Forgoing dental care for economic reasons in Switzerland: a population-based cross-sectional study over six years

Idris Guessous, Jean-Marc Theler, Claire Durosier Izart, Silvia Stringhini, Patrick Bodenmann, Jean-Michel Gaspoz, Hans Wolff.
Forgoing dental care for economic reasons in Switzerland: a six-year cross-sectional population-based study., BMC Oral Health, 30 September 2014, doi: 10.1186/1472-6831-14-121

Abstract

Background: While oral health is part of general health and well-being, disparities in oral health persist. The mechanisms that might explain this include socio-economic factors that may influence access to dental care in the absence of universal dental insurance coverage. We studied the development, prevalence and determinants (including socio-economic factors) of people foregoing dental care for economic reasons in a Swiss region over a six-year period.

Methods: Population-based repeated surveys (2007-2012) of a representative sample of the adult population in the canton of Geneva, Switzerland. Non-use of dental care, socio-economic and insurance status, marital status and presence of dependent children were assessed using standardised methods.

Results: A total of 4,313 people were included, of whom 10.6% (457/4,313) reported having foregone dental care for economic reasons in the last 12 months. The raw percentage ranged from 2.4% in the wealthiest group (monthly income ≥ CHF 13,000, CHF 1 ≈ $1) to 23.5% among participants with the lowest income (< CHF 3,000). Since 2007/8, renunciation of dental care has remained stable overall, but among people with a monthly income of <3,000 CHF, the adjusted percentage rose from 16.3% in 2007/8 to 20.6% in 2012 (P trend = 0.002). Forgoing dental care for economic reasons was associated with lower income, younger age, being female, active smoking, having dependent children, being divorced and not living with a partner, not having supplementary health insurance and receiving a health insurance premium subsidy.

Conclusions: In a region such as Switzerland without universal dental insurance cover, the prevalence of people foregoing dental care for economic reasons was high and highly dependent on income. Efforts should be made to prevent high-risk populations from forgoing dental care.

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