Barriers to oral healthcare and patterns of service utilization in rural Lucknow: a mixed-methods household study

Abstract Background Oral diseases represent a significant and growing public health burden in rural Lucknow. In Lucknow district, rural communities face a convergence of high disease prevalence, limited infrastructure, financial hardship, and entrenched socio-cultural barriers that collectively restrict access to timely dental care. Objectives The study aimed to assess oral health status, dental service-utilization patterns, financial and non-financial barriers to oral healthcare, and the factors influencing care-seeking among adults in rural Lucknow. Methods A convergent mixed-methods design was employed, integrating a cross-sectional quantitative survey ( n = 400) with Focus Group Discussions (2 FGDs, n = 12 participants) and clinical examination using the WHO Oral Health Assessment Form (2013). Results Clinical caries prevalence was 81.8% and periodontal disease was found in 55.8% of participants. A total of 60.8% of participants had never visited a dentist. Key barriers included high treatment cost (40.3%), perceived lack of need (19.5%), and transport difficulties (48%). Qualitative findings, mapped onto the 5 A’s framework, confirmed structural, financial, socio-cultural, and system-level barriers across all five access dimensions. Conclusions Oral healthcare utilization in the study setting was low and predominantly symptom-driven. Financial constraints, transport difficulties, limited availability of nearby services, and acceptability-related barriers were prominent. These findings identify health-service access domains that warrant further evaluation through context-specific implementation research.