Exploring Adolescents' Indirect Financial and Non-Financial Barriers to Dental Care Non-Attendance: The Role of Payment Methods

ALLA ALSHARIFSaba Kassim^*

• Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Medina, Saudi Arabia

Background and aims: Dental attendance is key to the preventionng and early detection of oral diseases. In Saudi Arabia (SA), dental care is publicly funded for citizens, yet; however, majority ofmany families opt for private care through insurance or out-of-pocket payment. This study has twofold: 1) to examine factors associated with regular dental attendance versus non-dental attendance among adolescents, and. 2) to explore the indirect financial and nonfinancial barriers to dental non-attendance of dental care, with a particular emphasis on how payment methods influence these barriers. An analytical cross-sectional survey was conducted among a convenience sample of adolescents in Al-Madinah, SA. Methods: An analytical cross-sectional survey was conducted among a convenience sample of adolescents in Al-Madinah, SA. Data collected included socio-demographic characteristics, oral health related variables (e.g., brushing teeth, dental attendance pattern) and barriers to non-dental attendance. Logistic regression identified factors associated with non-attendance for dental care. To analyse non-dental attendance drivers, we organised response into six thematic domains: affordability, availability, accessibility, motivation, perceived need, and fear/anxiety. We then classified affordability-including transportation costs, productivity loss, and childcare expenses-as an indirect financial barrier, whereas the remaining domains (availability, accessibility, motivation, perceived need, and fear/anxiety) were defined as non-financial barriers. Barriers were categorised into indirect financial (affordability e.g., transportation costs, productivity loss and childcare expenses) and non-financial (e.g., availability, accessibility, motivation, perceived need and fear and anxiety). These were compared in relation to the participants' payment methods. Results: Among 416 adolescents, (203 males, 48.9%), 315 (75.7%) reported non-dental attendanceattendance and 216 (51.9%) used out-of-pocket payment. Regression analysis showed that being male, using publicly funded dental services, and self-rating poor oral health were significantly associated with non-dental attendance adjusted odd ratio (AOR)=2.