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Cai Y, Zeng S, Hu Y, Xiao L, Liao Y, Yan Z, Zha W, Gu J, Wang Q, Hao M, Wu C. Factors associated with oral health service utilization among young people in southern China. BMC Oral Health 2024; 24:289. [PMID: 38418980 PMCID: PMC10903069 DOI: 10.1186/s12903-024-03994-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVES To identify the patterns and influencing factors of oral health service utilization among college students, and further to provide scientific evidence for policy making on oral health education and behavioral interventions for the college population. METHODS The study population was college students in Southern China. Totally 678 students participated in the survey. A self-designed questionnaire based on Anderson's model (predisposing factors, enabling factors, need factors) was used to survey college students. Descriptive statistics, χ2 test, and logistic regression were used to analyze influence factors of oral health service utilization among college students. RESULTS The utilization rate of oral health service in the past 12 months was 30.2%. The primary type of oral health service was treatment (59.6%), and only 12.8% were for prevention. There were 39% of the participants having oral health diseases, of which dental caries (25.7%) and oral bleeding (22.2%) were the main problems. The results from logistic regression analysis revealed that students with better beliefs (OR = 1.84, 95% CI:=1.02-3.43), frequent consumption of sugary drinks (OR = 2.90, 95% CI:=1.90-4.47), teeth brushing frequency > = 2 times per day (OR = 2.09, 95% CI = 1.24-3.61), frequent floss utilization (OR = 2.63, 95% CI = 1.21-5.76), dental caries (OR = 2.07, 95% CI = 1.35-3.17) used oral health services higher, while those lived in rural areas (OR:0.52, 95% CI = 0.34-0.80), and had only a fair concern (OR = 0.48, 95% CI = 0.31-0.74) or no concern (OR = 0.26, 95% CI = 0.08-0.67) on oral health utilized oral health services lower. CONCLUSIONS Chinese college students demonstrate some knowledge and attitudes towards oral health. However, they tend to neglect oral hygiene and have limited understanding of their own oral issues. Furthermore, the utilization of oral services, such as treatment, remains remarkably low, despite the availability of long-term and favorable health insurance policies. The utilization of oral health services among college students is influenced by various factors, including residing in rural areas, consuming sugary beverages on a daily basis, brushing teeth at least twice a day, and practicing flossing.
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Affiliation(s)
- Yunquan Cai
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
| | - Shaobo Zeng
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China
| | - Yimei Hu
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
| | - Lingfeng Xiao
- School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yanqing Liao
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
| | - Zihui Yan
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
| | - Wenxiang Zha
- Department of Public Health Surveillance, Linping Center for Disease Control and Prevention, Hangzhou, 311103, China
| | - Junwang Gu
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China
| | - Qi Wang
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China
| | - Ming Hao
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China
| | - Chunmei Wu
- School of Public Health and Health Management, Gannan Medical University, No. 1 Yixueyuan Road, Ganzhou, Jiangxi, 341000, China.
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, 341000, China.
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Cordeiro D, Herkrath FJ, Guedes AC, Garnelo L, Herkrath APC. Utilization of dental services by rural riverside populations covered by a Fluvial Family Health Team in Brazil. Rural Remote Health 2024; 24:8258. [PMID: 38225779 DOI: 10.22605/rrh8258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
INTRODUCTION Rural riverside populations of Brazil face several difficulties to access health services. The Brazilian National Primary Care Policy implemented the Fluvial Family Health Teams (FFHT), which is a specific primary care team arrangement for these territories. The aim of the study was to assess the use of dental services by adults living in rural riverside areas covered by a FFHT. METHODS A household-based cross-sectional survey was carried out with a rural riverside population of 38 localities on the left bank of the Rio Negro, Manaus, Amazonas, representative of the area covered by the FFHT. Stratified random sampling was calculated based on the number of adults and households in each riverside locality. An electronic questionnaire was used to obtain information on sociodemographic and oral health conditions, and the utilization of dental services. After descriptive analysis, logistic regression analyses were performed to estimate the odds ratios for the outcome 'use of dental health services over the past 12 months'. RESULTS A total of 492 individuals, aged 18 years or more, from 38 rural riverside areas were assessed. The mean age of participants was 43.5 years (standard deviation 17.0), ranging from 18.0 to 90.7 years. Of these participants, 3.1% had never been to a dentist and 21.9% had been to a dentist more than 3 years ago. Among those who attended the dental service, 77.4% of appointments occurred in public health services. Dental pain over the previous 6 months (odds ratio (OR)=2.44; 95% confidence interval (CI) 1.51-3.96), higher education (OR=2.62; 95%CI 1.23-5.56), most recent appointment in public health services (OR=1.86; 95%CI 1.19-2.93), edentulism (OR=0.38; 95%CI 0.17-0.85) and dissatisfaction with oral health (OR=0.59; 95%CI 0.38-0.93) were associated with the dental services utilization. CONCLUSION The study results revealed that approximately a quarter of the individuals did not use dental services over the previous 3 years or have never used them. Despite the increase in access provided by the FFHT, edentulous individuals, individuals dissatisfied with their oral health, and those with lower levels of education were less likely to use dental services, while individuals who experienced dental pain sought dental services more frequently. These findings suggest that the healthcare model offered to this population must be rearranged.
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Affiliation(s)
- Diego Cordeiro
- Doctoral Program in Public Health in the Amazon, Manaus, Amazonas, Brazil
| | - Fernando J Herkrath
- Superior School of Health Sciences, Amazonas State University, Av. Carvalho Leal 1777, Cachoeirinha, Manaus, Amazonas 69065-001, Brazil
| | - Adrielly C Guedes
- Leônidas and Maria Deane Institute, Oswaldo Cruz Foundation, Rua Teresina 476, Adrianópolis, Manaus, Amazonas 69057-070, Brazil
| | - Luiza Garnelo
- Leônidas and Maria Deane Institute, Oswaldo Cruz Foundation, Rua Teresina 476, Adrianópolis, Manaus, Amazonas 69057-070, Brazil
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Deerain M, Connolly M. Rural access to dental and oral health services. Aust J Rural Health 2023; 31:1036-1038. [PMID: 37850844 DOI: 10.1111/ajr.13050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Affiliation(s)
- Margaret Deerain
- Policy and Strategy Development, National Rural Health Alliance, Deakin, Australian Capital Territory, Australia
| | - Marnie Connolly
- National Rural Health Alliance, Deakin, Australian Capital Territory, Australia
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Shabestari M, Ansteinsson VE, Hovden EAS, Stangvaltaite-Mouhat L, Mdala I, Skudutyte-Rysstad R, Uhlen-Strand MM. One year of COVID-19 in dental health services in Norway: psychological impact, risk perceptions and vaccination status. BMC Health Serv Res 2023; 23:972. [PMID: 37684589 PMCID: PMC10486048 DOI: 10.1186/s12913-023-09981-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Increased psychological pressure on oral healthcare professionals (OHP) due to COVID-19 has been shown, yet little is known about the long-term psychological impacts. We aimed to study the psychological impact of COVID-19 and associated factors including perceived risk and preparedness and vaccination status among OHP in the first year after the lockdown period in Norway. METHODS A structured questionnaire sent electronically to dentists, dental hygienists and dental assistants inquired experiences and perceptions during the second year following the outbreak in Norway. The questionnaire comprised a COVID-19 fear scale and questions about risk perception, preparedness and vaccination status. Exploratory factor analysis (EFA) and Structural Equation Modeling (SEM) were used to assess psychological impact, perception of risk and preparedness according to vaccination status of the respondents. RESULTS The majority of the 708 respondents were female (92.8%), had ten or more years of work experience (67.1%), and worked in public dental clinics (95.9%). Fears and concerns related to COVID-19 were common, 72.6% feared getting infected and 85.4% feared infecting others. Of the 642 respondents who agreed that their workplaces handled the situation well, 55.6% were fully vaccinated. Three factors were retrieved from EFA: Insecurity, Instability and Infection. SEM showed that females were more concerned with Infection, and respondents with long clinical experience were less likely to express fear about Instability. Fully vaccinated individuals felt more insecure about becoming infected, and those agreeing that their workplaces handled the current situation well were concerned with Insecurity. CONCLUSIONS Despite widespread perception of adequate preparedness and high vaccine coverage, a considerable psychological impact and high levels of fear of COVID-19 were observed among the majority of OHP. Fully vaccinated individuals had a larger psychological burden than not fully vaccinated and those with unknown vaccination status. These findings can inform means and interventions to reduce negative impacts of fear in populations with a high psychological burden.
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Affiliation(s)
- M Shabestari
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway.
| | - V E Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - E A S Hovden
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | | | - I Mdala
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | | | - M M Uhlen-Strand
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
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Lin CE, Nguyen TM, McGrath R, Patterson A, Hall M. Dental Health Services Victoria value-based health care principles for oral health models of care. J Public Health Dent 2023; 83:325-328. [PMID: 37584232 DOI: 10.1111/jphd.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/08/2023] [Accepted: 07/17/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Efforts to progress oral healthcare reform can be challenging with competing interests of governments and service providers to achieve the intended outcomes. The value-based health care approach has been adopted in many areas of healthcare but has had limited applications to oral healthcare systems. Dental Health Services Victoria, an Australian state government funded entity, commenced its journey to value-based health care in 2016, to shift away from traditional dental service models that reward activity and volume towards a stronger emphasis on value and outcomes. AIMS To maintain the value-based health care agenda focus, Dental Health Services Victoria developed three key principles, which can be adopted by other organisations engaged in reforming oral healthcare, to improve the oral health for the population it serves. MATERIALS & METHODS In 2018, Dental Health Services Victoria developed a value-based health care framework, which has informed strategic organisation priorities for action. In 2023, the following three key principles are identified as being essential to support the operationalisation and development of effective models of oral healthcare: Principle 1 - Care is co-designed with the person or population Principle 2 - Prevention and early intervention are prioritised. Principle 3 - Consistent measurement of health outcomes and costs are embedded. DISCUSSION The exploration of the three key principles is an important communication tool to translate value-based health care into practice with key stakeholders. Further work is required to socialise them to within dental teams. CONCLUSION Organisations looking to commence the value-based health care agenda can apply Dental Health Services Victoria's three key principles as a first step.
