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All Journal Cakradonya Dental Journal
Fadli Alwi
Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan

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Healthcare Access Barriers, Socioeconomic, and Perceived Dental Needs Associated with Dental Self-Treatment Among Non-Utilizing Adults Fadli Alwi; Eka Julianti; Lia Handayani
Cakradonya Dental Journal Vol. 18 No. 1 (2026): February
Publisher : FKG Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/cdj.v18i1.624

Abstract

Dental self-treatment represent a significant public health challenge in Indonesia, accompanied by persistently low utilization of professional dental services. This study investigated the association between barriers to healthcare access and dental self-treatment among adults in Aceh, Indonesia, while adjusting for socioeconomic factors and perceived dental health needs. This cross-sectional study analysed data from N=11,061 non-users of dental services with reported dental and oral health needs (aged ≥25 years) derived from the 2023 Indonesian National Health Survey (SKI). Multilevel Poisson regression was applied to estimate prevalence ratios (PRs) with 95% confidence intervals (CIs). The results show prevalence of dental self-treatment was 47.7%, with significant district-level variation (VPC=3.83%). After adjusting for covariates, prolonged waiting time (PR=1.48; 95% CI: 1.35–1.63) and financial constraints (PR=1.20; 95% CI: 1.05–1.37) were associated with self-treatment. A cumulative effects following a dose-response pattern: individuals experiencing only one healthcare access barrier  had a higher prevalence of self-treatment (PR=1.43; 95% CI: 1.27–1.60), while those facing three barriers (waiting time, financial constraints, and distance) showed an even stronger association (PR=2.01; 95% CI: 1.63–2.47). These findings may reflect a systemic access limitations. The higher prevalence of dental self-treatment may be explained by the coexistence of clinical urgency, structural barriers, and socioeconomic vulnerabilities.
Associations of Health Insurance Type and Wealth Status Quintiles with Dental Care Utilization Among Indonesian Adults Pemmika Intato; Fadli Alwi
Cakradonya Dental Journal Vol. 18 No. 2 (2026): August
Publisher : FKG Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/cdj.v18i2.2173

Abstract

Dental care utilization remains low in Indonesia, structured by complex socioeconomic gradients. This cross-sectional study investigated the independent and interactive associations of health insurance type and wealth status quintiles with dental care utilization among Indonesian adults aged ≥ 25 years. Overall survey-weighted prevalence of dental care utilization was 8.27% [95% CI: 8.10, 8.43]. Compared with being uninsured, all health insurance types were significantly associated with higher utilization, led by private/other insurance (PR = 1.96; 95% CI: 1.79–2.13), government non-subsidized insurance (PR = 1.46; 95% CI: 1.39–1.54), and government subsidized insurance (PR = 1.24; 95% CI: 1.18–1.31). The highest quintile exhibited double the utilization of the lowest stratum (PR = 2.22; 95% CI: 2.06–2.40). Across all four insurance types, absolute risk differences between the highest and lowest wealth quintiles persisted (ranging from +7.00% to +19.68%), although formal multiplicative interaction terms were not statistically significant. Health insurance coverage and wealth status are independently associated with higher dental care utilization. Nevertheless, wealth-related differences in visits persist across all insurance types, indicating that targeted policy interventions addressing broader socioeconomic barriers remain essential.
Co-Authors Eka Julianti Lia Handayani Pemmika Intato