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Álvarez-Cruces DJ, Otondo-Briceño M, Nocceti-de-la-Barra A, Medina-Moreno A, Henríquez-Tejo R. Cultural topics with clinical implications needed in the dental curriculum to develop intercultural competence: A systematic review. J Dent Educ 2024; 88:922-932. [PMID: 38551308 DOI: 10.1002/jdd.13509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/02/2024] [Accepted: 02/23/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE To identify cultural topics with clinical implications to be incorporated into the dentistry curriculum to develop Intercultural Competence. METHODS Systematic review with PRISMA criteria that exported 216 articles from the Web of Science, Scopus, and SciELO databases from 2012 to 2022, of which 40 were selected. The inclusion criteria were theoretical and empirical scientific articles, of quantitative, qualitative, or mixed methods nature, on cultural topics. RESULTS The data analysis allowed the organization of information into four cultural topics: Development of professional intercultural self-awareness, Individual, family, and cultural implications, Construction of intercultural therapeutic relationships, and Specific clinical aspects, each with particular contents to be developed in the dentistry curriculum. However, some clinical issues have yet to be explored in-depth, leaving research possibilities open to all disciplines in dentistry. Additionally, it is necessary to analyze the cultural bias in the discussion and conclusion of some reviewed articles, as they were conducted from an ethnocentric perspective. Thus, peer reviewers of scientific journals and researchers in these topics must have appropriate training in Intercultural Competence. CONCLUSIONS This review provides a guide and pedagogical sequence of the cultural topics that should be incorporated into the dentistry curriculum to achieve Intercultural Competence, it also highlights a wide range of relevant aspects to consider in establishing an adequate therapeutic relationship. Explicit accreditation criteria contribute to the establishment of Intercultural Competence in the curricula; however, in countries that lack regulations, there is a moral and ethical duty to incorporate the subject so that the future professional can manage and establish inclusive healthcare.
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Affiliation(s)
- Debbie J Álvarez-Cruces
- Departamento de Patología y Diagnóstico, Facultad de Odontología, Universidad de Concepción, Concepcion, Chile
- Facultad de Educación, Universidad Católica de la Santísima Concepción, Concepcion, Chile
| | - Maite Otondo-Briceño
- Facultad de Educación, Universidad Católica de la Santísima Concepción, Concepcion, Chile
| | | | - Alejandra Medina-Moreno
- Departamento de Patología y Diagnóstico, Facultad de Odontología, Universidad de Concepción, Concepcion, Chile
| | - Rocío Henríquez-Tejo
- Departamento de Salud Pública, Facultad de Odontología, Universidad de Concepción, Concepcion, Chile
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Patel J, Nattabi B, Long R, Durey A, Naoum S, Kruger E, Slack-Smith L. The 5C model: A proposed continuous quality improvement framework for volunteer dental services in remote Australian Aboriginal communities. Community Dent Oral Epidemiol 2023; 51:1150-1158. [PMID: 36812158 DOI: 10.1111/cdoe.12850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVES Aboriginal and Torres Strait Islander communities in remote parts of Australia are some of the most underserviced communities in regard to oral health care. These communities rely on volunteer dental programmes such as the Kimberley Dental Team to fill the gaps in care, however, there are no known continuous quality improvement (CQI) frameworks to guide such organizations to ensure that they are delivering high-quality, community-centred, culturally appropriate care. This study proposes a CQI framework model for voluntary dental programmes providing care to remote Aboriginal communities. METHODS Relevant CQI models wherein the (i) behaviour of interest was quality improvement, and (ii) the health context was volunteer services in Aboriginal communities were identified from the literature. The conceptual models were subsequently augmented using a 'best fit' framework and the existing evidence synthesized to develop a CQI framework that aims to guide volunteer dental services to develop local priorities and enhance current dental practice. RESULTS A cyclical five-phase model is proposed starting with consultation and moving through the phases of data collection, consideration, collaboration and celebration. CONCLUSIONS This is the first proposed CQI framework for volunteer dental services working with Aboriginal communities. The framework enables volunteers to ensure that the quality of care provided is commensurate with the community needs and informed by community consultation. It is anticipated that future mixed methods research will enable formal evaluation of the 5C model and CQI strategies focusing on oral health among Aboriginal communities.
