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Dental avoidance among adolescents: a retrospective case–control study based on dental records in the public dental service in a Swedish county
Örebro University, School of Health Sciences. Public Dental Service, Dental research Department, Örebro County Council, Örebro, Sweden.
Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
Örebro University, School of Health Sciences.ORCID iD: 0000-0002-4226-6064
Örebro University, School of Health Sciences. Public Dental Service, Dental research Department, Örebro, Sweden.
2019 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 1, p. 1-8Article in journal (Refereed) Published
Abstract [en]

Objective: This study aimed to investigate the occurrence of missed dental appointments among 16–19-year-old adolescents in a Swedish county. A second aim was to explore associations between background and concomitant factors and missed appointments and to investigate if these associations differed between areas with different sociodemographic profiles.

Materials and methods: A list of booked, and missed, appointments for 10,158 individuals during 2012 was used for assessments. Based on the total sample, 522 cases with, and 522 matched controls without, dental avoidance behavior in 2012 were identified. Data on previous missed and cancelled appointments, oral health status, dental treatment, fear or behavior problems, and medical, and, where available, psychosocial or lifestyle factors were extracted from the dental records using a preset protocol covering the period 2009–2012.

Results: In 2012, 13.1% of 23,522 booked appointments were missed, with a higher proportion of missed appointments among boys than girls. Cases with avoidance behavior more often had a record of sociodemographic load and dental fear or behavior management problems. They also had more oral health problems, more invasive dental treatments, and, in the past, more missed and canceled appointments.

Conclusion: To enable good oral health and continued regular dental care, we need to pay more attention to adolescents’ individual situation and be observant of early signs of avoidance.

Place, publisher, year, edition, pages
Taylor & Francis, 2019. Vol. 77, no 1, p. 1-8
Keywords [en]
Dental care, utilization, adolescent
National Category
Dentistry
Identifiers
URN: urn:nbn:se:oru:diva-68444DOI: 10.1080/00016357.2018.1489978ISI: 000455890400001PubMedID: 30022701Scopus ID: 2-s2.0-85050359378OAI: oai:DiVA.org:oru-68444DiVA, id: diva2:1238268
Note

Funding Agencies:

Public Dental Service, Region Örebro County, Örebro University, Örebro  

Swedish Dental Hygienist Association (SDHA), Sweden 

Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2019-10-28Bibliographically approved
In thesis
1. No-shows in dental care: perspectives on adolescents' attendance pattern
Open this publication in new window or tab >>No-shows in dental care: perspectives on adolescents' attendance pattern
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

All children and adolescents living in Sweden have free dental care with regular check-ups. Yet, missed and cancelled dental appointments are not unusual. The overall aim was to explore potential explanatory factors associated with non-regular dental care and to seek a deeper understanding of why some adolescents fail to attend their dental appointments.

An integrative review (Paper I) identified and summarized different sets of environmental, individual and situational factors that could be associated with dental avoidance or non-attendance. Paper II found similar levels of dental fear between children and adolescents (8-19 yrs) with a Swedish or a non-Swedish background. The occurrence and patterns of missed dental appointments among 16–19-year-olds were investigated in Paper III, where we report that 13.1% of 23 522 booked dental appointments were missed in 2012. Boys had more missed appointments than girls, while no age differences were found. In a case-control design, adolescents with missed appointments more often had sociodemographic load, dental fear or dental behaviour management problems, poor oral health, emergency visits, tooth extractions, operative treatments, and over the past years, more missed and cancelled appointments. A history of missed and cancelled dental appointments predicted future missed and cancelled appointments. Twelve adolescent girls with missed appointments were interviewed in Paper IV and described several potential barriers or facilitators to accessing dental care. They highlighted that knowing what will happen during the dental visit was decisive to whether or not they would attend their appointments.

In conclusion, factors specifically associated with dental avoidance still need to be investigated. Dental fear should still be seen as potential causal factor for dental avoidance. Missed and cancelled dental appointments should never be ignored since they could predict future missed and cancelled appointments. The results indicate that missed dental appointments among adolescents remain a challenge for Swedish dental care.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2019. p. 96
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 202
Keywords
Adolescents, avoidance, dental attendance, dental care, dental fear, dental health services, oral health, utilization
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-76141 (URN)978-91-7529-307-3 (ISBN)
Public defence
2019-11-22, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-09-06 Created: 2019-09-06 Last updated: 2019-10-29Bibliographically approved

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Fägerstad, AnidaWindahl, JennyArnrup, Kristina

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