Dental Treatments for Adults by Insurance Status in Tehran, Iran

Objective: We evaluated dental treatments for adults in Tehran, in relation to their dental insurance status. Methods: The cross-sectional data through phone interviews were collected by four trained interviewers from May to July 2005. Using a two-stage stratified random technique, 3200 phone numbers were drawn; 1669 lines were unavailable. Of the 1531 subjects answering the phone call, 224 were not adults and 221 refused to participate, leaving 1086 subjects (83%) to be interviewed. The questions were about the respondent's insurance status, reason for the last visit and the item of treatment received; age, gender and level of education served as background information. A total of 69 respondents reported no dental visits and were excluded. Of all (n=1017), 58% were women, 60% were under 35 years of age. Statistical evaluation was by chi-square test. Results: Of all, 29% reported as having no dental insurance, 64% had public insurance (PUI) and 7% commercial insurance (COI), with no gender-difference. Being insured was more common among the oldest age group (82% vs. 67%; p=0.03) and among the highly educated subjects (84% vs. 66%; p<0.001). Regular check-up was the reason for the last dental visit for 16% of all, for 13% of the non-insured, 16% in the PUI and 27% in the COI group (p=0.02). The majority (84%) had made their visits due to dental problems. As their most recent item of treatment, 35% reported tooth restoration, 15% extraction, 15% endodontics, 13% diagnostics, 8% fixed prosthetics, 4% prevention, 3% surgery, and 7% other treatments. A clear difference according to the insurance status appeared for tooth extraction, reported by 21% of the non-insured subjects, by 18% in the PUI and 7% in the COI group (p=0.03). Diagnostics was reported by 12%, 13% and 21%, respectively (p=0.11). Conclusion: Having dental insurance slightly reflected as more conservative treatments.