People with oral pain who live in rural areas are nearly twice as likely as their urban counterparts to seek help only after they develop a problem and the pain is severe, reported researchers in the April issue of Public Health Reports.
Over a four-year period, University of Florida researchers studied patterns in access to dental care among 703 randomly selected people aged 45 years and older living in rural or urban counties in North Florida.
Researchers interviewed each participant and conducted an oral examination at the beginning of the study. They then conducted follow-up telephone interviews at six-month intervals to track participants’ financial status, symptoms of oral pain, and usage of dental services and treatment. They also interviewed participants in person and conducted additional oral examinations at two and four years.
Researchers found that rural residents and people who take a problem-oriented rather than preventive approach to oral health care were more likely to need emergency dental care for oral pain. These people were at the highest risk of needing pain-related emergency treatment.
Over the course of the study, 23 percent of the participants made at least one emergency dental visit because of painful symptoms owing to afflictions such as toothaches and abscesses. Sixty-seven percent of those who reported an emergency dental visit owing to pain rated their discomfort as severe.
Overall, men were 20 percent less likely to seek and receive dental care at all, even when they had severe oral pain.
Only 56 percent of patients who visited the dentist for emergency treatment of painful oral conditions described themselves as "very satisfied" with the outcome of their treatment, compared with 79 percent of those who sought urgent care but were pain-free at the time.
"What we found is there is a group of people who wait until their condition is of sufficient painful intensity and duration before deciding that it’s bad enough to pick up the phone and call the dentist," said lead author Joseph Riley, Ph.D., an assistant professor of public health services and research at UF’s College of Dentistry. "There is evidence that these people assume this problem-oriented approach to oral health because of low access to care, whether that be due to an inability to pay or the lack of dentists practicing in rural areas," Dr. Riley added.
He said he believes that access to care is not the only factor at play in determining why people with oral pain delay seeking dental treatment. "Dentistry is really about social and psychological factors; it’s perspective, and the preventive
