Dental service utilization among hospitalized patients with psychiatric and/or substance use disorders: a Norwegian cross-sectional study.

INTRODUCTION: Individuals with psychiatric and/or substance use disorders often have poor oral health, yet utilization of dental services remains low. This study examined dental attendance, barriers to care, and factors associated with regular dental care among inpatients in Norway. METHODS: This cross-sectional study included 138 adults hospitalized in specialist mental health and substance use services at the University Hospital of North Norway (median age 35.5 years, range 19-70, 60% men, 40% women). Participants completed a structured questionnaire covering various health domains and underwent clinical and radiographic oral examinations. Associations with irregular dental care, defined as attending dental services regularly less than every second year, were examined using block-wise logistic regression guided by Andersen's Behavioral Model of Health Service Use to evaluate the relative contribution of predisposing, enabling, behavioral, and need-related factors. The study was approved by the Regional Committee for Medical and Health Research Ethics, and all participants provided written informed consent. RESULTS: Regular dental care was reported by 28.7%, while 49.3% sought care for acute problems only. Financial constraints and dental fear were the main barriers to regular dental care. Negative experiences with dental care were frequently reported. In multivariable regression, lack of or unknown entitlement to free dental care was strongly associated with irregular care (OR = 3.15, 95% CI, 1.30-7.64). Lower toothbrushing frequency (OR = 2.53, 95% CI, 1.06-6.02) and low educational attainment (OR = 4.13, 95% CI, 1.03-16.62) were also associated with irregular care. After adjustment, neither self-reported dental health nor clinically assessed dental health was associated with regular dental care. CONCLUSION: Regular dental care was low despite poor oral health and was more strongly associated with entitlement to free dental care, toothbrushing frequency, and educational attainment than with clinical indicators of treatment need. Improving dental service utilization in this population may require not only financial coverage, but also clearer pathways into care and patient-centered approaches that promote safety, trust, and sustained engagement with dental services.