Theoretical frameworks for explaining dental health service utilization: A scoping review

Cahyannisa Farah, Iwany Amalliah Badruddin, Herry Novrinda, Armasastra Bahar, Han Dong-Hun

Abstract


Introduction: Oral diseases remain a major global public health challenge, contributing to disability, reduced quality of life, and increased healthcare costs. Although regular dental attendance improves oral health outcomes, the utilization of dental health services remains unequal across population due to complex individual, social, structural, and policy-related factors. Theoretical models are essential for understanding these determinants and informing interventions to improve access and equity, yet a comprehensive synthesis of these models is lacking. This scoping review aimed to identify, map, and synthesize theoretical models used to explain dental health service utilization. Methods: A scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Eight electronic databases (PubMed, Scopus, ProQuest, Cochrane Library, ScienceDirect, SpringerLink, JSTOR, and Emerald Insight) were searched, supplemented by manual screening of reference lists. English-language publications from 1960 to 2025 that proposed, adapted, or conceptualized theoretical models of dental health service utilization were included. Study selection, duplicate removal, and screening were performed using Rayyan.ai, followed by a narrative synthesis of study characteristics, theoretical foundations, and model components. Results: Of the 1,037 records identified, 25 studies met the inclusion criteria. Most were published after 2000 and originated from high-income countries, particularly Europe and the United States, with limited evidence from middle-income settings. Models were applied across diverse populations, including children, adults, older adults, women, migrants, rural communities, and other vulnerable groups. Most were adaptations of established health service utilization frameworks, while fewer proposed novel or context-specific models. Determinants were consistently grouped into five domains: individual characteristics, enabling and structural factors, need-related factors, psychosocial influences, and broader contextual and policy determinants. Conclusion: This review provides the a comprehensive synthesis of theoretical models explaining dental health service utilization. The findings offer a conceptual foundation for future research and support evidence-informed policies and interventions to improve equitable access to dental health services.

Keywords


dental health services, utilization, theoretical model

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References


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DOI: https://doi.org/10.24198/pjd.vol38no2.69159

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