Background/Objectives: Health system socio-economic inequities in dental care are a long-standing problem in Europe. The issue gained increased relevance during the recent pandemic due to service disruption and socio-economic inequities that become even more pronounced under such circumstances. However, while preventive dental programs are considered key elements of public health, little is known about their role in addressing equity in accessing dental care among different countries and over time between them. This research aims at investigating the relationship between preventive dental policy, socio-economic factors, and the inability to get appropriate dental care within EU member states. Methods: A longitudinal panel dataset at the country level, consisting of data collected during 2020 through 2024, was assembled using open sources of statistics from Europe and other international statistical databases. The dependent variable used in the study was the percentage of the population that had unmet dental care need because of cost. Independent variables were the presence or absence of preventive policies related to dentistry, educational attainment, gross domestic product per capita, unemployment rate, number of dentists, and out-of-pocket expenses. Balanced panel datasets and regressions with robust standard errors in random-effects models were estimated. Interaction terms were created to test the moderating effect of education level on the relationship between policies and access to care. Results: Cross-country variations in terms of the prevention policy environment, socio-economic status, and unmet dental care need were found from descriptive analysis. The higher level of out-of-pocket payment was always related to the higher unmet dental care need, while the lower GDP countries displayed poorer access. Using the balanced panel random-effects model, preventive dental policies and the interaction between preventive policies and educational level were insignificant factors predicting the unmet dental care need. On the other hand, higher out-of-pocket payments, education, and dentists per million population had nearly significant positive relationships. In the sensitivity analysis, GDP per capita showed a negative association, whereas dentists per million population remained positively associated with unmet dental care need. Conclusions: The findings suggest that inequalities in access to dental care during and after the COVID-19 period were shaped primarily by financial and structural determinants rather than by the presence of preventive policies alone. While preventive programs remain an important component of long-term oral health strategies, reducing direct household payment burden and strengthening health system capacity may represent more immediate mechanisms for maintaining equitable access to dental services during periods of system disruption.
Lupita et al. (Wed,) studied this question.