Barriers to Dental Services Utilization among Adult Population in India: A Scoping Review

Sudhakar Vundavalli; Meignana Arumugham Indiran; Radhika Doppalapudi; Sunitha Siddanna; Muhammad Nadeem Baig; Rakhi Issrani; Namdeo Prabhu

Authors

Sudhakar Vundavalli
Meignana Arumugham Indiran
Radhika Doppalapudi
Sunitha Siddanna
Muhammad Nadeem Baig
Rakhi Issrani
Namdeo Prabhu

Keywords:

Dental Care, Oral Health, Awareness

Abstract

Objective: To provide comprehensive information about barriers to using dental services in India. Material and Methods: Original research articles published on factors and(or) barriers to dental and oral health care services utilization were extracted from four electronic databases such as Scopus, PubMed, Web of Science, and EMBASE. The selection process involved looking for English-language articles published between 2005 and 2023 that addressed one or more areas of dental and oral health care barriers in India. Selected articles were analysed using thematic analysis. Results: 188 original studies were retrieved from the four databases, and 23 were extracted. The barriers to dental and oral health care service utilization were classified into three major themes: sociodemographic factors, dental care access, and individual factors. The findings of the selected articles showed that the high cost of dental care, educational level, fear of dental treatment, poor perception about teeth, and(or) lack of felt need and lack of time were the most frequently reported barriers. Conclusion: Appropriate utilization of dental and oral health care services was one of the key principles in achieving "Health for All."Dental care delivery systems should address the barriers to its utilization by incorporating policies to overcome the utilization barriers and community-based oral health awareness programs.

References

Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: A global public health challenge. Lancet 2019; 394(10194):249-260. https://doi.org/10.1016/S0140-6736(19)31146-8. Erratum in: Lancet 2019; 394(10203):1010.

World Health Organization. Oral Health. Available from: https://www.who.int/newsroom/fact-sheets/detail/oral-health. [Accessed on December 24, 2023].

Lin PY, Huang YH, Chen HH, Wang J, Chen SC, Chang HJ, et al. Decline in dental caries experience among schoolchildren in Taiwan, 2012-2020. Community Dent Oral Epidemiol 2023; 51(3):519-526. https://doi.org/10.1111/cdoe.12823

Ghanbari-Jahromi M, Bastani P, Jalali FS, Delavari S. Factors affecting oral and dental services` utilization among Elderly: A scoping review. BMC Oral Health 2023; 23(1):597. https://doi.org/10.1186/s12903-023-03285-4

Nishioka D, Ueno K, Kino S, Aida J, Kondo N. Sociodemographic inequities in dental care utilisation among governmental welfare recipients in Japan: A retrospective cohort study. Int J Equity Health 2021; 20(1):141. https://doi.org/10.1186/s12939-021-01473-8

Talukdar R, Barman D, Thakkar V, Kanungo S. Utilization of dental care services among adult Indian population: A meta-analysis of evidence from 2011-2022. Health Promot Perspect 2022; 12(4):325-335. https://doi.org/10.34172/hpp.2022.42

Kakatkar G, Bhat N, Nagarajappa R, Prasad V, Sharda A, Asawa K, et al. Barriers to the utilization of dental services in udaipur, India. J Dent 2011; 8(2):81-89.

Mohanty V, Jain S, Grover S. Oral healthcare-related perception, utilization, and barriers among schoolteachers: A qualitative study. J Indian Soc Pedod Prev Dent 2021; 39(2):154-158. https://doi.org/10.4103/JISPPD.JISPPD_368_20

Bommireddy VS, Koka KM, Pachava S, Sanikommu S, Ravoori S, Chandu VC. Dental service utilization: Patterns and barriers among rural elderly in Guntur district, Andhra Pradesh. J Clin Diagn Res 2016; 10(3):43-47. https://doi.org/10.7860/JCDR/2016/17834.7456

Yaddanapalli SC, Parveen Sultana SK, Lodagala A, Babu PC, Ravoori S, Pachava S. Oral healthcare-seeking behaviour and perception of oral health and general healthcare among WHO indexed age groups in East-Coast India. J Family Med Prim Care 2020; 9(7):3600-3606. https://doi.org/10.4103/jfmpc.jfmpc_350_20

Batra P, Saini P, Yadav V. Oral health concerns in India. J Oral Biol Craniofac Res 2020; 10(2):171-174. https://doi.org/10.1016/j.jobcr.2020.04.011

Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Implement 2021; 19(1):3-10. https://doi.org/10.1097/XEB.0000000000000277

Chandu V, Pachava S, Vadapalli V, Sanikommu S. Is the intention being realized in execution: Evaluation of Oral Health Promotion Program at a South Indian university. J Orofac Sci 2018; 10(2):121-126. https://doi.org/10.4103/jofs.jofs_140_18