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Affiliation(s)
- Clare Elizabeth Lin
- Dental Health Services Victoria, Carlton, Victoria, Australia
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tan Minh Nguyen
- Dental Health Services Victoria, Carlton, Victoria, Australia
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
- Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Roisin McGrath
- Dental Health Services Victoria, Carlton, Victoria, Australia
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Amy Patterson
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Martin Hall
- Dental Health Services Victoria, Carlton, Victoria, Australia
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Nagdev P, Iyer MR, Naik S, Khanagar SB, Awawdeh M, Al Kheraif AA, Anil S, Alsarani MM, Vellappally S, Alsadon O. Andersen health care utilization model: A survey on factors affecting the utilization of dental health services among school children. PLoS One 2023; 18:e0286945. [PMID: 37319189 PMCID: PMC10270576 DOI: 10.1371/journal.pone.0286945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/29/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Children's quality of life, academic performance, and future achievement can all be negatively affected by poor dental health. The present study aimed to assess the need for dental health services and the factors influencing their utilization using the Andersen health care utilization model among school children. METHODS The current cross-sectional study was conducted among schoolchildren aged 13 to 15 in Bangalore, India (n = 1100). A questionnaire was developed using the concepts of the Andersen healthcare usage model. The parents of the children filled out the questionnaire. The factors were investigated using bivariate analysis and multivariate logistic regression analysis. RESULTS About 78.1% of the children did not utilize dental health services. Regarding the reasons for not visiting a dentist, 65.8% said they did not have a dental problem, and 22.2% said they could not afford it. Bivariate analysis showed that age, gender, education level, occupation of the family's head of household, monthly family income, socioeconomic status, perceived oral health problems, accessibility of dental health facilities, and parental attitudes toward their children's oral health were significantly associated with using dental health services (p<0.05). Multiple regression analysis showed dental health service utilization was directly related to age (OR = 2.206), education, family size (OR = 1.33), and brushing frequency twice a day (OR = 1.575) with no significant relationship between distance to reach the dental facility, the number of dental visits, and socioeconomic status. CONCLUSION Dental health service utilization was low in the past year. The age, number of family members, parent's education level, travel time to the dental facility, the child's oral health behaviors, and positive parental attitude all play a role in a children's utilization of dental health service.
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Affiliation(s)
- Preethi Nagdev
- Department of Public Health Dentistry, SJM Dental College and Hospital, Chitradurga, India
| | - Murali R. Iyer
- Department of Public Health Dentistry, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Sachin Naik
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sanjeev Balappa Khanagar
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed Awawdeh
- Preventive Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdulaziz Abdullah Al Kheraif
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sukumaran Anil
- Department of Dentistry—Oral Health Institute, Hamad Medical Corporation, Doha, Qatar
| | - Majed M. Alsarani
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sajith Vellappally
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Omar Alsadon
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Gudipaneni RK, Alruwaili MFO, Ganji KK, Karobari MI, Kulkarni S, Metta KK, Assiry AA, Israelsson N, Bawazir OA. Sociobehavioural Factors Associated With Child Oral Health During COVID-19. Int Dent J 2023; 73:280-287. [PMID: 36641343 PMCID: PMC9742219 DOI: 10.1016/j.identj.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify the sociobehavioural factors that influenced children's oral health during the COVID-19 pandemic. METHODS The online cross-sectional study was conducted in Al Jouf Province in the northern region of Saudi Arabia. A total of 960 parents of children aged 5 to 14 years were invited by multistage stratified random sampling. Descriptive, multinomial, and multiple logistic regression analyses were performed to estimate odds ratios and determine the relationship between independent and dependent variables. P < .05 was considered statistically significant. RESULTS Of the 960 participants, 693 (72.1%) reported that their child had 1 or more untreated dental decay. The children of uneducated parents were 1.6-fold more likely to have 1 or more untreated dental decay (adjusted odds ratio [AOR], 1.66; 95% CI, 0.74-3.73; P < .001). The children of unemployed parents were 4.3-fold more likely to have a financial burden for a child dental visit (AOR, 4.34; 95% CI, 2.73-6.89; P < .001). Parents from a rural area were 26.3-fold more likely to have spent a lag period of over 2 years since their child's last dental visit (AOR, 26.34; 95% CI, 7.48-92.79; P < .001). Nursery-level children were 5.4-fold more likely to need immediate care (AOR, 5.38; 95% CI, 3.01-9.60; P < .001). CONCLUSIONS The present study demonstrated a very high prevalence of 1 or more untreated dental decay in our cohort. Children of rural areas, uneducated, unemployed, widow/divorced, low- and middle-income parents and nursery school children were linked to poorly predictive outcomes of child oral health during the pandemic.
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Affiliation(s)
- Ravi Kumar Gudipaneni
- Department of Preventive Dentistry, Pediatric Dentistry Division, College of Dentistry, Jouf University, Sakaka, Al Jouf, Saudi Arabia.
| | | | - Kiran Kumar Ganji
- Department of Preventive Dentistry, Periodontics Division, College of Dentistry, Jouf University, Al Jouf, Sakaka, Saudi Arabia
| | - Mohmed Isaqali Karobari
- Center for Transdisciplinary Research (CFTR), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences University, Chennai, Tamil Nadu, India
| | - Sachin Kulkarni
- School of Dentistry and Oral Health, University of Adelaide, Adelaide, South Australia, Australia; Griffith University, Gold Coast, Queensland, Australia
| | - Kiran Kumar Metta
- Department of Conservative Dental Sciences, Ibn Sina National College For Medical Studies, Jeddah, Saudi Arabia
| | - Ali A Assiry
- Preventive Dental Science Department, Faculty of Dentistry, Najran University, Najran, Saudi Arabia
| | | | - Omar A Bawazir
- Department of Preventive Dentistry, Pediatric Dentistry Division, College of Dentistry, Jouf University, Sakaka, Al Jouf, Saudi Arabia; Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Torres‐Mantilla JD, Newball‐Noriega EE. Factors associated with the use of oral health services in Peruvian children under the age of 12 years. Clin Exp Dent Res 2023; 9:230-239. [PMID: 36305044 PMCID: PMC9932245 DOI: 10.1002/cre2.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To determine the prevalence and factors associated with the use of oral health services in Peruvian children under 12 years of age. MATERIAL AND METHODS A secondary analysis of 2019 Demographic and Family Health Survey was conducted. The sample consisted of 40,751 children. The main variable was the use of dental services (attended/not attended) in the last 6 months, and the independent variables were gender, age, area of residence, wealth quintile, health insurance coverage, information received on oral health care, age, and educational level of the caregivers. Analyses of absolute and relative frequencies, differences in proportions, and multivariate analysis using generalized linear models were performed. RESULTS The dental service utilization prevalence during the last 6 months was 31%. Correlation was found with urban area residents (PRa = 0.945; 95% CI: 0.904-0.988), the Jungle geographical domain (PRa = 0.926; 95% CI: 0.877-0.977), the highest wealth quintile (PRa = 1.323; 95% CI: 1.232-1.421), the higher education level of the caregiver (PRa = 1.375; 95% CI: 1.231-1.536), affiliation with the Public Health Insurance (PRa = 1.112; 95% CI: 1.069-1.158), and the condition of having received information on oral health care (PRa = 2.355; 95% CI: 2.263-2.245) with respect to their baseline variables. CONCLUSIONS Several socio-demographic factors were correlated with the use of oral health services in Peruvian children under 12 years of age and the percentage of their use was low. Information on oral health care had a more significant impact on both, the population from the highest wealth quintile and the highest educational attainment.
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Affiliation(s)
- José Diego Torres‐Mantilla
- Unidad de Salud Pública, Escuela de Posgrado, Universidad Peruana Unión (UPeU)LimaPerú
- Departamento de Odonto‐estomatologíaHospital Carlos Lanfranco la HozLimaPerú
| | - Edda E. Newball‐Noriega
- Unidad de Salud Pública, Escuela de Posgrado, Universidad Peruana Unión (UPeU)LimaPerú
- Departamento de Ciencias BásicasEscuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión (UPeU)LimaPerú
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Raittio E, Torppa‐Saarinen E, Sokka T, Lahti S, Suominen A, Suominen AL, Heikkinen AM. Association of service use with subjective oral health indicators in a freedom of choice pilot. Clin Exp Dent Res 2023; 9:134-141. [PMID: 36263738 PMCID: PMC9932228 DOI: 10.1002/cre2.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES A freedom of choice pilot provided access to private oral health care services without queuing and with fixed public service-fees for participants in Tampere region, Finland in 2018-2019. The aim of this study was to investigate how use of oral health care services differed by demographics, socioeconomic status, dental fear, and self-reported oral health in this pilot. MATERIAL AND METHODS SMS-messages including a link to online questionnaire were sent to participants who had booked an appointment, and to those who had not booked an appointment despite registering to pilot. We categorized participants to (1) those who had booked their first appointment before receiving SMS (visitors), (2) those who booked an appointment after receiving the SMS-message (late-visitors), and (3) those who had not booked an appointment during pilot (nonvisitors). We used regression analysis to estimate the association of age, gender, dental fear, economic situation, Oral Health Impact Profile-14-severity (oral health-related quality of life [OHRQoL]), self-reported oral health and need for oral health care (exposures) with oral health care service use during the pilot (outcome). RESULTS Out of 2300 participants, 636 (28%) responded. Late-visitors were more likely older and reported more likely need for oral health care, poorer oral health and OHRQoL than visitors or nonvisitors. Nonvisitors were younger and had better OHRQoL than the others. The differences in the service use by gender, economic situation, and dental fear were small. CONCLUSIONS Service use during the pilot depended on the subjective oral health. Our findings highlight the potential of reminders in increasing care use among those with perceived need for services.
