Longitudinal analysis of dental healthcare costs among adolescents living in Amsterdam
DOI:
https://doi.org/10.2340/aos.v85.46952Keywords:
Regular dental visits, dental healthcare, epidemiology, oral healthcare consumption, public dental health, dental care for children, dental health services, health care costsAbstract
Objectives: The aim was to analyze patterns of oral healthcare consumption from 2009 to 2016 of adolescents living in Amsterdam. It was assessed whether visiting a dentist earlier in childhood and regular dental attendance between ages 10 and 16 were associated with oral healthcare consumption at age 17. Dental costs (in euros) were used as a proxy for oral healthcare consumption since data on dental performance codes, number of visits, or clinical data were not available in this study.
Methods: The study population consisted of all 12-year-old adolescents living in Amsterdam in 2012. Retrospective, longitudinal data on dental costs and sociodemographics were obtained via Statistics Netherlands. Explanatory variables were whether dental costs were incurred at age 9 (in 2009; yes/no and amount) and whether consecutive dental costs were incurred from the age of 10 to 16 (between 2010 and 2015; yes/no). The outcome was dental costs at age 17 (in 2016; yes/no and amount).
Results: Dental costs at age 17 were available for 6,871 children. Dental costs at age 9 and consecutive dental costs were significantly associated with having dental costs at age 17. The amount of dental costs at age 9 was significantly and positively associated with higher dental costs at age 17. No association was found between consecutive dental costs during childhood and the amount of dental costs at age 17.
Conclusions: A large volume of oral healthcare consumption earlier in childhood was associated with high dental costs for 17-year-olds. Adolescents who regularly visited a dentist during childhood continued to do so at age 17. However, regular dental attendance was not associated with lower dental costs at age 17.
Downloads
References
Global oral health status report – towards universal health coverage for oral health by 2030. Geneva: World Health Organization. 2022.
Eurostat – statistics explained: consulting a dentist. 2021. [cited 2024 Oct 16] Available from: https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_activities_statistics_-_consultations
Winkelmann J, Gomez Rossi J, van Ginneken E. Oral health care in Europe: financing, access and provision. Health Syst Transit. 2022;24(2):1–176. DOI: https://doi.org/10.1093/eurpub/ckac129.372
Mondzorg in beeld [Report ‘Oral healthcare depicted’]. Amsterdam: ABN AMRO Bank; 2024.
Winkelmann J, Gomez Rossi J, Schwendicke F, Dimova A, Atanasova E, Habicht T, et al. Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach. BMC Oral Health. 2022;22(1):65. DOI: https://doi.org/10.1186/s12903-022-02095-4
Richtlijn Mondzorg voor Jeugdigen preventie en behandeling van cariës [Guideline for oral healthcare for children -prevention and treatment of caries]. Utrecht: Kennisinstituut Mondzorg [Dutch Institute of Expertise for Oral Healthcare]; 2020.
Thomson WM, Williams SM, Broadbent JM, Poulton R, Locker D. Long-term dental visiting patterns and adult oral health. J Dent Res. 2010;89(3):307–11. DOI: https://doi.org/10.1177/0022034509356779
Crocombe LA, Broadbent JM, Thomson WM, Brennan DS, Poulton R. Impact of dental visiting trajectory patterns on clinical oral health and oral health-related quality of life. J Public Health Dent. 2012;72(1):36–44. DOI: https://doi.org/10.1111/j.1752-7325.2011.00281.x
Lee JJM, Schluter PJ, Hodgett M, Deng B, Hobbs M. Adolescents and oral health service utilization in Canterbury, New Zealand: a geospatial cross-sectional study. Community Dent Oral Epidemiol. 2023;51(3):388–98. DOI: https://doi.org/10.1111/cdoe.12858
Amarasena N, Luzzi L, Brennan D. Effect of different frequencies of dental visits on dental caries and periodontal disease: a scoping review. Int J Environ Res Public Health. 2023;20(19):6858. DOI: https://doi.org/10.3390/ijerph20196858
Staat van de mondzorg – tandartsbezoek [State of the oral healthcare]. [cited 2024 Oct 16]. Available from: https://www.staatvandemondzorg.nl
Gezondheidsenquête [National health survey]. CBS [Statistics Netherlands]; 2023 [cited 2024 Oct 16].
Vereniging van Nederlandse Gemeenten [The Association of Netherlands Municipalities]. 2016–2021. [cited 2024 Oct 16]. Available from: https://www.waarstaatjegemeente.nl/dashboard/dashboard/gezondheid.
Zorginstituut Nederland [National Health Care Institute] – tandarts en mondzorg [Dentist and oral healthcare]. [cited 2024 Oct 16]. Available from: https://www.zorginstituutnederland.nl/Verzekerde+zorg/tandarts-en-mondzorg-zvw.
