Sample records for accessing dental care

  1. Expanding oral care opportunities: direct access care provided by dental hygienists in the United States.

    PubMed

    Naughton, Doreen K

    2014-06-01

    Dental hygienists expand access to oral care in the United States. Many Americans have access to oral health care in traditional dental offices however millions of Americans have unmet dental needs. For decades dental hygienists have provided opportunities for un-served and under-served Americans to receive preventive services in a variety of alternate delivery sites, and referral to licensed dentists for dental care needs. Publications, state practice acts, state public health departments, the American Dental Hygienists' Association, and personal interviews of dental hygiene practitioners were accessed for information and statistical data. Dental hygienists in 36 states can legally provide direct access care. Dental hygienists are providing preventive services in a variety of settings to previously un-served and under-served Americans, with referral to dentists for dental needs. Dental hygienists have provided direct access to care in the United States for decades. The exact number of direct access providers in the United States is unknown. Limited research and anecdotal information demonstrate that direct access care has facilitated alternate entry points into the oral health systems for thousands of previously un-served and underserved Americans. Older adults, persons with special needs, children in schools, pregnant women, minority populations, rural populations, and others have benefited from the availability of many services provided by direct access dental hygienists. Legislatures and private groups are becoming increasingly aware of the impact that direct access has made on the delivery of oral health care. Many factors continue to drive the growth of direct access care. Additional research is needed to accumulate qualitative and quantitative outcome data related to direct access care provided by dental hygienists and other mid level providers of oral health services. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Access to dental care among 15–64 year old people

    PubMed Central

    Eslamipour, Faezeh; Heydari, Kamal; Ghaiour, Marzieh; Salehi, Hoda

    2018-01-01

    INTRODUCTION: The current study aims to study people's access to oral and dental health-care services and their satisfaction with the services provided to them. MATERIALS AND METHODS: A descriptive study with multi-stage sampling was conducted on 1360 people aged 16–64 years residing in Isfahan city, Iran. The required data were collected by a questionnaire which comprised of three main parts: demographic characteristics, patients’ access to oral and dental health-care services and its barriers and participants’ satisfaction with access to services. Data were analyzed by SPSS statistical software. RESULTS: The results showed 40% of participants reported an average level for oral health, and 82% of them did not have any problems regarding access to dental care facilities. The main causes of their dissatisfaction were high cost of services (60%) and insufficient health insurance coverage (40%). About 73% reported that they had to spend 30 min or less to access to a dental health-care facility. In addition, 50% of participants were satisfied with the provided services. The main reported reasons for referring to dentists were oral and dental problems (69%) and regular check-ups (15%). There was no significant relationship between participants’ gender, education level, insurance coverage, and access to dental health-care centers (P > 0.05). CONCLUSION: Most participants were satisfied with access to dental healthcare, but they were dissatisfied with the costs and inadequate insurance coverage. About half of the participants were satisfied with the services provided to them, and the highest level of satisfaction was reported for easy access to health-care centers. PMID:29693027

  3. Access to dental care and the capacity of the California dental care system.

    PubMed

    Brown, Timothy T; Pourat, Nadereh; Glassman, Paul; Chung, Jessica; Nicholson, Gina; Hong, Juliette S

    2012-03-01

    The authors estimated the following levels of technical efficiency for three types of dental practices in California where technical efficiency is defined as the maximum output that can be produced from a given set of inputs: generalists (including pediatric dentists), 96.5 percent; specialists, 77.1 percent; community dental clinics, 83.6 percent. Combining this with information on access, it is estimated that the California dental care system in 2009-10 could serve approximately 74 percent of the population.

  4. Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

    PubMed

    Prabhu, Neeta T; Nunn, June H; Evans, D J; Girdler, N M

    2010-01-01

    The goal of this study was to elicit the views of patients or parents/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients/parents/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.

  5. Income-Related Inequalities in Access to Dental Care Services in Japan.

    PubMed

    Nishide, Akemi; Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

    2017-05-12

    Background : This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods : The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results : Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions : There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system.

  6. Access Barriers to Dental Health Care in Children with Disability. A Questionnaire Study of Parents.

    PubMed

    Gerreth, Karolina; Borysewicz-Lewicka, Maria

    2016-03-01

    A patient's with disability everyday life is rife with many limitations such as architectural, transport, information as well as medical, psychological, legal, economic and social barriers. The aim of this study was to evaluate access to dental health care of special-care schoolchildren with intellectual disability on the basis of their parents' opinion. A questionnaire survey was carried out among 264 parents/caregivers of children from eight special-care schools in Poznan (Poland). Close-ended questions concerned children's barriers in access to dental care and parents' satisfaction with their children's dental care. Only 31.8% parents/caregivers did not have any problems with access to dental care and the most commonly reported barrier to obtaining dental care was protracted waiting time for a visit (36.7%). Most commonly, children were treated in dental surgery conditions (90.1%). Only 42.1% respondents were satisfied with their children's dental care. The research revealed that there is a need to improve the access of children with disability to dental care. Hence, it seems to be beneficial to set up specialist dental surgeries in special-care schools which would improve the access of children with disability to prophylaxis as well as dental treatment. © 2015 John Wiley & Sons Ltd.

  7. Midwives' and women's views on accessing dental care during pregnancy: an Australian qualitative study.

    PubMed

    Lim, M; Riggs, E; Shankumar, R; Marwaha, P; Kilpatrick, N

    2018-04-16

    Maternal behaviours during pregnancy are likely to play a significant role in the development of dental caries in children. Although midwives are well placed to discuss oral health and provide information to women, dental attendance by women during pregnancy is minimal. This study aimed to explore midwives' experience of facilitating pregnant women's access to dental care and to document women's experience of receiving dental information and care during pregnancy. Focus groups with midwives and telephone interviews with women who were referred to Monash Health Dental Services were conducted to explore their perspectives and experiences. The qualitative data was thematically analysed. Three focus groups with 13 midwives and telephone interviews with eight women who recently gave birth were conducted. Three key themes were identified: maternal oral health knowledge; barriers to accessing dental information and care during pregnancy; and suggested recommendations. This study highlighted the barriers that exist for midwives to discuss oral health with women and refer women to dental care, and women's experiences of accessing dental care during pregnancy. Ongoing collaboration between the maternity and dental services is required to strengthen midwives' knowledge, confidence and practise in supporting women to access dental care during pregnancy. © 2018 Australian Dental Association.

  8. Oral health and access to dental care: a qualitative exploration in rural Quebec.

    PubMed

    Emami, Elham; Wootton, John; Galarneau, Chantal; Bedos, Christophe

    2014-01-01

    We sought to explore how rural residents perceive their oral health and their access to dental care. We conducted a qualitative research study in rural Quebec. We used purposeful sampling to recruit study participants. A trained interviewer conducted audio-recorded, semistructured interviews until saturation was reached. We conducted thematic analysis to identify themes. This included interview debriefing, transcript coding, data display and interpretation. Saturation was reached after 15 interviews. Five main themes emerged from the interviews: rural idyll, perceived oral health, access to oral health care, cues to action and access to dental information. Most participants noted that they were satisfied with the rural lifestyle, and that rurality per se was not a threat to their oral health. However, they criticized the limited access to dental care in rural communities and voiced concerns about the impact on their oral health. Participants noted that motivation to seek dental care came mainly from family and friends rather than from dental care professionals. They highlighted the need for better education about oral health in rural communities. Residents' satisfaction with the rural lifestyle may be affected by unsatisfactory oral health care. Health care providers in rural communities should be engaged in tailoring strategies to improve access to oral health care.

  9. A national analysis of dental waiting lists and point-in-time geographic access to subsidised dental care: can geographic access be improved by offering public dental care through private dental clinics?

    PubMed

    Dudko, Yevgeni; Kruger, Estie; Tennant, Marc

    2017-01-01

    Australia is one of the least densely populated countries in the world, with a population concentrated on or around coastal areas. Up to 33% of the Australian population are likely to have untreated dental decay, while people with inadequate dentition (fewer than 21 teeth) account for up to 34% of Australian adults. Historically, inadequate access to public dental care has resulted in long waiting lists, received much media coverage and been the subject of a new federal and state initiative. The objective of this research was to gauge the potential for reducing the national dental waiting list through geographical advantage, which could arise from subcontracting the delivery of subsidised dental care to the existing network of private dental clinics across Australia. Eligible population data were collected from the Australian Bureau of Statistics website. Waiting list data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual state or territory dental health body. Quantum geographic information system software was used to map distribution of the eligible population across Australia by statistical area, and to plot locations of government and private dental clinics. Catchment areas of 5 km for metropolitan clinics and 5 km and 50 km for rural clinics were defined. The number of people on the waiting list and those eligible for subsidised dental care covered by each of the catchment areas was calculated. Percentage of the eligible population and those on the waiting list that could benefit from the potential improvement in geographic access was ascertained for metropolitan and rural residents. Fifty three percent of people on the waiting list resided within metropolitan areas. Rural and remote residents made up 47% of the population waiting to receive care. The utilisation of both government and private dental clinics for the delivery of subsidised dental care to the eligible population

  10. Children's Access to Dental Care Affected by Reimbursement Rates, Dentist Density, and Dentist Participation in Medicaid.

    PubMed

    Chalmers, Natalia I; Compton, Robert D

    2017-10-01

    To assess the relation between Medicaid reimbursement rates and access to dental care services in the context of dentist density and dentist participation in Medicaid in each state. Data were from Early and Periodic Screening, Diagnostic, and Treatment reports for 2014, Medicaid reimbursement rate in 2013, dentist density in 2014, and dentist participation in Medicaid in 2014. We assessed patterns of mediation or moderation. Reimbursement rates and access to dental care were directly related at the state level, but no evidence indicated that higher reimbursement rates resulted in overuse of dental services for those who had access. The relation between reimbursement rates and access to care was moderated by dentist density and dentist participation in Medicaid. We estimate that more than 1.8 million additional children would have had access to dental care if reimbursement rates were higher in states with low rates. Children who access the dental care system receive care, but reimbursement may significantly affect access. States with low dentist density and low dentist participation in Medicaid may be able to improve access to dental services significantly by increasing reimbursement rates.

  11. Changes in dental care access upon health care benefit expansion to include scaling

    PubMed Central

    2016-01-01

    Purpose This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. Methods A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010–2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Results Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. Conclusions The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system. PMID:28050318

  12. Changes in dental care access upon health care benefit expansion to include scaling.

    PubMed

    Park, Hee-Jung; Lee, Jun Hyup; Park, Sujin; Kim, Tae-Il

    2016-12-01

    This study aimed to evaluate the effects of a policy change to expand Korean National Health Insurance (KNHI) benefit coverage to include scaling on access to dental care at the national level. A nationally representative sample of 12,794 adults aged 20 to 64 years from Korea National Health and Nutritional Examination Survey (2010-2014) was analyzed. To examine the effect of the policy on the outcomes of interest (unmet dental care needs and preventive dental care utilization in the past year), an estimates-based probit model was used, incorporating marginal effects with a complex sampling structure. The effect of the policy on individuals depending on their income and education level was also assessed. Adjusting for potential covariates, the probability of having unmet needs for dental care decreased by 6.1% and preventative dental care utilization increased by 14% in the post-policy period compared to those in the pre-policy period (2010, 2012). High income and higher education levels were associated with fewer unmet dental care needs and more preventive dental visits. The expansion of coverage to include scaling demonstrated to have a significant association with decreasing unmet dental care needs and increasing preventive dental care utilization. However, the policy disproportionately benefited certain groups, in contrast with the objective of the policy to benefit all participants in the KNHI system.

  13. Prevention and Control of Dental Disease through Improved Access to Comprehensive Care.

    ERIC Educational Resources Information Center

    American Dental Association, Chicago, IL.

    Prevention of dental disease is the key to improving the nation's oral health. The American Dental Association (ADA) program of prevention and control of dental disease through improved access to comprehensive care concentrates on those who have special difficulties in receiving care: the poor, the elderly, the handicapped, the institutionalized…

  14. Access to dental care for persons with developmental disabilities in Ontario.

    PubMed

    Koneru, Anjani; Sigal, Michael J

    2009-03-01

    This study was undertaken to determine the proportion of persons primarily with developmental disabilities who encounter difficulties accessing dental care in Ontario, to identify perceived barriers to accessing dental care and to determine if persons with disabilities and their caregivers believe that oral health is important. Community organizations providing services mainly to persons with developmental disabilities in Ontario were recruited to circulate a questionnaire to their members by mail or the Internet. Fourteen organizations mailed out a total of 1,755 paper questionnaires in autumn 2006, of which 420 (23.9%) were returned; in addition, 236 Internet questionnaires were returned. Of the 656 paper and Internet responses, 634 were deemed valid. Most of the respondents had developmental disabilities. Almost three-quarters of respondents (464 [73.2%] ) reported being able to access dental services in Ontario. Personal (internal) factors were more likely to represent barriers to dental care than external factors. The majority of persons with disabilities and most caregivers believed that oral health is important for overall health.

  15. Disparities in children's oral health and access to dental care.

    PubMed

    Mouradian, W E; Wehr, E; Crall, J J

    Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professionally applied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental care is the most prevalent unmet health need in US children with wide disparities existing in oral health and access to care. Only 1 in 5 children covered by Medicaid received preventive oral care for which they are eligible. Children from low income and minority families have poorer oral health outcomes, fewer dental visits, and fewer protective sealants. Water fluoridation is the most effective measure in preventing caries, but only 62% of water supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children. Childhood oral disease has significant medical and financial consequences that may not be appreciated because of the separation of medicine and dentistry. The infectious nature of dental caries, its early onset, and the potential of early interventions require an emphasis on preventive oral care in primary pediatric care to complement existing dental services. However, many pediatricians lack critical knowledge to promote oral health. We recommend financial incentives for prioritizing Medicaid Early and Periodic Screening, Diagnostic, and Treatment dental services; managed care accountability; integration of medical and dental professional training, clinical care, and research; and national leadership. JAMA. 2000;284:2625-2631.

  16. Dental care access among individuals with Down syndrome: a Malaysian scenario.

    PubMed

    Abdul Rahim, Farah Salwa; Mohamed, Alizae Marny; Marizan Nor, Murshida; Saub, Roslan

    2014-11-01

    The purpose of this cross-sectional study was to assess the legal representatives' perceptions on dental care access of individuals with Down syndrome (DS) compared to their non-DS siblings in Peninsular Malaysia. This cross-sectional study was conducted throughout community-based rehabilitation centers (CBRC) and the Down Syndrome Organization. Legal representatives of individuals with DS within the criteria were given a structured and validated questionaire. This study demonstrated that individuals with DS (76.9%) significantly utilized more health services than non-DS siblings (23.1%). The service most regularly used was speech therapy followed by opthalmology and dental services. Twenty-five per cent of respondents reported difficulty in finding dental care services for their DS child and 46.9% admitted that healthcare for their DS child took more time. The majority of DS individuals received less complex dental treatment and none received any orthodontic treatment, despite their severe occlusal problems. A high proportion of parents appear to be able to access dental and medical care for their DS child. However, some parents perceived difficulty in finding oral healthcare.

  17. [Socioeconomic Gradients in Dental Care Accessibility in Germany].

    PubMed

    Leonhardt, Konrad Alexander; Hirsch, Christian

    2017-03-17

    The aim of this study was to determine whether dental care accessibility in Germany from 2002 to 2009 was linked to socioeconomic status (SES) or household net income (HHN). Analysis was based upon a nation-wide cross-sectional survey of German adults from 18 to 79 years (mean 49.1 years; 55% females) which was conducted by the "Bertelsmann Gesundheitsmonitor" from 2002-2009. Patients in Germany visit the dentist 2.4 times per year independently of the SES. Patients with higher income paid per income group 34 € (95%- KI: 6 €-63 €) more for their denture. People from the middle class had 1.28 (95% CI: 1.02-1.22), and people from the upper class had 1.86 (95%-CI: 1.58-2.18) as much dental coinsurance coverage as people from the lower class. The ability to pay for denture and obtain dental insurance coverage rose with higher SES or HHN. The rise of additional payments for dental services leads to discrepancies in dental health care. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Dental Care And Medicare Beneficiaries: Access Gaps, Cost Burdens, And Policy Options.

    PubMed

    Willink, Amber; Schoen, Cathy; Davis, Karen

    2016-12-01

    Despite the wealth of evidence that oral health is related to physical health, Medicare explicitly excludes dental care from coverage, leaving beneficiaries at risk for tooth decay and periodontal disease and exposed to high out-of-pocket spending. To profile these risks, we examined access to dental care across income groups and types of insurance coverage in 2012. High-income beneficiaries were almost three times as likely to have received dental care in the previous twelve months, compared to low-income beneficiaries-74 percent of whom received no dental care. We also describe two illustrative policies that would expand access, in part by providing income-related subsidies. One would offer a voluntary, premium-financed benefit similar to those offered by Part D prescription drug plans, with an estimated premium of $29 per month. The other would cover basic dental care in core Medicare Part B benefits, financed in part by premiums ($7 or $15 per month, depending on whether premiums covered 25 percent or 50 percent of the cost) and in part by general revenues. The fact that beneficiaries are forgoing dental care and are exposed to significant costs if they seek care underscores the need for action. The policies offer pathways for improving health and financial independence for older adults. Project HOPE—The People-to-People Health Foundation, Inc.

  19. Effects of a proposed rural dental school on regional dental workforce and access to care.

    PubMed

    Wanchek, Tanya N; Rephann, Terance J

    2013-01-01

    Southwest Virginia is a rural, low-income region with a relatively small dentist workforce and poor oral health outcomes. The opening of a dental school in the region has been proposed by policy-makers as one approach to improving the size of the dentist workforce and oral health outcomes. A policy simulation was conducted to assess how a hypothetical dental school in rural Southwest Virginia would affect the availability of dentists and utilization levels of dental services. The simulation focuses on two channels through which the dental school would most likely affect the region. First, the number of graduates who are expected to remain in the region was varied, based on the extensiveness of the education pipeline used to attract local students. Second, the number of patients treated in the dental school clinic under different dental school clinical models, including the traditional model, a patient-centered clinic model and a community-based clinic model, was varied in the simulation to obtain a range of additional dentists and utilization rates under differing dental school models. Under a set of plausible assumptions, the low yield scenario (ie private school with a traditional clinic) would result in three additional dentists residing in the region and a total of 8090 additional underserved patients receiving care. Under the high yield scenario (ie dental pipeline program with community based clinics) nine new dentists would reside in the region and as many as 18 054 underserved patients would receive care. Even with the high yield scenario and the strong assumption that these patients would not otherwise access care, the utilization rate increases to 68.9% from its current 60.1%. While the new dental school in Southwest Virginia would increase the dentist workforce and utilization rates, the high cost combined with the continued low rate of dental utilization suggests that there may be more effective alternatives to improving oral health in rural areas

  20. Linking Mother and Child Access to Dental Care

    PubMed Central

    Grembowski, David; Spiekerman, Charles; Milgrom, Peter

    2016-01-01

    Objectives Among young children in low-income families covered by Medicaid, we estimate by racial/ethnic group whether children who have mothers with a regular source of dental care (RSDC) at baseline have greater dental utilization in the following year than children with mothers without a regular source. Patients and Methods From a population of 108,151 children enrolled in Medicaid aged 3 to 6 and their low-income mothers in Washington state, a disproportionate stratified random sample of 11,305 children aged 3 to 6 was selected from enrollment records in four racial/ethnic groups: 3,791 Black; 2,806 Hispanic 1,902 White; and 2,806 other racial/ethnic groups. In a prospective cohort design, we conducted a baseline survey of mothers and for respondents, collected their children’s Medicaid dental claims in the 1-year follow-up period. Mutivariable regression models estimated the associations between the mothers having a RSDC at baseline and their children’s prospective dental utilization. Results About 38% of mothers had a RSDC. Among children of Black and Hispanic mothers, having a mother with a RSDC at baseline was associated with greater odds of receiving any dental care in the following year (OR 1.69, 95% CI 1.10-2.62 for children of Black mothers; OR 1.84, CI 1.23-2.73 for children of Hispanic mothers). For children with dental utilization, children of Black or Hispanic mothers with a RSDC received 1.22 (CI 1.08-1.38) and 1.10 (CI 1.01-1.19) more preventive services, respectively. For children of White mothers, associations were in the same direction but not significant. Conclusions For young children of Black and Hispanic mothers, dental care utilization is higher when their mothers have a RSDC. For low-income young children with Medicaid, increasing the mothers’ access to dental care may increase the children’s utilization of dental and preventive services, which, in turn, may reduce racial/ethnic inequalities in oral health. PMID:18829778

  1. Will improving access to dental care improve oral health-related quality of life?

    PubMed

    Crocombe, L A; Mahoney, G D; Spencer, A J; Waller, M

    2013-06-01

    The aim of this study was to determine if Australian Defence Force (ADF) members had better oral health-related quality of life (OHRQoL) than the general Australian population and whether the difference was due to better access to dental care. The OHRQoL, as measured by OHIP-14 summary indicators, of participants from the Defence Deployed Solomon Islands (SI) Health Study and the National Survey of Adult Oral Health 2004-06 (NSAOH) were compared. The SI sample was age/gender status-adjusted to match that of the NSAOH sample which was age/gender/regional location weighted to that of the Australian population. NSAOH respondents with good access to dental care had lower OHIP-14 summary measures [frequency of impacts 8.5% (95% CI = 5.4, 11.6), extent mean = 0.16 (0.11, 0.22), severity mean = 5.0 (4.4, 5.6)] than the total NSAOH sample [frequency 18.6 (16.6, 20.7); extent 0.52 (0.44, 0.59); severity 7.6 (7.1, 8.1)]. The NSAOH respondents with both good access to dental care and self-reported good general health did not have as low OHIP-14 summary scores as in the SI sample [frequency 2.6 (1.2, 5.4), extent 0.05 (0.01, 0.10); severity 2.6 (1.9, 3.4)]. ADF members had better OHRQoL than the general Australian population, even those with good access to dental care and self-reported good general health. © 2013 Australian Dental Association.

  2. Access to dental care among adults with physical and intellectual disabilities: residence factors.

    PubMed

    Pradhan, A; Slade, G D; Spencer, A J

    2009-09-01

    There is limited information about access and barriers to dental care among adults with disabilities. A mailed questionnaire survey of carers of 18-44-year-old South Australians with physical and intellectual disabilities (care recipients; n = 485) in family homes, community housing and institutions. Bivariate associations were tested using chi-square tests. Odds ratios (ORs) and 95 per cent confidence intervals (CI) were estimated for irregular dental visits (IDV). Carers from family homes and community housing were more likely to report problems in obtaining dental care than those at institutions (p < 0.001). Lack of dentists with adequate skills in special needs dentistry (SND) was the most frequently reported problem for carers from family homes and community housing. IDV were less likely (p < 0.01) for care recipients in institutions and community housing than in family homes. After adjusting for care recipients' age, gender and disability, odds of IDV was lower in community housing (OR = 0.2, 95% CI = 0.1, 0.3) and in institutions (OR = 0.1, 95% CI = 0.04, 0.3) relative to family homes. Care recipients in institutions and community housing had better access to dental care than those at family homes. The shortage of dentists in SND and treatment costs needs to be addressed.

  3. Cross-border dental care: 'dental tourism' and patient mobility.

    PubMed

    Turner, L

    2008-05-24

    Patient mobility is increasing. 'Dental tourism' is driven by numerous factors. These factors include the high cost of local care, delays in obtaining access to local dentists, competent care at many international clinics, inexpensive air travel, and the Internet's capacity to link 'customers' to 'sellers' of health-related services. Though dental tourism will benefit some patients, increased patient mobility comes with numerous risks. Lack of access to affordable and timely local care plays a significant role in prompting patients to cross borders and receive dental care outside their local communities.

  4. Parent or Caregiver, Staff, and Dentist Perspectives on Access to Dental Care Issues for Head Start Children in Ohio

    PubMed Central

    Siegal, Mark D.; Marx, Mary L.; Cole, Shannon L.

    2005-01-01

    Objectives. We conducted 5 surveys on consumer and provider perspectives on access to dental care for Ohio Head Start children to assess the need and appropriate strategies for action. Methods. We collected information from Head Start children (open-mouth screenings), their parents or caregivers (questionnaire and telephone interviews), Head Start staff (interviews), and dentists (questionnaire). Geocoded addresses were also analyzed. Results. Twenty-eight percent of Head Start children had at least 1 decayed tooth. For the 11% of parents whose children could not get desired dental care, cost of care or lack of insurance (34%) and dental office factors (20%) were primary factors. Only 7% of general dentists and 29% of pediatric dentists reported accepting children aged 0 through 5 years of age as Medicaid recipients without limitation. Head Start staff and dentists felt that poor appointment attendance negatively affected children’s receiving care, but parents/caregivers said finding accessible dentists was the major problem. Conclusions. Many Ohio Head Start children do not receive dental care. Medicaid and patient age were primary dental office limitations that are partly offset by the role Head Start plays in ensuring dental care. Dentists, Head Start staff, and parents/caregivers have different perspectives on the problem of access to dental care. PMID:16006416

  5. Dental Care in an Equal Access System Valuing Equity: Are There Racial Disparities?

    PubMed

    Boehmer, Ulrike; Glickman, Mark; Jones, Judith A; Orner, Michelle B; Wheler, Carolyn; Berlowitz, Dan R; Kressin, Nancy R

    2016-11-01

    Racial disparities in dental care have previously been shown in the Veterans Health Administration (VA)-a controlled access setting valuing equitable, high-quality care. The aim of this study is to examine current disparities in dental care by focusing on the receipt of root canal therapy (RCT) versus tooth extraction. This is a retrospective analysis of data contained in the VA's electronic health records. We performed logistic regressions on the independent measures along with a facility-specific random effect, using dependent binary variables that distinguished RCT from tooth extraction procedures. VA outpatients who had at least 1 tooth extraction or RCT visit in the VA in fiscal year 2011. A dependent binary measure of tooth extraction or RCT. Other measures are medical record data on medical comorbidities, dental morbidity, prior dental utilization, and demographic characteristics. The overall rate of preferred tooth-preserving RCT was 18.1% during the study period. Black and Asian patients were most dissimilar with respect to dental morbidity, medical and psychological disorders, and black patients had the least amount of eligibility for comprehensive dental care. After adjustment for known confounding factors of RCT, black patients had the lowest RCT rates, whereas Asians had the highest. Current quality improvement efforts and a value to improve the equity of care are not sufficient to address racial/ethnic disparities in VA dental care; rather more targeted efforts will be needed to achieve equity for all.

  6. Operationalisation of the construct of access to dental care: a position paper and proposed conceptual definitions.

    PubMed

    Harris, R V

    2013-06-01

    'Access' is a term readily used in a political and policy context, but one which has not leant itself to measurement of progress towards policy goals or comparisons between health systems. Like 'quality', 'access' is a multi-dimensional construct, but currently often remains a vague and abstract concept which is difficult to translate into something specific, concrete and therefore measureable. The paper describes previous work and identifies a need for a greater consensus and conceptual clarity in the selection of metrics for dental access. The construct of dental access is described as involving the concepts of 1: opportunity for access; 2, realised access (utilisation); 3, equity and 4, outcomes. Proposed conceptual definitions are given and a case made for measuring 'initial utilisation' separately from 'continued utilisation', reflecting modern approaches which distinguish 'entry access' (gaining entry to the dental care system), from the process of gaining access to higher levels of care. Using a distinction between 'entry access' and 'effective access' allows a choice of whether to restrict measurement to mainly supply side considerations, or alternatively to extend the measurement to include whether there is equity in the proportion of patients who are able obtain effective needed interventions. A development of conceptual definitions of dental access could facilitate measurement of progress towards policy goals and operationalisation of the construct.

  7. Access to dental public services by disabled persons.

    PubMed

    Leal Rocha, Lyana; Vieira de Lima Saintrain, Maria; Pimentel Gomes Fernandes Vieira-Meyer, Anya

    2015-03-13

    According to the World Health Organization, one in every 10 people has a disability, and more than two-thirds of them do not receive any type of oral dental care. The Brazilian Constitution of 1988 guarantees all civilians including disabled people the right to healthcare, shaping the guidelines of the Brazilian National Health Care System (Sistema Único de Saúde--SUS). However, there is limited information about the true accessibility of dental services. This study evaluated the accessibility of public dental services to persons with disabilities in Fortaleza, Ceará, which has the third highest disability rate in Brazil. A cross-sectional quantitative study using structured questionnaires was administered to dentists (n = 89) and people with disabilities (n = 204) to evaluate the geographical, architectural, and organizational accessibility of health facilities, the communication between professionals and patients with disabilities, the demand for dental services, and factors influencing the use of dental services by people with motor, visual, and hearing impairments. 43.1% of people with disabilities do not recognize their service as a priority of Basic Health Units (BHU), 52.5% do not usually seek dental care, and of those who do (n = 97), 76.3% find it difficult to receive care and 84.5% only seek care on an emergency basis. Forty-five percent are unaware of the services offered in the BHU. Of the dentists, 56.2% reported difficulty in communicating with deaf patients, and 97.8% desired interpreters stationed in the BHU. People with disabilities gave better accessibility ratings than dentists (p = 0.001). 37.3% of the patients and 43.8% of dentists reported inadequate physical access infrastructure (including doors, hallways, waiting rooms, and offices). Dentists (60%) reported unsafe environments and transportation difficulties as geographical barriers, while most people with disabilities did not report noticing these barriers. While access to dental

  8. The impact of universal access to dental care on disparities in caries experience in children.

    PubMed

    Ismail, A I; Sohn, W

    2001-03-01

    The authors investigated the association between socioeconomic status and the severity of dental caries in 6- and 7-year-old children who had had access to dental care throughout their lives. The children had lived since birth in Nova Scotia, Canada, a province with a universal publicly financed dental care program. The authors selected a representative sample of first-grade children using a stratified multistage sampling method of primary schools (n = 1,614). The response rate was 78.8 percent. Two dentists were trained to diagnose dental caries using modified World Health Organization criteria. Intra- and interexaminer reliability was excellent (kappa > or = 0.88). Of the children who were examined (n = 1,271), 955 were lifelong residents of Nova Scotia, Canada, and so were included in this analysis. Data were weighted and adjusted for clustering (design) effects. Only 8.4 percent of the children had visited a dental office before the age of 2 years, and 88.5 percent of the children had their first dental visit between the ages of 2 and 5 years. Children whose parents had completed a university education had a significantly lower mean number of decayed, missing and filled surfaces, or dmfs, in their primary teeth than did children whose parents had a lower education level. A Poisson regression model indicated that parents' high education status, optimal fluoride concentration in schools' water supplies, daily toothbrushing and dental visits for checkup were significantly associated with low dmfs scores. Having access to a universal publicly financed dental insurance program since birth did not eliminate the disparities in caries experience. This analysis of a highly utilized universal dental insurance program suggests that disparities in oral health status cannot be reduced solely by providing universal access to dental care. Focused efforts by professional and governmental organizations should be directed toward understanding the socioeconomic, behavioral and

  9. The dental care of U.S. children: access, use and referrals by nondentist providers, 2003.

    PubMed

    Chu, May; Sweis, Luciana E; Guay, Albert H; Manski, Richard J

    2007-10-01

    Improvements in oral health care services have not reached evenly across every segment of American society. The authors examine the role of nondentist practitioners in referring child patients for dental care by analyzing data from the 2003 Medical Expenditure Panel Survey conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. The authors provide national estimates of the percentage of the civilian noninstitutionalized population of the United States aged 2 through 17 years who had a dental visit, who had a dental checkup and who received advice from a nondentist health care provider to have a dental checkup. Overall, 38 percent of all poor, near-poor or low-income children and 60 percent of all middle- or high-income children aged 2 through 17 years reported having had a dental checkup during 2003. The authors observed no significant differences between poor, near-poor and low-income children and higher-income children in terms of having been advised by a nondentist health care provider to have a dental checkup. Although income may not predict the likelihood of patients' receiving advice from a nondentist health care provider to have a dental checkup, children from families with higher levels of income were more likely to seek dental care than were children from families with lower levels of income. Practice Implications. Efforts to increase access to dental care should aim to maximize the benefit of advice provided by nondentist health care practitioners to receive a dental checkup, so that children from families with limited income are as likely to receive a dental checkup as are children from families with higher levels of income.

  10. Southern Nevada assisted living residents' perception of their oral health status and access to dental care.

    PubMed

    Dounis, Georgia; Ditmyer, Marcia M; McCants, Robert; Lee, Yoonah; Mobley, Connie

    2012-06-01

    Oral health is an integral component of general health, and quality of life. The purpose of this study was to determine the perceptions of oral health status and acces\\s to dental care by Southern Nevada Assisted Living Facilities Residents. A cross-sectional questionnaire study design was used to survey residents between 34 and 99 years old residing in Assisted Living Facilities. Seventy respondents (42 males and 28 females) completed a survey that included personal oral hygiene, access to care, and demographic information. Data analyses included descriptive statistics and chi-square. Mean age was 75.78 years, and the majority had a college education (n = 41). Four currently smoked cigarettes. Twenty-nine (males = 14; females = 15) reported having dental insurance. Eleven respondents had seen a dentist twice a year, while 33 reported a visit less than 6 months. Forty-one reported the facility did not provide oral health care with majority (n = 64) indicating that accessing oral health care was difficult. Self-rated response to oral hygiene, a majority (n = 64) reported their oral hygiene as fair and five reported their oral hygiene as poor. Assisted living residents in Southern Nevada reported difficulty accessing dental services within and outside of the facility. Oral care models to address this unique population should be explored. © 2010 The Gerodontology Society and John Wiley & Sons A/S.

  11. Access to dental care and dental ill-health of people with serious mental illness: views of nurses working in mental health settings in Australia.

    PubMed

    Happell, Brenda; Platania-Phung, Chris; Scott, David; Hanley, Christine

    2015-01-01

    People with serious mental illness experience higher rates of oral and dental health problems than the wider population. Little is known about how dental health is viewed or addressed by nurses working with mental health consumers. This paper presents the views of nurses regarding the nature and severity of dental health problems of consumers with serious mental illness, and how often they provide advice on dental health. Mental health sector nurses (n=643) completed an online survey, including questions on dental and oral health issues of people with serious mental illness. The majority of nurses considered the oral and dental conditions of people with serious mental illness to be worse than the wider community. When compared with a range of significant physical health issues (e.g. cardiovascular disease), many nurses emphasised that dental and oral problems are one of the most salient health issues facing people with serious mental illness, their level of access to dental care services is severely inadequate and they suffer significantly worse dental health outcomes as a result. This study highlights the need for reforms to increase access to dental and oral health care for mental health consumers.

  12. Advanced dental education programs: status and implications for access to care in California.

    PubMed

    Glassman, Paul

    2012-01-01

    Primary care residencies in dentistry include general practice residency and advanced education in general dentistry--collectively known as postdoctoral general--dentistry and pediatric dentistry. These primary care programs are the most likely to serve underserved populations during the training experience. An expansion of primary care dental residency positions in California has the potential to positively impact access to care in California. However, there are significant political and financial barriers to realizing this potential.

  13. Long-Term Outcomes of a Dental Postbaccalaureate Program: Increasing Dental Student Diversity and Oral Health Care Access

    PubMed Central

    Wides, Cynthia D.; Brody, Harvey A.; Alexander, Charles J.; Gansky, Stuart A.; Mertz, Elizabeth A.

    2013-01-01

    The University of California, San Francisco School of Dentistry established the Dental Postbaccalaureate Program in 1998 to provide reapplication assistance to students from economically and/or educationally disadvantaged backgrounds who were previously denied admission to dental school. The goals were to increase diversity in the dental school student population and improve access to dental services for underserved populations. This article assesses the program’s short-, mid-, and long-term outcomes and is the first to examine long-term practice patterns after a dental postbaccalaureate program. Data collected on all participant (n=94) demographics, pre/post-program DAT scores, and post-program dental school admission results were used to assess short- and mid-term outcomes. Long-term outcomes and practice patterns were assessed using results of a census survey administered between 2009 and 2011 to the participants who had completed dental school and been in practice for at least two years (n=57). The survey had a response rate of 93 percent (n=53). Descriptive statistical techniques were used to examine the responses and to compare them to U.S. Census Bureau data and nationally available practice data for new dental graduates. Program participants’ DAT scores improved by an average of two points, and 98 percent were accepted to dental school. All survey respondents were practicing dentistry, and 81 percent reported serving underserved populations. These participants treat more Medicaid recipients than do most dentists, and their patient population is more diverse than the general population. The outcomes demonstrate that the program’s graduates are increasing diversity in the dental student population and that their practices are providing access to care for underserved populations. PMID:23658398

  14. Child- and state-level characteristics associated with preventive dental care access among U.S. children 5-17 years of age.

    PubMed

    Lin, Mei; Sappenfield, William; Hernandez, Leticia; Clark, Cheryl; Liu, Jihong; Collins, Jennifer; Carle, Adam C

    2012-12-01

    The objectives of this study is to identify factors associated with lack of preventive dental care among U.S. children and state-level factors that explain variation in preventive dental care access across states. We performed bivariate analyses and multilevel regression analyses among 68,350 children aged 5-17 years using the 2007 National Survey of Children's Health data and relevant state-level data. Odds ratios (ORs) for child- and state-level variables were calculated to estimate associations with preventive dental care. We calculated interval odds ratios (IOR), median odds ratios (MOR), and intraclass correlation coefficients (ICC) to quantify variation in preventive dental care across states. Lack of preventive dental care was associated with various child-level factors. For state-level factors, a higher odds of lack of preventive dental care was associated with a higher percentage of Medicaid-enrolled children not receiving dental services (OR = 1.30, 95 % confidence interval (CI): 1.15-1.47); higher percentage of children uninsured (OR = 1.48, 95 % CI: 1.29-1.69); lower dentist-to-population ratio (OR = 1.36, 95 % CI: 1.03-1.80); and lower percentage of dentists submitting Medicaid/State Children's Health Insurance Program claims (OR = 1.04, 95 % CI: 1.01-1.06). IORs for the first three state-level factors did not contain one, indicating that these state-level characteristics were important in understanding variation across states. Lack of preventive dental care varied by state (MOR = 1.40). The state-level variation (ICC = 3.66 %) accounted for a small percentage of child- and state-level variation combined. Child- and state-level characteristics were associated with preventive dental care access among U.S. children aged 5-17 years. State-level factors contribute to variation in dental care access across states and need to be considered in state-level planning.

  15. Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

    PubMed

    Brickle, Colleen M; Self, Karl D

    2017-09-01

    The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  16. Dental care coverage and income-related inequalities in foregone dental care in Europe during the great recession.

    PubMed

    Elstad, Jon Ivar

    2017-08-01

    This study examines income inequalities in foregone dental care in 23 European countries during the years with global economic crisis. Associations between dental care coverage from public health budgets or social insurance, and income-related inequalities in perceived access to dental care, are analysed. Survey data 2008-2013 from 23 countries were combined with country data on macro-economic conditions and coverage for dental care. Foregone dental care was defined as self-reported abstentions from needed dental care because of costs or other crisis-related reasons. Age-standardized percentages reporting foregone dental care were estimated for respondents, age 20-74, in the lowest and highest income quartile. Associations between dental care coverage and income inequalities in foregone dental care, adjusted for macro-economic indicators, were examined by country-level regression models. In all 23 countries, respondents in the lowest income quartile reported significantly higher levels of foregone dental care than respondents in the highest quartile. During 2008-2013, income inequalities in foregone dental care widened significantly in 13 of 23 countries, but decreased in only three countries. Adjusted for countries' macro-economic situation and severity of the economic crisis, higher dental care coverage was significantly associated with smaller income inequalities in foregone dental care and less widening of these inequalities. Income-related inequalities in dental care have widened in Europe during the years with global economic crisis. Higher dental care coverage corresponded to less income-related inequalities in foregone dental care and less widening of these inequalities. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Access Barriers to Dental Health Care in Children with Disability. A Questionnaire Study of Parents

    ERIC Educational Resources Information Center

    Gerreth, Karolina; Borysewicz-Lewicka, Maria

    2016-01-01

    Background: A patient's with disability everyday life is rife with many limitations such as architectural, transport, information as well as medical, psychological, legal, economic and social barriers. The aim of this study was to evaluate access to dental health care of special-care schoolchildren with intellectual disability on the basis of…

  18. Collaboration Between Medical Providers and Dental Hygienists in Pediatric Health Care.

    PubMed

    Braun, Patricia A; Cusick, Allison

    2016-06-01

    Basic preventive oral services for children can be provided within the medical home through the collaborative care of medical providers and dental hygienists to expand access for vulnerable populations. Because dental caries is a largely preventable disease, it is untenable that it remains the most common chronic disease of childhood. Leveraging the multiple visits children have with medical providers has potential to expand access to early preventive oral services. Developing interprofessional relationships between dental providers, including dental hygienists, and medical providers is a strategic approach to symbiotically expand access to dental care. Alternative care delivery models that provide dental services in the medical home expand access to these services for vulnerable populations. The purpose of this article is to explore 4 innovative care models aimed to expand access to dental care. Current activities in Colorado and around the nation are described regarding the provision of basic preventive oral health services (eg, fluoride varnish) by medical providers with referral to a dentist (expanded coordinated care), the colocation of dental hygiene services into the medical home (colocated care), the integration of a dental hygienist into the medical care team (integrated care), and the expansion of the dental home into the community setting through telehealth-enabled teams (virtual dental home). Gaps in evidence regarding the impacts of these models are elucidated. Bringing preventive and restorative dental services to the patient both in the medical home and in the community has potential to reduce long-standing barriers to receive these services, improve oral health outcomes of vulnerable patients, and decrease oral health disparities. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A comparative needs assessment of the dental health of adults attending dental access centres and general dental practices in Halton & St Helens and Warrington PCTs 2007.

    PubMed

    Milsom, K M; Jones, C; Kearney-Mitchell, P; Tickle, M

    2009-03-14

    Dental access centres (DACs) were introduced in England at the turn of the twenty-first century in response to a growing problem of access to NHS dental services. DACs were expected to offer NHS dental care primarily to those patients that were unwilling or unable to attend 'high street' dental practice. At the same time, the new NHS primary care dental contract in England, introduced in April 2006, has been associated in some areas with access difficulties, with routine dental patients having difficulty accessing NHS dental care. In light of these changes, have DACs become an alternative provider of NHS dental services to patients seeking routine dental care? In summer 2007, a cross sectional dental epidemiological study was undertaken in Halton & St Helens PCT and Warrington PCT to compare the dental health and attitudes to dental visiting of adult patients attending DACs and neighbouring 'high street' dental practices. The results of the study showed that DAC patients: were younger and from a more disadvantaged background than patients attending 'high street' practices; had worse oral health than 'high street' dental patients; experienced more frequent episodes of dental pain than 'high street' dental patients and were more likely to be dentally anxious; had different attitudes to dental health than their 'high street' counterparts. The study suggests that the DACs in Halton, St Helens and Warrington are offering treatment to a different population of patients to that seen in neighbouring 'high street' practices and therefore the DACs are fulfilling the function expected of them locally.

  20. Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community.

    PubMed

    Yap, Matthew; Kok, Mei-Ruu; Nanda, Soniya; Vickery, Alistair; Whyatt, David

    2018-03-01

    High rates of dental-related potentially preventable hospitalisations are thought to reflect poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined in Western Australia. Areas with persistently high rates of dental-related potentially preventable hospitalisations and emergency department (ED) presentations were mapped. Statistical models examined factors associated with these events. Persistently high rates of dental-related potentially preventable hospitalisations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita (RR 1.06, 95% CI 1.04-1.08) after adjusting for age, sex, socioeconomics, and Aboriginality. Persistently high rates of ED presentations were clustered in socioeconomically disadvantaged areas near metropolitan EDs and with fewer dentists per capita (RR 0.91, 0.88-0.94). A positive association between dental-related potentially preventable hospitalisations and poor (financial or geographic) access to dentists was not found. Rather, rates of such events were positively associated with socioeconomic advantage, plus greater access to hospitals and non-hospital dental services. Furthermore, ED presentations for dental conditions are inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policymakers should pursue alternative indicators of dental service accessibility.

  1. American Dental Association White Paper Targets Dental Care for the Underserved

    ERIC Educational Resources Information Center

    Berthold, Mark

    2005-01-01

    Reaffirming its leadership role toward better oral health for all Americans, the ADA has produced a white paper that also challenges policy-makers and the US to improve access to dental services. The white paper, "State and Community Models for Improving Access to Dental Care for the Underserved," was presented October 1 to the House of…

  2. Impact of a Community Dental Access Program on Emergency Dental Admissions in Rural Maryland.

    PubMed

    Rowland, Sandi; Leider, Jonathon P; Davidson, Clare; Brady, Joanne; Knudson, Alana

    2016-12-01

    To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed.

  3. Impact of a Community Dental Access Program on Emergency Dental Admissions in Rural Maryland

    PubMed Central

    Rowland, Sandi; Davidson, Clare; Brady, Joanne; Knudson, Alana

    2016-01-01

    Objectives. To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP’s impact on dental-related visits to a regional emergency department (ED). Methods. We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. Results. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Conclusions. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Policy Implications. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed. PMID:27736218

  4. Satisfaction of active duty soldiers with family dental care.

    PubMed

    Chisick, M C

    1997-02-01

    In the fall of 1992, a random, worldwide sample of 6,442 married and single parent soldiers completed a self-administered survey on satisfaction with 22 attributes of family dental care. Simple descriptive statistics for each attribute were derived, as was a composite overall satisfaction score using factor analysis. Composite scores were regressed on demographics, annual dental utilization, and access barriers to identify those factors having an impact on a soldier's overall satisfaction with family dental care. Separate regression models were constructed for single parents, childless couples, and couples with children. Results show below-average satisfaction with nearly all attributes of family dental care, with access attributes having the lowest average satisfaction scores. Factors influencing satisfaction with family dental care varied by family type with one exception: dependent dental utilization within the past year contributed positively to satisfaction across all family types.

  5. A comprehensive school-based/linked dental program: an essential piece of the California access to care puzzle.

    PubMed

    Fine, Jared I; Isman, Robert E; Grant, Catherine B

    2012-03-01

    California children suffer more from dental disease than any other chronic childhood disease. Disparities in access and oral health are disproportionately represented among children from minority and low-income families. A comprehensive school-based/linked dental program is one essential ingredient in addressing these problems. Described here are the goals, program elements, and challenges of building a seamless dental services system that could reduce barriers care, maximize resources, and employ best practices to improve oral health.

  6. Transnational dental care among Canadian immigrants.

    PubMed

    Calvasina, Paola; Muntaner, Carles; Quiñonez, Carlos

    2015-10-01

    This study examines predictors of transnational dental care utilization, or the use of dental care across national borders, over a 4-year period among immigrants to Canada. Data from the Longitudinal Survey of Immigrants to Canada (LSIC, 2001-2005) were used. Sampling and bootstrap weights were applied to make the data nationally representative. Bivariate and multiple logistic regression analyses were applied to identify factors associated with immigrants' transnational dental care utilization. Approximately 13% of immigrants received dental care outside Canada over a period of 4 years. Immigrants lacking dental insurance (OR = 2.05; 95% CI: 1.55-2.70), those reporting dental problems (OR = 1.45; 95% CI: 1.12-1.88), who were female (OR = 1.59; 95% CI: 1.22-2.08), aged ≥ 50 years (OR = 2.30; 95% CI: 1.45-3.64), and who were always unemployed (OR = 1.70; 95% CI: 1.20-2.39) were more likely to report transnational dental care utilization. History of social assistance was inversely correlated with the use of dental services outside Canada (OR = 0.48; 95% CI: 0.30-0.83). It is estimated that roughly 11 500 immigrants have used dental care outside Canada over a 4-year period. Although transnational dental care utilization may serve as an individual solution for immigrants' initial barriers to accessing dental care, it demonstrates weaknesses to in-country efforts at providing publicly funded dental care to socially marginalized groups. Policy reforms should be enacted to expand dental care coverage among adult immigrants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Improving access to oral health care services among underserved populations in the U.S.: is there a role for mid-level dental providers?

    PubMed

    Shaefer, H Luke; Miller, Matthew

    2011-08-01

    Nearly one-third of U.S. citizens lack access to basic preventive and primary oral health care services, which is primarily the result of the high costs of care and the uneven geographic distribution of dental providers. This article examines the case for and against one possible solution to address these barriers to oral health care: the introduction of a mid-level dental provider (MDP) position within the dental field.

  8. Utilization of dental care: An Indian outlook

    PubMed Central

    Gambhir, Ramandeep Singh; Brar, Prabhleen; Singh, Gurminder; Sofat, Anjali; Kakar, Heena

    2013-01-01

    Oral health has a significant impact on the quality of life, appearance, and self-esteem of the people. Preventive dental visits help in the early detection and treatment of oral diseases. Dental care utilization can be defined as the percentage of the population who access dental services over a specified period of time. There are reports that dental patients only visit the dentist when in pain and never bother to return for follow-up in most cases. To improve oral health outcomes an adequate knowledge of the way the individuals use health services and the factors predictive of this behavior is essential. The interest in developing models explaining the utilization of dental services has increased; issues like dental anxiety, price, income, the distance a person had to travel to get care, and preference for preservation of teeth are treated as barriers in regular dental care. Published materials which pertain to the use of dental services by Indian population have been reviewed and analyzed in depth in the present study. Dental surgeons and dental health workers have to play an adequate role in facilitating public enlightenment that people may appreciate the need for regular dental care and make adequate and proper use of the available dental care facilities. PMID:24082719

  9. Dental care utilization and expenditures in children with special health care needs.

    PubMed

    Beil, Heather; Mayer, Michelle; Rozier, R Gary

    2009-09-01

    The authors compared children with special health care needs (CSHCN) and children without special health care needs (SHCN) with respect to the odds, amount and determinants of having any dental care and dental care expenditures. The authors assessed data from the 2004 Medical Expenditures Panel Survey, Agency for Healthcare Research and Quality, to identify a sample of 8,518 children aged 2 to 17 years. The authors used logistic regression to determine the effect of having SHCN on the probability of having any dental care expenditure, for total dental care expenditures and procedure-specific expenditures. They tested the modifying effect between CSHCN and other variables on the probability of having any dental care expenditure. Compared with children without SHCN, CSHCN did not differ in the probability (odds ratio = 0.91, 95 percent confidence interval [CI] = 0.76 to 1.09) or amount (beta = 30.17, 95 percent CI = -162.93 to 223.27) of total dental care expenditures. Likewise, CSHCN did not differ in their likelihood of having undergone a preventive, restorative, diagnostic or other procedure. Known determinants of dental care utilization did not modify the relationships between having SCHN and any dental care expenditure. Despite the reported difficulty in CSHCN's accessing dental care, the authors found that CSHCN had dental care utilization and expenditures that were comparable with those of children without SHCN. Furthermore, the association of CSHCN status and any dental care expenditure was not modified by known determinants of dental care utilization. Future research should focus on characterizing risk for dental disease among CSHCN more accurately and identifying factors that affect dental care utilization in CSHCN, including provider and parent characteristics. The study results highlight low rates of dental care utilization among all young children, including CSHCN. Efforts to increase dental care utilization among children are warranted and need to

  10. Inequity in access to dental care services explains current socioeconomic disparities in oral health: the Swedish National Surveys of Public Health 2004-2005.

    PubMed

    Wamala, Sarah; Merlo, Juan; Boström, Gunnel

    2006-12-01

    To analyse the effects of socioeconomic disadvantage on access to dental care services and on oral health. Design, setting and outcomes: Cross-sectional data from the Swedish National Surveys of Public Health 2004 and 2005. Outcomes were poor oral health (self-rated oral health and symptoms of periodontal disease) and lack of access to dental care services. A socioeconomic disadvantage index (SDI) was developed, consisting of social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves. Swedish population-based sample of 17 362 men and 20 037 women. Every instance of increasing levels of socioeconomic disadvantage was associated with worsened oral health but, simultaneously, with decreased utilisation of dental care services. After adjusting for age, men with a mild SDI compared with those with no SDI had 2.7 (95% confidence interval (CI) 2.5 to 3.0) times the odds for self-rated poor oral health, whereas odds related to severe SDI were 6.8 (95% CI 6.2 to 7.5). The corresponding values among women were 2.3 (95% CI 2.1 to 2.5) and 6.8 (95% CI 6.3 to 7.5). Nevertheless, people with severe socioeconomic disparities were 7-9 times as likely to refrain from seeking the required dental treatment. These associations persisted even after controlling for living alone, education, occupational status and lifestyle factors. Lifestyle factors explained only 29% of the socioeconomic differences in poor oral health among men and women, whereas lack of access to dental care services explained about 60%. The results of the multilevel regression analysis indicated no additional effect of the administrative boundaries of counties or of municipalities in Sweden. Results call for urgent public health interventions to increase equitable access to dental care services.

  11. STIGMA AROUND HIV IN DENTAL CARE: PATIENTS' EXPERIENCES.

    PubMed

    Brondani, Mario A; Phillips, J Craig; Kerston, R Paul; Moniri, Nardin R

    2016-02-01

    Tooth decay and other oral diseases can be highly prevalent among people living with HIV/AIDS (PLWHA). Even though dental professionals are trained to provide equal and non-judgemental services to all, intentional or unintentional biases may exist with regard to PLWHA. We conducted qualitative descriptive research using individual interviews to explore the experiences of PLWHA accessing dental care services in Vancouver, Canada. We interviewed 25 PLWHA, aged 23-67 years; 21 were men and 60% reported fair or poor oral health. Thematic analysis showed evidence of both self-stigma and public stigma with the following themes: fear, self-stigma and dental care; overcoming past offences during encounters with dental care professionals; resilience and reconciliation to achieve quality care for all; and current encounters with dental care providers. Stigma attached to PLWHA is detrimental to oral care. The social awareness of dental professionals must be enhanced, so that they can provide the highest quality care to this vulnerable population.

  12. Traditional and emerging forms of dental practice. Cost, accessibility, and quality factors.

    PubMed Central

    Rovin, S; Nash, J

    1982-01-01

    The traditional and predominant manner of delivering dental care is through a fee-for-service, private practice system. A number of alternative dental care delivery systems have emerged and are being tested, and others are just emerging. These systems include department store practices, hospital dental services, health maintenance organizations, the independent practice of dental hygiene, and denturism. Although it is too soon to draw final conclusions about the efficacy and effectiveness of these systems, we examine them for their potential to compete with and change the way dental care is currently delivered. Using the parameters of cost, accessibility, and quality, we compare these systems to traditional dental practice. Some of these emerging forms clearly have the potential to complete favorably with traditional practice. Other seem less likely to alter the existing system substantially. The system which can best control costs, increase accessibility, and enhance quality will gain the competitive edge. PMID:7091453

  13. Barriers to dental care for children in Virginia with autism spectrum disorders.

    PubMed

    Brickhouse, Tegwyn H; Farrington, Frank H; Best, Al M; Ellsworth, Chad W

    2009-01-01

    The purposes of this study were to examine the reported use of dental services for families of children with autistic spectrum disorders and identify barriers that affect their access to dental care. Participants were caregivers of at least 1 child with an autism spectrum disorder. Caregivers completed a questionnaire that assessed access and barriers to dental services. Descriptive, bivariate, and multivariate regression analyses were conducted to examine dental care access issues in relation to individual factors. Each respondent's household income and child's history of difficult behavior in the dental office were significantly related to the ability to receive care when needed and whether the child had a regular dental provider. An inability to find a dentist with the skills or willingness to work with people with disabilities was the most frequent reason cited for not having a regular dental provider. Children with autism spectrum disorders who display difficult behavior are less likely to have a dentist for routine car, have longer intervals between dental appointments, and receive care when needed.

  14. Minimising barriers to dental care in older people

    PubMed Central

    Borreani, Elena; Wright, Desmond; Scambler, Sasha; Gallagher, Jennifer E

    2008-01-01

    Background Older people are increasingly retaining their natural teeth but at higher risk of oral disease with resultant impact on their quality of life. Socially deprived people are more at risk of oral disease and yet less likely to take up care. Health organisations in England and Wales are exploring new ways to commission and provide dental care services in general and for vulnerable groups in particular. This study was undertaken to investigate barriers to dental care perceived by older people in socially deprived inner city area where uptake of care was low and identify methods for minimising barriers in older people in support of oral health. Methods A qualitative dual-methodological approach, utilising both focus groups and individual interviews, was used in this research. Participants, older people and carers of older people, were recruited using purposive sampling through day centres and community groups in the inner city boroughs of Lambeth, Southwark and Lewisham in South London. A topic guide was utilised to guide qualitative data collection. Informants' views were recorded on tape and in field notes. The data were transcribed and analysed using Framework Methodology. Results Thirty-nine older people and/or their carers participated in focus groups. Active barriers to dental care in older people fell into five main categories: cost, fear, availability, accessibility and characteristics of the dentist. Lack of perception of a need for dental care was a common 'passive barrier' amongst denture wearers in particular. The cost of dental treatment, fear of care and perceived availability of dental services emerged to influence significantly dental attendance. Minimising barriers involves three levels of action to be taken: individual actions (such as persistence in finding available care following identification of need), system changes (including reducing costs, improving information, ensuring appropriate timing and location of care, and good patient

  15. Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method.

    PubMed

    Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali

    2013-08-01

    Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision-making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities.

  16. Oral and Dental Health Status among Adolescents with Limited Access to Dental Care Services in Jeddah.

    PubMed

    Bahannan, Salma A; Eltelety, Somaya M; Hassan, Mona H; Ibrahim, Suzan S; Amer, Hala A; El Meligy, Omar A; Al-Johani, Khalid A; Kayal, Rayyan A; Mokeem, Abeer A; Qutob, Akram F; Mira, Abdulghani I

    2018-05-17

    The purpose of this study was to assess the prevalence and associated factors of dental caries and periodontal diseases among 14⁻19-year-old schoolchildren with limited access to dental care services. A cross sectional study design was conducted during field visits to seven governmental schools in Al-Khomrah district, South Jeddah, over the period from September 2015 to May 2016. Clinical examinations and administered questionnaires were carried out in mobile dental clinics. The dentists carried out oral examinations using the dental caries index (DMFT), the simplified oral hygiene index (OHI-S), and the community periodontal index for treatment needs (CPITN). Statistical analyses were performed using SPSS 20. A total of 734 schoolchildren were examined. The prevalence of decayed teeth was 79.7% and was significantly higher among boys (88.9%) than girls (69.0%). About 11% of students had missing teeth, with a significantly higher figure among females than males (15.9% versus 7.3%); 19.8% of students had filled teeth. Moreover, a DMFT of seven or more was significantly more prevalent among males (43.3%) than females (26.8%), while the percentage of females with sound teeth was significantly higher than for males (20.4% and 9.6% respectively). The CPITN revealed 0, 1 and 2 scores among 14.6%, 78.2%, and 41.6% respectively. Males had a significantly higher percentage of healthy periodontal condition (23.8%) than females (3.8%). Dental caries prevalence was moderate to high, calculus and gingival bleeding were widespread among schoolchildren, and were more prevalent among students with low socioeconomic status.

  17. Access to Oral Health Care: A National Crisis and Call for Reform.

    PubMed

    Bersell, Catherine H

    2017-02-01

    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

  18. [The social value of teeth and access to dental health services].

    PubMed

    Fonseca, Luciara Leão Viana; Nehmy, Rosa Maria Quadros; Mota, Joaquim Antônio César

    2015-10-01

    Oral healthcare provided by the Unified Health System (SUS) faces the challenge of attending the epidemiological profile of Brazil's adult population. Qualitative research using semi-structured interviews was conducted to understand the experiences, expectations and perception of SUS users to services in Diamantina, State of Minas Gerais, and content analysis was used to assess the data. Discussion of the results was based on dialogue between the symbolic interactionism of Goffman and Bourdieu's concept of habitus. The results show that the users did not give importance to dental care during childhood and adolescence because care was unknown to them. There was no offer of treatment besides dental extraction. Today, they value teeth and suffer the embarrassment caused by rotten teeth. However, access to dental restoration via SUS is not possible. For their children, they perceive better access to information and care, but for specialized procedures there are barriers. They express resignation both in relation to the poor state of the teeth and the difficulties of access to dental care, which can be understood by the constant exclusion experienced by them in the past, shaping their actions in the present. It was concluded that oral health in SUS should incorporate the social value and the aesthetic dimension of teeth as a social right.

  19. Dental Care Utilization among North Carolina Rural Older Adults

    PubMed Central

    Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.

    2012-01-01

    Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural older adults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural older adults received dental care. Slightly more than one-quarter (27.1%) of dentate rural older adults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural older adults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public health policy to improve the health and quality of life of older adults in rural communities. PMID:22536828

  20. The rise and fall of dental therapy in Canada: a policy analysis and assessment of equity of access to oral health care for Inuit and First Nations communities.