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Affiliation(s)
- Eero Raittio
- Oral Health Care ServicesTampereFinland
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Department of Dentistry and Oral HealthAarhus UniversityAarhusDenmark
| | | | - Taru Sokka
- The Council of Tampere RegionTampereFinland
| | - Satu Lahti
- Department of Community DentistryUniversity of TurkuTurkuFinland
| | - Auli Suominen
- Department of Community DentistryUniversity of TurkuTurkuFinland
| | - Anna Liisa Suominen
- Institute of DentistryUniversity of Eastern FinlandKuopioFinland
- Oral Health Teaching Clinic, Kuopio University HospitalKuopioFinland
| | - Anna Maria Heikkinen
- Oral Health Care ServicesTampereFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
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García Pérez A, González-Aragón Pineda AE, Rodríguez Chávez JA, Villanueva Gutiérrez T, Pérez Pérez NG. Association Between Self-Reported Health and Education with Past-year Dental Visits among Older Mexican Adults: Results of the Mexican Health and Aging Study 2018. Oral Health Prev Dent 2022; 20:385-392. [PMID: 36259442 DOI: 10.3290/j.ohpd.b3500629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE To explore the relationship between of self-reported health (SRH) and educational attainment with pastyear dental visits in older adults in México. MATERIALS AND METHODS For this cross-sectional study, data were derived from the Mexican Health and Aging Study 2018 (MHAS-2018), which used a nationally-representative sample of older adults (50 years or older) in Mexico (n = 14,085). Variables taken from the MHAS questionnaire included residence (rural/urban), years of education, SRH, multimorbidity, pain severity, and past-year dental visits. A logistic regression model was used to identify the association between the variables and past-year dental visits. RESULTS While the percentage of past-year dental visits reported was 39.8%, this number declined with age [OR=0.76, p < 0.001], with older adults living in rural areas 34% less likely to report past-year dental visits than older adults living in urban areas. Older adults with no formal education were 73% less likely (OR=0.27; p < 0.001) to report past-year dental visits than older adults ≥10 years education. Older adults with poor SRH were 32% less likely (OR=0.68; p < 0.001) to report past-year dental visits than older adults with good/very good/excellent SRH. Sex, degree of multimorbidity, and pain level ([OR=1.37; p < 0.001] [OR=1.37; p < 0.001] and [OR=1.17; p < 0.001]) were all found to be positively associated with past-year dental visits in the study population. CONCLUSION The present study highlights the association between poor SRH, a low level of educational attainment, and less frequent past-year dental visits, as well as the finding that past-year dental visits declined with age in the older adults sampled.
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11
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Rulli D. Mental Health Issues in Health Care Providers. J Dent Hyg 2022; 96:4-5. [PMID: 35906083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Danielle Rulli
- Editorial Advisory Board and a clinical associate professor and Director, Graduate Dental Hygiene Program, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA. Dr. Rulli continues to practice dental hygiene as a member of the Department of Periodontics and Oral Medicine's faculty practice and has published on burnout in dental hygiene education
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12
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da Fonseca EP, Pereira-Junior EA, Palmier AC, Abreu MHNG. A Description of Infection Control Structure in Primary Dental Health Care, Brazil. Biomed Res Int 2021; 2021:5369133. [PMID: 34373834 PMCID: PMC8349252 DOI: 10.1155/2021/5369133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study is aimed at describing a score to assess infection control structures in Oral Health Teams (OHT) in Primary Health Care (PHC) in Brazil. METHODS Secondary data from a national external evaluation of PHC conducted in 2017 and 2018 were analyzed. The construction of the score used 14 variables, divided into the following: structural characteristics of the PHC, infection control equipment under conditions of use, and biosafety supplies in sufficient quantity. The questions were mostly dichotomous (yes/no). Descriptive analyses were carried out to characterize the OHT and factor analyses to reduce the number of observed variables to a specific number of factors. RESULTS Among 20,301 health units with OHT, 4,510 (22.2%) units did not have washable floors, ceilings, and walls; 8,406 (41.4%) did not have a sealer; 16,780 (82.7%) did not have taps with noncontact activation, and 4,663 (23.0%) units did not have rubber gloves. Regarding personal protective equipment (PPE), 1,618 (8.0%) units did not have a sufficient quantity of basic PPE. Three factors were defined to explain the 14 evaluated variables. The South region had the best score of infection control, while the North had the worst. CONCLUSIONS Regional inequalities in the failures in infection control structures identified in PHC with OHT were related to the physical structure, equipment, and supplies used for infection control and the absence of PPE for OHT.
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Affiliation(s)
- Emílio Prado da Fonseca
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Andréa Clemente Palmier
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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13
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Kranz AM, Estrada-Darley I, Stein BD, Dick AW. Racial/Ethnic Differences in Receipt of Oral Health Services in Medical and Dental Offices: Impact of Medicaid Policies on Young Children. Pediatr Dent 2021; 43:109-117. [PMID: 33892835 PMCID: PMC8075038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: The purpose of this study was to examine receipt of preventive oral health services (POHS) by race/ethnicity for young Medicaid-enrollees following the enactment of state policies enabling medical providers to deliver POHS. Methods: Using Medicaid data (2006 to 2014) from 38 states for 8,711,192 child-years (aged six months to five years), logistic regressions were used to examine differences within and between racial/ethnic groups (white, black, Hispanic, and "other" race/ethnicity groups) in terms of adjusted probabilities of receiving POHS in medical offices or any medical or dental offices. Models were adjusted for years since policy enactment and estimated separately for states with and without requirements that medical providers obtain POHS training. Results: Receipt of any POHS was 10.9 percentage points higher for Hispanic children and 4.7 percentage points higher for "other" race/ethnicity group children than white children after five or more years of policy enactment in states with training requirements (P<0.05). Findings for medical POHS and states without training requirements were similar but smaller in magnitude. Conclusions: Hispanic and "other" race/ethnicity group children benefitted more from the integration of POHS into medical offices than white children. Policies enabling delivery of POHS in medical offices increased receipt of POHS among some minority groups and may help to reduce disparities.
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Affiliation(s)
- Ashley M Kranz
- Dr. Kranz is a policy researcher, at the RAND Corporation, Arlington, Va., USA;,
| | - Ingrid Estrada-Darley
- Ms. Estrada-Darley is a PhD fellow and an assistant policy researcher, Pardee RAND Graduate School, Santa Monica, Calif., USA
| | - Bradley D Stein
- Dr. Stein is a physician and a senior policy researcher, RAND Corporation, Pittsburgh, Pa., USA
| | - Andrew W Dick
- Dr. Dick is senior economist, RAND Corporation, Boston, Mass., USA
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14
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Makanjuola JO, Ekowmenhenhen UI, Enone LL, Umesi DC, Ogundana OM, Arotiba GT. Mercury hygiene and biomedical waste management practices among dental health-care personnel in public hospitals in Lagos State, Nigeria. Afr Health Sci 2021; 21:457-469. [PMID: 34394328 PMCID: PMC8356574 DOI: 10.4314/ahs.v21i1.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Indiscriminate disposal of hospital wastes including mercury/amalgam wastes pose a serious threat to life and environment. There is a growing concern about biomedical waste (BMW) management among health care workers, however there are limited reports on BMW management by dental personnel in developing countries. OBJECTIVES This study investigated the level of knowledge of BMW, observance of proper mercury hygiene and BMW management practice among public dental personnel in Lagos State, Nigeria. METHODS A cross-sectional study regarding BMW management across public hospitals in Lagos State, Nigeria was conducted following institutional ethics committee approval. A self-administered questionnaire was utilized to obtain data from different facilities selected by purposive and simple random sampling techniques as applicable. The questionnaires were distributed among 437 respondents by convenience sampling. The resulting data were statistically tested using Chi-square and G-test with p-value < 0.05 indicating significant level. RESULTS Amongst 437 respondents, majority were females (62.5%) and the highest proportion fell within the age range of 25-34 years (44.4%). Only 17.2% of the respondents had good knowledge of BMW management/legislation and 4.1% had good BMW practice. Less than half (49.4%) of respondents disposed mercury-contaminated materials inside the trash and majority (92.2%) did not observe proper mercury hygiene. Significantly better mercury hygiene practices were observed in secondary facilities (p=0.040). CONCLUSION A minor proportion of public dental personnel had good knowledge and practice of proper mercury hygiene and BMW management. This shows there is an urgent need for training of health personnel on proper BMW handling and disposal in developing countries like Nigeria.
