The Utilization Rate of Dental Services between Iranian Households before and after the COVID-19 Pandemic

Document Type : Original Article(s)


1 PhD, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

2 MSc, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran


Background: The COVID-19 pandemic has caused challenges in accessing and utilizing healthcare, particularly dental services. This study focuses on determining the impact of the pandemic on Iranian households' use of dental services and the factors that influence it.
Methods: The statistical population of this study consisted of households throughout the country, with a sample size of 76,495 households. The study employed a logistic regression model, and statistical analysis was conducted using Access, Excel, and STATA 15 software.
Findings: The study found that fewer households utilized dental services after the outbreak of COVID-19. The ratio of dental service utilization before and after the occurrence of COVID-19 was 4.59% and 2.84% of households, respectively. Additionally, households with insurance coverage were more likely to use dental services, while households with an employed head, a highly educated head with high income, and households with elderly members were less likely to utilize dental services.
Conclusion: To improve the utilization of dental services after the COVID-19 pandemic among Iranian households, particularly those: without insurance, living in rural areas, with elderly members, and headed by women, evidence-based interventions should be implemented.


Sara Emamgholipour : PubMed , Google Scholar

Jafar Yahyavi Dizaj : PubMed, Google Scholar


Main Subjects

  1. ranter B, Hanson D. The social bases of cosmetic surgery in Australia. J Sociol 2015; 51(2): 189-206.
  2. Hajiabllo K, Hallajzadeh H, Masoudnia E. Comparison of social capital among the two groups of women with a history of cosmetic surgery and without performing cosmetic surgeries in Rasht.
    J Appl Sociol 2018; 29(4): 167-82.
  3. Tavassoli G, Modiri F. Women's tendency toward cosmetic surgery in Tehran [in Persian]. Women's Studs Sociol Psychol 2012; 10(1): 61-80.
  4. Salimi R, Gomar R, Heshmati B. The COVID-19 outbreak in Iran. J Glob Health 2020; 10(1): 010365.
  5. Kazemi-Karyani A, Safari-Faramani R, Amini S, Ramezani-Doroh V, Berenjian F, Yahyavi Dizaj MY, et al. World one-hundred days after COVID-19 outbreak: Incidence, case fatality rate, and trend.
    J Educ Health Promot 2020; 9: 199.
  6. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005; 83(9): 661-9.
  7. Peres MA, Macpherson LM, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet 2019; 394(10194): 249-60.
  8. Allin S, Masseria C, Mossialos E. Measuring socioeconomic differences in use of health care services by wealth versus by income. Am J Public Health 2009; 99(10): 1849-55.
  9. Amiresmaili M, Amini S, Shahravan A, Goudarzi R, Saberi-Anari SH. What determines utilization of dental care services? The case of Iran. J Oral Health Oral Epidemio 2018; 7(3): 139-47.
  10. Marin GH, Urdampilleta P, Zurriaga O. Determinants of dental care utilization by the adult population in Buenos Aires. Med Oral Patol Oral Cir Bucal 2010; 15(2): e316-21.
  11. Andkhoie M, Pandovska-Pelivanova E, Emmanuel S, Lateef F, Szafron M, Farag ME. Demand and burden of dental care in Canadian households. Int J Econ Finance 2014; 6(9): 73-82.
  12. Vecchio N. The use of dental services among older Australians: does location matter? Aust Econ Rev 2008; 41(3): 272-82.
  13. Kim CS, Han SY, Lee SE, Kang JH, Kim CW. Dental care utilization for examination and regional deprivation. J Prev Med Public Health 2015; 48(4): 195-202.
  14. Ghaderi H, Jamshidi RA, Ghorbani A. Estimation of dental services demand function of family in Sabzevar, Iran, in the urban area: 2007 [in Persian]. JHA 2010; 13(40): 7-12.
  15. Guiney H, Woods N, Whelton HP, Morgan K. Predictors of utilisation of dental care services in a nationally representative sample of adults. Community Dent Health 2011; 28(4): 269-73.
  16. Nguyen L, Häkkinen U, Rosenqvist G. Determinants of dental service utilization among adults--the case of Finland. Health Care Manag Sci 2005; 8(4): 335-45.
