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Factors influencing the use of oral health services among adolescents in New Zealand.

OBJECTIVES
This study investigated the impact of parental use of dental services, ethnicity and socio-economic background on adolescents' recent use of dental services.


DESIGN
Secondary analysis of cross-sectional data from the 2009 New Zealand Oral Health Survey (2009 NZOHS). PARTICIPANTS/MATERIALS AND METHODS: A sub-sample of all adolescent participants aged 12-17 years (n = 509) from the nationally representative 2009 NZOHS. The NZOHS included self-report data on oral health status, risks and protective factors, and utilisation of oral health services.


MAIN OUTCOME MEASURES
Outcome measures were 'most recent dental visit' and 'type of provider last visited'. Key exposure factors were 'most recent dental visit by primary caregiver' (among 12-14-year-olds), ethnicity, and socioeconomic deprivation. Univariate analysis for each outcome was conducted using survey-weighted estimates, followed by multivariable analysis using logistic regression.


RESULTS
Four in five adolescents reported having visited a dental provider within the last year (79.9%), with almost half having last visited a private general dental practice (46.6%). No significant associations were found for either outcome with the primary caregiver exposure factor (Most recent dental visit outcome fully adjusted OR (primary caregiver not visited) = 0.93, 95% CI 0.32, 2.72; Visited provider other than private general dental practice outcome fully adjusted OR (primary caregiver not visited) = 1.60, 95% CI 0.39, 6.57). Compared to European/Other adolescents, Māori and Pacific adolescents were significantly more likely to have not visited in the last year (Māori 12-14 years fully adjusted OR = 4.20, 95% CI 1.54, 11.50; Pacific 12-17 years fully adjusted OR = 2.61, 95% CI 0.84, 8.07--the latter was not significant after adjusting for socioeconomic deprivation), and significantly less likely to have last visited a private general dental practice (Māori 12-17 years fully adjusted OR = 2.16, 95% CI 1.13, 4.12; Pacific 12-17 years fully adjusted OR = 5.15, 95% CI 1.69, 15.74).


CONCLUSION
Ethnicity was strongly associated with use of oral health services among New Zealand adolescents. No statistically significant evidence was found that primary caregiver use of oral health services or socioeconomic deprivation were impacting on adolescent uptake of oral health services.