Barrier to Access and Dental Care Utilization Behavior with Related Independent Variables in the Elderly Population of Saudi Arabia

J Int Soc Prev Community Dent. 2019 Aug 6;9(4):349-355. doi: 10.4103/jispcd.JISPCD_21_19. eCollection 2019 Jul-Aug.

Abstract

Objectives: The study aimed to evaluate barriers associated with access and utilization of dental services among the elderly population of Saudi Arabia.

Materials and methods: A systematic random sample of 350 elderly people recruited from various gathering places of the elderly including all nursing home residents (n = 73) was included in this study. The data were collected through face-to-face structured interviews related to access and utilization of dental services, and sociodemographic, behavioral, medical, and financial barriers to dental services. Statistical analysis included frequency distributions, chi-squared tests, and regression analysis using the Statistical Package for the Social Sciences (SPSS) program.

Results: Approximately 37% of the elderly had proper access to and utilization of dental services. Independent variables that affect access and utilization of dental services were low income (odds ratio [OR] = 2.23, confidence interval [CI] = 1.34-3.72), unmarried participants (OR = 3.25, CI = 1.75-6.05), community residents (OR = 5.15, CI = 2.52-10.53), smokers (OR = 1.93, CI = 1.02-3.68), irregular users of toothbrushing (OR = 3.53, CI = 2.09-5.95), no dental insurance (OR = 1.88, CI = 1.06-3.37), and unaffordable price (OR = 2.55, CI = 1.38-4.69) in the bivariate analysis. In logistic regression analysis, the significant variables that were associated with proper access and utilization of dental services were having dental insurance (OR = 2.24, CI = 1.15-3.82), affordable prices (OR = 2.19, CI = 1.21-3.70), brushing regularly (OR = 3.58, CI = 2.01-6.37), higher education (OR = 1.87, CI = 1.10-3.20), and being married (OR = 1.68. CI = 0.97-2.91).

Conclusion: Lack of perceived need, no dental insurance, unaffordable price, transportation, and fear from dental treatment were the most common significant barriers to dental services.

Keywords: Access; Riyadh; Saudi Arabia; dental services; the elderly; utilization.