Dissatisfaction with the dental services and associated factors among adults

Roberto, Luana Leal; Martins, Andréa Maria Eleutério de Barros Lima; Paula, Alfredo Maurício Batista de; Ferreira, Efigênia Ferreira e; Haikal, Desirée Sant’ Ana

doi:10.1590/1413-81232017225.17362015

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FREE THEMES • Ciênc. saúde colet. 22 (5) • May 2017 • https://doi.org/10.1590/1413-81232017225.17362015 copy

Dissatisfaction with the dental services and associated factors among adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to identify factors associated with dissatisfaction with dental services among adults. It analyzed 830 adult participants of an epidemiological survey of oral health. The dependent variable was dissatisfaction with the dental service, and the independent ones were selected according to the theoretical model set forth by Andersen and Davidson (1997). Estimates were corrected by the sample design effect, and Binary Logistic Regression was carried out. It was found that about 11% of adults were dissatisfied with the dental service. In the final model, dissatisfaction with dental services was lower among older adults (OR = 0.559) and among smokers (OR = 0.332). On the other hand, it was higher among adults who self-perceived their chewing as negative (OR = 2,804), who self-perceived some discomfort in the mouth and head and neck region (OR = 2.065), and among those who did not have access to information on how to avoid oral problems (OR = 3.020). Therefore, the services need to access the perceptions and expectations expressed by users, and provide information in appropriate quantity and quality, in the context of “health literacy” in order to achieve greater satisfaction among its users.

