title: [Multilevel analysis of the use of oral health services by the pediatric population].
abstract: OBJECTIVE
  To analyze the variables associated with the use of oral health services in the last year by the population aged 6 to 15 years living in Spain and to determine whether there is variability in the use of these services among autonomous regions and, if so, whether this variability could be explained by variables related to the care model of the distinct autonomous regions.
  
  
  METHODS
  A cross-sectional study of the Spanish National Health Survey (2006) was carried out. Independent variables were individual (sociodemographic, dental disease, habits and socioeconomic) and contextual (type of dental care model and prevalence of unemployment in the autonomous region). Association was estimated by multilevel logistic regression.
  
  
  RESULTS
  Variance in the use of oral health services among autonomous regions was 0.16 (SE: 0.07), and 4.8% of the total variability was attributable to the autonomous region. The variables included in the model explained 83.11% of the variance. Individual variables associated with an increased likelihood of using dental services were the presence of disease and the frequency of brushing. Individual variables associated with a lower likelihood were age, origin, intake of sugary soft drinks and socioeconomic status. The contextual variables of being covered by a dental care model (of the type Childhood Dental Care Plan) older than 10 years doubled the likelihood of using oral health services compared with those without such coverage (OR=2.47, CI=2.04-2.99).
  
  
  CONCLUSIONS
  The use of oral health services during the last year by the pediatric population in Spain is lower than recommended. This use is associated with individual variables (demographic, dental health, habits and socioeconomic factors) and contextual variables (dental care model).
authors.affiliation: Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España. bl.laura1@gmail.com
authors.forename: Laura
authors.initials: L
authors.lastname: Barriuso Lapresa
authors.forename: Belén
authors.initials: B
authors.lastname: Sanz Barbero
mesh_terms: D000293:Adolescent; D001628:Beverages; D002648:Child; D003430:Cross-Sectional Studies; D019140:Dental Care for Children / Q000706:statistics & numerical data*; D003752:Dental Health Services / Q000706:statistics & numerical data*; D019422:Dietary Sucrose; D005260:Female; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007347:Insurance, Dental / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D009909:Oral Health; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013030:Spain; D009057:Stomatognathic Diseases / Q000453:epidemiology; D014099:Toothbrushing / Q000706:statistics & numerical data
chemical_list: D019422:Dietary Sucrose