Multimorbidity and Essential Dental Care Needs: Results From the 2003 and 2016-2017 Chilean National Health Survey.

OBJECTIVES: Oral diseases (ODs) and multimorbidity (MM) are major global public health challenges that share common risk factors. Chile has implemented the 'Multimorbidity patient-centred care model' (MPCM) to address this; however, improving oral healthcare for adults remains an unresolved challenge. This study aimed to compare the essential dental care need (EDCN) among Chilean adults with different levels of MM between ENS 2003 and 2016-17 National Health Surveys (ENS). METHODS: A serial cross-sectional study was conducted using secondary data from the ENS 2003 and ENS 2016-2017. Two MM definitions based on 18 chronic conditions were used: a standard definition (MM≥ 2 conditions) and a second approach categorising participants into four levels (MMG0-G3) using the MPCM risk score. EDCN was defined as the presence of at least one tooth with cavitated caries or a need for dentures. Crude and adjusted prevalence ratios (PR) were estimated using robust Poisson regression models accounting for the complex survey design. Three sensitivity analyses were performed for the missing data, and stratified analyses by age (< 65 vs. ≥ 65 years) and by time since last dental visit. The significance level was set to 0.05. RESULTS: A total of 2157 participants from ENS 2003 and 4024 from ENS 2016-17 were included. Among participants with MM, EDCN prevalence was 81.6% (95% CI: 74.5-85.1) in ENS 2003 and 69.2% (95% CI: 64.9-72.9) in ENS 2016-17. After adjustment for confounders, the prevalence of EDCN among those with MM≥ 2 decreased from 71.0% in ENS 2003 to 46.8% in ENS 2016-17. In the ENS 2016-17, after adjusting for confounders, participants < 65 years in the highest MM category (MMG3) had a 26% higher prevalence of EDCN compared to those in MMG0. CONCLUSIONS: Analyses from ENS 2016-17 suggest that greater MM burden may be associated with higher prevalence of EDCN among adults aged < 65 years. Strategies aimed at improving adult oral healthcare coverage and integrating the prevention of MM and ODs in younger populations may help reduce unmet dental care needs.