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Affiliation(s)
- Jilen Patel
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Barbara Nattabi
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Robyn Long
- Jungarni-Jutiya Indigenous Corporation, Halls Creek, Western Australia, Australia
| | - Angela Durey
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Steven Naoum
- Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Estie Kruger
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Patel J, Bear N, Long R, Naoum S, Slack-Smith L, Kruger E. The Kimberley Dental Team: A process evaluation of a volunteer dental programme serving remote Aboriginal communities in Australia. Community Dent Oral Epidemiol 2023; 51:1241-1249. [PMID: 37306125 DOI: 10.1111/cdoe.12885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 05/04/2023] [Accepted: 05/29/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aims to conduct a process evaluation of the Kimberley Dental Team (KDT), a not-for-profit, volunteer organization providing care to remote Aboriginal communities in Western Australia. METHODS A logic model was constructed to detail the operational context of the KDT model. Subsequently, the fidelity (the extent to which each of the programme's elements were implemented as planned), dose (types and quantity of services provided) and reach (demographic characteristics and communities serviced) of the KDT model were evaluated using service data, deidentified clinical records and volunteer rosters maintained by KDT from 2009 to 2019. Trends and patterns of service provision were analysed using total counts and proportions over time. A Poisson regression model was used to explore changed in the rates of surgical treatment over time. The associations between volunteer activity and service provision was also investigated using correlation coefficients and linear regression. RESULTS A total of 6365 patients (98% identifying as Aboriginal or Torres Strait Islander) were seen over the 10-year period with services being provided across 35 different communities in the Kimberley. Most services were provided to school-aged children, consistent with the programme's objectives. The peak preventive, restorative and surgical rates occurred among school-aged children, young adults and older adults respectively. A trend was observed indicating a reducing rate of surgical procedures from 2010 to 2019 (p < .001). The volunteer profile showed significant diversity beyond the conventional dentist-nurse structure and 40% being repeat volunteers. CONCLUSIONS The KDT programme maintained a strong focus on service provision to school-aged children over the last decade with the educational and preventive components being central to the care being provided. This process evaluation found that the dose and reach of the KDT model grew with an increase in resources and was adaptive to perceived community need. The model was shown to evolve through gradual structural adaptations contributing to its overall fidelity.
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Affiliation(s)
- Jilen Patel
- School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Natasha Bear
- Institute for Health Research, Notre Dame University, Perth, Western Australia, Australia
| | - Robyn Long
- Jungarni Jutiya Indigenous Corporation, Halls Creek, Western Australia, Australia
| | - Steven Naoum
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Estie Kruger
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
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March S, Mangoyana C, Oakley P, Lalloo R, Walsh LJ. Positive impacts of oral health services provision by a student-led primary care clinic to an Australian rural indigenous community. Aust Dent J 2023; 68:151-159. [PMID: 37150594 DOI: 10.1111/adj.12960] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND This study aimed to determine whether oral health services provision by a dental student clinical outplacement embedded within a Community Controlled Health Service positively impacted a rural Indigenous community and to explore the nature of these benefits. METHODS Aggregated and de-identified 2017, 2018 and 2019 student-led clinic services provision data were retrospectively analysed. The change in services mix over time was measured. Rural outplacement clinic operational costs to the university were estimated. Government-funded local public dental clinic waiting list and services provision data were used to identify any student clinic establishment effect. RESULTS The student-led clinic services mix shifted over time from mainly acute care for toothache towards prevention of disease and tooth restoration, indicating an improvement in patient oral health and correspondingly reduced system costs. Imputed value of 2017-2019 student-led clinic services provision totalled almost AUD$1 million. Government public clinic waiting list times decreased after full establishment of the student-led clinic, indicating decreased pressure on the public system. CONCLUSION The Community Controlled Health Service and university partnership improved community oral health care access, its timely delivery and simultaneously provided valuable human capital development from the student training experience. The student-led clinic's targeted Indigenous community showed oral health improvement over time. © 2023 Australian Dental Association.
