Impact of public dental care spending and insurance coverage on utilization disparities among Canadian jurisdictions.

OBJECTIVE

To investigate the role of public dental care spending and insurance coverage on dental services utilization disparities among different Canadian jurisdictions.

METHODS

We utilized Canadian Institute for Health Information provincial/territorial per capita estimates for public dental care expenditure, public information on legislated dental care programs, and oral health data from the 2007-2008 Canadian Community Health Survey to make inferences regarding the relationship between dentist visits in the past 12 months and self-perceived oral health. We performed descriptive statistics and binary logistic regression analysis to determine the relationship between dentist visits and self-perceived oral health status at the provincial/territorial level and on stratified data based on three age groups - children (12-17 years), adults (18-64 years), and seniors (65 years and older).

RESULTS

Overall, the presence of the "inverse care law" in dental care at the provincial/territorial level was evident. However, in the Canadian territories, which had the highest per capita public dental care expenditure, individuals with poor oral health had the highest odds of visiting a dentist compared with other jurisdictions. In jurisdictions with public dental care programs for children and/or seniors, children and seniors with poor oral health were more likely to visit dentists.

CONCLUSIONS

Jurisdictions with more public spending and greater population coverage for dental care appear to better cater to those with the highest oral health care needs.