Non-utilization of oral health services in ecuadorian children and its associated factors: a cross-sectional study

Background: Oral health care plays a critical role in childhood. Factors influencing the non-utilization of oral health services must be identified to improve oral health in children. Objective: To estimate the frequency of non-utilization of oral health services in Ecuadorian children and identify its associated factors. Material and Methods: A cross-sectional study was conducted in a probabilistic sample of 8,461 Ecuadorian children aged 5-9. The data were obtained from the 2012 National Survey of Health and Nutrition. The information on oral health care and sociodemographic variables was collected through a questionnaire applied to mothers or caregivers of the children. Bivariate and multivariate analyses, using logistic regression, were employed to identify factors associated with the non-utilization of oral health services. Results: 30.6% (95% CI:29.6-31.6) did not visit the dentist in the last year before the survey. 47.5% of parents or guardians mentioned that it was unnecessary, 13.8% did not attend due to a lack of time, and 9.8% did not have the necessary funds. Non-utilization of oral health services was associated with living in urban areas (OR: 1.26; 95% CI 1.13-1.41), in the Coast region (OR: 1.55; 95% CI 1.37-1.74), self-identify as indigenous (OR: 1.72; 95% CI 1.48-2.01), that the child lives only with the mother (OR: 1.13; 95% CI 1.01-1.28), only with the father (OR: 1.48; 95% CI 1.01-2.17), or in the absence of both (OR: 1.54; 95% CI 1.22-1.94). For each year of increasing age, the probability of not visiting the dentist decreased by 6% (OR: 0.94; 95% CI 0.90-0.97) and for each increase in the socioeconomic quintile by 11% (OR: 0.89; 95% CI 0.86-0.93). Conclusions: Demographic and socioeconomic factors associated with the non-utilization of oral health services in Ecuador act as barriers to dental care.