Toothache and tooth extraction as reasons for dental visits: an analysis of the 2019 National Health Survey

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Abstract: The aim of this study was to analyze the prevalence of dental visits due to toothache and tooth extraction in Brazil and its association with individual and contextual variables. This two-step cross-sectional study included persons aged 18 years and older in the 2019 National Health Survey who had visited a dentist in the 12 months prior to the interview (n = 40,369). The individual-level outcome was having a dental visit due to toothache or tooth extraction. The ecological-level outcome was the proportion of dental visits for these reasons relative to all dental visits by Brazilian state. Associations with individual – sociodemographic characteristics, number of teeth, and type of health service used – and ecological variables – HDI and dental service coverage – were assessed using Poisson regressions. The prevalence of dental visits due to toothache or extraction was higher among individuals with no formal education, household income < 25% of the minimum wage, of black and brown skin color, living in rural areas, who consulted in the public health system, with 10–19 and 1–9 teeth, and men. The proportion of dental visits due to toothache/extraction in Brazilian states was negatively associated with the HDI and the rate of dental emergency team/100,000 inhabitants and positively associated with primary dental care coverage. The prevalence of dental visits due to toothache/extraction was associated with individual and ecological characteristics, indicating inequities in reasons for dental visits in Brazil. The potential of a well-structured oral health care network to overcome these inequities is suggested and needs to be better explored.

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Ending the neglect of global oral health: time for radical action

Richard G. Watt, Blánaid Daly, Paul Allison … (2019)

Oral diseases are a major global public health problem affecting over 3·5 billion people. However, dentistry has so far been unable to tackle this problem. A fundamentally different approach is now needed. In this second of two papers in a Series on oral health, we present a critique of dentistry, highlighting its key limitations and the urgent need for system reform. In high-income countries, the current treatment-dominated, increasingly high-technology, interventionist, and specialised approach is not tackling the underlying causes of disease and is not addressing inequalities in oral health. In low-income and middle-income countries (LMICs), the limitations of so-called westernised dentistry are at their most acute; dentistry is often unavailable, unaffordable, and inappropriate for the majority of these populations, but particularly the rural poor. Rather than being isolated and separated from the mainstream health-care system, dentistry needs to be more integrated, in particular with primary care services. The global drive for universal health coverage provides an ideal opportunity for this integration. Dental care systems should focus more on promoting and maintaining oral health and achieving greater oral health equity. Sugar, alcohol, and tobacco consumption, and their underlying social and commercial determinants, are common risk factors shared with a range of other non-communicable diseases (NCDs). Coherent and comprehensive regulation and legislation are needed to tackle these shared risk factors. In this Series paper, we focus on the need to reduce sugar consumption and describe how this can be achieved through the adoption of a range of upstream policies designed to combat the corporate strategies used by the global sugar industry to promote sugar consumption and profits. At present, the sugar industry is influencing dental research, oral health policy, and professional organisations through its well developed corporate strategies. The development of clearer and more transparent conflict of interest policies and procedures to limit and clarify the influence of the sugar industry on research, policy, and practice is needed. Combating the commercial determinants of oral diseases and other NCDs should be a major policy priority.

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The global burden of oral diseases and risks to oral health

Poul Petersen, Denis Bourgeois, Hiroshi Ogawa … (2005)

This paper outlines the burden of oral diseases worldwide and describes the influence of major sociobehavioural risk factors in oral health. Despite great improvements in the oral health of populations in several countries, global problems still persist. The burden of oral disease is particularly high for the disadvantaged and poor population groups in both developing and developed countries. Oral diseases such as dental caries, periodontal disease, tooth loss, oral mucosal lesions and oropharyngeal cancers, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related oral disease and orodental trauma are major public health problems worldwide and poor oral health has a profound effect on general health and quality of life. The diversity in oral disease patterns and development trends across countries and regions reflects distinct risk profiles and the establishment of preventive oral health care programmes. The important role of sociobehavioural and environmental factors in oral health and disease has been shown in a large number of socioepidemiological surveys. In addition to poor living conditions, the major risk factors relate to unhealthy lifestyles (i.e. poor diet, nutrition and oral hygiene and use of tobacco and alcohol), and limited availability and accessibility of oral health services. Several oral diseases are linked to noncommunicable chronic diseases primarily because of common risk factors. Moreover, general diseases often have oral manifestations (e.g. diabetes or HIV/AIDS). Worldwide strengthening of public health programmes through the implementation of effective measures for the prevention of oral disease and promotion of oral health is urgently needed. The challenges of improving oral health are particularly great in developing countries.

