Dental Self-Medication and the Systemic Access Paradox in an Urban Turkish Clinical Population

Background To determine the prevalence of dental self-medication (D-SM) and to evaluate the structural, behavioral, and clinical factors associated with this behavior in a clinical population with high health insurance coverage and urban access to care. Methods This cross-sectional study included 253 adult patients who attended the Periodontology Clinic at the Uşak University Faculty of Dentistry. Data were collected using a 27-item structured questionnaire that assessed sociodemographic characteristics, oral health behaviors, D-SM practices, clinical triggers, and disclosure of D-SM to dentists. Results Although 92.9% of participants had active health insurance coverage, 24.1% reported D-SM. The most common reason for D-SM was difficulty obtaining a dental appointment (26.2%), with toothache being the main clinical trigger (73.8%). Among those practicing D-SM, 75.4% initially used pharmacological agents, mainly analgesics, and antibiotic use was reported in 10.9% of cases. The most common reference used to guide decision-making was previous dental treatment experience (32.8%). When the internet was the primary source of consultation, the prevalence of D-SM increased to 87.5%. D-SM was significantly more prevalent among participants aged 18–30 years (39.3%, p = 0.019) and among those employed in the health sector (41.7%, p = 0.009). Additionally, 59.0% of self-medicating participants did not disclose this behavior to their dentists. Conclusion D-SM persists even in populations with high insurance coverage and urban access to dental care, highlighting a systemic access paradox. This behavior seems to be driven not only by knowledge gaps but also by operational access barriers, a pain-centered reactive pattern, digital and social information pathways, and a significant clinical communication gap. Addressing this issue requires a multi-level strategy that includes rapid access or triage systems, improved digital health literacy, and trust-based clinical communication that routinely screens for D-SM behavior.