Dental Care Utilization by Adults in a Socially Diverse Metropolitan Area

Objectives: This study assessed the association of dental care utilization with individual and contextual characteristics, and measured disparities based on age and contextual deprivation. Materials and Methods: This cross-sectional study recruited 1,510 randomly selected adults residing in Tehran by phone-based interviews between January 2023 and June 2023. A questionnaire that consisted of questions about predisposing (sociodemographic), enabling (economic status, insurance coverage, neighborhood deprivation, and dental knowledge), and needs characteristics (oral health-related problems, and time loss) influencing dental care utilization was used for data collection. Dental care utilization was assessed using a dichotomized variable. The hierarchical logistic regression model and concentration indices were applied for data analysis using STATA 16 (alpha=0.05). Results: The participants' mean age was 46.21±18.43 years. Approximately 48.0% of the participants reported no dental care utilization. Enabling sources [dental insurance (P<0.001) and neighborhood deprivation (P<0.001)], and need factors [time loss due to oral conditions (P<0.001) and not wearing dentures P<0.001)] were significantly associated with dental care utilization. Age as a predisposing factor had a significant association with dental care utilization with a concentration index of -0.27 (P<0.001). Conversely, the concentration index of socioeconomic status was 0.03 (P=0.005). Conclusion: Disparities in dental care utilization were evident in more affluent groups and among younger age groups. Dental care utilization was associated with psychosocial loss, productivity loss, and contextual deprivation barriers. Moreover, Andersen’s model revealed that social structure, time loss, and enabling sources, rather than the other indicators, determined dental care utilization.