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Affiliation(s)
- John Oluwatosin Makanjuola
- Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-Araba, Surulere, Lagos State, Nigeria
| | - Uyi Idah Ekowmenhenhen
- Department of Preventive Dentistry, Lagos University Teaching Hospital, Idi-Araba, Surulere, Lagos State, Nigeria
| | - Lillian Lami Enone
- Department of Restorative Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
| | - Donna Chioma Umesi
- Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-Araba, Surulere, Lagos State, Nigeria
- Department of Restorative Dentistry, Lagos University Teaching Hospital, Idi-Araba, Surulere, Lagos State, Nigeria
| | - Oladunni Mojirayo Ogundana
- Department of Oral Biology and Maxillofacial Pathology, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-Araba, Surulere, Lagos State, Nigeria
| | - Godwin Toyin Arotiba
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Idi-Araba, Surulere, Lagos State, Nigeria
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Surulere, Lagos State, Nigeria
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Taylor HL, Apathy NC, Vest JR. Health information exchange use during dental visits. AMIA Annu Symp Proc 2021; 2020:1210-1219. [PMID: 33936497 PMCID: PMC8075496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dental and medical providers require similar patient demographic and clinical information for the management of a mutual patient. Despite an overlap in information needs, medical and dental data are created and stored in multiple records and locations. Electronic health information exchange (HIE) bridge gaps in health data spread across various providers. Enabling exchange via query-based HIE may provide critical information at the point of care during a dental visit. The purpose of this study is to characterize query-based HIE use during dental visits at two Federally Qualified Health Centers (FQHCs) that provided on-site dental services. First, we determine the proportion of dental visits for which providers accessed the HIE. Next, site, patient and visit characteristics associated with query-based HIE use during dental visits are examined. Last, among dental visits with HIE use, the aspects of the HIE that are accessed most frequently are described. HIE use was low (0.17%) during dental visits, however our findings from this study extend the body of research examining HIE use by studying a less explored area of the care continuum.
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Affiliation(s)
- Heather L Taylor
- Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN
- Regenstrief Institute, Indianapolis, IN
| | - Nate C Apathy
- Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN
- Regenstrief Institute, Indianapolis, IN
| | - Joshua R Vest
- Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN
- Regenstrief Institute, Indianapolis, IN
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Nam JW, Phansalkar RS, Lankin DC, McAlpine JB, Leme-Kraus AA, Bedran-Russo AK, Chen SN, Pauli GF. Targeting Trimeric and Tetrameric Proanthocyanidins of Cinnamomum verum Bark as Bioactives for Dental Therapies. J Nat Prod 2020; 83:3287-3297. [PMID: 33151073 PMCID: PMC8041212 DOI: 10.1021/acs.jnatprod.0c00570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The present study elucidated the structures of three A-type tri- and tetrameric proanthocyanidins (PACs) isolated from Cinnamomum verum bark to the level of absolute configuration and determined their dental bioactivity using two therapeutically relevant bioassays. After selecting a PAC oligomer fraction via a biologically diverse bioassay-guided process, in tandem with centrifugal partition chromatography, phytochemical studies led to the isolation of PAC oligomers that represent the main bioactive principles of C. verum: two A-type tetrameric PACs, epicatechin-(2β→O→7,4β→8)-epicatechin-(4β→6)-epicatechin-(2β→O→7,4β→8)-catechin (1) and parameritannin A1 (2), together with a trimer, cinnamtannin B1 (3). Structure determination of the underivatized proanthocyanidins utilized a combination of HRESIMS, ECD, 1D/2D NMR, and 1H iterative full spin analysis data and led to NMR-based evidence for the deduction of absolute configuration in constituent catechin and epicatechin monomeric units.
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Affiliation(s)
- Joo-Won Nam
- Department of Pharmaceutical Sciences, Program for Collaborative Research in the Pharmaceutical Sciences (PCRPS), University of Illinois at Chicago, Chicago, IL 60612, United States
- College of Pharmacy, Yeungnam University, Gyeongsan, Gyeongbuk 712-749, Korea
| | - Rasika S. Phansalkar
- Department of Pharmaceutical Sciences, Program for Collaborative Research in the Pharmaceutical Sciences (PCRPS), University of Illinois at Chicago, Chicago, IL 60612, United States
| | - David C. Lankin
- Department of Pharmaceutical Sciences, Program for Collaborative Research in the Pharmaceutical Sciences (PCRPS), University of Illinois at Chicago, Chicago, IL 60612, United States
| | - James B. McAlpine
- Department of Pharmaceutical Sciences, Program for Collaborative Research in the Pharmaceutical Sciences (PCRPS), University of Illinois at Chicago, Chicago, IL 60612, United States
- Institute for Tuberculosis Research, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Ariene A. Leme-Kraus
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Ana K. Bedran-Russo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, United States
- Department of General Dental Sciences, School of Dentistry, Marquette University, Milwaukee, WI 53233, United States
| | - Shao-Nong Chen
- Department of Pharmaceutical Sciences, Program for Collaborative Research in the Pharmaceutical Sciences (PCRPS), University of Illinois at Chicago, Chicago, IL 60612, United States
- Institute for Tuberculosis Research, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Guido F. Pauli
- Department of Pharmaceutical Sciences, Program for Collaborative Research in the Pharmaceutical Sciences (PCRPS), University of Illinois at Chicago, Chicago, IL 60612, United States
- Institute for Tuberculosis Research, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, United States
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Yonel Z, Cerullo E, Kröger AT, Gray LJ. Use of dental practices for the identification of adults with undiagnosed type 2 diabetes mellitus or non-diabetic hyperglycaemia: a systematic review. Diabet Med 2020; 37:1443-1453. [PMID: 32426909 DOI: 10.1111/dme.14324] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2020] [Indexed: 12/14/2022]
Abstract
AIM Type 2 diabetes is a growing global challenge. Evidence exists demonstrating the use of primary care (non-hospital based) dental practices to identify, through risk assessments, those who may be at increased risk of type 2 diabetes or who may already unknowingly have the condition. This review aimed to synthesize evidence associated with the use of primary care dental services for the identification of undiagnosed non-diabetic hyperglycaemia or type 2 diabetes in adults, with particular focus on the pick-up rate of new cases. METHOD Electronic databases were searched for studies reporting the identification of non-diabetic hyperglycaemia/type 2 diabetes in primary care dental settings. Returned articles were screened and two independent reviewers completed the data-extraction process. A descriptive synthesis of the included articles was undertaken due to the heterogeneity of the literature returned. RESULTS Nine studies were identified, the majority of which utilized a two-stage risk-assessment process with risk score followed by a point-of-care capillary blood test. The main barriers cited were cost, lack of adequate insurance cover and people having previously been tested elsewhere. The pick-up rate of new cases of type 2 diabetes and non-diabetic hyperglycaemia varied greatly between studies, ranging from 1.7% to 24% for type 2 diabetes and from 23% to 45% for non-diabetic hyperglycaemia, where reported. CONCLUSION This review demonstrates that although it appears there may be benefit in using the dental workforce to identify undiagnosed cases of non-diabetic hyperglycaemia and type 2 diabetes, further high-quality research in the field is required assessing both the clinical and cost effectiveness of such practice. (Prospero Registration ID: PROSPERO 2018 CRD42018098750).
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Affiliation(s)
- Z Yonel
- University of Birmingham, Birmingham School of Dentistry, Birmingham, UK
| | - E Cerullo
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - A T Kröger
- University of Birmingham, Birmingham School of Dentistry, Birmingham, UK
| | - L J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
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Affiliation(s)
- Bhakti Desai
- Fourth-Year Dental Student, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
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Watson S, McMullan J, Brocklehurst P, Tsakos G, Watt RG, Wassall RR, Sherriff A, Ramsay SE, Karki AJ, Tada S, Lappin C, Donaldson M, McKenna G. Development of a core outcome set for oral health services research involving dependent older adults (DECADE): a study protocol. Trials 2020; 21:599. [PMID: 32611443 PMCID: PMC7329504 DOI: 10.1186/s13063-020-04531-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/18/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Oral healthcare service provision for dependent older adults is often poor. For dental services to provide more responsive and equitable care, evidence-based approaches are needed. To facilitate future research, the development and application of a core outcome set would be beneficial. The aim of this study is to develop a core outcome set for oral health services research involving dependent older adults. METHODS A multi-step process involving consensus methods and including key stakeholders will be undertaken. This will involve identifying potentially relevant outcomes through a systematic review of previous studies examining the effectiveness of strategies to prevent oral disease in dependent older adults, combined with semi-structured interviews with key stakeholders. Stakeholders will include dependent older adults, family members, carers, care-home managers, health professionals, researchers, dental commissioners and policymakers. To condense and prioritise the long list of outcomes generated by the systematic review and semi-structured interviews, a Delphi survey consisting of several rounds with key stakeholders, as mentioned above, will be undertaken. The 9-point Likert scale proposed by the GRADE Working Group will facilitate this consensus process. Following the Delphi survey, a face-to-face consensus meeting with key stakeholders will be conducted where the stakeholders will anonymously vote and decide on what outcomes should be included in the finalised core outcome set. DISCUSSION Developing a core set of outcomes that are clinically and patient-centred will help improve the design, conduct and reporting of oral health services research involving dependent older adults, and ultimately strengthen the evidence base for high-quality oral health care for dependent older adults. TRIAL REGISTRATION The study was registered with the COMET initiative on 9 January 2018 http://www.cometinitiative.org/studies/details/1081?result=true .