    PubMed

    Leck, Victoria; Randall, Glen E

    2017-07-20

    Inequality between most Canadians and those from Inuit and First Nations communities, in terms of both access to oral health care services and related health outcomes, has been a long-standing problem. Efforts to close this equity gap led to the creation of dental therapy training programs. These programs were designed to produce graduates who would provide services in rural and northern communities. The closure of the last dental therapy program in late 2011 has ended the supply of dental therapists and governments do not appear to have any alternative solutions to the growing gap in access to oral health care services between most Canadians and those from Inuit and First Nations communities. A policy analysis of the rise and fall of the dental therapy profession in Canada was conducted using historical and policy documents. The analysis is framed within Kingdon's agenda-setting framework and considers why dental therapy was originally pursued as an option to ensure equitable access to oral health care for Inuit and First Nations communities and why this policy has now been abandoned with the closure of Canada's last dental therapy training school. The closure of the last dental therapy program in Canada has the potential to further reduce access to dental care in some Inuit and First Nations communities. Overlaps between federal and provincial jurisdiction have contributed to the absence of a coordinated policy approach to address the equity gap in access to dental care which will exacerbate the inequalities in comparison to the general population. The analysis suggests that while a technically feasible policy solution is available there continues to be no politically acceptable solution and thus it remains unlikely that a window of opportunity for policy change will open any time soon. In the absence of federal government leadership, the most viable option forward may be incremental policy change. Provincial governments could expand the scope of practice for

  1. Barriers to dental care for children with autism spectrum disorder.

    PubMed

    Barry, S; O'Sullivan, E A; Toumba, K J

    2014-04-01

    This study examined the problems encountered by children with autism spectrum disorder (ASD), when accessing dental care. This was a cross-sectional, case-control questionnaire study. A piloted questionnaire was developed to identify the main barriers to dental care experienced by patients with ASD in Hull and East Riding. The study group was comprised of parents/carers of children with ASD, and the control group was comprised of parents/carers of age matched healthy, neurotypical children. Results were analysed using Chi-square and Fisher's exact tests where appropriate. Significance was deemed at p < 0.05. Ordinal data was presented using medians and 25th and 75th centiles and compared using Mann-Whitney U test. A piloted questionnaire was developed to identify the main barriers to dental care experienced by patients with ASD in Hull and East Riding. The study group was comprised of parents/carers of children with ASD, and the control group was comprised of parents/carers of age matched healthy, neurotypical children. 112 subjects completed the questionnaire. There was no significant difference in accessing dental care between study and control groups (p = 0.051), although access was perceived as more difficult in the ASD group (p < 0.001). There was a significantly greater perceived difficulty in travelling to the dental surgery in the ASD group. Predicted negative behaviours were more frequent in the ASD group. All suggested interventions were predicted to be helpful in a significantly greater proportion of the ASD group. Difficulties exist for children with ASD in accessing dental care in the Hull and East Riding area.

  2. Protocol for diagnostic test accuracy study: the efficacy of screening for common dental diseases by Dental Care Professionals

    PubMed Central

    2013-01-01

    Background The bulk of service delivery in dentistry is delivered by general dental practitioners, when a large proportion of patients who attend regularly are asymptomatic and do not require treatment. This represents a substantial and unnecessary cost, given that it is possible to delegate a range of tasks to dental care professionals, who are a less expensive resource. Screening for the common dental diseases by dental care professionals has the potential to release general dental practitioner’s time and increase the capacity to care for those who don't currently access services. The aim of this study is to compare the diagnostic test accuracy of dental care professionals when screening for dental caries and periodontal disease in asymptomatic adults aged eighteen years of age. Methods/design Ten dental practices across the North-West of England will take part in a diagnostic test accuracy study with 200 consecutive patients in each practice. The dental care professionals will act as the index test and the general dental practitioner will act as the reference test. Consenting asymptomatic patients will enter the study and see either the dental care professionals or general dental practitioner first to remove order effects. Both sets of clinicians will make an assessment of dental caries and periodontal disease and enter their decisions on a record sheet for each participant. The primary outcome measure is the diagnostic test accuracy of the dental care professionals and sensitivity, specificity, positive predictive value and negative predictive values will be reported. A number of clinical factors will be assessed for confounding. Discussion The results of this study will determine whether dental care professionals can screen for the two most prevalent oral diseases. This will inform the literature and is apposite given the recent policy change in the United Kingdom towards direct access. PMID:24053760

  3. Dental care as a vital service response for disaster victims.

    PubMed

    Mosca, Nicholas G; Finn, Emanuel; Joskow, Renée

    2007-05-01

    Hurricane Katrina's impact on the infrastructure of public health and the health care system in the affected areas was unprecedented in the United States. Many dental offices were flood-bound in New Orleans and over 60% of dental practices were partially or completely damaged in affected counties in Mississippi. Most needs assessments conducted during the initial recovery operations did not include questions about access to oral health care. However, the extent of the destruction of the health care infrastructure demonstrated the need for significant state and federal support to make dental treatment accessible to survivors and evacuees. The Katrina response is one of the few times that state and federal government agencies responded to provide dental services to victims as part of disaster response and recovery. The purpose of this paper is to share our experiences in Mississippi and the District of Columbia providing urgent dental care to disaster victims as part of a crisis response.

  4. Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method

    PubMed Central

    Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali

    2013-01-01

    Background Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. Objectives This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. Patients and Methods This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision–making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. Results The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. Conclusions High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities. PMID:24578831

  5. Does optimal access to dental care counteract the oral health-related quality of life social gradient?

    PubMed

    Crocombe, L A; Mahoney, G D

    2016-12-01

    The aim of this study was to determine if an oral health-related quality of life (OHRQoL) social gradient existed when Australian Defence Force (ADF) members have universal and optimal access to dental care. A nominal roll included 4089 individuals who were deployed to the Solomon Islands as part of Operation ANODE and a comparison group of 4092 ADF personnel frequency matched to the deployed group on gender, age group and service type, from which 500 deployed and 500 comparison individuals were randomly selected. The dependent variables were the OHIP-14 summary measures. Rank was used to determine socioeconomic status. The demographic variables selected were: gender and age. The response rate was 44%. Of the individual OHIP-14 items, being self-conscious, painful aching and having discomfort when eating were the most common problems. Mean OHIP-14 severity was 2.8. In bivariate analysis, there was not a significant difference in mean OHIP-14 severity (p = 0.52) or frequency of OHIP-14 impacts (p = 0.57) by military rank. There was a significant increasing OHIP-14 extent score from commissioned officer to non-commissioned officer to other ranks (0.07, 0.19, 0.40, p = 0.03). Even with optimal access to dental care, there was an OHRQoL social gradient between military ranks in the ADF. © 2016 Australian Dental Association.

  6. Assessing the contribution of the dental care delivery system to oral health care disparities.

    PubMed

    Pourat, Nadereh; Andersen, Ronald M; Marcus, Marvin

    2015-01-01

    Existing studies of disparities in access to oral health care for underserved populations often focus on supply measures such as number of dentists. This approach overlooks the importance of other aspects of the dental care delivery system, such as personal and practice characteristics of dentists, that determine the capacity to provide care. This study aims to assess the role of such characteristics in access to care of underserved populations. We merged data from the 2003 California Health Interview Survey and a 2003 survey of California dentists in their Medical Study Service Areas (MSSAs). We examined the role of overall supply and other characteristics of dentists in income and racial/ethnic disparities in access, which was measured by annual dental visits and unmet need for dental care due to costs. We found that some characteristics of MSSAs, including higher proportions of dentists who were older, white, busy or overworked, and did not accept public insurance or discounted fees, inhibited access for low-income and minority populations. These findings highlight the importance of monitoring characteristics of dentists in addition to traditional measures of supply such as licensed-dentist-to-population ratios. The findings identify specific aspects of the delivery system such as dentists' participation in Medicaid, provision of discounted care, busyness, age, race/ethnicity, and gender that should be regularly monitored. These data will provide a better understanding of how the dental care delivery system is organized and how this knowledge can be used to develop more narrowly targeted policies to alleviate disparities. © 2014 American Association of Public Health Dentistry.

  7. Access to Oral Health Care: The Role of Federally Qualified Health Centers in Addressing Disparities and Expanding Access

    PubMed Central

    Shi, Leiyu; Hayashi, Arthur Seiji; Sharma, Ravi; Daly, Charles; Ngo-Metzger, Quyen

    2013-01-01

    Objectives. We examined utilization, unmet need, and satisfaction with oral health services among Federally Qualified Health Center patients. We examined correlates of unmet need to guide efforts to increase access to oral health services among underserved populations. Methods. Using the 2009 Health Center Patient Survey, we performed multivariate logistic regressions to examine factors associated with access to dental care at health centers, unmet need, and patient experience. Results. We found no racial or ethnic disparities in access to timely oral health care among health center patients; however, uninsured patients and those whose insurance does not provide dental coverage experienced restricted access and greater unmet need. Slightly more than half of health center patients had a dental visit in the past year, but 1 in 7 reported that their most recent visit was at least 5 years ago. Among health center patients who accessed dental care at their health center, satisfaction was high. Conclusions. These results underscore the critical role that health centers play in national efforts to improve oral health status and eliminate disparities in access to timely and appropriate dental services. PMID:23327254

  8. Dental auxiliaries for dental care traditionally provided by dentists.

    PubMed

    Dyer, Tom A; Brocklehurst, Paul; Glenny, Anne-Marie; Davies, Linda; Tickle, Martin; Issac, Ansy; Robinson, Peter G

    2014-08-20

    Poor or inequitable access to oral health care is commonly reported in high-, middle- and low-income countries. Although the severity of these problems varies, a lack of supply of dentists and their uneven distribution are important factors. Delegating care to dental auxiliaries could ease this problem, extend services to where they are unavailable and liberate time for dentists to do more complex work. Before such an approach can be advocated, it is important to know the relative effectiveness of dental auxiliaries and dentists. To assess the effectiveness, costs and cost effectiveness of dental auxiliaries in providing care traditionally provided by dentists. We searched the following electronic databases from their inception dates up to November 2013: the Cochrane Effective Practice and Organisation of Care (EPOC) Group's Specialised Register; Cochrane Oral Health Group's Specialised Register; the Cochrane Central Register of Controlled Trials (Issue 11, 2013); MEDLINE; EMBASE; CINAHL; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effectiveness; five other databases and two trial registries. We also undertook a grey literature search and searched the reference list of included studies and contacted authors of relevant papers. We included randomised controlled trials (RCTs), non-randomised controlled clinical trials (NRCTs), interrupted time series (ITSs) and controlled before and after studies (CBAs) evaluating the effectiveness of dental auxiliaries compared with dentists in undertaking clinical tasks traditionally performed by a dentist. Three review authors independently applied eligibility criteria, extracted data and assessed the risk of bias of each included study and two review authors assessed the quality of the evidence from the included studies, according to The Cochrane Collaboration's procedures. Since meta-analysis was not possible, we gave a narrative description of the results. We identified five studies (one cluster

  9. Strategic partnerships between academic dental institutions and communities: addressing disparities in oral health care.

    PubMed

    Johnson, Bradford R; Loomer, Peter M; Siegel, Sharon C; Pilcher, Elizabeth S; Leigh, Janet E; Gillespie, M Jane; Simmons, Raymond K; Turner, Sharon P

    2007-10-01

    A landmark report from the U.S. surgeon general identified disparities in oral health care as an urgent and high-priority problem. A parallel development in the dental education community is the growing consensus that significant curriculum reform is long overdue. The authors performed a literature review and conducted a series of structured interviews with key institutional and community stakeholders from seven geographical regions of the United States. They investigated a wide range of partnerships between community-based dental clinics and academic dental institutions. On the basis of their interviews and literature review, the authors identified common themes and made recommendations to the dental community to improve access to care while enhancing the dental curriculum. Reducing disparities in access to oral health care and the need for reform of the dental curriculum may be addressed, in part, by a common solution: strategic partnerships between academic dental institutions and communities. Practice Implications. Organized dentistry and individual practitioners, along with other major stakeholders, can play a significant role in supporting reform of the dental curriculum and improving access to care.

  10. Dental care of autistic children within the non-specialized Public Dental Service.

    PubMed

    Fahlvik-Planefeldt, C; Herrström, P

    2001-01-01

    Children with an autistic disorder may need more dental care and may also be more difficult to treat than healthy children. This study compared oral health in autistic and healthy children. Also explored was the dental management of autistic children within the non-specialized Public Dental Service. The study was designed as a case-control study with all cases of autistic disorders aged 3-19 years identified within a primary care area in southwest Sweden. One dentist did a clinical investigation of cases and one control per case. The patients, or their parents, answered a questionnaire. 28 patients were identified and 20 (71%) agreed to participate in the study. Cases and controls had a similar prevalence of fillings, caries, gingivitis and degree of oral hygiene. However, the need of orthodontic treatment seemed to be greater among the autistic children. According to a standardised assessment, autistic children were less able to cooperate in the dental treatment. Approximately 30% of the cases had occasionally been subjected to specialized dental care. The results of this study indicate that the care provided to autistic children within the non-specialized Public Dental Service is satisfactory, provided that there is access to a paediatric dentist when necessary.

  11. Complexities of Providing Dental Hygiene Services in Community Care Settings.

    PubMed

    Zarkowski, Pamela; Aksu, Mert N

    2016-06-01

    Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory, and ethical considerations create complexities and limits. Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet, inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care 'beyond the operatory.' An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Increasing Access to Dental and Medical Care by Allowing Greater Flexibility in Scope of Practice

    PubMed Central

    Hoffmann, Diane; Rowthorn, Virginia

    2015-01-01

    In recent years, advocates for increasing access to medical and oral health care have argued for expanding the scope of practice of dentists and physicians. Although this idea may have merit, significant legal and other barriers stand in the way of allowing dentists to do more primary health care, physicians to do more oral health care, and both professions to collaborate. State practice acts, standards of care, and professional school curricula all support the historical separation between the 2 professions. Current laws do not contemplate working across professional boundaries, leaving providers who try vulnerable to legal penalties. Here we examine the legal, regulatory, and training barriers to dental and medical professionals performing services outside their traditional scope of practice. PMID:26180970

  13. Cost as a barrier to accessing dental care: findings from a Canadian population-based study.

    PubMed

    Thompson, Brandy; Cooney, Peter; Lawrence, Herenia; Ravaghi, Vahid; Quiñonez, Carlos

    2014-01-01

    The aim of this study is to determine the demographic and socioeconomic characteristics of Canadians who report cost barriers to dental care. An analysis of data collected from the 2007/09 Canadian Health Measures Survey was undertaken from a sample of 5,586 Canadian participants aged 6-79. Cost barriers to dental care were operationalized through two questions: "In the past 12 months, have you avoided going to a dental professional because of the cost of dental care?" and "In the past 12 months, have you avoided having all the dental treatment that was recommended because of the cost?" Logistic regressions were conducted to identify relationships between covariates and positive responses to these questions. Approximately 17.3 percent of respondents had avoided a dental professional because of cost within the previous year, and 16.5 percent had declined recommended dental treatment because of cost. Adjusted estimates demonstrate that respondents with lower incomes and without dental insurance were over four times more likely to avoid a dental professional because of cost and approximately two and a half times more likely to decline recommended dental treatment because of cost. Nearly one out of five Canadians surveyed reported cost barriers to dental care. This study provides valuable baseline information for future studies to assess whether financial barriers to dental care are getting better or worse for Canadians. © 2014 American Association of Public Health Dentistry.

  14. Correlates of Unmet Dental Care Need Among HIV-Positive People Since Being Diagnosed with HIV

    PubMed Central

    Jeanty, Yves; Cardenas, Gabriel; Fox, Jane E.; Pereyra, Margaret; Diaz, Chanelle; Bednarsh, Helene; Reznik, David A.; Abel, Stephen N.; Bachman, Sara S.; Metsch, Lisa R.

    2012-01-01

    Objectives We analyzed the characteristics of people living with HIV/AIDS (PLWHA) who reported unmet oral health needs since testing positive and compared those characteristics with people reporting no unmet health needs. We also identified barriers to accessing oral health care for PLWHA. Methods We collected data from 2,469 HIV-positive patients who had not received oral health care in the previous 12 months and who had accessed care at Health Resources and Service Administration-funded Special Projects of National Significance Innovations in Oral Health Care Initiative demonstration sites. The outcome of interest was prior unmet oral health needs. We explore barriers to receiving oral health care, including cost, access, logistics, and personal factors. Bivariate tests of significance and generalized estimating equations were used in analyses. Results Nearly half of the study participants reported unmet dental care needs since their HIV diagnosis. People reporting unmet needs were more likely to be non-Hispanic white, U.S.-born, and HIV-positive for more than one year, and to have ever used crack cocaine or crystal methamphetamine. The top three reported barriers to oral care were cost, access to dental care, and fear of dental care. Additional reported barriers were indifference to dental care and logistical issues. Conclusion Innovative strategies are needed to increase access to and retention in oral health care for PLWHA. Key areas for action include developing strategies to reduce costs, increase access, and reduce personal barriers to receiving dental care, particularly considering the impact of poor oral health in this population. PMID:22547873

  15. Relationships between dental personnel and non-dental primary health care providers in rural and remote Queensland, Australia: dental perspectives.

    PubMed

    Stuart, Jackie; Hoang, Ha; Crocombe, Len; Barnett, Tony

    2017-06-19

    Collaboration between dental practitioners and non-dental primary care providers has the potential to improve oral health care for people in rural and remote communities, where access to oral health services is limited. However, there is limited research on collaboration between these professional disciplines. The purpose of this paper was to explore the relationships between dental practitioners and non-dental primary care providers from rural and remote areas of Queensland and to identify strategies that could improve collaboration between these disciplines from the perspective of dental participants. Semi-structured interviews were conducted between 2013 and 2015 with visiting, local and regional dental practitioners (n = 12) who had provided dental services to patients from eight rural and remote Queensland communities that did not have a resident dentist. Participants were purposely recruited through a snow ball sampling technique. Interview data were analysed using thematic analysis with the assistance of QSR Nvivo v.10. Four major themes emerged from the data: (1) Communication between dental practitioners and rural primary care providers; (2) Relationships between dental and primary care providers; (3) Maintenance of professional dualism; (4) Strategies to improve interprofessional relationships (with subthemes: face to face meetings; utilisation of technology; oral health training for primary care providers; and having a community based oral health contact person). Participants observed that there was a lack of communication between the dental providers who saw patients from these rural communities and the primary care providers who worked in each community. This was attributed to poor communication, the high turnover of staff and the siloed behaviours of some practitioners. Visiting dental practitioners were likely to have stronger professional relationships with hospital nursing, administrative and allied health care staff who were often long term

  16. Did Intraprofessional Training with Dental Therapists Affect Dental Students' Attitudes Toward Caring for the Underserved?

    PubMed

    Flynn, Priscilla M; Luthra, Makshita; Blue, Christine M

    2017-02-01

    Dental therapy was recently introduced as a new oral health care workforce model to increase care for vulnerable populations in Minnesota. Nine dental therapy and 98 dental students began intraprofessional training at the University of Minnesota in 2009. The aim of this longitudinal study was to determine whether intraprofessional education with the dental therapy students would affect the dental students' attitudes toward caring for underserved populations. One class of dental students was surveyed annually between 2009 and 2013 using the Attitudes Toward Health Care survey to measure attitudinal changes about treating vulnerable patients across their four years of dental school. Participation ranged from 68% to 99% in each year. The results showed that the dental students had positive attitudes toward treating vulnerable patients on entering dental school, but their attitudes became less positive over the four years. While the composite survey results were similar to other studies using the same instrument, variations were seen by domain. These students' attitudes about societal expectations and personal efficacy remained stable, while their dentist/student responsibility and access to care attitudes showed statistically significant declines. Their positive attitudes toward treating the underserved declined over four years regardless of intraprofessional training with dental therapy students. As attitudes toward caring for vulnerable patients are shaped by both personal attitudes and societal norms, additional research is needed to determine whether the addition of an intentional curricular thread may alter results over time compared to intraprofessional training alone.

  17. Facilitators and Barriers to Dental Care Among Mexican Migrant Women and Their Families in North San Diego County.

    PubMed

    Velez, Diane; Palomo-Zerfas, Ana; Nunez-Alvarez, Arcela; Ayala, Guadalupe X; Finlayson, Tracy L

    2017-10-01

    To qualitatively examine facilitators and barriers to dental care access and quality services among Mexican migrant women and their families living in North San Diego County, California. Six focus groups were conducted, with 52 participants. Three focus groups were with community residents (average group size of 10), and three were with community health workers/leaders (called Lideres; average group size of 7). The behavioral model for vulnerable populations theoretical framework guided qualitative data analyses. Predisposing factors to dental care access varied and included immigration status, language, and dental care experiences. Barriers to accessing quality dental services included high cost, lack of insurance coverage, dissatisfaction with providers, long wait times and discrimination. Participants expressed a desire for health policy changes, including affordable coverage for immigrants and their families. This study provided insights into how dental care providers, community health centers, and policymakers can improve dental care access and services to migrant populations.

  18. Dental Care Presents The Highest Level Of Financial Barriers, Compared To Other Types Of Health Care Services.

    PubMed

    Vujicic, Marko; Buchmueller, Thomas; Klein, Rachel

    2016-12-01

    The Affordable Care Act is improving access to and the affordability of a wide range of health care services. While dental care for children is part of the law's essential health benefits and state Medicaid programs must cover it, coverage of dental care for adults is not guaranteed. As a result, even with the recent health insurance expansion, many Americans face financial barriers to receiving dental care that lead to unmet oral health needs. Using data from the 2014 National Health Interview Survey, we analyzed financial barriers to a wide range of health care services. We found that irrespective of age, income level, and type of insurance, more people reported financial barriers to receiving dental care, compared to any other type of health care. We discuss policy options to address financial barriers to dental care, particularly for adults. Project HOPE—The People-to-People Health Foundation, Inc.

  19. Assessing Evidence-Based Practice Knowledge, Attitudes, Access and Confidence Among Dental Hygiene Educators.

    PubMed

    Stanley, Jennifer L; Hanson, Carrie L; Van Ness, Christopher J; Holt, Lorie

    2015-10-01

    To assess U.S. dental hygiene educators' evidence-based practice (EBP) knowledge, attitude, access and confidence and determine whether a correlation exists between assessment scores and level of education, length teaching and teaching setting (didactic, clinical or both). A cross-sectional survey was conducted with a sample of dental hygiene faculty from all 334 U.S. dental hygiene schools. ANOVA and Pearson correlation coefficient statistical analysis were utilized to investigate relationships between demographic variables and application of evidence-based principles of patient care. This study involved a non-probability sample (n=124), since the total faculty among all U.S. dental hygiene schools was not determined. Analysis demonstrated a positive correlation between EBP knowledge, access and confidence scores indicating that as knowledge scores increased, so did confidence and access scores (r=0.313, p<0.01 and r=0.189, p<0.05, respectively). Study findings also revealed that faculty who held advanced educational degrees scored significantly higher in EBP knowledge (F3,120=2.81, p<0.04) and confidence (F3,120=7.26, p<0.00). This study suggests the level of EBP knowledge, attitude, access and confidence increases with additional education. Therefore, more EBP training may be necessary for faculty who do not possess advanced education. Results of the study indicate that further incorporation of EBP into dental hygiene curricula may occur as dental hygiene educators' knowledge of EBP increases, which in turn could enhance students' acquisition of EBP skills and their application of EBP principles toward patient care. Copyright © 2015 The American Dental Hygienists’ Association.

  20. 'We are all scared for the baby': promoting access to dental services for refugee background women during pregnancy.

    PubMed

    Riggs, Elisha; Yelland, Jane; Shankumar, Ramini; Kilpatrick, Nicky

    2016-01-21

    Vulnerable populations such as people with refugee backgrounds are at increased risk of poor oral health. Given that maternal characteristics play a significant role in the development of dental caries in children, antenatal care offers an opportunity to both provide information to women about the importance of maternal oral health and accessing dental care. Although pregnant women are recognised for 'priority' care under Victorian state-government policy, rarely do they attend. This study aims to describe Afghan and Sri Lankan women's knowledge and beliefs surrounding maternal oral health, barriers to accessing dental care during pregnancy, and to present the perspectives of maternity and dental service providers in relation to dental care for pregnant women. One agency comprising both dental and maternity services formed the setting for the study. Using participatory methods that included working with bicultural community workers, focus groups were conducted with Afghan and Sri Lankan refugee background participants. Focus groups were also completed with midwives and dental service staff. Thematic analysis was applied to analyse the qualitative data. Four community focus groups were conducted with a total of 14 Afghan women, eight Sri Lankan women, and three Sri Lankan men. Focus groups were also conducted with 19 dental staff including clinicians and administrative staff, and with ten midwives. Four main themes were identified: perceptions of dental care during pregnancy, navigating dental services, maternal oral health literacy and potential solutions. Key findings included women and men's perception that dental treatment is unsafe during pregnancy, the lack of awareness amongst both the midwives and community members of the potential impact of poor maternal oral health and the overall lack of awareness and understanding of the 'priority of access' policy that entitles pregnant women to receive dental care cost-free. This study highlights a significant policy

  1. Better Together: Co-Location of Dental and Primary Care Provides Opportunities to Improve Oral Health.

    PubMed

    Pourat, Nadereh; Martinez, Ana E; Crall, James J

    2015-09-01

    Community Health Centers (CHCs) are one of the principal safety-net providers of health care for low-income and uninsured populations. Co-locating dental services in primary care settings provides an opportunity to improve access to dental care. Yet this study of California CHCs that provide primary care services shows that only about one-third of them co-located primary and dental care services on-site. An additional one-third were members of multisite organizations in which at least one other site provided dental care. The remaining one-third of CHC sites had no dental care capacity. Policy options to promote co-location include requiring on-site availability of dental services, providing infrastructure funding to build and equip dental facilities, and offering financial incentives to provide dental care and recruit dental providers.

  2. Health economic analyses of domiciliary dental care and care at fixed clinics for elderly nursing home residents in Sweden.

    PubMed

    Lundqvist, M; Davidson, T; Ordell, S; Sjöström, O; Zimmerman, M; Sjögren, P

    2015-03-01

    Dental care for elderly nursing home residents is traditionally provided at fixed dental clinics, but domiciliary dental care is an emerging alternative. Longer life expectancy accompanied with increased morbidity, and hospitalisation or dependence on the care of others will contribute to a risk for rapid deterioration of oral health so alternative methods for delivering oral health care to vulnerable individuals for whom access to fixed dental clinics is an obstacle should be considered. The aim was to analyse health economic consequences of domiciliary dental care for elderly nursing home residents in Sweden, compared to dentistry at a fixed clinic. A review of relevant literature was undertaken complemented by interviews with nursing home staff, officials at county councils, and academic experts in geriatric dentistry. Domiciliary dental care and fixed clinic care were compared in cost analyses and cost-effectiveness analyses. The mean societal cost of domiciliary dental care for elderly nursing home residents was lower than dental care at a fixed clinic, and it was also considered cost-effective. Lower cost of dental care at a fixed dental clinic was only achieved in a scenario where dental care could not be completed in a domiciliary setting. Domiciliary dental care for elderly nursing home residents has a lower societal cost and is cost-effective compared to dental care at fixed clinics. To meet current and predicted need for oral health care in the ageing population alternative methods to deliver dental care should be available.

  3. Assessing patterns of restorative and preventive care among children enrolled in Medicaid, by type of dental care provider.

    PubMed

    Taichman, L Susan; Sohn, Woosung; Lim, Sungwoo; Eklund, Stephen; Ismail, Amid

    2009-07-01

    The authors investigate the relationship of preventive dental treatment to subsequent receipt of comprehensive treatment among Medicaid-enrolled children. The authors analyzed Medicaid dental claims data for 50,485 children residing in Wayne County, Mich. The study sample included children aged 5 through 12 years in 2002 who had been enrolled in Medicaid for at least one month and had had at least one dental visit each year from 2002 through 2005. The authors assessed dental care utilization and treatment patterns cross-sectionally for each year and longitudinally. Among the Medicaid-enrolled children in 2002, 42 percent had had one or more dental visits during the year. At least 20 percent of the children with a dental visit in 2002 were treated by providers who billed Medicaid exclusively for diagnostic and preventive (DP) services. Children treated by DP care providers were less likely to receive restorative and/or surgical services than were children who were treated by dentists who provided a comprehensive mix of dental services. The logistic model showed that children who visited a DP-care provider were about 2.5 times less likely to receive restorative or surgical treatments than were children who visited comprehensive-care providers. Older children and African-American children were less likely to receive restorative and surgical treatments from both types of providers. The study results show that the type of provider is a significant determinant of whether children received comprehensive restorative and surgical services. The results suggest that current policies that support preventive care-only programs may achieve increased access to preventive care for Medicaid-enrolled children in Wayne County, but they do not provide access to adequate comprehensive dental care.

  4. A qualitative study of extended care permit dental hygienists in Kansas.

    PubMed

    Delinger, Janette; Gadbury-Amyot, Cynthia C; Mitchell, Tanya Villalpando; Williams, Karen B

    2014-06-01

    Currently, 37 states allow some type of alternative practice settings for dental hygienists. This qualitative study was designed to explore the experiences of the Extended Care Permit (ECP) dental hygienist in the state of Kansas. As a first ever study of this workforce model, a qualitative research design was chosen to illuminate the education and experiences of extended dental hygiene practitioners in order to understand the impact ECP legislation has had on increasing the public's access to oral health care services and define the advantages and limitation of this model as one potential solution to access to oral care. Snowball sampling was used to identify study participants who were actively engaged in extended care practice. Nine subjects, which included one ECP consultant and eight ECP providers, participated in this study. Data obtained via personal interviews and through document analysis data were subsequently coded and thematically analyzed by three examiners. An independent audit was conducted by a fourth examiner to confirm dependability of results. Seven major categories emerged from the data analysis: entrepreneur dental hygienist, partnerships, funding, barriers, sustainability, models of care and the impact of the ECP. The findings of this study revealed that ECP hygienists are making an impact with underserved populations, primarily children, the elderly and special needs patients. Copyright © 2014 The American Dental Hygienists’ Association.

  5. Does public transportation improve the accessibility of primary dental care in São Paulo, Brazil?

    PubMed

    Yuen, Aidan; Martins Rocha, Carla; Kruger, Estie; Tennant, Marc

    2018-06-01

    Advances in geospatial technologies have recognized the role of geographic distance as a barrier to healthcare accessibility. Frequent transportation is supposed to buffer issues with distance, while infrequent services impede the uptake of care. The role of public transportation on the accessibility of health care-including oral health care-is not well elucidated in the context of megacities, such as the municipality of São Paulo, Brazil. This study aimed to compare the supply of public transportation to primary dental clinics and the population between advantaged and disadvantaged areas in São Paulo city. A total of 4101 primary dental clinics in São Paulo city were identified and geocoded. Geographic coordinates were also retrieved for the 19 242 bus stops, 56 commuter rail stations and 64 rapid transit stations. Clinic locations and transport points were integrated with the city's 19 128 constituent census tracts-each containing sociodemographic data on the 11 252 204 residents-using Geographic Information Systems (GIS). Almost all clinics were located within 0.5 km of public transportation. Half of all clinics were within 0.5 km of high-frequency transport points, and three-quarters were within 1 km. Likewise, 99% of the population resided within 0.5 km of any public transportation. However, only 22% were within 0.5 km of high-frequency options, and half were within 1 km. Those within 0.5 km of high-frequency points had higher average monthly household incomes and lower illiteracy rates, with lower proportions of children and ethnic minorities, and higher proportions of older people. Clinics and populations in sociodemographically disadvantaged tracts have poorer public transportation links in São Paulo city. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The Supply of Dentists and Access to Care in Rural Kansas

    ERIC Educational Resources Information Center

    Allison, R. Andrew; Manski, Richard J.

    2007-01-01

    Context: Rural deficits in dental care and oral health are well documented and are typically attributed to the low number of dentists practicing in rural areas, but the relationships between rural residence, dental supply, and access to care have not been firmly established, impeding the development of effective public policy. Purpose: The purpose…

  7. Public and private dental services in NSW: a geographic information system analysis of access to care for 7 million Australians.

    PubMed

    Willie-Stephens, Jenny; Kruger, Estie; Tennant, Marc

    2014-06-01

    To investigate the distribution of public and private dental practices in NSW in relation to population distribution and socioeconomic status. Dental practices (public and private) were mapped and overlayed with Census data on Collection District population and Socio-Economic Indexes for Areas (SEIFA). Overall, there was an uneven geographic distribution of public and private dental practices across NSW. When the geographic distribution was compared to population socioeconomics it was found that in rural NSW, 12% of the most disadvantaged residents lived further than 50km from a public dental practice, compared to 0% of the least disadvantaged. In Sydney, 9% of the three most disadvantaged groups lived greater than 7.5km from a public dental practice, compared to 21% of the three least disadvantaged groups. The findings of this study can contribute to informing decisions to determine future areas for focus of dental resource development (infrastructure and workforce) and identifying subgroups in the population (who are geographically isolated from accessing care) where public health initiatives focused on amelioration of disease consequences should be a focus.

  8. Impact of dental therapists on productivity and finances: III. FQHC-run, school-based dental care programs in Connecticut.

    PubMed

    Bailit, Howard L; Beazoglou, Tryfon J; DeVitto, Judy; McGowan, Taegen; Myne-Joslin, Veronica

    2012-08-01

    In many developed countries, the primary role of dental therapists is to care for children in school clinics. This article describes Federally Qualified Health Center (FQHC)-run, school-based dental programs in Connecticut and explores the theoretical financial impact of substituting dental therapists for dentists in these programs. In schools, dental hygienists screen children and provide preventive services, using portable equipment and temporary space. Children needing dentist services are referred to FQHC clinics or to FQHC-employed dentists who provide care in schools. The primary findings of this study are that school-based programs have considerable potential to reduce access disparities and the estimated reduction in per patient costs approaches 50 percent versus providing care in FQHC dental clinics. In terms of substituting dental therapists for dentists, the estimated additional financial savings was found to be about 5 percent. Nationally, FQHC-operated, school-based dental programs have the potential to increase Medicaid/CHIP utilization from the current 40 percent to 60 percent for a relatively modest increase in total expenditures.

  9. Social work in dentistry: the CARES model for improving patient retention and access to care.

    PubMed

    Doris, Joan M; Davis, Elaine; Du Pont, Cynthia; Holdaway, Britt

    2009-07-01

    Social work programs in dental schools and dental clinics have been operated successfully since the 1940s, and have been documented as contributing to patients' access to care and to dental education. However, unlike medical social work, with which it has much in common, social work in dentistry has failed to become a standard feature of dental schools and clinics. Few of the social work initiatives that have been implemented in dental schools have survived after initial grant funding ran out, or the institutional supporters of the program moved on. The authors hope that the CARES program serves as a model for the successful development of other programs at the intersection of social work and dentistry to the benefit of both dental patients and providers.

  10. Medical care providers' perspectives on dental information needs in electronic health records.

    PubMed

    Acharya, Amit; Shimpi, Neel; Mahnke, Andrea; Mathias, Richard; Ye, Zhan

    2017-05-01

    The authors conducted this study to identify the most relevant patient dental information in a medical-dental integrated electronic health record (iEHR) necessary for medical care providers to inform holistic treatment. The authors collected input from a diverse sample of 65 participants from a large, regional health system representing 13 medical specialties and administrative units. The authors collected feedback from participants through 11 focus group sessions. Two independent reviewers analyzed focus group transcripts to identify major and minor themes. The authors identified 336 of 385 annotations that most medical care providers coded as relevant. Annotations strongly supporting relevancy to clinical practice aligned with 18 major thematic categories, with the top 6 categories being communication, appointments, system design, medications, treatment plan, and dental alerts. Study participants identified dental data of highest relevance to medical care providers and recommended implementation of user-friendly access to dental data in iEHRs as crucial to holistic care delivery. Identification of the patients' dental information most relevant to medical care providers will inform strategies for improving the integration of that information into the medical-dental iEHR. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  11. Effects of income and dental insurance coverage on need for dental care in Canada.

    PubMed

    Duncan, Laura; Bonner, Ashley

    2014-01-01

    To estimate the strength of the associations among income, dental insurance coverage and need for dental care (both urgent and nonurgent) in Canada. Multinomial logistic models were fit to data from the 2009 Canadian Health Measures Survey to test unadjusted associations among household income, dental insurance coverage and the need for urgent and nonurgent dental care. Adjusted associations, controlling for socio-demographic variables (age, sex, immigration status, education and province of residence) and oral health habits (brushing, flossing and visits to the dentist) were also evaluated. In the unadjusted model, need for treatment was lower among people with dental insurance than among those without insurance coverage (for urgent treatment: odds ratio [OR] 0.76, 95% confidence interval [CI] 0.66-0.89; for nonurgent treatment: OR 0.59, 95% CI 0.50-0.70). In addition, there was an income gradient, whereby people with higher income had less need for dental treatment (for urgent treatment: OR 0.99, 95% CI 0.99-1.00; for nonurgent treatment: OR 0.99, 95% CI 0.98-0.99). Controlling for socio-demographic and oral health variables decreased the magnitude of the association between dental insurance coverage and need for treatment (for urgent treatment: OR 0.80, 95% CI 0.68-0.95; for nonurgent treatment: OR 0.76, 95% CI 0.63-0.92). An interaction term between dental coverage and income was significant in relation to the need for nonurgent treatment: among lower-income individuals, having insurance slightly decreased the odds of needing nonurgent treatment, with this decrease in odds becoming greater for middle-income earners and even greater for high-income earners. Income-related inequality in need for dental care exists even in the presence of dental insurance coverage and good dental hygiene habits. These findings highlight the need for increased access to dental care for low-income populations and families living in poverty.

  12. Access to Dental Care for Rural Children: A Survey of Nebraska General Dentists

    ERIC Educational Resources Information Center

    McFarland, Kimberly K.; Salama, Fouad; Yaseen, Muhammad

    2011-01-01

    Background: Pediatric dentists are too few in number to care for all children. Therefore, the level of pediatric dental services provided by general dentists, especially in rural areas, is crucial to improving the dental health of children. Purpose: The objectives of the study were to establish a baseline in regard to the quantity of pediatric…

  13. Valuing the delivery of dental care: Heterogeneity in patients' preferences and willingness-to-pay for dental care attributes.

    PubMed

    Sever, Ivan; Verbič, Miroslav; Sever, Eva Klaric

    2018-02-01

    To examine the amount of heterogeneity in patients' preferences for dental care, what factors affect their preferences, and how much they would be willing to pay for improvement in specific dental care attributes. A discrete choice experiment (DCE) was used to elicit patients' preferences. Three alternative dental care services that differed in the type of care provider, treatment explanation, dental staff behavior, waiting time and treatment cost were described to patients. Patients (n=265) were asked to choose their preferred alternative. The study was conducted at a public dental clinic of the School of Dental Medicine, University of Zagreb. Mixed logit and latent class models were used for analysis. On average, the patients would be willing to pay €45 for getting a detailed explanation of treatment over no explanation. This was the most valued attribute of dental care, followed by dental staff behavior with marginal willingness-to-pay (WTP) of €28. Dental care provided by the faculty members and private dental care were valued similarly, while student-provided care was valued €23 less. Patients also disliked longer waiting time in the office, but this was the least important attribute. Four classes of patients with distinct preferences for dental care were identified. Older and/or more educated patients tended to give relatively less importance to treatment explanation. Higher education was also associated with a higher propensity to substitute faculty dental care with the private care providers. Large heterogeneity in patients' preferences was detected. Understanding their preferences may improve the delivery of dental care. Dental care providers should pay particular attention to providing a detailed treatment explanation to their patients. Dental care for older and/or more educated patients should be more attentive to interpersonal characteristics. Faculty dental care provided by faculty members could be price competitive to private care, and student

  14. Qualitative description of dental hygiene practices within oral health and dental care perspectives of Mexican-American adults and teenagers.

    PubMed

    Maupome, Gerardo; Aguirre-Zero, Odette; Westerhold, Chi

    2015-01-01

    The objectives of this study were to identify dental hygiene themes voiced by adults and teenagers of Mexican origin [or Mexican Americans (MAs)] and place these themes within the larger landscape of oral health and dental care perceptions. Interviews with urban-based MAs were analyzed to identify barriers, beliefs, and behaviors influencing engagement in dental hygiene practices. Adult (n = 16, ages 33-52) and teenage (n = 17, ages 14-19) MAs reported themes pertaining to structural factors (financial and economic-related barriers, the dual challenges of reduced access to care vis-à-vis successfully navigating the dental care system, and the effects of reduced social support derived from migration) and to individual factors (different agendas between MAs and health systems for dental care utilization and indications for oral self-care, including limited dental hygiene instruction from professionals and larger impacts from school-based and mass media). Also, prior experiences with dental hygiene, prevention, and associated themes were characterized by a range of attitudes from fatalistic to highly determined agency. Good family upbringing was instrumental for appropriate dental hygiene, anteceding good oral health; and outlining a loose structure of factors affecting oral health such as diet, having "weak" teeth, or personal habits. Themes from adults and teenagers in the Midwest United States were generally similar to other groups of MA parents and younger children. Dental hygiene was not salient relative to other oral health and dental care matters. Several opportunities for improvement of knowledge and enhancing motivation for dental hygiene practices were identified, both within and outside professional resources. © 2014 American Association of Public Health Dentistry.

  15. Dental Care for Medicaid and CHIP Enrollees

    MedlinePlus

    ... FAQs Home › Medicaid › Benefits › Dental Care Dental Care Dental Care Related Resources Learn How to Report the ... services and opportunities and challenges to obtaining care. Dental Benefits for Children in Medicaid Medicaid covers dental ...

  16. Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama

    PubMed Central

    Morrisey, Michael A.; Sen, Bisakha

    2017-01-01

    Importance There is a recommendation for children to have a dental home by 6 months of age, but there is limited evidence supporting the effectiveness of early preventive dental care or whether primary care providers (PCPs) can deliver it. Objective To investigate the effectiveness of preventive dental care in reducing caries-related treatment visits among Medicaid enrollees. Design, Setting, and Participants High-dimensional propensity scores were used to address selection bias for a retrospective cohort study of children continuously enrolled in coverage from the Alabama Medicaid Agency from birth between 2008 and 2012, adjusting for demographics, access to care, and general health service use. Exposures Children receiving preventive dental care prior to age 2 years from PCPs or dentists vs no preventive dental care. Main Outcome and Measures Two-part models estimated caries-related treatment and expenditures. Results Among 19 658 eligible children, 25.8% (n = 3658) received early preventive dental care, of whom 44% were black, 37.6% were white, and 16.3% were Hispanic. Compared with matched children without early preventive dental care, children with dentist-delivered preventive dental care more frequently had a subsequent caries-related treatment (20.6% vs 11.3%, P < .001), higher rate of visits (0.29 vs 0.15 per child-year, P < .001), and greater dental expenditures ($168 vs $87 per year, P < .001). Dentist-delivered preventive dental care was associated with an increase in the expected number of caries-related treatment visits by 0.14 per child per year (95% CI, 0.11-0.16) and caries-related treatment expenditures by $40.77 per child per year (95% CI, $30.48-$51.07). Primary care provider–delivered preventive dental care did not significantly affect caries-related treatment use or expenditures. Conclusions and Relevance Children with early preventive care visits from dentists were more likely to have subsequent dental care, including caries

  17. Investigating the "inverse care law" in dental care: A comparative analysis of Canadian jurisdictions.

    PubMed

    Dehmoobadsharifabadi, Armita; Singhal, Sonica; Quiñonez, Carlos

    2017-03-01

    To compare physician and dentist visits nationally and at the provincial/territorial level and to assess the extent of the "inverse care law" in dental care among different age groups in the same way. Publicly available data from the 2007 to 2008 Canadian Community Health Survey were utilized to investigate physician and dentist visits in the past 12 months in relation to self-perceived general and oral health by performing descriptive statistics and binary logistic regression, controlling for age, sex, education, income, and physician/dentist population ratios. Analysis was conducted for all participants and stratified by age groups - children (12-17 years), adults (18-64 years) and seniors (65 years and over). Nationally and provincially/territorially, it appears that the "inverse care law" persists for dental care but is not present for physician care. Specifically, when comparing to those with excellent general/oral health, individuals with poor general health were 2.71 (95% confidence interval [CI]: 2.70-2.72) times more likely to visit physicians, and individuals with poor oral health were 2.16 (95% CI: 2.16-2.17) times less likely to visit dentists. Stratified analyses by age showed more variability in the extent of the "inverse care law" in children and seniors compared to adults. The "inverse care law" in dental care exists both nationally and provincially/territorially among different age groups. Given this, it is important to assess the government's role in improving access to, and utilization of, dental care in Canada.

  18. [Dental care during pregnancy].

    PubMed

    Luc, Egea; Coulibaly, Nadin; Demoersman, Julien; Boutigny, Hervé; Soueidan, Assem

    2012-01-01

    to understand and analyze knowledge and practices of dentists regarding dental care during pregnancy using a questionnaire which focuses on the knowledge of the relationship between oral infections and complications of pregnancy, the attitude of practitioners on the implementation of dental care during pregnancy and the training of practitioners. 53.9% of pregnant women are not referred by an obstetrician. Only 59.8% of practitioners believe that dental anesthesia is not contraindicated, and most practitioners believe that the best time for care is the second trimester or after pregnancy. During pregnancy, practitioners realize the motivation for hygiene (90.7%), drainage of an abscess (82.2%), scaling (76.1%), the placement of a splint (74.1%), the treatment of caries (70%), and the removable prosthesis (67.2%). these results indicate the existence of a gap between the care of pregnant women and the state of the art in dental science, despite current clinical recommendations to deliver all necessary care to pregnant patients during the first, second and third trimester. Moreover, the results highlight the need to reinforce the initial training of dental students, but also to develop the training for practitioners in this field.

  19. Comparison of access and costs of Medicaid dental services in a hospital clinic and community practices.

    PubMed

    Marcus, M; Coulter, I; Mann, J; Leibowitz, A; Buchanan, J

    1996-01-01

    This paper reports the results of a three-year evaluation of access to dental care and its associated costs for Aid to Families with Dependent Children (AFDC) beneficiaries enrolled in a hospital-based health maintenance organization (HMO) or a fee-for-service (FFS) option. Medicaid enrollees (n = 3, l655) having a year of eligibility were assigned to either the hospital HMO or FFS care, and their use of dental care and its costs compared. A higher percent of those beneficiaries enrolled in the FFS option used dental care than those in the HMO plan. FFS enrollees also had more annual visits per person than those in the randomly assigned HMO group. FFS dental patients treated in the hospital had the highest costs of any payment-provider combination studied. To understand the mix of utilization rates, visits, and costs, one must take into account the way in which the HMO hospital plan is reimbursed, the way in which the dental department is reimbursed, and the way in which the dental provider is reimbursed.

  20. The Impact of Medicaid Reform on Children's Dental Care Utilization in Connecticut, Maryland, and Texas.

    PubMed

    Nasseh, Kamyar; Vujicic, Marko

    2015-08-01

    To measure the impact of Medicaid reforms, in particular increases in Medicaid dental fees in Connecticut, Maryland, and Texas, on access to dental care among Medicaid-eligible children. 2007 and 2011-2012 National Survey of Children's Health. Difference-in-differences and triple differences models were used to measure the impact of reforms. Relative to Medicaid-ineligible children and all children from a group of control states, preventive dental care utilization increased among Medicaid-eligible children in Connecticut and Texas. Unmet dental need declined among Medicaid-eligible children in Texas. Increasing Medicaid dental fees closer to private insurance fee levels has a significant impact on dental care utilization and unmet dental need among Medicaid-eligible children. © 2015 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Services Research.

  1. Meth mouth severity in response to drug-use patterns and dental access in methamphetamine users.

    PubMed

    Brown, Ronni E; Morisky, Donald E; Silverstein, Steven J

    2013-06-01

    Meth mouth is the rapid development of tooth decay in methamphetamine users. Our study questioned whether drug-use patterns and dental care access are risk factors affecting the severity of meth mouth. Participants received dental examinations, and the number of decayed, missing and filled teeth (DMFT) were counted and used to measure meth mouth severity.

  2. Unmet dental needs and barriers to care for children with significant special health care needs.

    PubMed

    Nelson, Linda P; Getzin, Anne; Graham, Dionne; Zhou, Jing; Wagle, Elke M; McQuiston, Jessie; McLaughlin, Suzanne; Govind, Akshay; Sadof, Matthew; Huntington, Noelle L

    2011-01-01

    The purpose of this study was to conduct the first known large scale survey of parents of children with special health care needs (CSHCN) to determine their child's: oral health status; access to dental care; perceived barriers (environmental/system and nonenvironmental/family); and oral health quality of life, accounting for each child's medical diagnosis and severity of diagnosis. A 72-item survey was sent to 3760 families of CSHCN throughout urban and rural Massachusetts. The study yielded 1,128 completed surveys. More than 90% of the children had seen a dentist within the past year; 66% saw a pediatric dentist, and 21% needed intense behavioral interventions. Although most families had high education levels, private dental insurance, and above average incomes, 20% of CSHCN had an unmet dental need. Children with craniofacial anomalies had twice as many unmet needs and children with cystic fibrosis had fewer unmet needs. Children with cerebral palsy, autism, developmental delay, and Down syndrome had more aversions to dental treatment, more treatment complications posed by their medical conditions, and more difficulty finding a dentist willing to provide care. Children with cystic fibrosis, metabolic disorders, or hemophilia encountered fewer barriers to care. The data paint a picture of high unmet dental needs with subpopulations of children with special health care needs who are more at risk for system barriers and internal family barriers to care based on their medical diagnoses.

  3. Insurance-Related Barriers to Accessing Dental Care Among African American Adults With Oral Health Symptoms in Harlem, New York City

    PubMed Central

    Siegel, Karolynn; Wolfson, Natalie H.; Mitchell, Dennis A.; Kunzel, Carol

    2011-01-01

    Although ability to pay is associated with dental care utilization, provision of public or private dental insurance has not eliminated dental care disparities between African American and White adults. We examined insurance-related barriers to dental care in interviews with a street-intercept sample of 118 African American adults in Harlem, New York City, with recent oral health symptoms. Although most participants reported having dental insurance (21% private, 50% Medicaid), reported barriers included (1) lack of coverage, (2) insufficient coverage, (3) inability to find a dentist who accepts their insurance, (4) having to wait for coverage to take effect, and (5) perceived poor quality of care for the uninsured or underinsured. These findings provide insights into why disparities persist and suggest strategies to removing these barriers to dental care. PMID:21680926

  4. Dental care providers' and patients' perceptions of the effect of health information technology in the dental care setting.

    PubMed

    Asan, Onur; Ye, Zhan; Acharya, Amit

    2013-09-01

    The use of electronic health records (EHRs) in dental care and their effect on dental care provider-patient interaction have not been studied sufficiently. The authors conducted a study to explore dental care providers' interactions with EHRs during patient visits, how these interactions influence dental care provider-patient communication, and the providers' and patients' perception of EHR use in the dental clinic setting during patient visits. The authors collected survey and interview data from patients and providers at three dental clinics in a health care system. The authors used qualitative and quantitative methods to analyze data obtained from patients and dental care providers. The provider survey results showed significant differences in perceptions of EHR use in patient visits across dental care provider groups (dentists, dental hygienists and dental assistants). Patient survey results indicated that some patients experienced a certain level of frustration and distraction because of providers' use of EHRs during the visit. The provider survey results indicated that there are different perceptions across provider groups about EHRs and the effect of computer use on communication with patients. Dental assistants generally reported more negative effects on communication with patients owing to computer use. Interview results also indicated that dental care providers may not feel comfortable interacting with the EHR without having any verbal or eye contact with patients during the patient's dental visit. A new design for dental operatories and locations of computer screens within the operatories should be undertaken to prevent negative nonverbal communication such as loss of eye contact or forcing the provider and patient to sit back to back, as well as to enhance patient education and information sharing.

  5. Factors associated with comprehensive dental care following an initial emergency dental visit.

    PubMed

    Johnson, Jeffrey T; Turner, Erwin G; Novak, Karen F; Kaplan, Alan L

    2005-01-01

    The purpose of this study was to characterize the patient population utilization of a dental home as grouped by: (1) age; (2) sex; and (3) payment method. A retrospective chart review of 1,020 patients, who initially presented for an emergency visit, was performed. From the original data pool, 2 groups were delineated: (1) those patients who returned for comprehensive dental care; and (2) those who did not return for comprehensive dental care. Patients with private dental insurance or Medicaid dental benefits were statistically more likely to return for comprehensive oral health care than those with no form of dental insurance. Younger patients (< or =3 years of age) were least likely to return for comprehensive dental care. Socioeconomic factors play a crucial role in care-seeking behaviors. These obstacles are often a barrier to preventive and comprehensive oral health care.

  6. Assuring access to dental care for low-income families in North Carolina. The NC Institute of Medicine Task Force Study.

    PubMed

    Silberman, P; Wicker, D A; Smith, S H; DeFriese, G H

    2000-01-01

    Following publication of the Task Force's recommendations for improving dental care access among low-income populations, North Carolina has taken several steps forward. The Division of Medical Assistance and the NC Dental Society are forming an advisory committee (comprising Medicaid patients, providers, and representatives from all elements of organized dentistry in the state) to review dental coverage and reimbursement rates. Using existing state funds, the NC Office of Research, Demonstrations and Rural Health Development has recruited 15 additional dentists and 1 dental hygienist to practice in community facilities serving low-income and uninsured patients. In 1999, the NC General Assembly revised the NC Dental Practice Act. Now, under the general direction of a licensed public health dentist, specially trained public health dental hygienists can perform oral health screenings and preventive and educational services outside the public school setting. The NC Institute of Medicine has begun exploring how to use dental hygienists to expand preventive dental services to underserved populations in federally-funded community or migrant health centers, state-funded health clinics, and the not-for-profit clinics that serve predominantly Medicaid, low-income or uninsured populations. A report is to be sent to the Governor and the Joint Legislative Commission on Governmental Operations no later than May 1, 2000. In 1999, the General Assembly directed the NC State Board of Dental Examiners to establish a procedure for streamlined licensing of dentists and dental hygienists who have been practicing in other states. This should increase the number of qualified dental practitioners in the state. The proposed rules governing the new licensing pathway are to be prepared by May 15, 2000. The Board of Dental Examiners will determine which new procedures will be needed to allow less burdensome and more timely entry of qualified out-of-state licensed applicants, while still

  7. Inequalities in the dental health needs and access to dental services among looked after children in Scotland: a population data linkage study.

    PubMed

    McMahon, Alex D; Elliott, Lawrie; Macpherson, Lorna Md; Sharpe, Katharine H; Connelly, Graham; Milligan, Ian; Wilson, Philip; Clark, David; King, Albert; Wood, Rachael; Conway, David I

    2018-01-01

    There is limited evidence on the health needs and service access among children and young people who are looked after by the state. The aim of this study was to compare dental treatment needs and access to dental services (as an exemplar of wider health and well-being concerns) among children and young people who are looked after with the general child population. Population data linkage study utilising national datasets of social work referrals for 'looked after' placements, the Scottish census of children in local authority schools, and national health service's dental health and service datasets. 633 204 children in publicly funded schools in Scotland during the academic year 2011/2012, of whom 10 927 (1.7%) were known to be looked after during that or a previous year (from 2007-2008). The children in the looked after children (LAC) group were more likely to have urgent dental treatment need at 5 years of age: 23%vs10% (n=209/16533), adjusted (for age, sex and area socioeconomic deprivation) OR 2.65 (95% CI 2.30 to 3.05); were less likely to attend a dentist regularly: 51%vs63% (n=5519/388934), 0.55 (0.53 to 0.58) and more likely to have teeth extracted under general anaesthesia: 9%vs5% (n=967/30253), 1.91 (1.78 to 2.04). LAC are more likely to have dental treatment needs and less likely to access dental services even when accounting for sociodemographic factors. Greater efforts are required to integrate child social and healthcare for LAC and to develop preventive care pathways on entering and throughout their time in the care system. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Potentially preventable dental care in operating rooms for children enrolled in Medicaid.

    PubMed

    Bruen, Brian K; Steinmetz, Erika; Bysshe, Tyler; Glassman, Paul; Ku, Leighton

    2016-09-01

    In this study, the authors examined the prevalence and cost of care for children enrolled in Medicaid for potentially preventable dental conditions who receive surgical care in hospital operating rooms (ORs) or ambulatory surgery centers (ASCs). The authors analyzed Medicaid data from 8 states to find cases in which children aged 1 to 20 years received surgical care in ORs or ASCs in 2010 and 2011 for potentially preventable diagnoses, as defined with diagnostic codes. For 6 states with complete data, there were 26,373 cases in 2011 in which children received OR or ASC surgical care for potentially preventable conditions. These cases represent approximately 0.5% of all children enrolled in Medicaid in these states and approximately 1% of children enrolled in Medicaid who received any dental care. There were $68 million in total Medicaid payments for these cases, with an average of $2,581 per case. Diagnostic codes indicated that 98% of cases were related to treatment of dental caries. More than two-thirds of the cases (71%) were children aged 1 to 5 years. Extrapolation to the United States suggests that approximately $450 million in additional expenditures occurred in 2011 because of OR or ASC surgical care for potentially preventable pediatric dental conditions, primarily related to early childhood caries. Strategies to improve prevention of early childhood caries, including community- and family-based education, and to increase access to timely and early dental care for low-income children could reduce the burdens and costs of these dental problems. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  9. [Pay for performance in dental care: A systematic narrative review of quality P4P models in dental care].

    PubMed

    Chenot, Regine

    2017-11-01

    Pay for performance (P4P) links reimbursement to the achievement of quality objectives. Experiences with P4P instruments and studies on their effects are available for the inpatient sector. A systematic narrative review brings together findings concerning the use and the effects of P4P, especially in dental care. A systematic literature search in PubMed and the Cochrane Library for reimbursement models using quality indicators provided 77 publications. Inclusion criteria were: year of publication not older than 2007, dental sector, models of quality-oriented remuneration, quality of care, quality indicators. 27 publications met the inclusion criteria and were evaluated with regard to the instruments and effects of P4P. The database search was supplemented by a free search on the Internet as well as a search in indicator databases and portals. The results of the included studies were extracted and summarized narratively. 27 studies were included in the review. Performance-oriented remuneration is an instrument of quality competition. In principle, P4P is embedded in an existing remuneration system, i.e., it does not occur in isolation. In the United States, England and Scandinavia, models are currently being tested for quality-oriented remuneration in dental care, based on quality indicators. The studies identified by the literature search are very heterogeneous and do not yield comparable endpoints. Difficulties are seen in the reproducibility of the quality of dental care with regard to certain characteristics which still have to be defined as quality-promoting properties. Risk selection cannot be ruled out, which may have an impact on structural quality (access to care, coordination). There were no long-term effects of P4P on the quality of care. In the short and medium term, adverse effects on the participants' motivation as well as shifting effects towards the private sector are described. A prerequisite for the functioning of P4P is the definition of clear

  10. Estimating Demand for and Supply of Pediatric Preventive Dental Care for Children and Identifying Dental Care Shortage Areas, Georgia, 2015.

    PubMed

    Cao, Shanshan; Gentili, Monica; Griffin, Paul M; Griffin, Susan O; Harati, Pravara; Johnson, Ben; Serban, Nicoleta; Tomar, Scott

    Demand for dental care is expected to outpace supply through 2025. The objectives of this study were to determine the extent of pediatric dental care shortages in Georgia and to develop a general method for estimation that can be applied to other states. We estimated supply and demand for pediatric preventive dental care for the 159 counties in Georgia in 2015. We compared pediatric preventive dental care shortage areas (where demand exceeded twice the supply) designated by our methods with dental health professional shortage areas designated by the Health Resources & Services Administration. We estimated caries risk from a multivariate analysis of National Health and Nutrition Examination Survey data and national census data. We estimated county-level demand based on the time needed to perform preventive dental care services and the proportion of time that dentists spend on pediatric preventive dental care services from the Medical Expenditure Panel Survey. Pediatric preventive dental care supply exceeded demand in Georgia in 75 counties: the average annual county-level pediatric preventive dental care demand was 16 866 hours, and the supply was 32 969 hours. We identified 41 counties as pediatric dental care shortage areas, 14 of which had not been designated by the Health Resources & Services Administration. Age- and service-specific information on dental care shortage areas could result in more efficient provider staffing and geographic targeting.

  11. Access to Dental Services for People Using a Wheelchair

    PubMed Central

    Nicolau, Belinda; Bedos, Christophe

    2015-01-01

    Objectives. We investigated the perspectives of people using a wheelchair and their difficulties in accessing dental services. Methods. Our participatory research was on the basis of a partnership between people using a wheelchair, dental professionals, and academic researchers. Partners were involved in a committee that provided advice at all stages of the project. Our team adopted a qualitative descriptive design. Between October 2011 and October 2012 we conducted semistructured individual interviews with 13 adults who lived in Montreal, Québec, Canada, and used a wheelchair full time. We audio-recorded and transcribed verbatim interviews, and we interpreted data using an inductive thematic analysis. Results. Oral health is of heightened importance to this group of people, who tend to use their mouth as a “third hand.” We identified successive challenges in accessing dental services: finding a dentist and being accepted, organizing transportation, entering the building and circulating inside, interacting with the dental staff, transferring and overcoming discomfort on the dental chair, and paying for the treatments. Conclusions. Governments, dental professional bodies, dental schools, and researchers should work with groups representing wheelchair users to improve access to dental services. PMID:26378836

  12. "They Told Me to Take Him Somewhere Else": Caregivers' Experiences Seeking Emergency Dental Care for Their Children.

    PubMed

    Meyer, Beau D; Lee, Jessica Y; Lampiris, Lewis N; Mihas, Paul; Vossers, Sarah; Divaris, Kimon

    2017-05-15

    The purpose of this mixed-methods study was to examine pediatric emergency dental trends in two safety net clinics and care-seeking experiences of young children's caregivers. Administrative data were used to describe and compare emergency first visits of children ages zero to six years in a community-based (CC) and a University-based (UC) safety net clinic from 2010 to 2014. In-person interviews were conducted with 11 caregivers of children ages zero to six presenting for nontrauma-related emergency visits at the UC from January to August 2016. Interviews were transcribed verbatim, coded, and analyzed inductively using Atlas. ti.7.5.9. The UC experienced significantly more emergency first visits (33 percent) than the CC (five percent, P<0.001), and the majority of these UC visits were referrals. Caregivers were dissatisfied with the experienced barriers of access to care and lack of child-centeredness, specifically the referral out of the dental home for emergency dental care. A considerable proportion of children's first visits at dental safety net clinics was emergency related. Children's caregivers voiced issues related to access to care and lack of child-centered care. Discordance was apparent between how professional organizations define the dental home and how caregivers experience it in the context of emergency care.

  13. Racial and ethnic disparities in dental care for publicly insured children.

    PubMed

    Pourat, Nadereh; Finocchio, Len

    2010-07-01

    Poor oral health has important implications for the healthy development of children. Children in Medicaid, especially Latinos and African Americans, experience high rates of tooth decay, yet they visit dentists less often than privately insured children. Even Latino and African American children with private insurance are less likely than white children to visit dentists and have longer intervals between dental visits. Furthermore, Latino and African American children in Medicaid are more likely than white children in Medicaid to have longer intervals between visits. These findings raise concerns about Medicaid's ability to address disparities in dental care access and, more broadly, in health care.