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Re-revisiting Andersen’s Behavioral Model of Health Services Use: a systematic review of studies from 1998–2011

Birgit Babitsch, Daniela Gohl, Thomas von Lengerke (2012)

Objective: This systematic review aims to assess the use and implementation of the Behavioral Model of Health Services Use developed by Ronald M. Andersen in recent studies explicity using this model. Methods: A systematic search was conducted using PubMed in April 2011. The search strategy aimed to identify all articles in which the Andersen model had been applied and which had been published between 1998 and March 2011 in English or German. The search yielded a total of 328 articles. Two researchers independently reviewed the retrieved articles for possible inclusion using a three-step selection process (1. title/author, 2. abstract, 3. full text) with pre-defined inclusion and exclusion criteria for each step. 16 studies met all of the inclusion criteria and were used for analysis. A data extraction form was developed to collect information from articles on 17 categories including author, title, population description, aim of the study, methodological approach, use of the Andersen model, applied model version, and main results. The data collected were collated into six main categories and are presented accordingly. Results: Andersen’s Behavioral Model (BM) has been used extensively in studies investigating the use of health services. The studies identified for this review showed that the model has been used in several areas of the health care system and in relation to very different diseases. The 1995 version of the BM was the version most frequently applied in the studies. However, the studies showed substantial differences in the variables used. The majority of the reviewed studies included age (N=15), marital status (N=13), gender/sex (N=12), education (N=11), and ethnicity (N=10) as predisposing factors and income/financial situation (N=10), health insurance (N=9), and having a usual source of care/family doctor (N=9) as enabling factors. As need factors, most of the studies included evaluated health status (N=13) and self-reported/perceived health (N=9) as well as a very wide variety of diseases. Although associations were found between the main factors examined in the studies and the utilization of health care, there was a lack of consistency in these findings. The context of the studies reviewed and the characteristics of the study populations seemed to have a strong impact on the existence, strength and direction of these associations. Conclusions: Although the frequently used BM was explicitly employed as the theoretical background for the reviewed studies, their operationalizations of the model revealed that only a small common set of variables was used and that there were huge variations in the way these variables were categorized, especially as it concerns predisposing and enabling factors. This may stem from the secondary data sets used in the majority of the studies, which limited the variables available for study. Primary studies are urgently needed to enrich our understanding of health care utilization and the complexity of the processes shown in the BM.

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Journal

Journal ID (publisher-id): bor

Title: Brazilian Oral Research

Abbreviated Title: Braz. oral res.

Publisher: Sociedade Brasileira de Pesquisa Odontológica - SBPqO (São Paulo, SP, Brazil )

ISSN (Print): 1806-8324

ISSN (Electronic): 1807-3107

Publication date (Print and electronic): 2022

Volume: 36

Electronic Location Identifier: e070

Affiliations

[3] Belo Horizonte Minas Gerais orgnameUniversidade Federal de Minas Gerais orgdiv1School of Nursing orgdiv2Department of Maternal and Child Nursing and Public Health Brazil

[4] Recife Pernambuco orgnameUniversidade Federal de Pernambuco orgdiv1Postgraduate Program in Child and Adolescent Health Brazil

[1] Porto Alegre Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul orgdiv1Department of Preventive and Social Dentistry Brazil

[2] Tubarão orgnameUniversidade do Sul de Santa Catarina orgdiv1Postgraduate Program in Health Sciences Brazil

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Publisher ID: S1806-83242022000100261 Publisher ID: S1806-8324(22)03600000261

DOI: 10.1590/1807-3107bor-2022.vol36.0070

SO-VID: 5932407e-fff3-4be9-9d62-14d075f37bb6

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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Date received : 31 August 2021

Date accepted : 02 February 2022

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Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 0

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Toothache and tooth extraction as reasons for dental visits: an analysis of the 2019 National Health Survey

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Most cited references 31

Ending the neglect of global oral health: time for radical action

The global burden of oral diseases and risks to oral health

Re-revisiting Andersen’s Behavioral Model of Health Services Use: a systematic review of studies from 1998–2011

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