Inequalities in preventive and restorative dental services in England, Wales and Northern Ireland

Key Points Demonstrates that the least educated individuals and those at the bottom of social hierarchy are less likely to seek/receive dental services that require asymptomatic visits. Suggests that indirect cost of use of dental services such as cost of transportation, taking time off work and waiting time at the office are potential barriers for the use of preventive/restorative services. Highlights that changes in the oral healthcare delivery system and at societal level could possibly promote asymptomatic dental visits to seek preventive care by those at the lower end of social hierarchy. Aims The objective of this study is to assess socioeconomic inequalities in the use of selected dental procedures. Methods Data is from the Adult Dental Health Survey 2009, a nationally representative cross-sectional survey of England, Northern Ireland and Wales. Overall, 6,279 participants were included in the analysis. Occupational classification and education were used to assess variations in the use of preventive, restorative services and tooth extraction using a series of logistic regression models, adjusting for age, sex, ethnicity, DMFT, self-reported oral health, dental visits and country. Results There were clear socioeconomic variations in the utilisation of preventive and restorative services. In the fully adjusted model those with no educational qualification were less likely to report ever having preventive services than those with a degree (OR 0.48, 95%CI: 0.36,0.65). Similarly, individuals in routine/manual occupation were significantly less likely to report ever having preventive services than those in managerial/professional occupation (OR 0.58, 95%CI: 0.46,0.74) in the fully adjusted model. Conclusion The findings imply that despite relatively equitable access and higher use of dental services in UK, the least educated and those at the bottom of social hierarchy are less likely to have preventive and restorative dental services.