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Aloshaiby A, Gaber A, Arheiam A. The oral health care system in Libya: a case study. BMC Oral Health 2024; 24:888. [PMID: 39097699 PMCID: PMC11297658 DOI: 10.1186/s12903-024-04684-x] [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: 02/26/2024] [Accepted: 07/30/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND This study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups. METHODS A single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study's aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents. RESULTS The analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults. CONCLUSION The oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya.
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Affiliation(s)
- Aisha Aloshaiby
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Amal Gaber
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Arheiam Arheiam
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya.
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Abuhaloob L, Tabche C, Amati F, Rawaf S. Provision of oral healthcare services in WHO-EMR countries: a scoping review. BMC Oral Health 2024; 24:705. [PMID: 38890617 PMCID: PMC11184680 DOI: 10.1186/s12903-024-04446-9] [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: 09/20/2023] [Accepted: 06/05/2024] [Indexed: 06/20/2024] Open
Abstract
Global neglect of oral healthcare services (OHCS) provision, mainly in Low- and Middle-Income Countries, exacerbates the deterioration of health systems and increases global health inequality.ObjectivesThe objective is to explore the profiles of available oral healthcare services in the WHO Eastern Mediterranean Region (EMR) countries.MethodsA systematic literature search was conducted of grey literature and databases (PubMed, Medline, Embase, and the Cochrane Library). Peer-reviewed articles that reviewed and/or evaluated OHCS in WHO-EMR countries were identified. No time or language limitations were applied. Two independent reviewers conducted the screening and data extraction. A third reviewer arbitrated disagreement. The evaluation of the OHCS provision followed the WHO framework for health system performance assessment. The extraction included socio-demographic characteristics of the studied population, OHCS profile, responsiveness, and health insurance coverage.ResultsOne hundred and thirty-seven studies were identified. The studies that met the inclusion criteria were fifteen published between 1987 and 2016. In addition, two reports were published in 2022. The included studies were conducted in Pakistan, Saudi Arabia, Iran, Libya, Egypt, Oman, Syria, Jourdan, Kuwait, and Tunisia. Generally, Ministries of Health are the main providers of OHCS. The provision for national dental care prevention programmes was highly limited. Furthermore, most of these Ministries of Health have struggled to meet their local populations' dental needs due to limited finances and resources for OHCS.ConclusionsOral and dental diseases are highly prevalent in the WHO-EMR region and the governments of the region face many challenges to meeting the OHCS needs of the population. Therefore, further studies to assess and re-design the OHCS in these countries to adapt dental care prevention into national health programmes are crucial.
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Affiliation(s)
- Lamis Abuhaloob
- WHO Collaborating Centre for Public Health Education and Training, Primary Care & Public Health, School of Public Health, Faculty of Medicine, Imperial College London, The Reynolds Building, St. Dunstan's Road, London, W6 8RP, UK.
| | - Celine Tabche
- WHO Collaborating Centre for Public Health Education and Training, Primary Care & Public Health, School of Public Health, Faculty of Medicine, Imperial College London, The Reynolds Building, St. Dunstan's Road, London, W6 8RP, UK
| | - Federica Amati
- WHO Collaborating Centre for Public Health Education and Training, Primary Care & Public Health, School of Public Health, Faculty of Medicine, Imperial College London, The Reynolds Building, St. Dunstan's Road, London, W6 8RP, UK
| | - Salman Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Primary Care & Public Health, School of Public Health, Faculty of Medicine, Imperial College London, The Reynolds Building, St. Dunstan's Road, London, W6 8RP, UK
