Factors associated with seeking and access to oral health services among Brazilian adolescents and young adults.

Abstract

Objective: To investigate individual and contextual factors associated with seeking and access to oral health services among Brazilian adolescents and young adults.

Methods: This cross-sectional study was based on data from the 2023 Brazilian National Oral Health Survey (SB Brasil 2023). The sample comprised 12-year-old adolescents and young adults aged 15 to 19 years (n=14,757). Four outcomes structured into two stages (seeking and access) were assessed, subdivided into general oral health services and public services specifically. Binary logistic regression models were fitted to estimate odds ratios (ORs), and a 5% significance level was adopted (p<0.05).

Results: All associations were statistically significant (p<0.001). Black race/skin color and income below the poverty line reduced the odds of seeking general oral health services (OR=0.86 and OR=0.84, respectively). For general access, socioracial inequities were more pronounced, intensifying the barrier for Black individuals (OR=0.79). Conversely, in the context of public services, the most vulnerable groups had the highest odds of both seeking and effectively accessing services, particularly Black individuals (ORseeking=2.72; ORaccess=2.57) and those with low income (ORseeking=2.31; ORaccess=2.38).

Conclusions: Seeking and access to oral health services are influenced by socioeconomic and racial inequities. The public system acts as a compensatory resource for vulnerable groups but remains insufficient to overcome access barriers.