No-shows in dental care – perspectives on adolescents’
attendance pattern
av
Anida Fägerstad
Akademisk avhandling
Avhandling för medicine doktorsexamen i medicinsk vetenskap, som kommer att försvaras offentligt
fredag den 22 november 2019 kl. 09.00, Hörsal C1, Campus USÖ, Örebro Universitet
Opponent: Professor Magnus Hakeberg Göteborgs universitet
Göteborg
Örebro universitet
Institutionen för hälsovetenskaper 701 82 ÖREBRO
Abstract
Anida Fägerstad (2019): No-shows in dental care – perspectives on adoles-cents’ attendance pattern. Örebro Studies in Medicine 202.
All children and adolescents living in Sweden have free dental care with reg-ular check-ups. Yet, missed and cancelled dental appointments are not unu-sual. The overall aim was to explore potential explanatory factors associated with non-regular dental care and to seek a deeper understanding of why some adolescents fail to attend their dental appointments.
An integrative review (Paper I) identified and summarized different sets of environmental, individual and situational factors that could be associated with dental avoidance or non-attendance. Paper II found similar levels of dental fear between children and adolescents (8-19 yrs) with a Swedish or a non-Swedish background. The occurrence and patterns of missed dental ap-pointments among 16–19-year-olds were investigated in Paper III, where we report that 13.1% of 23 522 booked dental appointments were missed in 2012. Boys had more missed appointments than girls, while no age differ-ences were found. In a case-control design, adolescents with missed appoint-ments more often had sociodemographic load, dental fear or dental behav-iour management problems, poor oral health, emergency visits, tooth extrac-tions, operative treatments, and over the past years, more missed and can-celled appointments. A history of missed and cancan-celled dental appointments predicted future missed and cancelled appointments. Twelve adolescent girls with missed appointments were interviewed in Paper IV and described sev-eral potential barriers or facilitators to accessing dental care. They high-lighted that knowing what will happen during the dental visit was decisive to whether or not they would attend their appointments.
In conclusion, factors specifically associated with dental avoidance still need to be investigated. Dental fear should still be seen as potential causal factor for dental avoidance. Missed and cancelled dental appointments should never be ignored since they could predict future missed and cancelled appointments. The results indicate that missed dental appointments among adolescents remain a challenge for Swedish dental care.
Keywords: adolescents, avoidance, dental attendance, dental care, dental
fear, dental health services, oral health, utilization.
Anida Fägerstad, School of Health Sciences, Örebro University, SE-701 82 Örebro, Sweden, anida.fagerstad@regionorebrolan.se
