Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, L8S 4L8, Canada.
Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, K0A 0K9, Canada.
BMC Oral Health. 2023 May 15;23(1):294. doi: 10.1186/s12903-023-02967-3.
Oral health plays a role in overall health, indicating the need to identify barriers to accessing oral care. The objective of this study was to identify barriers to accessing oral health care and examine the association between socioeconomic, psychosocial, and physical measures with access to oral health care among older Canadians.
A cross-sectional study was conducted using data from the Canadian Longitudinal Study on Aging (CLSA) follow-up 1 survey to analyze dental insurance and last oral health care visit. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between socioeconomic, psychosocial, and physical measures with access to oral care, measured by dental insurance and last oral health visit.
Among the 44,011 adults included in the study, 40% reported not having dental insurance while 15% had not visited an oral health professional in the previous 12 months. Several factors were identified as barriers to accessing oral health care including, no dental insurance, low household income, rural residence, and having no natural teeth. People with an annual income of <$50,000 were four times more likely to not have dental insurance (adjusted OR: 4.09; 95% CI: 3.80-4.39) and three times more likely to report not visiting an oral health professional in the previous 12 months (adjusted OR: 3.07; 95% CI: 2.74-3.44) compared to those with annual income greater than $100,000.
Identifying barriers to oral health care is important when developing public health strategies to improve access, however, further research is needed to identify the mechanisms as to why these barriers exist.
口腔健康对整体健康起着重要作用，这表明需要确定获取口腔护理的障碍。本研究的目的是确定获取口腔保健的障碍，并研究社会经济、心理社会和身体措施与加拿大老年人获取口腔保健之间的关联。
使用加拿大老龄化纵向研究（CLSA）随访 1 调查的数据进行了一项横断面研究，以分析牙科保险和最近一次口腔保健就诊情况。使用逻辑回归估计了社会经济、心理社会和身体措施与获取口腔保健之间的关联的优势比（OR）和 95%置信区间（CI），通过牙科保险和最近一次口腔保健就诊来衡量。
在纳入的 44011 名成年人中，40%的人报告没有牙科保险，而 15%的人在过去 12 个月内没有看过口腔卫生专业人员。有几个因素被确定为获取口腔保健的障碍，包括没有牙科保险、家庭收入低、居住在农村地区以及没有天然牙齿。年收入低于 50000 加元的人没有牙科保险的可能性是年收入超过 100000 加元的人的四倍（调整后的 OR：4.09；95%CI：3.80-4.39），并且在过去 12 个月内报告没有看过口腔卫生专业人员的可能性是年收入超过 100000 加元的人的三倍（调整后的 OR：3.07；95%CI：2.74-3.44）。
在制定改善获取途径的公共卫生策略时，确定口腔保健障碍很重要，但是，需要进一步研究以确定为什么存在这些障碍的机制。
