Children's access to dental care during the COVID-19 pandemic: a multi-country survey

We assessed the impact of COVID-19 on children's access to dental care and determine factors associated with problems in accessing dental care. A multi-country cross-sectional survey collected data from caregivers of children from August 2020 to February 2021. The questionnaire was developed guided by the framework of the Andersen's model of factors (predisposing, enabling and need). Multilevel logistic regression was used to assess the association between access-to-dental care problem and predisposing, enabling and need factors. A total of 4,843 caregivers from 20-countries reported on their children (52.3% males, mean age = 8.4 years) with 29.2% having access to care problem. A significantly greater percentage of caregivers from lower-middle-income countries (LMICs) than low-income countries (LICs), upper-middle-income countries (UMICs) and high-income countries (HICs) reported an access-to-dental care problem (P < .001). Caregivers living in LICS, university-educated caregivers, caregivers with older children and caregivers whose children had more frequent pain during the pandemic had higher odds of reporting an access to dental care problem. The association of the access problem with dental pain and dental insurance was modified by country income, showing a link between macrolevel contextual factors and the utilization of dental care in children that needs to be addressed in future studies.