The Effect of Referral for Dental Service on Dental-Service Utilization

Objectives: To determine how a one off dental education session and referral of study participants 8-11 years old for both preventive and curative treatment would affect the number of pupils who utilized oral health care services over a 12 months period when compared to the number of pupils who utilized oral health care services in prior year.
Methods: This cross-sectional study recruited 1,406 pupils aged 8-11 years from randomly selected primary schools in Enugu metropolis who received one off oral-health education and were given referral letters for preventive and/or curative treatment. Data on the pupils’ socio-demographic profile, family structure, and history of oral-health care utilization in the last 12 months preceding the study and within 12 months of receipt of referral letter were collected and the effect of these factors as predictors of past and recent oral-health care utilization were determined using logistic regression.

Results: Before issuing referral letters, only 4.3% of study participants had ever used oral-health services in the past 12 months. Within 12 months of issuing the referral letters, 9.0% of pupils used the oral-health services. Children from middle (APR: 0.46; CI: 0.29-0.73; p=0.001) and low socioeconomic strata (APR: 0.21; CI: 0.11-0.39; p<0.001) and those living with relatives/guardians (APR: 0.08, CI: 0.01-0.56; p=0.01) still were less likely to have utilized oral-health services. Most of the pupils who utilized oral-health services had never utilized an oral health care service prior to the issuance of a referral letter (p<0.001).

Conclusions: Dental education and referral of children for oral health care increased the number of children who utilized oral health care services. Socioeconomic status and type of parenthood may be a cause for dental access disparity.