The role of socioeconomic status, dental service use and oral health practices on periodontal health

AIM: To utilise Andersen's behavioral model as the theoretical framework to examine direct and indirect relationships between population characteristics, oral health behaviours and periodontitis and oral health impacts. MATERIALS AND METHODS: The model was tested in a general adult population (n = 1,886) in Norway, using structural equation modelling. Socioeconomic status, sense of coherence (SOC), dental anxiety, perceived treatment need, oral health behaviours and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal examinations consisted of full-mouth recordings. RESULTS: Andersen's model explained a large part of the variance in use of dental services (58%) and oral health-related impacts (55%), and to a less extent periodontitis (19%). More social structure and stronger SOC was related to more enabling resources, which in turn was associated with more use of dental services. More use of dental services was related to more periodontitis and more periodontitis was associated with increased oral health impacts. There was no association between use of dental services and oral health impacts. CONCLUSIONS: The result demonstrated complex relationships between population characteristics, oral health-related behaviours and oral health outcomes. The findings suggest a need for further studies examining the effectiveness of dental health care utilization related to periodontitis prevention and control.