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Affiliation(s)
- Sinead Watson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Julie McMullan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | | | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard G. Watt
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | | | - Sheena E. Ramsay
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | | | - Sayaka Tada
- Discipline of Endodontics, Operative Dentistry and Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Caroline Lappin
- Community Dental Service, South Eastern Health and Social Care Trust, Dundonald, UK
| | | | - Gerald McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
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Shrivastava R, Couturier Y, Girard F, Bedos C, Macdonald ME, Torrie J, Emami E. Appreciative inquiry in evaluating integrated primary oral health services in Quebec Cree communities: a qualitative multiple case study. BMJ Open 2020; 10:e038164. [PMID: 32595166 PMCID: PMC7322273 DOI: 10.1136/bmjopen-2020-038164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The Strategic Regional Plan of the Cree Board of Health and Social Services of James Bay (CBHSSJB), serving the Quebec Cree communities, mandates the objective of integrating oral health within primary healthcare. Emerging evidence suggests that the integration of oral health into primary healthcare can decrease oral health disparities. This research study aimed to answer the following research question: how and to what extent does the integration of oral health into primary healthcare address the oral health needs of the Cree communities? DESIGN We used a multiple-case study design within a qualitative approach and developmental evaluation methodology. The Discovery, Dream, Design and Destiny model of appreciative inquiry was selected as a study framework among existing frameworks of the developmental evaluation. SETTING Four purposefully selected Cree communities. PARTICIPANTS Healthcare providers, administrators and patients at the community wellness centres and hospital. OUTCOME MEASURES Integration of oral health into primary healthcare. RESULTS A total of 36 interviews and 6 focus group discussions were conducted. We identified ten themes in discovery and dream phases. The Discovery phase identified the strengths of the organisation in facilitating enablers of integration including strategic planning, organisational structure, cultural integration, coordinated networks and colocation. In the Dream phase, participants' oral healthcare stories expressed various dimensions of integration and their wish for strengthening integration via extending public oral healthcare programmes, increasing resources and improving organisational management. In the Design phase, recommendations were formulated for a future action plan within the CBHSSJB. CONCLUSION This study results suggested that the CBHSSJB has been successful in implementing oral health integration into primary care following its strategic planning. At present, the organisation could extend the level of integration into full integration by following study recommendations derived from the perspective of local stakeholders.
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Affiliation(s)
- Richa Shrivastava
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Yves Couturier
- School of Social Work, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Felix Girard
- Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
| | - Christophe Bedos
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | | | - Jill Torrie
- Public-Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Québec, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montréal, Québec, Canada
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Harnagea H, Couturier Y, Lamothe L, Emami E. [Integrating oral health care services into primary care in Quebec]. Sante Publique 2020; 31:809-816. [PMID: 32550663 DOI: 10.3917/spub.196.0809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Although integrated care is drawing considerable attention from health care policy makers, little is known about integration of oral health care services into primary care in Quebec. Therefore, the objective of this study was to compile information and compare the aspects of primary oral health care in two public health care organizations. METHOD An environmental scan was carried out in one rural and one urban primary health care organizations in Quebec. Data were collected from organizations' websites, operational documents, observational notes on facility visits, primary care meeting minutes, online pages of professional orders and face to face interviews (N = 74) and focus groups (N = 5), between November 2016 and October 2018. Thematic and Prior's documentation analyses were used to analyse the data. RESULTS Three themes were identified: normative aspects of integrated care delivery, integration trajectories, and integration initiatives. In both organizations, the integration of oral health into primary care rooted in public health sectors and dental teams were the key players. While urban center showed informal linkages between dental and non-dental primary care providers, the rural organization succeeded in coordination processes, even though these were also informal. CONCLUSION The majority of primary oral health care services are delivered in the public health sectors and the sustainability of integration initiatives in other primary health care sectors remains to be demonstrated. A better management of resources, as well as partnerships between public health care organizations and universities, could contribute to this integration.
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Roxo-Gonçalves M, Trevizani Martins MA, Martins MD, Aita Schmitz CA, Dal Moro RG, D'Avila OP, Varvaki Rados DR, Umpierre RN, Gonçalves MR, Carrard VC. Perceived usability of a store and forward telehealth platform for diagnosis and management of oral mucosal lesions: A cross-sectional study. PLoS One 2020; 15:e0233572. [PMID: 32502156 PMCID: PMC7274404 DOI: 10.1371/journal.pone.0233572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/07/2020] [Indexed: 11/18/2022] Open
Abstract
EstomatoNet was created in the south of Brazil to provides specialist support over a web-based platform to primary care dentists for diagnosis of oral lesions. To evaluate the usability of EstomatoNet and to identify user perceptions regarding their expectations and difficulties with the system; and to compare the perceptions of regular users of the service to those of first-time users. Sixteen dentists were selected for the study: 8 were frequent users of EstomatoNet and 8 were residents who had never used the Platform. To assess usability, participants were required to request telediagnosis support for a fictional case provided by the research team. During the process of uploading the information and sending the request, users were asked to “think out loud,” expressing their perceptions. The session was observed by an examiner with remote access to the user's screen (via Skype). After the simulation, users completed the System Usability Scale (SyUS), a validated tool with scores ranging from 0 to 100. The mean SyUS score assigned by frequent users was 84.7±6.6, vs. 82.2±9.3 for residents (satisfactory usability: score above 68). The difference between the groups was not statistically significant (Student t test, P = .55). The residents group took longer (347.1±101.1s) to complete the task than frequent users (252.8±80.3s); however, the difference between the groups was not statistically significant (Student t test, P = .06). In their subjective evaluation, users suggested the inclusion of a field to add further information on outcomes and resolution of the case and changes in the position of the “Send” button to improve workflow. The present results indicate satisfactory usability of EstomatoNet. The Platform seems to meet the needs of users regardless of how experienced they are; nevertheless, a few minor changes in some steps would improve the tool.
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Affiliation(s)
- Michelle Roxo-Gonçalves
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
| | - Marco Antonio Trevizani Martins
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Manoela Domingues Martins
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carlos André Aita Schmitz
- TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rafael Gustavo Dal Moro
- TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Otávio Pereira D'Avila
- TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Dimitris Rucks Varvaki Rados
- TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Internal Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Roberto Nunes Umpierre
- TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Primary HealthCare, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Marcelo Rodrigues Gonçalves
- TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Primary HealthCare, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Vinicius Coelho Carrard
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
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Gliosca LA, D Eramo LR, Bozza FL, Soken L, Abusamra L, Salgado PA, Squassi AF, Molgatini SL. Microbiological study of the subgingival biofilm in HIV+/HAART patients at a specialized dental service. Acta Odontol Latinoam 2019; 32:147-155. [PMID: 32176238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 12/01/2019] [Indexed: 06/10/2023]
Abstract
The aim of this study was to describe the microbiological profile of HIV patients under highly active antiretroviral treatment (HAART). This crosssectional study comprised 32 HIV patients with periodontal disease (PD) who had been under HAART for more than 6 months. Information about the patients' medical history was obtained from clinical records. Clinical dental examination was performed by a calibrated researcher using standard dental instruments to determine probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). A total 4,765 periodontal sites were evaluated, 125 of which were also studied microbiologically. Subgingival biofilm samples were obtained using sterile paper points; one set was used for microbiological culture studies and the other for endpoint PCR. Statistical analysis was performed using KruskalWallis and posthoc DunnBonferroni contrast tests. All participants were on HAART at the time of the study, and 90.6% had a viral load below 50 copies / mm3. Prevalence of periodontally active sites was low in the study population. Microbiological studies: Black pigmented anaerobic bacteria and fusiform CFU counts were significantly higher in samples from sites with BOP and PD ≥4mm (p 0.020 and p 0.005, respectively). Molecular Assays: Detection of Porphyromonas gingivalis (p 0.002), Tannerella forsythia (p 0.023) and Treponema denticola (p 0.015) was significantly more frequent at sites with BOP and PD ≥4mm. Conclusions: The patients living with HIV/AIDS under HAART studied here had low prevalence of clinical periodontal disease signs. However, significant detection of P. gingivalis, T. denticola, and T. forsythia in periodontal active sites, and the involvement of these microorganisms as potential HIV reactivators, show the importance of creating awareness among dental health professionals of the need for close dental and periodontal monitoring in HIV patients.
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Affiliation(s)
- Laura A Gliosca
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Microbiología, Laboratorio de Diagnóstico Microbiológico, Buenos Aires, Argentina.
- Universidad de Buenos Aires, Instituto de Investigaciones en Salud Pública, Buenos Aires, Argentina
| | - Luciana R D Eramo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Odontología Preventiva Comunitaria, Buenos Aires, Argentina
- Universidad de Buenos Aires, Instituto de Investigaciones en Salud Pública, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Odontología, Clínica para La Atención de Pacientes de Alto Riesgo médico: (CLAPAR I), Buenos Aires, Argentina
| | - Florencia L Bozza
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Microbiología, Laboratorio de Diagnóstico Microbiológico, Buenos Aires, Argentina
- Universidad de Buenos Aires, Instituto de Investigaciones en Salud Pública, Buenos Aires, Argentina
| | - Luciana Soken
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Microbiología, Laboratorio de Diagnóstico Microbiológico, Buenos Aires, Argentina
- Universidad de Buenos Aires, Instituto de Investigaciones en Salud Pública, Buenos Aires, Argentina
| | - Lorena Abusamra
- Servicio de Infectología. Hospital General de Agudos Dr. Juan A. Fernández, Buenos Aires, Argentina
| | - Pablo A Salgado
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Microbiología, Laboratorio de Diagnóstico Microbiológico, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Odontología Preventiva Comunitaria, Buenos Aires, Argentina
- Universidad de Buenos Aires, Instituto de Investigaciones en Salud Pública, Buenos Aires, Argentina
| | - Aldo F Squassi
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Odontología Preventiva Comunitaria, Buenos Aires, Argentina
- Universidad de Buenos Aires, Instituto de Investigaciones en Salud Pública, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Odontología, Clínica para La Atención de Pacientes de Alto Riesgo médico: (CLAPAR I), Buenos Aires, Argentina
| | - Susana L Molgatini
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Microbiología, Laboratorio de Diagnóstico Microbiológico, Buenos Aires, Argentina
- Universidad de Buenos Aires, Instituto de Investigaciones en Salud Pública, Buenos Aires, Argentina
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Reis CMR, Matta-Machado ATG, Amaral JHL, Mambrini JVDM, Werneck MAF, de Abreu MHNG. Understanding oral health care team performance in primary care: A mixed-method study. PLoS One 2019; 14:e0217738. [PMID: 31145771 PMCID: PMC6542530 DOI: 10.1371/journal.pone.0217738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/19/2019] [Indexed: 12/02/2022] Open
Abstract
Objective This study aims to describe the primary care services carried out by Oral Health Teams (OHTs) in Brazil, and to understand the nuances that lead to different levels of OHT performance. Material & methods A mixed-methods study with a sequential explanatory design was developed. In the quantitative phase, secondary data from a national survey (PMAQ-AB) was used to describe the work of 12,403 OHTs. Item response theory (IRT) was applied, to evaluate the psychometric qualities of 20 oral health questions from PMAQ-AB and to identify the performance of OHT. The quantitative results guided the selection of the qualitative sample. An extreme case sampling strategy was used (opposite results). OHTs were selected from Belo Horizonte metropolitan region in Brazil using scores measured by IRT. Data were collected through semi-structured interviews. Data analysis was conducted using deductive and inductive thematic analysis. Results Quantitative results showed that there are OHT with high and low performance in Brazil. The IRT analysis showed that items related to prostheses and oral cancer tend to discriminate high-performance OHTs from other OHTs. Qualitative results deepened the understanding of accessing oral health services and found several access barriers, such as the insufficient number of OHTs for the population, and a very long waiting time for dental consultations other than urgency. The qualitative results confirmed that high-performance OHTs tend to emphasize oral cancer surveillance and deliver prostheses in PHC services. Conclusion Despite the expansion of oral health in PHC in Brazil in recent years, OHTs still face many challenges such as: access barriers; failures in prevention, early diagnosis and follow-up of oral cancer cases; and insufficient rehabilitation with prostheses.
