Survey the Determinants of Access to Preventive Dental Services

Article Type:
Research/Original Article (دارای رتبه معتبر)
Background and Aim

Military dentistry combines patient-centered care with public health views to create services agile and comprehensive. The effect of oral disease on military personnel can significantly damage the individual's operational ability. A significant concern of various countries in providing universal health coverage is access to dental services and oral health care, which requires understanding the related barriers and facilitators. This study aimed to determine systematic relationships among determinants of access to preventive dental services.


This mixed-methods, descriptive-analytical study was carried out in 2021 using an operations research technique. In the qualitative phase, by the literature review and using the snowball method, an interview was done with ten experts in dental prevention and oral health. The conceptual research model based on the Saurman access model was designed into 30 sub-components and six main components by identifying and categorizing the obtained codes. In the quantitative stage, a 30-item questionnaire was designed using the Decision Making Trial and Evaluation Laboratory (DEMATEL) technique. The questionnaire was completed by 30 experts selected from medical sciences staff and line using purposive sampling. The data were analyzed in SPSS and DEMATEL through structural analysis of causal relationships.


A total of 30 variables were identified based on the qualitative findings. These variables were categorized into six components, including affordability, acceptability, accessibility, awareness and empowerment, adequacy, and availability based on the analytical framework of the study. The experts confirmed the proposed determinants of access to dental services and suggested no other component (P=0.0001). Analytical results indicated that "affordability" (impact factor=1.05) and "acceptability" (impact factor=0.37) affected access and were therefore assigned to the causes group. However, empowerment, accessibility, adequacy, and availability were influenced by access and were therefore assigned to the effects group. Finally, affordability (1.05, 11.88) and availability (-0.57 and 11.35) were identified as the most and most miniature essential components, respectively.


An essential factor in military personnel is "hidden" dental complications. By evaluating dental complications, this component is reduced approximately one-third. Identifying critical factors of access help design prevention interventions, health prevention, and promotion policies and removing barriers to public access to oral health care.

Journal of Military Medicine, Volume:24 Issue: 9, 2023
1648 to 1659  
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