Adult; Patient satisfaction; Access to information; Dental health services

Variables	N	%	Satisfied		Unsatisfied		p value

			n	%	n	%
Primary determinants of oral health
Personal characteristics
Propensity
Age group (in years)
34 to 39	426	52.6	370	86.7	56	13.3	0.039
40 to 45	404	47.4	369	91.9	35	8.1	0.039
Self-reported ethnic group
White/yellow	264	31.0	229	87.3	35	12.7	0.149
Indigenous / black / brown	566	69.0	510	90.0	56	10.0	0.149
Gender
Female	457	53.9	401	87.7	56	12.3	0.188
Male	373	46.1	338	90.9	35	9.1	0.188
Marital status
In common-law marriage	610	74.6	542	88.8	68	11.2	0.778
No common-law marriage	220	25.4	197	90.4	23	9.6	0.778
Schooling (years of study)
11 years and over	218	25.1	196	89.7	22	10.3	0.540
5 to 11 years	505	60.6	451	89.0	54	11.0
Below 4 years	107	14.4	92	88.9	15	11.1
Available resources
Per capita income*
US$828.00 and over	175	21.3	165	94.6	10	5.4	0.017
Less than US$828.00	626	78.7	551	88.3	75	11.7	0.017
Current employment status*
Employed	605	71.7	544	90.1	61	9.9	0.150
Unemployed	220	28.3	190	86.5	30	13.5	0.150
Dental treatment need
Reason for using dental treatment services
Routine consultation / maintenance	290	32.9	262	89.8	28	10.2	0.377
Oral problems	540	67.1	477	88.9	63	11.1	0.377
Oral health care system
Dental services used
SUS	290	34.7	252	86.9	38	13.1	0.148
Other	540	65.3	487	90.4	53	9.6	0.148
Household inserted in the ESF
Inserted	429	52.9	385	89.4	44	10.6	0.500
Not inserted	401	47.1	354	89.0	47	11.0	0.500
External environment
Reported general health
Chronic diseases*
No	427	51.3	378	88.1	49	11.9	0.510
Yes	398	48.7	358	90.9	40	9.1	0.510
Use of drugs
No	619	74.2	548	88.1	71	11.9	0.424
Yes	211	25.8	191	92.4	20	7.6	0.424
Physical realm of SF 12*
Satisfactory	572	69.0	513	89.6	59	10.4	0.443
Unsatisfactory	256	31.0	255	88.5	31	11.5	0.443
Mental realm of SF 12*
Satisfactory	514	62.8	458	89.0	56	11.0	0.976
Unsatisfactory	314	37.2	280	89.7	34	10.3	0.976
Satisfaction with life
Satisfactory	708	84.8	634	89.5	74	10.5	0.256
Unsatisfactory	122	15.2	105	87.3	17	12.7	0.256
Oral health behaviors
Personal practice
Oral hygiene practice
Daily brushing frequency*
Twice and over	526	64.2	471	89.1	55	10.9	0.603
Under twice a day	301	35.8	266	89.5	35	10.5	0.603
Dental floss use
Yes	432	50.2	388	88.9	44	11.1	0.454
No	398	49.8	351	89.5	47	10.5	0.454
Other practice
Oral self-examination*
Yes	163	20.0	144	89.5	19	10.5	0.676
No	665	80.0	595	89.3	70	10.7	0.676
Current or former smoker*
No	627	75.2	552	88.0	75	12.0	0.110
Yes	202	24.8	186	92.6	16	7.4	0.110
Current or former drinker*
No	558	67.8	495	88.7	63	11.3	0.679
Yes	271	32.2	243	90.1	28	9.9	0.679
Formal use of dental services
Access to information on oral problems prevention
Yes	518	60.4	489	93.8	29	6.2	0.000
No	302	39.6	243	82.5	59	17.5	0.000
Access to information on oral hygiene
Yes	698	83.6	637	91.5	61	8.5	0.000
No	132	16.4	102	77.4	30	22.6	0.000
Access to information on diet
Yes	426	51.5	389	91.7	37	8.3	0.031
No	404	48.5	350	86.6	54	13.4	0.031
Access to information on oral cancer
Yes	280	33.1	258	92.1	22	7.9	0.041
No	550	66.9	481	87.8	69	12.2	0.041
Access to information on how to perform oral self-examination
Yes	204	24.4	185	90.8	19	9.2	0.385
No	626	75.6	554	88.7	72	11.3	0.385
Use of dental services in the last year
Yes	379	45.7	344	90.8	35	9.2	0.144
No	451	54.3	395	87.8	56	12.2	0.144
Oral health outcomes
Oral health normative conditions
Mucous membrane changes*
No	717	86.6	636	88.7	81	11.3	0.473
Yes	111	13.4	101	92.3	10	7.7	0.473
Tooth count
28 to 32	372	45.5	331	88.3	41	11.7	0.342
20 to 27	273	32.3	248	91.2	25	8.8
19 or less	185	22.2	160	88.0	25	12.0
Dental prosthetics use
No	546	65.9	489	89.8	57	10.2	0.768
One arch wire	206	25.0	182	87.4	24	12.6
Two arch wires	78	9.1	68	90.1	10	9.9
Decayed, missing and filled teeth (DMFT)
0 to 15	279	36.0	253	90.6	26	9.4	0.218
16 to 21	280	32.4	252	89.8	28	10.2
22 to 32	271	31.6	234	87.0	37	13.0
Periodontal disease *
No	723	90.4	647	89.1	76	10.9	0.292
Yes	76	9.6	65	88.5	11	11.5	0.292
Normative need for dental treatment *
No	385	48.3	354	90.7	31	9.3	0.013
Yes	414	51.7	358	87.4	56	12.6	0.013
Oral health subjective conditions
Oral health self-perception
Excellent / good	418	48.6	390	92.1	28	7.9	0.000
Fair / Poor / Bad	412	51.4	349	86.4	63	13.6	0.000
Chewing self-perception
Excellent / good	489	58	452	93.2	37	6.8	0.000
Fair / Poor / Bad	341	42	287	83.6	54	16.4	0.000
Self-perception of the appearance of teeth and gums
Excellent / good	453	54	421	92.5	32	7.5	0.000
Fair / Poor / Bad	377	46	318	85.3	59	14.7	0.000
Self-perception of speech due to teeth and gums
Excellent / good	678	81.2	615	90.4	63	9.6	0.001
Fair / Poor / Bad	152	18.8	124	84.2	28	15.8	0.001
Self-perception of relationship due to oral health
Excellent / good	698	83	631	90.0	67	10.0	0.004
Fair / Poor / Bad	132	17	108	85.3	24	14.7	0.004
Self-perception of some discomfort in the mouth, head and neck region *
No	663	79.9	604	91.7	59	8.3	0.000
Yes	166	20.1	135	79.7	31	20.3	0.000
Self-perception of the need for dental treatment *
No	177	21.6	170	95.1	7	4.9	0.001
Yes	650	78.4	567	87.6	83	12.4	0.001
Pain in teeth and gums in the last 6 months
No	512	60.9	469	92.2	43	7.8	0.003
Yes	318	39.1	270	84.6	48	15.4	0.003
OHIP*
Did not impact	597	71.1	544	91.0	53	9.0	0.005
Impacted	230	28.9	194	85.2	36	14.8	0.005

Variables	OR (CI 95%)	p value
Primary determinants of oral health
Age group (in years)
34 to 39	1	0.056
40 to 45	0.559 (0.308-1.016)	0.056
Oral health behaviors
Current or former smoker
No	1	0.001
Yes	0.332 (0.174-0.634)	0.001
Access to information on oral problems prevention
Yes	1	0.000
No	3.020 (1.734-5.258)	0.000
Oral health outcomes
Chewing self-perception
Excellent / good	1	0.002
Fair / Poor / Bad	2.804 (1.475-5.329)	0.002
Self-perception of some discomfort in the mouth, head and neck region
No	1	0.021
Yes	2.065 (1.124-3.793)	0.021

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[1] Collaborations

LL Roberto carried out the analyses, data interpretation and writing of the paper. AMEBL Martins worked on the conception of the study and coordinated fieldwork and data processing. AMB Paula worked in critical review of the paper. EF Ferreira worked on the data interpretation and critical review of the paper. DS Haikal acted in the design of the study, contributed in the analysis, data interpretation and critical review of the paper.