Since 2002, adults have been able to choose oral health care services in the public sector or in the private sector in Finland. Though various subsidies for care exist in both sectors, the Public Dental Service (PDS) is a cheaper option for the patient but, on the other hand, there are no waiting lists for private care. The aim of this study was to assess middle-aged adults' use of dental services, willingness to pay (WTP) and ability to pay (ATP) for unexpected, urgent dental treatment.
Postal questionnaires on use of dental services were sent to a random sample of 1500 47-59 year old adults living in three large municipalities in the Helsinki region. The initial response rate was 65.8%. Two hypothetical scenarios were presented: "What would be the highest price you would be prepared to pay to have a lost filling replaced immediately, or, at the latest, the day after losing the filling?" and " How much could you pay for unexpected dental expenses at two weeks notice, if you suddenly needed more comprehensive treatment?" Logistic regression analysis was used to analyse factors related to WTP and ATP.
Most respondents (89.6%) had visited a dentist recently and a majority (76.1%) had used private services. For immediate replacement of a lost filling, almost all respondents (93.2%) were willing to pay the lower price charged in the PDS and 46.2% were willing to pay the private fee. High income and no subjective need for dental treatment were positively associated with the probability of paying a higher price. Most respondents (93.0%) were able to pay a low fee, EUR 50 and almost half (41.6%) at least EUR 300 for unexpected treatment at short notice. High income and male sex were associated with high ATP.
There was a strong and statistically significant relationship between income and WTP and ATP for urgent dental care, indicating that access to publicly provided services improved equity for persons with low income.
Skudutyte-Rysstad, Rasa; Eriksen, Harald M; Bjertness, Espen(Journal article; Tidsskriftartikkel; Peer reviewed, 2012)
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Abstract:
Oral health conditions have been investigated in 35-year-old Oslo citizens in four cross-sectional,
age-specific epidemiological studies performed in 1973, 1984, 1993 and 2003. The main aim of the
series of investigations was to monitor changes in oral health, including dental caries and endodontic and periodontal conditions. Data will give clues to what extent the documented improvements in oral health among children and adolescents also have been maintained into adulthood.
Random samples of 200-250 35-year-olds were selected from The Norwegian Bureau of Statistics
database and invited to participate. They completed a self administered questionnaire and were examined clinically and radiographically. The attendance rate varied between 64% and 80%.
The results presented are based on time-trend analyses. Caries prevalence, measured as the mean
DMFS scores, was high and stable from 1973 (DMFS=68.2) to 1984 (DMFS=66.5), but decreased from 1984 (DMFS=40.9) to 2003 (DMFS=26.1), indicating a 62% reduction in caries and treatment experience. During the whole period, the prevalence of root filled teeth and prevalence of apical periodontitis decreased, but no improvement from 1993 to 2003 could be demonstrated. Assessment of periodontal status showed that the proportion of persons with one or more periodontal pockets ≥6mm decreased from 22% in 1984 to 8% in 2003. The proportion of persons without recorded bone loss increased from 46% in 1973 to 76% in 2003.
The oral hygiene improved from 1973 to 1993 with no further improvement during the last decennium.
There has been a positive development in oral health among young, urban adults in Norway
during the last 30 years.
The aim of this study was to test the efficiency of an extended model of the theory of planned behavior (TPB) in predicting intention to improve oral health behaviors. The participants in this cross-sectional study were 153 first-year medical
students (mean age 20.16, 50 males and 103 females) who completed a questionnaire assessing intentions, attitudes, subjective norms, perceived behavioral control, oral health knowledge, and current oral hygiene behaviors. Attitudes toward oral health behaviors and perceived behavioral control contributed to the model for predicting intention, whereas subjective norms did not. Attitudes toward oral
health behaviors were slightly more important than
perceived behavioral control in predicting intention.
Oral health knowledge significantly affected affective and cognitive attitudes, while current behavior was not a significant predictor of intention to improve oral health behavior. The model had a slightly better fit among females than among males, but was similar for home and professional dental health care. Our findings revealed that attitude, perceived behavioral
control, and oral health knowledge are predictors
of intention to improve oral health behaviors. These findings may help both dentists and dental hygienists in educating patients in oral health and changing patients’ oral hygiene habits. (J Oral Sci 53, 369-377, 2011).