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Equality of specialist orthodontic care for adolescents in the Swedish public dental service : a cohort study

Göranson, Emma ; Sonesson, Mikael ; Dimberg, Lillemor ; Vähäsarja, Niko LU and Naimi-Akbar, Aron (2025) In BMC Oral Health 25(1).
Abstract

Background: In Sweden, dental care for children and adolescents, including specialist orthodontic treatment, is publicly funded. This study aims to analyze the impact of sociodemographic factors on the distribution of publicly funded specialist orthodontic treatment in a mid-sized Swedish region. Methods: A registry-based cohort study was conducted in Region Östergötland, including individuals born between 2000 and 2003. Sociodemographic data were obtained from Statistics Sweden (SCB), while dental health information was sourced from The Swedish Quality Registry for Caries and Periodontal Disease (SKaPa). The primary outcome variable was initiation of specialist orthodontic treatment, extracted from dental records. Statistical analysis... (More)

Background: In Sweden, dental care for children and adolescents, including specialist orthodontic treatment, is publicly funded. This study aims to analyze the impact of sociodemographic factors on the distribution of publicly funded specialist orthodontic treatment in a mid-sized Swedish region. Methods: A registry-based cohort study was conducted in Region Östergötland, including individuals born between 2000 and 2003. Sociodemographic data were obtained from Statistics Sweden (SCB), while dental health information was sourced from The Swedish Quality Registry for Caries and Periodontal Disease (SKaPa). The primary outcome variable was initiation of specialist orthodontic treatment, extracted from dental records. Statistical analysis was performed using Stata v.18.1. Results: The cohort comprised 16 893 individuals, with 51.5% males and 48.5% females. Specialist orthodontic treatment was initiated for 25.7% of the population (n = 4 342), with most treatments involving fixed appliances. Several sociodemographic factors were significantly associated with the likelihood of receiving orthodontic treatment. Females had 1.74 times higher odds (95% CI: 1.63–1.87) of receiving treatment compared to males. Individuals born in Sweden had 1.42 times greater odds (95% CI: 1.18–1.72) of receiving treatment compared to those born abroad. Similarly, children with Swedish-born parents had 1.16 times increased odds (95% CI: 1.04–1.30) compared to children with foreign-born parents. Children of mothers with university/college education had an OR of 1.29 (95% CI: 1.12–1.48), while those whose fathers had a university/college education had an OR of 1.19 (95% CI: 1.05–1.34), compared to parents with primary/lower secondary education. Conclusions: Males, individuals born outside Sweden, those with foreign born parents, and whose parents had lower educational levels were less likely to receive orthodontic treatment within the publicly funded dental health services in Region Östergötland. These findings suggest that sociodemographic factors influenced the distribution of orthodontic care, though the role of treatment demand requires further investigation.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cohort study, Healthcare disparities, Orthodontics, Sociodemographic Factors
in
BMC Oral Health
volume
25
issue
1
article number
841
publisher
BioMed Central (BMC)
external identifiers
  • pmid:40437452
  • scopus:105006739680
ISSN
1472-6831
DOI
10.1186/s12903-025-06220-x
language
English
LU publication?
yes
id
13344a4b-8fd3-43d4-a824-4d8a8941572e
date added to LUP
2025-07-15 09:12:31
date last changed
2025-07-15 09:13:46
@article{13344a4b-8fd3-43d4-a824-4d8a8941572e,
  abstract     = {{<p>Background: In Sweden, dental care for children and adolescents, including specialist orthodontic treatment, is publicly funded. This study aims to analyze the impact of sociodemographic factors on the distribution of publicly funded specialist orthodontic treatment in a mid-sized Swedish region. Methods: A registry-based cohort study was conducted in Region Östergötland, including individuals born between 2000 and 2003. Sociodemographic data were obtained from Statistics Sweden (SCB), while dental health information was sourced from The Swedish Quality Registry for Caries and Periodontal Disease (SKaPa). The primary outcome variable was initiation of specialist orthodontic treatment, extracted from dental records. Statistical analysis was performed using Stata v.18.1. Results: The cohort comprised 16 893 individuals, with 51.5% males and 48.5% females. Specialist orthodontic treatment was initiated for 25.7% of the population (n = 4 342), with most treatments involving fixed appliances. Several sociodemographic factors were significantly associated with the likelihood of receiving orthodontic treatment. Females had 1.74 times higher odds (95% CI: 1.63–1.87) of receiving treatment compared to males. Individuals born in Sweden had 1.42 times greater odds (95% CI: 1.18–1.72) of receiving treatment compared to those born abroad. Similarly, children with Swedish-born parents had 1.16 times increased odds (95% CI: 1.04–1.30) compared to children with foreign-born parents. Children of mothers with university/college education had an OR of 1.29 (95% CI: 1.12–1.48), while those whose fathers had a university/college education had an OR of 1.19 (95% CI: 1.05–1.34), compared to parents with primary/lower secondary education. Conclusions: Males, individuals born outside Sweden, those with foreign born parents, and whose parents had lower educational levels were less likely to receive orthodontic treatment within the publicly funded dental health services in Region Östergötland. These findings suggest that sociodemographic factors influenced the distribution of orthodontic care, though the role of treatment demand requires further investigation.</p>}},
  author       = {{Göranson, Emma and Sonesson, Mikael and Dimberg, Lillemor and Vähäsarja, Niko and Naimi-Akbar, Aron}},
  issn         = {{1472-6831}},
  keywords     = {{Cohort study; Healthcare disparities; Orthodontics; Sociodemographic Factors}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Oral Health}},
  title        = {{Equality of specialist orthodontic care for adolescents in the Swedish public dental service : a cohort study}},
  url          = {{http://dx.doi.org/10.1186/s12903-025-06220-x}},
  doi          = {{10.1186/s12903-025-06220-x}},
  volume       = {{25}},
  year         = {{2025}},
}