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Affiliation(s)
| | | | - João Henrique Lara Amaral
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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25
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Jessani A, Brondani MA. Availability of Medical and Oral Health Services for People Living with HIV in British Columbia, Canada. J Can Dent Assoc 2019; 84:j1. [PMID: 31199727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To conduct an environmental scan and categorize the scope of medical and oral health care services for people living with HIV (PLWHIV) across the province of British Columbia (BC). METHODS Data were collected using online search engines such as Google and Yahoo, as well as the websites of health services agencies and community/not-for-profit organizations in BC. Informal telephone conversations were conducted to confirm findings from the online scan. Available services were categorized in terms of scope (e.g., prevention, treatment or support) and geographic location in relation to the latest rates of new HIV infections per 100 000 people. In 2014, the number of people in BC known to be infected with HIV was 12 100, with the rate of new infections at 261 per 100 000 people. RESULTS We identified 104 organizations that were providing services exclusively for PLWHIV; these organizations were unevenly distributed across 40 out of 51 cities in BC. Of all the services offered at these organizations, 59% were preventive and educational in nature, 15% were related to treatment services for HIV-related conditions and 38% entailed support services including social assistance. Only 3% of the 104 organizations offered basic dental care. Services of any kind tended to cluster around metropolitan areas of high HIV prevalence, including Vancouver, while northern BC remains underserved despite having the second highest rate of new HIV infections in the province. CONCLUSIONS This study reveals a mismatch between the number and scope of services available for PLWHIV and the distribution of HIV infection across BC. Almost half of the services identified by the environmental scan were preventive, and only 3% offered some form of dental treatment exclusively to PLWHIV in BC.
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Raduege TJ. Benefits and Services. Issue Brief Health Policy Track Serv 2018; 2018:1-43. [PMID: 30681818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Berry MD. Medicaid Reimbursement. Issue Brief Health Policy Track Serv 2018; 2018:1-21. [PMID: 30694031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Frascino AV, Fava M, Cominato L, Odone-Filho V. Review of a three-year study on the dental care of onco-hematological pediatric patients. Clinics (Sao Paulo) 2018; 73:e721. [PMID: 30517306 PMCID: PMC6251250 DOI: 10.6061/clinics/2017/e721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/20/2018] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to provide an updated review of dental procedures undertaken at the dental unit of the Onco-hematology service of the Instituto da Criança at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (ICr/HC-FMUSP). We retrospectively reviewed 565 of 1902 medical and dental records of patients diagnosed with onco-hematological diseases who were seen in a 3-year study (January 2015 to December 2017). We assessed data regarding population characteristics, onco-hematological diagnosis and dental procedures performed. Of the selected medical records, preventive dentistry was the most common procedure undertaken in this population, followed by oral maxillofacial surgeries, restorative dentistry and oral mucositis treatment. The most prevalent malignant diagnosis was acute lymphocytic leukemia, and the most prevalent nonmalignant diagnosis was sickle-cell anemia. Preventive dental procedures represent most of the dental procedures undertaken in hospitalized onco-hematological pediatric patients.
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Affiliation(s)
- Alexandre Viana Frascino
- Instituto da Crianca (ICr), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Marcelo Fava
- Instituto da Crianca (ICr), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Louise Cominato
- Instituto da Crianca (ICr), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Vicente Odone-Filho
- Instituto da Crianca (ICr), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Policy on Workforce Issues and Delivery of Oral Health Care Services in a Dental Home. Pediatr Dent 2018; 40:31-5. [PMID: 32074841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Harnagea H, Lamothe L, Couturier Y, Emami E. How primary health care teams perceive the integration of oral health care into their practice: A qualitative study. PLoS One 2018; 13:e0205465. [PMID: 30312338 PMCID: PMC6185726 DOI: 10.1371/journal.pone.0205465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/25/2018] [Indexed: 11/25/2022] Open
Abstract
Recently, new models for the integration of oral health into primary care have been proposed. However, these models may be adopted by a variety of health care systems, and will reach successful outcomes only if they can be adapted to suit the local context. To this end, the objective of this study was to explore the perceptions of Quebec primary health care teams on the integration of oral health into primary care. A qualitative approach and interpretive description methodology were used to conduct the study within a case-study design. Purposeful sampling with maximum variation and snowball technique were used for recruitment of study participants. Seventy-four in-depth, semi-structured interviews and five focus groups were conducted with primary health care teams including health care providers and managers working in a rural and an urban health care center. The interview guide and study conceptual framework were based on the Rainbow model. Data collection and data analyses were conducted concurrently and continued until saturation was achieved. To analyze the data, four phases of qualitative analysis were followed. The thematic analysis included interview debriefing, transcript coding, data display, and interpretation. Data analysis was conducted both manually and with the use of Atlas-ti software. A total of four themes emerged from the interviews and focus group discussions. These themes covered all domains of the study theoretical model and included: 1) drivers of integration; 2) importance of integration; 3) professionals’ role in integrated care; and 4) barriers and enablers of integration. In general, most of the barriers expressed by study participants were related to the organizational and system domains of integration. Primary health care teams who provide care in rural and urban areas in Quebec expressed their concerns on the absence of integrated oral health services. Implementation of governance policies, the prioritization of educational and management measures as well as inter-professional collaboration toward innovative care models could facilitate this integration.
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Affiliation(s)
- Hermina Harnagea
- School of Public Health, Université de Montréal, Québec, Canada
- Public Health Research Institute, Université de Montréal, Québec, Canada
| | - Lise Lamothe
- School of Public Health, Université de Montréal, Québec, Canada
- Public Health Research Institute, Université de Montréal, Québec, Canada
| | - Yves Couturier
- School of Social Work, Université de Sherbrooke, Québec, Canada
| | - Elham Emami
- School of Public Health, Université de Montréal, Québec, Canada
- Public Health Research Institute, Université de Montréal, Québec, Canada
- Faculty of Dentistry, McGill University, Québec, Canada
- * E-mail:
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Aarabi G, Reissmann DR, Seedorf U, Becher H, Heydecke G, Kofahl C. Oral health and access to dental care - a comparison of elderly migrants and non-migrants in Germany. Ethn Health 2018; 23:703-717. [PMID: 28277023 DOI: 10.1080/13557858.2017.1294658] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To compare oral health, access barriers to dental care, oral health behavior and oral hygiene behavior of elderly German residents with and without immigration background. DESIGN In this cross-sectional explorative study, a convenience sample (N = 112, age ≥ 60 years, 54% immigrants) was recruited in four dental practices in Hamburg, Germany. Oral health was assessed with Decayed/Missing/Filled Teeth (DMFT), Papillary Bleeding Index (PBI), and Approximal Plaque Index (API). Dental health was operationalized as number of decayed teeth, and poor oral hygiene based on a PBI ≥ 40%. Access barriers and oral health behavior were assessed with a standardized questionnaire. RESULTS While caries experience was similar in migrants and non-migrants (DMFT mean: 24.8 vs. 23.4, n.s.), significantly more teeth were decayed (5.3 vs. 2.1, p < 0.001), and API (55.3% vs. 33.0%, p = 0.002) and PBI (46.3% vs. 30.5%, p = 0.016) were significantly higher in migrants. After adjusting for age, sex, income, education, and number of teeth, migrants still had on average 3 decayed teeth more than non-migrants. However, impact of migration background on poor oral health changed from OR = 3.61 (p = 0.007) to OR = 1.05 (n.s.) after adjusting for confounders, mainly due to lower income in migrants. Fewer migrants had visited a dentist within the past 12 months, and migrants were less likely to have a regular dentist that they visit and more often indicated language or cost barriers than non-migrants. CONCLUSION Elderly German migrants have higher treatment needs than non-migrants. Likely causes are poorer oral hygiene and lower utilization of dental care services. Specific prevention programs targeting migrants are warranted to improve oral health in this disadvantaged group.