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Affiliation(s)
- S March
- The University of Queensland School of Dentistry, Oral Health Centre, Brisbane, Queensland, Australia
| | - C Mangoyana
- The University of Queensland School of Dentistry, Oral Health Centre, Brisbane, Queensland, Australia
| | - P Oakley
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, Queensland, Australia
| | - R Lalloo
- The University of Queensland School of Dentistry, Oral Health Centre, Brisbane, Queensland, Australia
| | - L J Walsh
- The University of Queensland School of Dentistry, Oral Health Centre, Brisbane, Queensland, Australia
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Patel J, Durey A, Naoum S, Kruger E, Slack-Smith L. A scoping review to inform the use of continuous quality improvement in Australian Aboriginal oral health care. AUST HEALTH REV 2022; 46:478-484. [PMID: 35831033 DOI: 10.1071/ah21394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 06/17/2022] [Indexed: 11/23/2022]
Abstract
ObjectiveThe need to improve existing services to Aboriginal communities is prioritised by Australia's National Oral Health Plan. Although only an emerging area in dentistry, continuous quality improvement (CQI) approaches have positively impacted the delivery of primary health services to Aboriginal communities. This scoping review maps the applicability of CQI strategies to Aboriginal Australian oral healthcare services.MethodsA scoping review was conducted and studies that reported using CQI approaches to improve existing oral health services or quality of care deemed relevant to Aboriginal Australian communities were included.ResultsA total of 73 articles were retrieved and eight articles were included in the final synthesis. Several CQI tools were identified, including: plan-do-study-act cycles, dental quality alliance measures, prioritisation matrices, causal mapping and the use of collective impact methodology.ConclusionData exploring CQI in the context of Aboriginal oral health is scarce. The plan-do-study-act cycle and its variations show potential applicability to Aboriginal oral health care. However, for CQI approaches to be adequately implemented, the prevailing model of dental care requires a paradigm shift from quality assurance to quality improvement, acknowledging the impact of structural and process elements on care.
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Affiliation(s)
- Jilen Patel
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia; and Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Angela Durey
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
| | - Steven Naoum
- Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Estie Kruger
- School of Human Sciences, The University of Western Australia, WA, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
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Tynan A, Walker D, Tucker T, Fisher B, Fisher T. Managing oral health care and prevention: The experience of Aboriginal and Torres Strait Islanders living in a rural community in Queensland, Australia. Aust J Rural Health 2022; 30:228-237. [PMID: 35196414 PMCID: PMC9306970 DOI: 10.1111/ajr.12853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 06/30/2021] [Accepted: 01/31/2022] [Indexed: 12/01/2022] Open
Abstract
Objective To understand the experience of rural Aboriginal and Torres Strait Islanders in engaging with oral health care services and programs in order to support the development of oral health services and prevention programs that better meet their needs. Design The study used a qualitative research design, which aims to describe participants' lived experience of engaging with oral health services and prevention programs in a rural Aboriginal and Torres Strait Islander community. Focus group discussions and in‐depth interviews were conducted with 27 participants. The 15 transcribed discussions were analysed using a 6‐step phenomenological process. Setting A rural community in Queensland, Australia, with a predominantly Aboriginal population. Participants Participants were purposively recruited from established health and community groups. Main outcome System‐level barriers to accessing and engaging with oral health services and prevention influence how communities manage oral health and seek treatment. Results The study identified 4 main themes describing the community's experience: service location and the efforts required to access oral health services; the financial burden of accessing oral health care and practising prevention; lack of confidence in oral health services; and the avoidance or delaying of accessing care for dental problems. Results confirmed a high burden of oral disease but limited attendance at an oral health facility and difficulties engaging in preventative oral health behaviours. Treatment seeking was usually instigated by the experience of pain and typically at a tertiary health facility. Conclusion Aboriginal and Torres Strait Islanders in rural communities experience a high burden of oral disease but have limited engagement with oral health services. This is associated with system‐level barriers to accessing and engaging with oral health services and prevention.
