Early socioeconomic disadvantage as a predictor of dental care utilisation in adolescence and early adulthood

Abstract Background Inequalities in dental service utilisation are a universal concern that can exacerbate inequalities in oral health. This study aims to identify the effect of early socioeconomic disadvantage (SED) on dental care utilisation during adolescence and early adulthood. Methods Longitudinal secondary analysis of a subsample of the Avon Longitudinal Study of Parents and Children (ALSPAC) using Structural Equation Modelling (SEM). SED was assessed between pregnancy and when the child was two years and nine months. Perceived importance of oral health behaviours, Corah Dental Anxiety Scale, receiving any oral health advice, perceived dental need and the usual reason for dental visits were assessed through a dental questionnaire at 17 years. The effect of early SED and other predictors on the usual reason of dental visits was assessed for those completed the dental questionnaire at 17 years (n = 2468) (Model 1). The usual reason of dental visits was also assessed using another questionnaire at 23 years. The effect of early SED and other predictors on the usual reason of dental visits at 23 years was assessed for those completed both questionnaires at 17 and 23 years (n = 1639) (Model 2). Results Both models showed acceptable fit and yielded similar results. Early SED directly predicted the usual reason for dental visits at 17 years (β= -0.13) and 23 years (β= -0.10). Perceived importance of oral health behaviours was relatively the strongest predictor in both models. Dental anxiety and oral health advice showed indirect effect on irregular dental visits, mediated by high perceived need. High perceived need also mediated the relationship between less perceived importance of oral health behaviours and less regular dental visits. Conclusions The results showed the role of early SED. Addressing underlying social inequalities early in life and ensuring universal access to dental care are potential ways to reduce inequalities in dental care utilisation.