Barriers to the Access of Oral Health Care in Individuals from Lower Socioeconomic Communities in Karachi

Abstract

INTRODUCTION: Oral healthcare is a broad term that includes well-being of teeth, gums and broader oral environment. It is considered as a window to personal, economic and social development of individuals, irrespective of their age and gender. Poor oral health may lead to depression, demoralization, stress, and low self-esteem and may even impact social relations of an individual while also leading to great financial costs. It has direct impact on the physical health of an individual and it can be associated with chronic conditions including stroke, heart disease, diabetes, and cancer. The direct and indirect cost of poor oral health is very high as millions of school days and working hours are lost each year primarily because issues related to oral hygiene. It is unfortunate that oral treatment is considered amongst the most expensive treatments around the world, which hinders access of low and middle socioeconomic classes to proper oral health care mainly due to financial costs associated with it. OBJECTIVE: To determine the barriers that hinders the access to oral healthcare service utilization of low socio-economic communities in Karachi. METHODOLOGY: This cross sectional survey, after ethical approval from the Health Management Department of the College of Business Management, was carried out from March to June 2015. Using OpenEpi online calculator, sample size calculated and 385 respondents were randomly selected from two distinct low socio-economic communities of the Karachi. Data collected using World Health Organization Oral Health Survey Questionnaire for assesing personal and environmental factors influencing access to oral health service and analyzed using SPSS® version 22. RESULTS: Most of the participants were young-middle aged having some form of formal education. More than half of the participants had no access to a regular personal dentist before. About two-thirds deferred dental treatment as it was a considerable financial burden on their budget. We found statistically significant association between access to a regular dentist and educational qualification (p=0.000) and perceived expense of dental treatment (p=0004), while it was insignificant (p= 0.48) between access to a regular dentist and time taken for travelling. CONCLUSION: For those from low socioeconomic communities, education and travelling plays a role in limiting access to dental health care, however most powerful deterrent for such individuals is financial constraint.