Impact of the COVID-19 pandemic on dental care utilization in Indonesia: a critical analysis with policy implications

Abstract Background Despite a substantial proportion of Indonesia’s population suffering from oral health issues, only a small percentage of those affected access professional dental care services. The COVID-19 pandemic has further exacerbated challenges in accessing healthcare, with dental care services experiencing particularly pronounced disruptions. This study examined the determinants of access to primary dental care in Indonesia prior and during the pandemic period. Methods This study was a cross-sectional analysis that employed secondary data from Indonesian National Health Insurance (INHI) claim datasets to examine how oral and dental health services were utilized. We analyzed claims data from the INHI for 2019 and 2020, encompassing around 2,200,960 members, which represents approximately 1% of the total INHI enrollment. Logistic regression was employed to investigate the determinants of primary dental care access over this period, with a focus on examining how demographic and socioeconomic variables associated with access patterns. Results In 2019, an estimated 2.3% of INHI members accessed primary dental care services, with this rate declining to 1.6% in 2020 following the onset of the COVID-19 pandemic. Access was significantly higher for specific demographic groups; females, children, married people, premium payers, wage workers, and residents living in the Java-Bali region had greater likelihood to access dental care services, both prior and during pandemic. Stratification analysis revealed that children in the first class accessed dental services more frequently than those in lower classes, and notable regional disparities were observed, with reduced access among second- and third-class members and those residing outside the Java-Bali region. The decrease in dental care use among government-subsidized participants in 2020 suggested that the COVID-19 pandemic had intensified barriers to care for vulnerable populations. Conclusions COVID-19 pandemic has exacerbated difficulties in accessing dental care in Indonesia, particularly among government-subsidized and lower-class members, as well as those residing outside the Java-Bali region. Efforts to enhance support for vulnerable populations, improve regional healthcare infrastructure, and provide subsidies or incentives for dental care could help ensure more equitable access to essential services across Indonesia.