{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:45:44Z","timestamp":1785757544149,"version":"3.56.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Iran\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This retrospective, longitudinal, observational, descriptive study analyzed aggregated service counts extracted from Iran\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>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; \u221260.0% 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/drj.drj_716_25","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:00:13Z","timestamp":1785754813000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Dental service utilization trends in rural and semiurban health centers of Isfahan, Iran (2016-2021): A retrospective descriptive study"],"prefix":"10.4103","volume":"23","author":[{"given":"Pourya","family":"Tatari","sequence":"first","affiliation":[{"name":"Department of Oral Public Health, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Rezayatmand","sequence":"additional","affiliation":[{"name":"Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firoozeh","family":"Nilchian","sequence":"additional","affiliation":[{"name":"Department of Dental Public Health, Dental Materials Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6]]},"reference":[{"key":"R1-20260803","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1186\/s12903-025-06808-3","article-title":"Costs in dental care: A scoping review of methodologies and trends","volume":"25","author":"Tatari","year":"2025","journal-title":"BMC Oral Health"},{"key":"R2-20260803","doi-asserted-by":"crossref","first-page":"802","DOI":"10.26719\/2017.23.12.802","article-title":"Challenges impeding integration of oral health into primary health care","volume":"23","author":"Ghorbani","year":"2018","journal-title":"East Mediterr Health J"},{"key":"R3-20260803","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/j.1875-595X.2004.tb00013.x","article-title":"Oral health in Iran","volume":"54","author":"Pakshir","year":"2004","journal-title":"Int Dent 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