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Affiliation(s)
- Ghazal Aarabi
- a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Daniel R Reissmann
- a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Udo Seedorf
- a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Heiko Becher
- b Department of Medical Biometry and Epidemiology, Center for Experimental Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Guido Heydecke
- a Department of Prosthetic Dentistry, Center for Dental and Oral Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Christopher Kofahl
- c Department of Medical Sociology, Center for Psychosocial Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Barzangi J, Unell L, Skovdahl K, Arnrup K. Knowledge, experiences and attitudes of dental and health care personnel in Sweden towards infant dental enucleation. Eur Arch Paediatr Dent 2018; 19:229-237. [PMID: 29987668 PMCID: PMC6132442 DOI: 10.1007/s40368-018-0351-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 05/14/2018] [Indexed: 11/25/2022]
Abstract
Purpose To examine self-rated knowledge of clinical experiences and attitudes towards the practice of infant dental enucleation among dental and health care personnel in Sweden. Methods A questionnaire survey was performed among 776 licensed dental and health care personnel working in emergency departments, midwifery, child health centres, school health services and public dental health services in 10 Swedish cities. The response rate was 56.2% (n = 436). Results Fewer than a fifth of the respondents reported self-rated knowledge of the practice. Approximately 13% of personnel encountering children professionally believed they had seen subjected patients in their clinical practice. Personnel with self-rated knowledge and clinical experience worked mostly in dental care. Additionally, the personnel had diverging attitudes regarding agreement and disagreement concerning professional responsibility for patients subjected to or at risk of infant dental enucleation. Conclusions The study indicated there is need for increased knowledge about the practice and for clarification of obligatory responsibilities among dental and health care personnel regarding management and prevention of cases of infant dental enucleation.
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Affiliation(s)
- J Barzangi
- Dental Research Department, Public Dental Health Service, Örebro, Region Örebro County, Sweden.
- Specialisttandvårdskliniken, Västmanland Hospital Västerås, Västerås, Region Västmanland County, Sweden.
| | - L Unell
- Dental Research Department, Public Dental Health Service, Örebro, Region Örebro County, Sweden
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - K Skovdahl
- Faculty for Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - K Arnrup
- Dental Research Department, Public Dental Health Service, Örebro, Region Örebro County, Sweden
- School of Health Sciences, Örebro University, Örebro, Sweden
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Harnagea H. [Interprofessional collaboration in geriatric primary oral healthcare in Québec – Implementation landmarks]. Sante Publique 2018; 30:383-388. [PMID: 30541267 DOI: 10.3917/spub.183.0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Accelerated ageing of the population results in an ever-increasing number of functionally dependent elderly persons. Even healthy older people experience self-care deficits due to decreased mobility, endurance and sensory loss. Residents in long-term care centres depend on caregivers for the majority of their activities of daily living.Dental services for functionally dependent seniors generally remain inadequate. Several factors may explain this situation, including the absence of government guidelines and the lack of initial and continuing training of both dental and non-dental personnel.Based on a review of the scientific literature published between 1970-2016, four strategies were identified to improve this problem:Promoting, supporting and formalizing interprofessional collaboration.Building a common vision for oral health.Developing complementary and shared professional and relational skills.Redefining the roles and responsibilities of primary care practitioners.These strategies could be considered in the process of implementing a dental service adapted to the needs of this population group.
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Urata JY, Couch ET, Walsh MM, Rowe DJ. Nursing Administrators' Views on Oral Health in Long-Term Care Facilities: An exploratory study. J Dent Hyg 2018; 92:22-30. [PMID: 29739844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/04/2017] [Indexed: 06/08/2023]
Abstract
Purpose: To explore the knowledge, attitudes, and practices of supervising nurse administrators (SNAs) regarding the oral care provided to long-term care facility (LTCF) residents and the role of dental professionals in those facilities.Methods: The investigators of this study partnered with the National Association of Nursing Administrators to send this cross-sectional study consisting of a 35-item electronic survey to its members whose email addresses were in their database. Online software tabulated responses and calculated frequencies (percentages) of responses for each survey item.Results: Of the 2,359 potential participants, 171 (n=171) completed the survey for a 7% response rate. Only 25% of the respondents were familiar with the expertise of dental hygienists (DHs), however once informed, the majority were interested in having DHs perform oral health staff trainings, oral screenings, and dental referrals and initiate fluoride varnish programs. Most respondents correctly answered the oral health-related knowledge items, understood that oral health is important to general health, but reported that the LTCF residents' oral health was only "good" or "fair." Fewer than half, (48%) of the SNAs were "very satisfied" with the quality of oral care provided to the residents. While more than half reported that they had no dentist on staff or on-site dental equipment, 77% reported that they would consider on-site mobile oral care services. Oral health training for staff was provided primarily by registered nurses, however only 32% reported including identification of dental caries as part of the in-service training.Conclusion: This exploratory study lays the foundation for more extensive research investigating various strategies to improve the oral health of LTCF residents, including increased collaboration between DHs and SNAs.
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Raduege TJ. Benefits and Services. Issue Brief Health Policy Track Serv 2017; 2017:1-59. [PMID: 29360311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Mortenson LC. Medicaid Waivers. Issue Brief Health Policy Track Serv 2017; 2017:1-39. [PMID: 29361656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Abstract
This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relates to Dentistry in Society. In addition to treating individual patients, a Dentist must be able to focus on promoting health, monitoring interventions and implementing effective strategies of care at community and population levels. This necessarily involves understanding population demography and health trends, engaging with health policy and promoting health. A Dentist must also understand population demography and health trends, in the context of the healthcare system within which they work.
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Affiliation(s)
| | - J C Field
- The University of Sheffield, Sheffield, UK
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Löffler C, Böhmer F. The effect of interventions aiming to optimise the prescription of antibiotics in dental care-A systematic review. PLoS One 2017; 12:e0188061. [PMID: 29136646 PMCID: PMC5685629 DOI: 10.1371/journal.pone.0188061] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 10/31/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Abundant evidence in dentistry suggests that antibiotics are prescribed despite the existence of guidelines aiming to reduce the development of antibiotic resistance. This review investigated (1) which type of interventions aiming to optimise prescription of antibiotics exist in dentistry, (2) the effect of these interventions and (3) the specific strengths and limitations of the studies reporting on these interventions. METHOD Literature search was based on Medline, Embase, Global Health, Cochrane CENTRAL, ClinicalTrials.gov and Current Controlled Trials. Studies with one of the two primary outcomes were included: (1) The number of antibiotics prescribed and/or (2) the accuracy of the prescription, commonly measured as a percentage of adherence to local clinical guidelines. RESULTS Nine studies met these inclusion criteria. Five studies reported on the prescription of antibiotics in primary dental care and four studies focused on outpatient dental care. Interventions used in primary dental care included a combination of audit, feedback, education, local consensus, dissemination of guidelines and/or academic detailing. Trials in the outpatient setting made use of expert panel discussions, educational feedback on previous acts of prescribing, the dissemination of guidelines and the establishment of internal guidelines. All studies successfully reduced the number of antibiotics prescribed and/or increased the accuracy of the prescription. However, most studies were confounded by a high risk of selection bias, selective outcome reporting and high variance across study groups. In particular, information relating to study design and methodology was insufficient. Only three studies related the prescriptions to the number of patients treated with antibiotics. CONCLUSIONS This systematic review was able to offer conclusions which took the limitations of the investigated studies into account. Unfortunately, few studies could be included and many of these studies were confounded by a low quality of scientific reporting and lack of information regarding study methodology. High-quality research with objective and standardised outcome reporting, longer periods of follow-up, rigorous methodology and adequate standard of study reporting is urgently needed.
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Affiliation(s)
- Christin Löffler
- Institute of General Practice, Rostock University Medical Center, Rostock, Germany
| | - Femke Böhmer
- Institute of General Practice, Rostock University Medical Center, Rostock, Germany
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Abstract
The American Dental Association's Community Dental Health Coordinator program was designed to teach community health worker skills to dental auxiliaries. Case management, a valued skill utilized by medical providers, is largely unknown in the dental profession. When case management is incorporated into a dental professional's practice, prevention becomes amplified, leading to decreased costs and increased access.
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Affiliation(s)
- Jane Grover
- director, Council on Advocacy for Access and Prevention for the American Dental Association, Chicago, Illinois
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Maxey HL, Norwood CW, O'Connell JB, Liu Z. Impact of State Workforce Policies on Underserved Patients' Access to Dental Care: A longitudinal study. J Dent Hyg 2017; 91:26-39. [PMID: 29118277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 05/14/2017] [Indexed: 06/07/2023]
Abstract
Purpose: Dental diseases are almost entirely preventable, but discrepancies in access to oral healthcare limit the effectiveness of preventive interventions. Dental hygienists are strategically positioned to improve access to preventive dental procedures; however, state workforce policies determine their permitted clinical tasks.Methods: This study cross-referenced oral healthcare service use at Federally Qualified Health Centers (FQHCs) between 2004 and 2012 with the Dental Hygiene Professional Practice Index (DHPPI), which quantifies the various aspects of state policy environments for the dental hygiene workforce. More specifically, the study used generalized linear mixed-effects models to examine the influence of state policy environment on access to dental care at 958 FQHC grantees.Results: States with "favorable" policy environments consistently reported the highest proportion of FQHC patients accessing dental care services (18%), whereas states with "restrictive" environments reported the lowest proportion (12%).Conclusion: A smaller proportion of FQHC patients' receive dental examinations in states with restrictive state workforce policies; state lawmakers should frame workforce policies to protect public safety without limiting the oral health workforce's ability to provide important oral health services to underserved people.
