Int J Stomatol

Int J Stomatol ›› 2025, Vol. 52 ›› Issue (3): 380-389.doi: 10.7518/gjkq.2025056

• Original Articles • Previous Articles    

Utilization and influencing factors of oral health services among elderly people aged 65-74 years in Sichuan Pro-vince, China

Huiyu Yang1(),Yalan Deng1,Shirui Ren2,Shimeng Wang3,He Cai1,Li Cheng1,Tao Hu1()   

  1. 1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Dept. of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.Dept. of Cariology and Endodontics, Stomatological Hospital of Xiamen Medical College & Xiamen Key Laboratory of Stomatological Diseases Diagnosis and Treatment, Xiamen 361008, China
    3.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Dept. of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-06-07 Revised:2024-10-29 Online:2025-05-01 Published:2025-04-30
  • Contact: Tao Hu E-mail:505967357@qq.com;hutao@scu.edu.cn
  • Supported by:
    National Key Research and Development Program of China(2023YFC3605600);National Natural Science Foundation of China(72104162);Clinical Research Project of West China Hospital of Stomatology, Sichuan University(LCYJ-ZD-202301)

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Abstract:

Objective To understand the utilization of oral health services among elderly individuals aged 65-74 years in Sichuan Province, China; evaluate the influencing factors; and provide references for elderly oral health care policies. Methods Data from the Fourth National Oral Health Survey in Sichuan Province were used. The Anderson model was applied as a theoretical framework. Descriptive statistics, chi-square tests, multiple logistic regression, and structural equation modeling were used to analyze the utilization of oral health services and their influencing factors among elderly individuals. Results A total of 744 elderly individuals participated in the survey. The utilization rate of oral health services in the past 12 months was 24.1%, with only 8.4% of those pertaining to consultation and prevention. Multivariate logistic regression analysis revealed that education level, place of residence, self-assessment of oral health, brushing frequency, and the number of remaining teeth influenced the utilization of oral health services. Structural model analysis indicated that low education le-vels, rural residence, low brushing frequency, the presence of 20 or more teeth, and good self-assessment of oral health were associated with low utilization rates of oral health services among elderly individuals. Conclusion The utilization rate of oral health services among elderly individuals aged 65-74 years in Sichuan Province is relatively low, with most services being for treatment purposes. Utilization is influenced by education level, place of residence, self-assessment of oral health, brushing frequency, and the number of teeth.

Key words: oral health services, Anderson model, elderly people, structural equation model, regression analysis

CLC Number: 

  • R780.1

TrendMD: 

Fig 1

Conceptual model of dental service utilization among elderly individuals based on the Anderson model"

Tab 1

Variable classification and assignment"

变量赋值
性别1=女，2=男
教育程度1=高中及以上，2=初中，3=小学，4=未受教育
态度和知识1=低（0~6分），2=高（6~10分）
居住地1=城镇，2=乡村
家庭年收入1=高，2=较高，3=较低，4=低
自我口腔健康评估1=差，2=一般，3=好
抽烟状况1=抽烟，2=已戒烟，3=不抽烟
刷牙频率1=≥2次/d，2=1次/d，3=<1次/d，4=从不刷牙
饮食习惯1=差（≤9分），2=好（10~17分）
牙齿数目/颗1=<20，2=≥20

Tab 2

Utilization status of oral health services among the elderly"

调查项目例数百分比/%
口腔卫生服务利用
从未19125.7
>12个月37450.3
≤12个月17924.1
口腔卫生服务利用原因
咨询检查121.6
预防30.4
治疗16422.0
从未使用56575.9

Tab　3

Chi-square test of influencing factors for utilization of oral health services among the elderly people"

变量分类口腔卫生服务利用χ2值P值
从未>12个月≤12个月
性别女93196930.7340.693
男9817886
教育水平未受教育47472931.280<0.001
小学11019286
初中198130
高中及以上155434
态度和知识低109202950.6900.708
高8217284
居住地乡村1361937534.182<0.001
城镇55181104
家庭年收入低41102414.1910.651
较低6612557
较高375732
高479049
自我口腔健康评估好65843810.9450.027
一般6615575
差6013566
抽烟状况不抽烟1202431212.7210.606
已戒烟265328
抽烟457830
饮食习惯好1753391600.5450.761
差163519
刷牙频率从不3035640.641<0.001
<1次/d374214
=1次/d8217579
≥2次/d4212280
牙齿数目/颗≥20191003123.327<0.001
<20172274148

Tab 4

Logistic regression analysis results of influencing factors for utilization of oral health services among the elderly people"

变量分类参考组>12个月≤12个月
OR95%CIOR95%CI
教育水平小学未受教育1.5980.962~2.6541.0200.566~1.838
初中3.4961.745~7.002***1.4370.647~3.192
高中及以上2.4441.108~5.388*1.5450.652~3.662
居住地城镇乡村1.7941.145~2.811*2.1611.298~3.596**
自我口腔健康评估一般好1.5370.971~2.4341.7291.002~2.982*
差1.8081.120~2.918*2.2161.260~3.898**
刷牙频率<1次/d从不刷牙1.4180.686~2.9312.4490.813~7.373
=1次/d2.1881.145~4.183*5.2331.951~14.037**
≥2次/d2.1161.026~4.3667.3542.599~20.808***
牙齿数目/颗<20≥204.6202.603~8.201***2.8021.439~5.456**

Fig 2

Structural equation model of oral health service utilization among the elderly people"

Tab 5

Standardized regression weights and significance test results for the model"

变量βSE偏差校正的95%CIP值
下限上限
教育水平居住地0.4180.0310.3580.4780.002
刷牙频率0.3370.0290.2770.3930.002
牙齿数目-0.0700.018-0.106-0.0370.002
自我口腔健康评估-0.0450.037-0.1180.0280.195
口腔卫生服务利用-0.1530.036-0.223-0.0850.001
居住地刷牙频率0.3660.0310.3030.4240.002
牙齿数目-0.1160.035-0.190-0.0480.003
自我口腔健康评估-0.0150.041-0.0920.0700.739
口腔卫生服务利用-0.1750.038-0.243-0.0940.003
刷牙频率牙齿数目-0.1170.046-0.204-0.0240.009
自我口腔健康评估-0.1030.041-0.185-0.0310.007
口腔卫生服务利用-0.1590.039-0.235-0.0800.002
牙齿数目自我口腔健康评估0.1060.0350.0380.1720.004
口腔卫生服务利用-0.1150.032-0.180-0.0530.002
自我口腔健康评估口腔卫生服务利用-0.0970.035-0.165-0.0300.008

Tab 6

Total effects, direct effects, and indirect effects among variables in the structural model"

变量效应效应值
教育水平居住地刷牙频率牙齿数目自我口腔健康评估
居住地总0.418**
直接0.418**
间接无
刷牙频率总0.337**0.366**
直接0.184**0.366**
间接0.153**无
牙齿数目总-0.070**-0.116**-0.117**
直接无-0.073-0.117**
间接-0.070**-0.043**无
自我口腔健康评估总-0.045-0.015-0.103**0.106**
直接-0.0200.031-0.090*0.106**
间接-0.025-0.045**-0.012**无
口腔卫生服务利用总-0.153**-0.175**-0.159**-0.115**-0.097**
直接-0.053-0.122**-0.181**-0.105**-0.097**
间接-0.100**-0.053**0.022**-0.010**无
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