“Since I never felt pain, it didn’t occur to me to visit a dental clinic”: a qualitative exploration of social perceptions and influencers of oral care-seeking behaviour among adult Nigerians

Abstract

Despite the growing recognition of oral health as a vital component of overall well-being, utilization of dental services in many low- and middle-income countries remains low. In Nigeria, oral health-seeking behavior is often delayed, reactive, and shaped by complex socio-cultural and economic factors. Understanding these influences is essential to developing responsive oral health policies and interventions. This study explored the perceptions of Nigerian adults regarding the factors influencing their choice of oral health care and how these choices impact their oral health-related quality of life (OHRQoL). A qualitative study using a thematic approach was conducted at the Dental Centre of the University College Hospital, Ibadan. Twenty-five purposively selected adult patients attending the clinic for the first time participated in in-depth, semi-structured interviews. Interviews were conducted in English or Yoruba, transcribed, and thematically analyzed using ATLAS.ti 8. Data saturation, the point at which no new themes or concepts were emerging from subsequent interviews, was reached and reflexivity was maintained throughout the study to reduce bias. Three overarching themes emerged: (1) Factors driving care-seeking behavior, (2) Influencers of oral healthcare choices, and (3) The perceived impact of these choices on oral health-related quality of life. Most participants sought care only in response to pain, highlighting a predominantly symptom-driven pattern of behavior. Key barriers included financial constraints, fear of dental procedures, limited accessibility to services, and misinformation, often passed through family or community networks. Influences such as spousal encouragement, social media exposure, and self-motivation also shaped healthcare decisions. Participants reported that delayed care adversely affected their quality of life, contributing to physical discomfort, psychological distress, and reduced self-esteem. Oral health-seeking behavior among Nigerian adults is influenced by a complex interplay of economic, cultural, psychological, and systemic factors. Addressing these barriers requires multi-level interventions, including community-based oral health education, integration of dental services into primary healthcare, expansion of insurance coverage, and patient-centered clinical care. Leveraging social media for accurate health communication and fostering early health education through schools and family-centered programs are also recommended. These findings provide critical insights for policymakers, healthcare providers, and researchers aiming to improve oral health outcomes in Nigeria.