Inequalities in oral health service utilisation in Ireland: results from the Healthy Ireland Survey

BACKGROUND: Good oral health is important for overall health and wellbeing; poor oral health disproportionately affects disadvantaged groups and is associated with various non-communicable diseases, many of which have shared risk factors, including diabetes and cardiovascular disease. Regular dental attendance with risk assessment optimises oral health. Due to an ageing dentate population, demands on oral health services are predicted to increase in Ireland. This cross-sectional assessment of oral health service utilisation aimed to inform equitable national resource allocation. METHODS: Secondary analysis of the Healthy Ireland Survey 2022, a telephone-delivered survey of a representative sample of the Irish public aged ≥15 years, was conducted. Prevalence of dental attendance in the preceding year was measured with 95% Confidence Intervals (CIs). Logistic regression determined factors associated with dental attendance using Adjusted Odds Ratios (aORs). RESULTS: Response rate was 40.4% (N = 7,455). Most participants (81.3%) self-reported good or very good overall oral health; 49.3% had attended dental services in the previous year. Compared to comparative counterparts those of higher educational level (aOR 1.28 95% CI 1.09-1.50), those with private health insurance (aOR 1.66 95% CI 1.48-1.86) and those with no missing teeth (aOR 2.91 95% CI 2.19-3.85) were significantly more likely to have attended dental services in the previous year. Conversely, compared to those aged 25-34 years, those aged 65+ had significantly lower odds of dental attendance in the previous year. CONCLUSIONS: Disparities in oral healthcare utilisation identified in this study suggest potential unmet population oral health needs. Combined with population ageing and a growing scarcity of dentists available to provide care to disadvantaged groups such coverage gaps are key considerations for Irish oral healthcare planning, namely implementation of Ireland's National Oral Health Policy ‘Smile agus Sláinte’ 2019. KEY MESSAGES: • In this nationally representative cross-sectional survey of Irish adults notable disparities in oral health service utilisation were evident, especially among older adults. • Aligning with the universal health coverage agenda, suggested unmet population oral health needs are key considerations for national and international oral healthcare planning and resource allocation.