A longitudinal study of the relative importance of factors related to use of dental services among young adults

Background: The decline in the appropriate use of dental services from childhood to adulthood is of concern. The relative importance of factors influencing use of dental services in young adulthood should inform strategies to address this issue. Aim: To develop models predictive of inadequate utilisation of dental care in young adults and to determine the relative importance of health behaviours, need for dental care, and socio-demographic factors. Inadequate utilisation of dental care was determined as lack of visit for dental care during the study period and as problem-based care-seeking behavior. Methods: A random sample of Adelaide young adults was selected from the electoral roll. Participants were interviewed and offered a dental examination at baseline. Two and a half years later participants were contacted again and interviewed on the use of dental services and usual reason for visiting and a number of explanatory factors. The population attributable fractions for the explanatory variables which were significant in the model for this cohort of young adults were calculated using the log-binomial method. Results: There were 819 participants at follow-up a response rate of 65% of baseline participants. In the two and a half year period between baseline and follow-up about one quarter of young adults did not make a dental visit and over one third reported that they usually made a dental visit for a problem. The attributable fraction calculation indicated that 30% of infrequent visiting was attributed to reporting no need for dental care, 17% to difficulty paying a $100 dental bill, 17% to being male and 10% to smoking. The attributable fraction calculation indicated that 27% of usually visiting for a problem was attributed to having no tertiary education, 23% to not having dental insurance, 14% to being male, 12% to smoking, 10% to avoiding dental care due to cost and 5% to use of the public sector. Conclusion: Need and affordability factors were more important than general health behavior factors in influencing use of dental care by a cohort of young adults.