Utilization of Dental Services by Rural dwellers: Case of two Communities hosting a tertiary health facility

Background: Oral diseases have a significant impact on people's appearance, quality of life, and self-esteem, despite the fact that frequent dental visits aid in early identification, and prevention. In the rural areas, people find it difficult to visit dental care for a variety of reasons, and most times access to dental care is blamed for non-use. Aim: The aim of this study was to determine the level of dental service utilization in the University of Nigeria Teaching Hospital (UNTH) by inhabitants of the two host communities while highlighting the predisposing factors and barriers to the use of the services. Methodology: This descriptive cross-sectional study was conducted in the villages of Ituku and Ozalla hosting the University of Nigeria Teaching Hospital (UNTH) in Enugu State. A minimum sample size of 138 was calculated for each community yielding a total of 276. Information obtained from 69 households (2 per household) using a 21-question semistructured questionnaire include demographic characteristics, oral health awareness, dental service utilization, and barriers to service utilization. Data analysis was done with SPSS software version 20, and the Chi-square test identified differences between groups with the level of significance set at p ≤0.05. Results: The study involved 278 villagers aged 18 to 80 years, 140(50.4 %) were from Ozalla and 138(48.6%) from Ituku Community; 119/138 (86.2%) and 130/140 (92.9%) were aware of a dental clinic respectively. Also, 58/278 (20.9%) of the participants had previously used dental services at UNTH: [22 (37.9%) Ituku and 36 (62.1%) Ozalla (p=0.045)], but only 12/58 visited the clinic in the year prior to the study, so the utilization rate was only 20.6%. Scaling and polishing 29/58 (50.0%), and filling 20/58 (34.5%) were the popular treatments/services. The main reasons for seeking care at UNTH were severe pain 41/58 (70.7%) and inability to eat 17/58 (29.3 %). Lack of perceived need was the most prevalent barrier 101 /220 (45.9%) to using dental services, followed by unawareness of a dental clinic in UNTH for 38/220 (17.3%). The Association between awareness of the dental clinic and its utilization shows that it was exclusively among those who were aware (p< 0.001). Conclusion: There was a very low level of utilization of dental services at the University of Nigeria Teaching Hospital by dwellers of the host communities. However, awareness rather than access or distance to the hospital was key in influencing the visits with pain as the most compelling reason for attendance. Promotion of more platforms for enlightenment by all means with an emphasis on preventive approaches rather than symptom-driven visits is recommended.