  14. Racial Differences in Predictors of Dental Care Use

    PubMed Central

    Gilbert, Gregg H; Shah, Ging R; Shelton, Brent J; Heft, Marc W; Bradford, Edward H; Chavers, L Scott

    2002-01-01

    Objective To test five hypotheses that non-Hispanic African Americans (AAs) and non-Hispanic whites (NHWs) differ in responsiveness to new dental symptoms by seeking dental care, and differ in certain predictors of dental care utilization. Data Sources/Study Setting Florida Dental Care Study, comprising AAs and NHWs 45 years old or older, who had at least one tooth, and who lived in north Florida. Study Design We used a prospective cohort design. The key outcome of interest was whether dental care was received in a given six-month period, after adjusting for the presence of certain time-varying and fixed characteristics. Data Collection/Extraction Methods In-person interviews were conducted at baseline and 24 months after baseline, with six-monthly telephone interviews in between. Principal Findings African Americans were less likely to seek dental care during follow-up, with or without adjusting for key predisposing, enabling, and oral health need characteristics. African Americans were more likely to be problem-oriented dental attenders, to be unable to pay an unexpected $500 dental bill, and to report postbaseline dental problems. However, the effect of certain postbaseline dental signs and symptoms on postbaseline dental care use differed between AAs and NHWs. Although financial circumstance was predictive for both groups, it was more salient for NHWs in separate NHW and AA regressions. Frustration with past dental care, propensity to use a homemade remedy, and dental insurance were significant predictors among AAs, but not among NHWs. The NHWs were much more likely to have sought care for preventive reasons. Conclusions Racial differences in responsiveness to new dental symptoms by seeking dental care were evident, as were differences in other predictors of dental care utilization. These differences may contribute to racial disparities in oral health. PMID:12546283

  15. Interprofessional education: the inclusion of dental hygiene in health care within the United States - a call to action.

    PubMed

    Vanderbilt, Allison A; Isringhausen, Kim T; Bonwell, Patricia Brown

    2013-01-01

    There is a lack of access to oral health care in the United States for rural, underserved, uninsured, and low-income populations. There are widely recognized problems with the US health care system, including rapidly increasing costs and access to oral health. During the last decade, there has been a huge influx and push toward interprofessional education programs; however, these programs conveniently leave out dental hygiene. Interprofessional education can bring forth the collaboration, communication, and teamwork necessary to provide a comprehensive health care plan to treat oral health care needs in patients. As the advanced practice for dental hygiene emerges, it is imperative that the educational qualifications of dental hygienists are sufficient to enable them to safely provide the scope of services and care encompassed in these new expanded roles and to effectively participate as an interprofessional team member.

  16. Sorry doctor, I can't afford the root canal, I have a job: Canadian dental care policy and the working poor.

    PubMed

    Quiñonez, Carlos; Figueiredo, Rafael

    2010-01-01

    In Canada, most dental care is privately financed through employment-based insurance, with only a small amount of care supported by governments for groups deemed in social need. Recently, this low level of public financing has been linked to problems in accessing dental care, and one group that has received major attention are the working poor (WP), or those who maintain regular employment but remain in relative poverty. The WP highlight a significant gap in Canadian dental care policy, as they are generally not eligible for either public or private insurance. This is a mixed methods study, comprised of an historical review of Canadian dental care policy and a telephone interview survey of WP Canadian adults. By its very definitions, Canadian dental care policy recognizes the WP as persons with employment, yet incorrectly assumes that they will have ready access to employment-based insurance. In addition, through historically developed biases, it also fails to recognize them as persons in social need. Our telephone survey suggests that this policy approach has important impacts in that oral health and dental care outcomes are significantly mitigated by the presence of dental insurance. Canadian dental care policy should be reassessed in terms of how it determines need in order to close a gap that holds negative consequences for many Canadian families.

  17. Economic feasibility of alternative practitioners for provision of dental care to the underserved.

    PubMed

    Matthiesen, Anne

    2012-01-01

    This study assesses the viability of three alternative practitioner types for provision of dental care to the underserved. Key factors modeled include compensation, training and practice costs, productivity, and payer mix scenarios. Utilizing dental therapists or dental health aide therapists is cost-effective for enhancing access. However, to be sustainable, the practices will require a subsidy or a better reimbursement than modeled. Without tuition support, the debt burden will deter applicants mostlikely to treat the underserved.

  18. Oral Health Care for Children in Countries Using Dental Therapists in Public, School-Based Programs, Contrasted with That of the United States, Using Dentists in a Private Practice Model

    PubMed Central

    Friedman, Jay W.; Nash, David A.

    2013-01-01

    The United States faces a significant problem with access to oral health care, particularly for children. More than 50 countries have developed an alternative dental provider, a dental therapist, practicing in public, school-based programs, to address children’s access to care. This delivery model has been demonstrated to improve access to care and oral health outcomes while providing quality care economically. We summarize elements of a recent major review of the global literature on the use of dental therapists, “A Review of the Global Literature on Dental Therapists: In the Context of the Movement to Add Dental Therapists to the Oral Health Workforce in the United States.” We contrast the success of a school-based model of caring for children by dental therapists with that of the US model of dentists providing care for children in private practices. PMID:23865650

  19. Oral health care in remote Kimberley Aboriginal communities: the characteristics and perceptions of dental volunteers.

    PubMed

    Patel, J; Hearn, L; Slack-Smith, L M

    2015-09-01

    Aboriginal Australians face significant disparities in oral health and this is particularly the case in remote communities where access to dental services can be difficult. Using volunteers to provide dental care in the remote Kimberley region of Western Australia is a novel approach. This study comprised an anonymous online survey of volunteers working with the Kimberley Dental Team (KDT). The survey had a response fraction of 66% and explored volunteer demographic characteristics, factors that motivated their involvement, perceptions of oral health among Aboriginal communities, and barriers and enablers to oral health in remote Aboriginal communities. Volunteers were more likely to be female, middle-aged and engaged in full-time employment. The two most common reasons reported for volunteering were to assist the community and visit the Kimberley region. Education and access to reliable, culturally appropriate care were perceived as enablers to good oral health for Aboriginal people in the Kimberley while limited access to services, poor nutrition and lack of government support were cited as barriers. Volunteers providing dental services to remote areas in Western Australia had a diverse demographic profile. However, they share similar motivating factors and views on the current barriers and enablers to good oral health in remote Aboriginal communities. © 2015 Australian Dental Association.

  20. Dental Care in Scleroderma

    MedlinePlus

    Dental Care in Scleroderma People living with scleroderma face unique challenges while trying to maintain their oral ... They are more likely to be affected by dental conditions such as small mouth, dry mouth, jaw ...

  1. Factors associated with unmet dental care needs in Canadian immigrants: an analysis of the longitudinal survey of immigrants to Canada.

    PubMed

    Calvasina, Paola; Muntaner, Carles; Quiñonez, Carlos

    2014-12-03

    Immigrants are often considered to have poorer oral health than native born-populations. One possible explanation for immigrants' poor oral health is lack of access to dental care. There is very little information on Canadian immigrants' access to dental care, and unmet dental care needs. This study examines predictors of unmet dental care needs among a sample of adult immigrants to Canada over a three-point-five-year post-migration period. A secondary data analysis was conducted on the Longitudinal Survey of Immigrants to Canada (LSIC). Sampling and bootstrap weights were applied to make the data nationally representative. Simple descriptive analyses were conducted to describe the demographic characteristics of the sample. Bivariate and multiple logistic regression analyses were applied to identify factors associated with immigrants' unmet dental care needs over a three-point-five-year period. Approximately 32% of immigrants reported unmet dental care needs. Immigrants lacking dental insurance (OR = 2.63; 95% CI: 2.05-3.37), and those with an average household income of $20,000 to $40,000 per year (OR = 1.62; 95% CI: 1.01-2.61), and lower than $20,000 (OR = 2.25; 95% CI: 1.31-3.86), were more likely to report unmet dental care needs than those earning more than $60,000 per year. In addition, South Asian (OR = 1.85; CI: 1.25-2.73) and Chinese (OR = 2.17; CI: 1.47-3.21) immigrants had significantly higher odds of reporting unmet dental care needs than Europeans. Lack of dental insurance, low income and ethnicity predicted unmet dental care needs over a three-point-five-year period in a sample of immigrants to Canada.

  2. Dental care - child

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002213.htm Dental care - child To use the sharing features on ... please enable JavaScript. Proper care of your child's teeth and gums includes brushing and rinsing daily. It ...

  3. Dental Care Utilization for Examination and Regional Deprivation

    PubMed Central

    Kim, Cheol-Sin; Han, Sun-Young; Lee, Seung Eun; Kang, Jeong-Hee; Kim, Chul-Woung

    2015-01-01

    Objectives: Receiving proper dental care plays a significant role in maintaining good oral health. We investigated the relationship between regional deprivation and dental care utilization. Methods: Multilevel logistic regression was used to identify the relationship between the regional deprivation level and dental care utilization purpose, adjusting for individual-level variables, in adults aged 19+ in the 2008 Korean Community Health Survey (n=220 258). Results: Among Korean adults, 12.8% used dental care to undergo examination and 21.0% visited a dentist for other reasons. In the final model, regional deprivation level was associated with significant variations in dental care utilization for examination (p<0.001). However, this relationship was not shown with dental care utilization for other reasons in the final model. Conclusions: This study’s findings suggest that policy interventions should be considered to reduce regional variations in rates of dental care utilization for examination. PMID:26265665

  4. Public health dental hygiene: an option for improved quality of care and quality of life.

    PubMed

    Olmsted, Jodi L; Rublee, Nancy; Zurkawski, Emily; Kleber, Laura

    2013-10-01

    The purpose of this research was to document quality of life (QoL) and quality of care (QoC) measures for families receiving care from dental hygienists within public health departments, and to consider if oral health for families with economic disparities and cultural differences was improved. A descriptive research study using a retrospective record review was conducted considering QoC. A review of state epid "Do preventive oral health programs based in local health departments provide quality care services, thus impacting QoL for underserved populations?" A dental hygienist working in public health made significant contributions to improving access to care and QoL in a rural, socioeconomically disadvantaged community. A total of 2,364 children received education, 1,745 received oral screenings and 1,511 received dental sealants. Of these, 804 children with caries were referred, with 463 receiving restorations and follow-up care. QoL metrics basis assessed Health Outcomes & Health Determinants. Initial QoL data was ranked in the bottom half of the state, while 70% of original determinant data was also ranked in the bottom half of reported metrics. Dental hygienists in public health settings can positively affect patients offering preventive care outreach services. Education and sealant placement were considered effective as measured by access, delivery and, when required, referral for restorative care. Improvement in QoL for individuals was noted through improved health outcomes and determinant metrics.

  5. Balancing the role of the dental school in teaching, research and patient care; including care for underserved areas.

    PubMed

    Holbrook, W P; Brodin, P; Balciuniene, I; Brukiene, V; Bucur, M V; Corbet, E; Dillenberg, J; Djukanovic, D; Ekanayake, K; Eriksen, H; Fisher, J; Goffin, G; Hull, P; Kumchai, T; Lumley, P; Lund, J; Mathur, V; Novaes, A; Puriene, A; Roger-Leroi, V; Saito, I; Turner, S; Mabelya, L

    2008-02-01

    Inequalities within dentistry are common and are reflected in wide differences in the levels of oral health and the standard of care available both within and between countries and communities. Furthermore there are patients, particularly those with special treatment needs, who do not have the same access to dental services as the general public. The dental school should aim to recruit students from varied backgrounds into all areas covered by the oral healthcare team and to train students to treat the full spectrum of patients including those with special needs. It is essential, however, that the dental student achieves a high standard of clinical competence and this cannot be gained by treating only those patients with low expectations for care. Balancing these aspects of clinical education is difficult. Research is an important stimulus to better teaching and better clinical care. It is recognized that dental school staff should be active in research, teaching, clinical work and frequently administration. Maintaining a balance between the commitments to clinical care, teaching and research while also taking account of underserved areas in each of these categories is a difficult challenge but one that has to be met to a high degree in a successful, modern dental school.

  6. Disparities in unmet dental need and dental care received by pregnant women in Maryland.

    PubMed

    Singhal, Astha; Chattopadhyay, Amit; Garcia, A Isabel; Adams, Amy B; Cheng, Diana

    2014-09-01

    To examine prenatal dental care needs, utilization and oral health counseling among Maryland women who delivered a live infant during 2001-2003 and identify the factors associated with having a dental visit and having an unmet dental need during pregnancy. Pregnancy Risk Assessment Monitoring System is an ongoing population based surveillance system that collects information of women's attitudes and experiences before, during, and shortly after pregnancy. Logistic regression was used to model dental visits and unmet dental need using predictor variables for Maryland 2001-2003 births. Less than half of all women reported having a dental visit and receiving oral health advice during pregnancy. Twenty-five percent of women reported a need for dental care, of which 33 % did not receive dental care despite their perceived need. Multivariate modeling revealed that racial minorities, women who were not married and those with annual income <$40,000 were least likely to have a dental visit. Women who were not married, had low annual income, were older than 40 years of age, had an unintended pregnancy and received prenatal care later than desired were most likely to have an unmet dental need during pregnancy. Despite reported needs and existing recommendations to include oral health as a component of prenatal care, less than half of pregnant women have a dental visit during their pregnancy. One-third of women with a dental problem did not have a dental visit highlighting the unmet need for dental care during pregnancy.

  7. Projecting the Demand for Dental Care in 2040.

    PubMed

    Manski, Richard J; Meyerhoefer, Chad D

    2017-08-01

    The purpose of this study was to provide a forward-thinking assessment of the underlying factors likely to impact trends in dental care demand and the need for dental providers in 2020, 2025, and beyond. Dental workforce trends and their likely impact on the need for dentists are a function of predicted dental care demand, which will in turn be determined by the size and characteristics of our population size, economic outlook, the state of public and private dental care insurance, trends in dental care delivery, professionally determined dental care need, and population health beliefs. Projecting rates of dental care utilization far into the future is difficult because projections must be made using historical data, and established trends may not persist if there is structural change in the future. Nonetheless, when structural change occurs, it does not typically affect all aspects of the economy, so there is value in describing the likely future impact of current trends. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  8. Health care access disparities among children entering kindergarten in Nevada.

    PubMed

    Fulkerson, Nadia Deashinta; Haff, Darlene R; Chino, Michelle

    2013-09-01

    The objective of this study was to advance our understanding and appreciation of the health status of young children in the state of Nevada in addition to their discrepancies in accessing health care. This study used the 2008-2009 Nevada Kindergarten Health Survey data of 11,073 children to assess both independent and combined effects of annual household income, race/ethnicity, primary language spoken in the family, rural/urban residence, and existing medical condition on access to health care. Annual household income was a significant predictor of access to health care, with middle and high income respondents having regular access to care compared to low income counterparts. Further, English proficiency was associated with access to health care, with English-speaking Hispanics over 2.5 times more likely to have regular access to care than Spanish-speaking Hispanics. Rural residents had decreased odds of access to preventive care and having a primary care provider, but unexpectedly, had increased odds of having access to dental care compared to urban residents. Finally, parents of children with no medical conditions were more likely to have access to care than those with a medical condition. The consequences for not addressing health care access issues include deteriorating health and well-being for vulnerable socio-demographic groups in the state. Altogether these findings suggest that programs and policies within the state must be sensitive to the specific needs of at risk groups, including minorities, those with low income, and regionally and linguistically isolated residents.

  9. Caregiver perspectives in oral healthcare in an institutionalised elderly population without access to dental services: a pilot study.

    PubMed

    Matear, David; Barbaro, John

    2006-01-01

    The provision of dental services to elderly populations is a complicated area. When clients are cognitively impaired, a new set of variables are introduced as care can be influenced by designated family members, caregivers or administrators, who are responsible for the oral health care of the client and may influence the types of treatment the client will receive. Differences in attitudes and perceptions, with respect to oral health, may lead to better or worse access to care. The goals of this study are: (a) to gain a better understanding of the perceptions which may govern access and barriers to care within the institutionalised elderly population; and (b) to improve information on where and how to target educational and service resources, in order to reduce barriers to care. A convenience (non-randomised) sample of 100 residents with caregivers was selected from nursing homes without organised access to oral healthcare services. A structured interview was conducted with 40 family members. Questions explored the importance and priorities of dental services for elderly people in institutions. Services which family members deemed of highest importance were dentures (both to replace teeth and adjustments on existing dentures), pain relief, emergency dentistry, fillings, cleanings, check-ups, tooth removal and treatment for advanced gum disease. Services that family members felt were less important were complex restorations, cleaning instruction to caregivers and seniors, and services by a specialist. Services considered to be of least importance were root canal treatment and implants. The top service priorities identified by the sample of family members included: cleanings to prevent mouth disease; check-ups including X-rays; fillings; dentures to replace teeth; and dental treatment to relieve pain. This study found that family members and caregivers would like a basic dental service including check-ups and preventive care, with restorative, denture and surgical

  10. Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research.

    PubMed

    Wanyonyi, Kristina L; Radford, David R; Harper, Paul R; Gallagher, Jennifer E

    2015-09-15

    In primary care dentistry, strategies to reconfigure the traditional boundaries of various dental professional groups by task sharing and role substitution have been encouraged in order to meet changing oral health needs. The aim of this research was to investigate the potential for skill mix use in primary dental care in England based on the undergraduate training experience in a primary care team training centre for dentists and mid-level dental providers. An operational research model and four alternative scenarios to test the potential for skill mix use in primary care in England were developed, informed by the model of care at a primary dental care training centre in the south of England, professional policy including scope of practice and contemporary evidence-based preventative practice. The model was developed in Excel and drew on published national timings and salary costs. The scenarios included the following: "No Skill Mix", "Minimal Direct Access", "More Prevention" and "Maximum Delegation". The scenario outputs comprised clinical time, workforce numbers and salary costs required for state-funded primary dental care in England. The operational research model suggested that 73% of clinical time in England's state-funded primary dental care in 2011/12 was spent on tasks that may be delegated to dental care professionals (DCPs), and 45- to 54-year-old patients received the most clinical time overall. Using estimated National Health Service (NHS) clinical working patterns, the model suggested alternative NHS workforce numbers and salary costs to meet the dental demand based on each developed scenario. For scenario 1:"No Skill Mix", the dentist-only scenario, 81% of the dentists currently registered in England would be required to participate. In scenario 2: "Minimal Direct Access", where 70% of examinations were delegated and the primary care training centre delegation patterns for other treatments were practised, 40% of registered dentists and eight times

  11. Dental attendance patterns among older people: a retrospective review of records in public and private dental care in Sweden.

    PubMed

    Derblom, C; Hagman-Gustafsson, M-L; Gabre, P

    2017-11-01

    Nowadays, older people retain their natural teeth more frequently and so are at increased risk of oral disease. At the same time, discontinued contacts with dental services prevent access to preventive care and increase the risk of undetected disease. This study aims to evaluate how often older people discontinue regular dental visits and to establish the reasons. This study is a retrospective review of records of patients aged ≥75 years from seven Swedish clinics, three in the public dental service (PuDS) and four in the private (PrDS). All patients were examined in 2010, and their dental attendance records from 2010 to 2014 studied. Data included gender, dental insurance system, last performed planned examination, emergency visits, registrations in the recall system, cause of discontinued care and number of teeth and implants. In total, 993 records were studied, 303 in PuDS and 690 in PrDS. In both groups, 10% of patients had no complete dental examinations between 2010 and 2014 after baseline examination in 2010. One-quarter were not registered in the recall system after their last examinations, and this was more common in PrDS than PuDS. In many cases, no reason for discontinued regular visits were described in the records. The mean number of natural teeth was 19.0 in both groups, but there were more implants in the PrDS group. A large proportion of the participants risked losing regular contact with dental services. Dental services appeared to lack strategies for maintaining regular dental care for elderly patients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Dental care among young adults with intellectual disability

    PubMed Central

    Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn

    2015-01-01

    Dental care among young adults with intellectual disability (ID) is poorly documented and largely unmet. By using population-based data from the Metropolitan Atlanta Developmental Disabilities Follow-Up Study, we assessed factors associated with at least one or two dental visits per year among young adults with and without ID. Significantly fewer young adults with ID (45%) visited a dentist at least once per year, compared with those without ID (58%). ID severity and the presence of co-occurring developmental disabilities predicted dental care use. Sociodemographics, daily functioning, societal participation, dental services, and dental health factors were examined as predictors of dental care frequency. Our findings can help focus efforts toward improving the frequency of dental care visits among young adults with ID. PMID:23501584

  13. How Medicare Could Provide Dental, Vision, and Hearing Care for Beneficiaries.

    PubMed

    Willink, Amber; Shoen, Cathy; Davis, Karen

    2018-01-01

    The Medicare program specifically excludes coverage of dental, vision, and hearing services. As a result, many beneficiaries do not receive necessary care. Those that do are subject to high out-of-pocket costs. Examine gaps in access to dental, vision, and hearing services for Medicare beneficiaries and design a voluntary dental, vision, and hearing benefit plan with cost estimates. Uses the Medicare Current Beneficiary Survey, Cost and Use File, 2012, with population and costs projected to 2016 values. Among Medicare beneficiaries, 75 percent of people who needed a hearing aid did not have one; 70 percent of people who had trouble eating because of their teeth did not go to the dentist in the past year; and 43 percent of people who had trouble seeing did not have an eye exam in the past year. Lack of access was particularly acute for poor beneficiaries. Because few people have supplemental insurance covering these additional services, among people who received care, three-fourths of their costs of dental and hearing services and 60 percent of their costs of vision services were paid out of pocket. We propose a basic benefit package for dental, vision, and hearing services offered as a premium-financed voluntary insurance option under Medicare. Assuming the benefit package could be offered for $25 per month, we estimate the total coverage costs would be $1.924 billion per year, paid for by premiums. Subsidies to reach low-income beneficiaries would follow the same design as the Part D subsidy.

  14. The Primary Dental Care Workforce.

    ERIC Educational Resources Information Center

    Neenan, M. Elaine; And Others

    1993-01-01

    A study describes the characteristics of the current primary dental care workforce (dentists, hygienists, assistants), its distribution, and its delivery system in private and public sectors. Graduate dental school enrollments, trends in patient visits, employment patterns, state dental activities, and workforce issues related to health care…

  15. Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients.

    PubMed

    Glurich, Ingrid; Nycz, Gregory; Acharya, Amit

    2017-06-01

    Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bi-directional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: (1) current cross-disciplinary practice patterns, (2) epidemiological updates, (3) status on risk assessment and screening for dysglycemia in the dental setting, (4) status on implementation of quality metrics for oral health, (5) care model pilots, and (6) public health perspectives. The survey revealed: escalating prevalence of diabetes and periodontitis globally; greater emphasis on oral health assessment for diabetic patients in recent medical clinical practice guidelines; high knowledgeability surrounding oral-systemic impacts on diabetes and growing receptivity to medical-dental integration among medical and dental providers; increasing numbers of programs/studies reporting on positive impact of emerging integrated dental-medical care models on diabetic patient healthcare access and health outcomes; a growing evidence base for clinically significant rates of undiagnosed dysglycemia among dental patients reported by point-of-care pilot studies; no current recommendation for population-based screening for dysglycemia in dental settings pending a stronger evidence base; improved definition of true periodontitis prevalence in (pre)/diabetics; emerging recognition of the need for oral health quality indicators and tracking; evidence of persistence in dental access disparity; updated status on barriers to integration. The potential benefit of creating clinically-applicable integrated care

  16. Autism and primary care dentistry: parents' experiences of taking children with autism or working diagnosis of autism for dental examinations.

    PubMed

    Thomas, Nicole; Blake, Sharon; Morris, Christopher; Moles, David R

    2018-03-01

    Accessing and receiving preventative dental treatment can be difficult for children with autism due to sensory processing disorders and/or challenging behaviours coupled with a reported reluctance by dentists to treat these children. To gather dental experiences of UK parents of children with autism or working diagnosis of autism and explore how they feel primary care dental services can be improved. A total of 17 parents of children with a diagnosis or working diagnosis of autism took part in semi-structured interviews. Data were analysed thematically. Key themes identified were flexibility of the dental team and environment, confidence of the parents to advocate for their children's needs, continuity of services and clear referral pathways to specialist services. Cross-cutting all themes was the value of clear communication. The experiences provide greater understanding of issues such as hyper-empathy, the dental chair, challenges of the waiting room, perceived medical authority, and the importance of continuation of care. In line with previous research about the importance of family-centred care, a strong relationship between parents and the whole dental team is essential for children with autism to access dental examinations and have satisfactory experience of care. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Forgoing dental care for economic reasons in Switzerland: a six-year cross-sectional population-based study.

    PubMed

    Guessous, Idris; Theler, Jean-Marc; Durosier Izart, Claire; Stringhini, Silvia; Bodenmann, Patrick; Gaspoz, Jean-Michel; Wolff, Hans

    2014-09-30

    While oral health is part of general health and well-being, oral health disparities nevertheless persist. Potential mechanisms include socioeconomic factors that may influence access to dental care in the absence of universal dental care insurance coverage. We investigated the evolution, prevalence and determinants (including socioeconomic) of forgoing of dental care for economic reasons in a Swiss region, over the course of six years. Repeated population-based surveys (2007-2012) of a representative sample of the adult population of the Canton of Geneva, Switzerland. Forgone dental care, socioeconomic and insurance status, marital status, and presence of dependent children were assessed using standardized methods. A total of 4313 subjects were included, 10.6% (457/4313) of whom reported having forgone dental care for economic reasons in the previous 12 months. The crude percentage varied from 2.4% in the wealthiest group (monthly income ≥ 13,000 CHF, 1 CHF ≈ 1$) to 23.5% among participants with the lowest income (<3,000 CHF). Since 2007/8, forgoing dental care remained stable overall, but in subjects with a monthly income of <3,000 CHF, the adjusted percentage increased from 16.3% in 2007/8 to 20.6% in 2012 (P trend = 0.002). Forgoing dental care for economic reasons was independently associated with lower income, younger age, female gender, current smoking, having dependent children, divorced status and not living with a partner, not having a supplementary health insurance, and receipt of a health insurance premium cost-subsidy. In a Swiss region without universal dental care insurance coverage, prevalence of forgoing dental care for economic reasons was high and highly dependent on income. Efforts should be made to prevent high-risk populations from forgoing dental care.

  18. Socioeconomic inequalities in the non-use of dental care in Europe

    PubMed Central

    2014-01-01

    Introduction Oral health is an important component of people’s general health status. Many studies have shown that socioeconomic status is an important determinant of access to health services. In the present study, we explored the inequality and socioeconomic factors associated with people’s non-use of dental care across Europe. Methods We obtained data from the European Union Statistics on Income and Living Conditions survey conducted by Eurostat in 2007. These cross-sectional data were collected from people aged 16 years and older in 24 European countries, except those living in long-term care facilities. The variable of interest was the prevalence of non-use of dental care while needed. We used the direct method of standardisation by age and sex to eliminate confounders in the data. Socioeconomic inequalities in the non-use of dental care were measured through differences in prevalence, the relative concentration index (RCI), and the relative index of inequality (RII). We compared the results among countries and conducted standard and multilevel logistic regression analyses to examine the socioeconomic factors associated with the non-use of dental care while needed. Results The results revealed significant socio-economic inequalities in the non-use of dental care across Europe, the magnitudes of which depended on the measure of inequality used. For example, inequalities in the prevalence of non-use among education levels according to the RCI ranged from 0.005 (in the United Kingdom) to −0.271 (Denmark) for men and from −0.009 (Poland) to 0.176 (Spain) for women, whereas the RII results ranged from 1.21 (Poland) to 11.50 (Slovakia) for men and from 1.62 (Poland) to 4.70 (Belgium) for women. Furthermore, the level-2 variance (random effects) was significantly different from zero, indicating the presence of heterogeneity in the probability of the non-use of needed dental care at the country level. Conclusion Overall, our study revealed considerable

  19. Prevalence of dental caries and dental care utilization in preschool urban children enrolled in a comparative-effectiveness study

    PubMed Central

    Kopycka-Kedzierawski, D T.; Billings, R J.

    2011-01-01

    Aim To assess dental caries prevalence and dental care utilization in pre-school children enrolled in urban childcare centres that participated in a comparative-effectiveness study. Study design Cross-sectional study. Methods Caries prevalence was determined in a cohort of children 12-60 months of age. Eligible children were randomized into two groups: group one received a traditional visual/tactile oral examination and group two received a Teledentistry examination. Questionnaires were administered to the children's parents/guardians to gather demographics and information about using dental and medical services. Results Of 234 children examined, approximately 28% had caries experience. The mean dfs score was 1.56 with a range of 0 to 34 carious surfaces. The mean dfs score for the children examined by means of Teledentistry was 1.75 and for the children examined by means of the traditional visual/tactile method mean dfs was 1.40; the means between the two groups were not significantly different. Twenty-six children showed evidence of being treated for dental caries. According to the parents, 31.5% of the children had never had a dental check-up before, only 3% of the children were lacking dental insurance and majority of the parents (92%) did not perceive accessing dental care for the children as a problem. Statistics The Wilcoxon Mann-Whitney test and the Kruskal-Wallis test were used to assess statistical differences among groups of children. Conclusions The data show that 28% of the children had caries and, of these, 61% had never been treated for caries, thus indicating that continued efforts are needed to improve oral health care utilization by inner-city preschool children. PMID:21640057

  20. Enhanced skills in periodontology: evaluation of a pilot scheme for general dental practitioners and dental care professionals in London.

    PubMed

    Ghotane, S G; Harrison, V; Radcliffe, E; Jones, E; Gallagher, J E

    2017-05-12

    Background The need for periodontal management is great and increasing; thus, the oral and dental workforce should be suitably equipped to deliver contemporary care. Health Education London developed a training scheme to extend the skills of dentists and dental care professionals (DCPs).Aim To examine the feasibility of assessing a skill-mix initiative established to enhance skills in clinical periodontology involving the views of patients, clinicians and key stakeholders, together with clinical and patient outcomes in London.Methods This mixed methods feasibility and pilot study involved four parallel elements: a postal questionnaire survey of patients; analysis of clinical logbooks; self-completion questionnaire survey of clinicians; and semi-structured interviews of key stakeholders, including clinicians.Results Twelve of the 19 clinicians participated in the evaluation, returning completed questionnaires (63%) and providing access to log diaries and patients. Periodontal data from 42 log-diary cases (1,103 teeth) revealed significant improvement in clinical outcomes (P = 0.001 for all). Eighty-four percent (N = 99) of the 142 patients returning a questionnaire reported improved dental health; however, responses from hospital patients greatly exceeded those from dental practice. Interviews (N = 22) provided evidence that the programme contributed to professional healthcare across four key domains: 'service', 'quality care', 'professional' and 'educational'. Clinicians, while supportive of the concept, raised concerns regarding the mismatch of their expectations and its educational and service outcomes.Discussion The findings suggest that it is feasible to deliver and evaluate inter-professional extended skills training for dentists and dental care professionals, and this may be evaluated using mixed methods to examine outcomes including clinical log diaries, patient questionnaires and stakeholder interviews. This inter-professional course represents a positive

  1. Planning oral health and clinical discharge in primary care: the comprehensive dental care protocol outcome.

    PubMed

    Cavalcanti, Yuri Wanderley; Dantas de Almeida, Leopoldina de Fátima; Barbosa, Ailma de Souza; Nascimento Padilha, Wilton Wilney

    2015-03-01

    The dental care must be driven by preventive and curative measures that can contribute to the population's oral health promotion. To evaluate the impact of the actions proposed by a comprehensive dental care protocol (CDCP) on the oral health condition of primary care users. The sample consisted of 32 volunteers, assisted throughout the six phases proposed by the CDCP: diagnosis of dental needs; resolution of urgencies; restorative interventions; application of promotional measures; evaluation of the achieved health level; and periodic controls. Data were collected through clinical exams, which measured the simplified oral hygiene index (OHI-S), gingival bleeding index (GBI) and the decayed, missing and filled teeth (DMFT) Index, before and after the CDCP was implemented. Statistical analysis consisted of the Wilcoxon test, at 5% significance level (α = 0.05). The OHI-S and GBI indices showed a significant reduction (p < 0.05) from the initial (1.4 ± 0.6 and 46.3 ± 19.9) to final condition (0.9 ± 0.3 and 21.5 ± 7.5). The decayed, missing and filled teeth and the missing teeth component were not significantly altered (p > 0.05), showing final values equal to 12.7 ± 9.6 and 5.6 ± 7.8, respectively. Decayed elements were fully converted into filled elements, and the final values of the decayed and filled elements were, respectively, 0.0 ± 0.0 and 7.3 ± 5.7 (p < 0.05). The enactment of the CDCP had a beneficial effect on the oral health of the population assisted by the dental services offered in primary care and this protocol seems to ft the public dental service demands. The CDCP can be useful to public dental service planning since it showed an efficient clinical outcome to the patients. We consider that this protocol should be employed in primary care oral health services in order to achieve overall upgrade, access enlargement and public oral health promotion.

  2. Dental Anxiety and the Use of Oral Health Services Among People Attending Two HIV Primary Care Clinics in Miami

    PubMed Central

    Singer, Richard; Cardenas, Gabriel; Xavier, Jessica; Jeanty, Yves; Pereyra, Margaret; Rodriguez, Allan; Metsch, Lisa R.

    2012-01-01

    Objectives We examined factors associated with dental anxiety among a sample of HIV primary care patients and investigated the independent association of dental anxiety with oral health care. Methods Cross-sectional data were collected in 2010 from 444 patients attending two HIV primary care clinics in Miami-Dade County, Florida. Corah Dental Anxiety Scores and use of oral health-care services were obtained from all HIV-positive patients in the survey. Results The prevalence of moderate to severe dental anxiety in this sample was 37.8%, while 7.9% of the sample was characterized with severe dental anxiety. The adjusted odds of having severe dental anxiety were 3.962 times greater for females than for males (95% confidence interval [CI] 1.688, 9.130). After controlling for age, ethnicity, gender, education, access to dental care, and HIV primary clinic experience, participants with severe dental anxiety had 69.3% lower adjusted odds of using oral health-care services within the past 12 months (vs. longer than 12 months ago) compared with participants with less-than-severe dental anxiety (adjusted odds ratio = 0.307, 95% CI 0.127, 0.742). Conclusion A sizable number of patients living with HIV have anxiety associated with obtaining needed dental care. Routine screening for dental anxiety and counseling to reduce dental anxiety are supported by this study as a means of addressing the impact of dental anxiety on the use of oral health services among HIV-positive individuals. PMID:22547875

  3. Dental therapists: a global perspective.

    PubMed

    Nash, David A; Friedman, Jay W; Kardos, Thomas B; Kardos, Rosemary L; Schwarz, Eli; Satur, Julie; Berg, Darren G; Nasruddin, Jaafar; Mumghamba, Elifuraha G; Davenport, Elizabeth S; Nagel, Ron

    2008-04-01

    In 1921, New Zealand began training school dental nurses, subsequently deploying them throughout the country in school-based clinics providing basic dental care for children. The concept of training dental nurses, later to be designated dental therapists, was adopted by other countries as a means of improving access to care, particularly for children. This paper profiles six countries that utilise dental therapists, with a description of the training that therapists receive in these countries, and the context in which they practice. Based on available demographic information, it also updates the number of dental therapists practising globally, as well as the countries in which they practice. In several countries, dental therapy is now being integrated with dental hygiene in training and practice to create a new type of professional complementary to a dentist. Increasingly, dental therapists are permitted to treat adults as well as children. The paper also describes the status of a current initiative to introduce dental therapy to the United States. It concludes by suggesting that dental therapists can become valued members of the dental team throughout the world, helping to improve access to care and reducing existing disparities in oral health.

  4. Dental Care Coverage and Use: Modeling Limitations and Opportunities

    PubMed Central

    Moeller, John F.; Chen, Haiyan

    2014-01-01

    Objectives. We examined why older US adults without dental care coverage and use would have lower use rates if offered coverage than do those who currently have coverage. Methods. We used data from the 2008 Health and Retirement Study to estimate a multinomial logistic model to analyze the influence of personal characteristics in the grouping of older US adults into those with and those without dental care coverage and dental care use. Results. Compared with persons with no coverage and no dental care use, users of dental care with coverage were more likely to be younger, female, wealthier, college graduates, married, in excellent or very good health, and not missing all their permanent teeth. Conclusions. Providing dental care coverage to uninsured older US adults without use will not necessarily result in use rates similar to those with prior coverage and use. We have offered a model using modifiable factors that may help policy planners facilitate programs to increase dental care coverage uptake and use. PMID:24328635

  5. Dental Care Coverage and Use: Modeling Limitations and Opportunities

    PubMed Central

    Moeller, John F.; Chen, Haiyan

    2014-01-01

    Objectives. We examined why older US adults without dental care coverage and use would have lower use rates if offered coverage than do those who currently have coverage. Methods. We used data from the 2008 Health and Retirement Study to estimate a multinomial logistic model to analyze the influence of personal characteristics in the grouping of older US adults into those with and those without dental care coverage and dental care use. Results. Compared with persons with no coverage and no dental care use, users of dental care with coverage were more likely to be younger, female, wealthier, college graduates, married, in excellent or very good health, and not missing all their permanent teeth. Conclusions. Providing dental care coverage to uninsured older US adults without use will not necessarily result in use rates similar to those with prior coverage and use. We have offered a model using modifiable factors that may help policy planners facilitate programs to increase dental care coverage uptake and use. PMID:25343171

  6. Special care dentistry for general dental practice.

    PubMed

    Greig, Vicki; Sweeney, Petrina

    2013-01-01

    Although special care dentistry (SCD) is a fairly recent specialty, the principles and practice of SCD have been developed since the 1980s. Shared care of these patients with general dental practitioners remains vital to ensure that comprehensive care is provided. This article aims to discuss some of the patient groups commonly seen in SCD clinics and give an insight into the varied complex medical and social aspects of care which are managed as part of providing appropriate, safe and holistic care. Many patients who currently fall under the remit of special care dentistry could be treated safely in general dental practice. This article acts as an introduction to special care dentistry for general dental practitioners.

  7. Increasing Access to Oral Health Care for People Living with HIV/AIDS in Rural Oregon

    PubMed Central

    Jones, Jill; Mofidi, Mahyar; Bednarsh, Helene; Gambrell, Alan; Tobias, Carol R.

    2012-01-01

    Access to oral health care for people living with HIV/AIDS is a severe problem. This article describes the design and impact of an Innovations in Oral Health Care Initiative program, funded through the Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance (SPNS) program, that expanded oral health-care services for these individuals in rural Oregon. From April 2007 to August 2010, 473 patients received dental care (exceeding the target goal of 410 patients) and 153 dental hygiene students were trained to deliver oral health care to HIV-positive patients. The proportion of patients receiving oral health care increased from 10% to 65%, while the no-show rate declined from 40% to 10%. Key implementation components were leveraging SPNS funding and services to create an integrated delivery system, collaborations that resulted in improved service delivery systems, using dental hygiene students to deliver oral health care, enhanced care coordination through the services of a dental case manager, and program capacity to adjust to unanticipated needs. PMID:22547878

  8. Facing a moral dilemma--introducing a dental care insurance within the public dental service.

    PubMed

    Hallberg, Lillemor R-M; Hakeberg, Magnus; Hallberg, Ulrika

    2012-01-01

    Through the reform entitled "Dental care insurance-dental care at a fixed price", patients are offered a dental insurance, a capitation plan, that ensures that they can visit the dentist regularly during a period of three years at a fixed price per month (Frisktandvård).This insurance may be offered to all patients. The aim of this study was to generate a theory explaining the main concern for the staff at the public dental service when they have to introduce and advocate dental care insurance to patients. Interview data from 17 persons, representing different professions within the public dental service, were collected and analyzed simultaneously in line with guidelines for grounded theory. The results indicated that dentists/dental hygienists experienced several difficult standpoints concerning the implementation of the dental insurance, somewhat of a moral dilemma. The staff generally had a "cautiously positive attitude" to the forthcoming dental care insurance, but had perceptions how and when the patients should be offered the insurance and what that may mean to the clinic.The respondents reflected about the economic aspects for the clinic and how the oral health may be affected over time for the patients.

  9. Dental attendance among adult Finns after a major oral health care reform.

    PubMed

    Raittio, Eero; Kiiskinen, Urpo; Helminen, Sari; Aromaa, Arpo; Suominen, Anna Liisa

    2014-12-01

    Between 2001 and 2002, all age limits restricting the availability of subsidized private dental care and Public Dental Services (PDS) were abolished in Finland. In addition, the reform aimed to address income- and residence-related disparities in access to subsidized oral health care services. The aim of this study was to analyse how dental attendance and factors associated with it changed after the reform. We carried out three consecutive surveys on the use of oral health care services and perceived oral health. The surveys were conducted in 2001 (n = 2837), in 2004 (n = 2420) and in 2007 (n = 2296), and the study population comprised Finnish adults born in 1970 or earlier. Logistic regression analyses were used to examine factors associated with the use of the services. The percentage of respondents who attended dental care regularly or had used oral health care services over the past 12 months rose between 2001 and 2007. In particular, there was an increase in the proportion of subjects who used PDS. The average number of visits to a private dentist decreased between 2001 and 2007. In the regression analyses, the use of services was associated with older age, perceived lack of need for care, perceived toothache during the past 12 months, perceived good oral health, lower number of missing teeth and regular dental visiting habits. The use of private dental care services was associated with perceived good oral health and perceived lack of need for care, higher household income and older age in all three study years while the use of PDS was associated with younger age, perceived good oral health and perceived lack of need for care only in 2001. The use of oral health care services rose and age did not seem to be a barrier to the use of oral health care services after the reform, as was the aim of the reform. No change in the association of household income with the use of oral health care services was seen after the OHCR. © 2014 John Wiley & Sons A

  10. Extending Medicare coverage to medically necessary dental care.

    PubMed

    Patton, L L; White, B A; Field, M J

    2001-09-01

    Periodically, Congress considers expanding Medicare coverage to include some currently excluded health care services. In 1999 and 2000, an Institute of Medicine committee studied the issues related to coverage for certain services, including "medically necessary dental services." The committee conducted a literature search for dental care studies in five areas: head and neck cancer, leukemia, lymphoma, organ transplantation, and heart valve repair or replacement. The committee examined evidence to support Medicare coverage for dental services related to these conditions and estimated the cost to Medicare of such coverage. Evidence supported Medicare coverage for preventive dental care before jaw radiation therapy for head or neck cancer and coverage for treatment to prevent or eliminate acute oral infections for patients with leukemia before chemotherapy. Insufficient evidence supported dental coverage for patients with lymphoma or organ transplants and for patients who had undergone heart valve repair or replacement. The committee suggested that Congress update statutory language to permit Medicare coverage of effective dental services needed in conjunction with surgery, chemotherapy, radiation therapy or pharmacological treatment for life-threatening medical conditions. Dental care is important for members of all age groups. More direct, research-based evidence on the efficacy of medically necessary dental care is needed both to guide treatment and to support Medicare payment policy.

  11. Oral health and dental care during pregnancy.

    PubMed

    Steinberg, Barbara J; Hilton, Irene V; Iida, Hiroko; Iada, Hiroko; Samelson, Renee

    2013-04-01

    Current research shows that women tend to receive less dental care than usual when they are pregnant. In 2012, the first national consensus statement on oral health care during pregnancy was issued, emphasizing both the importance and safety of routine dental care for pregnant women. This article reviews the current recommendations for perinatal oral health care and common oral manifestations during pregnancy. Periodontal disease and its association with preterm birth and low birth weight are also discussed, as is the role played by dental intervention in these adverse outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Local health department activities to ensure access to care.

    PubMed

    Luo, Huabin; Sotnikov, Sergey; Shah, Gulzar

    2013-12-01

    Local health departments (LHDs) can play an important role in linking people to personal health services and ensuring the provision of health care when it is otherwise unavailable. However, the extent to which LHDs are involved in ensuring access to health care in its jurisdictions is not well known. To provide nationally representative estimates of LHD involvement in specific activities to ensure access to healthcare services and to assess their association with macro-environment/community and LHD capacity and process characteristics. Data used were from the 2010 National Profile of Local Health Departments Study, Area Resource Files, and the Association of State and Territorial Health Officials' 2010 Profile of State Public Health Agencies Survey. Data were analyzed in 2012. Approximately 66.0% of LHDs conducted activities to ensure access to medical care, 45.9% to dental care, and 32.0% to behavioral health care. About 28% of LHDs had not conducted activities to ensure access to health care in their jurisdictions in 2010. LHDs with higher per capita expenditures and larger jurisdiction population sizes were more likely to provide access to care services (p <0.05). There is substantial variation in LHD engagement in activities to ensure access to care. Differences in LHD capacity and the needs of the communities in which they are located may account for this variation. Further research is needed to determine whether this variation is associated with adverse population health outcomes. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

  13. Dental screening and referral of young children by pediatric primary care providers.

    PubMed

    dela Cruz, Georgia G; Rozier, R Gary; Slade, Gary

    2004-11-01

    gain access to dental care. This study has identified several factors that need consideration in the further exploration and development of primary care physicians' role in providing for the oral health of their young patients. First, instructional efforts to increase providers' dental knowledge or opinions of the importance of oral diseases are unlikely to be effective in increasing dental referral unless they include methods to increase confidence in providers' ability to identify and appropriately refer children with disease. Medical education in oral health may need to be designed to include components that address self-efficacy in providing risk assessment, early detection, and referral services. Traditional, didactic instruction does not fulfill these requirements, but because the effectiveness of instructional methods for teaching medical providers oral health care, particularly confidence-building aspects, is untested, controlled evaluations are necessary. A second conclusion from this study is that the referral environment is more important than provider knowledge, experience, opinions, or patient characteristics in determining whether medical practitioners refer at-risk children for dental care. Most providers in this study held positive opinions about providing dental services in their practices, had relatively high levels of knowledge, screened for dental disease, accessed risk factors in their patients, and referred; they can be instrumental in helping young children get dental care, yet most providers face difficulties in making dental referrals, and changes in the availability of dental care will be necessary to decrease these barriers before referral can be most effective. The longer-term approach of increasing the number of dental graduates can be complemented in the shorter term by other approaches to increase dentists' participation in Medicaid, such as increases in reimbursement rates; training general dentists to treat young children; and community

  14. Medicaid Adult Dental Benefits Increase Use Of Dental Care, But Impact Of Expansion On Dental Services Use Was Mixed.

    PubMed

    Singhal, Astha; Damiano, Peter; Sabik, Lindsay

    2017-04-01

    Dental coverage for adult enrollees is an optional benefit under Medicaid. Thirty-one states and the District of Columbia have expanded eligibility for Medicaid under the Affordable Care Act. Millions of low-income adults have gained health care coverage and, in states offering dental benefits, oral health coverage as well. Using data for 2010 and 2014 from the Behavioral Risk Factor Surveillance System, we examined the impact of Medicaid adult dental coverage and eligibility expansions on low-income adults' use of dental care. We found that low-income adults in states that provided dental benefits beyond emergency-only coverage were more likely to have had a dental visit in the past year, compared to low-income adults in states without such benefits. Among states that provided dental benefits and expanded their Medicaid program, regression-based estimates suggest that childless adults had a significant increase (1.8 percentage points) in the likelihood of having had a dental visit, while parents had a significant decline (8.1 percentage points). One possible explanation for the disparity is that after expansion, newly enrolled childless adults might have exhausted the limited dental provider capacity that was available to parents before expansion. Additional policy-level efforts may be needed to expand the dental care delivery system's capacity. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Managing HIV/hepatitis positive patients: present approach of dental health care workers and students.

    PubMed

    Shinde, Nagesh; Baad, Rajendra; Nagpal, Deepak Kumar J; Prabhu, Prashant R; Surekha, L Chavan; Karande, Prasad

    2012-11-01

    People with HIV/HBsAg in India frequently encounter discrimination while seeking and receiving health care services. The knowledge and attitudes of health care workers (HCWs) influences the willingness and ability of people with HIV/HBsAg to access care, and the quality of the care they receive. The objective of this study was to asses HIV/HBsAg-related knowledge, attitudes and risk perception among students and dental HCWs. A cross-sectional survey was conducted on 250 students and 120 dental HCWs in the form of objective questionnaire. Information was gathered regarding demographic details (age, sex, duration of employment, job category); HIV/ HBsAg-related knowledge and attitudes; risk perception; and previous experience caring for HIV-positive patients. The HCWs in this study generally had a positive attitude to care for the people with HIV/HBsAg. However, this was tempered by substantial concerns about providing care, and the fear of occupational infection with HIV/HBsAg. A continuing dental education program was conducted to resolve all the queries found interfering to provide care to HIV/HBsAg patients. But even after the queries were resolved the care providing capability was not attained. These findings show that even with advanced knowledge and facilities the attitude of dental HCWs and students require more strategic training with regards to the ethics and moral stigma associated with the dreaded infectious diseases (HIV/HBsAg).

  16. Current update on portable dental equipment.

    PubMed

    Charlton, David G; Ehrlich, A D; Miniotis, Nicholas J

    2007-02-01

    The dental care needs of the elderly are increasing as their population grows. For some of the elderly (eg, the nonambulatory, homebound, institutionalized), accessing dental care is a problem because they are unable to visit a traditional dental clinic. In the past, dental care has been taken to the homebound or institutionalized elderly by dentists using portable dental equipment. However, the perception that such equipment is difficult or impossible to obtain has limited the availability of on-site care. The purpose of this article is to describe various types of portable dental equipment and their features so that dentists interested in providing care to this group of patients are aware of them.

  17. Perceptions of primary health care service users regarding dental team practices in Brazil.

    PubMed

    Baumgarten, Alexandre; Veiga, Rochelle Santos Da; Bulgarelli, Patricia Tavora; Diesel, Vitor Motta; Bulgarelli, Alexandre Favero

    2018-05-01

    The Unified Health System (SUS) is the Brazilian set of public health services that offers global access to health care and disease treatments for all citizens. These services have been evaluated by means of a national survey assessing the users' perceptions.AimTo explore and characterize the SUS users' perceptions regarding primary dental team practices in the five Brazilian geographical regions. Descriptive study. The sample consisted of 37 262 subjects. Data were collected by means of the Ministry of Health survey, conducted between 2012 and 2014. Variables used in the present study are associated with SUS users' perspectives of satisfaction, access, and use of services. The study utilized bivariate data analysis, and dichotomous variables were derived for analysis following 95% reliability.FindingsThis study observed similarities and proportionality of perceptions in the Brazilian territory. In most macro-regions, dental teams did not develop an active search for dental treatment absentees. However, the SUS users reported very good and good perceptions, which were homogeneously distributed across five Brazilian regions, thereby showing an overall positive perception of primary dental treatment.

  18. Perceptions of Oral Health, Preventive Care, and Care-Seeking Behaviors Among Rural Adolescents

    PubMed Central

    Dodd, Virginia J.; Logan, Henrietta; Brown, Cameron D.; Calderon, Angela; Catalanotto, Frank

    2015-01-01

    BACKGROUND An asymmetrical oral disease burden is endured by certain population subgroups, particularly children and adolescents. Reducing oral health disparities requires understanding multiple oral health perspectives, including those of adolescents. This qualitative study explores oral health perceptions and dental care behaviors among rural adolescents. METHODS Semistructured individual interviews with 100 rural, minority, low socioeconomic status adolescents revealed their current perceptions of oral health and dental care access. Respondents age ranged from 12 to 18 years. The sample was 80% black and 52% male. RESULTS Perceived threat from dental disease was low. Adolescents perceived regular brushing and flossing as superseding the need for preventive care. Esthetic reasons were most often cited as reasons to seek dental care. Difficulties accessing dental care include finances, transportation, fear, issues with Medicaid coverage and parental responsibility. In general, adolescents and their parents are in need of information regarding the importance of preventive dental care. CONCLUSIONS Findings illuminate barriers to dental care faced by low-income rural adolescents and counter public perceptions of government-sponsored dental care programs as being “free” or without cost. The importance of improved oral health knowledge, better access to care, and school-based dental care is discussed. PMID:25388597

  19. Perceptions of oral health, preventive care, and care-seeking behaviors among rural adolescents.

    PubMed

    Dodd, Virginia J; Logan, Henrietta; Brown, Cameron D; Calderon, Angela; Catalanotto, Frank

    2014-12-01

    An asymmetrical oral disease burden is endured by certain population subgroups, particularly children and adolescents. Reducing oral health disparities requires understanding multiple oral health perspectives, including those of adolescents. This qualitative study explores oral health perceptions and dental care behaviors among rural adolescents. Semistructured individual interviews with 100 rural, minority, low socioeconomic status adolescents revealed their current perceptions of oral health and dental care access. Respondents age ranged from 12 to 18 years. The sample was 80% black and 52% male. Perceived threat from dental disease was low. Adolescents perceived regular brushing and flossing as superseding the need for preventive care. Esthetic reasons were most often cited as reasons to seek dental care. Difficulties accessing dental care include finances, transportation, fear, issues with Medicaid coverage and parental responsibility. In general, adolescents and their parents are in need of information regarding the importance of preventive dental care. Findings illuminate barriers to dental care faced by low-income rural adolescents and counter public perceptions of government-sponsored dental care programs as being "free" or without cost. The importance of improved oral health knowledge, better access to care, and school-based dental care is discussed. © 2014, American School Health Association.

  20. Medicaid: State and Federal Actions Have Been Taken to Improve Children's Access to Dental Services, but Gaps Remain. Report to Congressional Requesters. GAO-09-723

    ERIC Educational Resources Information Center

    US Government Accountability Office, 2009

    2009-01-01

    Children's access to Medicaid dental services is a long-standing concern. The tragic case of a 12-year-old boy who died from an untreated infected tooth that led to a fatal brain infection renewed attention to this issue. He was enrolled in Medicaid--a joint federal and state program that provides health care coverage, including dental care, for…

  1. The virtual dental home: a critique.

    PubMed

    Friedman, Jay W; Nash, David A; Mathu-Muju, Kavita R

    2017-09-01

    The Virtual Dental Home is a concept of the Pacific Center for Special Care of the Arthur A. Dugoni School of Dentistry in San Francisco. It is designed to improve access to dental care for underserved populations, specifically children and institutionalized adults. This article describes the development and implementation of the Virtual Dental Home, subsequently critiquing the concept. The criteria for a dental home are not met by the program. It is the equivalent of a traditional public oral health prevention and screening program, with the additional dimension of allowing dental hygienists and assistants to place interim glass ionomer restorations in dental cavities. The critique questions the need to insert a "cloud" dentist into the process. The routine utilization of radiographs is also challenged. The VDH not only lacks the attributes of a dental home, it has not been shown to be as efficient and effective as traditional programs staffed by dental hygienists and dental therapists. The article concludes by describing how programs utilizing dental therapists could address the deficiencies of the Virtual Dental Home, effectively improving access to oral health care for underserved populations. © 2017 American Association of Public Health Dentistry.

  2. Attitudes towards financing of dental care in a Swedish population.

    PubMed

    Arnbjerg, D; Söderfeldt, B; Palmqvist, S

    1996-04-01

    The aim of the present study was to describe attitudes towards financing of dental care and to investigate the importance of different background factors for these attitudes. A questionnaire was sent to a random sample of 3000 persons aged 45-69 years, living in Orebo County, Sweden, with 79.4% response. In the questionnaire the respondents indicated their agreement with four statements on issues concerning financing of dental care, using visual analogue scales. After the answers had been dichotomized, 45% agreed that "all dental care should be free of charge', 32% agreed that "all dental care should be provided by the county', 46% agreed that "it is more important to use resources on heart transplants than on dental care', and 43% agreed that "no public reimbursement should be given to cosmetic dental care'. The attitudes were associated with the following background factors: gender, age, marital status, place of residence, education, socioeconomic status, dental care system, dentist of choice, time since last dentist contact, and attitudes toward dental appearance and dental function. Different background factors were associated with each of the four different attitudes, and only educational level seemed to covary with all four attitudes. It is concluded that attitudes towards financing of dental care varied considerably within this population and that the different attitudes could be related to different background factors.

  3. Oral healthcare access and adequacy in alternative long-term care facilities.

    PubMed

    Smith, Barbara J; Ghezzi, Elisa M; Manz, Michael C; Markova, Christiana P

    2010-01-01

    This study was undertaken to determine practices and perceived barriers to access related to oral health by surveying administrators in Michigan alternative long-term care facilities (ALTCF). A 24-item questionnaire was mailed to all 2,275 Michigan ALTCF serving residents aged 60+. Facility response rate was 22% (n = 508). Eleven percent of facilities had a written dental care plan; 18% stated a dentist examined new residents; and 19% of facilities had an agreement with a dentist to come to the facility, with 52% of those being for emergency care only. The greatest perceived barriers were willingness of general and specialty dentists to treat residents at the nursing facility and/or private offices as well as financial concerns. Substantial barriers to care were uniformly perceived. Oral health policies and practices within Michigan ALTCF vary, as measured by resources, attitudes, and the availability of professional care. There is limited involvement by dental professionals in creating policy and providing consultation and service.

  4. From repairing the consequences of disease to managed wellness: lessons from 20 years of managing dental care.

    PubMed

    Leben, J R

    1995-01-01

    As the 21st century approaches, dentistry will be challenged by multiple pressures. The demographic trends of a growing population are outpacing the supply of dental manpower. Economic trends, including fewer family wage jobs, less full-time employment, and more single-parent families, create pressure on the ability to afford dental care. Competitive and reform pressures continue in the health-care field and are gaining momentum in dental care. Even without these pressures, traditional dental approaches have not been able to address the bulk of the needs of the population, as indicated by published assessments of the dental health of various segments or the overall use of dental services in the country. The challenge created by these demographic, economic, and competitive pressures on the KPDCP and the dental profession as a whole is to shift away from the individual patient, disease-model repair and improve management of dental wellness as the means of improving access to dental services for an even greater number of people. This challenge can be met by implementing the currently neglected clinical knowledge contained in our dental literature, taking action to find answers for the things we do not know, and by applying our knowledge to preventing the onset and/or progression of dental disease, decreasing unneeded and/or ineffective treatments, and avoiding premature entrance into the cycle of rerestoration.

  5. Pressures on the dental care system in the United States.

    PubMed Central

    Wotman, S; Goldman, H

    1982-01-01

    A number of significant pressures are creating tensions in the dental profession and the dental care delivery system. These pressures may be categorized in five major areas: 1) regulation and deregulation pressures involve changes in the state dental practice acts, court decisions concerning antitrust and advertising, and the inclusion of consumers on State professional regulatory boards; 2) cost of services includes factors involving the out-of-pocket cost of dental care and the growth of dental insurance; 3) dentist-related factors include the increased number of dentists and the indebtedness of dental graduates; 4) the pressures of changes in the American populations include the decline in population growth and the increase in proportion of elderly people; 5) changes in the distribution of dental care are based on new epidemiologic data concerning dental caries and progress in the prevention of periodontal disease. Many of these pressures are inducing competition in the dental care system. It is clear that the dental care system is in the process of change as it responds to these complex pressures. PMID:7091458

  6. Pressures on the dental care system in the United States.

    PubMed

    Wotman, S; Goldman, H

    1982-07-01

    A number of significant pressures are creating tensions in the dental profession and the dental care delivery system. These pressures may be categorized in five major areas: 1) regulation and deregulation pressures involve changes in the state dental practice acts, court decisions concerning antitrust and advertising, and the inclusion of consumers on State professional regulatory boards; 2) cost of services includes factors involving the out-of-pocket cost of dental care and the growth of dental insurance; 3) dentist-related factors include the increased number of dentists and the indebtedness of dental graduates; 4) the pressures of changes in the American populations include the decline in population growth and the increase in proportion of elderly people; 5) changes in the distribution of dental care are based on new epidemiologic data concerning dental caries and progress in the prevention of periodontal disease. Many of these pressures are inducing competition in the dental care system. It is clear that the dental care system is in the process of change as it responds to these complex pressures.

  7. Prevalence and Factors Associated with the Utilization of Dental Care Services among Factory Workers in Nava Nakorn Industrial Estate, Pathumthani Province, Thailand.

    PubMed

    Jaidee, Jeeratip; Ratanasiri, Amornrat; Chatrchaiwiwatana, Supaporn; Soonthon, Surasak

    2015-07-01

    The present study aimed to find out the utilization prevalence of dental care services among factory workers over a period of one year and factors associated with utilization of dental care services. This was a cross-sectional analytic study. The study population was factory workers in Nava Nakorn Industrial Estate randomly sampled using Probability Proportion to Size Cluster Sampling Method. The tool was a questionnaire about utilization of dental care services. Among the sample group of 1,500 workers from 16 factories, almost 2/3 (63.9%) had never used any dental care services in the previous year while only 36.1% did. A multivariable logistic regression analysis showed that workplace, accommodation, tooth decay, toothache history, transportation, experience in using social security fund for dental care services, availability and accessibility of dental care services, brushing teeth regularly after meals, using dental care services regularly in a dental clinic, and agreement with the idea that a tooth extraction and medication by a dentist could reduce the risk of progression of disease, statistical significance (p-value < 0.05), were factors associated with the utilization of dental care services at R2 (The Nagelkerke R Square) 0.38. That the prevalence of the factory workers who did not use dental care services during the last one year was 63.9 percent. This study identified three groups of factors associated with the utilization of dental care services as: 1) Predisposing factors, 2) Enabling factors, and 3) Need factors.

  8. Fear of deportation is not associated with medical or dental care use among Mexican-origin farmworkers served by a federally-qualified health center--faith-based partnership: an exploratory study.

    PubMed

    López-Cevallos, Daniel F; Lee, Junghee; Donlan, William

    2014-08-01

    Migrant and seasonal farmworkers face many health risks with limited access to health care and promotion services. This study explored whether fear of deportation (as a barrier), and church attendance (as an enabling factor), were associated with medical and dental care use among Mexican-origin farmworkers. Interviews were conducted with 179 farmworkers who attended mobile services provided by a local federally-qualified health center (FQHC) in partnership with area churches, during the 2007 agricultural season. The majority of respondents (87 %) were afraid of being deported, and many (74 %) attended church. Although about half of participants reported poor/fair physical (49 %) and dental (58 %) health, only 37 % of farmworkers used medical care and 20 % used dental care during the previous year. Fear of deportation was not associated with use of medical or dental care; while church attendance was associated with use of dental care. Findings suggest that despite high prevalence of fear of deportation, support by FQHCs and churches may enable farmworkers to access health care services.

