What is the function of psychosocial factors in predicting length of time since last dental visit? A secondary data analysis

Aim: To conduct a secondary analysis of the Adult Dental Health Survey, UK (ADHS.UK) data to investigate the function of (i) psychosocial factors (costs, dental anxiety, communication) and whether their interaction mediates the relationship between perception of need and length of time since last dental visit.

Methods: The data used from the ADHS.UK interview questionnaires included demography, costs, perception of treatment need, communication, dental anxiety and reported dental attendance. The data was subjected to X2-analysis and hierarchical logistic regression analysis.

Results: Time since last dental visit was significantly associated with all demographic and psychosocial variables. The hierarchical logistic regression analysis tested 3 models. Model 1 examined the demography and explained 2% of the variance. Model 2 showed that those in intermediate (e.g. clerical staff) and routine (e.g. agriculture workers) occupations and those who were unemployed/never worked had a greater likelihood of increased interval between dental visits, explaining an additional 2% of the variance of the time interval between dental visits. Model 3 provided an additional 10% of the variance, which included costs, perceived need, communication and dental anxiety. The interaction of the perception of need by extreme dental anxiety (OR = 0.52; 95%CI: 0.40, 0.69), improved the fit of the model (X2 (df1) = 22.85, p< 0.001).

Conclusion: This study revealed that dental anxiety, communication and treatment costs acted as barriers to accessing dental care. Dental anxiety acted as a mediator in the relationship between perception of need and increased time interval between dental visits.