Socioeconomic and Geographic Factors Influencing Dental Care Utilization Among Thai Adults and the Elderly: 2003–2013

Abstract This study aimed to assess trends and determinants of dental care utilization (DU) among Thai adults and the elderly in 2003, 2009, and 2013. Data on DU among Thai adults aged ≥ 20 years, as reported in the Health and Welfare Survey (HWS), was analyzed in relation to independent variables including demographic, socioeconomic, and geographic characteristics. Supplementary analyses were conducted to examine disparities across socioeconomic strata, including type of dental facility utilized, health insurance entitlement, and type of dental treatment received. The results showed that DU remained low and showed a slight decline. Multivariate logistic regression confirmed significant associations between utilization and demographic, socioeconomic, and geographic determinants. Women had 1.5 times higher odds of utilization compared with men (p < 0.001). Socioeconomic disparities were evident: individuals in the wealthiest quintile and those with tertiary or higher education reported approximately twice the utilization of their counterparts (p < 0.001). Bangkok residents demonstrated greater utilization than those in other regions (p < 0.001). The lowest socioeconomic status (SES) subgroup predominantly sought care at community hospitals, utilized the Universal Coverage Scheme (UCS), and received dental care primarily through tooth extraction, in contrast to wealthier groups. In summary, over the ten-year period, Thailand attempted to expand accessibility for dental care utilization by increased number of dental personnel and reduce financial barrier. However, there has been a slight change in rate of use. This finding suggests that reducing socioeconomic inequalities, geographic disparities, and differences in insurance benefits is essential to improving access to dental care.