Abstract
Aims: This study aimed to investigate the pattern and background of dental avoidance among adolescents 16-19 years in the Swedish system of free dental care.
Methods: From lists of booked and missed dental appointments during the year 2012, 522 cases with avoidance behavior and 522 matched controls without were identified. Data on oral health status, dental treatment, fear or behaviour problems, medical or psychological factors, tobacco use or other documented factors of potential explanatory value were recorded from dental records 2009-2012 according to a pre-specified protocol. Descriptive statistics, non-parametric and parametric bivariate tests (ongoing) and logistic regressions (ongoing) were applied. The study was approved by the Regional Ethical Review Board and was performed in accordance with the principles stated in the Declaration of Helsinki.
Results: In total, 3,090 of 23,522 (13.1%) booked appointments were missed, with a higher proportion among boys (1,842/12,619; 14.6%) than girls (1,248/10,903; 11.4%; p<0.001). Cases with avoidance behaviour 2012 had poorer oral health status i.e. more often dentin caries (327 (63.0%) vs. 245 (46.9%); p<0.001),gingivitis (249 (48.1%) vs. 142 (27.2%); p<0.001), extraction experiences (94 (18.0%) vs 60 (11.5%); p=0.003), and more often recordings of dental fear or behaviour problems (75 (14.4%) vs. 34 (6.5%); p<0.001), tobacco use (138 (26.5%) vs. 85 (16.3%); p<0.001). Those who were dental avoiders also had more previous signs of avoidance (308 (59.0%) vs. 137 (26.2%); p<0.001) than the controls. Logistic regression analyses in five steps revealed that social load, dental disease and appointments discriminated for dental avoidance in 2012.
Conclusions: To enable good oral health and a continuation of regular dental care, it is necessary to pay more attention to each adolescents’ individual situation and to be observant of early signs of avoidance.
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