Objectives: To explore reasons for underutilization of dental services covered by a governmental funded program in Alberta.

Methods: A survey questionnaire was sent to 4,000 randomly selected clients of Alberta Health Benefit program. 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 prior to the survey (non-users). Difficulties faced by those who reported receiving at least one dental service (users) were also collected.

Results: Among 795 returned surveys, 597 had at least one child. A total of 1,303 children aged 1 to 19 years (mean age = 11.79 years, SD = 4.2) were included in the analysis. Of the 1,303 children, 443 (34%) did not receive any covered dental services (non-users); the most common reason (50.7%) was 'no perceived need' labeled for 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 the dental care users was also insufficient coverage (44.9%). About 57% of parents were aware of the covered yearly fluoride application; however, only 34.3% of their children received fluoride and 14.2% had sealants.

Conclusions: Low-income families underutilized available dental benefits for children. Perceived need seemed to be the primary determinant of utilization. Parental awareness about the coverage did not seem to promote the utilization of preventive measures for young children.

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