Trends in socioeconomic disparities in the utilization of dental care in Brazil and Sweden

Abstract

Aims: To describe trends in socioeconomic disparities in utilization of dental care. Methods: We obtained cross-sectional data from Sweden in the period 1968—2000 and from Brazil in 1986 and 2002 for 16 state capitals. The outcome was the percentage of people who reported that they had visited the dentist in the last 12 months, calculated for a higher and a lower income group and stratified by sex, age (two groups: young and adults) and dental status. Adjusted prevalence differences and prevalence ratios were produced using Poisson regression. Results: In Brazil, there was a decline in use of dental care among the 15—19 year olds in the period 1986—2002, but not among the 35—44 year olds. In Sweden, there was a decline among the young and adults between 1991 and 2000. Overall, socioeconomic disparities in use of dental services between the higher and the lower economic groups showed a decline in both countries. The reduction in disparities among young Brazilians was 1.1 percentage points per year (p < 0.01), but among the other age groups the decline was not significant (p>0.01). In the last surveys, the gap remained in both countries and age groups (p < 0.01). Conclusions: The recent decline in utilization of dental care and in the socioeconomic gap may mirror improvements in oral health. However, there are still relevant and persistent disparities in utilization of dental care in both countries, with a higher proportion of people of higher socioeconomic status visiting the dentist.