  9. Access to Fluoridated Water and Adult Dental Caries: A Natural Experiment.

    PubMed

    Peres, M A; Peres, K G; Barbato, P R; Höfelmann, D A

    2016-07-01

    Systematic reviews have found no evidence to support a benefit of water fluoridation (WF) to prevent dental caries in adult populations. The aim of this natural experiment was to investigate whether lifetime access to fluoridated water is associated with dental caries experience among adults from Florianópolis, Brazil. The data originated from a population-based cohort study (EpiFloripa Adult) initiated in 2009 (n = 1,720) when participants were aged 20 to 59 years. The second wave was carried out in 2012 (n = 1,140) and included a dental examination and a face-to-face questionnaire. Participants residing at the same address since the age of 7 y or before were included in the primary analyses. Sensitivity analyses were also performed. WF was implemented in the city in 2 different periods of time: 1982 (60% of the population) and 1996. Dental caries was assessed by the decayed, missing, and filled teeth (DMFT) index. A combination of residential status, participant's age, and year of implementation of WF permitted the creation of participants' lifetime access to fluoridated water: >75%, 50% to 75%, and <50% of a participant's lifetime. Covariates included sex, age, socioeconomic mobility, educational attainment, income, pattern of dental attendance, and smoking. Participants who accessed fluoridate water <50% of their lifetime presented a higher mean rate ratio of DMFT (1.39; 95% CI, 1.05-1.84) compared with those living >75% of their lifetime with residential access to fluoridated water. Participants living between 50% and 75% and <50% of their lives in fluoridated areas presented a decayed and filled teeth mean ratio of 1.34 (95% CI, 1.02-1.75) and 1.47 (95% CI, 1.05-2.04) higher than those with residential access to fluoridated water >75% of their lifetime, respectively. Longer residential lifetime access to fluoridated water was associated with less dental caries even in a context of multiple exposures to fluoride. © International & American Associations for

  10. Dental experience and self-perceived dental care needs of patients with angioedema.

    PubMed

    Lodi, G; Sardella, A; Bez, C; Demarosi, F; Cicardi, M; Carrassi, A

    2001-01-01

    The purpose of this study was to investigate the self-perceived dental care needs and dental experiences of patients with angioedema. At the 1998 annual meeting of the Voluntary Association for the Fight, Study and Treatment of Hereditary Angioedema ("Associazione volontaria per la lotta, lo studio e la terapia dell'angioedema ereditario"), a self-administered questionnaire was distributed to participants affected by hereditary or acquired angioedema. Fifty-seven persons completed the questionnaire (37 females, 20 males; mean age, 39 +/- 17 yrs; range, 5-76). The vast majority (91%) had the hereditary form of the disease. One-third of the respondents had some problems in obtaining oral treatment, with one person having been refused care. About half of the group had experienced an acute attack following dental treatment. Preventive measures needed improvement in about two-thirds of respondents. More than half (58%) of the group perceived a need for dental care. We conclude that persons with angioedema may experience difficulty in obtaining dental treatment, a common cause of acute attacks.

  11. Attitude of dental hygienists, general practitioners and periodontists towards preventive oral care: an exploratory study.

    PubMed

    Thevissen, Eric; De Bruyn, Hugo; Colman, Roos; Koole, Sebastiaan

    2017-08-01

    Promoting oral hygiene and stimulating patient's responsibility for his/her personal health remain challenging objectives. The presence of dental hygienists has led to delegation of preventive tasks. However, in some countries, such as Belgium, this profession is not yet legalized. The aim of this exploratory study was to compare the attitude towards oral-hygiene instructions and patient motivational actions by dental hygienists and by general practitioners/periodontists in a context without dental hygienists. A questionnaire on demographics (six items), oral-hygiene instructions (eight items) and patient motivational actions (six items) was distributed to 241 Dutch dental hygienists, 692 general practitioners and 32 periodontists in Flanders/Belgium. Statistical analysis included Fisher's exact-test, Pearson's chi-square test and multiple (multinomial) logistic regression analysis to observe the influence of profession, age, workload, practice area and chair-assistance. Significant variance was found between general practitioners and dental hygienists (in 13 of 14 items), between general practitioners and periodontists (in nine of 14 items) and between dental hygienists and periodontists (in five of 14 items). In addition to qualification, chair-assistance was also identified as affecting the attitude towards preventive oral care. The present study identified divergence in the application of, and experienced barriers and opinions about, oral-hygiene instructions and patient motivational actions between dental hygienists and general practitioners/periodontists in a context without dental hygienists. In response to the barriers reported it is suggested that preventive oriented care may benefit from the deployment of dental hygienists to increase access to qualified preventive oral care. © 2017 FDI World Dental Federation.

  12. Predictors of dental care utilization among working poor Canadians.

    PubMed

    Muirhead, V E; Quiñonez, C; Figueiredo, R; Locker, D

    2009-06-01

    This study used the Gelberg-Andersen Behavioral Model for Vulnerable Populations to identify predictors of dental care utilization by working poor Canadians. A cross-sectional stratified sampling study design and telephone survey methodology was used to collect data from a nationally representative sample of 1049 working poor individuals aged 18 to 64 years. Working poor persons worked > or = 20 h a week, were not full-time students and had annual family incomes <$34,300. A pretested questionnaire included sociodemographic items, self-reported oral health measures and two dental care utilization outcomes: time since their last dental visit and the usual reason for dental visits. Hierarchical stepwise logistic analyses identified independent predictors associated with visiting the dentist >1 year ago: male gender (OR = 1.63; P = 0.005), aged 25-34 years (OR = 2.05; P = 0.02), paying for dental care with cash or credit (OR = 2.31; P < 0.001), past welfare recipients (OR = 1.65; P = 0.03), <21 teeth (OR = 4.23; P < 0.001) and having a perceived need for dental treatment (OR=2.78; P < 0.001). Sacrificing goods or services to pay for dental treatment was associated with visiting the dentist within the past year. The predictors of visiting the dentist only when in pain/trouble were lone parent status (OR = 4.04; P < 0.001), immigrant status (OR = 1.72; P = 0.006), paying for dental care with cash or credit (OR = 2.71; P < 0.001), a history of an inability to afford dental care (OR = 1.62; P = 0.01), a satisfactory/poor/very poor self-rated oral health (OR = 2.10; P < 0.001), number of teeth <21 (OR = 2.58; P < 0.001) and having a perceived need for dental treatment (OR = 2.99; P < 0.001). This study identified predisposing and enabling vulnerabilities that jeopardize the dental care-seeking practices of working poor persons. Dental care utilization was associated with relinquishing spending on other goods and services, which suggests that dental care utilization is a

  13. Association of Dental Care with Adherence to HEDIS Measures

    PubMed Central

    Mosen, David; Pihlstrom, Dan; Snyder, John; Smith, Ning; Shuster, Elizabeth; Rust, Kristal

    2016-01-01

    Context: The dental setting represents an unrealized opportunity to increase adherence to preventive services and improve health outcomes. Objective: To compare adherence to a subset of Healthcare Effectiveness Data and Information Set (HEDIS) measures among a population that received dental care with a population that did not receive dental care. Design: Using a retrospective cohort design, we identified 5216 adults who received regular dental care and 5216 persons who did not. The groups were matched on propensity scores, were followed for 3 years, and retained medical and dental benefits. Receipt of dental care was defined as 1 or more dental visits in each 12-month period. Main Outcome Measures: Outcome measures were assessed in a subpopulation that qualified for 1 of 5 HEDIS denominator groups (dental = 4184 patients; nondental = 3871 patients). They included 3 preventive measures (cervical, colorectal, and breast cancer screening), 4 chronic disease management services (hemoglobin A1c and low-density lipoprotein cholesterol testing, and nephropathy and retinopathy screening among the diabetes mellitus [DM] population), and 4 health outcome measures (poor glycemic control, low-density lipoprotein cholesterol control, blood pressure control in the DM population, and blood pressure control in the hypertensive population). Results: Dental care was associated with higher adherence to all three cancer screening measures, one of four disease management services (higher retinopathy screening), and three of four health outcomes (better glycemic control in the DM population and better blood pressure control in the DM and hypertensive populations). Conclusions: Dental care was associated with improved adherence to 7 of 11 HEDIS measures. PMID:26580145

  14. Washington state foster care: dental utilization and expenditures.

    PubMed

    Melbye, Molly L R; Chi, Donald L; Milgrom, Peter; Huebner, Colleen E; Grembowski, David

    2014-01-01

    To identify factors associated with dental utilization and expenditures for children enrolled in Washington State (WA) foster care (FC). This cross-sectional study used 2008 Medicaid enrollment and claims files for children ages <18 years enrolled in the WA FC program for ≥11 months (N = 10,177). Regression models were used to examine associations between utilization and expenditures and sex, race, age group, Supplemental Security Income (SSI) (i.e., disability), substance abuse, behavior problems, placement setting (Foster Home Care, Kinship Care, Group Care, Other), and urbanicity. Only 43 percent of the children utilized any dental care; the adjusted mean expenditure was $198.35 [95% confidence interval (CI) $181.35, $215.36]. Fewer utilized diagnostic (41 percent), preventive (39 percent), restorative (11 percent), or complex (5 percent) services. Associated with utilization (P ≤ 0.01) were: female [ARR = 1.05, 95% CI(1.01, 1.10)]; 0-2 years [ARR = 0.18, 95% CI(0.15, 0.21)], [3-5 years ARR = 0.78, 95% CI(0.74, 0.83)]; Native American [ARR = 0.85, 95% CI(0.80, 0.91)]; SSI [ARR = 1.10, 95% CI(1.04, 1.17)]; Kinship Care [ARR = 0.94, 95% CI(0.90, 0.98)]; Group Care [ARR = 1.25 95% CI(1.15, 1.37)]; and urban/rural urbanicity with population <20 K [ARR = 1.20 95% CI(1.12, 1.30)]. Associated with expenditures (P < 0.05) were: ages 0-2 years [-$153.66, 95% CI(-$168.33, -$139.00)], 3-5 years [-$98.71, 95% CI(-$116.78, -$80.65)], 6-11 years [-$16.83 95% CI(-$33.52, -$0.14)]; African American [-$32.05 95% CI(-$47.99, -$16.12)]; Kinship Care [$28.57 95% CI($14.00, $43.15)]. Most children enrolled in WA FC for ≥11 months during 2008 did not receive dental care. Research is needed to determine the level of unmet need among children in FC and interventions to improve access to oral health of the children. Enforcement of existing federal legislation is needed. © 2013 American Association of Public Health Dentistry.

  15. Involving Parents in Their Children's Dental Care.

    ERIC Educational Resources Information Center

    Becker, Donna

    1998-01-01

    Asserts that parent education is vital to good dental hygiene for the whole family. Discusses what Head Start staffers can do to ensure that children's dental needs are being met, particularly in assisting parents with taking responsibility for children's dental hygiene. Covers dental care tips for parents, questions and answers about dental…

  16. Satisfaction with dental care and its role in dental health-related behaviour among lithuanian university employees.

    PubMed

    Sakalauskienė, Zana; Machiulskiene, Vita; Murtomaa, Heikki; Vehkalahti, Miira M

    2015-01-01

    To assess factors related to satisfaction with dental care and its role in dental health-related behaviour among Lithuanian university employees. Our cross-sectional survey collected data on respondents' satisfaction with dental care using 24 statements. The self-administered questionnaire also inquired about dental attendance, dental health-related behaviour and attitudes, self-assessed dental status and background details. All 35- to 44-year-old employees (n = 862) of four universities in Lithuania were invited to participate; 64% (n = 553) responded, 78% of them were women. Statements on satisfaction with technical, personal and organisational dimensions of the dental surgery were assessed using a five-point scale, ranging from entirely agree to entirely disagree, with higher scores indicating stronger agreement. Overall satisfaction scores were summed and subjects divided into tertiles to evaluate dental health-related behaviour. For the logistic regression model, subjects were divided into two groups of satisfaction level (below and above the mean of the sum score). Subjects were highly satisfied with dental care, with the mean sum score being 99.5 (SD = 12.62, range 59-120). Stronger satisfaction was reported by those visiting private practices (p < 0.001) and the same dentist longer (p = 0.006) and by those who entirely agreed with the statements on dental health-related attitudes (p ≤ 0.001). The logistic regression model showed that higher satisfaction with dental care level was more likely for those who indicated check-up-based regular dental attendance (OR = 1.7) and brushing their teeth at least twice daily (OR = 1.6). Satisfaction with dental care is positively related to individuals' dental health-related attitudes and behaviour among highly-educated subjects in particular.

  17. Private or NHS General Dental Service care in the United Kingdom? A study of public perceptions and experiences.

    PubMed

    Hancock, M; Calnan, M; Manley, G

    1999-12-01

    Recent changes in the NHS General Dental Service have led to a reduction in the availability of NHS dental care and increased charges. This study explores public and user views and experiences of NHS and private dental care in the light of these changes. The study employed a combination of quantitative and qualitative methods. The first phase involved a postal survey of a random sample of adults on the electoral registers in a county in Southern England, which yielded a response rate of 55 per cent (n = 1506). Follow-up face-to-face interviews were carried out with sub-samples (n = 50) selected from survey respondents. The evidence shows greater satisfaction with certain aspects of private care than with NHS dental care and suggests that the decline in perceived quality of NHS care is less to do with the quality of dental technical skills and more to do with perceived access and availability. However, there was general support for the egalitarian principles associated with NHS dentistry, although payment for dental care by users was acceptable even though dentistry on the NHS was preferred. The shift in the balance of NHS and private dental care reflects the interests and preferences of dentists rather than of the public. It suggests, however, that a continued shift towards private practice is a trend that the public will not find acceptable, which might limit the extent of expansion of private practice.

  18. Identifying barriers to receiving preventive dental services: expanding access to preventive dental hygiene services through affiliated practice.

    PubMed

    Gross-Panico, Michelle L; Freeman, Wilbur K

    2012-01-01

    Minority children and children from lower income families are more likely to experience the burden of oral disease. Since oral disease reduces quality of life, it is a priority to utilize preventive dental services. The research questions ask if affiliated practice increases utilization of preventive dental services by underserved children from birth to 18 years of age, and what the barriers to receiving preventive dental services are and their level of importance. A survey was administered to parents/guardians of patients from birth to 18 years of age who received preventive dental services from Catholic Healthcare West East Valley Children's Dental Clinic, an affiliated practice dental clinic in Chandler, Arizona. Thirty-four surveys were completed: 21 completed in English and 13 completed in Spanish. The data was analyzed to provide descriptive statistics and non-parametrically analyzed using the Friedman's, Kendall's W and Wilcoxon Signed Ranks Tests. The cost of preventive dental services is more important to this population than both convenience of appointment time and distance traveled. As the cost increases for preventive dental services, this population will utilize preventive dental services less frequently. The study indicated that the increase of self-reported utilization of preventive dental services by underserved children, ranging in age from birth to 18 years old, in Arizona affiliated practice dental clinics, was primarily impacted by perceived reduced costs of receiving care. Funding efforts, reimbursement mechanisms and legislative policies should support this dental care delivery model to provide care to underserved children, adults and seniors throughout the U.S.

  19. How the Maori community sees the dental-care system.

    PubMed

    Edward, S J

    1992-10-01

    This report has addressed the question of how the Maori community sees the system of oral health care by indicating the complex factors influencing the Maori community's attitude toward health issues. These factors preclude the Maori community from many of the perceived benefits of the present oral health-care system. There is a need in this current climate of debate over health policies to re-focus on primary prevention policies that will be relevant to the Maori community of today. No one is seen in the Maori community to be articulating concern for oral health issues. The challenge for the Dental Council of New Zealand is how then to create a focus on oral health issues within the Maori community, and to actively promote oral health care and encourage usage of a system that is affordable, available, accessible, and appropriate. Practical and relevant recommendations arising from Rapuora: Health and Maori Women 1984 and the Hui Hauora Mokopuna, 1990(10) should be considered when planning future health-care systems. Health was one of the four key areas highlighted in the Ka Awatea report, and it will be an important feature of the work of the new Ministry of Maori Development. It is timely that the Dental Council of New Zealand and the Ministry of Maori Development should facilitate oral health-care systems for the future in partnership with the Maori community.

  20. Inequity in dental care utilization in the Indonesian population with a self-assessed need for dental treatment.

    PubMed

    Maharani, Diah Ayu

    2009-07-01

    Dental caries is one of the most prevalent infectious diseases in Indonesia. More than half of all cases are left untreated. This may be due to inequity in the use of dental care that is caused by economic and geographic barriers. Therefore, the objective of this study was to provide evidence of socioeconomic-related inequality and horizontal inequity in dental care utilization among Indonesian adults who reported having had dental problems and to describe the sources of any identified inequality. We used secondary cross-sectional data from the Indonesian National Socio-Economic Survey 2004 and from the Indonesian Medical Council. Respondents included individuals at least 15 years old who reported having had dental care needs within a one-month recall period (N = 20,718). A concentration curve and a concentration index were employed to describe the extent of inequality. A horizontal inequity index was applied to identify inequity. A decomposition method was used to describe the sources of inequality. The concentration curve indicated a slightly pro-rich inequality in dental care utilization. The concentration index showed a significant concentration of dental care utilization among groups with higher socioeconomic status (SES). The horizontal inequity index illustrated higher unmet dental care needs among lower SES groups. Decomposition revealed that higher SES, urban Java Island residency, and insurance coverage were positively associated with the likelihood of dental care utilization. This study concludes that the expansion of health insurance, especially targeted at low SES groups, and a regionally equitable distribution of dentists may reduce economic and geographic barriers to dental care in the future.

  1. Dental anxiety in patients seeking care at the University Dental Hospital in Sri Lanka.

    PubMed

    Ekanayake, L; Dharmawardena, D

    2003-06-01

    The purpose of the study was to determine the prevalence and factors affecting dental anxiety in patients seeking dental care. A cross sectional study. 503 first visit patients attending the University Dental Hospital in Peradeniya, Sri Lanka. Corah's dental anxiety scale was used to assess the dental anxiety in these patients. The prevalence of dental anxiety was 32% (DAS score > or = 12) while 12% were considered to be extremely anxious (DAS score > or = 15). Females were found to be more dentally anxious than males. Level of education was associated with dental anxiety. Problem oriented attenders had a significantly higher mean DAS score than regular attenders. Those who had an extraction at the last dental visit were significantly more dentally anxious than those who had a restoration/scaling. Negative dental experience was not associated with dental anxiety. The logistic regression model revealed that gender, level of education and 'fear' which was cited as the reason for the delay in seeking care for the presenting complaint were significant predictors of dental anxiety. However, only 4% of the variation in dental anxiety could be explained by these independent variables. Socio-demographic factors and variables related to past dental experiences had a limited influence in explaining dental anxiety in this sample of dental patients.

  2. Exploring dental student participation in interdisciplinary care team conferences in long-term care.

    PubMed

    Huynh, Jeremy; Donnelly, Leeann R; Brondani, Mario A

    2017-06-01

    The purpose of this study was to explore how the participation of dental hygiene students in interdisciplinary care conferences conducted in long-term care (LTC) facilities influenced the staff's awareness of oral health, the student's provision of care as well as the student's ability to work on an interdisciplinary team. Oral health in LTC continues to be poor despite many educational and clinical interventions. The care of a frail elder requires an interdisciplinary team approach, yet dental professionals are often absent from these teams. As an educational intervention, dental hygiene students, in addition to providing clinical care to residents and education to staff in a LTC facility, have been participating in interdisciplinary care conferences for 4 years. Nine LTC facility staff and eight students participated in two focus groups and five personal interviews to discuss their experiences of the care conferences. Narratives were transcribed verbatim and thematic analysis was conducted. Four major themes emerged that described the essence of the experience of involving dental professionals within interdisciplinary care conference: (i) addressing oral health, (ii) reciprocal learning, (iii) dealing with complexity and (iv) impact of collaborative care. Overall, students found the educational intervention to be worthwhile that allowed for the development of interdisciplinary skills and a greater understanding of dental geriatrics. The dental support in care conferences was welcomed by the staff as it facilitated a new way of exchanging knowledge and experiences so that a more holistic approach to care could be undertaken by all. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  3. Preventive dental health care experiences of preschool-age children with special health care needs.

    PubMed

    Huebner, Colleen E; Chi, Donald L; Masterson, Erin; Milgrom, Peter

    2015-01-01

    This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Study methods included 90 parent interviews and dental examinations of their preschool-age children. Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37% experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.

  4. Referrals for dental care during pregnancy.

    PubMed

    Kloetzel, Megan K; Huebner, Colleen E; Milgrom, Peter

    2011-01-01

    Oral health is essential to overall health in the prenatal period. Pregnancy is not a time to delay dental care. Several studies have shown an association between periodontal disease and poor pregnancy outcomes including preterm birth. Interventions to provide periodontal treatment to pregnant women yield inconsistent results regarding preterm birth but have established the safety of periodontal therapy during pregnancy. Postpartum women in poor dental health readily transmit the tooth decay pathogen Streptococcus mutans from their saliva to their infants, resulting in increased risk of early childhood caries. Preventive services and treatment for acute problems should be recommended, fears allayed, and women referred. Dental radiographs may be performed safely with the use of appropriate shielding. Nonemergent interventions are best provided between 14 and 20 weeks' gestation for comfort and optimal fetal safety. Most gravid women do not seek dental care. Increased interprofessional communication to encourage dentists to treat pregnant women will reduce the number of women without care. In states where it is available, Medicaid coverage of dental services for pregnant women is typically allowed during pregnancy and for 2 months postpartum. Women's health providers should understand the importance of protecting oral health during pregnancy and educate their patients accordingly. © 2011 by the American College of Nurse-Midwives.

  5. Referrals for Dental Care During Pregnancy

    PubMed Central

    Kloetzel, Megan K.; Huebner, Colleen E.; Milgrom, Peter

    2011-01-01

    Oral health is essential to overall health in the prenatal period. Pregnancy is not a time to delay dental care. Several studies have shown an association between periodontal disease and poor pregnancy outcomes including preterm birth. Interventions to provide periodontal treatment to pregnant women yield inconsistent results regarding preterm birth but have established the safety of periodontal therapy during pregnancy. Postpartum, women in poor dental health readily transmit the tooth decay pathogen Streptococcus mutans from their saliva to their infants resulting in increased risk of early childhood caries. Preventive services and treatment for acute problems should be recommended, fears allayed, and women referred. Dental x-rays may be performed safely with the use of appropriate shielding. Non-emergent interventions are best provided between 14 and 20 weeks of gestation for comfort and optimal fetal safety. Most gravid women do not seek dental care. Increased interprofessional communication to encourage dentists to treat pregnant women will reduce the number of women without care. In states where it is available, Medicaid coverage of dental services for pregnant women is typically allowed during pregnancy and for two months postpartum. Women’s health providers should understand the importance of protecting oral health during pregnancy and educate their patients accordingly. PMID:21429074

  6. Expenditures on family dental care by active duty soldiers.

    PubMed

    Chisick, M C

    1996-01-01

    Expenditures on family dental care by U.S. active duty soldiers were explored in this 1992 worldwide survey. Of 9,560 respondents (62% response rate), 7,187 claimed dependents and 5,569 provided reliable data. Mean annual expenditures and multinomial regression on a distribution of expenditures were calculated. Results show average family dental care expenditures were as follows: total sample, $135; childless couples, $59; couples with children, $154; and single parents, $120. Between 72 and 83% of families spent $0 on dental care. Excluding non-spenders, overall expenditures averaged as follows: total sample, $531; childless couples, $354; couples with children, $560; and single parents, $470. Regression results show that expenditures on family dental care by soldiers are influenced by different factors depending on family composition. Policy measures to encourage optimal dental care by families of active duty soldiers should focus on increasing insurance coverage and use.

  7. Variation, certainty, evidence, and change in dental education: employing evidence-based dentistry in dental education.

    PubMed

    Marinho, V C; Richards, D; Niederman, R

    2001-05-01

    Variation in health care, and more particularly in dental care, was recently chronicled in a Readers Digest investigative report. The conclusions of this report are consistent with sound scientific studies conducted in various areas of health care, including dental care, which demonstrate substantial variation in the care provided to patients. This variation in care parallels the certainty with which clinicians and faculty members often articulate strongly held, but very different opinions. Using a case-based dental scenario, we present systematic evidence-based methods for accessing dental health care information, evaluating this information for validity and importance, and using this information to make informed curricular and clinical decisions. We also discuss barriers inhibiting these systematic approaches to evidence-based clinical decision making and methods for effectively promoting behavior change in health care professionals.

  8. Children with Special Health Care Needs in CHIP: Access, Use, and Child and Family Outcomes.

    PubMed

    Zickafoose, Joseph S; Smith, Kimberly V; Dye, Claire

    2015-01-01

    To assess how the Children's Health Insurance Program (CHIP) affects outcomes for children with special health care needs (CSHCN). We used data from a survey of parents of recent and established CHIP enrollees conducted from January 2012 through March 2013 as part of a congressionally mandated evaluation of CHIP. We identified CSHCN in the sample using the Child and Adolescent Health Measurement Initiative's CSHCN screener. We compared the health care experiences of established CHIP enrollees to the pre-enrollment experiences of previously uninsured and privately insured recent CHIP enrollees, controlling for observable characteristics. Parents of 4142 recent enrollees and 5518 established enrollees responded to the survey (response rates, 46% recent enrollees and 51% established enrollees). In the 10 survey states, about one-fourth of CHIP enrollees had a special health care need. Compared to being uninsured, parents of CSHCN who were established CHIP enrollees reported greater access to and use of medical and dental care, less difficulty meeting their child's health care needs, fewer unmet needs, and better dental health status for their child. Compared to having private insurance, parents of CSHCN who were established CHIP enrollees reported similar levels of access to and use of medical and dental care and unmet needs, and less difficulty meeting their child's health care needs. CHIP has significant benefits for eligible CSHCN and their families compared to being uninsured and appears to have some benefits compared to private insurance. Copyright © 2015 Academic Pediatric Association. All rights reserved.

  9. Preventive dental health care experiences of preschool-age children with special health care needs

    PubMed Central

    Huebner, Colleen E.; Chi, Donald L.; Masterson, Erin; Milgrom, Peter

    2014-01-01

    Purpose This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Methods Study methods included 90 parent interviews and dental examinations of their preschool-age children. Results Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37 percent experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Conclusions Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. PMID:25082666

  10. Social insurance for dental care in Iran: a developing scheme for a developing country.

    PubMed

    Jadidfard, Mohammad-Pooyan; Yazdani, Shahram; Khoshnevisan, Mohammad-Hossein

    2012-12-01

    This study aimed to describe the current situation with regard to dental care provided under social insurance in Iran in qualitative terms and to assess it critically with regard to equity and efficiency. After a thorough review of the relevant literature, a template of topics, which included population coverage, range of treatment provided, contracting mechanisms, fees, level of co-payments and dental share of total health expenditures, was developed by a panel of Iranian health finance experts. It was used during interviews with informed persons from the different Iranian social funds. These interviews were recorded and transcribed. The transcriptions were checked for accuracy by those who had been interviewed and were then analysed. It was found that, currently, four major social funds are involved in health (including dental) insurance in Iran, under the supervision of The Supreme Council of Health Insurance, located at the newly integrated Ministry of Cooperatives, Labour & Social Welfare. Around 90% of Iranians are covered for health insurance within a Bismarckian system to which the employed, the employers, and the Government contribute. The system has developed piecemeal over the years and is characterised by a complexity of revenue-collection schemes, fragmented insurance pools, and passive purchasing of dental services. The dental sector of Iranian social insurance should establish a strategic purchasing plan for dental care with the aim of improving performance and access to care. Within the plan, there should be a basic benefit package of dental services based on the relative cost-effectiveness of interventions, educating an adequate number of allied dental professionals to provide simple services, and introducing mixed payment methods.

  11. Parents’ Traditional Cultural Values and Mexican-Origin Young Adults’ Routine Health and Dental Care

    PubMed Central

    Updegraff, Kimberly A.; Kuo, Sally I-Chun; McHale, Susan M.; Umaña-Taylor, Adriana J.; Wheeler, Lorey A.

    2017-01-01

    Purpose To investigate the prospective associations between Mexican-origin mothers’ and fathers’ traditional cultural values and young adults’ health and dental care utilization and to test the moderating role of youth gender. Methods Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents’ cultural values (time 1) and young adults’ health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents’ traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents’ cultural values and young adults’ routine care. Results Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23–9.83, p = .019). Furthermore, for females only, mothers’ more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08–.64, p = .005) and dental care (OR = .26; 95% CI: .09–.75, p = .012) in young adulthood. Conclusions Our findings highlight the importance of examining intragroup variability in culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. PMID:27988108

  12. Federal role in dental public health: dental care for special populations.

    PubMed

    Reifel, Nancy

    2005-07-01

    California is home to more than 70 dental clinics operated or funded by the U.S. government. They operate on annual appropriations from Congress to serve a specific population and regulations that specify the type of dental services provided are usually promulgated at the national level. Dental clinics have the challenge of creating a program that delivers high-quality care within these financial and programmatic constraints. In California, U.S. government appropriations are the main source of funding dental clinics of immigration services, the Veterans Administration, the Bureau of Prisons, the Coast Guard, and American Indian clinics. The evolution and current practices of these five dental public health programs are described.

  13. Wicked problems: policy contradictions in publicly financed dental care.

    PubMed

    Quiñonez, Carlos

    2012-01-01

    To review two policy issues that define publicly financed dental care as a "wicked policy problem." Historical review. By demonstrating how governments have shifted their funding focus from direct delivery care, to public third-party financing arrangements in private dental offices, and by their willingness to fund composite restorations in public fee schedules, it is clear that the logic and sustainability of public programming needs reconsideration. The current contradictions in public dental care programs speak to the need for policy makers to reassess their goals, and ask whether decisions are based more on political necessity than on a logical evidence-informed approach to the delivery of publicly financed dental care. © 2012 American Association of Public Health Dentistry.

  14. India's baby boomers: In driving need for dental care

    PubMed Central

    Dandakeri, Savita; Dandekeri, Shilpa; Rai, B. Gunachandra; Suvarna, Nitin; Ragher, Mallikarjuna; Prabhu, Rachana

    2015-01-01

    The present paper aims to review the literature on increasing health care challenges and needs of a growing Indian geriatric population. It also focuses on the need to overcome the shortfalls in its current oral health status in elderly. This review is based on a PubMed database search engine published in the period from 1990 to 2010 in various dental journals. Different strategies are designed to provide better facilities and easy access of these facilities not only to elderly living in the city but to the one's in rural areas. It is emphasized that geriatric dentistry should be included in the educational systems to help resolve problems of oral health care for the elderly in India. PMID:26538894

  15. Basic principles of dental office logistics: organizing dental supplies and equipment for optimal accessibility.

    PubMed

    Mamoun, John

    2012-01-01

    To maximize office production, dentists should continuously perform treatment-related tasks throughout the workday. To this end, the office should logically organize and store dental instruments, disposables, materials, handpieces, and small equipment to optimize accessibility of these items at the moment when the dentist needs them. The office needs multiple copies of these items to prevent their inaccessibility during the workday due to breakdown, inventory depletion, or lack of a sterilized copy of the item when needed. Staff should know where all items are located in the office at all times to minimize the time needed to search for them. This article describes how to organize dental items in an office for optimal accessibility to the dentist during procedures.

  16. Factors of importance to maintaining regular dental care after a behavioural intervention for adults with dental fear: a qualitative study.

    PubMed

    Morhed Hultvall, Majlis; Lundgren, Jesper; Gabre, Pia

    2010-11-01

    Dental phobia is prevalent in the general population and can be successfully treated through cognitive behavioural therapy, which results in patients being able to cope with dental treatments. The aim of this study was to increase the understanding of factors of importance for maintaining regular dental care after completion of a cognitive behavioural therapy programme. A qualitative study design was used. Fourteen individuals who had successfully completed the programme and had thereafter been referred to a general dental practitioner were interviewed. An interview guide with open-ended questions was used. The interviews were tape-recorded and transcribed verbatim. The texts were analysed using descriptive and qualitative content analysis (Grounded Theory). The manifest analysis identified four content areas: experience of dental care, content of the behavioural therapy programme, perception of therapy and impact on quality of life. The latent analysis identified influence on quality of life, security, activity and barriers to dental care as categories. Although all informants had successfully completed the dental fear treatment programme, only a few stated that they had an uncomplicated relation to dental care afterwards. Barriers to dental care were lack of money and fear. A sense of security was conclusive to coping with dental care, and a respectful approach on the part of the dental care personnel was essential to development of this sense. Confidence in one's own ability to cope with dental care and the right to guide the treatment were important. Thus the theme in the present study was self-efficacy and respectful dental care personnel.

  17. Infant dental care (image)

    MedlinePlus

    Even though newborns and infants do not have teeth, care of the mouth and gums is important. ... sugar water. As the child grows, establishing proper dental hygiene will promote healthy teeth and gums which ...

  18. Emerging allied dental workforce models: considerations for academic dental institutions.

    PubMed

    McKinnon, Monette; Luke, Gina; Bresch, Jack; Moss, Myla; Valachovic, Richard W

    2007-11-01

    The U.S. surgeon general defined the national oral health care crisis in 2001 in Oral Health in America: A Report of the Surgeon General. The report concluded that the public infrastructure for oral health is not sufficient to meet the needs of disadvantaged groups and is disproportionately available depending upon certain racial, ethnic, and socioeconomic factors within the U.S. population. Now, several new workforce models are emerging that attempt to address shortcomings in the oral health care workforce. Access to oral health care is the most critical issue driving these new workforce models. Currently, three midlevel dental workforce models dominate the debate. The purpose of this report is to describe these models and their stage of development to assist the dental education community in preparing for the education of these new providers. The models are 1) the advanced dental hygiene practitioner; 2) the community dental health coordinator; and 3) the dental health aide therapist.

  19. The experience of adverse childhood experiences and dental care in childhood.

    PubMed

    Crouch, Elizabeth; Radcliff, Elizabeth; Nelson, Joni; Strompolis, Melissa; Martin, Amy

    2018-06-06

    Routine preventive dental care is important to overall child health and well-being. However, the experience of adversity in childhood may prevent children from getting adequate preventive care. This study seeks to explore how the prevalence of adverse childhood experiences (ACEs) and the role of a protective adult may be associated with dental care utilization in childhood. Data from the 2016 South Carolina Behavioral Risk Factor Surveillance System (SC BRFSS), which interviews adults eighteen year of age and older, were used in this study. Dental care utilization in childhood was measured as the adult retrospectively reported frequency of dental care in childhood: at least once every 2 years (adequate dental care) or less often than every 2 years (inadequate dental care). ACEs were determined by asking about each of respondent's childhood exposure to eleven childhood experiences, including divorce, parental incarceration, domestic violence, drug and alcohol abuse, mental illness and emotional, physical or sexual abuse. The presence of a protective adult in childhood included respondents who had an adult who made them feel safe and protected during childhood. Descriptive and bivariate statistics explored differences in the adequacy of child dental care by ACE exposure, the presence of a protective adult and selected demographic characteristics. Multivariate regression models were used to examine the impact of counts and types of ACEs and the presence of a protective adult with inadequate childhood dental care. The unweighted study sample included 7079 respondents ageing from 18 to 79 years of age Sampling weights were used for all analyses. Among all respondents, 71.7% reported receiving adequate dental care during childhood; 28.3% responded that they received inadequate dental care. Adjusting for sociodemographic characteristics, respondents who experienced four or more ACEs had a higher likelihood of inadequate dental care than respondents who reported no ACEs

  20. Dental implant tourism.

    PubMed

    Barrowman, R A; Grubor, D; Chandu, A

    2010-12-01

    Access and affordability of dental care can be problematic for some in the Australian community. Therefore, dental tourism is increasingly becoming more attractive to some patients due to decreased expense, increased convenience and immediacy of treatment. However, there are significant issues for both clinician and patient in regards to dental tourism. Lack of accountability and regulation are the main issues and this is particularly evident when complications occur. This paper presents five cases where complications have arisen in the setting of dental tourism. © 2010 Australian Dental Association.

  1. Preventive care and recall intervals. Targeting of services in child dental care in Norway.

    PubMed

    Wang, N J; Aspelund, G Ø

    2010-03-01

    Skewed caries distribution has made interesting the use of a high risk strategy in child dental services. The purpose of this study was to describe the preventive dental care given and the recall intervals used for children and adolescents in a low caries risk population, and to study how the time spent for preventive care and the length of intervals were associated with characteristics of the children and factors related to care delivery. Time spent for and type of preventive care, recall intervals, oral health and health behaviour of children and adolescents three to 18 years of age (n = 576) and the preventive services delivered were registered at routine dental examinations in the public dental services. The time used for preventive dental care was on average 22% of the total time used in a course of treatment (7.3 of 33.4 minutes). Less than 15% of the variation in time spent for prevention was explained by oral health, oral health behaviours and other characteristics of the children and the service delivery. The mean (SD) recall intervals were 15.4 (4.6) months and 55% of the children were given intervals equal to or longer than 18 months. Approximately 30% of the variation in the length of the recall intervals was explained by characteristics of the child and the service delivery. The time used for preventive dental care of children in a low risk population was standardized, while the recall intervals to a certain extent were individualized according to dental health and dental health behaviour.

  2. [Community coordination of dental care needs in a home medical care support ward and at home].

    PubMed

    Sumi, Yasunori; Ozawa, Nobuyoshi; Miura, Hiroko; Miura, Hisayuki; Toba, Kenji

    2011-01-01

    The purpose of this study was to ascertain the current statuses and problems of dental home care patients by surveying the oral care status and needs of patients in the home medical care support ward at the National Center for Geriatrics and Gerontology. Patients that required continuous oral management even after discharge from the hospital were referred to local dental clinics to receive home dental care. We investigated the suitability and problems associated with such care, and identified the dental care needs of home patients and the status of local care coordination, including those in hospitals. The subjects were 82 patients. We ascertained their general condition and oral status, and also investigated the problems associated with patients judged to need specialized oral care by a dentist during oral treatment. Patients who required continuous specialized oral care after discharge from hospital were referred to dental clinics that could provide regular care, and the problems at the time of referral were identified. Dry mouth was reported by many patients. A large number of patients also needed specialized dental treatment such as the removal of dental calculus or tooth extraction. Problems were seen in oral function, with 38 of the patients (46%) unable to gargle and 23 (28%) unable to hold their mouths open. About half of the patients also had dementia, and communication with these patients was difficult. Of the 43 patients who were judged to need continuing oral care after discharge from hospital, their referral to a dental clinic for regular care was successful for 22 (51%) patients and unsuccessful for 21 (49%) patients. The reasons for unsuccessful referrals included the fact that the family, patient, nurse, or caregiver did not understand the need for specialized oral care. The present results suggest the need for specialized oral treatment in home medical care. These findings also suggest that coordinating seamless dental care among primary physicians

  3. Dental care professionals: their training and clinical practice in the UK.

    PubMed

    Hartridge, Sarah

    2010-12-01

    Since the event of compulsory registration, Dental Care Professionals now make up approximately 60% of the dental workforce. This article outlines training for all groups of Dental Care Professionals and discusses their clinical practice, emphasizing the importance of their involvement in the delivery of holistic patient care. To promote understanding of training and the current roles and responsibilities of the wider dental team.

  4. "Tooth worms", poverty tattoos and dental care conflicts in Northeast Brazil.

    PubMed

    Nations, Marilyn K; Nuto, Sharmêniade de Araújo Soares

    2002-01-01

    While medical anthropologists have studied doctor-patient clinical conflicts during the last 25-30 years, dentist-patient communication clashes have received scant attention to date. Besides structural barriers and power inequities, such conceptual differences further dehumanize dental care and lower service quality. Potential for dentist-patient discordance is greater in developing regions--such as Northeast Brazil--where there exists a wider socio-economic gap between professionals and laypersons. A critical anthropological evaluation of oral health services quality is undertaken in two rural communities in Ceará, Brazil where the PAHO-inspired Local Oral Health Inversion of Attention Program was implemented in 1994. This 6-month qualitative field study utilized ethnographic interviews with key informants, participant-observation and projective techniques to probe professionals' and patients' explanatory models (EMs) of oral health. Despite the recent expansion of services into rural regions, the authors conclude that the quality of dental care remains problematic. Patients' culturally constructed EMs of teeth rotted (estraga) by "tooth worms" (lagartas) differ substantively from dentists' model of dental decay by Streptococcus mutans. "Exploding chins" (queixo estourado), "spoiled, rotting teeth" (dente pĵdi) and "false plates" or teeth (chapas) tattoo and stigmatize the poor, reinforcing gross class inequities. Dentists' dominant discourse largely ignores lay logic, ridicules popular practices and de-legitimates, even castigates, popular healers despite their pivotal role in primary oral health care. Poor parents are not only barred from clinics but are blamed for children's rotten teeth. In sum, universal access to dental care is more a myth (even nightmare) than a reality. Dentists all too often "avert"--not "invert"--attention from poor Brazilian patients. In order to improve oral health in this setting, both "societal decay" and bacteria-laden plaque

  5. Parents' Traditional Cultural Values and Mexican-Origin Young Adults' Routine Health and Dental Care.

    PubMed

    Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A

    2017-05-01

    To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p < .012) in young adulthood. Our findings highlight the importance of examining intragroup variability in culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Preparing the Future Dental Hygiene Workforce: Knowledge, Skills, and Reform.

    PubMed

    Fried, Jacquelyn L; Maxey, Hannah L; Battani, Kathryn; Gurenlian, JoAnn R; Byrd, Tammi O; Brunick, Ann

    2017-09-01

    With the health care delivery system in transition, the way in which oral health care services are delivered in 2040 will inevitably change. To achieve the aims of reduced cost, improved access, and higher quality and to advance population wellness, oral health care will likely become a more integrated part of medical care. An integrated primary care system would better meet the needs of an increasingly diverse and aging U.S. population with uneven access to health care services. By 2040, trends suggest that a smaller proportion of dental hygienists will work in traditional solo dental offices; many more will practice with multidisciplinary health care teams in large-group dental and medical practices and in a variety of non-traditional community settings. This integration will require changes in how dental hygienists are educated. To shape the skill sets, clinical judgment, and knowledge of future practitioners, current dental hygiene curricula must be reexamined, redirected, and enhanced. This article examines some of the factors that are likely to shape the future of dental hygiene practice, considers the strengths and weaknesses of current curricula, and proposes educational changes to prepare dental hygienists for practice in 2040. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  7. Dental education in Colombia

    PubMed Central

    Jaramillo, Jorge A.; Pulido, Jairo H. Ternera; Núñez, Jaime A. Castro; Bird, William F.; Komabayashi, Takashi

    2014-01-01

    This article describes Colombia's development of formal dentistry, its dental school system, curriculum, and dental licensure, and current issues in oral health care. In 1969, there were only 4 dental schools in Colombia; at this writing there are 21. Five dental schools are public and the other 16 are private. Nearly all classes are conducted in Spanish. Undergraduate pre-dental coursework is not a prerequisite for dental school in Colombia. To obtain licensure, Colombian dental students must complete 5 years of study in dental school, earn a diploma, and work for the government for 1 year. There are approximately 41,400 dentists in Colombia, and the number is increasing quickly. However, the unemployment rate among dentists is very high, even though graduation from dental school is extremely difficult. Although the 1,100:1 ratio of citizens to dentists is considered satisfactory, access to dental care is limited due to the high rate of poverty. PMID:20339245

  8. Introducing care pathway commissioning to primary dental care: measuring performance.

    PubMed

    Harris, R; Bridgman, C; Ahmad, M; Bowes, L; Haley, R; Saleem, S; Singh, R; Taylor, S

    2011-12-09

    Care pathways have been used in a variety of ways: firstly to support quality improvement through standardising clinical processes, but also for secondary purposes, by purchasers of healthcare, to monitor activity and health outcomes and to commission services. This paper focuses on reporting a secondary use of care pathways: to commission and monitor performance of primary dental care services. Findings of a project involving three dental practices implementing a system based on rating patients according to their risk of disease and need for care are outlined. Data from surgery-based clinical databases and interviews from commissioners and providers are reported. The use of both process and outcome key performance indicators in this context is discussed, as well as issues which arise such as attributability of outcome measures and strategic approaches to improving quality of care.

  9. Disparities in access to preventive health care services among insured children in a cross sectional study.

    PubMed

    King, Christian

    2016-07-01

    Children with insurance have better access to care and health outcomes if their parents also have insurance. However, little is known about whether the type of parental insurance matters. This study attempts to determine whether the type of parental insurance affects the access to health care services of children.I used data from the 2009-2013 Medical Expenditure Panel Survey and estimated multivariate logistic regressions (N = 26,152). I estimated how family insurance coverage affects the probability that children have a usual source of care, well-child visits in the past year, unmet medical and prescription needs, less than 1 dental visit per year, and unmet dental needs.Children in families with mixed insurance (child publicly insured and parent privately insured) were less likely to have a well-child visit than children in privately insured families (odds ratio = 0.86, 95% confidence interval 0.76-0.98). When restricting the sample to publicly insured children, children with privately insured parents were less likely to have a well-child visit (odds ratio = 0.82, 95% confidence interval 0.73-0.92), less likely to have a usual source of care (odds ratio = 0.79, 95% confidence interval 0.67-0.94), and more likely to have unmet dental needs (odds ratio = 1.68, 95% confidence interval 1.10-2.58).Children in families with mixed insurance tend to fare poorly compared to children in publicly insured families. This may indicate that children in these families may be underinsured. Expanding parental eligibility for public insurance or subsidizing private insurance for children would potentially improve their access to preventive care.

  10. Use of dental care by elderly Chinese immigrants in Canada.

    PubMed

    Lai, Daniel W L; Hui, Nelson T A

    2007-01-01

    This study examines the predictors for elderly Chinese immigrants' use of dental care services. In 2003, a study entitled "Health and Well Being of Older Chinese in Canada" collected data from seven cities in which 2,272 Chinese Canadians aged 55 years and older were surveyed. Data from 1,537 of these individuals were used to examine the use of dental care services by the elderly Chinese. Hierarchical logistic regression analysis was used to examine the predicting factors for use of dental care. More than half (52.1 percent) of the elder Chinese immigrants did not use any dental care services within the past year of the study. Being older, living in Quebec, and having poorer physical health reduced the probability that an older Chinese immigrant would use dental care services. On the other hand, being an immigrant from Hong Kong, having lived in Canada for a longer period of time, strong social support, and having dental problems increase the probability of dental service use. The findings support the need for considering the cultural characteristics and background of elderly Chinese immigrants when strengthening oral health promotion. This should encompass understanding of the holistic concept of health that includes oral health and its connections with other physical health issues.

  11. Dental Care for the Mentally Retarded; A Handbook for Ward Personnel.

    ERIC Educational Resources Information Center

    Alabama Univ., Birmingham. Dental Advisory Committee.

    Included in a handbook are discussions on general information for dental health for the institutionalized retarded, their need for dental care, the attendant's role in providing care, dental information for the attendant, how and when to use a toothbrush, care of toothbrushes and equipment, and indications of abnormal mouth conditions. Information…

  12. Beginning the socialization to a new workforce model: dental students' preliminary knowledge of and attitudes about the role of the dental therapist.

    PubMed

    Blue, Christine; Phillips, Robert; Born, David; Lopez, Naty

    2011-11-01

    The purpose of the study reported here was to assess first- and second-year dental students' knowledge of and attitudes about the role of the dental therapist in the oral health care delivery system. The results of this study are informing the continued development and implementation of a new dental workforce training model at the University of Minnesota. Dental students at the university (Classes of 2012 and 2013) were surveyed in 2009, with follow-up surveys planned for the subsequent five years. Multiple-choice questions and statements to be ranked using a Likert scale were used to determine what the students knew and thought about dental therapists' scope of practice, care delivery, work quality, cost-effectiveness, and role in reducing disparities in oral health care access. The results suggest that the students had generally neutral or uncertain attitudes about dental therapy, based on minimal knowledge about the role of dental therapists. In addition, we found little difference in attitudes between the two classes, the only exception being that the first-year students less often perceived the therapists as a solution to access problems. These baseline data are guiding the intraprofessional training of dental, dental hygiene, and dental therapy students toward the goal of positive socialization to a new workforce model and affirmation of the dental therapist as a member of the oral health care team.

  13. Influences of market competition on dental care utilization under the global budget payment system.

    PubMed

    Tsai, Wen-Chen; Kung, Pei-Tseng; Chang, Wei-Chieh

    2007-12-01

    The degrees of market competition usually influence providers' behaviors. This study investigated the influence of medical market competition on the utilization of dental care under the global budget payment system. This study also examined the relative factors that influence the utilization of dental care. This study used the healthcare sub-regions (HCSRs) in the healthcare net as the observation units. The dataset was the National Health Insurance dental care claim data from 1999 to 2002. The degree of market competition of dental care was measured by the Herfindahl Index (HI). The influences of medical market competition on the utilization of dental care were analyzed by multiple linear regression analysis. When the market had a higher degree of competition, people had a higher number of dental utilizations after controlling for the other variables. When market competition increased by 1%, annual expenditures and frequencies of dental care as well as frequencies of tooth-filling per person increased by 0.4%. Thirty-three percent of dental expenditures could be explained by increases in the degree of market competition. Females or highly educated people had a positive correlation with dental utilization. However, the agricultural population negatively correlated with dental utilization. Average household income had no significant relationship with the frequency of dental care but had a significant negative association with dental expenditures when dental care was covered by health insurance. After the global budget payment system for dental care was implemented, increases in dental care market competition led to the increase in utilization of dental care services.

  14. Reasons for attending dental-care services in Ouagadougou, Burkina Faso.

    PubMed Central

    Varenne, Benoît; Msellati, Philippe; Zoungrana, Célestin; Fournet, Florence; Salem, Gérard

    2005-01-01

    OBJECTIVE: To determine why patients attend dental-care facilities in Ouagadougou, Burkina Faso and to improve understanding of the capacity of oral health-care services in urban west Africa. METHODS: We studied a randomly selected sample of patients attending 15 dental-care facilities in Ouagadougou over a 1-year period in 2004. Data were collected using a simple daily record form. FINDINGS: From a total of 44,975 patients, the final sample was established at 14,591 patients, of whom 55.4% were new patients and 44.6% were "booking patients". Most patients seeking care (71.9%) were aged 15-44 years. Nongovernmental not-for-profit dental services were used by 41.5% of all patients, 36% attended private dental-care services, and 22.5% of patients visited public services. The most common complaint causing the patient to seek dental-care services was caries with pulpal involvement (52.4%), and 60% of all complaints were associated with pain. The patients' dental-care requirements were found to differ significantly according to sex, health insurance coverage and occupation. CONCLUSION: Urban district health authorities should ensure provision of primary health-care services, at the patients' first point of contact, which are directed towards the relief of pain. In addition to the strengthening of outreach emergency care, health centres should also contribute to the implementation of community-based programmes for the prevention of oral disease and the promotion of oral health. Exchange of experiences from alternative oral health-care systems relevant to developing countries is urgently needed for tackling the growing burden of oral disease. PMID:16211155

  15. Provision of dental care in aged care facilities NSW Australia- Part 2 as perceived by the carers (care providers).

    PubMed

    Webb, Bettine C; Whittle, Terry; Schwarz, Eli

    2015-12-01

    To investigate carers' perception of the provision of dental care in aged care facilities (ACFs) New South Wales (NSW), Australia. Carers are responsible for 'hands-on, day-to-day' care of residents, including dental care, yet there were no specific figures available concerning their role in NSW ACFs. Questionnaires were mailed to 406 NSW directors of nursing (DONs) requesting completion by a carer who was proficient in English and without the influence of the DON. The 23-item questionnaire was presented in 4 sections, and the data qualitatively analysed. 211 questionnaires were completed and returned, giving a response rate of 52%. Carers were mostly female (91.9%) in the 40-50 and >50 age groups. Oral health training had been received by 66.7% of carers, and although 73.2% thought that their training was adequate, carers in general requested further training. Long waiting periods for government dental services (69.4%) and resident unable to communicate oral health problems (69.2%) were seen as the most frequent barriers to dental care. Almost all carers reported the availability of electric tooth brushes, fluoride gel, disclosing tablets/gel, interdental brushes and the use of a foam mouth prop, while few reported the use of other dental care products. As carers provided almost all of oral health care for residents, emphasis should be placed on training in geriatric dental care techniques and use of dental products. © 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  16. Role of the single assessment process in the care of older people. How will primary dental care practitioners be involved?

    PubMed

    Lane, Elizabeth A; Gallagher, Jennifer E

    2006-10-01

    Following the publication of the National Service Framework for Older People, there have been developments across health and social care to facilitate holistic assessment of older people's needs, through what is called a 'single assessment process' or 'SAP'. In this paper, readers are introduced to the SAP. The process can be seen as a 'one-stop' approach to the assessment of vulnerable older people that facilitates cross-referral between the agencies involved and triggers access to dental care. The paper explores the benefits of this new way of working in support of older people and how it will provide an opportunity for innovative dental practitioners to integrate oral healthcare for people with complex health and social care needs into the SAP. In concludes that as local commissioning evolves, opportunities for practitioners to develop targeted services for this important patient group should be expanded to improve the uptake of healthcare and oral healthcare.

  17. Advancing education in dental hygiene.

    PubMed

    Battrell, Ann; Lynch, Ann; Steinbach, Pam; Bessner, Sue; Snyder, Josh; Majeski, Jean

    2014-06-01

    The changing health care environment and societal imperatives indicate the need for transformative change within the dental hygiene profession to serve the emerging needs of the public. The American Dental Hygienists' Association is leading the way toward meaningful change. The American Dental Hygienists' Association (ADHA) has as its vision the integration of dental hygienists into the health care delivery system as essential primary care providers to expand access to oral health care. This article provides data on current dental hygiene education programs and those in development. Also included is a discussion regarding how the dental hygiene profession can better serve the health and wellness needs of society by transforming the way graduates are prepared for the future. ADHA's dental hygiene survey center data, policies and a futuristic analysis plus a review of the professional literature describe the current state of dental hygiene education and the profession. A discussion of societal, health care and educational trends that creates the imperative for transformation of the dental hygiene profession is provided. Ultimately, the purpose of advancing education in dental hygiene is to achieve better oral and overall health for more people. The profession's responsibility to the public includes evaluating its own ability to provide care and taking the steps necessary to ensure its maximum effectiveness. ADHA is leading this process for dental hygienists in diverse ways. It is imperative that the dental hygiene profession understands and embraces the changing health care environment. Through open dialog and the sharing of evidence the professional path will be determined along with forward movement for the benefit of society and the dental hygiene profession. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan.

    PubMed

    Nasir, Elwalid Fadul; Astrøm, Anne Nordrehaug; David, Jamil; Ali, Raouf Wahab

    2009-11-16

    HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview. A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8). Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental

  19. Time trends in socio-economic inequalities in the lack of access to dental services among children in Spain 1987-2011.

    PubMed

    Pinilla, Jaime; Negrín-Hernández, Miguel A; Abásolo, Ignacio

    2015-01-31

    Adult oral health is predicted by oral health in childhood. Prevention improves oral health in childhood and, consequently in adulthood, so substantial cost savings can be derived from prevention. The burden of oral disease is particularly high for disadvantaged and poor population groups in both developing and developed countries. Therefore, an appropriate and egalitarian access to dental care becomes a desirable objective if children's dental health is to be promoted irrespective of socioeconomic status. The aim of this research is to analyse inequalities in the lack of access to dental care services for children in the Spanish National Health System by socio-economic group over the period 1987-2011. Pooled data from eight editions of the Spanish National Health Survey for the years 1987-2011, as well as contextual data on state dental programmes are used. Logistic regressions are used to examine the related factors to the probability of not having ever visited the dentist among children between 6 and 14 years old. Our lack of access variable pays particular attention to the socioeconomic level of children's household. The mean probability of having never been to the dentist falls considerably from 49.5% in 1987 to 8.4% in 2011. Analysis by socioeconomic level indicates that, in 1987, the probability of not having ever gone to the dentist is more than two times higher for children in the unskilled manual social class than for those in the upper non-manual social class (odds ratio 2.35). And this difference is not reduced significantly throughout the period analysed, rather it increases as in 1993 (odds of 2.39) and 2006 (odds of 3.03) to end in 2011 slightly below than in 1987 (odds ratio 1.80). There has been a reduction in children's lack of access to dentists in Spain over the period 1987-2011. However, this reduction has not corrected the socioeconomic inequalities in children's access to dentists in Spain.

  20. General dental practitioner's views on dental general anaesthesia services.

    PubMed

    Threlfall, A G; King, D; Milsom, K M; Blinkhom, A S; Tickle, M

    2007-06-01

    Policy has recently changed on provision of dental general anaesthetic services in England. The aim of this study was to investigate general dental practitioners' views about dental general anaesthetics, the reduction in its availability and the impact on care of children with toothache. Qualitative study using semi-structured interviews and clinical case scenarios. General dental practitioners providing NHS services in the North West of England. 93 general dental practitioners were interviewed and 91 answered a clinical case scenario about the care they would provide for a 7-year-old child with multiple decayed teeth presenting with toothache. Scenario responses showed variation; 8% would immediately refer for general anaesthesia, 25% would initially prescribe antibiotics, but the majority would attempt to either restore or extract the tooth causing pain. Interview responses also demonstrated variation in care, however most dentists agree general anaesthesia has a role for nervous children but only refer as a last resort. The responses indicated an increase in inequalities, and that access to services did not match population needs, leaving some children waiting in pain. Most general dental practitioners support moving dental general anaesthesia into hospitals but some believe that it has widened health inequalities and there is also a problem associated with variation in treatment provision. Additional general anaesthetic services in some areas with high levels of tooth decay are needed and evidence based guidelines about caring for children with toothache are required.

  1. Assessment of dentally related functional competency for older adults with cognitive impairment--a survey for special-care dental professionals.

    PubMed

    Chen, Xi; Clark, Jennifer J J

    2013-01-01

    This survey was to study whether and how dental professional assess dental-related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special-care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry, or other postgraduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally related function; 45% did not ever or did not regularly assess dental-related function for OACI. Dental-related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients' function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

  2. Types of Dental Fear as Barriers to Dental Care among African American Adults with Oral Health Symptoms in Harlem

    PubMed Central

    Siegel, Karolynn; Schrimshaw, Eric W.; Kunzel, Carol; Wolfson, Natalie H.; Moon-Howard, Joyce; Moats, Harmon L.; Mitchell, Dennis A.

    2013-01-01

    To examine the types of dental fear experienced by African American adults and the role of these fears in the utilization of dental care, in-depth interviews were conducted with a street-intercept sample of 118 African Americans living in Harlem, New York City, who had experienced at least one oral health symptom in the past six months. Despite their oral symptoms, participants delayed or avoided dental care (often for years) due to a variety of dental fears, including fears of: 1) pain from needles; 2) the dental drill; 3) having teeth extracted; 4) contracting an illness (e.g., HIV/AIDS) from unsanitary instruments; 5) X-rays; 6) receiving poor quality care or mistreatment. These findings provide insights into the situations that provoke fears about dental treatment among African Americans and suggest strategies to address these fears in order to remove these barriers and increase the utilization of dental care by African American adults. PMID:24212175

  3. Users’ dissatisfaction with dental care: a population-based household study

    PubMed Central

    Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição; dos Santos, Pedro Eleutério; Carreiro, Danilo Lima; Souza, João Gabriel Silva; Ferreira e Ferreira, Efigênia

    2015-01-01

    OBJECTIVE To examine whether demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care are associated with users’ dissatisfaction with such are. METHODS Cross-sectional study of 781 people who required dental care in Montes Claros, MG, Southeastern Brazil, in 2012, a city with of medium-sized population situated in the North of Minas Gerais. Household interviews were conducted to assess the users’ dissatisfaction with dental care (dependent variable), demographic, socioeconomic conditions, oral health subjectivity and characterization of dental care (independent variables). Sample calculation was used for the finite population, with estimates made for proportions of dissatisfaction in 50.0% of the population, a 5.0% error margin, a non-response rate of 5.0% and a 2.0% design effect. Logistic regression was used, and the odds ratio was calculated with a 5% significance level and 95% confidence intervals. RESULTS Of the interviewed individuals, 9.0% (7.9%, with correction for design effect) were dissatisfied with the care provided. These were associated with lower educational level; negative self-assessment of oral health; perception that the care provider was unable to give dental care; negative evaluation of the way the patient was treated, the cleanliness of the rooms, based on the examination rooms and the toilets, and the size of the waiting and examination rooms. CONCLUSIONS The rate of dissatisfaction with dental care was low. This dissatisfaction was associated with socioeconomic conditions, subjectivity of oral health, skill of the health professionals relating to the professional-patient relationship and facility infrastructure. Educational interventions are suggested that aim at improving the quality of care among professionals by responsible agencies as is improving the infrastructure of the care units. PMID:26270017

  4. Methamphetamine Use and Dental Problems Among Adults Enrolled in a Program to Increase Access to Oral Health Services for People Living with HIV/AIDS

    PubMed Central

    Walter, Angela W.; Bachman, Sara S.; Reznik, David A.; Cabral, Howard; Umez-Eronini, Amarachi; Nath, Avantika; Flournoy, Minnjuan W.; Young, Nancy S.

