Neighborhood-Level Inequalities in Dental Care of Adolescents and Young Adults in Southwestern Ontario

Naima Abouseta; Noha Gomaa; S Jeffrey Dixon; Sharat Chandra Pani

doi:10.3390/children9020183

Neighborhood-Level Inequalities in Dental Care of Adolescents and Young Adults in Southwestern Ontario

Children (Basel). 2022 Feb 1;9(2):183. doi: 10.3390/children9020183.

Authors

Naima Abouseta¹, Noha Gomaa^{2

3

4}, S Jeffrey Dixon⁵, Sharat Chandra Pani⁶

Affiliations

¹ Department of Medical Biophysics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada.
² Oral Diagnostic Sciences, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada.
³ Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6G 2M1, Canada.
⁴ Children's Health Research Institute, Lawson Health Research Institute, London, ON N6C 2R5, Canada.
⁵ Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada.
⁶ Pediatric Dentistry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada.

Abstract

We examined whether the association of neighborhood-level socioeconomic status (SES) with the cost of dental care and dental care outcomes differs between adolescents and young adults. A total of 2915 patient records were split into two groups: adolescents (15 to 17 years of age) and young adults (18 to 24 years of age). Three dental care outcomes-routine oral evaluation (OEV-CH-A), utilization of preventive services (PRV-CH-A), and dental treatment services (TRT-CH-A)-were determined according to the Dental Quality Alliance (DQA) criteria. Associations of neighborhood SES and other sociodemographic variables with dental care outcomes and the cost of dental care were assessed using binary logistic and univariate linear regression models, respectively. Young adults had significantly lower PRV-CH-A and higher TRT-CH-A scores when compared to adolescents. We observed a significant negative association between TRT-CH-A and median household income in both adolescents and young adults. Utilization of dental treatment services was positively associated with the cost of care in both age groups, whereas utilization of preventive services was inversely associated with the cost of care in young adults, but not in adolescents. Neighborhood-level income was inversely associated with increased TRT-CH-A in both young adults and adolescents. In summary, young adults showed significantly worse preventive and treatment outcomes when compared to adolescents. Moreover, individuals from neighborhoods with a lower household income showed a significantly higher cost of dental care, yet worse treatment outcomes.

Keywords: adolescent oral health; cost of dental care; dental treatment outcomes; geographic information system (GIS); oral health inequality; young adults.