DIAGNOSES OF DENTAL DISEASE IN REGIONS WITH LOW AND HIGH NUMBERS OF DENTISTS

Abstract

Background: The average number of dental practitioners (DPs) in Lithuania is one of the highest in Europe, but DPs are unequally distributed over the country. In the regions with low numbers, DPs may be able to provide only urgent dental care, with less emphasis given to prevention of oral diseases and maintenance of oral health.

Aim: To investigate if acute dental diseases (ADD) were diagnosed and recorded more often in regions with low number of DPs compared to regions with high number of DPs.

Methods: The diagnoses of dental diseases (DD) among 2-17 year-olds were retrieved from the Lithuanian Hygiene Institute database and selected diagnoses were dichotomized as ADD (pulpitis, acute periapical periodontitis and periapical abscess) and chronic and/or prevention prone (initial carious lesion, carious lesion in dentine and/or cementum, arrested carious lesion and erosion). The number of DPs for 2015 for 59 Lithuanian towns and municipalities was retrieved from the Lithuanian Dental Chamber. The regions were categorized as high coverage (10- 14.99 dentists for 10,000 inhabitants) and low coverage (0-4.99 dentists for 10,000 inhabitants). Out of 59 towns and municipalities, all four highest coverage regions and all 13 lowest coverage regions were included. Analyses were performed using Excel 2013 and SPSS version 24. The study was evaluated as a quality assurance project that used anonymised data for which ethics approval was not required.

Results: In the selected regions in total 142,409 2-17 year- olds were registered as having at least one diagnosis from the International Classification of Diseases during the year 2015; 25,930 (18.2%) subjects had a DD. The most common DD was a carious lesion in dentine and/or cementum, (87 (45%) and 5552 (78%)) and (56 (45%) and 2301 (85%)) in high and low coverage regions, respectively. However, in one low coverage region it was an initial carious lesion (230, 47%). Univariate binary logistic regression analysis, showed that 2-17 year-olds in high coverage regions had 12% increased odds of having ADD compared to their peers in low coverage regions (OR=1.12, 95% CI 1.05-1.2).

Conclusions: Despite the high number of dentists in the country, it seems that children and adolescents, receiving free of charge dental care, do not benefit adequately from the system and the unequal distribution of DPs does not seem to have a substantial role.