    2012-01-01

    Objective We examined the association between methamphetamine (meth) use and dental problems in a large sample of HIV-positive adults. Methods We gathered data from 2,178 interviews across 14 sites of the U.S. Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance Innovations in Oral Health Care Initiative from May 2007 to August 2010. We used multivariate generalized estimating equations to test the association between meth use and dental problems, adjusting for potential confounders. Results Past and current meth use was significantly associated with more dental problems. The study also found that poor self-reported mental health status, fewer years since testing positive for HIV, a history of forgoing dental care, less frequent teeth brushing, poor self-reported oral health status, oral pain, grinding or clenching teeth, some alcohol use, more years of education, and self-reported men-who-have-sex-with-men HIV risk exposure (compared with other exposure routes) were significantly associated with dental problems. Conclusion Individuals who are HIV-positive with a history of meth use experience access barriers to oral health care and more dental problems. Our study demonstrated that it is possible to recruit this population into dental care. Findings suggest that predisposing, enabling, and need factors can serve as demographic, clinical, and behavioral markers for recruiting people living with HIV/AIDS into oral health programs that can mitigate dental problems. PMID:22547874

  5. Mercury in dental amalgam: Are our health care workers at risk?

    PubMed

    Sahani, M; Sulaiman, N S; Tan, B S; Yahya, N A; Anual, Z F; Mahiyuddin, W R Wan; Khan, M F; Muttalib, K A

    2016-11-01

    Dental amalgam in fillings exposes workers to mercury. The exposure to mercury was investigated among 1871 dental health care workers. The aim of the study was to evaluate the risk of mercury exposure among dental compared to nondental health care workers and to determine other risk factors for mercury exposure. Respondents answered questionnaires to obtain demographic, personal, professional, and workplace information and were examined for their own amalgam fillings. Chronic mercury exposure was assessed through urinary mercury levels. In total, 1409 dental and 462 nondental health care workers participated in the study. Median urine mercury levels for dental and nondental health care workers were 2.75 μg/L (interquartile range [IQR] = 3.0175) and 2.66 μg/L (IQR = 3.04) respectively. For mercury exposure, there were no significant risk factor found among the workers involved within the dental care. The Mann-Whitney test showed that urine mercury levels were significantly different between respondents who eat seafood more than 5 times per week compared to those who eat it less frequently or not at all (p = 0.003). The urinary mercury levels indicated significant difference between dental workers in their practice using squeeze cloths (Mann-Whitney test, p = 0.03). Multiple logistic regression showed that only the usage of cosmetic products that might contain mercury was found to be significantly associated with the urinary mercury levels (odds ratio [OR] = 15.237; CI: 3.612-64.276). Therefore, mean urinary mercury levels of health care workers were low. Exposure to dental amalgam is not associated with high mercury exposure. However, usage of cosmetic products containing mercury and high seafood consumption may lead to the increase of exposure to mercury. Exposure to the high levels of mercury from dental amalgam can lead to serious health effects among the dental health care workers. Nationwide chronic mercury exposure among dental personnel was assessed through

  6. WEALTH EFFECT AND DENTAL CARE UTILIZATION IN THE U.S.

    PubMed Central

    Manski, Richard J.; Moeller, John F.; Chen, Haiyan; Clair, Patricia A. St.; Schimmel, Jody; Pepper, John V.

    2012-01-01

    Objective The purpose of this article is to examine the relationship of wealth and income and the relative impact of each on dental utilization in a population of older Americans, using data from the Health and Retirement Study (HRS). Methods Data from the Health and Retirement Study (HRS) were analyzed for U.S. individuals aged 51 years and older during the 2008 wave of the HRS. The primary focus of the analysis is the relationship between wealth, income and dental utilization. We estimate a multivariable model of dental use controlling for wealth, income and other potentially confounding covariates. Results We find that both wealth and income each have a strong and independent positive effect on dental care use of older Americans [p<.05]. A test of the interaction between income and wealth in our model failed to show that the impact on dental care utilization as wealth increases depends on a person's income level, or, alternatively, that the impact on dental use as income increases depends on a person's household wealth status [p>.05]. Conclusions Relative to those living in the wealthiest U.S. households, the likelihood of utilizing dental care appears to decrease with a decline in wealth. The likelihood of utilizing dental care also appears to decrease with a decline in income as well. PMID:22515635

  7. Does dental undergraduate education and postgraduate training enable intention to provide inhalation sedation in primary dental care? A path analytical exploration.

    PubMed

    Yuan, S; J Carson, S; Rooksby, M; McKerrow, J; Lush, C; Humphris, G; Freeman, R

    2017-08-01

    To examine how quality standards of dental undergraduate education, postgraduate training and qualifications together with confidence and barriers could be utilised to predict intention to provide inhalation sedation. All 202 dentists working within primary dental care in NHS Highland were invited to participate. The measures in the questionnaire survey included demographic information, undergraduate education and postgraduate qualifications, current provision and access to sedation service, attitudes towards confidence, barriers and intention to provide inhalation sedation. A path analytical approach was employed to investigate the fit of collected data to the proposed mediational model. One hundred and nine dentists who completed the entire questionnaire participated (response rate of 54%). Seventy-six per cent of dentists reported receiving lectures in conscious sedation during their undergraduate education. Statistically significantly more Public Dental Service dentists compared with General Dental Service (GDS) dentists had postgraduate qualification and Continuing Professional Development training experience in conscious sedation. Only twenty-four per cent of the participants stated that they provided inhalation sedation to their patients. The findings indicated that PDS dentists had higher attitudinal scores towards inhalation sedation than GDS practitioners. The proposed model showed an excellent level of fit. A multigroup comparison test confirmed that the level of association between confidence in providing inhalation sedation and intention varied by group (GDS vs. PDS respondents). Public Dental Service respondents who showed extensive postgraduate training experience in inhalation sedation were more confident and likely to provide this service. The quality standards of dental undergraduate education, postgraduate qualifications and training together with improved confidence predicted primary care dentists' intention to provide inhalation sedation.

  8. Dental Care for a Child with Cleft Lip and Palate

    MedlinePlus

    ... Donor Spotlight Fundraising Ideas Vehicle Donation Volunteer Efforts Dental Care for a Child with Cleft Lip and ... submenu What We Do Cleft & Craniofacial Educational Materials Dental Care for a Child with Cleft Lip and ...

  9. A Decade in Dental Care Utilization among Adults and Children (2001–2010)

    PubMed Central

    Vujicic, Marko; Nasseh, Kamyar

    2014-01-01

    Objective To decompose the change in pediatric and adult dental care utilization over the last decade. Data 2001 through 2010 Medical Expenditure Panel Survey. Study Design The Blinder-Oaxaca decomposition was used to explain the change in dental care utilization among adults and children. Changes in dental care utilization were attributed to changes in explained covariates and changes due to movements in estimated coefficients. Controlling for demographics, overall health status, and dental benefits variables, we estimated year-specific logistic regression models. Outputs from these models were used to compute the Blinder-Oaxaca decomposition. Principal Findings Dental care utilization decreased from 40.5 percent in 2001 to 37.0 percent in 2010 for adults and increased from 43.2 percent in 2001 to 46.3 percent in 2010 for children (p < .05). Among adults, changes in insurance status, race, and income contributed to a decline in adult dental care utilization (−0.018, p < .01). Among children, changes in controlled factors did not substantially change dental care utilization, which instead may be explained by changes in policy, oral health status, or preferences. Conclusions Dental care utilization for adults has declined, especially among the poor and uninsured. Without further policy intervention, disadvantaged adults face increasing barriers to dental care. PMID:24299620

  10. Does access to general dental treatment affect the number and complexity of patients presenting to the acute hospital service with severe dentofacial infections?

    PubMed

    Bowe, Conor M; Gargan, Mary Louise; Kearns, Gerard J; Stassen, Leo F A

    2015-01-01

    This is a retrospective study to review the treatment and management of patients presenting with odontogenic infections in a large urban teaching hospital over a four-year period, comparing the number and complexity of odontogenic infections presenting to an acute general hospital in two periods, as follows: Group A (January 2008 to March 2010) versus Group B (April 2010 to December 2011). The background to the study is 'An alteration in patient access to primary dental care instituted by the Department of Health in April 2010'. a) to identify any alteration in the pattern and complexity of patients' presentation with odontogenic infections following recent changes in access to treatment via the Dental Treatment Services Scheme (DTSS) and the Dental Treatment Benefit Scheme (DTBS) in April 2010; and, b) to evaluate the management of severe odontogenic infections. Data was collated by a combination of a comprehensive chart review and electronic patient record analysis based on the primary discharge diagnosis as recorded in the Hospital In-Patient Enquiry (HIPE) system. Fifty patients were admitted to the National Maxillofacial Unit, St James's Hospital, under the oral and maxillofacial service over a four-year period, with an odontogenic infection as the primary diagnosis. There was an increased number of patients presenting with odontogenic infections during Group B of the study. These patients showed an increased complexity and severity of infection. Although there was an upward trend in the numbers and complexity of infections, this trending did not reach statistical significance. The primary cause of infection was dental caries in all patients. Dental caries is a preventable and treatable disease. Increased resources should be made available to support access to dental care, and thereby lessen the potential for the morbidity and mortality associated with serious odontogenic infections. The study at present continues as a prospective study.

  11. Dental Care for Survivors of Adolescent and Young Adult Cancer: Special Considerations

    PubMed Central

    Fair, Douglas; Wright, Jennifer; Kirchhoff, Anne C.

    2016-01-01

    Purpose: Oral health is important for quality of life, but may be undermanaged for survivors of cancer. We examine dental care use and barriers among long-term survivors of adolescent and young adult (AYA) cancer in comparison to individuals without a history of cancer. Methods: The 2008–2012 Medical Expenditure Panel Survey (MEPS) identified 1216 individuals diagnosed with cancer at AYA ages (15–39 years), who were at least 5 years from diagnosis. A comparison group was matched using age, sex, and other factors. We evaluated self-reported dental visits in the previous 12 months, and inability and delay in receiving necessary dental care among survivors and the comparison group. Furthermore, individual factors associated with dental care use were identified using multivariable logistic regressions. Results: Of survivors, 60.86% reported no dental visits in the previous year compared to 51.96% of the comparison individuals (p < 0.001). Survivors were more likely to report inability (10.71% vs. 6.29%, p = 0.001) and delay (8.12% vs. 4.45%, p = 0.001) in getting necessary dental care than the comparison group. Notably, survivors without dental insurance were more likely to report inability and delay. Female survivors were more likely to use dental care than males (odds ratio = 1.76, 95% confidence interval 1.15–2.71, p = 0.01). Hispanic survivors, those diagnosed at younger ages, and uninsured survivors were less likely to have at least one dental visit. Conclusion: Survivors of AYA cancer need timely surveillance to manage late effects, including dental complications. Yet, these survivors, particularly those who are uninsured, delay dental care more often than individuals from the general population. Survivor-specific interventions are needed to reduce dental care barriers. PMID:27028878

  12. Transitioning from Pediatric to Adult Dental Care for Adolescents with Special Health Care Needs: Dentist Perspectives--Part Two.

    PubMed

    Bayarsaikhan, Zoljargal; Cruz, Stephanie; Neff, John; Chi, Donald L

    2015-01-01

    The purpose of this study was to understand dental care transitions for adolescents with special health care needs (ASHCNs) from the dentist perspective. We conducted semi-structured interviews with 13 dentists (seven pediatric dentists and six general dentists) to learn about the dental transition process for ASHCNs. Most dentists believed transitions from child-centered to adult-centered dental care were important for ASHCNs. Dentists reported two main barriers to transitions: (1) low dental reimbursements by Medicaid; and (2) a shortage of general dentists qualified or willing to treat ASHCNs. Pediatric and general dentists reported playing complimentary roles in facilitating transitions for ASHCNs and their families. Dentists acknowledged the challenges that adolescents with special health care needs and their families face in transitioning to adult-centered care and believed in the importance of ASHCNs maintaining a dental home. Pediatric dentists and general dentists play a key role in working together to implement dental transition plans for ASHCNs and to ensure successful dental transitions.

  13. Dental care in children with developmental disabilities: attention deficit disorder, intellectual disabilities, and autism.

    PubMed

    Charles, Jane M

    2010-01-01

    The Federal government reports that 13% of Americans between birth and 18 years of old meet the definition of a child with special health care needs. These children and young adults present unique challenges for both pediatric and general dentists to provide access to the oral health care system--establishing a treatment plan for those with unique medical, behavioral and dental needs and maintaining oral health over the lifetime. The purpose of this article was to describe the characteristics of 3 common developmental disabilities and the challenges these issues present to the oral health care practitioner.

  14. Views of Dental Providers on Primary Care Coordination at Chairside: A Pilot Study.

    PubMed

    Northridge, Mary E; Birenz, Shirley; Gomes, Danni M; Golembeski, Cynthia A; Greenblatt, Ariel Port; Shelley, Donna; Russell, Stefanie L

    2016-06-01

    There is a need for research to facilitate the widespread implementation, dissemination and sustained utilization of evidence-based primary care screening, monitoring and care coordination guidelines, thereby increasing the impact of dental hygienists' actions on patients' oral and general health. The aims of this formative study are to explore dental hygienists' and dentists' perspectives regarding the integration of primary care activities into routine dental care, and assess the needs of dental hygienists and dentists regarding primary care coordination activities and use of information technology to obtain clinical information at chairside. This qualitative study recruited 10 dental hygienists and 6 dentists from 10 New York City area dental offices with diverse patient mixes and volumes. A New York University faculty dental hygienist conducted semi-structured, in-depth interviews, which were digitally recorded and transcribed verbatim. Data analysis consisted of multilevel coding based on the Consolidated Framework for Implementation Research, resulting in emergent themes with accompanying categories. The dental hygienists and dentists interviewed as part of this study do not use evidence-based guidelines to screen their patients for primary care sensitive conditions. Overwhelmingly, dental providers believe that tobacco use and poor diet contribute to oral disease, and report using electronic devices at chairside to obtain web-based health information. Dental hygienists are well positioned to help facilitate greater integration of oral and general health care. Challenges include lack of evidence-based knowledge, coordination between dental hygienists and dentists, and systems-level support, with opportunities for improvement based upon a theory-driven framework. Copyright © 2016 The American Dental Hygienists’ Association.

  15. Evidence of effectiveness of preventive dental care in reducing dental treatment use and related expenditures.

    PubMed

    Pourat, Nadereh; Choi, Moonkyung Kate; Chen, Xiao

    2018-02-06

    Preventive dental health services are intended to reduce the likelihood of development of tooth decay and the need for more intensive treatment overtime. The evidence on the effectiveness of preventive dental care in reducing treatment services and expenditures is lagging for adults, particularly those with lower incomes and chronic conditions. We assessed the impact of preventive dental services on dental treatment service use and expenditures overall and by category of service. We calculated the annual numbers of preventive (periodic diagnostic and prophylactic procedures) and treatment (restorative, surgery, prosthodontic, endodontic, and periodontic) services per beneficiary using Medicaid enrollment and claims data for beneficiaries with three categories of conditions (diabetes, heart disease, and respiratory disease) from 10 largest California counties. We used Cragg hurdle exponential regression models controlling for past service use, demographics, length of enrollment, and county. We found that using preventive services in 2005-2007 was associated with higher likelihood and number of treatment dental services used, but associated with lower treatment expenditures in 2008. The reduction in expenditures was noted only in restorative, prosthodontics, and periodontic services. The findings provide much needed evidence of the contribution of preventive dental care in maintaining oral health of low-income adults with chronic conditions and potential for savings to the Medicaid program. Providing lower cost preventive dental care to the individuals with chronic conditions would achieve better oral health and lower treatment expenditures. © 2018 American Association of Public Health Dentistry.

  16. Effectiveness of a quality management program in dental care practices.

    PubMed

    Goetz, Katja; Campbell, Stephen M; Broge, Björn; Brodowski, Marc; Wensing, Michel; Szecsenyi, Joachim

    2014-04-28

    Structured quality management is an important aspect for improving patient dental care outcomes, but reliable evidence to validate effects is lacking. We aimed to examine the effectiveness of a quality management program in primary dental care settings in Germany. This was an exploratory study with a before-after-design. 45 dental care practices that had completed the European Practice Assessment (EPA) accreditation scheme twice (intervention group) were selected for the study. The mean interval between the before and after assessment was 36 months. The comparison group comprised of 56 dental practices that had undergone their first assessment simultaneously with follow-up assessment in the intervention group. Aggregated scores for five EPA domains: 'infrastructure', 'information', 'finance', 'quality and safety' and 'people' were calculated. In the intervention group, small non-significant improvements were found in the EPA domains. At follow-up, the intervention group had higher scores on EPA domains as compared with the comparison group (range of differences was 4.2 to 10.8 across domains). These differences were all significant in regression analyses, which controlled for relevant dental practice characteristics. Dental care practices that implemented a quality management program had better organizational quality in contrast to a comparison group. This may reflect both improvements in the intervention group and a selection effect of dental practices volunteering for the first round of EPA practice assessment.

  17. Oral health and dental care in aged care facilities in New South Wales, Australia. Part 3 concordance between residents' perceptions and a professional dental examination.

    PubMed

    Webb, Bettine C; Whittle, Terry; Schwarz, Eli

    2016-09-01

    To determine the perceptions of dental care held by the residents in aged care facilities (ACFs) in New South Wales (NSW) and to compare these perceptions with clinical observations. No specific data exist relating to NSW residents' perceptions of dental care compared with a clinical examination. Planning for appropriate oral health programs in ACFs necessitate such data. Four Area Health Services of Sydney and 25 low care ACFs were selected from which representative residents were sampled who completed a survey and underwent a basic dental examination. Of the subjects (25 males, 96 females), 76.9% had never received a dental visit as entering the ACF; 14.1% suffered from dental pain; 69.4% wore dentures and of these 18.3% required assistance in cleaning. Dentures were cleaned twice/day in 54.9% of cases. Natural teeth were reported present in 71.9% of residents, and 85.1% did not require assistance in cleaning. Appropriate dental care facilities and dry mouth were most frequent problems highlighted. Clinical examinations showed that 69% were denture wearers; oral hygiene and denture hygiene were considered good in 15.7% of cases. A high level of concordance existed between self-reports and examination. Increased awareness about oral health across leadership, caregivers and residents with appropriate dental health education and dedicated space within facilities would provide a much needed improvement for addressing oral health issues of the ACF residents. This might be the right time to plan for the future challenges that will need to be met by the NSW care system. © 2015 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  18. Clinical leadership and prevention in practice: is a needs led preventive approach to the delivery of care to improve quality, outcomes and value in primary dental care practice a realistic concept?

    PubMed Central

    2015-01-01

    Background There is a need to improve access to, and the quality of, service delivery in NHS primary dental care. Building public health thinking and leadership capacity in clinicians from primary care teams was seen as an underpinning component to achieving this goal. Clinical teams contributed to service redesign concepts and were contractually supported to embrace a preventive approach. Methods Improvement in quality and preventive focus of dental practice care delivery was explored through determining the impact of several projects, to share how evidence, skill mix and clinical leadership could be utilised in design, implementation and measurement of care outcomes in general dental practice in order to champion and advocate change, during a period of substantial change within the NHS system. The projects were: 1. A needs-led, evidence informed preventive care pathway approach to primary dental care delivery with a focus on quality and outcomes. 2. Building clinical leadership to influence and advocate for improved quality of care; and spread of learning through local professional networks. This comprised two separate projects: improved access for very young children called “Baby Teeth DO Matter” and the production of a clinically led, evidence-based guidance for periodontyal treatment in primary care called “Healthy Gums DO Matter”. Results What worked and what hindered progress, is described. The projects developed understanding of how working with ‘local majorities’ of clinicians influenced, adoption and spread of learning, and the impact in prompting wider policy and contract reform in England. Conclusions The projects identified issues that required change to meet population need. Clinicians were allowed to innovate in an evironment working together with commissioners, patients and public health colleagues. Communication and the development of clinical leadership led to the development of an infrastructure to define care pathways and decision

  19. Clinical leadership and prevention in practice: is a needs led preventive approach to the delivery of care to improve quality, outcomes and value in primary dental care practice a realistic concept?

    PubMed

    Bridgman, Colette; McGrady, Michael G

    2015-01-01

    There is a need to improve access to, and the quality of, service delivery in NHS primary dental care. Building public health thinking and leadership capacity in clinicians from primary care teams was seen as an underpinning component to achieving this goal. Clinical teams contributed to service redesign concepts and were contractually supported to embrace a preventive approach. Improvement in quality and preventive focus of dental practice care delivery was explored through determining the impact of several projects, to share how evidence, skill mix and clinical leadership could be utilised in design, implementation and measurement of care outcomes in general dental practice in order to champion and advocate change, during a period of substantial change within the NHS system. The projects were: 1. A needs-led, evidence informed preventive care pathway approach to primary dental care delivery with a focus on quality and outcomes. 2. Building clinical leadership to influence and advocate for improved quality of care; and spread of learning through local professional networks. This comprised two separate projects: improved access for very young children called “Baby Teeth DO Matter” and the production of a clinically led, evidence-based guidance for periodontyal treatment in primary care called "Healthy Gums DO Matter". What worked and what hindered progress, is described. The projects developed understanding of how working with 'local majorities' of clinicians influenced, adoption and spread of learning, and the impact in prompting wider policy and contract reform in England. The projects identified issues that required change to meet population need. Clinicians were allowed to innovate in an environment working together with commissioners, patients and public health colleagues. Communication and the development of clinical leadership led to the development of an infrastructure to define care pathways and decision points in the patient's journey.

  20. A land untouched by dentistry - singapore brings dental care to afghanistan.

    PubMed

    Tan, Peng Hui; Chew, Bertrand; Wee, Wee Chee; Tan, Bernard

    2011-01-01

    In 2007, the Singapore Armed Forces deployed a Dental Project Team (DPT) to the capital city of the Bamiyan Province in Afghanistan. The team set up the province's first modern dental facility. Besides providing primary dental care to the 60,000 population there, the Singaporeans also trained and prepared a team of Afghan dentist and dental assistants. The Afghan dental team took over the dental clinic and continued to provide care when it was time for the DPT to depart for home. Braving challenging security and austere living conditions, the DPT completed its mission successfully. Copyright © 2011 Elsevier. Published by Elsevier B.V. All rights reserved.

  1. Workforce skill mix: modelling the potential for dental therapists in state-funded primary dental care.

    PubMed

    Gallagher, Jennifer E; Lim, Zhenlui; Harper, Paul R

    2013-04-01

    South Central Strategic Health Authority [SHA], with a population of four million, is one of 10 regions of England with responsibility for workforce planning. To explore future scenarios for the use of the skill mix within the dental team to inform the commissioning of dental therapy training. Data on population demography, oral health needs and demands, dental workforce, activity and dental utilisation were used to create demand (needs-informed) and supply models. Population trends and changing oral health needs and dental service uptake were included in the demand model. Linear programming was used to obtain the optimal make-up of the dental team. Based on the optimal scenario, workforce volumes and costs were examined across a range of scenarios up to 2013. Baseline levels of dental therapists were low and estimated as only achieving 10-20% of the current potential job competency. The optimal exploratory scenario in terms of costs and volume of staff was based on dental therapists working full time and providing 70% of routine care that is within their current job competency; this scenario required 483 therapists by 2013, a figure that appeared achievable. Increasing the level of job competency provided by therapists revealed potentially higher benefits in terms of reduced cost and requiring fewer dentists. The findings suggest that dental therapists can play a more significant role in the provision of primary dental care, both currently and in future; they also highlight the need for health services to routinely collect data that can inform workforce analysis and planning. © 2013 FDI World Dental Federation.

  2. 32 CFR 732.25 - Accounting classifications for nonnaval medical and dental care expenses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... and dental care expenses. 732.25 Section 732.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Accounting Classifications for Nonnaval Medical and Dental Care Expenses and Standard Document Numbers § 732.25 Accounting classifications for...

  3. 32 CFR 732.25 - Accounting classifications for nonnaval medical and dental care expenses.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and dental care expenses. 732.25 Section 732.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Accounting Classifications for Nonnaval Medical and Dental Care Expenses and Standard Document Numbers § 732.25 Accounting classifications for...

  4. 32 CFR 732.25 - Accounting classifications for nonnaval medical and dental care expenses.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and dental care expenses. 732.25 Section 732.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Accounting Classifications for Nonnaval Medical and Dental Care Expenses and Standard Document Numbers § 732.25 Accounting classifications for...

  5. 32 CFR 732.25 - Accounting classifications for nonnaval medical and dental care expenses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and dental care expenses. 732.25 Section 732.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Accounting Classifications for Nonnaval Medical and Dental Care Expenses and Standard Document Numbers § 732.25 Accounting classifications for...

  6. 32 CFR 732.25 - Accounting classifications for nonnaval medical and dental care expenses.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and dental care expenses. 732.25 Section 732.25 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Accounting Classifications for Nonnaval Medical and Dental Care Expenses and Standard Document Numbers § 732.25 Accounting classifications for...

  7. Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003-2008.

    PubMed

    Monteiro, Camila Nascimento; Beenackers, Mariëlle A; Goldbaum, Moisés; de Azevedo Barros, Marilisa Berti; Gianini, Reinaldo José; Cesar, Chester Luiz Galvão; Mackenbach, Johan P

    2016-12-07

    Access to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the "Smiling Brazil" Program, the largest public oral health care program in the world, could have influenced this increase in access. However, we do not yet know if inequalities in the use of dental health services persist after the improvement in access. The aims of this study are to analyze socioeconomic differences for dental health service use between 2003 and 2008 in São Paulo and to examine changes in these associations since the implementation of the Smiling Brazil program in 2003. Data was obtained via two household health surveys (ISA-Capital 2003 and ISA-Capital 2008) which investigated living conditions, lifestyle, health status and use of health care services. Logistic regression was used to analyze associations between socioeconomic factors and dental services use. Additionally, trends from 2003 to 2008 regarding socioeconomic characteristics and dental health service use were explored. Overall, dental health service use increased between 2003 and 2008 and was at both time points more common among those who had higher income, better education, better housing conditions, private health care plans and were Caucasian. Inequalities in use of dental health care did not decrease over time. Among the reasons for not seeking dental care, not having teeth and financial difficulty were more common in lower socioeconomic groups, while thinking it was unnecessary was more common in higher socioeconomic groups. The Brazilian oral health policy is still in a period of expansion and seems to have contributed slightly to increased dental health service use, but has not influenced socioeconomic inequalities in the use of these services. Acquiring deeper knowledge about inequalities in dental health service use will contribute to better understanding of potential barriers to reducing them.

  8. Dental Care Every Day: A Caregiver's Guide. Practical Oral Care for People with Developmental Disabilities

    ERIC Educational Resources Information Center

    National Institute of Dental and Craniofacial Research (NIDCR), 2009

    2009-01-01

    Taking care of someone with a developmental disability requires patience and skill. As a caregiver, you know this as well as anyone does. You also know how challenging it is to help that person with dental care. It takes planning, time, and the ability to manage physical, mental, and behavioral problems. Dental care isn't always easy, but you can…

  9. Cultivating professional responsibility in a dental hygiene curriculum.

    PubMed

    Blue, Christine M

    2013-08-01

    To prepare dental hygienists for future roles in the health care system, dental hygiene education must prepare graduates with skills, ethics, and values that align with professional responsibility. The objective of this study was to determine the effectiveness of curricular changes designed to develop professional identity and responsibility over the entire span of the dental hygiene curriculum. Twenty-four dental hygiene students at the University of Minnesota were surveyed about their attitudes toward access to dental care, society's and health professionals' responsibility to care for the underserved, and their personal efficacy to provide care for the underserved. Surveys were conducted at three time points in the curriculum. The Attitudes Toward Health Care instrument adapted by Holtzman for dental use was used to survey the students. The findings indicate that this institution's curricular changes were effective in cultivating professional responsibility among these students. Their attitude scores increased across the six-semester curriculum, and students in their last semester of the program believed that all individuals have a right to dental care and that society has an obligation to provide dental care. These students' sense of obligation to care for the needy became stronger and their perceptions of their own ability to impact the community and act as an agent of change also increased.

  10. Care delivery and compensation system changes: a case study of organizational readiness within a large dental care practice organization in the United States.

    PubMed

    Cunha-Cruz, Joana; Milgrom, Peter; Huebner, Colleen E; Scott, JoAnna; Ludwig, Sharity; Dysert, Jeanne; Mitchell, Melissa; Allen, Gary; Shirtcliff, R Mike

    2017-12-20

    Dental care delivery systems in the United States are consolidating and large practice organizations are becoming more common. At the same time, greater accountability for addressing disparities in access to care is being demanded when public funds are used to pay for care. As change occurs within these new practice structures, attempts to implement change in the delivery system may be hampered by failure to understand the organizational climate or fail to prepare employees to accommodate new goals or processes. Studies of organizational behavior within oral health care are sparse and have not addressed consolidation of current delivery systems. The objective of this case study was to assess organizational readiness for implementing change in a large dental care organization consisting of staff model clinics and affiliated dental practices and test associations of readiness with workforce characteristics and work environment. A dental care organization implemented a multifaceted quality improvement program, called PREDICT, in which community-based mobile and clinic-based dental services were integrated and the team compensated based in part on meeting performance targets. Dental care providers and supporting staff members (N = 181) were surveyed before program implementation and organizational readiness for implementing change (ORIC) was assessed by two 5-point scales: change commitment and efficacy. Providers and staff demonstrated high organizational readiness for change. Median change commitment was 3.8 (Interquartile range [IQR]: 3.3-4.3) and change efficacy was 3.8 (IQR: 3.0-4.2). In the adjusted regression model, change commitment was associated with organizational climate, support for methods to arrest tooth decay and was inversely related to office chaos. Change efficacy was associated with organizational climate, support for the company's mission and was inversely related to burnout. Each unit increase in the organizational climate scale predicted 0

  11. Caregiver financial distress, depressive symptoms and limited social capital as barriers to children's dental care in a mid-western county in the United States.

    PubMed

    Kruger, J S; Kodjebacheva, G D; Kunkel, L; Smith, K D; Kruger, D J

    2015-12-01

    To identify barriers to children's access to dental care. A cross-sectional health survey. All residential census tracts in Genesee County, Michigan, USA. 498 adults who reported having children in their households, extracted from 2,932 randomly selected adult participants in the 2009 and 2011 surveys. Stepwise logistic regression was used to predict two dependent variables: children's lack of any visits to dentists' offices and unmet dental care needs (defined as needing dental care but not receiving it due to cost) in the previous year as reported by the adults. Independent variables included gender, age, education, race/ethnicity, financial planning, financial distress, fear of crime, stress, depressive symptoms, experiences of discrimination, and neighbourhood social capital. Of the 498 adults, 29.9% reported that they had children who had not visited a dentist in the past 12 months and 13% reported that they had household children with unmet dental care needs in the past year. Adults who reported higher depressive symptoms, lower neighbourhood social capital, greater financial distress, and who were younger were more likely to have household children who did not visit a dentist in the past year. Financial distress was the only significant predictor when controlling for other variables to predict unmet dental care needs. Factors beyond financial distress affect children's dental care; these include parental depressive symptoms and lower neighbourhood social capital. Interventions promoting parental mental health and social integration may increase dental care among children.

  12. Pattern of Utilisation of Dental Health Care Among HIV-positive Adult Nigerians.

    PubMed

    Adedigba, Michael A; Adekanmbi, Victor T; Asa, Sola; Fakande, Ibiyemi

    2016-01-01

    To determine the pattern of dental care utilisation of people living with HIV (PLHIV). A cross-sectional questionnaire survey of 239 PLHIV patients in three care centres was done. Information on sociodemographics, dental visit, risk groups, living arrangement, medical insurance and need of dental care was recorded. The EC Clearinghouse and WHO clinical staging was used to determine the stage of HIV/AIDS infection following routine oral examinations under natural daylight. Multivariate logistic regression models were created after adjusting for all the covariates that were statistically significant at univariate/bivariate levels. The majority of subjects were younger than 50 years, about 93% had not seen a dentist before being diagnosed HIV positive and 92% reported no dental visit after contracting HIV. Among nonusers of dental care, 14.3% reported that they wanted care but were afraid to seek it. Other reasons included poor awareness, lack of money and stigmatisation. Multivariate analysis showed that lack of dental care was associated with employment status, living arrangements, educational status, income per annum and presenting with oral symptoms. The area under the receiver operating curve was 84% for multivariate logistic regression model 1, 70% for model 2, 67% for model 3 and 71% for model 4, which means that the predictive power of the models were good. Contrary to our expectations, dental utilisation among PLHIV was generally poor among this group of patients. There is serious and immediate need to improve the awareness of PLHIVs in African settings and barriers to dental care utilisation should also be removed or reduced.

  13. [Different forms of payment systems for dental services and their impact on care].

    PubMed

    Sória, Marina Lara; Bordin, Ronaldo; da Costa Filho, Luiz Cesar

    2002-01-01

    The Brazilian dental care sector is facing a paradoxical crisis characterized by a surplus of dentists and a large contingent of people lacking dental care, thus highlighting the need to improve management strategies. One necessary step is to analyze the various payment schemes for dental services. This paper reviews two important approaches, fee for service and capitation, and considers the impacts and consequences of payment strategies on the dental care system.

  14. Providing dental care for the patient with autism.

    PubMed

    Waldman, H Barry; Perlman, Steven P; Wong, Allen

    2008-09-01

    The increasing number of children and adults with autism spectrum disorders highlights the need to provide a full range of services, including dental care. A review of the autism spectrum, the magnitude of the problem, and approaches to providing services by dental practitioners are presented.

  15. Geography Matters: State-Level Variation in Children's Oral Health Care Access and Oral Health Status

    PubMed Central

    Fisher-Owens, Susan A.; Soobader, Mah-J; Gansky, Stuart A.; Isong, Inyang A.; Weintraub, Jane A.; Platt, Larry J.; Newacheck, Paul W.

    2016-01-01

    Objectives To ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences Study Design Observational study using cross-sectional surveys Methods Using the 2007 National Survey of Children's Health, we examined state variation in parent's report of children's oral health care access (absence of a preventive dental visit) and oral health status. We assessed the unadjusted prevalences of these outcomes, then adjusted with child-, family-, and neighborhood-level variables using logistic regression; these results are presented directly and graphically. Using multilevel analysis, we then calculated the degree to which child-, family-, and community-level variables explained state variation. Finally, we quantified the influence of state-level variables on state variation. Results Unadjusted rates of no preventive dental care ranged 9.0-26.8% (mean 17.5%), with little impact of adjusting (10.3-26.7%). Almost 9% of population had fair/poor oral health; unadjusted range 4.1-14.5%. Adjusting analyses affected fair/poor oral health more than access (5.7-10.7%). Child, family and community factors explained ~¼ of the state variation in no preventive visit and ~½ of fair/poor oral health. State-level factors further contributed to explaining up to a third of residual state variation. Conclusion Geography matters: where a child lives has a large impact on his or her access to oral health care and oral health status, even after adjusting for child, family, community, and state variables. As state-level variation persists, other factors and richer data are needed to clarify the variation and drive changes for more egalitarian and overall improved oral health. PMID:26995567

  16. A new primary dental care service compared with standard care for child and family to reduce the re-occurrence of childhood dental caries (Dental RECUR): study protocol for a randomised controlled trial.

    PubMed

    Pine, Cynthia; Adair, Pauline; Burnside, Girvan; Robinson, Louise; Edwards, Rhiannon Tudor; Albadri, Sondos; Curnow, Morag; Ghahreman, Marjan; Henderson, Mary; Malies, Clare; Wong, Ferranti; Muirhead, Vanessa; Weston-Price, Sally; Whitehead, Hilary

    2015-11-04

    In England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions. This 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants, initially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under general anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be conducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services across the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of motivational interviewing) delivered between enrollment and 6 weeks post-extraction, followed by directed prevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be the dental caries experienced by 2 years post-enrollment at the level of dentine involvement on any tooth in either dentition, which had been caries-free at the baseline assessment. The participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of engagement with dental care makes the children and their families scheduled for extraction particularly difficult to recruit to an RCT. Variations in service delivery between sites have

  17. Oral health needs and barriers to dental care in hospitalized children.

    PubMed

    Nicopoulos, Martine; Brennan, Michael T; Kent, M Louise; Brickhouse, Tegwyn H; Rogers, Mary K; Fox, Philip C; Lockhart, Peter B

    2007-01-01

    The goal of this study was to examine the oral health status and utilization of dental care reported by hospitalized children. A bedside oral examination was performed on hospitalized children. Past dental treatment and current oral health needs were assessed. The mean age (+/- SD) of 120 enrolled patients was 6.7 (+/- 2.9) years (range 3 to 12); 60% were males. The age of the patients' first dental office visit was 3.5 +/- 1.8 years, with 28% having never seen a dentist. Unmet oral health needs (e.g., untreated dental caries) were noted in 42% of children, and soft tissue (mucosal) abnormalities in 59% of children. Children with chronic medical conditions reported barriers to receiving dental care more often (24%) than children with acute medical conditions (3.5%) (p=0.04). A high prevalance of unmet oral health needs and soft tissue abnormalities was identified in a hospitalized pediatric population. Children with chronic medical conditions were more likely to experience barriers to obtaining dental care.

  18. Dental assessment prior to stem cell transplant: treatment need and barriers to care.

    PubMed

    Durey, K; Patterson, H; Gordon, K

    2009-05-09

    To assess the treatment needs of patients undergoing pre-haematopoietic stem cell transplant (HSCT) dental assessment, to collate the examination findings and treatment provided and to define the management issues impacting on care. Single centre retrospective analysis. Salaried Primary Care Dental Service, Western General Hospital, Edinburgh, UK. One hundred and sixteen available charts of patients who attended for pre-transplant dental assessment during April 2004-June 2007 were examined. Ninety-four patients, 52 men (55.3%) and 42 women (43.6%), were included. Patients were referred a mean of 31.5 (SD 18.82) days before admission for transplant. Dental assessment occurred, on average, 7.88 days (SD 6.78) following referral. Eighty-eight (93.6%) patients were dentate, while six (6.3%) were edentulous. Eighty-eight (93.6%) patients presented with oral disease; 89 (94.7%) patients received dental care. Issues impacting on care were medical (n = 88, 93.6%), time constraints (n = 73, 77.7%), no GDP (n = 25, 26.7%), dental complexity (n = 5, 5.3%) and anxiety management (n = 1, 1.1%). The majority of patients required dental care, most of which, for healthy adults, would normally be completed within a primary care setting. However, the issues surrounding the care of patients destined for HSCT indicate that there is a place for a dedicated dental service as part of the multidisciplinary team.

  19. The Oral Health Self-Care Behavior and Dental Attitudes among Nursing Home Personnel

    PubMed Central

    Wiener, R. Constance; Meckstroth, Richard

    2014-01-01

    The need for nursing home care will increase for the next several decades. Rural areas will be impacted in particular, as many older adults live in rural areas. Daily oral infection control changes when a person moves from independent living to institutional living. Oral care to dependent individuals is influenced by many factors. The purpose of this study is to determine the association of oral health self-care behavior with dental attitudes in nursing home personnel in a rural state. A survey was provided to attendees at an oral health conference. Questions were asked to determine dental knowledge, oral health self-care behavior, and dental care attitudes. Of 128 long term care health care facilities’ personnel invited, there were 31 attendees, and 21 of the attendees participated (67.7%). Nursing home personnel had a high level of dental knowledge. Oral health self-care behavior was independently influenced by dental knowledge (β=0.17; p=0.0444) and dental attitudes (β=0.55; p=.0081). Further investigation is needed to determine if oral health self-care attitudes and oral self-care behavior of nursing home personnel are factors in the provision of quality daily oral infection control for dependent nursing home residents living in rural areas. PMID:25349776

  20. Integrating a Primary Oral Health Care Approach in the Dental Curriculum: A Tanzanian Experience

    PubMed Central

    Mumghamba, Elifuraha G.

    2014-01-01

    This paper is based on a conference presentation made during the inauguration of the Faculty of Dentistry, Kuwait University, as a World Health Organization Collaborating Centre for Primary Oral Health Care (POHC) on November 27-28, 2012. The aim of this paper is to review how the POHC approach has been integrated into the dental curriculum, sharing the Tanzanian experience as a case presentation from a developing country. The burden of oral diseases worldwide is high, and the current oral health workforce is inadequate to meet the challenges. Curative oral health care is very costly and not accessible to the poor and minorities. To tackle the problem, the POHC approach rooted in primary health care that emphasizes equity, community involvement, prevention, appropriate technology and a multi-sectorial approach was developed and has been operating for more than 3 decades now. Execution of a comprehensive POHC requires a trained oral health workforce mix with essential competencies. For this case study, a literature search was done using the search engines subscribed to by the library of Muhimbili University of Health and Allied Sciences, including PubMed, Cochrane, ScienceDirect and Scopus, Wiley-Blackwell Interscience, Sage and the Health InterNetwork Access to Research Initiative (HINARI) that gives access to Scirus and Google Scholar. Challenges are discussed with an emphasis more on addressing the common risk factors and determinants of oral health. Integration of the POHC approach in the dental curriculum for training a competent workforce is crucial in attaining better oral health. Resources are still a major challenge, and the impact of the POHC approach in the curriculum is yet to be evaluated. PMID:24246734

  1. Assessment of Dentally-related Functional Competency for Older Adults with Cognitive Impairment – A Survey for Special-care Dental Professionals

    PubMed Central

    Chen, Xi; Clark, Jennifer JJ

    2013-01-01

    This survey was to study whether and how dental professional assess dental-related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special-care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry or other post-graduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally-related function; 45% did not ever or did not regularly assess dental-related function for OACI. Dental-related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients' function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population. PMID:23451924

  2. Developing Dental Students' Awareness of Health Care Disparities and Desire to Serve Vulnerable Populations Through Service-Learning.

    PubMed

    Behar-Horenstein, Linda S; Feng, Xiaoying; Roberts, Kellie W; Gibbs, Micaela; Catalanotto, Frank A; Hudson-Vassell, Charisse M

    2015-10-01

    Service-learning in dental education helps students integrate knowledge with practice in an underserved community setting. The aim of this study was to explore how a service-learning experience affected a small group of dental students' beliefs about cultural competence, professionalism, career development, desire to practice in a community service setting, and perceptions about access and disparities issues. Prior to beginning their first year of dental school, five first-year dental students at one U.S. dental school participated in a six-week service-learning program in which they interned at one of three at-risk settings in order to experience health care delivery there. After the program, 60 reflective writing assignments completed by the participants were analyzed using grounded theory methods; interviews with the students were used to corroborate the findings from that analysis. Seven themes identified in the journal reflections and interview findings showed enhanced awareness of social health care issues and patient differences, as well as a social justice orientation and desire to address disparities. Building on this study, future research should explore the curricular components of service-learning programs to ensure students receive ample opportunity to reflect upon their experiences in order to integrate previously held assumptions with their newfound knowledge.

  3. Experience of socioeconomic-related inequality in dental care utilization among Thai elderly under universal coverage.

    PubMed

    Somkotra, Tewarit

    2013-04-01

    To assess the socioeconomic-related inequality in dental care utilization among Thai elderly and to determine factors associated with the observed inequality after the country achieved universal coverage. The data were taken from the nationally representative Thailand Health & Welfare Survey 2007. Data of 10,096 Thai elderly (aged over 60 years) were selected. Descriptive analyses of the features of dental care utilization among Thai elderly were carried out, in addition to the concentration index (Cindex ) being used to quantify the extent of socioeconomic-related inequality in dental care utilization. Logistic regression was used to determine factors associated with inequality in dental care. Socioeconomic-related inequality in dental care utilization among Thai elderly was shown. Also, utilization was more concentrated among wealthier older adults, as shown by the positive value of Cindex (equals 0.244). The poor elderly, however, were more likely to utilize dental care at public facilities, particularly primary care facilities. Multivariate analysis showed that certain demographic, socioeconomic and geographic characteristics were particularly associated with poor-rich differences in dental care utilization among Thai elderly. Although socioeconomic-related inequality in dental care utilization among Thai elderly exists, the pro-poor utilization at public facilities, particularly primary care facilities, substantiates the concerted effort to reducing inequality in dental care utilization for Thai elderly. © 2012 Japan Geriatrics Society.

  4. [Comperative characteristics of different organizational approaches to the provision of dental care in Ukraine and Slovakia].

    PubMed

    Рогач, Іван; Слабкий, Генадій; Погоріляк, Рената; Ціцвакова, Марина; Шип, Денис; Данко, Дана

    Saving dental health is a priority, which is controlled by the European strategy for the World Health Organization to achieve ≪Health for All≫. To study and compare organizational approaches to the organization of dental care in Ukraine and Slovakia. In the course of the work we used statistical, bibliosemantic methods and the method of structural and logical analysis, the data of the statistical branch reporting of Ukraine, Slovakia and the data of the European database ≪Health for All≫ were used. It is established that the provision of the population with educational institutions for future dentists in Ukraine is one university for 2154566 people, and in Slovakia - one for 676 764 people. Obviously, access to dental education in the Slovak Republic is better than in Ukraine. In the course of the study, we found that the level of provision of dentists for 10 thousand people in Ukraine is 4.56, and in Slovakia-5.75, which is 26% more than in Ukraine. In Slovakia, the level of availability of dentists is 5.75, too, with a reliable difference in the profile of administrative territories Conclusion. Both countries are working to achieve international goals to ensure dental health for the period till 2025. Therefore, the exchange of good experience, which gained in Ukraine and Slovakia for the organization of dental care will improve the performance of dental services of both countries to achieve these goals.

  5. Virtual patient instruction for dental students: can it improve dental care access for persons with special needs?

    PubMed

    Sanders, Carla; Kleinert, Harold L; Boyd, Sara E; Herren, Chris; Theiss, Lynn; Mink, John

    2008-01-01

    An interactive, virtual-patient module was produced on compact disc (CD-ROM) in response to the critical need to increase dental students' clinical exposure to patients with developmental disabilities. A content development team consisting of dental faculty members, parents of children with developmental disabilities, an individual with a developmental disability, and educational specialists developed the interactive, virtual-patient module. The module focused on a young man with congenital deafblindness presenting as a new patient with a painful molar. Students were required to make decisions regarding clinical interactions throughout the module. Differences in both comfort and knowledge level were measured pre- and post-module completion, as well as the dental students' overall satisfaction with the learning experience. Significant results were obtained in students' perceived comfort and knowledge base. Participants reported overall satisfaction using the modules. This study demonstrated that an interactive, multi-media (CD-ROM), virtual patient learning module for dental students could be an effective tool in providing students needed clinical exposure to patients with developmental disabilities.

  6. Views of Dental Providers on Primary Care Coordination at Chairside: A Pilot Study

    PubMed Central

    Northridge, Mary E.; Birenz, Shirley; Gomes, Danni; Golembeski, Cynthia A.; Greenblatt, Ariel Port; Shelley, Donna; Russell, Stefanie L.

    2016-01-01

    Purpose There is a need for research to facilitate the widespread implementation, dissemination, and sustained utilization of evidence-based primary care screening, monitoring, and care coordination guidelines, thereby increasing the impact of dental hygienists’ actions on patients’ oral and general health. The aims of this formative study are to: (1) explore dental hygienists’ and dentists’ perspectives regarding the integration of primary care activities into routine dental care; and (2) assess the needs of dental hygienists and dentists regarding primary care coordination activities and use of information technology to obtain clinical information at chairside. Methods This qualitative study recruited ten hygienists and six dentists from ten New York City area dental offices with diverse patient mixes and volumes. A New York University faculty hygienist conducted semi-structured, in-depth interviews, which were digitally recorded and transcribed verbatim. Data analysis consisted of multilevel coding based on the Consolidated Framework for Implementation Research, resulting in emergent themes with accompanying categories. Results The dental hygienists and dentists interviewed as part of this study fail to use evidence-based guidelines to screen their patients for primary care sensitive conditions. Overwhelmingly, dental providers believe that tobacco use and poor diet contribute to oral disease, and report using electronic devices at chairside to obtain web-based health information. Conclusion Dental hygienists are well positioned to help facilitate greater integration of oral and general health care. Challenges include lack of evidence-based knowledge, coordination between dental hygienists and dentists, and systems-level support, with opportunities for improvement based upon a theory-driven framework. PMID:27340183

  7. Organization and management of community-based dental education programs: an overview from the dental Pipeline program.

    PubMed

    Bailit, Howard L

    2010-10-01

    Disparities in access to dental care are a major problem in the United States. Effectively run community-based dental education programs can make a significant contribution to reducing access disparities and at the same time enrich the educational experiences of dental students and residents. For complex historical reasons, dental schools did not base their clinical training programs in community hospitals and clinics like the other health professions. Now, because of trends in school finances, changes in societal values, and limitations in current educational experiences, schools are increasing the time students spend in community clinics. This is likely to continue. The chapters in the first section of the report on the Pipeline, Profession, and Practice: Community-Based Dental Education program--for which this chapter serves as an introduction-provide detailed information on the operation of community-based education programs.

  8. Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits.

    PubMed

    Zlotnick, Cheryl; Tam, Tammy; Ye, Yu

    2017-10-01

    Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.

  9. A Pilot Quality Improvement Collaborative to Improve Safety Net Dental Access for Pregnant Women and Young Children.

    PubMed

    Vander Schaaf, Emily B; Quinonez, Rocio B; Cornett, Amanda C; Randolph, Greg D; Boggess, Kim; Flower, Kori B

    2018-02-01

    Objectives To determine acceptability and feasibility of a quality improvement (QI) collaborative in safety net dental practices, and evaluate its effects on financial stability, access, efficiency, and care for pregnant women and young children. Methods Five safety net dental practices participated in a 15-month learning collaborative utilizing business assessments, QI training, early childhood oral health training, and prenatal oral health training. Practices collected monthly data on: net revenue, no-show rates, total encounters, and number of encounters for young children and pregnant women. We analyzed quantitative data using paired t-tests before and after the collaborative and collected supplemental qualitative feedback from clinic staff through focus groups and directed email. Results All mean measures improved, including: higher monthly revenue ($28,380-$33,102, p = 0.37), decreased no-show rate (17.7-14.3%, p = 0.11), higher monthly dental health encounters (283-328, p = 0.08), and higher monthly encounters for young children (8.8-10.5, p = 0.65), and pregnant women (2.8-9.7, p = 0.29). Results varied by practice, with some demonstrating largest increases in encounters for young children and others pregnant women. Focus group participants reported that the collaborative improved access for pregnant women and young children, and that QI methods were often new and difficult. Conclusion for practice Participation by safety net dental practices in a QI collaborative is feasible and acceptable. Individual sites saw greater improvements in different outcomes areas, based on their own structures and needs. Future efforts should focus on specific needs of each dental practice and should offer additional QI training.

  10. Determinants of Dental Care Attendance during Pregnancy: A Systematic Review.

    PubMed

    Rocha, Juliana Schaia; Arima, Letícia Yumi; Werneck, Renata Iani; Moysés, Samuel Jorge; Baldani, Márcia Helena

    2018-01-01

    Despite the fact that dental care attendance during pregnancy has been recommended by guidelines and institutions, the demand for dental services is still low among pregnant women. The aim of this study was to identify and analyze the determinants of dental care attendance during pregnancy. We performed a systematic literature search in the electronic databases PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Library in Dentistry, Cumulative Index to Nursing and Allied Health Literature, and Medline using relevant keywords. Studies were filtered by publication year (2000-2016) and language (English, Portuguese, Spanish, and French). The included studies were assessed for quality. Their characteristics and statistically significant factors were reported. Fourteen papers were included in the review. The prevalence of dental service usage during pregnancy ranged from 16 to 83%. Demographic factors included women's age, marital status, parity, and nationality. The socioeconomic factors were income, educational level, and type of health insurance. Many psychological and behavioral factors played a role, including oral health practices, oral health and pregnancy beliefs, and health care maintenance. Referred symptoms of gingivitis, dental pain, or dental problems were perceived need. Demographic, socioeconomic, psychological, behavioral factors and perceived need were associated with the utilization of dental services during pregnancy. More well-designed studies with reliable outcomes are required to confirm the framework described in this review. © 2018 S. Karger AG, Basel.

  11. Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States.

    PubMed

    Caldwell, Julia T; Ford, Chandra L; Wallace, Steven P; Wang, May C; Takahashi, Lois M

    2016-08-01

    To examine whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. We linked Medical Expenditure Panel Survey (2005-2010) data to geographic data from the American Community Survey (2005-2009) and Area Health Resource File (2010). We categorized census tracts as rural and urban by using the Rural-Urban Commuting Area Codes. Respondent sample sizes ranged from 49 839 to 105 306. Outcomes were access to a usual source of health care, cholesterol screening, cervical screening, dental visit within recommended intervals, and health care needs met. African Americans in rural areas had lower odds of cholesterol screening (odds ratio[OR] = 0.37; 95% confidence interval[CI] = 0.25, 0.57) and cervical screening (OR = 0.48; 95% CI = 0.29, 0.80) than African Americans in urban areas. Whites had fewer screenings and dental visits in rural versus urban areas. There were mixed results for which racial/ethnic group had better access. Rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.

  12. Dental Education Required for the Changing Health Care Environment.

    PubMed

    Fontana, Margherita; González-Cabezas, Carlos; de Peralta, Tracy; Johnsen, David C

    2017-08-01

    To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  13. Curative procedures of oral health and structural characteristics of primary dental care.

    PubMed

    Baumgarten, Alexandre; Hugo, Fernando Neves; Bulgarelli, Alexandre Fávero; Hilgert, Juliana Balbinot

    2018-04-09

    To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services. A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent

  14. Dental Care among Young Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn

    2013-01-01

    Dental care among young adults with intellectual disability (ID) is poorly documented and largely unmet. By using population-based data from the Metropolitan Atlanta Developmental Disabilities Follow-Up Study, we assessed factors associated with at least one or two dental visits per year among young adults with and without ID. Significantly fewer…

  15. Special Report on Dental Care for Handicapped People.

    ERIC Educational Resources Information Center

    Rehabilitation Services Administration (DHEW), Washington, DC.

    The document presents a Department of Health, Education and Welfare (HEW) special report on dental care for the handicapped. The nature and extent of the problem of providing dental services to the handicapped population is examined. The handicapped population is defined and their oral health status reviewed. Factors contributing to the poor oral…

  16. Socio-Economic Determinants of the Need for Dental Care in Adults.

    PubMed

    Trohel, Gilda; Bertaud-Gounot, Valérie; Soler, Marion; Chauvin, Pierre; Grimaud, Olivier

    2016-01-01

    Oral health has improved in France. However, there are still inequalities related to the socio-economic status. The aim of this study was to measure the prevalence of dental care needs in an adult population and to identify the demographic, socio-economic and behavioral variables that may explain variations in this parameter. A cross-sectional analysis of the French SIRS cohort (n = 2,997 adults from the Paris region; 2010 data) was carried out to determine the prevalence of self-reported dental care needs relative to demographic, socio-economic and behavioral variables. A logistic regression model was used to identify the variables that were most strongly associated with the level of need. In 2010, the prevalence of the need for dental care in the SIRS cohort was 35.0% (95% CI [32.3-37.8]). It was lower in people with higher education levels (31.3% [27.9-34.6]), without immigrant background (31.3% [28.0-34.6]) and with comprehensive health insurance (social security + complementary health cover; 32.8% [30.2-35.4]). It decreased as the socio-economic status increased, but without following a strict linear change. It was also lower among individuals who had a dental check-up visit in the previous two years. In multivariate analyses, the socioeconomic variables most strongly associated with the need for dental care were: educational attainment (OR = 1.21 [1.02-1.44]), income level (OR = 1.66 [1.92-2.12]) and national origin (OR = 1.53 [1.26-1.86]). These results confirm that the prevalence of dental care needs is higher among adults with low socio-economic status. Education level, income level and also national origin were more strongly associated with the need for dental care than insurance cover level.

  17. Questionnaire for measuring organisational attributes in dental-care practices: psychometric properties and test-retest reliability.

    PubMed

    Goetz, Katja; Hasse, Philipp; Szecsenyi, Joachim; Campbell, Stephen M

    2016-04-01

    The consideration of organisational aspects, such as shared goals and clear communication, within the health care team is important to ensure good quality care. In primary health care, the instrument Survey of Organizational Attributes for Primary Care (SOAPC) is available to measure organisational attributes of care. However, there is no instrument available for dental care. The aim of the present study was to investigate psychometric properties and test-retest reliability of the version of SOAPC adapted for dental care, namely the Survey of Organizational Attributes in Dental Care (SOADC). The SOADC consists of 21 items in the following four subscales: communication; decision making; stress/chaos; and history of change. Convergent construct validity was measured using the job satisfaction scale. A total of 287 dental-care practices were asked to participate in the validation study. Psychometric properties and test-retest reliability were observed. A total of 43 dental-care practices responded to the survey. At baseline, 178 dental-care staff completed the questionnaire, and 4 weeks later 138 did so. Internal consistency, measured by Cronbach's alpha, was 0.718 or higher in the subscales. The test-retest reliability for each subscale and the overall SOADC score demonstrated good correlations over the 4-week test-retest interval, except for 'history of change'. A strong correlation with the aggregated job-satisfaction scale showed high convergent construct validity of SOADC. The consideration of organisational aspects from the perspective of dental-care teams is important for providing good quality of care. The SOADC is a reliable instrument with good psychometric properties and is suitable for the evaluation of organisational attributes in dental-care practices. © 2015 FDI World Dental Federation.

  18. The Influence of Co-Morbidity and Other Health Measures on Dental and Medical Care Use among Medicare beneficiaries 2002

    PubMed Central

    Chen, Haiyan; Moeller, John; Manski, Richard J.

    2011-01-01

    Objective To assess the impact of co-morbidity and other health measures on the use of dental and medical care services among the community-based Medicare population with data from the 2002 Medicare Current Beneficiary Survey. Methods A co-morbidity index is the main independent variable of our study. It includes oral cancer as a co-morbidity condition and was developed from Medicare claims data. The two outcome variables indicate whether a beneficiary had a dental visit during the year and whether the beneficiary had an inpatient hospital stay during the year. Logistic regressions estimated the relationship between the outcome variables and co-morbidity after controlling for other explanatory variables. Results High scores on the co-morbidity index, high numbers of self-reported physical limitations, and fair or poor self-reported health status were correlated with higher hospital use and lower dental care utilization. Similar results were found for other types of medical care including medical provider visits, outpatient care, and prescription drugs. A multiple imputation technique was used for the approximate 20% of the sample with missing claims, but the resulting co-morbidity index performed no differently than the index constructed without imputation. Conclusions Co-morbidities and other health status measures are theorized to play either a predisposing or need role in determining health care utilization. The study’s findings confirm the dominant role of these measures as predisposing factors limiting access to dental care for Medicare beneficiaries and as need factors producing higher levels of inpatient hospital and other medical care for Medicare beneficiaries. PMID:21972460

  19. Alternative Practice Dental Hygiene in California: Past, Present, and Future

    PubMed Central

    MERTZ, ELIZABETH; GLASSMAN, PAUL

    2012-01-01

    This study examines the development of the registered dental hygienist in alternative practice in California through an analysis of archival documents, stakeholder interviews, and two surveys of the registered dental hygienist in alternative practice. Designing, testing and implementing a new practice model for dental hygienists took 23 years. Today, registered dental hygienists in alternative practice have developed viable alternative methods for delivering preventive oral health care services in a range of settings with patients who often have no other source of access to care. PMID:21337961

  20. Geography matters: state-level variation in children's oral health care access and oral health status.

    PubMed

    Fisher-Owens, S A; Soobader, M J; Gansky, S A; Isong, I A; Weintraub, J A; Platt, L J; Newacheck, P W

    2016-05-01

    To ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences. Observational study using cross-sectional surveys. Using the 2007 National Survey of Children's Health, we examined state variation in parents' report of children's oral health care access (absence of a preventive dental visit) and oral health status. We assessed the unadjusted prevalences of these outcomes, then adjusted with child-, family-, and neighbourhood-level variables using logistic regression; these results are presented directly and graphically. Using multilevel analysis, we then calculated the degree to which child-, family-, and community-level variables explained state variation. Finally, we quantified the influence of state-level variables on state variation. Unadjusted rates of no preventive dental care ranged 9.0-26.8% (mean 17.5%), with little impact of adjusting (10.3-26.7%). Almost 9% of the population had fair/poor oral health; unadjusted range 4.1-14.5%. Adjusting analyses affected fair/poor oral health more than access (5.7-10.7%). Child, family and community factors explained ∼¼ of the state variation in no preventive visit and ∼½ of fair/poor oral health. State-level factors further contributed to explaining up to a third of residual state variation. Geography matters: where a child lives has a large impact on his or her access to oral health care and oral health status, even after adjusting for child, family, community, and state variables. As state-level variation persists, other factors and richer data are needed to clarify the variation and drive changes for more egalitarian and overall improved oral health. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. The relationship between access to and use of dental services following expansion of a primary care service to embrace dental team training.

    PubMed

    Wanyonyi, K L; Radford, D R; Gallagher, J E

    2013-11-01

    To investigate changes in the patient population and treatment case-mix within an expanded primary care dental training facility in Southern England. Cross-sectional analysis of patient management system data. Electronic data for patients with a closed/completed treatment plan in the 12-month period prior to, and following, dental service expansion were extracted for analysis (n = 4343). Descriptive analysis involved age, sex, payment status, deprivation status and treatment activity. Logistic regression was used to model the likelihood of treatment involving laboratory constructed devices (crowns, bridges, dentures), in relation to demography and deprivation in each time period. The volume of patients using the service increased by 48.3% (1749 cf 2594). The average age increased from 31.97 (95%CI: 30.8, 32.5) to 36.4 years (95%CI: 35.6, 37.1); greatest increase was in the over 75 years age-group (96%). The patient base became less deprived: patients exempt from payment reduced from 43.2% (n = 755) to 28.6% (n = 741) (P = 0.001) and the mean population deprivation score (IMD) reduced from 24.5 (95%CI: 23.8, 25.2) to 22.3 (95%CI: 21.7, 22.8). The volume and proportion of care involving laboratory constructed devices increased from 8.3% (n = 145) to 15.8% (n = 411) whilst assessments without interventive care decreased (34.5%-26.3%). On a logistic regression, the odds of having treatment involving laboratory constructed devices, increased with increasing age in both time periods 7% (95% CI: 1.06-1.08) and 6% (95% CI: 1.05-1.07) respectively. Furthermore, the odds increased by 38% OR: 1.38 (95% CI: 1.01-1.89) in period 2, for white patients. After adjusting for these effects, the odds of having care that involved laboratory constructed devices were less in period 2 than period 1 (100% cf 43%) for those who were technically exempt from payment (OR = 2.0; 95% CI 1.34 to 2.90 cf, OR = 1.43; 95% CI 1.13-1.81). The patient population altered in relation to age and socio

  2. Household Expenditure for Dental Care in Low and Middle Income Countries

    PubMed Central

    Masood, Mohd; Sheiham, Aubrey; Bernabé, Eduardo

    2015-01-01

    This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries) who participated in the WHO World Health Survey (WHS) were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE) in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries. PMID:25923691

  3. Access to oral health care services among adults with learning disabilities: a scoping review.

    PubMed

    Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H; Khalil, Hesham S

    2016-01-01

    The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Using the Arksey O'Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet.