Krishnan L, Balasubramanium A, Iyer K, Kumar PDM. Factors affecting the unmet dental needs and dental service utilisation among urban slum dwellers of Chennai city, India. Indian J Public Health Res Dev 2019; 10(11):1451-1456. https://doi.org/10.5958/0976-5506.2019.03515.0

Nagdev P, Iyer MR, Naik S, Khanagar SB, Awawdeh M, Al Kheraif AA, et al. Andersen health care utilization model: A survey on factors affecting the utilization of dental health services among school children. PLoS ONE 2023; 18(6):e0286945. https://doi.org/10.1371/journal.pone.0286945

Gupta S, Ranjan V, Rai S, Mathur H, Solanki J, Koppula SK. Oral health services utilization among the rural population of western Rajasthan, India. J Indian Acad Oral Med Radiol 2014; 26(4):410-413. https://doi.org/10.4103/0972-1363.155688

Garcha V, Shetiya SH, Kakodkar P. Barriers to oral health care amongst different social classes in India. Community Dent Health 2010; 27(3):158-162.

Kadaluru UG, Kempraj VM, Muddaiah P. Utilization of oral health care services among adults attending community outreach programs. Indian J Dent Res 2012; 23(6):841-842. https://doi.org/10.4103/0970-9290.111290

Gupta E, Robinson PG, Marya CM, Baker SR. Oral health inequalities: Relationships between environmental and individual factors. J Dent Res 2015; 94(10):1362-1368. https://doi.org/10.1177/0022034515592880

Pradeep Y, Chakravarty KK, Simhadri K, Ghenam A, Naidu GM, Vundavalli S. Gaps in need, demand, and effective demand for dental care utilization among residents of Krishna district, Andhra Pradesh, India. J Int Soc Prev Community Dent 2016; 6(Suppl 2):S116-121. https://doi.org/10.4103/2231-0762.189737

Bommireddy VS, Gayathri Naidu SSN, Kondapalli TP, Kommineni HC, Madem R, Padagala GMY. Oral hygiene habits, oral health status, and oral health care seeking behaviors among spinning mill workers in Guntur district: A cross-sectional study. J Family Med Prim Care 2020; 9(6):3025-3029. https://doi.org/10.4103/jfmpc.jfmpc_349_20

Nija MA, Gireesh G, Mathew MM, Venkitachalam R. Oral health care-seeking behaviour and influencing factors among 18-34 years old women in Kochi, India. Int J Community Med Public Health 2020; 7(11):4478-4484. https://doi.org/10.18203/2394-6040.ijcmph20204748

Sharma AS, Sheth SA, Dhaduk PJ, Chovateeya SR, Mistry BJ, Jogi MR. Oral hygiene practices and factors affecting oral health service utilization among children (11-14 years) of government school of Nikol ward of East zone of Ahmedabad, Gujarat, India. Contemp Clin Dent 2019; 10(2):299-303. https://doi.org/10.4103/ccd.ccd_549_18

Jain VK, Sequeira P, Jain J, Chancy U, Maliyil M, Bhagwandas S. Barriers in utilization of oral health care services among patients attending primary and community health centres in Virajpet, South Karnataka. Natl J Med Dent Res 2013; 1(3):39-47.

Rambabu T, Koneru S. Reasons for use and non-use of dental services among people visiting a dental hospital in urban India: a descriptive study. J Educ Health Promot 2018; 7:99. https://doi.org/10.4103/jehp.jehp_193_17

Verma H, Aggarwal AK, Rattan V, Mohanty U. Access to public dental care facilities in Chandigarh. Indian J Dent Res 2012; 23(1):121. https://doi.org/10.4103/0970-9290.99057

Deolia SG, Kela KS, Sawhney IM, Sonavane PA, Nimbulkar G, Reche A. Evaluation of oral health care seeking behaviour in rural population of central India. J Family Med Prim Care 2020; 9(2):886-891. https://doi.org/10.4103/jfmpc.jfmpc_990_19

Nagaraj A, Ganta S, Yousuf A, Pareek S. Enculturation, myths and misconceptions regarding oral health care practices among rural female folk of Rajasthan. Stud Ethno-Medicine 2014; 8(2):157-164. https://doi.org/10.1080/09735070.2014.11917630

Fotedar S, Sharma KR, Bhardwaj V, Sogi GM. Barriers to the utilization of dental services in Shimla, India. Eur J Gen Dent 2013; 2(02):139-143. https://doi.org/10.4103/2278-9626.112314

Bhatt S, Gaur A. Dental caries experience and utilization of oral health services among Tibetan refugee-background children in Paonta Sahib, Himachal Pradesh, India. J Immigr Minor Health 2019; 21(3):461-465. https://doi.org/10.1007/s10903-018-0769-7

Reddy LS, Doshi D, Reddy BS, Kulkarni S, Reddy MP, Satyanarayana D, et al. Self-reported obstacles to regular dental care among information technology professionals. J Clin Diagn Res 2016; 10(10):132-137. https://doi.org/10.7860/jcdr/2016/20655.8696

India. National Health Accounts Estimates for India 2019-20, Union ministry of Health. 2023. Available from: https://main.mohfw.gov.in/sites/default/files/5NHA_19-20_dt%2019%20April%202023_web_version_1.pdf?utm_medium=email&utm_source=transaction [Accessed on February 24, 2024].

