Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.
Region Östergötland, Tandvårdsenheten, Linköping, Sweden.
Eur J Oral Sci. 2021 Jun;129(3):e12778. doi: 10.1111/eos.12778. Epub 2021 Mar 5.
We explored how socio-demographic and personal characteristics contribute to avoidance of dental appointment due to cost over time from age 55 (in 1997) to 75 (in 2017) and assessed the implications for oral health-related quality of life. In 1992, 6346 residents born in 1942 consented to participate in a prospective questionnaire survey, and 3060 (48.2%) of them completed postal follow-ups every fifth year until 2017. Oral health-related quality of life was assessed using the Oral Impact on Daily Performance inventory. The frequency of avoidance of dental appointment due to cost declined from 7.0% (in 1997) to 5.4% (in 2017), whereas the frequency of oral impacts declined from 26.0% in 2007 to 24.0% in 2017. Generalized Estimating Equation models revealed that avoidance of dental appointments due to cost was more likely reported in 1997 (OR: 1.5: 1.2-1.8) than in 2017, more likely in low educated people, and less likely in those using private dental care services. Avoidance of dental appointment due to cost was associated with impaired oral health-related quality of life. Social inequalities in avoidance of dental appointment due to cost and oral impacts did not vary across time but persisted into older ages despite the dental health care reforms that had been implemented.
我们探讨了社会人口学和个人特征如何随着时间的推移导致人们在 55 岁（1997 年）至 75 岁（2017 年）期间因费用而避免看牙医，并评估了这对口腔健康相关生活质量的影响。1992 年，有 6346 名出生于 1942 年的居民同意参与一项前瞻性问卷调查，其中 3060 名（48.2%）人在之后的每五年完成一次邮寄随访，直至 2017 年。口腔健康相关生活质量使用日常口腔活动影响量表进行评估。因费用而避免看牙医的频率从 1997 年的 7.0%下降到 2017 年的 5.4%，而口腔影响的频率从 2007 年的 26.0%下降到 2017 年的 24.0%。广义估计方程模型显示，2017 年（OR：1.5: 1.2-1.8）比 1997 年更有可能报告因费用而避免看牙医，受教育程度较低的人更有可能，而使用私人牙科服务的人则不太可能。因费用而避免看牙医与口腔健康相关生活质量受损有关。因费用而避免看牙医和口腔影响的社会不平等在不同时间没有变化，但尽管实施了牙科保健改革，这些不平等仍然持续到老年。
