ArticleCommunity dentistry and oral epidemiology2019
Predictors of dental care utilization in north-central Appalachia in the USA.
Article in Community dentistry and oral epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Appalachian Numeracy and Literacy and Oral Health, an Ecological Study, PIAAC and BRFSS.Journal of public health dentistry · 2025Article
- Dental anxiety and oral health in American Indian and Alaska natives.Journal of public health dentistry · 2025Article
- Perceptions and determinants of oral health care among Iranian pregnant women: a qualitative study.BMJ open · 2024Article
- Inequality in dental flossing behavior among Korean adults based on household income levels.Epidemiology and health · 2024Article
- Utilization of dental care among adult populations: a scoping review of applied models.BMC oral health · 2023Article
- Barriers to oral care: a cross-sectional analysis of the Canadian longitudinal study on aging (CLSA).BMC oral health · 2023Article
- Periodontal treatment and subsequent clinical outcomes and medical care costs: A retrospective cohort study.PloS one · 2023Article
- Oral health and related risk indicators in north-central Appalachia differ by rurality.Community dentistry and oral epidemiology · 2021Article
- An Investigation of the Association between Health Screening and Dental Scaling in Korea.International journal of environmental research and public health · 2021Article
- Contextual and individual factors associated with public dental services utilisation in Brazil: A multilevel analysis.PloS one · 2021Article
- Article
- Determinants of Dental Service Use Based on the Andersen Model: A Study Protocol for a Systematic Review.Healthcare (Basel, Switzerland) · 2020Article
- Transmission of dental fear from parent to adolescent in an Appalachian sample in the USA.International journal of paediatric dentistry · 2019Article
- A Framework for Understanding the Role of Psychological Processes in Disease Development, Maintenance, and Treatment: The 3P-Disease Model.Frontiers in psychology · 2019Article
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14 authors.
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Abstract
objectivesDental utilization is an important determinant of oral health and well-being. The aim of this study was to evaluate potential associations between a variety of biopsychosocial factors and dental utilization in north-central Appalachia, USA, a region where oral health disparities are profound.
methodsThis study used household-based data from the Center for Oral Health Research in Appalachia (COHRA1) study in north-central Appalachia, including 449 families with 868 adults. The generalized estimating equation (GEE) approach was used to determine the best-fitting predictor model for dental utilization among adult family members.
resultsOn average across West Virginia and Pennsylvania, having dental insurance was associated with greater dental utilization over a 3-year time period (OR = 2.20, 95% CI = 1.54, 3.14). When stratified by state, the association held for only West Virginia (OR = 2.41, 95% CI = 1.54, 3.79) and was nonsignificant for Pennsylvania residents (OR = 1.50, 95% CI = 0.80, 2.79). Individuals from Pennsylvania were more likely to utilize dental care and participants from West Virginia less so (2.31, 95% CI = 1.57, 3.40). Females from Pennsylvania were more likely than males to regularly seek dental care (OR = 1.44, 95% CI = 1.00, 2.05), and a higher income was associated with greater frequency of regular dental visits (OR = 1.21, 95% CI = 1.09, 1.34) in West Virginia. Individuals from Pennsylvania who scored higher on the Physiological Arousal subscale of the Dental Fear Survey were more likely to attend routine care visits (OR = 1.18, 95% CI = 1.03, 1.35). Across both states, more fatalistic beliefs related to oral health care also predicted less routine care (OR = 0.87, 95% CI = 0.81, 0.94), and more investment in or more positive attitudes towards one's oral health also was associated with higher utilization (OR = 1.18, 95% CI = 1.13, 1.23).
conclusionsOverall, the findings of this study suggest state residency, sex, insurance, income, fatalistic beliefs, health values, and aspects of dental care-related anxiety and fear predicted dental care utilization in north-central Appalachia. These findings reinforce the need to address insurance and other economic factors affecting utilization and to consider how individual-level fatalistic beliefs and oral health values may affect utilization of routine oral health care.
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