University of Oulu

Suominen, Anna L.; Helminen, Sari; Lahti, Satu; Vehkalahti, Miira M.; Knuuttila, Matti; Varsio, Sinikka; Nordblad, Anne. Use of oral health care services in Finnish adults : results from the cross-sectional Health 2000 and 2011 Surveys. BMC Oral Health 2017 17:78, DOI: 10.1186/s12903-017-0364-7

Use of oral health care services in Finnish adults : results from the cross-sectional Health 2000 and 2011 Surveys

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Author: Suominen, Anna L.1,2,3,4; Helminen, Sari5; Lahti, Satu6;
Organizations: 1Institute of Dentistry, University of Eastern Finland
2Department of Oral and Maxillofacial Surgery, Kuopio University Hospital
3The Living Environment and Health Unit, National Institute for Health and Welfare (THL)
4The Health Monitoring Unit, National Institute for Health and Welfare (THL)
5The Social Insurance Institution (Kela)
6Department of Community Dentistry, Institute of Dentistry, University of Turku
7Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki
8Medical Research Center, Oulu University Hospital & Oulu University
9Department of Social Services and Health Care, City of Helsinki
10Department of Social and Health Services, Unit of Health Services, The Ministry of Social Affairs and Health
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.3 MB)
Persistent link:
Language: English
Published: Springer Nature, 2017
Publish Date: 2017-07-04


Background: During the 2000s, two major legislative reforms concerning oral health care have been implemented in Finland. One entitled the whole population to subsidized care and the other regulated the timeframes of access to care. Our aim was, in a cross-sectional setting, to assess changes in and determinants of use of oral health care services before the first reform in 2000 and after both reforms in 2011.

Methods: The data were part of the nationally representative Health 2000 and 2011 Surveys of adults aged ≥ 30 years and were gathered by interviews and questionnaires. The outcome was the use of oral health care services during the previous year. Determinants of use among the dentate were grouped according to Andersen’s model: predisposing (sex, age group), enabling (education, recall, dental fear, habitual use of services, household income, barriers of access to care), and need (perceived need, self-rated oral health, denture status). Chi square tests and logistic regression analyses were used for statistical evaluation.

Results: No major changes or only a minor increase in overall use of oral health care services was seen between the study years. An exception were those belonging to oldest age group who clearly increased their use of services. Also, a significant increase in visiting a public sector dentist was observed, particularly in the age groups that became entitled to subsidized care in 2000. In the private sector, use of services decreased in younger age groups. Determinants for visiting a dentist, regardless of the service sector, remained relatively stable. Being a regular dental visitor was the most significant determinant for having visited a dentist during the previous year. Enabling factors, both organizational and individual, were emphasized. They seemed to enable service utilization particularly in the private sector.

Conclusions: Overall changes in the use of oral health care services were relatively small, but in line with the goals set for the reform. Older persons increased use of services in both sectors, implying growing need. Differences between public and private sectors persisted, and recall, costs of care and socioeconomic factors steered choices between the sectors, sustaining inequity in access to care.

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Series: BMC oral health
ISSN: 1472-6831
ISSN-E: 1472-6831
ISSN-L: 1472-6831
Volume: 17
Article number: 78
DOI: 10.1186/s12903-017-0364-7
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Funding: The authors disclose receipt of the following financial support for the research, authorship, and/or publication of this article: the Finnish Dental Society Apollonia.
Dataset Reference: The data that support the findings of this study are available from the National Institute for Health and Welfare (THL) but restrictions apply to the availability of these data, which were used under license for the current study, and are thus not publicly available. Data are, however, available from the authors upon reasonable request and with permission of the National Institute for Health and Welfare (THL).
Copyright information: © The Author(s). 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.