Psychosocial factors and dental services utilization among Brazilian low-income children

OBJECTIVES: To assess psychosocial factors associated with “having never had a dental visit” among Brazilian low-income children. METHODS: A cross-sectional study was performed at the working area of the federal Primary Health Care program (Family Health Program) in a city of Southern Brazil, as part of a survey on access to dental services, funded by the National Council for the Scientific and Technological Development. The probabilistic sample included 125 children aged zero to 12 years old, whose parents answered a questionnaire about socioeconomic conditions, perceived needs, oral hygiene habits and access to dental services. The impact of oral health conditions on the child's quality of life was assessed by the Parents-Child Perceptions Questionnaire (adapted version). Multivariate models of logistic regression analysis instructed hypothesis on covariates for never having had a dental visit, as adjusted by age. RESULTS: Thirty eight percent of surveyed children had never had a dental visit; this outcome was inversely associated with age (p = 0.03). The multivariate model identified, as explicative factors to the odds of having never had a dental visit: low schooling of the mother (Odds Ratio 7.0; 95% Confidence Interval 1.3 - 37.5), having never received information on children oral health (OR 337.4; 95%CI 30.5 - 3732.7), and insufficient frequency of toothbrushing (OR 12.6; 95%CI 2.2 - 70.8). The odds of having never consulted a dentist was lower for children presenting some impact of oral conditions on their quality of life, mainly referring to the report of pain (OR 0.01; 95%CI 0.001 - 0.2). CONCLUSIONS: Low schooling of the mother, lack of knowledge on oral health and the absence of parental perceptions about the child's dental needs can be considered individual barriers of access to dental services. The identification of these factors by the dental team may instruct the planning of programs aimed at children oral health, thus allowing an enlarged access to dental services.