11-year analysis of inequalities in access to oral health care in Peru

BACKGROUND: Demographic and health surveys are a major source of information for monitoring oral health conditions among vulnerable populations. OBJECTIVE: To assess the association between socioeconomic inequality, measured by the wealth index, and time elapsed since the last dental visit among Peruvian children and older adults from 2013 to 2023. METHODS: A repeated cross-sectional analytical study was conducted using secondary data from the Demographic and Family Health Survey (ENDES) from 2013 to 2023. The dependent variable was time since the last dental visit (years), and the independent variable was the wealth index. Additional variables included survey year, place of last dental care, region, area and place of residence, altitude, health insurance coverage, sex, and age. Descriptive statistics and Mann-Whitney U and Kruskal-Wallis tests were applied. After logarithmic transformation of the dependent variable, hierarchical linear regression was performed with a 95% confidence level and p < 0.05. RESULTS: Among children, the longest mean time since the last dental visit was observed in 2020 (6.65 years, SD = 4.90), and among older adults in 2016 (8.54 years, SD = 9.10). The wealth index was significant among children in 2021 (p = 0.017) and 2022 (p = 0.005), whereas among older adults it was significant from 2016 to 2023 (p < 0.05). CONCLUSION: These findings suggest persistent socioeconomic inequalities in timely access to dental care, particularly among older adults and in specific years among children. Further formal trend analyses are needed to determine whether these inequalities have widened over time.