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Khemiss M, Ben Messaoud NS, Hadidane M, Ben Khelifa M, Ben Saad H. The relationship between obesity and oral-health status in North African adults: A comparative study. Int J Dent Hyg 2024; 22:167-176. [PMID: 37804219 DOI: 10.1111/idh.12767] [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: 09/14/2021] [Revised: 09/21/2022] [Accepted: 09/03/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION The strength of the association between obesity and oral health is still indecisive. OBJECTIVE The objectives of the study were to compare some oral-health data between two groups involving obese (OG) and normal weight (NWG) participants and determine the influencing factors of the periodontal probing depth (PPD). METHODS This was a cross-sectional study including 67 Tunisian adults [OG (n = 33, body mass index (BMI) > 30 kg/m2 ), NWG (n = 34, BMI: 18.5-25.0 kg/m2 )]. The plaque level was recorded using the plaque index (PI). Gingival index (GI) was used to evaluate gingival inflammation. The depths of the sulci/pockets were probed using a periodontal probe. Stimulated saliva was collected for 5 min, and salivary flow rate (SFR) was determined. Salivary baseline pH (SBpH) was measured. A multivariable regression analysis was performed between PPD and some independent variables [i.e. obesity status, age, sex, socioeconomic status, systemic diseases and PI data]. RESULTS The OG and NWG were age- and sex-matched and included comparable percentages of participants with systemic diseases (27.3 vs. 29.4%, respectively). The OG included a higher percentage of participants having a low socioeconomic status (87.9 vs. 64.7%, respectively). Compared with the NWG, the OG: (i) had comparable values of daily toothbrushing frequency, PI, GI and tooth mobility, (ii) included comparable percentages of irregular brushers, of participants with periodontitis, PI classes [0-1]and [1-2]; and GI classes [0-1], [1-2] and [2, 3]; (iii) had a higher PPD (2.02 ± 0.41 vs. 2.35 ± 0.22 mm, respectively), (iv) had lower SBpH (7.59 ± 0.21 vs. 7.45 ± 0.22, respectively) and SFR (1.98 ± 0.28 vs. 1.60 ± 0.32 mL/mn, respectively) and (v) included a higher percentage of participants having a PI class [2, 3] (67.6 vs. 87.9%, respectively). The multivariable regression analysis revealed that only obesity status, age and PI classes influenced the PPD, altogether explained 29.62% of the PPD variance. CONCLUSION Obesity poses a risk for oral health, and obese adults had altered PPD and lower BSpH and SFR. Dentists should make obese patients aware of the health risks of obesity in an attempt to reduce the potential oral complications associated with this epidemic.
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Affiliation(s)
- Mehdi Khemiss
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
- Research Laboratory N8 LR12SP10: Functional and Aesthetic Rehabilitation of Maxillary, Farhat Hached University Hospital of Sousse, Sousse, Tunisia
| | - Nour Sayda Ben Messaoud
- Research Laboratory N8 LR12SP10: Functional and Aesthetic Rehabilitation of Maxillary, Farhat Hached University Hospital of Sousse, Sousse, Tunisia
- Department of Dental Medicine, Farhat Hached University Hospital of Sousse, Sousse, Tunisia
| | - Meriem Hadidane
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Mohamed Ben Khelifa
- Department of Dental Medicine, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
- Research Laboratory N8 LR12SP10: Functional and Aesthetic Rehabilitation of Maxillary, Farhat Hached University Hospital of Sousse, Sousse, Tunisia
| | - Helmi Ben Saad
- Hôpital Farhat Hached, Service de Physiologie et Explorations Fonctionnelles, Université de Sousse, Sousse, Tunisie
- Hôpital Farhat HACHED, Laboratoire de Recherche LR12SP09 'Insuffisance cardiaque', Université de Sousse, Sousse, Tunisie
- Faculté de Médecine de Sousse, Service de Physiologie et Explorations Fonctionnelles, Université de Sousse, Sousse, Tunisie
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Crescente LG, Gehrke GH, Santos CMD. [Changes in the prevalence of decayed permanent teeth in Brazil and upper-middle income countries in the years 1990 and 2017]. CIENCIA & SAUDE COLETIVA 2022; 27:1181-1190. [PMID: 35293454 DOI: 10.1590/1413-81232022273.46812020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 03/05/2021] [Indexed: 11/22/2022] Open
Abstract
The distribution of caries is uneven and strongly associated with the different socioeconomic profiles of countries. The scope of this study was to describe the changes in the prevalence of decayed permanent teeth in Brazil and in upper-middle income countries for the years 1990 and 2017. It is a descriptive study based on secondary data extracted from the Global Burden of Disease. The 53 countries included in the upper-middle income group were included. Caries prevalence estimates were collected for the years 1990 and 2017. The percentage change in prevalence was calculated between the two years. The values of the Human Development Index (HDI) for each country were also collected. The results show the trend of a reduction in the prevalence of decayed permanent teeth in Brazil and in most upper-middle income countries. The prevalence of untreated caries in Brazil was 38.17% in 1990 and 37.46% in 2017. Brazil occupies the 41st position in the ranking of the reduction in the prevalence of caries among the 53 countries evaluated. The countries that achieved the greatest reductions in the prevalence of caries were those with an improvement in their HDI. In this respect, the need to review public oral health policies is revealed, as well as a reflection on addressing the inequities present in the countries surveyed.
