Prevalence and socioeconomic factors associated with non-utilization of dental care in Lebanon: A nationwide cross-sectional survey.

OBJECTIVES: To assess the prevalence of non-utilization of dental care in Lebanon and associated socioeconomic factors and self-care behaviours. METHODS: A nationwide, quantitative, survey-based study was conducted by trained interviewers with Lebanese residents aged ≥18 years between July and September 2019. Univariate analyses were performed using Pearson Chi Square test or the Fisher's exact test followed by a binary logistic regression using the SPSS Version 25. RESULTS: Of the 1070 participants, 247 (23.1%) did not utilise any type of healthcare and 144/247 (58.3%) did not utilise dental care. The prevalence of non-utilization of dental care was estimated at 13.5%. Only 4.7% of the respondents consulted their dentist in the past year, among which 53% cited pain/emergencies as the reason for their consultation. Socioeconomic factors associated with the non-utilization of dental care were lack of social medical insurance (OR, 0.49 [95% CI, 0.31 to 0.79]) and long waiting time/patient time restriction (OR, 2.05 [95% CI, 1.26 to 3.35]). On the other hand, facilitators for utilization of dental care included ethical standards/personal qualities of the dentist (OR, 0.53 [95% CI, 0.32 to 0.88]) and convenient cost with respect to the individual's economic status (OR, 0.28 [95% CI, 0.18 to 0.43]). CONCLUSION: This study suggests that dental care practices in Lebanon, including the non-utilization of dental care, are suboptimal. Measures such as reducing sugar and tobacco consumption, providing information on oral hygiene, and using fluoride products are inexpensive; however, implementing these measures may take substantial time and input by multiple stakeholders.

Recours aux soins dentaires au Liban : de la perception vers la réalité.

INTRODUCTION: In the context of public health, seeking or not seeking dental care is a poorly documented topic. However, its control is essential for the establishment of effective prevention. PURPOSE OF RESEARCH: The main objective of our study is to explore the perceptions, attitudes, social representations and factors determining the behavior of the Lebanese population seeking oral care in two governorates, Beirut and Mount Lebanon.The method follows the descriptive qualitative approach. Semi-directed exploratory interviews were conducted with 20 beneficiaries and 7 dentists. The data was analyzed thematically in several stages according to the Kreuter and Green model. RESULTS: The results of our study showed that several factors hamper the beneficiaries’ use of dental care. The lack of knowledge about the association between dental health and general health, the negative perceptions of citizens towards prevention and dentistry as well as financial incapacity remain primordial factors obstructing the seeking of dental care. On the other hand, health education, changing perceptions as well as cost coverage or reimbursement would be factors that could promote the use of dental care. CONCLUSION: Not seeking dental care remains a worrying problem in a developing country like Lebanon. The impact is considerable on oral health and on general health with all its consequences on an already fragile health system.

Development of an Arabic Version of the Hiroshima University-Dental Behavioral Inventory: Cross-cultural Adaptation, Reliability, and Validity.

The Hiroshima University-Dental Behavioral Inventory (HU-DBI) has not been adequately translated to the Arabic language. The aim of this study is the translation and cultural adaption of the English HU-DBI into standard Arabic. The English HU-DBI was translated into Arabic by three bilingual dental academics. A nonmedical professional performed backward translation into English. The three bilinguals compared both English versions and accordingly modified the Arabic version. English and Arabic versions were answered by 58 bilingual participants. Focus groups and cognitive interviews were conducted to pretest the working version, after which the final Arabic version was tested for test-retest validity on 58 dental students. Bilingual validity and test-retest validity were assessed using the kappa statistic. Responses were similar in the English and Arabic versions for bilingual individuals and on both tests in the test-retest sample. Kappa values ranged from 0.85 to 1.00 for bilingual validity and between 0.82 and 1.00 for test-retest reliability. In conclusion, the Arabic HU-DBI will enable the assessment of knowledge and attitudes toward oral diseases and their prevention in Arab countries and will allow meaningful comparisons between different countries in the region.