  4. Fund allocation within Australian dental care: an innovative approach to output based funding.

    PubMed

    Tennant, M; Carrello, C; Kruger, E

    2005-12-01

    Over the last 15 years in Australia the process of funding government health care has changed significantly. The development of dental funding models that transparently meet both the service delivery needs for data at the treatment level and policy makers' need for health condition data is critical to the continued integration of dentistry into the wider health system. This paper presents a model of fund allocation that provides a communication construct that addresses the needs of both policy makers and service providers. In this model, dental treatments (dental item numbers) have been grouped into eight broad dental health conditions. Within each dental health condition, a weighted average price is determined using the Department of Veterans Affairs' (DVA) fee schedule as the benchmark, adjusted for the mix of care. The model also adjusts for the efficiency differences between sectors providing government funded dental care. In summary, the price to be applied to a dental health condition category is determined by the weighted average DVA price adjusted by the sector efficiency. This model allows governments and dental service providers to develop funding agreements that both quantify and justify the treatment to be provided. Such a process facilitates the continued integration of dental care into the wider health system.

  5. Medical care transition planning and dental care use for youth with special health care needs during the transition from adolescence to young adulthood: a preliminary explanatory model

    PubMed Central

    Chi, Donald L.

    2013-01-01

    Objectives To test the hypotheses that youth with special health care needs (YSHCN) with a medical care transition plan are more likely to use dental care during the transition from adolescence to young adulthood and that different factors are associated with dental utilization for YSHCN with and YSHCN without functional limitations. Methods National Survey of CSHCN (2001) and Survey of Adult Transition and Health (2007) data were analyzed (N=1,746). The main predictor variable was having a medical care transition plan, defined as having discussed with a doctor how health care needs might change with age and having developed a transition plan. The outcome variable was dental care use in 2001 (adolescence) and 2007 (young adulthood). Multiple variable Poisson regression models with robust standard errors were used to estimate covariate-adjusted relative risks (RR). Results About 63% of YSHCN had a medical care transition plan and 73.5% utilized dental care. YSHCN with a medical care transition plan had a 9% greater relative risk (RR) of utilizing dental care than YSHCN without a medical care transition plan (RR:1.09; 95% CI:1.03–1.16). In the models stratified by functional limitation status, having a medical care transition plan was significantly associated with dental care use, but only for YSHCN without functional limitations (RR:1.11; 95% CI:1.04–1.18). Conclusions Having a medical care transition plan is significantly associated with dental care use, but only for YSHCN with no functional limitation. Dental care should be an integral part of the comprehensive health care transition planning process for all YSHCN. PMID:23812799

  6. Understanding Muslim patients: cross-cultural dental hygiene care.

    PubMed

    Sirois, M L; Darby, M; Tolle, S

    2013-05-01

    Healthcare providers who understand the basic pillars of Islamic beliefs and common religious practices can apply these concepts, anticipate the needs of the Muslim patient and family, and attract Muslim patients to the practice. Cross cultural knowledge can motivate dental hygienists to adopt culturally acceptable behaviors, strengthen patient-provider relationships and optimize therapeutic outcomes. Trends in Muslim population growth, Islamic history and beliefs, modesty practices, healthcare beliefs, contraception, childbearing, childrearing, pilgrimage, dietary practices, dental care considerations and communication are explained. This paper reviews traditional Muslim beliefs and practices regarding lifestyle, customs, healthcare and religion as derived from the literature and study abroad experiences. Recommendations are offered on how to blend western healthcare with Islamic practices when making introductions, appointments, eye contact, and selecting a practitioner. The significance of fasting and how dental hygiene care can invalidate the fast are also discussed. The ultimate goal is for practitioners to be culturally competent in providing care to Muslim patients, while keeping in mind that beliefs and practices can vary widely within a culture. © 2012 John Wiley & Sons A/S.

  7. Child Care Providers' Knowledge About Dental Injury First Aid in Preschool-age Children.

    PubMed

    Sienkiewicz, Kristine L; Rainchuso, Lori; Boyd, Linda D; Giblin, Lori

    2017-06-01

    Purpose: The aim of this study was to assess child care providers' level of knowledge of first aid management and attitudes towards dental injuries among preschool-age children within Fairfield County, Connecticut and Boston, Massachusetts. Methods: This descriptive cross-sectional study used a web-based, validated questionnaire adapted from several studies with permission from authors. A panel of 5 dental experts determined the relevance of the questions and overall content (I-CVI range 0.8-1; S-CVI = 0.95). The 28 question survey included demographics, level of knowledge, attitudes about traumatic dental injuries, emergency management, and 2 case study questions on management of luxation and tooth fracture. Survey data was coded and analyzed for associations and trends using STATA® statistics/data analysis software v. 11.2. Results: A total of 100 child care providers completed the online questionnaire. Eighty-four percent self-reported little to no knowledge about dental injury management. Sixty percent of child care providers agreed that they are responsible for managing dental injuries. Approximately two-thirds of child care providers reported not feeling adequately informed about dental injuries, with 77% expressing interest in receiving more information. Conclusions: The majority of child care providers' do not have the knowledge to perform adequate first aid following a dental injury. Professional development on first aid for dental injuries is recommended among this workforce population. Copyright © 2017 The American Dental Hygienists’ Association.

  8. Curricular Guidelines for Dental Hygiene Care for the Handicapped.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1984

    1984-01-01

    The American Association of Dental Schools' guidelines for dental hygiene curriculum cover the scope and definitions of care for the handicapped, interrelationships between disciplines and courses, a curriculum overview, primary educational goals, prerequisites, a core content outline, specific behavioral objectives, sequencing, faculty, and…

  9. Cruise medicine: the dental perspective on health care for passengers during a world cruise.

    PubMed

    Sobotta, Bernhard A J; John, Mike T; Nitschke, Ina

    2008-01-01

    Although more than 100 million passengers have taken a cruise since 1980, it is not known what dental treatment needs occur at sea. The routine dental documentation of a 2-month period at sea on a cruise ship carrying 1,619 passengers was analyzed. The subjects for the study were 57 passengers (3.5% of 1,619), with a mean age of 71 years (+/-9.8 y). Age, gender, number of natural teeth and implants, prosthetic status, diagnosis, treatment performed, percentage of emergency and routine procedures, number of appointments, duration of appointment, time since last visit to the dentist, and cabin category as indicator of socioeconomic status were extracted. Oral health-related quality of life (OHRQoL) was measured using the 14-item Oral Health Impact Profile. Passengers had a mean number of 20 natural teeth plus substantial fixed and removable prosthodontics. Emergency dental treatment accounted for 97% of the chairside time. The three most frequent emergency diagnoses were defective restorations (36%), pulpal disease (20%), and defective prosthesis and caries (both 11.5%). Common emergency therapies provided were complex surgical-prosthodontic rehabilitation, various endodontic treatments, and extractions. Per 1,000 persons/month, passengers required 21.6 emergency plus 2.5 routine appointments; 49% of passengers had seen a dentist within 3 months before going to sea. Passengers do attend their dentist for routine care/checkups before the voyage, yet experience complex dental emergencies. This is due to the presence of a high number of restorations that fail unexpectedly. Some failures are so severe that they would have forced the passenger to abort the cruise had there been no dental service available. The ease of access to quality dental care may explain the relatively low level of perceived problems as characterized by OHRQoL scores.

  10. Unravelling referral paths relating to the dental care of children: a study in Liverpool.

    PubMed

    Harris, Rebecca V; Pender, Susan M; Merry, Alison; Leo, Anthony

    2008-04-01

    To describe primary care referral networks relating to children's dental care and the main influences on referral decisions taken by dentists working in a primary care setting. A postal questionnaire to all 130 general dental practitioners (GDPs) in contract with Primary Care Trusts (PCTs), and 24 Community Dental Service (CDS) dentists in Liverpool. Characteristics of patient groups and factors influencing the choice of referral pathway of children referred from primary dental care. There were good responses rates (110 [85%] GDPs and 22 [92%] CDS dentists). The two main reasons why GDPs referred children to hospitals were (a) for treatment under general anaesthetic (GA) or relative analgesia (RA) and (b) for restorative care of dentally anxious children. GDPs also referred anxious children requiring simple restorative care and/or RA to the CDS. Only eight GDPs (7%) cited a lack of experience as a reason for referral of dentally anxious children for simple restorative care, compared to 53 (48%) who cited a lack of RA facilities, and 25 (23%) who cited financial considerations. GDPs refer children to both hospital services and the CDS, and identify a lack of RA facilities and economic pressures as key reasons for referral.

  11. Oral health need and access to dental services: evidence from the National Survey of Children's Health, 2007.

    PubMed

    Bell, Janice F; Huebner, Colleen E; Reed, Sarah C

    2012-04-01

    This study examines associations between parents' report of their children's oral health and receipt of a dental visit for preventive care. We conducted a cross-sectional analysis of oral health status and receipt of a preventive dental visit among US children and youth, ages 1-17 years, using data from the 2007 National Survey of Children's Health (n = 86,764). Survey-weighted logistic regression was used to estimate associations between perceived oral health status and receipt of a preventive dental health visit in the prior 12 months. Overall, 78 % of children and youth received at least one preventive dental health visit in the prior year. Among the youngest children, lower oral health status was associated with higher odds of receiving a preventive dental visit; among older children, lower oral health status was associated with lower odds of receiving a dental visit for preventive care. Use of preventive dental health care is below national target goals. Younger children in worse oral health are more likely, and older youth less likely, to receive preventive dental care. Public health efforts to educate parents to seek early and ongoing preventive oral health care, rather than services in response to problems, may yield oral health benefits later in childhood and over the life course.

  12. Patterns of dental services and factors that influence dental services among 64-65-year-old regular users of dental care in Denmark.

    PubMed

    Christensen, Lisa B; Rosing, Kasper; Lempert, Susanne M; Hede, Børge

    2016-03-01

    To describe the pattern of dental services provided to 64-65-year-old Danes who are regular users of dental care over a 5-year period, to analyse whether this pattern is associated with socio-demographic and/or socioeconomic factors, and if different uses of dental services are related to dental status and caries experience. Finally, to discuss the future planning of dental services aimed at the increasing population of elderly citizens. [Correction made on 21 March 2014, after first online publication: The sentence 'Data on elderly's dental service are scarce, although increased use is seen and more teeth are present in this age group.' was removed.] A cross-sectional study of all aged 64-65 (n = 37 234) who received a dental examination in 2009 was conducted. Clinical data comprised dental services received under the National Health Insurance reimbursement scheme, dental status and DMFT. Geographical, socio-demographic and socioeconomic data derived from public registers. Almost all received restorations, while periodontal treatment was received by <50% during 5 years. Heavy use of dental services was dominated by periodontal services. Periodontal services were most prevalent in the capital and the most affluent areas. Relatively more extractions were related to low income and persons in least affluent areas. Total number of services was highest among women, persons with ≥20 teeth, persons living in the capital, and where the ratio user per dentist was low. For future planning of dental care for elderly, dental status, geographical and social area-based factors and to some degree gender, income, and education must be taken into consideration as all these factors seem to influence the future demand for dental services. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  13. Effects of Global Budgeting on the Distribution of Dentists and Use of Dental Care in Taiwan

    PubMed Central

    Hsueh, Ya-Seng A; Lee, Shoou-Yih D; Huang, Yu-Tung A

    2004-01-01

    Objective To examine the effects of global budgeting on the distribution of dentists and the use and cost of dental care in Taiwan. Data Sources (1) Monthly dental claim data from January 1996 to December 2001 for the entire insured population in Taiwan. (2) The 1996–2001 population information for the cities, counties and townships in Taiwan, abstracted from the Taiwan-Fukien Demographic Fact Book. Study Design Longitudinal, using the autocorrelation model. Principal Findings Results indicated decline in dental care utilization, particularly after the implementation of dental global budgeting. With few exceptions, dental global budgeting did not improve the distribution of dental care and dentist supply. Conclusions The experience of the dental global budget program in Taiwan suggested that dental global budgeting might contain dental care utilization and that several conditions might have to be met in order for the reimbursement system to have effective redistributive impact on dental care and dentist supply. PMID:15544648

  14. Oral health equity and unmet dental care needs in a population-based sample: findings from the Survey of the Health of Wisconsin.

    PubMed

    Malecki, Kristen; Wisk, Lauren E; Walsh, Matthew; McWilliams, Christine; Eggers, Shoshannah; Olson, Melissa

    2015-07-01

    We used objective oral health screening and survey data to explore individual-, psychosocial-, and community-level predictors of oral health status in a statewide population of adults. We examined oral health status in a sample of 1453 adult Wisconsin residents who participated in the Survey of the Health of Wisconsin Oral Health Screening project, conducted with the Wisconsin Department of Health Services during 2010. We found significant disparities in oral health status across all individual-, psychosocial-, and community-level predictors. More than 15% of participants had untreated cavities, and 20% did not receive needed oral health care. Individuals who self-reported unmet need for dental care were 4 times as likely to have untreated cavities as were those who did not report such a need, after controlling for sociodemographic and behavioral factors. Our results suggested that costs were a primary predictor of access to care and poor oral health status. The results underscored the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers (e.g., the costs associated with unmet dental care) and promoting preventive health behaviors (e.g., teeth brushing).

  15. Periodontal Disease, Regular Dental Care Use, and Incident Ischemic Stroke.

    PubMed

    Sen, Souvik; Giamberardino, Lauren D; Moss, Kevin; Morelli, Thiago; Rosamond, Wayne D; Gottesman, Rebecca F; Beck, James; Offenbacher, Steven

    2018-02-01

    Periodontal disease is independently associated with cardiovascular disease. Identification of periodontal disease as a risk factor for incident ischemic stroke raises the possibility that regular dental care utilization may reduce the stroke risk. In the ARIC (Atherosclerosis Risk in Communities) study, pattern of dental visits were classified as regular or episodic dental care users. In the ancillary dental ARIC study, selected subjects from ARIC underwent fullmouth periodontal measurements collected at 6 sites per tooth and classified into 7 periodontal profile classes (PPCs). In the ARIC study 10 362 stroke-free participants, 584 participants had incident ischemic strokes over a 15-year period. In the dental ARIC study, 6736 dentate subjects were assessed for periodontal disease status using PPC with a total of 299 incident ischemic strokes over the 15-year period. The 7 levels of PPC showed a trend toward an increased stroke risk (χ 2 trend P <0.0001); the incidence rate for ischemic stroke/1000-person years was 1.29 for PPC-A (health), 2.82 for PPC-B, 4.80 for PPC-C, 3.81 for PPC-D, 3.50 for PPC-E, 4.78 for PPC-F, and 5.03 for PPC-G (severe periodontal disease). Periodontal disease was significantly associated with cardioembolic (hazard ratio, 2.6; 95% confidence interval, 1.2-5.6) and thrombotic (hazard ratio, 2.2; 95% confidence interval, 1.3-3.8) stroke subtypes. Regular dental care utilization was associated with lower adjusted stroke risk (hazard ratio, 0.77; 95% confidence interval, 0.63-0.94). We confirm an independent association between periodontal disease and incident stroke risk, particularly cardioembolic and thrombotic stroke subtype. Further, we report that regular dental care utilization may lower this risk for stroke. © 2018 American Heart Association, Inc.

  16. Oral Health Disparities and Unmet Dental Needs among Preschool Children in Chelsea, MA: Exploring Mechanisms, Defining Solutions.

    PubMed

    Isong, Inyang; Dantas, Laila; Gerard, Macda; Kuhlthau, Karen

    Significant disparities exist in children's receipt of preventive dental care (PDC) in the United States. Many of the children at greatest risk of dental disease do not receive timely PDC; when they do receive dental care, it is often more for relief of dental pain. Chelsea is a low-income, diverse Massachusetts community with high rates of untreated childhood caries. There are various dental resources available in Chelsea, yet many children do not access dental care at levels equivalent to their needs. Using Chelsea as a case-study, to explore factors contributing to forgone PDC (including the age 1 dental visit) in an in-depth way. We used a qualitative study design that included semi-structured interviews with parents of preschool children residing in Chelsea, and Chelsea-based providers including pediatricians, dentists, a dental hygienist and early childhood care providers. We examined: a) parents' dental attitudes and oral health cultural beliefs; b) parents' and providers' perspectives on facilitators and barriers to PDC, reasons for unmet needs, and proposed solutions to address the problem. We recorded, transcribed and independently coded all interviews. Using rigorous, iterative qualitative data analyses procedures, we identified emergent themes. Factors perceived to facilitate receipt of PDC included Head-Start oral health policies, strong pediatric primary care/dental linkages, community outreach and advertising, and parents' own oral health experiences. Most parents and providers perceived there to be an adequate number of accessible dental services and resources in Chelsea, including for Medicaid enrollees. However, several barriers impeded children from receiving timely PDC, the most frequently cited being insurance related problems for children and adults. Other barriers included limited dental services for children <2 years, perceived poor quality of some dental practices, lack of emphasis on prevention-based dental care, poor care

  17. Breaking bad medical news in a dental care setting.

    PubMed

    Güneri, Pelin; Epstein, Joel; Botto, Ronald W

    2013-04-01

    Dental care providers may diagnose diseases and conditions that affect a patient's general health. The authors reviewed issues related to breaking bad medical news to dental practice patients and provide guidance to clinicians about how to do so. To help reduce the potentially negative effects associated with emotionally laden communication with patients about serious health care findings, the authors present suggestions for appropriately and sensitively delivering bad medical news to both patients and their families in a supportive fashion. Preparing to deliver bad news by means of education and practice is recommended to help prevent or reduce psychological distress. One form of communication guidance is the ABCDE model, which involves Advance preparation, Building a therapeutic relationship or environment, Communicating well, Dealing with patient and family reactions, and Encouraging and validating emotions. An alternative model is the six-step SPIKES sequence-Setting, Perception, Invitation or Information, Knowledge, Empathy, and Strategize and Summarize. Using either model can assist in sensitive and empathetic communication. For both practitioners' and patients' well-being, empathetic and effective delivery of bad medical news should be included in dental school curricula and continuing education courses. Dental care providers should be familiar with the oral manifestations of diseases and the care needed before the patient undergoes medical treatment and use effective communication necessary to share bad news with patients.

  18. [Relationship between community-based dental health programs and health care costs for the metabolic syndrome].

    PubMed

    Takeuchi, Noriko; Yamamoto, Tatsuo; Hirai, Aya; Morita, Manabu; Kodera, Ryousei

    2010-11-01

    Health care costs have been increasing year by year and health programs are needed which will allow reduction in the burden. The present community-based ecological study examined the relationship between implementation of dental health care programs and health care costs for the metabolic syndrome. We calculated the monthly health care cost for the metabolic syndrome per capita for each municipality in Okayama Prefecture (n = 27) using the national health insurance receipts for 1997 and 2007 for diabetes mellitus, hypertension, cardiovascular disorder, cerebral vascular disorder, and atherosclerosis as principal diseases. Information was obtained from each municipality on the implementation of public dental health services consisting of 10 programs, including visits for oral hygiene guidance, health consultation for periodontal disease, preventive long-term care, participation of dental hygienists in public health service, programs for improving oral function in the aged, and etc. The municipalities were divided into two groups based on the implementation/non-implementation of each dental health program. Then, the change in health care cost for metabolic syndrome per capita between 1997 and 2007 was compared between the two groups according to each dental health program. RESULTS Health care costs for metabolic syndrome were reduced in decade in the municipalities which executed dental health care programs such as 'preventive long-term care' or 'health consultation for periodontal disease', being greater in the municipalities which did not. More decrease in health care costs was further observed in the municipalities where the other seven programs were also implemented. Any direct relationship between dental health programs and health care costs for the metabolic syndrome remains unclear. However, our data suggests that costs might be decreased in municipalities which can afford to implement dental health programs. Health care costs for the metabolic syndrome in

  19. Dental health-care service utilisation and its determinants in West Iran: a cross-sectional study.

    PubMed

    Rezaei, Satar; Woldemichael, Abraha; Zandian, Hamed; Homaie Rad, Enayatollah; Veisi, Navid; Karami Matin, Behzad

    2018-06-01

    Dental health care is not only an effective strategy for the prevention, early diagnosis and treatment of oral diseases but also contributes to the general health of communities. This study aimed to investigate the situation of dental health-care service utilisation and its determinants in Kermanshah city, western Iran, in 2015. A cross-sectional study on a total of 894 household heads was conducted. The participants were selected using a multistage sampling technique. A self-administered questionnaire was used to collect the data. Multiple logistic regression was performed to assess factors associated with utilisation of dental-care services and a negative binomial regression was carried out to identify the main factor associated with the frequency of visiting a dentist for dental health care. A statistically significant association was considered at a value of P < 0.05. All the analyses were performed using STATA version 12. Of the total household heads who participated in the study, 60.3% and 9.9% reported visiting a dentist for dental treatment in the past year and for 6-monthly dental check-ups, respectively. The average ± standard deviation number of visits by a respondent was 2.08 ± 2.97. Of the total number of respondents, 281 (31.4%) reported visiting a dentist once or twice in the last 12 months for dental health-care services, while 28.9% reported visiting a dentist more than twice in the same time period. Ageing, having dental insurance, higher income, being a university graduate, self-rated poor oral health and not regularly brushing own teeth were the main factors associated with utilisation of dental health-care services. Our study indicates that dental health-care utilisation among households in the study area was influenced by a number of factors, including being socio-economically disadvantaged, self-rated poor oral health and not regularly brushing own teeth. Therefore, in this setting, dental-intervention programmes, including dental health

  20. Influence of dental care systems on dental status. A comparison between two countries with different systems but similar living standards.

    PubMed

    Palmqvist, S; Söderfeldt, B; Vigild, M

    2001-03-01

    To evaluate the influence of two different dental care systems on dental status, taking into account relevant socio-economic factors. Questionnaire studies on randomly sampled subjects in Denmark and Sweden using questionnaire forms as identical as possible with regard to the different languages. The studies were performed late in 1998 in both countries. Questionnaires were sent to 1,175 subjects aged 45-69 years in Denmark (response rate 73%) and to 1,001 subjects aged 55-79 years in Sweden (response rate 67%). Questions about dental status and about socioeconomic factors and attitudes toward dental care were included. In logistic regression models, various dichotomies of dental conditions were used as dependent variables. State (Denmark vs. Sweden) was used as an independent variable together with socioeconomic factors and attitudes. There were great differences between the countries in dental status. In the regression model with 'wearing removable denture(s)' as the dependent variable, state was the strongest predictor with an OR of above 4.1 for Denmark compared to Sweden. much stronger than variables such as age, income, education and residence. The results indicate that the Swedish dental care system has been superior to the Danish one regarding dental status in middle aged and older populations in these two countries.

  1. The dental safety net in Connecticut.

    PubMed

    Beazoglou, Tryfon; Heffley, Dennis; Lepowsky, Steven; Douglass, Joanna; Lopez, Monica; Bailit, Howard

    2005-10-01

    Many poor, medically disabled and geographically isolated populations have difficulty accessing private-sector dental care and are considered underserved. To address this problem, public- and voluntary-sector organizations have established clinics and provide care to the underserved. Collectively, these clinics are known as "the dental safety net." The authors describe the dental safety net in Connecticut and examine the capacity and efficiency of this system to provide care to the noninstitutionalized underserved population of the state. The authors describe Connecticut's dental safety net in terms of dentists, allied health staff members, operatories, patient visits and patients treated per dentist per year. The authors compare the productivity of safety-net dentists with that of private practitioners. They also estimate the capacity of the safety net to treat people enrolled in Medicaid and the State Children's Health Insurance Program. The safety net is made up of dental clinics in community health centers, hospitals, the dental school and public schools. One hundred eleven dentists, 38 hygienists and 95 dental assistants staff the clinics. Safety-net dentists have fewer patient visits and patients than do private practitioners. The Connecticut safety-net system has the capacity to treat about 28.2 percent of publicly insured patients. The dental safety net is an important community resource, and greater use of allied dental personnel could substantially improve the capacity of the system to care for the poor and other underserved populations.

  2. Oral health in children in Denmark under different public dental health care schemes.

    PubMed

    Christensen, L B; Petersen, P E; Hede, B

    2010-06-01

    To describe and analyse oral health of children and adolescents under two types of dental health care schemes under the Public Dental Health Service in Denmark, and to analyse possible influence of socio-economic and socio-cultural factors. Data on children's oral health status was obtained from public oral health registers and were pooled with data from questionnaires sent to parents of the children and adolescents. The study comprised individuals aged 5, 12 and 15, in total 2168 persons, randomly drawn from four municipalities with dental care provided by salaried dentists in public dental clinics and three municipalities with dental care provided by dentists in private practice. 70% of the parents completed a questionnaire including questions on socio-economic and socio-cultural background, lifestyle-related factors, self assessment of parents' oral- and general health. After the data were merged, the final study population represented 60% of the original target population. The mean caries experience (DMFS+dmfs) was 2.2 and further analysis of caries experience in each age group showed no variations in relation to type of provider of dental care. However, multiple dummy regression analyses demonstrated that low education, poor general health, foreign citizenship and smoking habits of the parents were important determinants for high level of caries in their children. Occurrence of dental caries as well as changes over time in levels of dental caries of Danish children did not vary by scheme of Public Dental Health Service, i.e. whether dental health care was provided by public employed dentists or by private practitioners. However, social inequalities still relate to caries experience in children and adolescents. Adjustment of preventive oral health activities strategy seems to be needed.

  3. Major metropolis rail system access to dental care for the retired and elderly: a high-resolution geographic study of Sydney, Australia.

    PubMed

    Zainab, Uswa-I; Kruger, Estie; Tennant, Marc

    2015-12-01

    This study examined the spatial accessibility of the Sydney Dental Hospital, to the people of metropolitan Sydney, using a geographic information systems approach. Sydney, Australia's largest city and the state capital of New South Wales, has 4.6 million people, with one-fifth of the Australian population (4.6 million people). Public dental services exist, but accessibility is limited to some specific population groups, who meet specific eligibility criteria. All adults (those older than 15 years) were included in the study, and two subsets of this population, retirees (older than 65 years) and elderly (older than 85 years), were also examined according to their proximity to the Sydney Dental Hospital, which is located immediately adjacent to the central train station. Census data (population data) and train station geo-coding data were integrated with high-resolution geographic information systems to analyse population spatial accessibility. Irrespective of the socioeconomic status, it was found that 43% of all the adults, 42.5% of the retirees and 41.6% of elders lived 2 km away from the nearest train station. Two-thirds of those in lower socioeconomic status lived within 2 km of a train station, whilst half of those in the higher socioeconomic status groups lived within 2 km from a train station. Metropolitan Sydney is an example of good urban planning where train stations are appropriately placed in high population density and low socioeconomic areas. The same should be investigated in other major metropolises, especially those still in growth and planning transportation systems. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  4. Does dental health of 6-year-olds reflect the reform of the Israeli dental care system?

    PubMed

    Natapov, Lena; Sasson, Avi; Zusman, Shlomo P

    2016-01-01

    The National health insurance law enacted in 1995 did not include dental care in its basket of services. Dental care for children was first included in 2010, initially up till 8 years of age. The eligibility age rose to 12 years in 2013. The dental survey of 6 year-olds in 2007 found that the average of decayed, missing and filled teeth index (dmft) was 3.31 and 35 % of children were caries free. The current cross sectional survey of dental health for 6 year-olds was conducted as a comparison to the pre-reform status. Twenty-three local authorities were randomly selected nationwide. Two Grade 1 classes were randomly chosen in each. The city of Jerusalem was also included in the survey because of its size. The children were examined according to the WHO Oral Health Survey Methods 4th ed protocol. The dental caries index for deciduous teeth (dmft: decayed, missing, filled teeth) was calculated. One thousand two hundred ten children were examined. 61.7 % of the children suffered from dental decay and only 38.3 % were caries free. The mean dmft was 2.56; d = 1.41 (teeth with untreated caries), f = 1.15 (teeth damaged by decay and restored), virtually none were missing due to caries. Dental caries prevalence was rather consistent, an average of over 2 teeth affected per child. Although there is no major change in comparison to former surveys, there is more treated than untreated disease. In the present survey the f component is higher than in the past, especially in the Jewish sector where it is the main component. It is still lower in the Arab sector. Although the level of dental disease remained rather constant, an increase in the treatment component was observed. In order to reduce caries prevalence, preventive measures such as school dental services and drinking water fluoridation should be extended and continued. Primary preventive dental services should be established for children from birth, with an emphasis on primary health care and educational

  5. Occupational safety among dental health-care workers

    PubMed Central

    Shimoji, Shigehiro; Ishihama, Kohji; Yamada, Hidefumi; Okayama, Masaki; Yasuda, Kouichi; Shibutani, Tohru; Ogasawara, Tadashi; Miyazawa, Hiroo; Furusawa, Kiyofumi

    2010-01-01

    Compared to other health-care workers, dental health-care workers come in close contact with patients and use a variety of sharp and high-speed rotating instruments. It is important to understand the characteristics of the occupational accidents that occur. We reviewed incident reports from April 1, 2005, to March 31, 2010, at Matsumoto Dental University Hospital. In addition, questionnaires dealing with identification of occupational safety issues, especially splash exposures, were conducted for dentists, dental hygienists, and nurses. Thirty-two occupational injuries were reported during the study period, including 23 sharp instrument injuries (71.9%), 6 splash exposures (18.8%), and 3 others. Of the six splash exposures, only two cases involved potential contamination with blood or other potentially infectious patient material. Of the 66 workers who experienced sharps injuries, 20 workers (30.3%, 20/66) reported them to the hospital work safety team. The questionnaire revealed high incident of splash exposures and conjunctiva exposures: 87.9% (51/58) and 60.3% (35/58) in dentists and 88.6% (39/44) and 61.4% (27/44) in dental hygienists. The compliance rate for routine use of protective eyewear was 60.3% (35/58) for dentists and 34.1% (15/44) for hygienists. Of the presented informational items included in the questionnaire, those that strongly persuaded respondents to use protective eyewear were ‘splatters from the patient’s mouth contain blood’ (90%, 99/110) and ‘dental operations at our clinic are performed based only on a questionnaire without serious examinations for HBV, HCV, and HIV’ (71.8%, 79/110). The reason of low compliance of protective eyewear among dentists might relate to fine dental procedures. Appropriate information is important for the motive of wearing personal protective equipment, and an early educational program may have a potential to increase compliance with the use of that equipment. PMID:23745061

  6. Occupational safety among dental health-care workers.

    PubMed

    Shimoji, Shigehiro; Ishihama, Kohji; Yamada, Hidefumi; Okayama, Masaki; Yasuda, Kouichi; Shibutani, Tohru; Ogasawara, Tadashi; Miyazawa, Hiroo; Furusawa, Kiyofumi

    2010-01-01

    Compared to other health-care workers, dental health-care workers come in close contact with patients and use a variety of sharp and high-speed rotating instruments. It is important to understand the characteristics of the occupational accidents that occur. We reviewed incident reports from April 1, 2005, to March 31, 2010, at Matsumoto Dental University Hospital. In addition, questionnaires dealing with identification of occupational safety issues, especially splash exposures, were conducted for dentists, dental hygienists, and nurses. Thirty-two occupational injuries were reported during the study period, including 23 sharp instrument injuries (71.9%), 6 splash exposures (18.8%), and 3 others. Of the six splash exposures, only two cases involved potential contamination with blood or other potentially infectious patient material. Of the 66 workers who experienced sharps injuries, 20 workers (30.3%, 20/66) reported them to the hospital work safety team. The questionnaire revealed high incident of splash exposures and conjunctiva exposures: 87.9% (51/58) and 60.3% (35/58) in dentists and 88.6% (39/44) and 61.4% (27/44) in dental hygienists. The compliance rate for routine use of protective eyewear was 60.3% (35/58) for dentists and 34.1% (15/44) for hygienists. Of the presented informational items included in the questionnaire, those that strongly persuaded respondents to use protective eyewear were 'splatters from the patient's mouth contain blood' (90%, 99/110) and 'dental operations at our clinic are performed based only on a questionnaire without serious examinations for HBV, HCV, and HIV' (71.8%, 79/110). The reason of low compliance of protective eyewear among dentists might relate to fine dental procedures. Appropriate information is important for the motive of wearing personal protective equipment, and an early educational program may have a potential to increase compliance with the use of that equipment.

  7. The effect of health and dental insurance on US children's dental care utilization for urgent and non-urgent dental problems - 2008.

    PubMed

    Naavaal, Shillpa; Barker, Laurie K; Griffin, Susan O

    2017-12-01

    We examined the association between utilization of care for a dental problem (utilization-DP) and parent-reported dental problem (DP) urgency among children with DP by type of health care insurance coverage. We used weighted 2008 National Health Interview Survey data from 2,834 children, aged 2-17 years with at least one DP within the 6 months preceding survey. Explanatory variables were selected based on Andersen's model of healthcare utilization. Need was considered urgent if DP included toothache, bleeding gums, broken or missing teeth, broken or missing filling, or decayed teeth and otherwise as non-urgent. The primary enabling variable, insurance, had four categories: none, private health no dental coverage (PHND), private health and dental (PHD), or Medicaid/State Children's Health Insurance Program (SCHIP). Predisposing variables included sociodemographic characteristics. We used bivariate and multivariate analyses to identify explanatory variables' association with utilization-DP. Using logistic regression, we obtained adjusted estimates of utilization-DP by urgency for each insurance category. In bivariate analyses, utilization-DP was associated with both insurance and urgency. In multivariate analyses, the difference in percent utilizing care for an urgent versus non-urgent DP among children covered by Medicaid/SCHIP was 32 percentage points; PHD, 25 percentage points; PHND, 12 percentage points; and no insurance, 14 percentage points. The difference in utilization by DP urgency was higher for children with Medicaid/SCHIP compared with either PHND or uninsured children. Expansion of Medicaid/SCHIP may permit children to receive care for urgent DPs who otherwise may not, due to lack of dental insurance. © 2016 American Association of Public Health Dentistry.

  8. Dental caries, age and anxiety: factors influencing sedation choice for children attending for emergency dental care.

    PubMed

    Carson, P; Freeman, R

    2001-02-01

    The aim of the study was to examine how physical (dental caries) and psychosocial (age, dental anxiety and dental health behaviour) factors, associated with child and parent, influenced dentists' sedation choice when a child presents in pain. 600 parents whose children were aged between 5 and 11 years took part: 200 attended for routine dental care (RDC); the remaining 400 attended as emergency patients and were offered either dental general anaesthesia (DGA) or relative analgesia (RA). The subjects were approached and invited to take part. The researcher was blind as to the child's pattern of dental attendance and the type of sedation offered. All parents and children completed self-reported ratings of dental anxiety. The children's teeth were examined to determine past and present dental caries experience. The results showed that children who were offered DGA had greater experience of dentinal caries, were younger and dentally anxious. The children offered RA were older, had a higher frequency of brushing their teeth with fluoride toothpaste and were also dentally anxious. Discriminant analysis showed that 2 canonical functions provided clear categorisation of the three treatment groups. Function 1 was a physical (dental caries) factor, which was related to the child's experience of dentinal caries. Function 2 was a psychosocial factor, which was related to the child's age, dental anxiety and frequency of tooth brushing. A greater proportion of the variance in the treatment offered was explained by Function 1, suggesting that the most important factor in the decision to offer DGA was dentinal caries. Function 2 was of lesser importance. The findings have implications for the type of sedation offered to children presenting for emergency care. These children may not otherwise receive treatment and the need to provide less anxiety provoking forms of sedation must be promoted. By doing so, parents who have only brought their children when in pain may take advantage

  9. Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States

    PubMed Central

    Ford, Chandra L.; Wallace, Steven P.; Wang, May C.; Takahashi, Lois M.

    2016-01-01

    Objectives. To examine whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. Methods. We linked Medical Expenditure Panel Survey (2005–2010) data to geographic data from the American Community Survey (2005–2009) and Area Health Resource File (2010). We categorized census tracts as rural and urban by using the Rural–Urban Commuting Area Codes. Respondent sample sizes ranged from 49 839 to 105 306. Outcomes were access to a usual source of health care, cholesterol screening, cervical screening, dental visit within recommended intervals, and health care needs met. Results. African Americans in rural areas had lower odds of cholesterol screening (odds ratio[OR] = 0.37; 95% confidence interval[CI] = 0.25, 0.57) and cervical screening (OR = 0.48; 95% CI = 0.29, 0.80) than African Americans in urban areas. Whites had fewer screenings and dental visits in rural versus urban areas. There were mixed results for which racial/ethnic group had better access. Conclusions. Rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply. PMID:27310341

  10. A preliminary analysis of the US dental health care system's capacity to treat children with special health care needs.

    PubMed

    Kerins, Carolyn; Casamassimo, Paul S; Ciesla, David; Lee, Yosuk; Seale, N Sue

    2011-01-01

    The purpose of this study was to use existing data to determine capacity of the US dental care system to treat children with special health care needs (CSHCN). A deductive analysis using recent existing data was used to determine the: possible available appointments for CSHCN in hospitals and educational programs/institutions; and the ratio of CSHCN to potential available and able providers in the United States sorted by 6 American Academy of Pediatric Dentistry (AAPD) districts. Using existing data sets, this analysis found 57 dental schools, 61 advanced education in general dentistry programs, 174 general practice residencies, and 87 children's hospital dental clinics in the United States. Nationally, the number of CSHCN was determined to be 10,221,436. The distribution, on average, of CSHCN per care source/provider ranged from 1,327 to 2,357 in the 6 AAPD districts. Children's hospital dental clinics had fewer than 1 clinic appointment or 1 operating room appointment available per CSHCN. The mean number of CSHCN patients per provider, if distributed equally, was 1,792. The current US dental care system has extremely limited capacity to care for children with special health care needs.

  11. Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

    PubMed

    Wanyonyi, Kristina L; Radford, David R; Gallagher, Jennifer E

    2017-01-01

    This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008-2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients' individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (<18 years) and older adults (≥65 years) received preventive care in the form of 'instruction and advice', compared with 46% of working age adults (18-64 years); p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001): 'partial dentures' (7%); 'scale and polish' (3.7%); 'tooth extraction' (3%; p = 0.001), and 'instruction and advice' (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive 'instruction and advice' than non-smokers (OR 4.124; 95% CI: 3.088-5.508; p = 0.01). A further new finding from the multilevel models was a significant difference in treatment related to area of

  12. Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

    PubMed Central

    Radford, David R.; Gallagher, Jennifer E.

    2017-01-01

    Objective This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Methods Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008–2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients’ individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Results Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (<18 years) and older adults (≥65 years) received preventive care in the form of ‘instruction and advice’, compared with 46% of working age adults (18–64 years); p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001): ‘partial dentures’ (7%); ‘scale and polish’ (3.7%); ‘tooth extraction’ (3%; p = 0.001), and ‘instruction and advice’ (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive ‘instruction and advice’ than non-smokers (OR 4.124; 95% CI: 3.088–5.508; p = 0.01). A further new finding from the multilevel models was a

  13. Dental care for pregnant women: an assessment of North Carolina general dentists.

    PubMed

    Da Costa, Elizabeth Prada; Lee, Jessica Y; Rozier, R Gary; Zeldin, Leslie

    2010-08-01

    The authors conducted a study to examine factors associated with general dentists' provision of care for pregnant women and the extent to which they provide comprehensive dental care. The authors mailed an 86-item questionnaire to 1,000 practicing general dentists in North Carolina. Survey domains included provider knowledge about pregnancy and dental health, dental treatment practices, barriers to providing care, outcome expectancy, and personal and practice demographics. The primary dependent variables the authors analyzed were whether dentists provided any treatment to pregnant women and, among those who did, the extent to which they provided comprehensive services. The authors performed multivariate regression analyses to determine factors associated with dentists' provision of care to pregnant women (P < .05). A total of 513 surveys were returned (a response rate of 51.3 percent), of which 495 surveys had complete responses. The authors included the completed surveys in their analyses. The mean age of the respondents was 46 years. The results of multivariate analysis showed that respondents who perceived a lack of demand for services among pregnant women and provided preconception counseling were less likely to provide any treatment for pregnant patients than were those who perceived a demand for services and who did not provide preconception counseling, respectively. Dentists who were male, had a low knowledge score, provided preconception counseling and treated largely white populations of patients were less likely than female dentists, those who had moderate or high knowledge scores, and those who treated a population of minority patients to provide comprehensive care for pregnant women. Most general dentists in private practice provide care for pregnant women, but the authors found notable gaps in dental provider knowledge and comprehensive dental services available for pregnant women. Although many general dentists provide some dental care to pregnant

  14. Leadership theory: implications for developing dental surgeons in primary care?

    PubMed

    Willcocks, S

    2011-02-12

    The development of leadership in healthcare has been seen as important in recent years, particularly at the clinical level. There have been various specific initiatives focusing on the development of leadership for doctors, nurses and other health care professions: for example, a leadership competency framework for doctors, the LEO programme and the RCN clinical leadership programme for nurses. The NHS has set up a Leadership Council to coordinate further developments. However, there has not been the same focus in dentistry, although the recent review of NHS dental services (Steele review) has proposed a need for leadership initiatives in NHS dentistry as a medium-term action. Central to this will be a need to focus on the leadership role for dental surgeons. Leadership is all the more important in dentistry, given the change of government and the policy of retrenchment, major public sector reform, the emergence of new organisations such as new commissioning consortia, possible changes to the dental contract, new ways of working, and changes to the profession such as the requirements for the revalidation of dental surgeons. The question is: which leadership theory or approach is best for dental surgeons working in primary care? This paper builds on earlier work exploring this question in relation to doctors generally, and GPs, in particular, and planned work on nurses. It will seek to address this question in relation to dental surgeons working in primary care.

  15. Does Smoking Hamper Oral Self-Care Among Dental Professionals?

    PubMed

    Ghasemi, Hadi; Khami, Mohammad Reza; Virtanen, Jorma I; Vehkalahti, Miira M

    2015-05-01

    Smoking may impact oral self-care (OSC). This study aimed to analyze the role of smoking in OSC among Iranian dental health professionals. The cross-sectional data were collected at two annual dental meetings and seven randomly selected dental schools in Iran. A total of 1,459 respondents composed of 967 general dental practitioners (GDPs), 229 dental educators (DE), and 263 senior dental students (DS) anonymously completed a self-administered questionnaire inquiring about smoking status and OSC. Thirty percent of the male and 12% of the female dental health professionals reported smoking tobacco. There was no difference between their professional status. Women reported better OSC than did men, but only 26% of the women and 17% of the men followed the three most important recommendations for OSC. Smoking was associated with infrequent tooth brushing and flossing, irregular use of fluoride containing toothpaste, consumption of sugary snacks and weak adherence to the recommended OSC guidelines. Dental health education should place more emphasis on smoking counseling and cessation among dental health professionals.

  16. Access to oral health care services among adults with learning disabilities: a scoping review

    PubMed Central

    Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H.; Khalil, Hesham S.

    2016-01-01

    Summary Background The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. Objectives The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Methods Using the Arksey O’Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Results Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. Conclusions The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet. PMID:28149451

  17. Standard of care in North American small animal dental service.

    PubMed

    Eisner, Edward R

    2013-05-01

    Veterinary standard of care is peer-regulated, measured as the level of care provided and acceptable among most veterinarians in a given geographic area. This article proposes that today it should be the responsibility of the guiding organization of each medical discipline, such as the American Veterinary Dental College for the veterinary dental profession, to provide guidance to ruling Medical Boards regarding a recommended standard of care, rather than being defined by geographic boundaries. Within each medical discipline, specialists should be held to a higher standard than generalists, with both operating to a standard of care commensurate with their training. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. A Competition between Care Teams Improved Recording of Diagnoses in Primary Dental Care: A Longitudinal Follow-Up Study.

    PubMed

    Kallio, Jouko; Kauppila, Timo; Suominen, Lasse; Heikkinen, Anna Maria

    2017-01-01

    A playful competition was launched in a primary dental health care system to improve the recording of diagnoses into an electronic patient chart system and to study what diagnoses were used in primary dental care. This was a longitudinal follow-up study with public sector primary dental care practices in a Finnish city. A one-year-lasting playful competition between the dental care teams was launched and the monthly percentage of dentists' visits with recorded diagnosis before, during, and after the intervention was recorded. The assessed diagnoses were recorded with the International Classification of Diseases (ICD-10). Before the competition, the level of diagnosis recordings was practically zero. At the end of this intervention, about 25% of the visits had a recorded diagnosis. Two years after the competition, this percentage was 35% without any additional measures. The most frequent diagnoses were dental caries (K02, 38.6%), other diseases of hard tissues of teeth (K03, 14.8%), and diseases of pulp and periapical tissues (K04, 11.4%). Commitment to the idea that recording of diagnoses was beneficial improved the recording of dental diagnoses. However, the diagnoses obtained did not accurately reflect the reputed prevalence of oral diseases in the Finnish population.

  19. The impact of integration of dental services on oral health in long-term care: qualitative analysis.

    PubMed

    Finkleman, Gary I; Lawrence, Herenia P; Glogauer, Michael

    2012-06-01

    To qualitatively analyse how integration of dental service in long-term care (LTC) impacts residents and their oral health. Few studies have attempted to merge inductive and deductive data to clarify the significance of the complex psychosocial environment in LTC facilities. Understanding the subjective oral health experience of LTC residents in their social setting is key to uncovering behavioural patterns that may be limiting the oral care provided to LTC residents. A cross-sectional study was performed involving 61 residents in three Ontario LTC facilities. Observations and reflective notes were recorded during open-ended interviews using a structured questionnaire to stimulate conversation topics. This ensured that each resident received the same prompting during the interview process. Inductive analysis was used to identify common patterns and themes within field notes and transcriptions. The major themes identified included oral hygiene, oral discomfort, general health, appearance, dental access, and denture related issues. Oral hygiene and discomfort were the dominating categories within the facilities. Two of the three LTC centres identified in this study failed to provide appropriate oral care for their residents. Future research needs to be directed at prospective studies assessing the effect of oral health education and mandatory dental examinations o entry within LTC centres utilising qualitative and quantitative analyses. © 2010 The Gerodontology Society and John Wiley & Sons A/S.

  20. Performance indicators used to assess the quality of primary dental care.

    PubMed

    González, Grisel Zacca; Klazinga, Niek; ten Asbroek, Guus; Delnoij, Diana M

    2006-12-01

    An appropriate quality of medical care including dental care should be an objective of every government that aims to improve the oral health of its population. To determine performance indicators that could be used to assess the quality of primary dental care at different levels of a health care system, the sources for data collection and finally, the dimensions of quality measured by these indicators. An explorative study of the international literature was conducted using medical databases, journals and books, and official websites of organisations and associations. This resulted in a set of 57 indicators, which were classified into the following dimensions for each intended user group: For patients: health outcomes and subjective indicators; for professionals: their performance and the rates of success, failure and complications; for health care system managers and policymakers: their resources, finances and health care utilisation. A set of 57 performance indicators were identified to assess the quality of primary dental care at the levels of patients, professionals and the health care system. These indicators could be used by managers and decision-makers at any level of the health care system according to the characteristics of the services.

  1. [Association between preventive care provided in public dental services and caries prevalence].

    PubMed

    Celeste, Roger Keller; Nadanovsky, Paulo; De Leon, Antonio Ponce

    2007-10-01

    To assess the association between preventive care provided in public dental services and young people's oral health. Oral health data on 4,033 young people aged 15 to 19 years living in 85 municipalities of the state of Rio Grande do Sul, Southern Brazil, were obtained from the national oral health survey "Saúde Bucal Brasil 2003" for the period 2002-2003. The following variables were studied: age, gender, income, education, time elapsed since last dental visit, reason for dental visit, and water fluoridation. Data on dental care services were obtained from the national database of public health services. Statistical analysis was performed using multilevel logistic regression. Youngsters from the 21 municipalities with the lowest preventive care (scaling + fluoride + sealants) rates per 100 inhabitants were 2.27 (95% CI: 1.45;3.56) more likely to have non-filled dental cavities than those from the 21 municipalities with the highest care rates. After adjustment for a number of individual and contextual factors this likelihood decreased to 1.76 (95% CI: 1.13;2.72). The variance attributable to variables at municipal level was 14.1% for the empty model and decreased to 10.5% for the fully adjusted model. Rio Grande do Sul public dental services may have contributed for the reduction in the number of non-filled cavities in young people. However, it was not possible to detect the impact of this service on total dental caries experience.

  2. Alaska Dental Health Aide Program.

    PubMed

    Shoffstall-Cone, Sarah; Williard, Mary

    2013-01-01

    In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

  3. Alaska Dental Health Aide Program

    PubMed Central

    Shoffstall-Cone, Sarah; Williard, Mary

    2013-01-01

    Background In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN) Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska's Tribal Health Organizations (THO) developed a new and diverse dental workforce model to address AI/AN oral health disparities. Objectives This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA) Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. Results The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Conclusions Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities. PMID:23984306

  4. Dental caries in Victorian nursing homes.

    PubMed

    Silva, M; Hopcraft, M; Morgan, M

    2014-09-01

    The poor oral health of nursing home residents is the cause of substantial morbidity and has major implications relating to health care policy. The aim of this study was to measure dental caries experience in Australians living in nursing homes, and investigate associations with resident characteristics. Clinical dental examinations were conducted on 243 residents from 19 nursing homes in Melbourne. Resident characteristics were obtained from nursing home records and interviews with residents, family and nursing home staff. Two dental examiners assessed coronal and root dental caries using standard ICDAS-II criteria. Residents were elderly, medically compromised and functionally impaired. Most required assistance with oral hygiene and professional dental care was rarely utilized. Residents had high rates of coronal and root caries, with a mean 2.8 teeth with untreated coronal caries and 5.0 root surfaces with untreated root caries. Functional impairment and irregular professional dental care were associated with higher rates of untreated tooth decay. There were no significant associations with medical conditions or the number of medications taken. Nursing home residents have high levels of untreated coronal and root caries, particularly those with high needs due to functional impairment but poor access to professional services. © 2014 Australian Dental Association.

  5. The future dental workforce?

    PubMed

    Gallagher, J E; Wilson, N H F

    2009-02-28

    The Editor-in-Chief of the BDJ has previously raised important questions about dental workforce planning and the implications for dental graduates of recent changes and pressures. It is now time to revisit this issue. Much has changed since the last workforce review in England and Wales, and the rate of change is in all probability set to increase. First, at the time of writing this paper the momentous step of including dental care professionals (DCPs) on General Dental Council (GDC) registers in the United Kingdom has recently been completed. Second, the Scope of Practice of all dental professionals has been under consultation by the General Dental Council, and research evidence suggests that greater use should be made of skill-mix in the dental team. Third, within England, Lord Darzi has just published the 'Final Report of the NHS Next Stage Review', which emphasises 'quality care' and 'team-working' as key features of healthcare; this report was accompanied by an important document entitled 'A High Quality Workforce', in which plans for local workforce planning within the NHS are outlined, placing responsibilities at national, local and regional levels. Fourth, policy makers across the UK are wrestling with addressing oral health needs, promoting health and facilitating access to dental care, all of which have implications for the nature and shape of the dental workforce. Fifth, with the impact of globalisation and European policies we are net gainers of dentists as well as having more in training. Sixth, although there have been reviews and policy initiatives by regulatory, professional and other bodies in support of shaping the dental workforce, there has been little serious consideration of skill-mix and funding mechanisms to encourage team-working. Together, these events demand that we enter a fresh debate on the future dental workforce which should extend beyond professional and national boundaries and inform workforce planning. This debate is of great

  6. Oral Health Disparities and Unmet Dental Needs among Preschool Children in Chelsea, MA: Exploring Mechanisms, Defining Solutions

    PubMed Central

    Isong, Inyang; Dantas, Laila; Gerard, Macda; Kuhlthau, Karen

    2014-01-01

    Background Significant disparities exist in children’s receipt of preventive dental care (PDC) in the United States. Many of the children at greatest risk of dental disease do not receive timely PDC; when they do receive dental care, it is often more for relief of dental pain. Chelsea is a low-income, diverse Massachusetts community with high rates of untreated childhood caries. There are various dental resources available in Chelsea, yet many children do not access dental care at levels equivalent to their needs. Objective Using Chelsea as a case-study, to explore factors contributing to forgone PDC (including the age 1 dental visit) in an in-depth way. Methods We used a qualitative study design that included semi-structured interviews with parents of preschool children residing in Chelsea, and Chelsea-based providers including pediatricians, dentists, a dental hygienist and early childhood care providers. We examined: a) parents’ dental attitudes and oral health cultural beliefs; b) parents’ and providers’ perspectives on facilitators and barriers to PDC, reasons for unmet needs, and proposed solutions to address the problem. We recorded, transcribed and independently coded all interviews. Using rigorous, iterative qualitative data analyses procedures, we identified emergent themes. Results Factors perceived to facilitate receipt of PDC included Head-Start oral health policies, strong pediatric primary care/dental linkages, community outreach and advertising, and parents’ own oral health experiences. Most parents and providers perceived there to be an adequate number of accessible dental services and resources in Chelsea, including for Medicaid enrollees. However, several barriers impeded children from receiving timely PDC, the most frequently cited being insurance related problems for children and adults. Other barriers included limited dental services for children <2 years, perceived poor quality of some dental practices, lack of emphasis on

  7. Examining the implications of dental treatment costs for low-income families.

    PubMed

    Snow, Patrick; McNally, Mary E

    2010-01-01

    Dental disease is concentrated among those with low socioeconomic status. Dental care is not publicly funded, and many Canadians must therefore make difficult financial choices when accessing dental care. Families who live in poverty have difficulty meeting even their most basic household needs, so dental treatment may not be affordable. The objective of this study was to understand how the cost of dental treatment affects the monthly budgets of families with low incomes. A chart review was conducted for a sample of 213 new patients examined at the Dalhousie University dental clinic over a 1-year period. Costs for proposed treatment plans were averaged. The patients" ability to pay for proposed treatment was examined in the context of various income scenarios. Two hundred and one patients were included in the final analysis. Dental treatment costs per patient averaged approximately $1600 for the year, with 42% of the planned treatment completed within the first year. The estimated monthly cost of completed treatment was $55. When the cost of a healthy diet was included in the monthly budget, it was determined that families in Nova Scotia with parents working for minimum wage and those receiving income assistance would experience a 100% shortfall for dental expenses. Low-income families in Nova Scotia were unable to afford both a nutritious diet and dental care. This is disturbing, given the links between a healthy diet and both overall health and dental health. An understanding of the significance of income shortfalls for those with low incomes, especially as they affect even basic nutritional needs, will help dental professionals to appreciate the seriousness of this issue and the difficulties that many Canadians face when trying to access basic dental care.

  8. Oral Health Equity and Unmet Dental Care Needs in a Population-Based Sample: Findings From the Survey of the Health of Wisconsin

    PubMed Central

    Wisk, Lauren E.; Walsh, Matthew; McWilliams, Christine; Eggers, Shoshannah; Olson, Melissa

    2015-01-01

    Objectives. We used objective oral health screening and survey data to explore individual-, psychosocial-, and community-level predictors of oral health status in a statewide population of adults. Methods. We examined oral health status in a sample of 1453 adult Wisconsin residents who participated in the Survey of the Health of Wisconsin Oral Health Screening project, conducted with the Wisconsin Department of Health Services during 2010. Results. We found significant disparities in oral health status across all individual-, psychosocial-, and community-level predictors. More than 15% of participants had untreated cavities, and 20% did not receive needed oral health care. Individuals who self-reported unmet need for dental care were 4 times as likely to have untreated cavities as were those who did not report such a need, after controlling for sociodemographic and behavioral factors. Conclusions. Our results suggested that costs were a primary predictor of access to care and poor oral health status. The results underscored the role that primary care, in conjunction with dental health care providers, could play in promoting oral health care, particularly in reducing barriers (e.g., the costs associated with unmet dental care) and promoting preventive health behaviors (e.g., teeth brushing). PMID:25905843

  9. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health... facilities designated as primary medical care, mental health, and dental health professional shortage areas... primary care, dental, or mental health services in these HPSAs. NHSC health [[Page 38839

  10. Improving efficiency and access to mental health care: combining integrated care and advanced access.

    PubMed

    Pomerantz, Andrew; Cole, Brady H; Watts, Bradley V; Weeks, William B

    2008-01-01

    To provide an example of implementation of a new program that enhances access to mental health care in primary care. A general and specialized mental health service was redesigned to introduce open access to comprehensive mental health care in a primary care clinic. Key variables measured before and after implementation of the clinic included numbers of completed referrals, waiting time for appointments and clinic productivity. Workload and pre/post-implementation waiting time data were gathered through a computerized electronic monitoring system. Waiting time for new appointments was shortened from a mean of 33 days to 19 min. Clinician productivity and evaluations of new referrals more than doubled. These improvements have been sustained for 4 years. Moving mental health services into primary care, initiating open access and increasing use of technological aids led to dramatic improvements in access to mental health care and efficient use of resources. Implementation and sustainability of the program were enhanced by using a quality improvement approach.

  11. Promoting oral health care among people living in residential aged care facilities: Perceptions of care staff.

    PubMed

    Villarosa, Amy R; Clark, Sally; Villarosa, Ariana C; Patterson Norrie, Tiffany; Macdonald, Susan; Anlezark, Jennifer; Srinivas, Ravi; George, Ajesh

    2018-04-23

    This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  12. Access to special care dentistry, part 7. Special care dentistry services: seamless care for people in their middle years--part 1.

    PubMed

    Lewis, D; Fiske, J; Dougall, A

    2008-09-27

    Children and older people have been relatively well served by specialist dental care. Despite increasing disability amongst people in their middle years, there have been no or few dedicated dental teams with responsibility for provision of their oral care. This article explores the ethos and practicality of seamless care across the age groups and the primary/secondary care interface, with a focus on embedding oral health into general healthcare plans through the multidisciplinary team approach. The article explores four conditions--rheumatoid arthritis, Huntingdon's disease, multiple sclerosis and diabetes. It considers the features of each condition and how they can impact on both oral health and the delivery of dental services. It also considers the elements of care that contribute to a holistic and seamless approach to oral care services.

  13. Relationship between Primary and Secondary Dental Care in Public Health Services in Brazil.

    PubMed

    Martins, Renata Castro; Reis, Clarice Magalhães Rodrigues Dos; Matta Machado, Antonio Thomaz Gonzaga da; Amaral, João Henrique Lara do; Werneck, Marcos Azeredo Furquim; Abreu, Mauro Henrique Nogueira Guimarães de

    2016-01-01

    This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients. The specialties with the highest frequencies were endodontics (68.4%), minor oral surgery (65.8%), periodontics (63.0%), radiology (46.8%), oral medicine (40.2%), orthodontics (20.5%) and implantology (6.2%). In all percentiles, the shortest wait time for secondary care was for radiology, followed by oral medicine and the other specialties. In the 50th percentile, the wait for endodontics, periodontics, minor oral surgery and orthodontics was 30 days, while for implantology, the wait was 60 days. Finally, in the 75th percentile, the wait for endodontics, orthodontics and implantology was 90 days or more. Two clusters, with different frequencies of OHT access to specialties, were identified. Cluster 1 (n = 7,913) included the OHTs with lower frequencies in all specialties except orthodontics and implantology compared with Cluster 2 (n = 4,474). Of the Brazilian regions, the South and Southeast regions had the highest frequencies for Cluster 2, with better rates for the relationship between primary and secondary care. This study suggests certain difficulties in the relationship between primary and secondary care in specific specialties in oral health, with a great number of OHTs with limited access to DSCs, in addition to different performance in terms of OHT access to DSCs across Brazilian regions.

  14. Program for coordinated dental care under general anaesthesia for children with special needs.

    PubMed

    de Nova-García, M Joaquín; Martínez, M Rosa Mourelle; Sanjuán, Carmen Martín; López, Nuria E Gallardo; Cabaleiro, Esther Carracedo; García, Yolanda Alonso

    2007-12-01

    To draw up a program for coordination of dental care for children with special needs between the Course at the Universidad Complutense de Madrid (UCMC) (Specialisation in holistic dental care for children with special needs), and the Disabled Children's Oral Health Unit (DCOHU) within the Madrid Health Service (SERMAS). UCMC Protocol for children with special needs. Design of a clinical pathway based on consensus amongst the professionals involved. Algorithm for dental care for children with special needs. Matrix covering all activities and timing for full dental diagnosis in such patients (general health, oral health and behaviour) to facilitate proper referral of patients requiring general anaesthesia. Inclusion in the matrix of those responsible for each activity. Improved team work (University - primary health care) in patient evaluation, in provision of information to parents and guardians and in health care quality. From the teaching point of view, students learn to adopt a systematic approach in the decision-making process.

  15. Factors associated with dental health care coverage in Mexico: Findings from the National Performance Evaluation Survey 2002-2003.

    PubMed

    Pérez-Núñez, Ricardo; Medina-Solis, Carlo Eduardo; Maupomé, Gerardo; Vargas-Palacios, Armando

    2006-10-01

    To determine the level of dental health care coverage in people aged > or =18 years across the country, and to identify the factors associated with coverage. Using the instruments and sampling strategies developed by the World Health Organization for the World Health Survey, a cross-sectional national survey was carried out at the household and individual (adult) levels. Dental data were collected in 20 of Mexico's 32 states. The relationship between coverage and environmental and individual characteristics was examined through logistic regression models. Only 6098 of 24 159 individual respondents reported having oral problems during the preceding 12 months (accounting for 14 284 621 inhabitants of the country if weighted). Only 48% of respondents reporting problems were covered, although details of the appropriateness, timeliness and effectiveness of the intervention(s) were not assessed. The multivariate regression model showed that higher level of education, better socioeconomic status, having at least one chronic disease and having medical insurance were positively associated with better dental care coverage. Age and sex were also associated. Overall dental health care coverage could be improved, assuming that ideal coverage is 100%. Some equality of access issues are apparent because there are differences in coverage across populations in terms of wealth and social status. Identifying the factors associated with sparse coverage is a step in the right direction allowing policymakers to establish strategies aimed at increasing this coverage, focusing on more vulnerable groups and on individuals in greater need of preventive and rehabilitative interventions.

