OBJECTIVES : Sub-Saharan Africa, the world’s poorest region faces an extreme scourge of HIV/AIDS and non-communicable diseases (NCDs) in a milieu of political and economic instability. Oral diseases like Noma, dental caries and oral cancer are prevalent NCDs causing pain, disfigurement, and death. Community based studies on barriers in the use of oral health services are sparse in Nigeria. This study describes predisposing, enabling, and need factors on oral health service utilization pattern in Lagos, Nigeria.

METHODS : 400 rural and urban respondents were enlisted by multi-stage sampling and the cross-sectional design was implemented through face-to-face interviews. Covariates included demographic characteristics, health insurance, health facilities/personnel in the community and perceived need while outcome of interest was prior unmet oral health needs. Pearson’s χ2 and logistic regression analyses ascertained associations.

RESULTS : Only 35.5% (n= 142) respondents had ever utilized oral health services while the prevalence of unmet need was 62.9% and 47.1% in the rural and urban regions respectively; Cost, fear and absence of clinics were the most cited barriers. Logistic regression modelling showed these unmet needs were significantly more likely among rural residents (OR = 4.93, CI = 2.01–10.16), those with <12yrs of formal education (OR=3.84, CI= 2.66-5.97), financial constraints (OR=4.89, CI = 1.89-9.86), poor attitude (OR: 2.47; CI: 1.33-5.25) and distant dental clinics (OR = 3.81, CI = 2.32-6.02). [p values < 0.001)

CONCLUSIONS : Our study highlights the inequities in oral health delivery especially among the poorly educated and deprived rural residents. Policies are required to address cost, health insurance, tax rebates for employers that provide health care benefits; incentives for personnel in rural areas and to attract counterpart funding from donor agencies. These approaches are required to increase funding for public health, refocus service provision towards preventive care and to incorporate oral health components in the existing primary health care system.