Akshay V, Umashankar GK, Pramila M, Maiti R, Aswini M, Manjusha PC. Oral health utilization and awareness of Ayushman Bharat (PMJAY) health insurance scheme in Bangalore. Int J Community Med Public Health 2021, 8(8):4012-4018. https://doi.org/10.18203/2394-6040.ijcmph20213037

Jeddy N, Nithya S, Radhika T, Jeddy N. Dental anxiety and influencing factors: A cross-sectional questionnaire-based survey. Indian J Dent Res 2018; 29(1):10-15. https://doi.org/10.4103/ijdr.IJDR_33_17

Muneer MU, Ismail F, Munir N, Shakoor A, Das G, Ahmed AR, et al. Dental anxiety and influencing factors in adults. Healthcare 2022; 10(12):2352. https://doi.org/10.3390/healthcare10122352

Appukuttan D, Subramanian S, Tadepalli A, Damodaran LK. Dental anxiety among adults: an epidemiological study in South India. N Am J Med Sci 2015; 7(1):13-18. https://doi.org/10.4103/1947-2714.150082

Qu X, Qi X, Wu B. Disparities in dental service utilization among adults in Chinese megacities: Do health insurance and city of residence matter? Int J Environ Res Public Health 2020; 17(18):6581. https://doi.org/10.3390/ijerph17186851

Adams C, Slack-Smith L, Larson A, O’Grady M. Dental visits in older western Australians: A comparison of urban, rural and remote residents. Aust J Rural Health 2004; 12(4):143-149. https://doi.org/10.1111/j.1440-1854.2004.00599.x

Aquilanti L, Santarelli A, Mascitti M, Procaccini M, Rappelli G. Dental care access and the elderly: What is the role of teledentistry? A systematic review. Int J Environ Res Public Health 2020; 17(23):9053. https://doi.org/10.3390/ijerph17239053

Leung KC, Chu CH. Dental care for older adults. Int J Environ Res Public Health 2022; 20(1):214. https://doi.org/10.3390/ijerph20010214

Okamoto E. Japan's dental care facing population aging: How universal coverage responds to the changing needs of the elderly. Int J Environ Res Public Health 2021; 18(17):9359. https://doi.org/10.3390/ijerph18179359

Zangiabadi S, Costanian C, Tamim H. Dental care use in Ontario: The Canadian community health survey (CCHS). BMC Oral Health 2017; 17(1):165. https://doi.org/10.1186/s12903-017-0453-7

Ghanbari-Jahromi M, Bastani P, Jalali FS, Delavari S. Factors affecting oral and dental services` utilization among Elderly: A scoping review. BMC Oral Health 2023; 23(1):597. https://doi.org/10.1186/s12903-023-03285-4

Sano Y, Antabe R. Regular dental care utilization: The case of immigrants in Ontario, Canada. J Immigr Minor Health 2022; 24(1):162-169. https://doi.org/10.1007/s10903-021-01265-w

Godoi H, Singh A, de Mello ALSF, Brennan DS, Peres MA. Area-level social development and indicators of public dental services in Southern Brazil. Community Dent Oral Epidemiol 2019; 47(3):274-280. https://doi.org/10.1111/cdoe.12455

Brega AG, Johnson RL, Schmiege SJ, Jiang L, Wilson AR, Albino J. Longitudinal association of health literacy with parental oral health behaviour. Health Lit Res Pract 2021; 5(4):333-341. https://doi.org/10.3928/24748307-20211105-01

Mialhe FL, Santos BL, Bado FMR, Oliveira Júnior AJ, Soares GH. Association between oral health literacy and dental outcomes among users of primary healthcare services. Braz Oral Res 2022; 36:e004. https://doi.org/10.1590/1807-3107bor-2022.vol36.0004

Gill M, Pal K, Gambhir RS. Oral hygiene practices, attitude, and access barriers to oral health among patients visiting a rural dental college in North India. J Dent Res Ver 2014; 1(3):114-117. https://doi.org/10.4103/2348-2915.146486

Nagarjuna P, Reddy VC, Sudhir KM, Kumar RK, Gomasani S. Utilization of dental healthcare services and its barriers among the patients visiting community health centers in Nellore district, Andhra Pradesh: A cross-sectional, questionnaire study. J Indian Assoc Public Health Dent 2016; 14(4):451-455. https://doi.org/10.4103/2319-5932.195844

Telangana. Kanti Velugu. My scheme. Available from: https://cm.telangana.gov.in/2019/06/kanti-velugu/. [Accessed on January 20, 2024].