  16. Effects of early dental office visits on dental caries experience.

    PubMed

    Beil, Heather; Rozier, R Gary; Preisser, John S; Stearns, Sally C; Lee, Jessica Y

    2014-10-01

    We determined the association between timing of a first dentist office visit before age 5 years and dental disease in kindergarten. We used North Carolina Medicaid claims (1999-2006) linked to state oral health surveillance data to compare caries experience for kindergarten students (2005-2006) who had a visit before age 60 months (n=11,394) to derive overall exposure effects from a zero-inflated negative binomial regression model. We repeated the analysis separately for children who had preventive and tertiary visits. Children who had a visit at age 37 to 48 and 49 to 60 months had significantly less disease than children with a visit by age 24 months (incidence rate ratio [IRR]=0.88; 95% confidence interval [CI]=0.81, 0.95; IRR=0.75; 95% CI=0.69, 0.82, respectively). Disease status did not differ between children who had a tertiary visit by age 24 months and other children. Medicaid-enrolled children in our study followed an urgent care type of utilization, and access to dental care was limited. Children at high risk for dental disease should be given priority for a preventive dental visit before age 3 years.

  17. Perspectives on evolving dental care payment and delivery models.

    PubMed

    Rubin, Marcie S; Edelstein, Burton L

    2016-01-01

    Health care reform is well under way in the United States as reflected in evolving delivery, financing, and payment approaches that are affecting medicine ahead of dentistry. The authors explored health systems changes under way, distinguished historical and organizational differences between medicine and dentistry, and developed alternative models to characterize the relationships between these professions. The authors explored a range of medical payment approaches, including those tied to objective performance metrics, and their potential application to dentistry. Advances in understanding the essential role of oral health in general health have pulled dentistry into the broader discussion of care integration and payment reform. Dentistry's fit with primary and specialty medical care may take a variety of forms. Common provider payment approaches in dentistry-fee-for-service, capitation, and salary-are tied insufficiently to performance when measured as either health processes or health outcomes. Dentistry can anticipate potential payment reforms by observing changes already under way in medicine and by understanding alternative payment approaches that are tied to performance metrics, such as those now in development by the Dental Quality Alliance and others. Novel forms of dental practice may be expected to evolve continuously as medical-dental integration and payment reforms that promote accountability evolve. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  18. Income inequality, disinvestment in health care and use of dental services.

    PubMed

    Bhandari, Bishal; Newton, Jonathan T; Bernabé, Eduardo

    2015-01-01

    To explore the interrelationships between income inequality, disinvestment in health care, and use of dental services at country level. This study pooled national estimates for use of dental services among adults aged 18 years or older from the 70 countries that participated in the World Health Survey from 2002 to 2004, together with aggregate data on national income (GDP per capita), income inequality (Gini coefficient), and disinvestment in health care (total health expenditure and dentist-to-population ratio) from various international sources. Use of dental services was defined as having had dental problems in the last 12 months and having received any treatment to address those needs. Associations between variables were explored using Pearson correlation coefficients and linear regression. Data from 63 countries representing the six WHO regions were analyzed. Use of dental services was negatively correlated with Gini coefficient (Pearson correlation coefficient -0.48, P < 0.001) and positively correlated with GDP per capita (0.40, P < 0.05), total health expenditure (0.45, P < 0.001), and dentist-to-population ratio (0.67, P < 0.001). The association between Gini coefficient and use of dental services was attenuated but remained significant after adjustments for GDP per capita, total health expenditure, and dentist-to-population ratio (regression coefficient -0.36; 95% CI -0.57, -0.15). This study shows an inverse relationship between income inequality and use of dental services. Of the two indicators of disinvestment in health care assessed, only dentist-to-population ratio was associated with income inequality and use of dental services. © 2014 American Association of Public Health Dentistry.

  19. Non-dental primary care providers’ views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study

    PubMed Central

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-01-01

    Objectives To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Design Qualitative study with semistructured interviews and thematic analysis. Setting Four remote communities in outback Queensland, Australia. Participants 35 primary care providers who had experience in providing oral health advice to patients and four dental care providers who had provided oral health services to patients from the four communities. Results In the absence of a resident dentist, rural and remote residents did present to non-dental primary care providers with oral health problems such as toothache, abscess, oral/gum infection and sore mouth for treatment and advice. Themes emerged from the interview data around communication challenges and strategies to improve oral health. Although, non-dental care providers commonly advised patients to see a dentist, they rarely communicated with the dentist in the nearest regional town. Participants proposed that oral health could be improved by: enabling access to dental practitioners, educating communities on preventive oral healthcare, and building the skills and knowledge base of non-dental primary care providers in the field of oral health. Conclusions Prevention is a cornerstone to better oral health in rural and remote communities as well as in more urbanised communities. Strategies to improve the provision of dental services by either visiting or resident dental practitioners should include scope to provide community-based oral health promotion activities, and to engage more closely with other primary care service providers in these small communities. PMID:26515687

  20. Organisational aspects of dental practices: do dental students think like patients or like general dental practitioners?

    PubMed

    Sonneveld, R E; Brands, W G; Bronkhorst, E M; Welie, J V M; Truin, G J

    2013-02-01

    In view of transparency in health care, the widespread desire for more patient-centred care, and in an attempt to facilitate educational programmes that effectively respond to these changes, two research questions are formulated: (i) How do dental students rate the importance of various organisational aspects of dental practices compared with dental patients and general dental practitioners (GDPs), and what prescripts, defined as specific operational responsibilities of GDPs in these matters, do dental students propose? and (ii) In doing so, do students resemble patients or GDPs? In two survey studies, dental students (n = 198), patients (n = 3127) and GDPs (n = 303) were asked to rate by questionnaire the importance of 41 organisational aspects of a general dental practice and proposed specific operational responsibilities ('prescripts'). Seven of 41 aspects were rated as important by the majority of the students. Although in a different rank order, three aspects were predominantly selected by all three groups: continuing education, accessibility by telephone and Dutch-speaking GDP. For most aspects, significant differences were found between the prescripts proposed by students and those proposed by patients, and few differences were found between students and GDPs. The findings do not permit the general conclusion that the views of dental students resemble those of patients or GPDs. Looking at the overall rank order, the three respondent groups showed a great resemblance although significant differences were found for specific aspects. With regard to the proposed prescripts, students showed realistic views and the majority wants to participate in continuing education and work with protocols and guidelines. In this, they tend to resemble GDPs more than they resemble patients. © 2012 John Wiley & Sons A/S.

  1. Self-Reported Obstacles to Regular Dental Care among Information Technology Professionals.

    PubMed

    Reddy, L Swetha; Doshi, Dolar; Reddy, B Srikanth; Kulkarni, Suhas; Reddy, M Padma; Satyanarayana, D; Baldava, Pavan

    2016-10-01

    Good oral health is important for an individual as well as social well-being. Occupational stress and work exhaustion in Information Technology (IT) professionals may influence the oral health and oral health related quality of life. To assess and compare self-reported obstacles for regular dental care and dental visits among IT professionals based on age, gender, dental insurance and working days per week. A cross-sectional study was conducted among 1,017 IT professionals to assess the self-reported obstacles to regular oral health care in Hyderabad city, Telangana, India. The Dental Rejection of Innovation Scale (DRI-S) was employed in this study. Comparison between means of DRI-S based on variables was done using t-test and ANOVA. The association between variables and DRI-S was determined using Chi-square test. A total of 1017 participants comprising of 574 (56%) males and 443 (44%) females participated in the study. As age increased, a significant increase in mean DRI-S scores was seen for total and individual domains except for the "Situational" domain wherein higher mean score (9.42±2.5; p=0.0006) was observed among 30-39 years age group. Even though females reported higher mean scores for total and individual domains when compared to males, nevertheless significant difference was seen only for total (p=0.03) and "Lack of Knowledge" (p=0.001) domain. Self-reported obstacles to regular dental care was more with increasing age, increased number of working days per week, irregular dental visits and absence of dental insurance facility.

  2. Quality of Health Insurance Coverage and Access to Care for Children in Low-Income Families.

    PubMed

    Kreider, Amanda R; French, Benjamin; Aysola, Jaya; Saloner, Brendan; Noonan, Kathleen G; Rubin, David M

    2016-01-01

    An increasing diversity of children's health coverage options under the US Patient Protection and Affordable Care Act, together with uncertainty regarding reauthorization of the Children's Health Insurance Program (CHIP) beyond 2017, merits renewed attention on the quality of these options for children. To compare health care access, quality, and cost outcomes by insurance type (Medicaid, CHIP, private, and uninsured) for children in households with low to moderate incomes. A repeated cross-sectional analysis was conducted using data from the 2003, 2007, and 2011-2012 US National Surveys of Children's Health, comprising 80,655 children 17 years or younger, weighted to 67 million children nationally, with household incomes between 100% and 300% of the federal poverty level. Multivariable logistic regression models compared caregiver-reported outcomes across insurance types. Analysis was conducted between July 14, 2014, and May 6, 2015. Insurance type was ascertained using a caregiver-reported measure of insurance status and each household's poverty status (percentage of the federal poverty level). Caregiver-reported outcomes related to access to primary and specialty care, unmet needs, out-of-pocket costs, care coordination, and satisfaction with care. Among the 80,655 children, 51,123 (57.3%) had private insurance, 11,853 (13.6%) had Medicaid, 9554 (18.4%) had CHIP, and 8125 (10.8%) were uninsured. In a multivariable logistic regression model (with results reported as adjusted probabilities [95% CIs]), children insured by Medicaid and CHIP were significantly more likely to receive a preventive medical (Medicaid, 88% [86%-89%]; P < .01; CHIP, 88% [87%-89%]; P < .01) and dental (Medicaid, 80% [78%-81%]; P < .01; CHIP, 77% [76%-79%]; P < .01) visits than were privately insured children (medical, 83% [82%-84%]; dental, 73% [72%-74%]). Children with all insurance types experienced challenges in access to specialty care, with caregivers of children

  3. The practical oral care video--evaluation of a dental awareness month initiative.

    PubMed

    Chalmers, J M; Robinson, J; Nankivell, N

    2005-06-01

    A collaborative effort for the Australian Dental Association's Dental Awareness Month in 2002 included the production of 'Practical Oral Care - a video for residential care staff'. This evaluation of the project aimed to profile the video purchasers, evaluate the usefulness and appropriateness of the video and accompanying booklet using a mailed questionnaire, and elicit appropriate and practical themes for future geriatric oral health promotion and research. A national mail-out of evaluation questionnaires was undertaken to all purchasers of the video. Of the 792 purchasers at the time of the project, 294 questionnaires were returned with 83.7 per cent from residential aged care facilities, 12.6 per cent from dental professionals and 3.7 per cent from health educators. The great majority of purchasers agreed or strongly agreed that the booklet was practical and useful, video was the best format, video length was appropriate, content was realistic, the video assisted staff to identify residents at risk for dental problems and better meet their oral care needs, and improved awareness about oral care issues. Analysis of purchasers' comments highlighted the need for the production of videos on more specific practical oral care issues with behaviourally difficult residents and residents with dementia, to be supplemented with a self-directed learning package. The Practical Oral Care video was a successful national collaborative geriatric oral health promotion initiative and provided the opportunity to increase awareness about oral care issues in residential care.

  4. Medicaid dental coverage alone may not lower rates of dental emergency department visits.

    PubMed

    Fingar, Kathryn R; Smith, Mark W; Davies, Sheryl; McDonald, Kathryn M; Stocks, Carol; Raven, Maria C

    2015-08-01

    Medicaid was expanded to millions of individuals under the Affordable Care Act, but many states do not provide dental coverage for adults under their Medicaid programs. In the absence of dental coverage, patients may resort to costly emergency department (ED) visits for dental conditions. Medicaid coverage of dental benefits could help ease the burden on the ED, but ED use for dental conditions might remain a problem in areas with a scarcity of dentists. We examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. Higher density of dental providers was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. County-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for. Providing dental coverage alone might not reduce Medicaid-funded dental ED visits if patients do not have access to dental providers. Project HOPE—The People-to-People Health Foundation, Inc.

  5. Health Insurance Coverage and Access to Care Among US-Born and Foreign-Born Sexual Minorities.

    PubMed

    Gonzales, Gilbert; Dedania, Reema; Driscoll, Ryan

    2018-06-26

    Sexual minorities and immigrants face unique challenges to accessing health care in the United States. This study used data on nonelderly adults (n = 100,667) from the 2013-2016 National Health Interview Survey. Unadjusted prevalence estimates and multivariable logistic regression models (with and without interactions between immigration and sexual minority status) were used to compare health insurance coverage and access to care by immigration and sexual minority status. We did not find any differences in uninsurance, having a usual source of care, and a recent office visit by sexual orientation for US-born and foreign-born adults. However, compared to their heterosexual counterparts, US-born and foreign-born sexual minorities were more likely to have an emergency room visit in the prior year and report financial-related barriers to medical care, dental care, prescription medications, and mental health care. Foreign-born sexual minorities were more likely to have an emergency room visit and unmet mental health care needs due to cost compared to other subpopulations after controlling for sociodemographic characteristics. Broadening the knowledge and scope of research on sexual minority immigrants can inform targeted health policy approaches with the goal of achieving health equity for sexual minority immigrants.

  6. Travelling for teeth: characteristics and perspectives of dental care tourism in Hungary.

    PubMed

    Osterle, A; Balázs, P; Delgado, J

    2009-04-25

    Despite quite lively debates about dental care tourism, scientific studies into the size and the characteristics of the phenomenon remain widely lacking. The present study is the first to measure the phenomenon in one of the most prominent destination countries, Hungary, with a particular focus on the Western Hungarian region and the capital Budapest. A questionnaire has been sent to dentists in these regions. The response rate is 25.3% in Western Hungary and 20.7% in Budapest. According to the survey, patients from neighbouring countries dominate dental care tourism in the border regions of Western Hungary, while Budapest attracts more patients from countries further away. In terms of motivation, dentists regard relative price levels but also service considerations as being of major importance for patients coming to Hungary for dental care. The study confirms Hungary as a centre for dental care tourism, attracting patients from bordering countries but also patients travelling longer distances. Price levels have been a major factor making Hungary an international treatment destination. With price differences narrowing down, broader service quality is increasingly emphasised as a selling strategy.

  7. Periodontal Health, Perceived Oral Health and Dental Care Utilization of Breast Cancer Survivors

    PubMed Central

    Taichman, L. Susan; Griggs, Jennifer J.; Inglehart, Marita R.

    2015-01-01

    OBJECTIVES This population-based analysis examined the prevalence of periodontal diseases along with the self-perceived oral health and patterns of dental care utilization of breast cancer survivors in the U.S. METHODS Data from the 1999–2004 NHANES were utilized, examining information from 3,354 women between 50–85 years of age. Primary outcomes were gingivitis and periodontitis, self-perceived oral health and dental care utilization. Logistic regression analyses were used to estimate relationships of breast cancer diagnosis and primary outcomes, while controlling for confounding factors. RESULTS Breast cancer survivors were more likely to be older than 55 years, white, non-smokers, have higher levels of education and income and a higher prevalence of osteoporosis. Breast cancer survivors were significantly less likely to have dental insurance (p=0.04). Utilization of dental services and reason for last dental visit did not significantly differ between groups. A history of a breast cancer diagnosis did not increase the odds of gingivitis (OR=1.32; 95% CI: 0.53–3.63), periodontitis (OR=1.82; 95% CI = 0.89–4.01) or poor self-perceived oral health (OR=0.89; 95% CI: 0.61–1.33) after adjusting for age, race, education, dental care utilization, and smoking status. CONCLUSIONS In this sample, a history of breast cancer does not significantly impact periodontal health, self-perceived oral health and dental care utilization. However, efforts should be made to assure that breast cancer survivors have dental insurance. PMID:25648337

  8. Utilization of Hospital Emergency Departments for non-traumatic dental care in New Hampshire, 2001-2008.

    PubMed

    Anderson, Ludmila; Cherala, Sai; Traore, Elizabeth; Martin, Nancy R

    2011-08-01

    Hospital Emergency Departments (ED) provide a variety of medical care, some of which is for non-urgent, chronic conditions. We describe the statewide use of hospital ED for selected non-traumatic dental conditions that occurred during 2001-2008 in New Hampshire. Using the administrative hospital discharge dataset for 2001-2007, and provisional 2008 data, we identified all visits for selected dental conditions and calculated age-adjusted rates per 10,000 New Hampshire residents by several socio-demographic characteristics. The Spearman correlation coefficient was used to assess the statistical significance for trend over time. Emergency department visits for non-traumatic dental conditions increased significantly from 11,067 in 2001 to 16,238 visits in 2007 (P < 0.007). There were persistent differences in ED visits by age, county and primary payor, and varying difference by gender. Self-paying individuals and those 15-44 years old were the most frequent ED dental care users. The most frequent dental complains (46%) were diseases of the teeth and supporting structures, diagnostic code ICD-9-CM-525. Dental care associated ED visits have increased in New Hampshire. Individuals seeking dental treatment in ED are not receiving definitive treatment, and they misuse limited resources. Future studies need to determine the specific barriers to timely and effective dental care in dental offices. Ongoing consistent monitoring of ED use for non-traumatic dental conditions is essential.

  9. Pediatric Dental Care: Prevention and Management Protocols Based on Caries Risk Assessment

    PubMed Central

    RAMOS-GOMEZ, FRANCISCO J.; CRYSTAL, YASMI O.; NG, MAN WAI; CRALL, JAMES J.; FEATHERSTONE, JOHN D.B.

    2012-01-01

    Recent increases in caries prevalence in young children, especially among minorities and the economically disadvantaged, highlight the need for early establishment of dental homes and simple, effective infant oral care preventive programs for all children as part of a medical disease prevention management model.1–3 This article presents an updated approach and practical tools for pediatric dental caries management by risk assessment, CAMBRA, in an effort to stimulate greater adoption of infant oral care programs among clinicians and early establishment of dental homes for young children. PMID:21162350

  10. [Improving the physician-dental surgeon relationship to improve patient care].

    PubMed

    Tenenbaum, Annabelle; Folliguet, Marysette; Berdougo, Brice; Hervé, Christian; Moutel, Grégoire

    2008-04-01

    This study had two aims: to assess the nature of the relationship between general practitioners (GPs) and dental surgeons in relation to patient care and to evaluate qualitatively their interest in the changes that health networks and shared patient medical files could bring. Questionnaires were completed by 12 GPs belonging to ASDES, a private practitioner-hospital health network that seeks to promote a partnership between physicians and dental surgeons, and by 13 private dental surgeons in the network catchment area. The GPs and dentists had quite different perceptions of their relationship. Most dentists rated their relationship with GPs as "good" to "excellent" and did not wish to modify it, while GPs rated their relationship with dentists as nonexistent and expressed a desire to change the situation. Some GPs and some dentists supported data exchange by sharing personal medical files through the network. Many obstacles hinder communication between GPs and dentists. There is insufficient coordination between professionals. Health professionals must be made aware of how changes in the health care system (health networks, personal medical files, etc) can help to provide patients with optimal care. Technical innovations in medicine will not be beneficial to patients unless medical education and training begins to include interdisciplinary and holistic approaches to health care and preventive care.

  11. A political economic theory of the dental care market.

    PubMed Central

    Lipscomb, J; Douglass, C W

    1982-01-01

    A theory of the dental care market is introduced which proposes that the vertically integrated (local/state/national) structure of the profession services as an organizational vehicle both for intra-professional debate and for developing provider-oriented dental care policy. We suggest that a special relationship exists between professionalism and professional regulation. Such regulation has functioned simultaneously to limit competition and to foster a prized consumption commodity for providers: professionalism and professional esteem. The organized pursuit of this commodity inherently dampens competition. Professionalism itself plays a crucial role in: 1) securing for organized dentistry a form of state regulation in which the providers themselves are the principal decision-makers; and 2) influencing provider and consumer market behavior in several significant respects, the net result being the formation of maintenance of a type of "leadership cartel" in the local market. Thus, a political-economic theory of the dental care market formally acknowledges professionalism as valued by established dentists and recent graduates as a central determining influence. Traditional models of pure competition and monopoly emerge as special, extreme cases of the general theory. Hypotheses are offered regarding consumer and provider behavior, market dynamics, and health policy and regulation. PMID:7091455

  12. Travel burden and dentist bypass among dentally insured children.

    PubMed

    McKernan, Susan C; Pooley, Mark J; Momany, Elizabeth T; Kuthy, Raymond A

    2016-06-01

    Using administrative data from Iowa Medicaid and a large private dental insurer, we compared distance to the nearest primary care dentist for children ages 6-15 in 2012. Additionally, we examined rates of provider bypass in both populations as an indicator of spatial accessibility to dental care. We calculated measures of travel burden, including distance to the nearest primary care dentist and distance to current primary care dentist. Distance outcomes and rates of bypass, traveling beyond the nearest dentist for care, were compared by insurance type. We found that Medicaid-enrolled children lived farther from the nearest dentist and farther from their current dentist than privately insured children. However, rates of bypass were higher among the privately insured population. These results were consistent among urban and rural residents; additionally, both rural populations demonstrated greater travel distances than urban dwellers. Travel burden was greater among Medicaid-enrolled children. Lower rates of bypass, in conjunction with lower rates of dental utilization in this population, may indicate a distance threshold beyond which dental care becomes unattainable. © 2016 American Association of Public Health Dentistry.

  13. Improvements in dental care using a new mobile app with cloud services.

    PubMed

    Lin, Chia-Yung; Peng, Kang-Lin; Chen, Ji; Tsai, Jui-Yuan; Tseng, Yu-Chee; Yang, Jhih-Ren; Chen, Min-Huey

    2014-10-01

    Traditional dental care, which includes long-term oral hygiene maintenance and scheduled dental appointments, requires effective communication between dentists and patients. In this study, a new system was designed to provide a platform for direct communication between dentists and patients. A new mobile app, Dental Calendar, combined with cloud services specific for dental care was created by a team constituted by dentists, computer scientists, and service scientists. This new system would remind patients about every scheduled appointment, and help them take pictures of their own oral cavity parts that require dental treatment and send them to dentists along with a symptom description. Dentists, by contrast, could confirm or change appointments easily and provide professional advice to their patients immediately. In this study, 26 dentists and 32 patients were evaluated by a questionnaire containing eight dental-service items before and after using this system. Paired sample t test was used for statistical analysis. After using the Dental Calendar combined with cloud services, dentists were able to improve appointment arrangements significantly, taking care of the patients with sudden worse prosthesis (p < 0.05). Patients also achieved significant improvement in appointment reminder systems, rearrangement of appointments in case of sudden worse prosthesis, and establishment of a direct relationship with dentists (p < 0.05). Our new mobile app, Dental Calendar, in combination with cloud services, provides efficient service to both dentists and patients, and helps establish a better relationship between them. It also helps dentists to arrange appointments for patients with sudden worsening of prosthesis function. Copyright © 2014. Published by Elsevier B.V.

  14. Disparities in access to care and satisfaction among U.S. children: the roles of race/ethnicity and poverty status.

    PubMed

    Shi, Leiyu; Stevens, Gregory D

    2005-01-01

    The study assessed the progress made toward reducing racial and ethnic disparities in access to health care among U.S. children between 1996 and 2000. Data are from the Household Component of the 1996 and 2000 Medical Expenditure Panel Survey. Bivariate associations of combinations of race/ethnicity and poverty status groups were examined with four measures of access to health care and a single measure of satisfaction. Logistic regression was used to examine the association of race/ethnicity with access, controlling for sociodemographic factors associated with access to care. To highlight the role of income, we present models with and without controlling for poverty status. Racial and ethnic minority children experience significant deficits in accessing medical care compared with whites. Asians, Hispanics, and blacks were less likely than whites to have a usual source of care, health professional or doctor visit, and dental visit in the past year. Asians were more likely than whites to be dissatisfied with the quality of medical care in 2000 (but not 1996), while blacks and Hispanics were more likely than whites to be dissatisfied with the quality of medical care in 1996 (but not in 2000). Both before and after controlling for health insurance coverage, poverty status, health status, and several other factors associated with access to care, these disparities in access to care persisted between 1996 and 2000. Continued monitoring of racial and ethnic differences is necessary in light of the persistence of racial/ethnic and socioeconomic disparities in access to care. Given national goals to achieve equity in health care and eliminate racial/ ethnic disparities in health, greater attention needs to be paid to the interplay of race/ethnicity factors and poverty status in influencing access.

  15. Implications of the growth of dental education in India.

    PubMed

    Mahal, Ajay S; Shah, Naseem

    2006-08-01

    By influencing the supply of trained human resources, the dental education sector can play a significant role in influencing policy goals of ensuring good quality and equitable access to oral health services in developing countries. Our research goal was to assess quantitatively the size of the Indian dental education sector, its growth over time, and the implications of this growth for equity and quality in oral health care. Information on the location of teaching institutions, the year of establishment, type of ownership, and seat capacity was obtained from government sources, the Dental Council of India, and websites of individual institutions to estimate the growth in the undergraduate dental education sector, including the role of the private sector from 1950 to 2005. Data on location of training capacity and institutions were used to assess the geographical distribution of undergraduate dental education capacity in India. Registration data on dentists, the size of available faculty relative to regulatory requirements, and penalties imposed on offending faculty and education institutions were used to assess the impact of the growing Indian dental education sector on graduate quality and equitable access. Dental colleges and enrollment capacity have grown rapidly over the five decades since 1950, mainly due to a growing private sector. There is regional inequality in the location of dental education schools in India with a bias toward economically better-off regions. The growth in the dental education sector has translated into increased overall access, although accompanied by rising inequality in access and possibly lower quality of dental education.

  16. A Cognitive Behavioural Intervention for Dental Anxiety for People with Learning Disabilities: A Case Study

    ERIC Educational Resources Information Center

    Prangnell, Simon J.; Green, Karen

    2008-01-01

    Dental anxiety is a common form of anxiety problem, and research suggests that more people with learning disabilities experience dental anxiety than in the general population. Very little work has been done to investigate effective non-medical approaches for supporting people with a learning disability and dental anxiety to access dental care.…

  17. Comprehensive dental services for an underserved and medically compromised population provided through a community partnership and service learning.

    PubMed

    Chávez, Elisa M; LaBarre, Eugene; Fredekind, Richard; Isakson, Paul

    2010-01-01

    The University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco established a comprehensive dental care program at Laguna Honda Hospital, a public, skilled nursing facility. The program had three goals: (1) to provide dental students and residents an opportunity to provide oral health care for adults who were frail and medically compromised who could not come into the clinics, (2) to increase students' access to patients who needed removable prosthodontics, and (3) to fulfill Pacific's commitment to public service. Laguna Honda and Pacific pooled their resources to bring comprehensive dental care to patients who were not able to access the dental school clinics. The long-term goals are to restore and maintain the oral health of those who reside in the facility, and to educate future dentists to provide oral health care for similar populations.

  18. [The impact on costs and care of two approaches to reduce employees' dental plan expenses in a private company].

    PubMed

    Costa Filho, Luiz Cesar da; Duncan, Bruce Bartholow; Polanczyk, Carisi Anne; Sória, Marina Lara; Habekost, Ana Paula; Costa, Carolina Covolo da

    2008-05-01

    The present study evaluated the dental care plan offered to 4,000 employees of a private hospital and their respective families. The analysis covered three stages: (1) baseline (control), when dental care was provided by an outsourced company with a network of dentists paid for services, (2) a renegotiation of costs with the original dental care provider, and (3) provision of dental care by the hospital itself, through directly hired dentists on regular salaries. Monthly economic and clinical data were collected for this research. The dental plan renegotiation reduced costs by 37% in relation to baseline, and the hospital's own dental service reduced costs by 50%. Renegotiation led to a 31% reduction in clinical procedures, without altering the dental care profile; the hospital's own dental service did not reduce the total number of clinical procedures, but modified the profile of dental care, since procedures related to the causes of diseases increased and surgical/restorative procedures decreased.

  19. Non-dental primary care providers' views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study.

    PubMed

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-10-29

    To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Qualitative study with semistructured interviews and thematic analysis. Four remote communities in outback Queensland, Australia. 35 primary care providers who had experience in providing oral health advice to patients and four dental care providers who had provided oral health services to patients from the four communities. In the absence of a resident dentist, rural and remote residents did present to non-dental primary care providers with oral health problems such as toothache, abscess, oral/gum infection and sore mouth for treatment and advice. Themes emerged from the interview data around communication challenges and strategies to improve oral health. Although, non-dental care providers commonly advised patients to see a dentist, they rarely communicated with the dentist in the nearest regional town. Participants proposed that oral health could be improved by: enabling access to dental practitioners, educating communities on preventive oral healthcare, and building the skills and knowledge base of non-dental primary care providers in the field of oral health. Prevention is a cornerstone to better oral health in rural and remote communities as well as in more urbanised communities. Strategies to improve the provision of dental services by either visiting or resident dental practitioners should include scope to provide community-based oral health promotion activities, and to engage more closely with other primary care service providers in these small communities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Periodontal health, perceived oral health, and dental care utilization of breast cancer survivors.

    PubMed

    Taichman, L Susan; Griggs, Jennifer J; Inglehart, Marita R

    2015-01-01

    This population-based analysis examined the prevalence of periodontal diseases along with the self-perceived oral health and patterns of dental care utilization of breast cancer survivors in the United States. Data from the 1999-2004 National Health and Nutrition Surveys were utilized, examining information from 3,354 women between 50 and 85 years of age. Primary outcomes were gingivitis and periodontitis, self-perceived oral health, and dental care utilization. Logistic regression analyses were used to estimate relationships of breast cancer diagnosis and primary outcomes while controlling for confounding factors. Breast cancer survivors were more likely to be older than 55 years, white, nonsmokers, have higher levels of education and income, and a higher prevalence of osteoporosis. Breast cancer survivors were significantly less likely to have dental insurance (P = 0.04). Utilization of dental services and reason for last dental visit did not significantly differ between groups. A history of a breast cancer diagnosis did not increase the odds of gingivitis [odds ratio (OR):  1.32; 95 percent confidence interval (CI): 0.53-3.63], periodontitis (OR: 1.82; 95 percent CI:  0.89-4.01), or poor self-perceived oral health (OR: 0.89; 95 percent CI: 0.61-1.33) after adjusting for age, race, education, dental care utilization, and smoking status. In this sample, a history of breast cancer does not significantly impact periodontal health, self-perceived oral health, and dental care utilization. However, efforts should be made to assure that breast cancer survivors have dental insurance. © 2015 American Association of Public Health Dentistry.

  1. Dental and Oral Problem Patterns and Treatment Seeking Behavior of Geriatric Population

    PubMed Central

    AlZarea, Bader K.

    2017-01-01

    Background: The manifestations of oral changes and disorders affecting the geriatric population are different from the rest of the population. Inaccessibility to dental care is a compelling impediment to avail oral health services. Objective: The aims were to assess the dental and oral problems and to find out the determinants of oral health seeking behaviour among elderly population of Al-Jouf province, Saudi Arabia. Methods: The present cross sectional study included geriatric patients of 60 years and above, who visited the College of Dentistry, Al-Jouf University. A simple pre-structured questionnaire was filled by the patients, which comprised of demographic details and the different oral complaints of elderly and the type of health care utilized for those complaints. Results: Out of total 892 elderly persons included, 51.79% were males and 48.21 were females. The most common oral problem was missing tooth (78.69%) followed by gum problems (74.21%). 39.5% males and 28.0% females visited general dental practitioners for oral health care. Majority of the participants (32.8%) suggested accessibility as a basic factor in determining the health care source. The difference in the distribution of male and females or association between the type of care and gender and distribution for choosing a health care source was found to be statistically significant (p < 0.05). Conclusion: Inaccessibility to dental care emerged as an important barrier to avail oral health services. Adequate access to medical and dental care can reduce premature morbidity and mortality, preserve function, and enhance overall quality of life. PMID:28553412

  2. Evaluating the Impact of Dental Care on Housing Intervention Program Outcomes Among Homeless Veterans

    PubMed Central

    Nunez, Elizabeth; Gibson, Gretchen; Jones, Judith A.; Schinka, John A.

    2013-01-01

    Objectives. In this retrospective longitudinal cohort study, we examined the impact of dental care on outcomes among homeless veterans discharged from a Department of Veterans Affairs (VA) transitional housing intervention program. Methods. Our sample consisted of 9870 veterans who were admitted into a VA homeless intervention program during 2008 and 2009, 4482 of whom received dental care during treatment and 5388 of whom did not. Primary outcomes of interest were program completion, employment or stable financial status on discharge, and transition to permanent housing. We calculated descriptive statistics and compared the 2 study groups with respect to demographic characteristics, medical and psychiatric history (including alcohol and substance use), work and financial support, and treatment outcomes. Results. Veterans who received dental care were 30% more likely than those who did not to complete the program, 14% more likely to be employed or financially stable, and 15% more likely to have obtained residential housing. Conclusions. Provision of dental care has a substantial positive impact on outcomes among homeless veterans participating in housing intervention programs. This suggests that homeless programs need to weigh the benefits and cost of dental care in program planning and implementation. PMID:23678921

  3. Disparities in Health Care Access and Receipt of Preventive Services by Disability Type: Analysis of the Medical Expenditure Panel Survey

    PubMed Central

    Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M

    2014-01-01

    Objective To examine differences in access to health care and receipt of clinical preventive services by type of disability among working-age adults with disabilities. Data Source Secondary analysis of Medical Expenditure Panel Survey (MEPS) data from 2002 to 2008. Study Design We conducted cross-sectional logistic regression analyses comparing people with different types of disabilities on health insurance status and type; presence of a usual source of health care; delayed or forgone care; and receipt of dental checkups and cancer screening. Data Collection We pooled annualized MEPS data files across years. Our analytic sample consisted of adults (18–64 years) with physical, sensory, or cognitive disabilities and nonmissing data for all variables of interest. Principal Findings Individuals with hearing impairment had better health care access and receipt than people with other disability types. People with multiple types of limitations were especially likely to have health care access problems and unmet health care needs. Conclusions There are differences in health care access and receipt of preventive care depending on what type of disability people have. More in-depth research is needed to identify specific causes of these disparities and assess interventions to address health care barriers for particular disability groups. PMID:24962662

  4. The relationship between body system-based chronic conditions and dental utilization for Medicaid-enrolled children: a retrospective cohort study.

    PubMed

    Chi, Donald L; Raklios, Nicholas A

    2012-08-07

    Dental care is the most common unmet health care need for children with chronic conditions. However, anecdotal evidence suggests that not all children with chronic conditions encounter difficulties accessing dental care. The goals of this study are to evaluate dental care use for Medicaid-enrolled children with chronic conditions and to identify the subgroups of children with chronic conditions that are the least likely to use dental care services. This study focused on children with chronic conditions ages 3-14 enrolled in the Iowa Medicaid Program in 2005 and 2006. The independent variables were whether a child had each of the following 10 body system-based chronic conditions (no/yes): hematologic; cardiovascular; craniofacial; diabetes; endocrine; digestive; ear/nose/throat; respiratory; catastrophic neurological; or musculoskeletal. The primary outcome measure was use of any dental care in 2006. Secondary outcomes, also measured in 2006, were use of diagnostic dental care, preventive dental care, routine restorative dental care, and complex restorative dental care. We used Poisson regression models to estimate the relative risk (RR) associated with each of the five outcome measures across the 10 chronic conditions. Across the 10 chronic condition subgroups, unadjusted dental utilization rates ranged from 44.3% (children with catastrophic neurological conditions) to 60.2% (children with musculoskeletal conditions). After adjusting for model covariates, children with catastrophic neurological conditions were significantly less likely to use most types of dental care (RR: 0.48 to 0.73). When there were differences, children with endocrine or craniofacial conditions were less likely to use dental care whereas children with hematologic or digestive conditions were more likely to use dental care. Children with respiratory, musculoskeletal, or ear/nose/throat conditions were more likely to use most types of dental care compared to other children with chronic

  5. OI Issues: Dental Care for Persons with OI

    MedlinePlus

    ... Better Bones Upcoming Events Online Store OI Issues: Dental Care for Persons with OI Introduction Osteogenesis imperfecta ( ... jaws and may or may not affect the teeth. About half of the people who have OI ...

  6. Oral Health: Brush Up on Dental Care Basics

    MedlinePlus

    ... Mayo Clinic Staff Your smile depends on simple dental care habits, such as brushing and flossing. But ... your oral health. Oral health begins with clean teeth. Keeping the area where your teeth meet your ...

  7. Insurance + Access ≠ Health Care: Typology of Barriers to Health Care Access for Low-Income Families

    PubMed Central

    DeVoe, Jennifer E.; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A.

    2007-01-01

    PURPOSE Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. METHODS A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, “Is there anything else you would like to tell us?” Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. RESULTS Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. CONCLUSIONS Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere. PMID:18025488

  8. A Care Pathway for Children Unable to Accept Dental Care Within the General Dental Services Involving the Use of Inhalation Sedation and General Anaesthesia.

    PubMed

    Shepherd, Allyson R; Ali, Halimah

    2015-05-01

    Dental treatment is the commonest reason for a child to be in hospital in the UK. This is a shocking statistic for a preventable disease. How can we reduce the high numbers of dental general anaesthetics? It is essential that dental treatment under general anaesthesia (GA) is fully justifiable, ensuring that the right patients receive the right treatment. Guidance for general dental practitioners on when to refer a child for a dental GA is discussed. Treatment planning for this dentally high-risk group of children requires a holistic approach. It is complex and requires an experienced and competent clinical team, including dental care professionals with additional postgraduate qualifications. Often, alternative treatments are successful and a GA can be avoided. An audit of 85 patients referred for GA with Oldham Community Dental Service demonstrated 35% of patients accepted treatment with local anaesthesia only, 25% required inhalation sedation and only 25% were actually referred on for GA. Treatment for this group of patients must include the availability and provision of appropriate alternative treatment modalities, with the right staff and facilities, including those for dental general anaesthetic sessions. Ongoing follow-up within the general dental services is essential for this group of patients.

  9. Integrating Social Determinants of Health into Dental Curricula: An Interprofessional Approach.

    PubMed

    Sabato, Emily; Owens, Jessica; Mauro, Ann Marie; Findley, Patricia; Lamba, Sangeeta; Fenesy, Kim

    2018-03-01

    Approaching patient care from a holistic perspective, incorporating not only the patient's medical and dental history but also psychosocial history, improves patient outcomes. Practitioners should be trained to provide this style of care through inclusive education, including training working on interprofessional teams. A component of this education must incorporate social determinants of health into the treatment plan. Social determinants of health include income, race/ethnicity, education level, work opportunities, living conditions, and access to health care. Education regarding social determinants of health should be woven throughout dental curricula, including hands-on application opportunities. This education must extend to patient care situations rather than be limited to didactic settings. This article explains the need to incorporate social determinants of health into dental education and illustrates how social determinants education is being addressed in two U.S. dental schools' curricula, including how to weave social determinants of health into interprofessional education. These descriptions may serve as a model for curricular innovation and faculty development across the dental education community.

  10. Serious psychological distress as a barrier to dental care in community-dwelling adults in the United States.

    PubMed

    Xiang, Xiaoling; Lee, Wonik; Kang, Sung-wan

    2015-01-01

    To examine whether serious psychological distress (SPD), a nonspecific indicator of past year mental health problems, was associated with subsequent dental care utilization, dental expenditures, and unmet dental needs. We analyzed data from panel 13 thru 15 of the Medical Expenditure Panel Survey -Household Component (n=31,056). SPD was defined as a score of 13 or higher on the Kessler Psychological Distress Scale (K6). Logistic regression, zero-inflated negative binomial model, and generalized linear model (GLM) with a gamma distribution were used to test the study hypotheses. Adults with SPD had, in the subsequent year, 35 percent lower odds of adhering to annual dental checkups and a twofold increase in the odds of having unmet dental needs. Although adults with SPD did not have significantly more dental visits than those without SPD, they spent 20 percent more on dental care. SPD was a modest independent risk factor for lack of subsequent preventive dental care, greater unmet dental needs, and greater dental expenditures. In addition to expanding adult dental coverage, it is important to develop and evaluate interventions to increase the utilization of dental care particularly preventive dental services among people with mental illness in order to improve oral health and reduce dental expenditures among this vulnerable population. © 2014 American Association of Public Health Dentistry.

  11. Honoring Dental Patients' Privacy Rule Right of Access in the Context of Electronic Health Records.

    PubMed

    Ramoni, Rachel B; Asher, Sheetal R; White, Joel M; Vaderhobli, Ram; Ogunbodede, Eyitope O; Walji, Muhammad F; Riedy, Christine; Kalenderian, Elsbeth

    2016-06-01

    A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this study was to understand how academic dental institutions execute the Privacy Rule's right of access in the context of electronic health records (EHRs). A validated electronic survey was distributed to the clinical deans of 62 U.S. dental schools during a two-month period in 2014. The response rate to the survey was 53.2% (N=33). However, three surveys were partially completed, and of the 30 completed surveys, the 24 respondents who reported using axiUm as the EHR at their dental school clinic were the ones on which the results were based (38.7% of total schools at the time). Of the responses analyzed, 86% agreed that clinical modules should be considered part of a patient's dental record, and all agreed that student teaching-related modules should not. Great variability existed among these clinical deans as to whether administrative and financial modules should be considered part of a patient record. When patients request their records, close to 50% of responding schools provide the information exclusively on paper. This study found variation among dental schools in their implementation of the Privacy Rule right of access, and although all the respondents had adopted EHRs, a large number return records in paper format.

  12. Rights of dental patients in the EU - a legal assessment.

    PubMed

    Van den Bossche, Anne-Marie; Ploscar, Paula

    2012-11-30

    This contribution presents the legal framework for intra-European mobility of dental patients. After presenting the EU competences in respect of healthcare and a brief look into the various routes of patient mobility, the article sets out the rules for access to dental care, treatment abroad and reimbursement through social security. In addition, we focus on the impact of European Union (EU) law upon national systems in respect of professional insurance, complaints procedures and information mechanisms. In conclusion, we reflect on the development in EU law of an independent set of rights to cross-border dental care and its consequences for financing and reimbursement of care, as well as for national practices in respect of professional liability and insurance.

  13. Predictors of utilisation of dental care services in a nationally representative sample of adults.

    PubMed

    Guiney, H; Woods, N; Whelton, H; Morgan, K

    2011-12-01

    The objective of this study was to identify the predictors of utilisation of dental care services in Ireland. The 2007 Irish Survey of Lifestyle, Attitudes and Nutrition is a cross-sectional study, conducted in 2006/2007 (n = 10,364), by interviews at home to a representative sample of adults aged 18 years or over. Multivariate logistic regression was used to investigate the influence of socioeconomic, predisposing and enabling factors on the odds of males and females having a dental visit in the past year. The significant predictors of visiting the dentist in the past year were for males: having 3rd level education, employment status, earning 50,000 euros or more, location of residence, use of a car, brushing frequently, and dentition status. For females, the predictors were being between 25-34 or 55-64 years-old, education level, earning 50,000 euros or more, location of residence, use of a car, brushing frequently and dentition status. Predictors of the use of dental services vary by gender. Predictors common to both genders were education level, higher income, location of residence, use of a car, brushing frequently and dentition status. Many of the predictors of dental visiting in the past year are also related to social inequalities in health. These predictors may be useful markers of impact for policies designed to address inequalities in access to oral health services.

  14. Annual Report on Children's Health Care: Dental and Orthodontic Utilization and Expenditures for Children, 2010-2012.

    PubMed

    Berdahl, Terceira; Hudson, Julie; Simpson, Lisa; McCormick, Marie C

    2016-01-01

    To examine general dental and orthodontic utilization and expenditures by health insurance status, public health insurance eligibility, and sociodemographic characteristics among children aged 0 to 17 years using data from 2010-2012. Nationally representative data from the Medical Expenditure Panel Survey (2010-2012) provided data on insurance status, public health insurance eligibility, and visits to dental providers for both general dental care and orthodontic care. Overall, 41.9% of US children reported an annual dental office-based visit for general (nonorthodontic) dental care. Fewer Hispanic (34.7%) and non-Latino black children (34.8%) received dental care compared to non-Hispanic whites (47.3%) and Asians (40.3%). Children living in families with the lowest income were also the least likely to have a visit (32.9%) compared to children in the highest-income families (54.7%). Among children eligible for public coverage, Medicaid-eligible children had the lowest percentage of preventive dental visits (29.2%). Socioeconomic and racial/ethnic disparities in use and expenditures for orthodontic care are much greater than those for general and preventive dental care. Average expenditures for orthodontic care were $1,823, of which 56% ($1,023) was paid out of pocket by families. Our findings provide a baseline assessment for examining trends in the future, especially as coverage patterns for children may change as the Affordable Care Act is implemented and the future of the State Child Health Insurance Program remains uncertain beyond 2017. Published by Elsevier Inc.

  15. Should Dental Schools Train Dentists to Routinely Provide Limited Preventive Primary Medical Care? Two Viewpoints: Viewpoint 1: Dentists Should Be Trained to Routinely Provide Limited Preventive Primary Care and Viewpoint 2: Dentists Should Be Trained in Primary Care Medicine to Enable Comprehensive Patient Management Within Their Scope of Practice.

    PubMed

    Giddon, Donald B; Donoff, R Bruce; Edwards, Paul C; Goldblatt, Lawrence I

    2017-05-01

    This Point/Counterpoint acknowledges the transformation of dental practice from a predominantly technically based profession with primary emphasis on restoration of the tooth and its supporting structures to that of a more medically based specialty focusing on the oral and maxillofacial complex. While both viewpoints accept the importance of this transformation, they differ on the ultimate desired outcome and how changes should be implemented during training of dentists as oral health professionals. Viewpoint 1 argues that, in response to a shortage of both primary care providers and access to affordable oral health care, dentists need to be able and willing to provide limited preventive primary care (LPPC), and dental educators should develop and implement training models to prepare them. Among changes proposed are consideration of three types of practitioners: oral physicians with sufficient training to provide LPPC; dentists with excellent technical proficiency but minimal medical and surgical training; and mid-level providers to provide simple restorative and uncomplicated surgical care. Viewpoint 2 argues that the objective of dentists' education in primary care medicine is to help them safely and effectively provide all aspects of oral health care, including appropriate preventive medical care, that already fall within their scope of knowledge and practice. Dental educators should encourage students to use this knowledge to take full ownership of non-tooth-related pathologic conditions of the oral and maxillofacial complex not currently managed in the dental setting, but encouraging graduates to expand into non-dental LPPC outside the recognized scope of practice will only further exacerbate fragmentation of care.

  16. Examining Whether Dental Therapists Constitute a Disruptive Innovation in US Dentistry

    PubMed Central

    2011-01-01

    Dental therapists—midlevel dental providers who are roughly analogous to nurse practitioners in medicine—might constitute a disruptive innovation within US dentistry. Proponents tend to claim that dental therapists will provide more equitable access to dental care; opponents tend to view them from a perspective that focuses on retaining the current attributes of the dental profession. Therapists display traits similar to those of disruptive innovations: their attributes are different from dentists’, they may not initially be valued by current dental patients, they may appeal to current dental underutilizers, and they may transform the dental delivery system. Whether dental therapists constitute a disruptive innovation will only be determined retrospectively. PMID:21852623

  17. Evidence-Based Practice Knowledge, Attitude, Access and Confidence: A comparison of dental hygiene and dental students.

    PubMed

    Santiago, Victoria; Cardenas, Melissa; Charles, Anne Laure; Hernandez, Estefany; Oyoyo, Udochukwu; Kwon, So Ran

    2018-04-01

    Purpose: The purpose of this study was to evaluate whether current educational strategies at a dental institution in the United States made a difference in dental hygiene (DNHY) and dental students' (D3) learning outcomes in the four domains of evidence-based practice (EBP), knowledge, attitude, accessing evidence, and confidence (KACE), following a 12-week research design course. Methods: All participants DNHY (n=19) and D3 (n=96) enrolled in the research design course at Loma Linda University completed a paper KACE survey distributed on the first day of class. Students completed the KACE survey once more at the end of the 12-week course. Pre- and post-survey results were compared both within and between the DNHY and D3 student groups to identify the learning outcomes in the four domains of EBP; knowledge, attitude, accessing evidence, and confidence in EBP. Descriptive statistics were conducted to profile all variables in the study; the level of significance was set at α=0.05. Results: All DNHY students (n=19) completed the pre and post KACE surveys; of the D3 (n=96) students enrolled in the course 82% (n=79) competed the post-survey. Comparison of the survey results showed that both DNHY and D3 students demonstrated statistically significant increases in their level of knowledge and attitude (p < 0.05) towards EBP. In the attitude domain, DNHY students indicated more positive attitudes towards EBP (p < 0.001) than their D3 student cohorts. Neither group demonstrated significant changes in confidence in applying EBP (p > 0.05). Conclusion: DNHY and D3 students increased their knowledge and developed more positive attitudes towards EBP following a 12-week research design course. Study results identify improvement areas for EBP knowledge acquisition including determining levels of evidence, analysis of study results, and evaluating the appropriateness of research study designs through the use of validated EBP survey instrument. Copyright © 2018 The American

  18. Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting.

    PubMed

    Corrigan, Dale M; Walker, Mary P; Liu, Ying; Mitchell, Tanya Villalpando

    2014-01-01

    The purpose of this study was to identify predictors and/or factors associated with medically compromised patients seeking dental care in the oncology dental support clinic (ODSC) at the University of Missouri-Kansas City (UMKC) School of Dentistry. An 18-item survey was mailed to 2,541 patients who were new patients to the clinic from 2006 to 2011. The response rate was approximately 18% (n = 450). Analyses included descriptive statistics of percentages/frequencies as well as predictors based on correlations. Fifty percent of participants, 100 females and 119 males, identified their primary medical diagnosis as cancer. Total household income (p < .001) and the importance of receiving dental care (p < .001) were significant factors in relation to self-rated dental health. Perceived overall health (p < .001) also had a significant association with cancer status and the need for organ transplants. This study provided the ODSC at UMKC and other specialty clinics with vital information that can contribute to future planning efforts. © 2013 Special Care Dentistry Association and Wiley Periodicals, Inc.

  19. Examining dental expenditure and dental insurance accounting for probability of incurring expenses.

    PubMed

    Teusner, Dana; Smith, Valerie; Gnanamanickam, Emmanuel; Brennan, David

    2017-04-01

    There are few studies of dental service expenditure in Australia. Although dental insurance status is strongly associated with a higher probability of dental visiting, some studies indicate that there is little variation in expenditure by insurance status among those who attend for care. Our objective was to assess the overall impact of insurance on expenditures by modelling the association between insurance and expenditure accounting for variation in the probability of incurring expenses, that is dental visiting. A sample of 3000 adults (aged 30-61 years) was randomly selected from the Australian electoral roll. Dental service expenditures were collected prospectively over 2 years by client-held log books. Questionnaires collecting participant characteristics were administered at baseline, 12 months and 24 months. Unadjusted and adjusted ratios of expenditure were estimated using marginalized two-part log-skew-normal models. Such models accommodate highly skewed data and estimate effects of covariates on the overall marginal mean while accounting for the probability of incurring expenses. Baseline response was 39%; of these, 40% (n = 438) were retained over the 2-year period. Only participants providing complete data were included in the analysis (n = 378). Of these, 68.5% were insured, and 70.9% accessed dental services of which nearly all (97.7%) incurred individual dental expenses. The mean dental service expenditure for the total sample (those who did and did not attend) for dental care was AUS$788. Model-adjusted ratios of mean expenditures were higher for the insured (1.61; 95% CI 1.18, 2.20), females (1.38; 95% CI 1.06, 1.81), major city residents (1.43; 95% CI 1.10, 1.84) and those who brushed their teeth twice or more a day (1.50; 95% CI 1.15, 1.96) than their respective counterparts. Accounting for the probability of incurring dental expenses, and other explanatory factors, insured working-aged adults had (on average) approximately 60% higher individual

  20. Educational and therapeutic behavioral approaches to providing dental care for patients with Autism Spectrum Disorder.

    PubMed

    Nelson, Travis M; Sheller, Barbara; Friedman, Clive S; Bernier, Raphael

    2015-01-01

    Autism Spectrum Disorder (ASD) is a condition which most dentists will encounter in their practices. Contemporary educational and behavioral approaches may facilitate successful dental care. A literature review was conducted for relevant information on dental care for children with ASD. Educational principles used for children with ASD can be applied in the dental setting. Examples include: parent involvement in identifying strengths, sensitivities, and goal setting; using stories or video modeling in advance of the appointment; dividing dental treatment into sequential components; and modification of the environment to minimize sensory triggers. Patients with ASD are more capable of tolerating procedures that they are familiar with, and therefore should be exposed to new environments and stimuli in small incremental steps. By taking time to understand children with ASD as individuals and employing principles of learning, clinicians can provide high quality dental care for the majority of patients with ASD. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.

  1. [Efficiency of preventive dental care in school dentistry system].

    PubMed

    Avraamova, O G; Kolesnik, A G; Kulazhenko, T V; Zadapaeva, S V; Shevchenko, S S

    2014-01-01

    Ways of development of Russian school dentistry are defined and justified based on the analysis according to logistics, personnel, legal, financial and economic basis for the reorientation of the service for preventive direction, which should be a priority in the current conditions. The implemented model of school dental care based on team work of the dentist and dental hygienist proved to be highly efficient and may be recommended for wide introduction in practice.

  2. Perspectives on providing good access to dental services for elderly people: patient selection, dentists' responsibility and budget management.

    PubMed

    Grytten, Jostein; Holst, Dorthe

    2013-06-01

    To suggest a model for organizing and financing dental services for elderly people so that they have good access to services. There are few studies on how dental services for elderly people should be organized and financed. This is surprising if we take into consideration the fact that the proportion of elderly people is growing faster than any other group in the population, and that elderly people have more dental diseases and poorer access to dental services than the rest of the adult population. In several countries, dental services are characterized by private providers who often operate in a market with competition and free price-setting. Private dentists have no community responsibility, and they are free to choose which patients they treat. Literature review and critical reasoning. In order to avoid patient selection, a patient list system for elderly people is recommended, with per capita remuneration for the patients that the dentist is given responsibility for. The patient list system means that the dentist assumes responsibility for a well-defined list of elderly people. Our model will lead to greater security in the dentist/patient relationship, and patients with great treatment needs will be ensured access to dental services. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  3. Smile Alabama! Initiative: Interim Results from a Program To Increase Children's Access to Dental Care.

    ERIC Educational Resources Information Center

    Greene-McIntyre, Mary; Finch, Mary Hayes; Searcy, John

    2003-01-01

    An Alabama initiative aimed to improve access to oral health care for Medicaid-eligible children through four components: improved Medicaid claims processing, increased reimbursement for providers, outreach and educational activities to support providers, and parent and patient education about children's oral health. In the first 3 program years,…

  4. Nutritional and dental issues in patients with intellectual and developmental disabilities.

    PubMed

    Ziegler, Jane; Spivack, Evan

    2018-04-01

    People with intellectual and developmental disabilities are among the most disadvantaged and underserved groups of dental patients. Considerable health care disparities for this population have been identified, particularly oral and dental health as well as access to dental care services. People with Down syndrome and cerebral palsy have a variety of nutritional and dental considerations. These people have a higher prevalence of untreated caries and periodontal disease than the general population and may have higher rates of obesity, edentulism, and chronic oral and systemic diseases. Diet choices may affect the oral health and may play an important role in the systemic health of these people. Suggestions to improve and affect dietary intake are provided. Health issues within this population require a holistic approach to care. Concerns about oral health and diet must be addressed to support optimal health. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

  5. Proposal of a trigger tool to assess adverse events in dental care.

    PubMed

    Corrêa, Claudia Dolores Trierweiler Sampaio de Oliveira; Mendes, Walter

    2017-11-21

    The aim of this study was to propose a trigger tool for research of adverse events in outpatient dentistry in Brazil. The tool was elaborated in two stages: (i) to build a preliminary set of triggers, a literature review was conducted to identify the composition of trigger tools used in other areas of health and the principal adverse events found in dentistry; (ii) to validate the preliminarily constructed triggers a panel of experts was organized using the modified Delphi method. Fourteen triggers were elaborated in a tool with explicit criteria to identify potential adverse events in dental care, essential for retrospective patient chart reviews. Studies on patient safety in dental care are still incipient when compared to other areas of health care. This study intended to contribute to the research in this field. The contribution by the literature and guidance from the expert panel allowed elaborating a set of triggers to detect adverse events in dental care, but additional studies are needed to test the instrument's validity.

  6. Changes in socioeconomic inequalities in the use of dental care following major healthcare reform in Chile, 2004-2009.

    PubMed

    Cornejo-Ovalle, Marco; Paraje, Guillermo; Vásquez-Lavín, Felipe; Pérez, Glòria; Palència, Laia; Borrell, Carme

    2015-03-04

    The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004-2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20-39, 40-59, 60-63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (CIndex) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for dental care needs. The use of dental care significantly increased between 2004 and 2009, especially in those with public health insurance, with lower educational level and lower socioeconomic status. The CIndex for the total population significantly decreased both for the proportion who used dental care, and also the mean number of visits. Findings suggest that the use of dental care increased and socioeconomic-related inequalities in the utilization of dental care declined after a Major Health Reform, which included universal coverage for some dental cares in Chile. However, efforts to ameliorate these inequalities require an approach that moves beyond a sole focus on rectifying health coverage.

  7. Adult Dental Health Survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care.

    PubMed

    Hill, K B; Chadwick, B; Freeman, R; O'Sullivan, I; Murray, J J

    2013-01-01

    The importance of understanding barriers to dental attendance of adults in the UK was acknowledged in the first Adult Dental Health Survey in 1968 and has been investigated in all subsequent ADH surveys. In 1968, approximately 40% of dentate adults said they attended for a regular check-up; by 2009 this was 61%. Attendance patterns were associated with greater frequency of toothbrushing, use of additional dental hygiene products, lower plaque and calculus levels. Just under three-fifths of adults said they had tried to make an NHS dental appointment in the previous five years. The vast majority (92%) successfully received and attended an appointment, while a further 1% received an appointment but did not attend. The remaining 7% of adults were unable to make an appointment with an NHS dentist. The majority of adults were positive about their last visit to the dentist, with 80% of adults giving no negative feedback about their last dentist visit. Cost and anxiety were important barriers to care. Twenty-six percent of adults said the type of treatment they had opted for in the past had been affected by the cost and 19% said they had delayed dental treatment for the same reason. The 2009 survey data demonstrated a relationship between dental anxiety and dental attendance. Adults with extreme dental anxiety were more likely to attend only when they had trouble with their teeth (22%) than for a regular check-up.

  8. A prototype mobile application for triaging dental emergencies.

    PubMed

    Stein, Corey D; Xiao, Xiang; Levine, Steven; Schleyer, Titus K L; Hochheiser, Harry; Thyvalikakath, Thankam P

    2016-10-01

    Evidence suggests that dental emergencies are likely to occur when preferred care is less accessible. Communication barriers often exist that cause patients to receive suboptimal treatment or experience discomfort for extended lengths of time. Furthermore, limitations in the conventional approach for managing dental emergencies prevent dentists from receiving critical information before patient visits. The authors developed a mobile application to mediate the uncertainty of dental emergencies. The development and study consisted of a needs analysis and quality assessment of intraoral images captured by smartphones, prototype development, refining the prototype through usability inspection methods, and formative evaluation through usability testing with prospective users. The developed application successfully guided all users through a series of questions designed to capture clinically meaningful data by using familiar smartphone functions. All participants were able to complete a report within 4 minutes, and all clinical information was comprehended by the users. Patient-provided information accompanied by high-resolution images may help dentists substantially in predicting urgency or preparing necessary treatment resources. The results illustrate the feasibility of patients using smartphone applications to report dental emergencies. This technology allows dentists to assess care remotely when direct patient contact is less practical. This study's results demonstrate that patients can use mobile applications to transmit clinical data to their dentists and suggest the possibility of expanding the use of mobile applications to enhance access to routine and emergency dental care. The authors addressed how to enable patients to communicate emergency needs directly to a dentist while obviating patient emergency department visits. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  9. Geographic distribution of point-in-time access to subsidised dental services in Western Australia.

    PubMed

    Dudko, Yevgeni; Kruger, Estie; Tennant, Marc

    2016-02-01

    Dental Health Services (DHS) is the largest public primary oral healthcare provider in WA. The objective of this study was to calculate probable distance patients are expected to travel to the nearest clinic, gauge utilisation rates and predict the direction of likely changes in future demand for subsidised dental care. Eligible population data was collected from the Department of Human Services and the Australian Bureau of Statistics websites and integrated with the waiting list and the recall list data provided by the DHS. In total, 65% of the eligible WA population are residing in the metropolitan area; however, only 19% of those are either on the waiting list or have already received subsidised care. In all, 35% of the total eligible WA population are residing in country areas. A total of 30% of the eligible country WA patients are located within a 100-km range of a Government Dental Clinic, with only 11% of those either on the waiting list or having already received subsidised dental care. Country WA residents are at a significant disadvantage by comparison to their metropolitan counterparts. Eligible WA country residents are up to 40% less likely to receive treatment when compared to the metropolitan residents.

  10. Listening to Parents: A Qualitative Look at the Dental and Oral Care Experiences of Children with Autism Spectrum Disorder.

    PubMed

    Lewis, Charlotte; Vigo, Lynn; Novak, Louise; Klein, Eileen J

    2015-01-01

    Children with autism spectrum disorder (ASD) experience various barriers to optimal dental and oral care. The purpose of this study was to conduct focus groups of parents of children with autism spectrum disorder and subsequent qualitative analysis of the interviews in order to better understand problems in dental and oral care encountered by children with ASD. Four focus groups, comprised of parents of children with ASD, ranging in age from three to 17 years old, were assembled. We took a semi-structured approach, facilitating discussion about home oral hygiene and professional dental care. Audiotapes were transcribed and independently coded by four investigators who then jointly identified themes. There were three overarching, interrelated themes: (1) There is variability between children with ASD in how they tolerate dental and oral care and in what facilitates such care. (2) Parents want more extensive dental care for their children with ASD. (3) Each child's dental and oral care should be individualized based on parents' input about the unique characteristics and needs of their child. There is no "one size fits all" approach to dental and oral care for children with autism spectrum disorder. Parents are valuable partners in informing the unique dental and oral care needs of their child with ASD.

