Preventive and curative dental services utilization among children aged 12 years and younger in Tehran, Iran, based on the Andersen behavioral model: A generalized structural equation modeling

Abstract

World Health Organization invites the nations to progress towards universal health care coverage. This study evaluated preventive and curative dental services utilization among children aged 12 years and younger in Tehran, Iran, based on the Andersen behavioral model using a generalized structural equation modeling. A phone-based cross-sectional study was conducted in Tehran, Iran, on 886 children in 2023. Information on curative and preventive/consultation dental service utilization and associated factors was collected by a standard questionnaire. We used a generalized structural equation model (GSEM) to build a model based on Andersen's behavioral model. Of 886 children, 22.1% used curative dental services, and 19.9% used preventive/consultation services in the past year. Among children aged 6 years and younger, age (OR = 1.87, p-value <0.001) and parent-perceived oral health need (OR = 54.77, p-value <0.001) predicted curative services utilization and age (OR = 1.45, p-value <0.001), knowledge (OR = 1.36, p-value <0.001), dental visit before the age of one (OR = 6.05, p-value = 0.04), and socioeconomic status (OR = 1.65, p-value = 0.03) predicted preventive/consultation services utilization. Regarding children aged 7 to 12, knowledge (OR = 1.28, p-value = 0.03), dental visit before the age of one (OR = 11.12, p-value = 0.02), socioeconomic status (OR = 2.53, p-value = 0.01), dental insurance (OR = 4.17, p-value <0.001), and parent-perceived oral health need (OR = 19.48, p-value <0.001) associated with curative dental services utilization, and dental visit before the age of one (OR = 10.05, p-value = 0.02), oral health behavior (OR = 1.25, p-value = 0.04), socioeconomic status (OR = 3.74, p-value <0.001), and parent-perceived oral health need (OR = 4.62, p-value <0.001) related to preventive/consultation services utilization. The findings of this study underscore the significant influence of predisposing, enabling, and need factors on dental services utilization among children aged 12 years and younger. These results provide a valuable perspective for policymakers, highlighting the modifiable determinants that could be targeted to improve dental services utilization in this age group.

Fig 1. The theoretical model of study based on Andersen’s behavioral model of dental service utilization.

Fig 2. Generalized structural equation model for Tehran inhabitant children aged six years and younger B) 7–12 year-old.

Fig 3. Generalized structural equation model for Tehran inhabitant children aged 7–12 year-old.

Fig 4

The ROC curve related to the model: A) curative service utilization for children aged 6 years and younger, B) preventive/consultation service utilization for children aged 6 years old and younger, C) curative service utilization for 7 to 12-year-old children, D) preventive/consultation service utilization for 7-to-12-year-old children.