization perceived by the study participants was the high cost of treatment (474, 65.4%) followed by lack of awareness to seek dental care (417, 57.5%) and difficult access to oral health services due to scarce dental facility (393, 54.2%). Conclusions The findings of this study showed low dental care utilization status by the adult residents of Jiri which was associated with age and employment status. High cost of dental treatment, lack of awareness and accessibility were the major perceived barriers. Utilization of dental services can be increased by tackling concerns about the affordability of oral health care, adequate accessibility of public dental facility, and oral health education and promotion at community level.

Access to dental services is a core component of public healthcare. The aim of this study was to evaluate the perceptions and experiences of the public regarding access, quality and affordability of dental services in Pakistan. It was an analytical cross-sectional study based on an online survey. The data collection instrument was based on eight items related to participant perceptions and experiences of dental services in public and private sectors. Pretesting of the survey questionnaire was done, and the target participants were approached through social media, and dental service providers. A total of 1007 participants representing all provinces of the country responded to the study questionnaire including 54.32% (n = 547) females and 45.68% (n = 460) males. Education and financial status showed the largest effect on perceptions. Although all groups agreed that dental professionals contribute positively to improving public health, those in the 'No Education' or 'Poor' groups showed fewer positive perceptions about the accessibility, quality, and affordability of dental services. Perceptions of dental services between genders showed minimal differences. Chi-squared tests of association showed significant (p < 0.001) relationships between personal awareness of oral health and respondent characteristics such as education, employment, financial status and location. This study provides useful insights into the public perceptions and experiences of dental health services in Pakistan. The findings reveal disparities in access, quality, and affordability of dental services among disadvantaged groups, particularly within the public sector. Oral health awareness was also reported to be low amongst people with low educational and financial status. Given the limitations of the current study, further research using qualitative methods may provide a more in-depth understanding of the facilitators and barriers to dental services to inform a major reform to improve public dental services in the country. Members of the public with previous experience of using dental services were involved in pretesting of the study questionnaire Pretesting of the survey questionnaire was done in two phases: In the first phase, cognitive interviews were conducted with eight members of the public including four participants each with proficiency in English and Urdu. The purpose of the cognitive interviews was to determine that the participants were able to comprehend all items of the questionnaire accurately. In the second phase the questionnaire was piloted with 15 members of the public who were given a choice to answer the questionnaire in English or Urdu based on their individual preference.

Background Oral health is essential to general health and well-being. The utilization of oral health care services represents an important factor in reducing oral health morbidities. In order to understand the disparities in the frequency of dental visits, it is necessary to identify determinants that influence the use of those services. The aim of the current study was to investigate the determinants of the number of dental visits in Germany during the COVID-19 pandemic. Methods We used data from the general adult population in Germany with n  = 2,807 individuals in the analytical sample. Average age was 46.5 years (SD: 15.2 years, range 18 to 74 years) and 48.2% of the individuals were female. The number of dental visits in the preceding 12 months served as outcome measure. Grounded on the extended Andersen model, various determinants were included in regression analysis. Multiple negative binomial regressions were used. Results Negative binomial regressions showed that a higher number of dental visits was significantly associated with personality-related (higher conscientiousness, IRR: 1.09, 95% CI: 1.03–1.15; higher neuroticism, IRR: 1.06, 95% CI: 1.00-1.12) and psychosocial factors (higher loneliness, IRR: 1.12, 95% CI: 1.02–1.22). In contrast, only very few predisposing characteristics, and none of the enabling resources and need factors were significantly associated with the outcome measure. Conclusions This study particularly emphasized the importance of personality-related factors and psychosocial factors (in terms of loneliness) for the number of dental visits during the pandemic. These factors, often overlooked in prior research, deserve further attention in upcoming studies dealing with the number of dental visits.

Background Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. Methods A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients’ relative cost. DRC are the quantified average financial resources required for an adult Tanzanian’s overall consumption per day. Results Tooth extractions were found to cost four times the DRC whereas restorations were 9–10 times the DRC. Studied facilities provided tooth extractions (100 %), scaling (86 %), fillings (79 %), root canal treatment (46 %) and fabrication of removable partial dentures (32 %). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50 % of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. Conclusions Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.

Background This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen’s behavioural model to explore influencing factors, thereby providing a reference for future policy making. Methods This study is a cross-sectional study. Data of 40,305 children aged 3–5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016. Patient data were collected using a questionnaire, which was answered by the child’s parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchical logistic regression results were then analysed to find the factors associated with oral health service utilization. Results The oral health service utilization prevalence during the prior 12 months were 9.5% (95%CI: 8.1–11.1%) among 3-year-old children, 12.1% (95%CI: 10.8–13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6–19.4%) among 5-year-old children. “No dental diseases” (71.3%) and “dental disease was not severe” (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor’s degree or higher (OR: 2.29, 95%CI: 1.97–2.67, p  < 0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43–1.89, p  < 0.001), annual per capital income more than 25,000 CNY (OR: 1.40, 95%CI: 1.18–1.65, p  < 0.001),think their child have worse or bad oral health (OR: 3.54, 95%CI: 2.84–4.40, p  < 0.001), and children who often have toothaches (OR: 9.72, 95%CI: 7.81–12.09, p  < 0.001) were more likely to go to the dentist in the past year. Conclusion The prevalence of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.

Cultural background influences how migrants and ethnic minority populations view and assess health. Poor oral health literacy (OHL) may be a hindrance in achieving good oral health. This systematic review summarizes the current quantitative evidence regarding OHL of migrants and ethnic minority populations. The PubMed database was searched for original quantitative studies that explore OHL as a holistic multidimensional construct or at least one of its subdimensions in migrants and ethnic minority populations. 34 publications were selected. Only 2 studies specifically addressed OHL in migrant populations. Generally, participants without migration background had higher OHL than migrant and ethnic minority populations. The latter showed lower dental service utilization, negative oral health beliefs, negative oral health behavior, and low levels of oral health knowledge. Due to its potential influence on OHL, oral health promoting behavior, attitudes, capabilities, and beliefs as well as the cultural and ethnic background of persons should be considered in medical education and oral health prevention programs.

On May 25, 2000, Surgeon General David Satcher issued Oral Health in America: A Report of the Surgeon General. The release of this first-ever report on the oral, health of Americans brought attention to the oral health needs in their country and affirmed their importance to general health and well-being. The report emphasized that good oral health is more than just preserving one's smile, Aside from causing dental pain, diminished function, and reduced quality of life, oral disease and related conditions can affect overall physical, psychological, social, and economic well-being. Here, Murthy examines the oral health progress in US.

Improving oral health is a leading population health goal; however, curricula preparing health professionals have a dearth of oral health content and clinical experiences. We detail an educational and clinical innovation transitioning the traditional head, ears, eyes, nose, and throat (HEENT) examination to the addition of the teeth, gums, mucosa, tongue, and palate examination (HEENOT) for assessment, diagnosis, and treatment of oral–systemic health. Many New York University nursing, dental, and medical faculty and students have been exposed to interprofessional oral health HEENOT classroom, simulation, and clinical experiences. This was associated with increased dental–primary care referrals. This innovation has potential to build interprofessional oral health workforce capacity that addresses a significant public health issue, increases oral health care access, and improves oral–systemic health across the lifespan.