Dental health and access to dental care for ethnic minorities in Sweden

Objective. To describe access to dental care in a population-based sample of foreign-born Swedish residents in relation to dental health. Design. The study was based on data from the Immigrant Survey of Living Conditions in four minority study groups consisting of a total of 1,898 Swedish residents born in Poland, Chile, Turkey and Iran aged 27-60. An age-matched study group of 2,477 Swedish-born residents from the Survey of Living Conditions of 1996 was added as a comparison group. The study also included 2,228 children aged 3-15 years in the minority households and 2,892 children in the households of the Swedish-born study group. Results. The risk of poor dental health was higher in all four minority study groups than for the Swedish-born study group after adjusting for socio-economic variables. In the adult minority study groups the adjusted odds ratios (ORs) for having prostheses and problems with chewing was 6.3 (4.3-9.1) and 2.7 (1.8-4.3), respectively, for the Polish-born, 4.8 (3.3-7.1) and 3.2 (2.1-4.9) for the Chilean-born, 4.6 (3.1-6.9) and 4.8 (3.6-7.2) for the Turkish-born, and 2.7 (1.5-4.8) and 6.5 (4.1-10.3) for the Iranian-born compared with the Swedish-born. In the child study group all four minority groups had an increased risk of caries ranging from OR 1.6 (1.3-2.1) in the Chilean group to 2.5 (2.0-3.0) in the Turkish group compared with the children with Swedish-born parents. The adults in all four minority study groups more often lacked regular treatment by a dentist than Swedish-born residents. The OR for not having been treated by a dentist during the 2 years preceding the interview ranged from 1.9 (1.4-2.6) in the Polish-born study group to 3.0 (2.3-4.0) in the Chilean-born study group after adjustment for socio-economic factors and general health. Conclusion. This study demonstrates that adults in minority populations in Sweden use less dental care despite having greater needs of dental treatment than the majority population. This inequity calls for action in health policy and preventive dental health programmes.