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Affiliation(s)
- Anna Tynan
- Baillie Henderson Hospital, Darling Downs Health, Toowoomba, Queensland, Australia.,The Rural Clinical School, The University of Queensland, Toowoomba, Queensland, Australia
| | - David Walker
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Taygan Tucker
- Kingaroy Hospital, Darling Downs Health, Kingaroy, Queensland, Australia
| | - Barry Fisher
- Kingaroy Hospital, Darling Downs Health, Kingaroy, Queensland, Australia
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Challenges in the provision and utilization of oral health services among the Australian Indigenous population: a scoping review. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01661-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Nurdin MF, Yusof ZYM. Facilitators and Barriers to the Implementation of Preschool Oral Healthcare Programme in Malaysia from the Perspective of Dental Therapists: A Qualitative Study. CHILDREN-BASEL 2020; 7:children7120266. [PMID: 33276484 PMCID: PMC7760564 DOI: 10.3390/children7120266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
The Preschool Oral Healthcare Programme (POHP) was introduced in Malaysia by the Ministry of Health in 1984 to provide oral healthcare for 5–6-year-old children. Most of its evaluations were directed towards assessing children’s oral health status. Little emphasis has been placed on assessing the programme feasibility from the perspectives of the oral health personnel. The objective of the study was to explore the facilitators and barriers to the implementation of the POHP using the perspectives of dental therapists (DT) in Selangor state, Malaysia. This study took a qualitative approach using focus group discussion (FGD) as the data collection method. The data were transcribed verbatim followed by thematic analysis using NVivo 12 Pro version software. A total of 13 FGDs had been conducted involving 114 DT. The main facilitators were good dental teamwork, assistance from schools and teachers, sufficient training of DT, adequate support from dental administration, and good cooperation from the children. The main barriers were lack of financial support, manpower, time, inadequate support from preschools and children, language barrier, and accessibility to sugary food and drinks at schools. The study provided important insights regarding the POHP that would be useful for programme improvement through policy changes, workforce training, and enhanced school participation.
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Affiliation(s)
- Muhammad Farid Nurdin
- Oral Health Program, Ministry of Health, Level 5, Block E10, Precinct 1, Putrajaya 62590, Malaysia;
| | - Zamros Yuzadi Mohd Yusof
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence: ; Tel.: +601-9382-4503
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Arrow P, Piggott S, Carter S, McPhee R, Atkinson D, Mackean T, Kularatna S, Tonmukayakul U, Brennan D, Nanda S, Palmer D, Jamieson L. Atraumatic Restorative Treatments in Australian Aboriginal Communities: A Cluster-randomized Trial. JDR Clin Trans Res 2020; 6:430-439. [PMID: 33016169 DOI: 10.1177/2380084420963949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The management of early childhood caries (ECC) is challenging. OBJECTIVES A model of care based on Atraumatic Restorative Treatment and the Hall Technique (ART-HT) to manage ECC was evaluated among remote Aboriginal communities in Australia. METHODS Aboriginal communities in the North-West of Western Australia were invited to participate and consenting communities were randomized into early or delayed intervention for the management of ECC. Children were examined at baseline and at the 11-mo follow-up. The early intervention group (test) was provided with the ART-based dental care at baseline while the delayed intervention group (control) was advised to seek care through the usual care options available within the community. At follow-up, both groups were examined by calibrated examiners, and were offered care using the ART-HT approach. Changes from baseline to follow-up in caries experience were tested using paired tests. Multivariate analysis after multiple imputation of missing data used generalised estimating equation (GEE) controlling for clustering within communities. RESULTS A total of 25 communities and 338 children (mean age = 3.6 y, SD 1.7) participated in the study (test = 177). At follow-up, 231 children were examined (68% retention, test = 125). At follow-up, children in the test group had more filled teeth (test filled teeth = 1.2, control filled teeth = 0.2, P < 0.001) and decreased levels of decayed teeth (mean test = 0.7 fewer teeth with decay, mean control = 1.0 more tooth with decay, P < 0.001). GEE analysis controlled for baseline caries experience, age, sex, and community water fluoride levels found increased rates of untreated decayed teeth (RR = 1.4, P = 0.02) and decreased rates of filled teeth (RR = 0.2, P < 0.001) at follow-up among the control group. CONCLUSION A model of care relying on the principles of minimally invasive atraumatic approaches enabled the delivery of effective dental services to young children (<6 y) in remote Aboriginal Australian communities resulting in increased levels of care and improved oral health. KNOWLEDGE TRANSFER STATEMENT This cluster-randomized trial tested a multi-component model of dental care to young children with ECC in remote Aboriginal communities in Australia. The intervention, based on the atraumatic approaches using minimally invasive techniques encompassing preventive care, Atraumatic Restorative Treatment and the Hall Technique (ART-HT), delivered more restorative care and reduced the incidence of caries. This model of care was more effective than available standard care and should be incorporated into mainstream service delivery programs.
