title: Transnational dental care among Canadian immigrants.
abstract: OBJECTIVE
  This study examines predictors of transnational dental care utilization, or the use of dental care across national borders, over a 4-year period among immigrants to Canada.
  
  
  METHODS
  Data from the Longitudinal Survey of Immigrants to Canada (LSIC, 2001-2005) were used. Sampling and bootstrap weights were applied to make the data nationally representative. Bivariate and multiple logistic regression analyses were applied to identify factors associated with immigrants' transnational dental care utilization.
  
  
  RESULTS
  Approximately 13% of immigrants received dental care outside Canada over a period of 4 years. Immigrants lacking dental insurance (OR = 2.05; 95% CI: 1.55-2.70), those reporting dental problems (OR = 1.45; 95% CI: 1.12-1.88), who were female (OR = 1.59; 95% CI: 1.22-2.08), aged ≥ 50 years (OR = 2.30; 95% CI: 1.45-3.64), and who were always unemployed (OR = 1.70; 95% CI: 1.20-2.39) were more likely to report transnational dental care utilization. History of social assistance was inversely correlated with the use of dental services outside Canada (OR = 0.48; 95% CI: 0.30-0.83).
  
  
  CONCLUSIONS
  It is estimated that roughly 11 500 immigrants have used dental care outside Canada over a 4-year period. Although transnational dental care utilization may serve as an individual solution for immigrants' initial barriers to accessing dental care, it demonstrates weaknesses to in-country efforts at providing publicly funded dental care to socially marginalized groups. Policy reforms should be enacted to expand dental care coverage among adult immigrants.
authors.affiliation: Faculty of Dentistry & Global Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Paola
authors.initials: P
authors.lastname: Calvasina
authors.affiliation: Bloomberg Faculty of Nursing, Institute for Global Health Equity and Innovation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Carles
authors.initials: C
authors.lastname: Muntaner
authors.affiliation: Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
authors.forename: Carlos
authors.initials: C
authors.lastname: Quiñonez
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D003729:Dental Care / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007347:Insurance, Dental / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: dental care; dental insurance; immigrants; transnational care