title: Dental health services utilization and associated factors in children 6 to 12 years old in a low-income country.
abstract: OBJECTIVE
  To determine the factors associated with the dental health services utilization among children ages 6 to 12 in León, Nicaragua.
  
  
  METHODS
  A cross-sectional study was carried out in 1,400 schoolchildren. Using a questionnaire, we determined information related to utilization and independent variables in the previous year. Oral health needs were established by means of a dental examination. To identify the independent variables associated with dental health services utilization, two types of multivariate regression models were used, according to the measurement scale of the outcome variable: a) frequency of utilization as (0) none, (1) one, and (2) two or more, analyzed with the ordered logistic regression and b) the type of service utilized as (0) none, (1) preventive services, (2) curative services, and (3) both services, analyzed with the multinomial logistic regression.
  
  
  RESULTS
  The proportion of children who received at least one dental service in the 12 months prior to the study was 27.7 percent. The variables associated with utilization in the two models were older age, female sex, more frequent toothbrushing, positive attitude of the mother toward the child's oral health, higher socioeconomic level, and higher oral health needs.
  
  
  CONCLUSIONS
  Various predisposing, enabling, and oral health needs variables were associated with higher dental health services utilization. As in prior reports elsewhere, these results from Nicaragua confirmed that utilization inequalities exist between socioeconomic groups. The multinomial logistic regression model evidenced the association of different variables depending on the type of service used.
authors.affiliation: Area Académica de Odontología del Instituto de Ciencias de la Salud de la Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, México. cemedinas@yahoo.com
authors.forename: Carlo Eduardo
authors.initials: CE
authors.lastname: Medina-Solis
authors.forename: Gerardo
authors.initials: G
authors.lastname: Maupomé
authors.forename: Herrera Miriam
authors.initials: HM
authors.lastname: del Socorro
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pérez-Núñez
authors.forename: Leticia
authors.initials: L
authors.lastname: Avila-Burgos
authors.forename: Hector
authors.initials: H
authors.lastname: Lamadrid-Figueroa
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D003710:Demography; D003752:Dental Health Services / Q000706:statistics & numerical data*; D003906:Developing Countries; D005260:Female; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D009527:Nicaragua; D025341:Principal Component Analysis; D012959:Socioeconomic Factors