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Affiliation(s)
- P Arrow
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Piggott
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - S Carter
- Western Australia Dental Health Services, Research and Evaluation, Health Department of Western Australia, Perth, Western Australia, Australia
| | - R McPhee
- Kimberley Aboriginal Medical Services, Broome, Australia
| | - D Atkinson
- Rural Clinical School of Western Australia, University of Western Australia, Broome, Australia
| | - T Mackean
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
| | - S Kularatna
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - U Tonmukayakul
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - D Brennan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - S Nanda
- Health Department Western Australia, Office of Chief Dental Officer, Perth, Australia
| | - D Palmer
- Community Development, Community Development, Murdoch University, Perth, Australia
| | - L Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
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Tynan A, Walker D, Tucker T, Fisher B, Fisher T. Factors influencing the perceived importance of oral health within a rural Aboriginal and Torres Strait Islander community in Australia. BMC Public Health 2020; 20:514. [PMID: 32303214 PMCID: PMC7164228 DOI: 10.1186/s12889-020-08673-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/07/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Indigenous Australians suffer from higher rates of oral disease and have more untreated dental problems and tooth extractions than the general population. Indigenous Australians also have lower rates of accessing oral health services and are more likely to visit for a problem rather than a check-up. Multiple issues effect health service and prevention programs including: characteristics of health services such as distances to health services; existence of social and cultural barriers; available wealth and social support; and, characteristics of the individual and community including the importance given to the disease. This paper seeks to explore the perceived importance of oral health within a rural Indigenous community in Australia and the factors influencing this perception. METHODS The study used a phenomenology research design incorporating focus group discussions and in-depth interviews. It was undertaken in partnership with communities' Health Action Group who guided the focus, implementation and reporting of the research. A convenience sample was recruited from established community groups. Thematic analysis on the transcripts was completed. RESULTS Twenty-seven community members participated in three focus groups and twelve in-depth interviews. The study found that the community gives high priority to oral health. Factors influencing the importance include: the perceived severity of symptoms of oral disease such as pain experienced due to tooth ache; lack of enabling resources such as access to finance and transport; the social impact of oral disease on individuals including impact on their personal appearance and self-esteem; and health beliefs including oral health awareness. Participants also noted that the importance given to oral health within the community competed with the occurrence of multiple health concerns and family responsibilities. CONCLUSION This paper highlights the high importance this rural Indigenous community gives to oral health. Its findings suggest that under-utilisation of oral health services is influenced by both major barriers faced in accessing oral health services; and the number and severity of competing health and social concerns within the community. The study results confirm the importance of establishing affordable, culturally appropriate, community-based oral health care services to improve the oral health of rural Indigenous communities.
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Affiliation(s)
- Anna Tynan
- Research Fellow, Research Support Team, Baillie Henderson Hospital, Darling Downs Health, Corner of Torr and Hogg Street, Toowoomba, Queensland, Australia.
- Honorary Research Fellow, The Rural Clinical School, The University of Queensland, West Street, Toowoomba, Queensland, Australia.
