Sector-differences in Adults’ Dental Care Service Utilisation: 11-year Register-based Observations

Objective

This register-based study evaluated sector-specific differences in adults’ utilisation of dental care services in Helsinki, Finland in 2007-2017.

Methods

The target population comprised all inhabitants aged 20+ years in Helsinki over an 11-year period, from 2007 to 2017. The data, aggregated into 5-year age groups by treatment year and type of treatment, included inhabitants with at least 1 visit to a dentist in the private or public sector. In 2007-2017, the numbers of all patients ranged between 229,772 and 261,488. The patient age groups were analysed for periodontal, restorative, endodontic, and oral surgery treatment received. Attendance rates (%) refer to the number of patients per number of inhabitants. Proportions (%) of patients receiving various treatment types refer to numbers of patients per all patients. Comparisons between the age groups included percentual change in absolute numbers and percentage points in rates. The treatment-year trends were analysed by applying linear regression models.

Results

Attendance rate for all adult patients was 49.5% in 2007 and 48.8% in 2017. During the 11-year period, adults’ attendance to private service decreased (31.4%-24.9%) but increased to public service (18.1%-23.9%). Patients receiving periodontal care increased in both the private (67%-72%) and public (36%-45%) sectors, while patients with restorative care decreased in both sectors private (67%-58%) and public (58%-48%). Further, fewer private- than public-sector patients received oral surgery or endodontic treatment.

Conclusions

Sector-specific differences in patient treatments may indicate over- or undertreatment choices in restorative and periodontal care.