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

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.