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      Clinical and non-clinical variables associated with preventive and curative dental service utilisation: a cross-sectional study among adolescents and young adults in Central Mexico


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          The present study aimed to identify preventive and curative dental health service utilisation (DHSU) in the context of associated clinical and non-clinical factors among adolescents and young adults in Mexico.


          Cross-sectional study.


          Applicants to a public university in Mexico.


          Participants were 638 adolescents and young adults aged 16–25 randomly selected from university applicants.


          Data were collected using a self-administered questionnaire filled out by the students. For assessment of dental caries experience, we used the index of decayed, missing and filled teeth.

          Primary outcome

          The dependent variable was DHSU in the previous 12 months, coded as 0=non-use, 1=use of curative services and 2=use of preventive services.


          The mean age was 18.76±1.76 years, and 49.2% were women. The prevalence of DHSU was 40.9% (95% CI 37.1 to 44.8) for curative services and 22.9% (95% CI 19.7 to 26.3) for preventive services. The variables associated with curative services were age, sex, mother’s education, dental pain in the previous 12 months, caries experience, use of self-care devices and oral health knowledge. For preventive services, the variables associated were mother’s education, dental pain in the previous 12 months, caries experience, use of self-care devices and self-perception of oral health.


          While differences emerged by type of service, a number of variables (sociodemographic and socioeconomic characteristics as well as dental factors) remained in the final model. Greater oral health needs and socioeconomic inequalities remained as predictors of both types of DHSU. Given the differences revealed by our study, oral health policies should refer those seeking dental care for oral diseases to preventive services, and promote the use of such services among the poorer and less educated population groups.

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          Most cited references31

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          Logistic regression in the medical literature: standards for use and reporting, with particular attention to one medical domain.

          Logistic regression (LR) is a widely used multivariable method for modeling dichotomous outcomes. This article examines use and reporting of LR in the medical literature by comprehensively assessing its use in a selected area of medical study. Medline, followed by bibliography searches, identified 15 peer-reviewed English-language articles with original data, employing LR, published between 1985 and 1999, pertaining to patient interest in genetic testing for cancer susceptibility. Articles were examined for each of 10 criteria for proper use and reporting of LR models. Substantial shortcomings were found in both use of LR and reporting of results. For many studies, the ratio of the number of outcome events to predictor variables (events per variable) was sufficiently small to call into question the accuracy of the regression model. Additionally, no studies reported validation analysis, regression diagnostics, or goodness-of-fit measures. It is recommended that authors, reviewers, and editors pay greater attention to guidelines concerning the use and reporting of LR models.
            • Record: found
            • Abstract: not found
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            A Generalized Hosmer–Lemeshow Goodness-of-Fit Test for Multinomial Logistic Regression Models

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              Is Open Access

              Socioeconomic and psychosocial predictors of dental healthcare use among Brazilian preschool children

              Background Disparities in utilization of oral healthcare services have been attributed to socioeconomic and individual behavioral factors. Parents’ socioeconomic status, demographics, schooling, and perceptions of oral health may influence their children’s use of dental services. This cross-sectional study assessed the relationships between socioeconomic and psychosocial factors and the utilization of dental health services by children aged 1–5 years. Methods Data were collected through clinical exams and a structured questionnaire administered during the National Day of Children’s Vaccination. A Poisson regression model was used to estimate prevalence ratios and 95% confidence intervals. Results Data were collected from a total of 478 children. Only 112 (23.68%) were found to have visited a dentist; 67.77% of those had seen the dentist for preventive care. Most (63.11%) used public rather than private services. The use of dental services varied according to parental socioeconomic status; children from low socioeconomic backgrounds and those whose parents rated their oral health as “poor” used dental services less frequently. The reason for visiting the dentist also varied with socioeconomic status, in that children of parents with poor socioeconomic status and who reported their child’s oral health as “fair/poor” were less likely to have visited the dentist for preventive care. Conclusion This study demonstrated that psychosocial and socioeconomic factors are important predictors of the utilization of dental care services.

                Author and article information

                BMJ Open
                BMJ Open
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                18 September 2019
                : 9
                : 9
                : e027101
                [1 ] departmentAcademic Area of Dentistry, The Health Sciences Institute , Autonomous University of the State of Hidalgo , Pachuca, Hidalgo, Mexico
                [2 ] departmentAdvanced Studies and Research Center in Dentistry , Dr. Keisaburo Miyata School of Dentistry, the Autonomous University of the State of Mexico , Toluca, Mexico
                [3 ] departmentSchool of Dentistry , The Autonomous University of San Luis Potosí , San Luis Potosi, Mexico
                [4 ] departmentSchool of Dentistry , The Autonomous University of Campeche , Campeche, Mexico
                [5 ] departmentHealth Systems Research Center , The National Institute of Public Health , Cuernavaca, Mexico
                [6 ] departmentRichard M. Fairbanks School of Public Health , Indiana University/Purdue University , Indianapolis, Indiana, USA
                [7 ] Indiana University Network Science Institute , Bloomington, Indiana, USA
                Author notes
                [Correspondence to ] Dr Carlo Eduardo Medina-Solís; cemedinas@ 123456yahoo.com ; Dr Leticia Ávila-Burgos; leticia.avila@ 123456insp.mx
                Author information
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                : 08 October 2018
                : 17 August 2019
                : 21 August 2019
                Health Services Research
                Original Research
                Custom metadata

                oral health,health services,inequalities,adolescents,mexico
                oral health, health services, inequalities, adolescents, mexico


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