Staat van de mondzorg – preventieve en curatieve zorg [State of the oral healthcare] incl infographic Preventive treatment for children. 2022. [cited 2024 Oct 16]. Available from: https://www.staatvandemondzorg.nl
van Ligten TS, Duijster D, Zaura E, Volgenant CMC. Influence of early and regular dental visits on dental health care costs of primary school children in Amsterdam. Int Dent J. 2025;75(4):100839. DOI: https://doi.org/10.1016/j.identj.2025.100839
van Spreuwel P, van der Heijden G, Su N, van Loveren C, Jerkovic-Cosic K. Effective Prevention of Early Childhood Caries in Well-Baby Clinics: Results of a Pragmatic Randomized Trial. Caries Res. 2025;59(6):529-43. DOI: https://doi.org/10.1159/000545116
Verlinden DA, Reijneveld SA, Lanting CI, van Wouwe JP, Schuller AA. Socio-economic inequality in oral health in childhood to young adulthood, despite full dental coverage. Eur J Oral Sci. 2019;127(3):248–53. DOI: https://doi.org/10.1111/eos.12609
Royal Dutch Dental Association. Tarievenlijst tandheelkundige zorg [List of Dutch dental performance codes]. 2016.
Migratieachtergrond [Migration background]. The Hague: CBS [Statistics Netherlands]; 2021.
Rijksoverheid – voortgezet onderwijs [Government of the Netherlands- secondary education]. Available from: https://www.rijksoverheid.nl/onderwerpen/voortgezet-onderwijs
Opleidingsniveau [Educational level]. The Hague: CBS [Statistics Netherlands]; 2020.
IBM Corp. IBM SPSS statistics for windows, Version 25.0. Armonk, NY: IBM Corp; 2017.
Broadbent JM, Foster Page LA, Thomson WM, Poulton R. Permanent dentition caries through the first half of life. Br Dent J. 2013;215(7):E12. DOI: https://doi.org/10.1038/sj.bdj.2013.991
Nowak AJ, Casamassimo PS, Scott J, Moulton R. Do early dental visits reduce treatment and treatment costs for children? J Mich Dent Assoc. 2016;98(1):36–42.
Baadoudi F, Maskrey N, Listl S, van der Heijden GJ, Duijster D. Improving oral healthcare: towards measurement? Br Dent J. 2016;221(9):547–8. DOI: https://doi.org/10.1038/sj.bdj.2016.813
Brennan DS, Spencer AJ. Influence of patient, visit, and oral health factors on dental service provision. J Public Health Dent. 2002;62(3): 148–57. DOI: https://doi.org/10.1111/j.1752-7325.2002.tb03436.x
Nermo H, Hadler-Olsen E. Are dental visiting patterns and oral pain associated with dental disease among Norwegian adults? A cross-sectional study based on the Tromso study. Clin Exp Dent Res. 2023;9(4):679–88. DOI: https://doi.org/10.1002/cre2.753
Ghanem AS, More M, Nagy AC. Assessing the impact of sociodemographic and lifestyle factors on oral health: a cross-sectional study in the Hungarian population. Front Public Health. 2023;11:1276758. DOI: https://doi.org/10.3389/fpubh.2023.1276758
Signalement Mondzorg [Description of oral healthcare]. Diemen: Zorginstituut Nederland [National Health Care Institute]; 2018.
Schuller AA, Vermaire JH, Verrips GHW. [Kies-voor-Tanden Study: caries among 17-year-olds in the Netherlands]. Ned Tijdschr Tandheelkd. 2020;127(2):109–17. DOI: https://doi.org/10.5177/ntvt.2020.02.19088
Julihn A, Ekbom A, Modeer T. Migration background: a risk factor for caries development during adolescence. Eur J Oral Sci. 2010;118(6): 618–25. DOI: https://doi.org/10.1111/j.1600-0722.2010.00774.x
Bissar AR, Oikonomou C, Koch MJ, Schulte AG. Dental health, received care, and treatment needs in 11- to 13-year-old children with immigrant background in Heidelberg, Germany. Int J Paediatr Dent. 2007;17(5):364–70. DOI: https://doi.org/10.1111/j.1365-263X.2007.00846.x
Brennan DS, Spencer AJ. Childhood oral health and SES predictors of caries in 30-year-olds. Caries Res. 2014;48(3):237–43. DOI: https://doi.org/10.1159/000354044
Singh A, Peres MA, Watt RG. The relationship between income and oral health: a critical review. J Dent Res. 2019;98(8):853–60. DOI: https://doi.org/10.1177/0022034519849557
Kallestal C, Wall S. Socio-economic effect on caries. Incidence data among Swedish 12–14-year-olds. Community Dent Oral Epidemiol. 2002;30(2):108–14. DOI: https://doi.org/10.1034/j.1600-0528.2002.300204.x
Hall-Scullin E, Whitehead H, Milsom K, Tickle M, Su TL, Walsh T. Longitudinal study of caries development from childhood to adolescence. J Dent Res. 2017;96(7):762–7. DOI: https://doi.org/10.1177/0022034517696457
Huishoudinkomen [Household income]. The Hague: CBS [Statistics Netherlands]; 2025.
Published
Issue
Section
License
Copyright (c) 2026 Tessa S. van Ligten, Catherine M.C. Volgenant, Egija Zaura, Denise Duijster
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Odontologica Scandinavica publishes high quality original research papers as well as critical reviews relevant on diseases of the oral cavity, their treatment, epidemiology and associated biomaterials and their development.