| | - David Walker
- Honorary Research Fellow. School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Taygan Tucker
- Dental Therapist, Oral Health Services - Nhulunbuy, Top End Health Services, Northern Territory Government Endeavour Square, Gove Dental Clinic, Endeavour Square, Nhulunbuy, Northern Territory, Australia
| | - Barry Fisher
- Indigenous Liaison Officer, Kingaroy Hospital, Darling Downs Health, 166 Youngman Street, Kingaroy, Queensland, Australia
| | - Tarita Fisher
- Health Service Manager, Darling Downs Health, PO Box 361, Murgon, Queensland, Australia
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Sunell S, Wright AE, Udahl BK, Benbow P. Educational Models for the Re-Establishment of Dental Therapy Education in Canada. J Dent Educ 2019; 83:914-923. [PMID: 30962312 DOI: 10.21815/jde.019.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/04/2019] [Indexed: 11/20/2022]
Abstract
With the closure of the Canadian dental therapy program in Saskatchewan in 2011 and the increasing need for oral health providers, there have been growing discussions at the national and provincial levels regarding the re-establishment of a provider with dental therapy abilities. The aims of this study were to define models for dental therapy education in Canada and explore how dental therapy abilities could best be integrated into Canadian post-secondary education. In 2017, purposeful sampling was used to invite key informants to participate in a semi-structured interview. Participants were individuals from government, education, and regulation and those working with underserved populations in Canada and internationally. A 75% response rate (n=53) was achieved. Thematic analysis was employed for coding of data and generation of themes. Respondents highlighted the need to include minimally invasive restorative services in the current scope of dental hygiene practice across all Canadian jurisdictions and to build dental therapy abilities with or upon accredited dental hygiene curricula. The models supported by respondents were a fourth-year option built on three-year diploma education, a one-year postgraduate diploma based on a baccalaureate degree and a current dental hygiene registration, and a three-year dental therapy diploma incorporating core courses in accredited dental hygiene diploma education. While the respondents' views were divergent, the educational model that received the most support involved a two- to three-term addition to current three-year dental hygiene diploma education. In contrast to international trends, the respondents valued learner flexibility to exit with a diploma dental hygiene credential, thus making the dental therapy scope optional. These educational models provide a starting point for further analysis and exploration.
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Affiliation(s)
- Susanne Sunell
- Susanne Sunell, EdD, is Educational Consultant and Researcher, Omni Educational Group Ltd., Vancouver, Canada; Ann E. Wright, RDH, MBA, is Practice Consultant, ROI Corporation, Mississauga, Canada; Brenda K. Udahl, RDH, MHRD, was Academic Chair of Dental Programs, Saskatchewan Polytechnic, Regina, Canada, at the time of this study; and Paula Benbow, RDH, MPH, was Manager of Health Policy, Canadian Dental Hygienists Association, Ottawa, Canada, at the time of this study.
| | - Ann E Wright
- Susanne Sunell, EdD, is Educational Consultant and Researcher, Omni Educational Group Ltd., Vancouver, Canada; Ann E. Wright, RDH, MBA, is Practice Consultant, ROI Corporation, Mississauga, Canada; Brenda K. Udahl, RDH, MHRD, was Academic Chair of Dental Programs, Saskatchewan Polytechnic, Regina, Canada, at the time of this study; and Paula Benbow, RDH, MPH, was Manager of Health Policy, Canadian Dental Hygienists Association, Ottawa, Canada, at the time of this study
| | - Brenda K Udahl
- Susanne Sunell, EdD, is Educational Consultant and Researcher, Omni Educational Group Ltd., Vancouver, Canada; Ann E. Wright, RDH, MBA, is Practice Consultant, ROI Corporation, Mississauga, Canada; Brenda K. Udahl, RDH, MHRD, was Academic Chair of Dental Programs, Saskatchewan Polytechnic, Regina, Canada, at the time of this study; and Paula Benbow, RDH, MPH, was Manager of Health Policy, Canadian Dental Hygienists Association, Ottawa, Canada, at the time of this study
| | - Paula Benbow
- Susanne Sunell, EdD, is Educational Consultant and Researcher, Omni Educational Group Ltd., Vancouver, Canada; Ann E. Wright, RDH, MBA, is Practice Consultant, ROI Corporation, Mississauga, Canada; Brenda K. Udahl, RDH, MHRD, was Academic Chair of Dental Programs, Saskatchewan Polytechnic, Regina, Canada, at the time of this study; and Paula Benbow, RDH, MPH, was Manager of Health Policy, Canadian Dental Hygienists Association, Ottawa, Canada, at the time of this study