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Abstract
Objectives: To test the psychometric properties of an adapted Arabic version of the state trait anxiety-form Y (STAI-Y) in Saudi adult dental patients. Methods: In this cross-sectional study, the published Arabic version of the STAI-Y was evaluated by 2 experienced bilingual professionals for its compatibility with Saudi culture and revised prior to testing. Three hundred and eighty-seven patients attending dental clinics for treatment at the Faculty of Dentistry Hospital, King Abdullah University, Jeddah, Kingdom of Saudi Arabia, participated in the study. The Arabic version of the modified dental anxiety scale (MDAS) and visual analogue scale (VAS) ratings of anxiety were used to assess the concurrent criterion validity. Results: The Arabic version of the STAI-Y had high internal consistency reliability (Cronbach’s alpha: 0.989) for state and trait subscales. Factor analysis indicated unidimensionality of the scale. Correlations between STAI-Y scores and both MDAS and VAS scores indicated strong concurrent criterion validity. Discriminant validity was supported by the findings that higher anxiety levels were present among females as opposed to males, younger individuals as compared to older individuals, and patients who do not visit the dentist unless they have a need as opposed to more frequent visitors to the dental office. Conclusion: The Arabic version of the STAI-Y has an adequate internal consistency reliability, generally similar to that reported in the international literature, suggesting it is appropriate for assessing dental anxiety in Arabic speaking populations.
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Affiliation(s)
- Maha A Bahammam
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
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McEvoy PM, Van Ness CJ, Simmer-Beck ML, Branson BG, Hunt K, Gadbury-Amyot CC. Experiences of the Kansas Extended Care Permit Providers: A descriptive study. J Dent Hyg 2017; 91:12-20. [PMID: 29118079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 03/14/2017] [Indexed: 06/07/2023]
Abstract
Purpose: A total of 40 states to date have expanded the role of dental hygienists with the goal of improving access to basic oral health services for underserved populations. In Kansas, legislative changes have resulted in the Extended Care Permit (ECP) designation. The purpose of this study is to describe the experiences of registered dental hygienists in Kansas holding ECP certificates (ECP RDH) as of July of 2014.Methods: Secondary data analysis was performed utilizing data collected from a survey conducted in 2014 by Oral Health Kansas. All registered ECP RDH's were sent the 32-item survey via Survey Monkey®. Descriptive statistical analyses consisted of frequency distributions, and measures of central tendency. Inferential analyses using t-tests and ANOVA were conducted to compare groups.Results: A total of 73 responses were received from the (n= 176) surveys that were e-mailed for a 41% response rate. Of the clinicians who responded, 80%, worked at least part-time and in school settings. The most consistent barriers to providing care were the inability to directly bill insurance (52%), financial sustainability (42%) and physical requirements (42%). Follow-up tests found significant differencs between clinician groups when examining barriers.Conclusion: Although the ECP legislation appears to be expanding access to care for citizens in Kansas, significant barriers still exist in making this a viable model for oral healthcare delivery.
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Brown J. How to hire your dental team. CDS Rev 2017; 110:16-17. [PMID: 29461724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Durbin M. We can't do it alone. CDS Rev 2017; 110:20. [PMID: 29461727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
SINCE 2013, THE CDS FOUNDATION HAS PROVIDED FREE DENTAL CARE TO THE UNDERSERVED AT ITS CLINIC IN WHEATON.
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Studies Find Teledentistry Programs Increase Patient Access to Dental Services. N Y State Dent J 2017; 83:58. [PMID: 29920037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Bersell CH. Access to Oral Health Care: A National Crisis and Call for Reform. J Dent Hyg 2017; 91:6-14. [PMID: 29118145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose: According to the report Healthy People 2020, oral health is integral to overall health and access to dental services is essential to promoting and maintaining good oral health. Yet, those who need dental care the most are often the least likely to receive it. The dental hygiene profession is poised to play a pivotal role in the resolution of oral health disparities. The purpose of this manuscript is to examine the critical issue of access to oral health care in the United States from various perspectives and consider potential implications for dental professionals and the oral health care system. This report focuses on major underserved and vulnerable populations and highlights several barriers that significantly affect the ability to access and navigate the oral health care system. These include low socioeconomic status; the shortage and maldistribution of dentists; a lack of professional training regarding current evidence-based oral health guidelines; deficient continuity of care due to inadequate interdisciplinary collaboration; low oral health literacy; and patient perceptions and misconceptions about preventive dental care. This report also contains an update on provider participation in Medicaid; the state of children's oral health; and emerging workforce models, state initiatives, and legislative reforms. Recommendations increasing access to care require local, state, and federal stakeholders to combine forces that take advantage of the existing dental hygiene workforce, utilize innovative delivery models, improve license reciprocity, reduce prohibitive supervision, and expand the dental hygiene scope of practice. The major focus of future research will be on the implementation of mid-level oral health care providers. Dental hygienists are an integral part of the access to care solution and have a great opportunity to lead the call to action and fulfill the American Dental Hygienists' Association's mandate that oral health care is the right of all people.
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Affiliation(s)
- Deborah Greenspan
- Department of Orofacial Sciences, School of Dentistry, University of California-San Francisco, Box 0422, Room S-612, San Francisco, CA 94143-0422, USA.
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de Castro RD, Rangel MDL, da Silva MAA, de Lucena BTL, Cavalcanti AL, Bonan PRF, Oliveira JDA. Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users. Int J Environ Res Public Health 2016; 13:ijerph13101026. [PMID: 27775584 PMCID: PMC5086765 DOI: 10.3390/ijerph13101026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/15/2016] [Accepted: 10/10/2016] [Indexed: 11/16/2022]
Abstract
The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user’s perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws.
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Affiliation(s)
- Ricardo Dias de Castro
- Programa de Pós-Graduação em Odontologia, Universidade Federal da Paraíba, João Pessoa 58051-900, PB, Brazil.
- Centro de Ciências da Saúde, Departamento de Fonoaudiologia, Universidade Federal da Paraíba, João Pessoa 58051-900, PB, Brazil.
| | - Marianne de Lucena Rangel
- Programa de Pós-Graduação em Odontologia, Universidade Federal da Paraíba, João Pessoa 58051-900, PB, Brazil.
| | - Marcos André Azevedo da Silva
- Centro de Ciências da Saúde, Graduação em Odontologia, Universidade Federal da Paraíba, João Pessoa 58051-900, PB, Brazil.
| | - Brunna Thaís Lucwu de Lucena
- Centro de Ciências da Saúde, Departamento de Fonoaudiologia, Universidade Federal da Paraíba, João Pessoa 58051-900, PB, Brazil.
| | - Alessandro Leite Cavalcanti
- Programa de Pós-Graduação em Odontologia, Universidade Estadual da Paraíba, Campina Grande 58429-500, PB, Brazil.
| | - Paulo Rogério Ferreti Bonan
- Programa de Pós-Graduação em Odontologia, Universidade Federal da Paraíba, João Pessoa 58051-900, PB, Brazil.
| | - Julyana de Araújo Oliveira
- Programa de Pós-Graduação em Odontologia, Universidade Federal da Paraíba, João Pessoa 58051-900, PB, Brazil.
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Whitman E. Treating dental care as healthcare. Mod Healthc 2016; 46:32. [PMID: 30398789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Shannon CK, Price SS, Jackson J. Predicting Rural Practice and Service to Indigent Patients: Survey of Dental Students Before and After Rural Community Rotations. J Dent Educ 2016; 80:1180-1187. [PMID: 27694291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 05/30/2016] [Indexed: 06/06/2023]
Abstract
Community-based clinical rotations in rural areas expose dental students to diverse patient populations, practice models, and career opportunities as well as rural culture. The aims of this study at West Virginia University were to determine the best predictors of rural practice, assess the predictive validity of students' intention to practice in a rural area before and after their rural rotations, and evaluate the relationship between students' intention to practice in a rural area and intention to provide care for indigent patients. Online survey data were submitted pre- and post-rural clinical rotation by 432 of 489 dental students over the study period 2001-12, yielding an 88% response rate. In 2013, practice addresses from the West Virginia Board of Dentistry were added to the student database. The results showed that significant predictors of rural practice site were intended rural practice choice, rural hometown, and projected greater practice accessibility for indigent patients. The likelihood of students' predicting they would choose a rural practice increased after completion of their rural rotations. After the rotations, students predicted providing greater accessibility to indigent patients; these changes occurred for those who changed their predictions to rural practice choice after the rotations and those who subsequently entered rural practice. The dental students with a rural background or a greater service orientation were also more likely to expect to enter a rural practice and actually to do so after graduation. These findings suggest that dental school curricula that include rural rotations may increase students' sensitivity to issues of indigent patients and increase students' likelihood of rural practice choice.
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Affiliation(s)
- C Ken Shannon
- Dr. Shannon is Associate Professor Emeritus, Department of Family Medicine, West Virginia University; Dr. Price is Professor, Diagnostic Sciences, and Associate Dean of Admissions, Recruitment, and Access, School of Dentistry, West Virginia University; and Ms. Jackson is Director of Research, Institute for Community and Rural Health, Robert C. Byrd Health Sciences Center, West Virginia University
| | - Shelia S Price
- Dr. Shannon is Associate Professor Emeritus, Department of Family Medicine, West Virginia University; Dr. Price is Professor, Diagnostic Sciences, and Associate Dean of Admissions, Recruitment, and Access, School of Dentistry, West Virginia University; and Ms. Jackson is Director of Research, Institute for Community and Rural Health, Robert C. Byrd Health Sciences Center, West Virginia University.
| | - Jodie Jackson
- Dr. Shannon is Associate Professor Emeritus, Department of Family Medicine, West Virginia University; Dr. Price is Professor, Diagnostic Sciences, and Associate Dean of Admissions, Recruitment, and Access, School of Dentistry, West Virginia University; and Ms. Jackson is Director of Research, Institute for Community and Rural Health, Robert C. Byrd Health Sciences Center, West Virginia University
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