Barriers to dental service utilization in children: a systematic review and meta-analysis

BACKGROUND: Oral health is important for overall well-being, as it affects a person’s ability to speak and eat. However, the use of dental services is often limited by factors such as cost, transportation, and fear. This systematic review and meta-analysis study aims to assess the barriers that limit the use of dental services among children. MATERIALS AND METHODS: The study’s eligibility criteria included cross-sectional studies published in English up to August 2024 that reported parental perceptions of the barriers to dental service use among children. This systematic review follows the Cochrane Handbook for Systematic Reviews of Interventions and the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Newcastle-Ottawa Quality Assessment Scale was used to evaluate the methodological quality of the included articles. For the meta-analysis, random-effects models were conducted, and forest plots were used to present the results. RESULTS: Three databases were searched: PubMed, Google Scholar, and Web of Science. A total of 794 titles were screened, and 11 studies were included in the final analysis. The primary outcome was the percentage of the children who did not utilize dental services due to cost, transportation, and fear. Among these included studies, 27% of parents identified cost as a barrier to their children’s use of dental services (95% CI: 0.12–0.46). An additional 14% of parents reported fear as a barrier (95% CI: 0.02–0.35), and 7% of parents reported transportation as a barrier (95% CI: 0.01–0.16). CONCLUSION: This systematic review and meta-analysis study identifies cost as the highest reported barrier by parents regarding dental service utilization by their children. It may be recommended to raise awareness about the importance of oral health and address these barriers by formulating targeted policies and healthcare strategies.