The effect of social and personal factors on the utilisation of dental services in Glasgow, Scotland.

This study examined potential mediators of dental attendance among two distinct adult populations who lived in contrasting social environments (deprived and affluent). The aim of the study was to describe and quantify the effect of both the potentially modifiable and the fixed factors which influence use of dental services. A two-stage weighted random sampling technique was used to select 863 participants who were interviewed. Of these participants, 372 lived in 'affluent' areas and 491 in 'deprived' areas. The 45 minute interview explored many aspects of oral health, and related behaviour and attitudes. The results showed a highly significant association between social deprivation and reported dental attendance (P < 0.001). Social environment was also significantly related to asymptomatic dental attendance. Deprived respondents' dental behaviours were significantly affected by life events and yet structural/organisational barriers to attendance had a significantly greater impact on the affluent population's dental visiting patterns than they did on the deprived population's. A regression model indicated that the best predictors of dental attendance were social environment, dental anxiety, perceptions about denture wearers and the value placed upon restored teeth. The study suggests that the barriers to dental attendance experienced by deprived populations are not easily modifiable, but belong instead to a group which relate to the socio-political agenda. The study also demonstrates the importance of accurate and regularly updated community registers for use in population based health services research.