Social inequality in dental services among people with type 1 and type 2 diabetes. A register-based study among 4,615,690 Danes

Aims To examine dental service use among people with and without diabetes adjusted for socioeconomic factors.Methods Using Danish registers, we included 4,615,690 Danish adults (age 18+); 0.52% had type 1 diabetes (T1D) and 5.85% had type 2 diabetes (T2D). Main outcome was any record of visits at a dental hygienist or dentist within the past two years.Results Among people with T1D, the proportion who did not visit a dentist in the two-year period was 27.6%; among T2D it was 35.7%, whereas the proportion was 31.0% for the non-diabetes population. The adjusted relative risk (RR) for not having visited a dentist within the past two years was 0.93 (CI: 0.91 to 0.95) for persons with T1D and 1.25 (CI: 1.24 to 1.26) for persons with T2D, both compared to the non-diabetes population. The RR was twofold to threefold higher among people in the lowest income quintiles compared to the highest quintile for people with T1D and T2D, respectively.Conclusions Social inequality was evident in dental visits. Financial support as a solution to decrease social inequality is one possibility, but increased awareness among health care professionals or increased health literacy among people with diabetes could also be at stake.