  17. Pizarro V, Ferrer M, Domingo‐Salvany A, Benach J, Borrell C, Pont A, et al. The utilization of dental care services according to health insurance coverage in Catalonia (Spain). Community Dent Oral Epidemiol 2009; 37(1): 78-84.
  18. Al-Hussyeen AJ. Factors affecting utilization of dental health services and satisfaction among adolescent females in Riyadh City. Saudi Dent J 2010; 22(1): 19-25.
  19. Kakatkar G, Bhat N, Nagarajappa R, Prasad V, Sharda A, Asawa K, et al. Barriers to the utilization of dental services in Udaipur, India. J Dent (Tehran) 2011; 8(2): 81-9.
  20. De Rosa S, Spaccarotella C, Basso C, Calabro MP, Curcio A, Filardi PP, et al. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 Eur Heart J 2020; 41(22): 2083-8.
  21. Rezaei S, Hajizadeh M, Irandoost SF, Salimi Y. Socioeconomic inequality in dental care utilization in Iran: a decomposition approach. Int J Equity Health 2019; 18(1): 161.
  22. Baum A, Schwartz MD. Admissions to Veterans Affairs hospitals for emergency conditions during the COVID-19 pandemic. JAMA 2020; 324(1): 96-9.
  23. Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J, et al. Impact of the COVID-19 pandemic on emergency department visits-United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69(23): 699-704.
  24. Salerno R, Conti CB, De Silvestri A, Campbell Davies SE, Mezzina N, Ardizzone S. The impact of covid-19 pandemic on urgent endoscopy in Italy: a nation-wide multicenter study. Scand J Gastroenterol 2020; 55(7): 870-6.
  25. McDonald HI, Tessier E, White JM, Woodruff M, Knowles C, Bates C, et al. Early impact of the coronavirus disease (COVID-19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020. Euro Surveill 2020; 25(19): 2000848.
  26. Moynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open 2021; 11(3): e045343.
  27. Hjern A, Grindefjord M, Sundberg H, Rosén M. Social inequality in oral health and use of dental care in Sweden. Community Dent Oral Epidemiol 2001; 29(3): 167-74.
  28. Varenne B, Petersen PE, Fournet F, Msellati P, Gary J, Ouattara S, et al. Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso: evidence from a household survey. BMC Health Serv Res 2006; 6: 164.
  29. Listl S. Income-related inequalities in dental service utilization by Europeans aged 50+. J Dent Res 2011; 90(6): 717-23.
  30. Homaie Rad E, Kavosi Z, Arefnezhad M. Economic inequalities in dental care utilizations in Iran: Evidence from an urban region. Med J Islam Repub Iran 2016; 30: 383.
  31. Rezaei S, Ghahramani E, Hajizadeh M, Nouri B, Bayazidi S, Khezrnezhad F. Dental care utilization in the west of Iran: a cross-sectional analysis of socioeconomic determinants. Int J Hum Rights Healthc 2016; 9(4): 235-41.
  32. Khan A, Thapa JR, Zhang D. Preventive dental checkups and their association with access to usual source of care among rural and urban adult residents. J Rural Health 2017; 33(4): 419-26.
  33. Reda SF, Reda SM, Thomson WM, Schwendicke F. Inequality in utilization of dental services: a systematic review and meta-analysis. Am J Public Health 2018; 108(2): e1-7.
  34. Sabbah W, Tsakos G, Sheiham A, Watt RG. The role of health-related behaviors in the socioeconomic disparities in oral health. Soc Sci Med 2009; 68(2): 298-303.
  35. Baldani MH, Antunes JLF. Inequalities in access and utilization of dental services: a cross-sectional study in an area covered by the Family Health Strategy. Cad Saude Publica 2011; 27(Suppl 2): S272-83.
  36. Duncan L, Bonner A. Effects of income and dental insurance coverage on need for dental care in Canada. J Can Dent Assoc 2014; 80: e6.
  37. Ayo-Yusuf IJ, Ayo-Yusuf OA, Olutola BG. Health insurance, socio-economic position and racial disparities in preventive dental visits in South Africa. Int J Environ Res Public Health 2013; 10(1): 178-91.
  38. Bhatti T, Rana Z, Grootendorst P. Dental insurance, income and the use of dental care in Canada. J Can Dent Assoc 2007; 73(1): 57.
  39. Lutfiyya MN, Gross AJ, Soffe B, Lipsky MS. Dental care utilization: examining the associations between health services deficits and not having a dental visit in past 12 BMC Public Health 2019; 19(1): 265.
  40. Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 2004; 79(1): 6-16.