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Irving M, Stewart R, Spallek H, Blinkhorn A. Using teledentistry in clinical practice as an enabler to improve access to clinical care: A qualitative systematic review. J Telemed Telecare 2017; 24:129-146. [PMID: 28092220 DOI: 10.1177/1357633x16686776] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Access to dental care is important for overall health, but can remain problematic for those in rural or isolated locations. It can be difficult to encourage clinicians to choose or continue a rural health career. Teledentistry is showing some promise as a strategy to support rural, isolated and new health care workers. This study aims to explore the quantitative and qualitative framework associated with teledentistry in an effort to uncover the interaction of multiple influences on its delivery and sustainability. Methods A systematic search of the literature was undertaken and studies were included if they evaluated consultative teledentistry, reports on implementation of teledentistry in practice or attitudes to teledentistry. Studies were evaluated qualitatively. Results Thirty-nine studies were included focusing on the accuracy, effectiveness or description a teledentistry project in practice. Five main themes were identified in the qualitative analysis: (1) using information and communication technology (ICT), (2) regulatory and system improvements, (3) accuracy of teledentistry, (4) effectiveness, including increasing access to clinical services, efficiencies and acceptability, and (5) building and increasing clinical capacity of the dental workforce. Conclusion Teledentistry provides a viable option for remote screening, diagnosis, consultation, treatment planning and mentoring in the field of dentistry. Rapidly developing information and communication technologies have increasingly shown improving cost effectiveness, accuracy and efficient remote assistance for clinicians. There is high acceptability for teledentistry amongst clinicians and patients alike. Remuneration of advising clinicians is critical to sustainability.
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Affiliation(s)
- Michelle Irving
- 1 The Poche Centre for Indigenous Health, University of Sydney, New South Wales, Australia.,2 Faculty of Dentistry, University of Sydney, New South Wales, Australia
| | - Rosemary Stewart
- 1 The Poche Centre for Indigenous Health, University of Sydney, New South Wales, Australia
| | - Heiko Spallek
- 2 Faculty of Dentistry, University of Sydney, New South Wales, Australia
| | - Anthony Blinkhorn
- 2 Faculty of Dentistry, University of Sydney, New South Wales, Australia
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13
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Irving M, Gwynne K, Angell B, Tennant M, Blinkhorn A. Client perspectives on an Aboriginal community led oral health service in rural Australia. Aust J Rural Health 2016; 25:163-168. [PMID: 27377919 DOI: 10.1111/ajr.12307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE An oral health service was implemented, using a unique community development approach, for Northern NSW Australian Aboriginal communities in 2013-14. This study examined the views of children (and parents) who accessed the service, including: the extent of reported dental problems, oral health knowledge, attitudes and behaviour, accessibility of oral health services, satisfaction and cultural sensitivity of the service. METHODS A survey of the children who accessed this service was conducted between October 2014 and December 2014. RESULTS A total of 49 (71%) Aboriginal children aged 4-14 (or parents of), provided responses to the survey. All agreed that healthy teeth were important (100%), but many thought oral disease leading to extraction was normal (68%). High levels of oral pain were reported (66%), half (53%) reported brushing morning and night. Access to the new dental health service was reported as 'easy' (92%). Many walked (47%) or were driven (35%) in <30 min (90%). All respondents were happy with their dental treatment, and that their Aboriginal heritage was respected by the oral health team (100%). CONCLUSION The implementation of a new community led oral health service to Northern NSW Aboriginal communities was shown here to be well-utilised, respected and in an area of high need. The collaborative approach could be continued to be utilised to implement targeted, community led health promotion programs to facilitate and encourage better oral health practices for the Aboriginal children in these communities.
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Affiliation(s)
- Michelle Irving
- The Poche Centre for Indigenious Health, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
| | - Kylie Gwynne
- The Poche Centre for Indigenious Health, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - Blake Angell
- The Poche Centre for Indigenious Health, University of Sydney, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The University of Western Australia, Perth, Western Australia, Australia
| | - Anthony Blinkhorn
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
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14
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Lam R. Epidemiology and outcomes of traumatic dental injuries: a review of the literature. Aust Dent J 2016; 61 Suppl 1:4-20. [DOI: 10.1111/adj.12395] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R Lam
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology; The University of Western Australia; Western Australia Australia
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