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Affiliation(s)
- Luiza Gasparotto Crescente
- Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Enfermagem, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil.
| | - Gabriela Hammes Gehrke
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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Mohammadpour M, Bastani P, Brennan D, Ghanbarzadegan A, Bahmaei J. Oral health policymaking challenges in Iran: a qualitative approach. BMC Oral Health 2020; 20:158. [PMID: 32487152 PMCID: PMC7268740 DOI: 10.1186/s12903-020-01148-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 05/24/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND As the strategies proposed for oral health improvement in developed countries are not adapted for developing ones, this study aimed to identify the challenges of oral health policy implementation in Iran as a low-income developing country. METHODS This qualitative study was conducted in 2019 in Iran as a middle-eastern developing country. The study population consisted of experts who had experience in oral health and were willing to participate in the study. Snowball sampling was used to select 12 participants for semi-structured interviews and saturation was achieved after 16 interviews. Guba and Lincoln criteria including credibility, transferability, confirmability and dependability were used to determine reliability and transparency, and finally a five-step framework analysis method was used to analyze the data. RESULTS The analysis of the interviews resulted in identification of 7 main themes that were categorized into 5 problems of policy implementation as proposed by the Matus framework. The main themes of executive and preventive challenges to implement oral health policies were categorized as organizational problems, the main themes of educational and resource challenges were situated as material problems, and the main themes of insurance, policy making and trusteeship challenges were considered as legal, policymaking and perspective. CONCLUSION The implementation of oral health policies has faced some challenges. It seems that the national coverage of oral health and integration of these services in prevention and serious attention to the private sector can be considered as the most important strategies for achieving improved oral health in Iran.
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Affiliation(s)
- Mohammadtaghi Mohammadpour
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peivand Bastani
- grid.412571.40000 0000 8819 4698Health Human Recourses Research Center, School of Health Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - David Brennan
- grid.1010.00000 0004 1936 7304Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide, Adelaide, South Australia Australia
| | - Arash Ghanbarzadegan
- grid.1010.00000 0004 1936 7304Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, University of Adelaide, Adelaide, South Australia Australia
| | - Jamshid Bahmaei
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Knevel R, Gussy MG, Farmer J. Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries. Int J Dent Hyg 2016; 15:95-105. [PMID: 27943545 DOI: 10.1111/idh.12260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The purpose of this study was to scope the literature that exists about factors influencing oral health workforce planning and management in developing countries (DCs). METHODS The Arksey and O'Malley method for conducting a scoping review was used. A replicable search strategy was applied, using three databases. Factors influencing oral health workforce planning and management in DCs identified in the eligible articles were charted. FINDINGS Four thousand citations were identified; 41 papers were included for review. Most included papers were situational analyses. Factors identified were as follows: lack of data, focus on the restorative rather than preventive care in practitioner education, recent increase in number of dental schools (mostly private) and dentistry students, privatization of dental care services which has little impact on care maldistribution, and debates about skill mix and scope of practice. Oral health workforce management in the eligible studies has a bias towards dentist-led systems. Due to a lack of country-specific oral health related data in developing or least developed countries (LDCs), oral health workforce planning often relies on data and modelling from other countries. DISCUSSION AND CONCLUSION Approaches to oral health workforce management and planning in developing or LDCs are often characterized by approaches to increase numbers of dentists, thus not ameliorating maldistribution of service accessibility. Governments appear to be reducing support for public and preventative oral healthcare, favouring growth in privatized dental services. Changes to professional education are necessary to trigger a paradigm shift to the preventive approach and to improve relationships between different oral healthcare provider roles. This needs to be premised on greater appreciation of preventive care in health systems and funding models.
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Affiliation(s)
- Rjm Knevel
- Department of Dentistry and Oral Health, College of Science, Health & Engineering, La Trobe University, Bendigo, Vic., Australia
| | - M G Gussy
- La Trobe University, Bendigo, Vic., Australia
| | - J Farmer
- Centre for Social Impact, Swinburne University, Sydney, NSW, Australia
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Mahboobi N, Alavian SM. Oral conditions might cause severe outcomes in patients with viral hepatitis infection. HEPATITIS MONTHLY 2014; 14:e25866. [PMID: 25737733 PMCID: PMC4329236 DOI: 10.5812/hepatmon.25866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 12/08/2014] [Accepted: 11/13/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Nima Mahboobi
- Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Nima Mahboobi, Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188989161, E-mail:
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