Incidence of dental caries among susceptible community-dwelling older adults using fluoride toothpaste: 2-year follow-up study.

Objectives: To explore reasons for the underuse of dental services covered by a government-funded program in Alberta.

Methods: In 2011, a survey questionnaire was sent to 4000 randomly selected clients of the Alberta Child Health Benefit and the Alberta Adult Health Benefit programs. Only respondents with children were included in the analysis. Reasons were explored among those who indicated that their children did not receive any dental services in the year before the survey. Difficulties faced by those who reported receiving at least 1 dental service were also noted.

Results: Among 795 respondents, 597 had at least 1 child. A total of 1303 children aged 1-19 years (mean age 11.79 years, standard deviation 4.2) were included in the analysis. Of these children, 443 (34.0%) had not received any covered dental services; the most common reason (50.7%) was no perceived need (interpreted from the replies "my child was too young" or "had no dental problems") followed by perceived insufficient coverage (38.6%). The most common challenge reported by dental care users was also insufficient coverage (44.9%). About 57% of parents were aware that annual fluoride application was covered by the program; however, only 34.3% of their children received fluoride and 14.2% had sealants.

Conclusions: Low-income families underuse available dental benefits for children. Perceived need seems to be the primary determinant of use. Parental awareness about the coverage does not seem to promote the use of preventive measures for young children.