Dental service utilization trends in rural and semiurban health centers of Isfahan, Iran (2016–2021): A retrospective descriptive study

Abstract

Background: Iran’s oral health reform plan aimed to shift primary dental care toward prevention
through the family dentist program, yet longitudinal evidence on real‑world service mix is limited.
We assessed 6‑year trends in dental service utilization in rural and semiurban primary healthcare
facilities in Isfahan, Iran.
Materials and Methods: This retrospective, longitudinal, observational, descriptive study analyzed
aggregated service counts extracted from Iran’s integrated health system (SIB) for two healthcare
networks in Isfahan from 2016 to 2021. We included Level 2 clinical procedures recorded under the
family dentist program and categorized them as preventive (fluoride varnish, fissure sealants, and
scaling) or curative/treatment (restorations, extractions, and pulpotomy). Trends were summarized
using annual volumes, year‑to‑year percentage change, and the proportional share of preventive
versus curative services. Data were analyzed using descriptive statistics; no inferential statistical tests
were applied, and a significance threshold was not defined, given the descriptive nature of the study.
Results: A total of 133,075 Level 2 dental services were delivered over the study period. Utilization
peaked in 2017 (28,290 services) and remained high in 2019 (28,027), suggesting a period of
increased throughput during the implementation and maturation of the oral health reform package
in primary health care, followed by a sharp decline in 2020 (11,215; −60.0% vs. 2019) and partial
recovery in 2021 (20,691; +84.5% vs. 2020). Preventive share dropped to 7.2% in 2017, increased
to 21.0% by 2019, and remained near 19% in 2020–2021. Health Center No. 2 delivered a higher
cumulative volume than No. 1 (76,697 vs. 56,378 services). Permanent tooth extractions were the
most frequent procedure (66,152), exceeding the total number of restorations (28,160).
Conclusion: Despite a stable preventive component in later years and postpandemic recovery,
service delivery remained strongly treatment‑ and extraction‑oriented, indicating a limited shift
toward prevention within the primary care dental package.
Key Words: Dental care, health services accessibility, primary health care, rural health services

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Firoozeh Nilchian: Pubmed,Google Scholar