  11. Dental health of Spanish children: an investigation in primary care.

    PubMed

    Turabián, J L; de Juanes, J R

    1990-03-01

    The oral hygiene of patients between seven and 14 years old from a health centre in Toledo was studied through case-finding from March to December 1987. A total of 304 interviews were held; bad dental care (frequency of teeth brushing with fluoride toothpaste less than once per day and/or daily consumption of chocolate and sweets) was found in 83%, and caries were diagnosed through inspection in 92% of the patients. Seventy three per cent reported washing their teeth only occasionally or never; 40% consumed sweets daily; 53% had never visited the dentist; and 50% had not received preventive care for dental disease. These results contrast with those from the United Kingdom and other developed countries, indicating a precarious state of dental health in Spain, a fact which should be taken into account by the Spanish health organization when comparing the health levels between different countries.

  12. Income-related inequalities in preventive and curative dental care use among working-age Japanese adults in urban areas: a cross-sectional study.

    PubMed

    Murakami, Keiko; Aida, Jun; Ohkubo, Takayoshi; Hashimoto, Hideki

    2014-09-19

    Preventive dental care use remains relatively low in Japan, especially among working-age adults. Universal health insurance in Japan covers curative dental care with an out-of-pocket payment limit, though its coverage of preventive dental care is limited. The aim of this study was to test the hypothesis that income inequality in dental care use is found in preventive, but not curative dental care among working-age Japanese adults. A cross-sectional survey was conducted using a computer-assisted, self-administered format for community residents aged 25-50 years. In all, 4357 residents agreed to participate and complete the questionnaire (valid response rate: 31.3%). Preventive dental care use was measured according to whether the participant had visited a dentist or a dental hygienist during the past year for dental scaling or fluoride or orthodontic treatments. Curative dental care use was assessed by dental visits for other reasons. The main explanatory variable was equivalent household income. Logistic regression analyses with linear trend tests were conducted to determine whether there were significant income-related gradients with curative or preventive dental care use. Among the respondents, 40.0% of men and 41.5% of women had used curative dental care in the past year; 24.1% of men and 34.1% of women had used preventive care. We found no significant income-related gradients of curative dental care among either men or women (p = 0.234 and p = 0.270, respectively). Significant income-related gradients of preventive care were observed among both men and women (p < 0.001 and p = 0.003, respectively). Among women, however, income-related differences were no longer significant (p = 0.126) after adjusting for education and other covariates. Compared with men with the lowest income, the highest-income group had a 1.79-fold significantly higher probability for using preventive dental care. The prevalence of preventive dental care use was lower than that of curative

  13. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca.

    PubMed

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

  14. Evaluating the Impact of Expanded Practice Dental Hygienists in Oregon: An Outcomes Assessment.

    PubMed

    Bell, Kathryn P; Coplen, Amy E

    2016-06-01

    Currently the dental hygiene practice model in Oregon includes the Expanded Practice Dental Hygienist (EPDH), which allows dental hygienists with an Expanded Practice Permit (EPP) to provide care to limited access populations without the supervision of a dentist. The number and types of services provided by EPDH practitioners is thus far undocumented. The purpose of this study is to conduct an outcomes assessment of EPDH practitioners in order to quantify the impact, defined by count of services, on the access to care crisis in Oregon. A 16 question confidential survey was developed and approved by the Pacific University institutional review board. The mail-based survey was sent to 181 EPDHs in Oregon in November 2011 (all EPDHs except pilot testers and one author). A second mailing was sent to non-respondents. Data were analyzed using descriptive statistics and chi-square analysis in SPSS. The response rate was 39% (n=71). Approximately 41% (n=29) of the respondents were currently using their EPP to provide care to limited access patients with an additional 21% (n=15) planning to start their own expanded practice. The majority of practicing EPDHs provide care in residential care facilities (n=21) and in school settings (n=13). Of the current practicing EPP holders, 76% practice ≤10 hours per week, and 66% make <$10,000 per year. Total services reported in an average month from all responding EPDH practitioners were: 254 adult prophylaxes, 1,003 child prophylaxes, 106 adult fluorides, 901 child fluorides and 1,994 fluoride varnishes, among many other preventive procedures. To a limited extent, the amount and type of services provided by EPDHs has now been quantified, and EPDHs are making an impact on the access to care crisis in Oregon. Continued outcomes assessment is needed to further quantify the impact of EPDHs. Copyright © 2016 The American Dental Hygienists’ Association.

  15. Evaluating the impact of expanded practice dental hygienists in Oregon: an outcomes assessment.

    PubMed

    Bell, Kathryn P; Coplen, Amy E

    2015-02-01

    Currently the dental hygiene practice model in Oregon includes the Expanded Practice Dental Hygienist (EPDH), which allows dental hygienists with an Expanded Practice Permit (EPP) to provide care to limited access populations without the supervision of a dentist. The number and types of services provided by EPDH practitioners is thus far undocumented. The purpose of this study is to conduct an outcomes assessment of EPDH practitioners in order to quantify the impact, defined by count of services, on the access to care crisis in Oregon. A 16 question confidential survey was developed and approved by the Pacific University institutional review board. The mail-based survey was sent to 181 EPDHs in Oregon in November 2011 (all EPDHs except pilot testers and one author). A second mailing was sent to non-respondents. Data were analyzed using descriptive statistics and chi-square analysis in SPSS. The response rate was 39% (n = 71). Approximately 41% (n = 29) of the respondents were currently using their EPP to provide care to limited access patients with an additional 21% (n = 15) planning to start their own expanded practice. The majority of practicing EPDHs provide care in residential care facilities (n = 21) and in school settings (n=13). Of the current practicing EPP holders, 76% practice ≤ 10 hours per week, and 66% make < $10,000 per year. Total services reported in an average month from all responding EPDH practitioners were: 254 adult prophylaxes, 1,003 child prophylaxes, 106 adult fluorides, 901 child fluorides and 1,994 fluoride varnishes, among many other preventive procedures. To a limited extent, the amount and type of services provided by EPDHs has now been quantified, and EPDHs are making an impact on the access to care crisis in Oregon. Continued outcomes assessment is needed to further quantify the impact of EPDHs. Copyright © 2015 The American Dental Hygienists’ Association.

  16. Workplace health in dental care - a salutogenic approach.

    PubMed

    Lindmark, U; Wagman, P; Wåhlin, C; Rolander, B

    2018-02-01

    The purpose was to explore self-reported psychosocial health and work environments among different dental occupations and workplaces from a salutogenic perspective. A further purpose was to analyse possible associations between three salutogenic measurements: The Sense of Coherence questionnaire (SOC), the Salutogenic Health Indicator Scale (SHIS) and the Work Experience Measurement Scale (WEMS). Employees in the Public Dental Service in a Swedish county council (n = 486) were invited to respond to a self-reported web survey including demographics, work-related factors, the SOC, the SHIS and the WEMS. This study showed positive associations between employee characteristics and self-reported overall psychosocial health as well as experienced work environment. Autonomy was reported more among men than women (P < 0.000) and to a higher degree by dentists and dental hygienists than dental nurses (P < 0.000). Meaningfulness, happiness, job satisfaction, autonomy and positive to reorganization were reported by personnels aged less than 40 years (P ≤ 0.047). Clinical coordinators reported significant better health (SOC, SHIS) and experienced more autonomy, better management and more positive to reorganization than other dental professions. Dental hygienists and nurses experienced less time pressure than dentists (P ≤ 0.007). Better health and positive work experiences were also seen in smaller clinics (P ≤ 0.29). Dental professionals reported a high degree of overall psychosocial health as well as a positive work experience. Some variations could be seen between employee characteristics such as gender, years in dental care, professionals, managing position and workplace size. Identify resources and processes at each workplace are important and should be included in the employee's/employers dialogue. © 2016 The Authors. International Journal of Dental Hygiene Published by John Wiley & Sons Ltd.

  17. The relationship between body system-based chronic conditions and dental utilization for Medicaid-enrolled children: a retrospective cohort study

    PubMed Central

    2012-01-01

    Background Dental care is the most common unmet health care need for children with chronic conditions. However, anecdotal evidence suggests that not all children with chronic conditions encounter difficulties accessing dental care. The goals of this study are to evaluate dental care use for Medicaid-enrolled children with chronic conditions and to identify the subgroups of children with chronic conditions that are the least likely to use dental care services. Methods This study focused on children with chronic conditions ages 3-14 enrolled in the Iowa Medicaid Program in 2005 and 2006. The independent variables were whether a child had each of the following 10 body system-based chronic conditions (no/yes): hematologic; cardiovascular; craniofacial; diabetes; endocrine; digestive; ear/nose/throat; respiratory; catastrophic neurological; or musculoskeletal. The primary outcome measure was use of any dental care in 2006. Secondary outcomes, also measured in 2006, were use of diagnostic dental care, preventive dental care, routine restorative dental care, and complex restorative dental care. We used Poisson regression models to estimate the relative risk (RR) associated with each of the five outcome measures across the 10 chronic conditions. Results Across the 10 chronic condition subgroups, unadjusted dental utilization rates ranged from 44.3% (children with catastrophic neurological conditions) to 60.2% (children with musculoskeletal conditions). After adjusting for model covariates, children with catastrophic neurological conditions were significantly less likely to use most types of dental care (RR: 0.48 to 0.73). When there were differences, children with endocrine or craniofacial conditions were less likely to use dental care whereas children with hematologic or digestive conditions were more likely to use dental care. Children with respiratory, musculoskeletal, or ear/nose/throat conditions were more likely to use most types of dental care compared to other

  18. [Health care plans: interfaces between the public and private system in the dental sector].

    PubMed

    Pietrobon, Louise; da Silva, Cíntia Magali; Batista, Luciana Rodrigues Vieira; Caetano, João Carlos

    2008-01-01

    The present work presents a brief history of health plans in Brazil examining the interface between the public and the private sector. The evolution and regulation of the supplementary care system is analyzed, the different care modalities are defined and the main differences between health plans and dental care insurance are pointed out. The coverage provided by the supplementary care system and its relationship with the public health system is shown on the basis of current data. On the other hand, the study focuses on the care services, health plans and the labor market in the sector correlating, also on the basis of current data, the challenges and new opportunities of the supplementary care market, mainly in the dental sector. Although the dental sector is living an extraordinary moment within the private health care system and given that ANS data are pointing to a growth of this sector of 210% over last the 7 years, the service coverage of the supplementary care sector mainly directed to medical and inpatient care does not meet the real demand for integrated health care.

  19. A Prototype Mobile Application for Triaging Dental Emergencies

    PubMed Central

    Stein, Corey D.; Xiao, Xiang; Levine, Steven; Schleyer, Titus K. L.; Hochheiser, Harry; Thyvalikakath, Thankam P

    2016-01-01

    Evidence suggests that dental emergencies are likely to occur when preferred care is less accessible. Communicative barriers often exist that cause patients to receive sub-optimal treatment or remain in discomfort for extended lengths of time. Furthermore, limitations in the conventional approach for managing dental emergencies prevent dentists from receiving critical information prior to patient visits. We developed a mobile application to mediate the uncertainty of dental emergencies. Patient-provided information accompanied by high-resolution images may significantly help dentists predict urgency or prepare necessary treatment resources. The development and study consisted of a needs analysis and quality assessment of intraoral images captured by smartphones; prototype development; refining the prototype through usability inspection methods; and formative evaluation through usability testing with prospective users. The developed application successfully guided all users through a series of questions designed to capture clinically meaningful data using familiar smartphone functions. All participants were able to complete a report within 4 minutes and all clinical information was comprehendible by the users. Our results illustrate the feasibility of patients utilizing smartphone applications to report dental emergencies. This technology allows dentists to remotely assess care when direct patient contact is less practical. This study demonstrates that patients can use mobile applications to transmit clinical data to their dentists and suggests the possibility of expanding its use to enhance access to routine and emergency dental care. Here, we address how we can enable patients to directly communicate emergent needs to a dentist while relieving them of enduring emergency room visits. PMID:27206728

  20. What should we expect from Switzerland's compulsory dental insurance reform?

    PubMed

    di Bella, Enrico; Krejci, Ivo; Ardu, Stefano; Leporatti, Lucia; Montefiori, Marcello

    2018-04-10

    A vast and heated debate is arising in Switzerland as a result of some recent citizens' initiatives aimed at introducing compulsory dental health care insurance. The Grand Conseils of the Vaud, Geneva, and Neuchâtel cantons recently approved three public initiatives and their citizens are expected to vote on the proposal in 2018. The process of collecting signatures has begun in several other cantons and the discussion has now moved to a national level. At present, there is no scientific research that can help policy-makers and citizens to understand the main economic implications of such reform. We attempt to fill this gap by analysing three critical issues: the level and determinants of unmet needs for dental care in Switzerland; the protection of vulnerable individuals; and the economic sustainability of reform. The results show that income is not a unique determinant of barriers to access to dental care but rather, cultural and socio-demographic factors impact the perceived level of unmet dental care needs. The reform might only partially, if at all, improve the equity of the current system. In addition, the results show that the 1% wage-based contribution that the reform promoters suggest should finance the insurance is inadequate to provide full and free dental care to Swiss residents, but is merely sufficient to guarantee basic preventive care, whereas this could be provided by dental hygienists for less.

  1. The impact of out-of-pocket payments for dental care on household finances in low and middle income countries.

    PubMed

    Bernabé, Eduardo; Masood, Mohd; Vujicic, Marko

    2017-01-23

    Dental care is extremely costly and beyond most people means in developing countries. The primary aim of this study was to determine the impact of out-of-pocket payments for dental care on household finances in 40 low and middle income countries. A second aim was to compare the burden of payments for dental care with that for other health services. We used data from 174,257 adults, aged 18 years and above, who reported their total and itemized household expenditure in the past four weeks as part of the World Health Surveys. The financial burden on households was measured using the catastrophic health expenditure (CHE) and impoverishment approaches. A household was classified as facing CHE if it spent 40% or more of its capacity to pay, and as facing impoverishment if it fell below the country-specific poverty line after spending on health care was subtracted from household expenditure. The odds of experiencing CHE and impoverishment due to expenditure on dental care were estimated from two-level logistic regression models, controlling for various individual- and country-level covariates. Households that paid for dental care had 1.88 (95% Confidence Interval: 1.78-1.99) greater odds of incurring CHE and 1.65 (95% CI: 1.52-1.80) greater odds of facing impoverishment, after adjustment for covariates. Furthermore, the impact of paying for dental care was lower than that for medications or drugs, inpatient care, outpatient care and laboratory tests but similar to that of health care products, traditional medicine and other health services. Households with recent dental care spending were more likely to use a large portion of their disposable income and fall below the poverty line. Policy makers ought to consider including dental care as part of universal health care and advocate for the inclusion of dental care coverage in health insurance packages.

  2. Oral and dental health issues in people with mental disorders.

    PubMed

    Torales, Julio; Barrios, Iván; González, Israel

    2017-09-21

    Patients with mental disorders are subject to a greater number of risk factors for oral and dental disease than the general population. This is mostly caused by the side effects of the medications that they receive, lack of self-care, difficulty to access health services, a negative attitude towards healthcare providers, and patients’ lack of cooperation in dental treatments. The most common psychiatric disorders in our population are depression, anxiety disorders, schizophrenia, bipolar disorder, and dementia. In disorders such as anxiety and depression, the main issue is the loss of interest in self-care, which results in a poor hygiene. The most frequent oral and dental diseases in these patients are dental cavities and periodontal disease. The purpose of this brief review is to provide up-to-date information about the management of oral and dental diseases of patients with mental disorders.

  3. In new territory: consent and the extended duties dental nurse.

    PubMed

    Elsden, Jacqui

    2015-02-01

    With the introduction of direct access to treatment from dental care professionals (DCPs) in 2013, dental nurses are being trained to support the wider dental team in a number of additional skills. The name for this expanded team role is Extended Duties Dental Nurse (EDDN). These new duties take the EDDN into new territories, one of which includes the issue of consent. This article explains the background to direct access and the extra responsibilities for EDDNs in terms of consent and indemnity. It explores the new knowledge required to gain valid consent and presents a scenario for consideration. The article concludes that it is important for EDDNs to develop their professional approach, taking early advice from the referring dentist and/or professional indemnity adviser if faced with an unfamiliar scenario.

  4. Oral hygiene practices and dental service utilization among pregnant women.

    PubMed

    Boggess, Kim A; Urlaub, Diana M; Massey, Katie E; Moos, Merry-K; Matheson, Matthew B; Lorenz, Carol

    2010-05-01

    utilization during pregnancy exist. Medical and dental care providers who treat women of reproductive age and pregnant women need to develop policy strategies to address this population's access barriers to, and use of, dental care services.

  5. New leaders in dentistry: dental students.

    PubMed

    Hammer, Dan

    2010-01-01

    Leadership opportunities for dental students have opened dramatically in recent decades because of the humanistic approach to education that shares responsibility for learning between students and faculty and that values mutual respect. Technology has also had an effect because it creates instant access and global communities. This new student leadership is most apparent in the American Student Dental Association (ASDA), which recently developed a White Paper on ethics, assisted in the establishment of Student Professionalism and Ethics Clubs at schools, and is developing a policy on unsupervised dental care. Students are also demonstrating leadership in research; in dual degrees that enhance teaching and policy; and in community service and outreach.

  6. Disparities in Regular Source of Dental Care among Mothers of Medicaid-Enrolled Preschool Children

    PubMed Central

    Grembowski, David; Spiekerman, Charles; Milgrom, Peter

    2008-01-01

    For mothers of Medicaid children aged 3 to 6 years, we examined whether mothers’ characteristics and local supply of dentists and public dental clinics are associated with having a regular source of dental care. Disproportionate stratified sampling by racial/ethnic group selected 11,305 children aged 3 to 6 in Medicaid in Washington state. Mothers (N=4,373) completed a mixed-mode survey that was combined with dental supply measures. Results reveal 38% of mothers had a regular dental place and 27% had a regular dentist. Dental insurance, greater education, income, and length of residence and better mental health were associated with having a regular place or dentist for Black, Hispanic and White mothers, along with increased supply of private dentists and safety net clinics for White and Hispanic mothers. Mothers lacking a regular source of dental care may increase oral health disparities in their children. PMID:17982208

  7. Popular initiatives in 2014-2016 call for the introduction of mandatory dental care insurance in Switzerland: The contrasting positions at stake.

    PubMed

    di Bella, Enrico; Leporatti, Lucia; Montefiori, Marcello; Krejci, Ivo; Ardu, Stefano

    2017-06-01

    Switzerland's mandatory health insurance system provides coverage for a standard benefits package for all residents. However, adult dental care is covered only in case of accidents and inevitable dental illnesses, while routine dental care is almost completely financed out-of-pocket. In general, unmet health needs in Switzerland are low, but unmet dental needs are significant, when compared with other countries in Europe. Recent popular initiatives in Switzerland have aimed to introduce a mandatory insurance model for dental care through a mandatory contribution of 1% of gross salaries toward dental care insurance. In three cantons, the proposals have collected the required number of signatures and a public referendum is expected to be held in 2017/2018. If implemented, the insurance system is expected to have a significant impact on the dental profession, dental care demand, and the provision of dental services. The contrasting positions of stakeholders for and against the reform reflect a rare situation in which dental care policy issues are being widely discussed at all levels. However, such a discussion is of crucial relevance not only for Switzerland, but also for the whole of Europe, which has significant levels of unmet needs for dental care, especially among vulnerable and deprived individuals, and new solutions to expand dental care coverage are required. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  8. Oral health challenges facing Dubai children with Autism Spectrum Disorder at home and in accessing oral health care.

    PubMed

    Mansoor, D; Al Halabi, M; Khamis, A H; Kowash, M

    2018-06-01

    To investigate the challenges faced by Autism Spectrum Disorder (ASD) children and their families in Dubai from three different perspectives of dental care: oral care at home, oral care at the dentist and access to oral care, and to compare the results to their normally developing peers. A case-control comparative study of 84 ASD and 53 healthy children attending special needs centres and schools in Dubai including siblings of the autistic children. Data collection was by a survey questionnaire completed by parents or guardians. More parents of ASD children compared to parents of healthy children reported difficulties across almost all oral care variables explored. The majority of ASD children's parents (83.3%) reported that their children need assistance in brushing their teeth compared with 15.4% of the healthy controls (p-value < 0.001). The ASD children's uncooperative behaviour increased during dental visits and significantly more parents (37%) rated their child's experience as negative compared with 9.5% among the parents of control children (p-value=0.006). The autistic children had visited a dentist mostly for extractions. This study indicates that autistic children in Dubai experience more challenges and barriers to oral care than their typically developing healthy peers.

  9. Improving Access to Dental Hygiene Services in the European Regional Dental Command Concurrent With Implementation of the U.S. Army Dental Care Reengineering Initiative.

    DTIC Science & Technology

    1998-05-15

    finders with the recall appointment intervals tailored to the caries and periodontal disease assessment of the patient. The use of this critical pathway...implicate periodontal disease as a major risk factor in cardiovascular disease , stroke, and production of low-birth weight babies (Loesche, et al...Assessing the Relationship Between Dental Disease and Coronary Heart Disease in Elderly U. S. Veterans. Journal of the American Dental Association. 129. 301

  10. Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

    PubMed

    Piovesan, Chaiana; Ardenghi, Thiago Machado; Mendes, Fausto Medeiros; Agostini, Bernardo Antonio; Michel-Crosato, Edgard

    2017-03-30

    The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

  11. Catalog of Completed Health Care and Dental Care Studies.

    DTIC Science & Technology

    1987-12-01

    Army Oral lie ith jaintenanc, AD A0()’ )’rtjr, ur, on 1x--ntal Itealth Status of Army lersonnel Jun 79 Current Dental Officer Practice and Uti ...HCSD Report No. 80-001B) Sep 80 Decentralized Inpatient Pharmacy Service Study AD) A)OU’,()’, (Job Satisfaction Between Pharmacists Perfotm irj Patient...Care Activities and Pharmacists Perfotrninq Dispensary or Supervisory Flinctions): Part C (HCSD Report No. 80-001C) Jun 30 Non-Poductive Factor

  12. The roles of federal legislation and evolving health care systems in promoting medical-dental collaboration.

    PubMed

    Edelstein, Burton L

    2014-01-01

    Recent federal health care legislation contains explicit and implicit drivers for medical-dental collaboration. These laws implicitly promote health care evolution through value-based financing, "big data" and health information technology, increased number of care providers and a more holistic approach. Additional changes--practice aggregation, consumerism and population health perspectives--may also influence dental care. While dentistry will likely lag behind medicine toward value-based and accountable care organizations, dentists will be affected by changing consumer expectations.

  13. Changes in Socioeconomic Inequalities in the Use of Dental Care Following Major Healthcare Reform in Chile, 2004–2009

    PubMed Central

    Cornejo-Ovalle, Marco; Paraje, Guillermo; Vásquez-Lavín, Felipe; Pérez, Glòria; Palència, Laia; Borrell, Carme

    2015-01-01

    The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004–2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20–39, 40–59, 60–63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (CIndex) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for dental care needs. The use of dental care significantly increased between 2004 and 2009, especially in those with public health insurance, with lower educational level and lower socioeconomic status. The CIndex for the total population significantly decreased both for the proportion who used dental care, and also the mean number of visits. Findings suggest that the use of dental care increased and socioeconomic-related inequalities in the utilization of dental care declined after a Major Health Reform, which included universal coverage for some dental cares in Chile. However, efforts to ameliorate these inequalities require an approach that moves beyond a sole focus on rectifying health coverage. PMID:25749319

  14. Palliative Dental Care- A Boon for Debilitating

    PubMed Central

    Chintamaneni, Raja Lakshmi; Mpv, Prabhat; Gummadapu, Sarat; Salvadhi, Shyam Sundar

    2014-01-01

    World Health Organization defines “palliative care” as the active total care of patients whose disease is not responding to curative treatment. Palliative care actually deals with patients at the terminal end stage of the disease. We always face a question why a dentist should be in a palliative team? What is the exact role of dentist? Dental treatment may not always be strenuous and curative, but also can focus on improving quality of life of the patient. Hence forth the present paper enlightens the importance of dentist role in palliative team. PMID:25121074

  15. Population-centered Risk- and Evidence-based Dental Interprofessional Care Team (PREDICT): study protocol for a randomized controlled trial.

    PubMed

    Cunha-Cruz, Joana; Milgrom, Peter; Shirtcliff, R Michael; Bailit, Howard L; Huebner, Colleen E; Conrad, Douglas; Ludwig, Sharity; Mitchell, Melissa; Dysert, Jeanne; Allen, Gary; Scott, JoAnna; Mancl, Lloyd

    2015-06-20

    To improve the oral health of low-income children, innovations in dental delivery systems are needed, including community-based care, the use of expanded duty auxiliary dental personnel, capitation payments, and global budgets. This paper describes the protocol for PREDICT (Population-centered Risk- and Evidence-based Dental Interprofessional Care Team), an evaluation project to test the effectiveness of new delivery and payment systems for improving dental care and oral health. This is a parallel-group cluster randomized controlled trial. Fourteen rural Oregon counties with a publicly insured (Medicaid) population of 82,000 children (0 to 21 years old) and pregnant women served by a managed dental care organization are randomized into test and control counties. In the test intervention (PREDICT), allied dental personnel provide screening and preventive services in community settings and case managers serve as patient navigators to arrange referrals of children who need dentist services. The delivery system intervention is paired with a compensation system for high performance (pay-for-performance) with efficient performance monitoring. PREDICT focuses on the following: 1) identifying eligible children and gaining caregiver consent for services in community settings (for example, schools); 2) providing risk-based preventive and caries stabilization services efficiently at these settings; 3) providing curative care in dental clinics; and 4) incentivizing local delivery teams to meet performance benchmarks. In the control intervention, care is delivered in dental offices without performance incentives. The primary outcome is the prevalence of untreated dental caries. Other outcomes are related to process, structure and cost. Data are collected through patient and staff surveys, clinical examinations, and the review of health and administrative records. If effective, PREDICT is expected to substantially reduce disparities in dental care and oral health. PREDICT can be

  16. Representation of dental care and oral health in children's drawings.

    PubMed

    Torriani, D D; Goettems, M L; Cademartori, M G; Fernandez, R R; Bussoletti, D M

    2014-06-01

    Paediatric dentistry requires knowledge of preventive measures, restorative skills and an understanding of child development. This exploratory, descriptive and qualitative study has analysed children's drawings regarding their perception of dental treatment and oral health. Children aged from six to ten years attending a dental school for treatment were randomly invited to create a drawing about 'dental treatment' and 'oral health'. Verbal expressions made by the children whilst drawing were also recorded and attached to the drawings. These representations were analysed and categorised using Vygotsky postulations for context reading. During the drawing analysis different themes emerged. Five categories regarding perceptions of dental treatment were identified: personal relationship; power relation; trauma; childhood resistance; and contextualisation of dental care in the child's life. Three categories relating to oral health were determined: dichotomy of health/sickness; ludic representation of health; and sickness seen as a process. Drawing can be used to understand children's emotions and expectations about dental treatment. Besides possessing technical skills and scientific knowledge, dentists have an obligation to pay attention to children's feelings.

  17. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  18. Dental therapy practice patterns in Minnesota: a baseline study.

    PubMed

    Blue, Christine M; Kaylor, Mary Beth

    2016-10-01

    A chronic shortage of dentists, the importance of oral health, and the lack of access to care led to the introduction of a new oral health practitioner in Minnesota, the dental therapist. Dental therapy graduates from the University of Minnesota have been in practice since 2012. To date, there has been no formal study of how they have been incorporated into dental practice. The purpose of this study was to obtain baseline knowledge of dental therapists' practice patterns in Minnesota and determine if dentists' patterns of work changed after a dental therapist was employed. Four dental practices were sampled purposefully to obtain various practice types and geographic locations within Minnesota. Secondary data were collected from practice management software databases in each practice between January-March, 2015. Data were used to describe the work undertaken by dental therapists, the types of patients seen and payer mix. Additionally, data from 6 months before and after employment of the dental therapist were collected to determine whether dentists' practice patterns changed after a dental therapist was employed. Dental therapists were employed full-time, seeing an average of 6.8 patients per day. No distinct pattern emerged with regard to ages of patients seen by dental therapists. Dental therapists saw up to 90% of uninsured patients or patients on public assistance. Restorative services across practices comprised an average of 68% of work undertaken by dental therapists. Dentists delegated a full range of procedures within the dental therapy scope of practice indicating trust and acceptance of dental therapists. Dentists in two practices began to take on more complex dental procedures after a dental therapist joined the practice. Dental therapists are treating a high number of uninsured and underinsured patients, suggesting that they are expanding access to dental care in rural and metropolitan areas of Minnesota. Dentists appear to have an adequate workload for

  19. Disparities in dental health of rural Australians: hospitalisation rates and utilisation of public dental services in three communities in North Queensland.

    PubMed

    Carlisle, Karen; Larkins, Sarah; Croker, Felicity

    2017-01-01

    experience poorer oral health and are a greater risk of hospitalisation for dental conditions compared with the whole of Queensland. Whilst public dental services account for a small proportion of all dental care across the state, service utilisation data provide a unique insight into the population groups who may not be accessing public dental services. In the rural context, more effective use of the local workforce and a flexible approach to funding models could have a positive impact on access to dental care.

  20. The Motivation-Facilitation Theory of Prenatal Care Access.

    PubMed

    Phillippi, Julia C; Roman, Marian W

    2013-01-01

    Despite the availability of services, accessing health care remains a problem in the United States and other developed countries. Prenatal care has the potential to improve perinatal outcomes and decrease health disparities, yet many women struggle with access to care. Current theories addressing access to prenatal care focus on barriers, although such knowledge is minimally useful for clinicians. We propose a middle-range theory, the motivation-facilitation theory of prenatal care access, which condenses the prenatal care access process into 2 interacting components: motivation and facilitation. Maternal motivation is the mother's desire to begin and maintain care. Facilitation represents the goal of the clinic to create easy, open access to person-centered beneficial care. This simple model directs the focus of research and change to the interface of the woman and the clinic and encourages practice-level interventions that facilitate women entering and maintaining prenatal care. © 2013 by the American College of Nurse‐Midwives.

  1. Insurance + access not equal to health care: typology of barriers to health care access for low-income families.

    PubMed

    Devoe, Jennifer E; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A

    2007-01-01

    Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, "Is there anything else you would like to tell us?" Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere.

  2. The effects of gender disparities on dental hygiene education and practice in Europe.

    PubMed

    Luciak-Donsberger, C

    2003-11-01

    In Europe, over 96.5% of dental hygienists are women. The objective of this report was to examine the impact of gender role stereotyping on the image of the dental hygiene profession and on disparities in educational attainment and work regulations within Europe. Data pertaining to regulated or non-regulated dental hygiene practice in 22 European countries were analysed according to possible gender impact on access to education and on the structure of the delivery of care. It was examined whether there is a correlation between national differences found in the dental hygiene profession and gender related disparities found in other work-related areas. Results show that the gender bias in the dental hygiene profession has an effect on equal access to education, and on equal occupational opportunities for dental hygienists within the European Union (EU) and beyond. In northern Europe, higher educational attainment in the field of dental hygiene, more extensive professional responsibilities and greater opportunities for self-employment in autonomous practice tend to correlate with greater equality in the work force. In eastern Europe, lower educational and professional opportunities in dental hygiene correlate with greater gender disparities found in other work-related areas. In some western European countries, the profession has not been implemented because of the political impact of organised dentistry, which expects financial loss from autonomous dental hygiene practice. In order to fulfil mandates of the EU, initiatives must be taken to remove the gender bias in the delivery of preventive care and to promote equal access to educational attainment and to professional development in the whole of Europe for those who choose to do so.

  3. Impact of Early Head Start in North Carolina on Dental Care Use Among Children Younger Than 3 Years.

    PubMed

    Burgette, Jacqueline M; Preisser, John S; Weinberger, Morris; King, Rebecca S; Lee, Jessica Y; Rozier, R Gary

    2017-04-01

    To examine the effects of North Carolina Early Head Start (EHS), an early education program for low-income children younger than 3 years and their families, on dental care use among children. We performed a quasi-experimental study in which we interviewed 479 EHS and 699 non-EHS parent-child dyads at baseline (2010-2012) and at a 24-month follow-up (2012-2014). We estimated the effects of EHS participation on the probability of having a dental care visit after controlling for baseline dental care need and use and a propensity score covariate; we included random effects to account for EHS program clustering. The odds of having a dental care visit of any type (adjusted odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.74, 3.48) and having a preventive dental visit (adjusted OR = 2.6; 95% CI = 1.84, 3.63) were higher among EHS children than among non-EHS children. In addition, the adjusted mean number of dental care visits among EHS children was 1.3 times (95% CI = 1.17, 1.55) the mean number among non-EHS children. This study is the first, to our knowledge, to demonstrate that EHS participation increases dental care use among disadvantaged young children.

  4. Dental care habits and knowledge of oral health in insulin-dependent diabetics.

    PubMed

    Thorstensson, H; Falk, H; Hugoson, A; Kuylenstierna, J

    1989-06-01

    The aim of this study was to investigate dental care habits and knowledge of oral health in age- and sex-matched adult long and short duration insulin-dependent diabetics and non-diabetics. Ninety-four long and 86 short duration diabetics and 86 non-diabetics, aged 20-70 years, participated in the study. All subjects answered a questionnaire with 38 questions about dental visits, attitudes to and knowledge of dental diseases, toothcleaning, dietary and smoking habits, and oral sensations. Among the diabetics there was a rather large group that did not visit a dentist annually. The diabetics also required more emergency dental care and were not as willing as the non-diabetics to spend time and money on their teeth. The compliance with dietary advice was poor among the diabetics. Oral discomfort such as prickling and burning sensations, metallic and bad taste was rare in both diabetics and non-diabetics. In the diabetics, however, a feeling of mouth dryness was common.

  5. [Dental care for foreigners in Hungary].

    PubMed

    Balázs, Péter; Oesterle, August

    2008-10-01

    High quality elective dental care for foreign patients was not exceptional in Hungary before the collapse of the old regime in 1989. Nevertheless, it became business as usual only in the new era thanks to the open state borders and the international competitive market environment. Unfortunately, no scientific study concerning this phenomenon has been conducted so far, however its professional and economic significance has been indicated by day-to-day experience. Additionally, the term "dental tourism" also used in international scientific papers became a commonplace in Hungary with unfavourable connotations. The present survey was the first to study this phenomenon by scientific standards in the most involved areas, namely in the capital city Budapest and in three counties in the Western Hungarian Region. Data collecting was performed by a self-reported questionnaire sent via conventional mail to all members of the Dental Section of the Hungarian Medical Chamber practicing in those indicated regions. Respond rates were 20.65% in Budapest and 25.34% in Western Hungary. The sample obtained this way, clearly indicated dimensions of cross-border patient migration and its economic significance as well. In Western Hungary 80.81% of foreign patients came from the neighbouring Austria and two out of ten practices realized 40 to 100% of their income out of this business. In Budapest foreign patients' nationality was more diversified. The largest group arrived from the United Kingdom (9.93%). Nevertheless the economic impact of dental tourism in Budapest is not relevant and outbalanced by a considerable domestic demand on the local private market.

  6. Dental utilization by children in Hispanic agricultural worker families in California

    PubMed Central

    Finlayson, Tracy L.; Gansky, Stuart A.; Shain, Sara G.; Weintraub, Jane A.

    2014-01-01

    Background Agricultural worker families encounter multiple barriers to accessing all needed dental care. This study investigated predisposing, enabling, and need factors associated with children's past year dental utilization among Hispanic agricultural worker families in central California. Methods Oral health survey and clinical data were collected from families participating in a larger, population-based study in 2006-7. Generalized estimating equation logit regression assessed effects on a dental visit among children aged 0-17 (n=405). Analyses adjusted for clustering of children in the same household. Predisposing (sociodemographics), enabling (child's dental insurance, usual source of dental care, caregiver past year dental visit, acculturation level, income and education), and need (caregiver's oral health rating, perception of cavities, and clinically-determined treatment urgency) factors were examined. Results Half (51%) the children had a past year dental visit, while 23% had never been to a dentist. In the final model, children were less likely to have a past year dental visit if they were foreign-born, male, had caregivers that thought they had cavities or were unsure, and if the dentist recommended treatment ‘at earliest convenience’. Children aged 6-12, with a regular dental care source, and whose caregivers had a recent dentist visit were more likely to have a past year dental visit. Conclusions Children were more likely to have a past year dental visit if they had a usual source of dental care (OR =4.78, CI=2.51-9.08), and if the caregiver had a past year dental visit (OR=1.88, CI=1.04-3.38). Emphasis should be placed on these two modifiable factors to increase children's dental utilization. PMID:25621285

  7. Public Health Dental Hygienists in Massachusetts: A Qualitative Study.

    PubMed

    Rainchuso, Lori; Salisbury, Helen

    2017-06-01

    Purpose: The aim of this qualitative, phenomenological study was to explore the attitudes and perceptions of public health dental hygienists on providing preventive care to underserved populations in Massachusetts. Methods: Non-probability purposive sampling was used for initial participant recruitment, and snowball sampling occurred thereafter. Data collection occurred through semi-structured interviews. Qualitative analysis was conducted using Pitney and Parker's eight-step CREATIVE process. Results: Data saturation occurred with 10 participants (n=10), one-third of the public health dental hygienists who are practicing in Massachusetts. The majority of practice settings included school-based programs (70%), while programs for children with special needs (10%) were the least common. Two major themes emerged from the data; (a) the opportunity to be an oral health change agent and (b) barriers to practice. Six subcategories emerged from the data and are reviewed within the context of their associated themes. Additionally, career satisfaction emerged as an unintended theme, and was reported as the driving force for the majority of participants. Conclusion: This study revealed a better understanding of the public health dental hygiene workforce model in Massachusetts. Public health dental hygienists in Massachusetts perceive themselves as change agents within the health care profession, and although barriers to practice are plentiful, these oral health care professionals are committed to improving access to dental care. Copyright © 2017 The American Dental Hygienists’ Association.

  8. Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models

    PubMed Central

    2012-01-01

    Background About one-third of adults with diabetes have severe oral complications. However, limited previous research has investigated dental care utilization associated with diabetes. This project had two purposes: to develop a methodology to estimate dental care utilization using claims data and to use this methodology to compare utilization of dental care between adults with and without diabetes. Methods Data included secondary enrollment and demographic data from Washington Dental Service (WDS) and Group Health Cooperative (GH), clinical data from GH, and dental-utilization data from WDS claims during 2002–2006. Dental and medical records from WDS and GH were linked for enrolees continuously and dually insured during the study. We employed hurdle models in a quasi-experimental setting to assess differences between adults with and without diabetes in 5-year cumulative utilization of dental services. Propensity score matching adjusted for differences in baseline covariates between the two groups. Results We found that adults with diabetes had lower odds of visiting a dentist (OR = 0.74, p < 0.001). Among those with a dental visit, diabetes patients had lower odds of receiving prophylaxes (OR = 0.77), fillings (OR = 0.80) and crowns (OR = 0.84) (p < 0.005 for all) and higher odds of receiving periodontal maintenance (OR = 1.24), non-surgical periodontal procedures (OR = 1.30), extractions (OR = 1.38) and removable prosthetics (OR = 1.36) (p < 0.001 for all). Conclusions Patients with diabetes are less likely to use dental services. Those who do are less likely to use preventive care and more likely to receive periodontal care and tooth-extractions. Future research should address the possible effectiveness of additional prevention in reducing subsequent severe oral disease in patients with diabetes. PMID:22776352

  9. Collaborative Dental Hygiene Practice in New Mexico and Minnesota.

    PubMed

    Hodges, Kathleen O; Rogo, Ellen J; Cahoon, Allison C; Neill, Karen

    2016-06-01

    This descriptive, comparative study was conducted to examine characteristics, services, models and opinions among collaborative dental hygiene practitioners in New Mexico and Minnesota. A self-designed online questionnaire, distributed via SurveyMonkey®, was utilized to collect data from 73 subjects who met the inclusion criteria. A multi-phase administration process was followed. Content validity and reliability was established. Descriptive statistics were used for analysis of 6 research questions. The Mann-Whitney U, Pearson Chi-Square and Fisher's Exact tests were employed to analyze 4 null hypotheses (p=0.05). Most participants (n=36) were experienced clinicians who chose to work in an alternative setting after 28 years or more in the field and reported increased access to care as the reason for practicing collaboratively. A variety of services were offered and private insurance and Medicaid were accepted, although many practitioners did not receive direct reimbursement. The majority of New Mexico participants worked in private dental hygiene practices, earned advanced degrees and serviced Health Provider Shortage Areas. The majority of Minnesota respondents worked in various facilities, earned associate's degrees and were uncertain if Health Provider Shortage Areas were served. There were no significant differences in the variables between practitioners in both states. New Mexico and Minnesota collaborative dental hygiene practitioners are similar in characteristics, services, and opinions although models of practice vary. Collaborative dental hygiene practice is a viable answer to increasing access to care and is an option for patients who might otherwise go without care, including the unserved, underserved, uninsured and underinsured. Copyright © 2016 The American Dental Hygienists’ Association.

  10. Access to Dental Care for Children in Rhode Island. Rhode Island Kids Count Issue Brief.

    ERIC Educational Resources Information Center

    Katz, Linda; Fontes, Janice; Ross, Maureen; Lawrence, Robin; Andrews, John; Kernan, Sharon; Leddy, Tricia; O'Bara, Joan; Young, John

    Dental disease restricts activities in school, work, and home, and often significantly diminishes the quality of life for many children and adults, especially those who are low income or uninsured. Noting that dental caries (tooth decay) is the most common preventable chronic childhood disease, this Kids Count issue brief considers the extent to…

  11. Dental Considerations in Pregnancy-A Critical Review on the Oral Care

    PubMed Central

    VT, Hemalatha; T, Manigandan; T, Sarumathi; Nisha V, Aarthi; A, Amudhan

    2013-01-01

    Pregnancy is a dynamic physiological state which is evidenced by several transient changes. These can develop as various physical signs and symptoms that can affect the patients health, perceptions and interactions with others in the environment. The patients may not always understand the relevance of the adaptations of their bodies to the health of their foetuses. A gestational woman requires various levels of support throughout this time, such as medical monitoring or intervention, preventive care and physical and emotional assistance. The dental management of pregnant patients requires special attention. Dentists, for example, may delay certain elective procedures so that they coincide with the periods of pregnancy which are devoted to maturation versus organogenesis. At other times, the dental care professionals need to alter their normal pharmacological armamentarium to address the patients’ needs versus the foetal demands. Applying the basics of preventive dentistry at the primary level will broaden the scope of the prenatal care. Dentists should encourage all the patients of the childbearing ages to seek oral health counseling and examinations as soon as they learn that they are pregnant. This article has reviewed some of the physiologic changes and the oral pathologies which are associated with pregnancy, and how these alterations can affect the dental care of the patient. PMID:23814753

  12. Dental considerations in pregnancy-a critical review on the oral care.

    PubMed

    Vt, Hemalatha; T, Manigandan; T, Sarumathi; Nisha V, Aarthi; A, Amudhan

    2013-05-01

    Pregnancy is a dynamic physiological state which is evidenced by several transient changes. These can develop as various physical signs and symptoms that can affect the patients health, perceptions and interactions with others in the environment. The patients may not always understand the relevance of the adaptations of their bodies to the health of their foetuses. A gestational woman requires various levels of support throughout this time, such as medical monitoring or intervention, preventive care and physical and emotional assistance. The dental management of pregnant patients requires special attention. Dentists, for example, may delay certain elective procedures so that they coincide with the periods of pregnancy which are devoted to maturation versus organogenesis. At other times, the dental care professionals need to alter their normal pharmacological armamentarium to address the patients' needs versus the foetal demands. Applying the basics of preventive dentistry at the primary level will broaden the scope of the prenatal care. Dentists should encourage all the patients of the childbearing ages to seek oral health counseling and examinations as soon as they learn that they are pregnant. This article has reviewed some of the physiologic changes and the oral pathologies which are associated with pregnancy, and how these alterations can affect the dental care of the patient.

  13. Geographic location and indirect costs as a barrier to dental treatment: a patient perspective.

    PubMed

    Curtis, B; Evans, R W; Sbaraini, A; Schwarz, E

    2007-12-01

    The recently published National Survey of Adult Oral Health 2004-06 indicated that tooth loss, mean decayed and number of DMF teeth were all higher outside capital city locations. In addition, dental attendance patterns were worse in terms of frequency, reason for visit, and continuity in rural and remote locations, but there was no difference by geographical location in terms of financial barriers to dental care. The objective of this research was to identify, quantify and analyse some of the non-treatment costs associated with dental treatment from the perspective of the patient and to determine whether the perceived impact of those costs may limit access to dental care. This cohort study was nested within a clinical trial. Patients had been allocated to treatment arms within clusters dependent on the randomization status of the dental practice they usually attended, classified as major city, regional or remote. A questionnaire was developed from a series of focus groups in which patients were asked to identify the domains of non-treatment costs associated with a dental visit that were important to them and to quantify those costs. Factor analysis was used to reduce these items to four core scales. These scales were assessed for reliability and validity. Regression and ANCOVA was used to explore differences in DMFS scores between the three groups and a predictive model developed to adjust for potential confounders. Two core scales were identified as key drivers on the perceived impact of indirect costs associated with dental visits; travel impact and family impact. Patients living in remote locations incurred significantly higher indirect costs associated with dental treatment and higher mean DMFS scores. Patient perception of the impact of travel costs and impact on family life are major drivers restricting access to dental services for people living in remote locations in New South Wales. Further research using outcomes directly related to access is required to

  14. Perception of studying dental law and ethics among postgraduate dental students in the UK.

    PubMed

    Wassif, H S

    2015-08-14

    Law and ethics is an integral part of medical and dental professional practice. The subject is touched upon in the undergraduate curriculum. Historically, dentists interested in postgraduate study in this subject have accessed courses on medical law and ethics. While there are areas of shared interest (for example, consent, confidentiality) there are differences in emphasis and content (for example, end of life care, organ transplants, etc) which are not relevant to dentistry. A new postgraduate certificate (PgCert) course was approved by the University of Bedfordshire designed specifically for dental practitioners, making it the only university accredited course in the UK that is specific to dental staff. Students' perception of the subject of dental law and ethics at a postgraduate level was not known. The first PgCert student cohort was assessed at the start and the end of the course using two questionnaires. Sixteen students, all qualified dental practitioners working in the UK, took part. The perception toward the subject of dental law and ethics was in-line with the current guideline and regulations governing the dental profession. Perception of dental law was clearer at the end of the course compared to the beginning while dental ethics remained a challenging subject.

  15. The Impact of the Affordable Care Act's Dependent Coverage Mandate on Use of Dental Treatments and Preventive Services.

    PubMed

    Shane, Dan M; Wehby, George L

    2017-09-01

    Oral health problems are the leading chronic conditions among children and younger adults. Lack of dental coverage is thought to be an important barrier to care but little empirical evidence exists on the causal effect of private dental coverage on use of dental services. We explore the relationship between dental coverage and dental services utilization with an analysis of a natural experiment of increasing private dental coverage stemming from the Affordable Care Act's (ACA)-dependent coverage mandate. To evaluate whether increased private dental insurance due to the spillover effect of the ACA-dependent coverage health insurance mandate affected utilization of dental services among a group of affected young adults. 2006-2013 Medical Expenditure Panel Surveys. We used a difference-in-difference regression approach comparing changes in dental care utilization for 25-year olds affected by the policy to unaffected 27-year olds. We evaluate effects on dental treatments and preventive services RESULTS:: Compared to 27-year olds, 25-year olds were 8 percentage points more likely to have private dental coverage in the 3 years following the mandate. We do not find compelling evidence that young adults increased their use of preventive dental services in response to gaining insurance. We do find a nearly 5 percentage point increase in the likelihood of dental treatments among 25-year olds following the mandate, an effect that appears concentrated among women. Increases in private dental coverage due to the ACA's-dependent coverage mandate do not appear to be driving significant changes in overall preventive dental services utilization but there is evidence of an increase in restorative care.

  16. Care Provided by Students in Community-Based Dental Education: Helping Meet Oral Health Needs in Underserved Communities.

    PubMed

    Mays, Keith A; Maguire, Meghan

    2018-01-01

    Since 2000, reports have documented the challenges faced by many Americans in receiving oral health care and the consequences of inadequate care such as high levels of dental caries among many U.S. children. To help address this problem, many dental schools now include community-based dental education (CBDE) in their curricula, placing students in extramural clinics where they provide care in underserved communities. CBDE is intended to both broaden the education of future oral health professionals and expand care for patients in community clinics. The aim of this study was to develop a three-year profile of the patients seen and the care provided by students at extramural clinics associated with one U.S. dental school. Three student cohorts participated in the rotations: final-year students in the Doctor of Dental Surgery, Bachelor of Science in Dental Hygiene, and Master of Dental Therapy programs. The study was a retrospective analysis of data retrieved from the school's database for three consecutive academic years. The data included patients' demographics and special health care needs status (based on information collected by students from their patients) and procedures students performed while on rotations. For the three-year period, the results showed a total of 43,128 patients were treated by 418 student providers. Approximately 25% of all encounters were with pediatric patients. Students completed 5,908 child prophylaxis, 5,386 topical fluoride varnish, and 7,678 sealant procedures on pediatric patients. Annually, 7% of the total patients treated had special health care needs. The results show that these students in CBDE rotations provided a substantial amount of oral health care at extramural sites and gained additional experience in caring for a diverse population of patients and performing a wide range of procedures.

  17. Predictors of dental avoidance among Australian adults with different levels of dental anxiety.

    PubMed

    Armfield, Jason M; Ketting, Manon

    2015-09-01

    It has been proposed that avoidance of dental visits might be the main determinant of poor oral health outcomes in people with high dental anxiety (HDA). This study aimed to determine the predictors of dental avoidance among people with HDA and also whether these predictors differed from those found in people with lower dental anxiety (LDA). Study participants (n = 596; response rate = 41.1%) comprised a random cross-sectional sample of the Australian adult population who completed a mailed self-complete questionnaire containing items relating to the use and accessibility of dental services, trust in dental professionals, dental anxiety, dental experiences, self-perceived oral health, vulnerability-related perceptions of visiting the dentist, and psychological health. Multiple imputation was used to replace missing values and statistically significant variables in bivariate analyses were entered into a multivariable logistic generalized linear model. More than two-thirds of participants with HDA were currently avoiding or delaying a dental visit. Among people with HDA, dental avoidance was independently and significantly predicted by difficulty paying a $300 dental bill, having no or only little trust in the last-visited dentist, perceived treatment need and dental anxiety. Among people with LDA, only perceived treatment need and dental anxiety predicted avoidance. In addition to their high anxiety, a number of additional barriers to dental visiting were found for people with HDA. These barriers, especially cost and communication issues with dentists, need to be addressed to assist people with HDA obtain necessary, regular dental care. (c) 2015 APA, all rights reserved).

  18. Socioeconomic inequalities in the use of dental care services during early childhood: an epidemiological survey.

    PubMed

    Souza, João Gabriel Silva; Sampaio, Aline Araújo; Costa Oliveira, Bárbara Emanoele; Jones, Kimberly Marie; Martins, Andréa Maria Eleutério De Barros Lima

    2018-05-03

    The use of dental care services contributes to the improvement of children's healthy behaviors, reducing the prevalence of future dental problems. In this way, the purpose of this study was to describe the use of dental care service during early childhood and the possible socioeconomic inequalities in this use. Data from the Brazilian Oral Health Survey (SB Brasil, 2010) were used. Interviews with the children's parents and clinical examinations with the children were conducted in a 5-year-old representative sample. Descriptive, bivariate and multiple hierarchical statistical analyses were applied. Of the 7241 children included, 3812 (53.2%) had used dental care services at least once in their lifetimes, and 1872 (48.8%) had used services for check-up/prevention. The use of dental services was greater among children with a higher family income (P < 0.05). The use of check-ups was lower among children with non-White skin color (Black and Browns) and among those who did not live in state capitals (P < 0.05). Clinical conditions and self-perception were also associated with the use (P < 0.05). Socioeconomic differences in the general use of dental care and in its use for check-ups were identified during early childhood, indicating the presence of inequalities. © 2018 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. The potential oral health impact of cost barriers to dental care: findings from a Canadian population-based study

    PubMed Central

    2014-01-01

    Background Prior to the 2007/09 Canadian Health Measures Survey, there was no nationally representative clinical data on the oral health of Canadians experiencing cost barriers to dental care. The aim of this study was to determine the oral health status and dental treatment needs of Canadians reporting cost barriers to dental care. Methods A secondary data analysis of the 2007/09 Canadian Health Measures Survey was undertaken using a sample of 5,586 Canadians aged 6 to 79. Chi square tests were conducted to test the association between reporting cost barriers to care and oral health outcomes. Logistic regressions were conducted to identify predictors of reporting cost barriers. Results Individuals who reported cost barriers to dental care had poorer oral health and more treatment needs compared to their counterparts. Conclusions Avoiding dental care and/or foregoing recommended treatment because of cost may contribute to poor oral health. This study substantiates the potential likelihood of progressive dental problems caused by an inability to treat existing conditions due to financial barriers. PMID:24962622

  20. Child Health and Access to Medical Care

    PubMed Central

    Leininger, Lindsey; Levy, Helen

    2016-01-01

    It might seem strange to ask whether increasing access to medical care can improve children’s health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children’s health. Nonetheless, they find that, on the whole, policies to improve access indeed improve children’s health, with the caveat that context plays a big role—medical care “matters more at some times, or for some children, than others.” Focusing on studies that can plausibly show a causal effect between policies to increase access and better health for children, and starting from an economic framework, they consider both the demand for and the supply of health care. On the demand side, they examine what happens when the government expands public insurance programs (such as Medicaid), or when parents are offered financial incentives to take their children to preventive appointments. On the supply side, they look at what happens when public insurance programs increase the payments that they offer to health-care providers, or when health-care providers are placed directly in schools where children spend their days. They also examine how the Affordable Care Act is likely to affect children’s access to medical care. Leininger and Levy reach three main conclusions. First, despite tremendous progress in recent decades, not all children have insurance coverage, and immigrant children are especially vulnerable. Second, insurance coverage alone doesn’t guarantee access to care, and insured children may still face barriers to getting the care they need. Finally, as this issue of Future of Children demonstrates, access to care is only one of the factors that policy makers should consider as they seek to make the nation’s children healthier. PMID:27516723

  1. Receipt of preventive dental care among special-needs children enrolled in Medicaid: a crisis in need of attention.

    PubMed

    Mitchell, Jean M; Gaskin, Darrell J

    2008-10-01

    Although not widely recognized, tooth decay is the most common childhood chronic disease among children ages five to seventeen. Despite higher rates of dental caries and greater needs, low-income minority children enrolled in Medicaid are more likely to go untreated relative to their higher income counterparts. No research has examined this issue for children with special needs. We analyzed Medicaid enrollment and claims data for special-needs children enrolled in the District of Columbia Medicaid program to evaluate receipt of recommended preventive dental care. Use of preventive dental care is abysmally low and has declined over time. Enrollment in managed care rather than fee for service improves the likelihood that special-needs children receive recommended preventive dental services, whereas residing farther from the Metro is an impediment to receipt of dental care.

  2. School-Based Health Centers Make Sense: Ensuring All Kids Have Access to the Health Care They Need to Be Healthy and Safe, and to Do Their Best in School. Issue Brief

    ERIC Educational Resources Information Center

    Children Now, 2014

    2014-01-01

    School-based health centers (SBHCs) are an innovative and effective way to address California's severe health care access problem among children. By providing critical health care services to kids in school, SBHCs ensure children get the medical, mental health, and dental care they need to be healthy and safe, and to support their ability to…

  3. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca

    PubMed Central

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Introduction Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. Aim: To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. Methods A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. Results 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Conclusion Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population. PMID:25328594

  4. Rural and remote dental services shortages: filling the gaps through geo-spatial analysis evidence-based targeting.

    PubMed

    Shiika, Yulia; Kruger, Estie; Tennant, Marc

    Australia has a significant mal-distribution of its limited dental workforce. Outside the major capital cities, the distribution of accessible dental care is at best patchy. This study applied geo-spatial analysis technology to locate gaps in dental service accessibility for rural and remote dwelling Australians, in order to test the hypothesis that there are a few key location points in Australia where further dental services could make a significant contribution to ameliorating the immediate shortage crisis. A total of 2,086 dental practices were located in country areas, covering a combined catchment area of 1.84 million square kilometers, based on 50 km catchment zones around each clinic. Geo-spatial analysis technology was used to identify gaps in the accessibility of dental services for rural and remote dwelling Australians. An extraction of data was obtained to analyse the integrated geographically-aligned database. Results: Resolution of the lack of dental practices for 74 townships (of greater than 500 residents) across Australia could potentially address access for 104,000 people. An examination of the socio-economic mix found that the majority of the dental practices (84%) are located in areas classified as less disadvantaged. Output from the study provided a cohesive national map that has identified locations that could have health improvement via the targeting of dental services to that location. The study identified potential location sites for dental clinics, to address the current inequity in accessing dental services in rural and remote Australia.

  5. The development of a primary dental care outreach course.

    PubMed

    Waterhouse, P; Maguire, A; Tabari, D; Hind, V; Lloyd, J

    2008-02-01

    The aim of this work was to develop the first north-east based primary dental care outreach (PDCO) course for clinical dental undergraduate students at Newcastle University. The process of course design will be described and involved review of the existing Bachelor of Dental Surgery (BDS) degree course in relation to previously published learning outcomes. Areas were identified where the existing BDS course did not meet fully these outcomes. This was followed by setting the PDCO course aims and objectives, intended learning outcomes, curriculum and structure. The educational strategy and methods of teaching and learning were subsequently developed together with a strategy for overall quality control of the teaching and learning experience. The newly developed curriculum was aligned with appropriate student assessment methods, including summative, formative and ipsative elements.

  6. Children--The Effect of Rural Residence on Dental Unmet Need for Children with Special Health Care Needs

    ERIC Educational Resources Information Center

    Skinner, Asheley Cockrell; Slifkin, Rebecca T.; Mayer, Michelle L.

    2006-01-01

    Background: Unmet need for dental care is the most prevalent unmet health care need among children with special health care needs (CSHCN), even though these children are at a greater risk for dental problems. The combination of rural residence and special health care needs may leave rural CSHCN particularly vulnerable to high levels of unmet…

  7. Computerized Dental Injection Fear Treatment

    PubMed Central

    Heaton, L.J.; Leroux, B.G.; Ruff, P.A.; Coldwell, S.E.

    2013-01-01

    One in four adults reports a clinically significant fear of dental injections, leading many to avoid dental care. While systematic desensitization is the most common therapeutic method for treating specific phobias such as fear of dental injections, lack of access to trained therapists, as well as dentists’ lack of training and time in providing such a therapy, means that most fearful individuals are not able to receive the therapy needed to be able to receive necessary dental treatment. Computer Assisted Relaxation Learning (CARL) is a self-paced computerized treatment based on systematic desensitization for dental injection fear. This multicenter, block-randomized, dentist-blind, parallel-group study conducted in 8 sites in the United States compared CARL with an informational pamphlet in reducing fear of dental injections. Participants completing CARL reported significantly greater reduction in self-reported general and injection-specific dental anxiety measures compared with control individuals (p < .001). Twice as many CARL participants (35.3%) as controls (17.6%) opted to receive a dental injection after the intervention, although this was not statistically significant. CARL, therefore, led to significant changes in self-reported fear in study participants, but no significant differences in the proportion of participants having a dental injection (ClinicalTrials.gov, NCT00609648). PMID:23690352

  8. [To finish with fear of dental care].

    PubMed

    Bohl, J B; Bracconi, M; Herve, C; Pirnay, P

    2015-06-01

    The patient facing the dentist knows fear, anxiety. The symbolism of the mouth and teeth from childhood is an entirely specific nature of the human body. The terrifying image of dental treatment and dentist that has long been stigmatized through painting, literature, theater and cinema can change today. Many therapeutic options to the management of anxiety in dental phobia; anesthesia, conscious sedation, combined with a soothing cabinet, a caring dentist, targeted use of medications or milder alternative methods; homeopathy, herbal medicine, acupuncture, psychotherapy, places the patient's interests at the center of the caregiving relationship. But this treatment panel is also offered him the difficulty of the choice. This exercise without systematization, according to the patient with competence and kindness. Some patients may be sent or processed in collaboration with other health professionals.

  9. Dental health care providers' views on child physical abuse in Malaysia.

    PubMed

    Hussein, A S; Ahmad, R; Ibrahim, N; Yusoff, A; Ahmad, D

    2016-10-01

    To assess the knowledge, attitudes and experience of a group of Malaysian dental health care providers regarding child physical abuse (CPA) cases in terms of frequency of occurrence, diagnosis, risk factors and reporting. A questionnaire was distributed to all dental health care providers attending a national paediatric dentistry conference in Kuantan, Malaysia, and demographical variables, knowledge, attitudes and experience about CPA, risk factors and the reasons for not reporting abuse cases were collected. Descriptive statistics and bivariance analysis were performed. A 5 % level of statistical significance was applied for the analyses (p ≤ 0.05). The response rate was 74.7 %. Half of the respondents (52.8 %) stated that the frequency of occurrence of CPA is common in Malaysia. Full agreement between dental health care providers was not determined concerning the identification of signs of CPA and its risk factors. Although 83.3 % were aware that reporting CPA is a legal requirement in Malaysia, only 14.8 % have reported such cases. Lack of adequate history was the main reason for not reporting. Virtually two-thirds of the respondents (62 %) indicated that they had not received sufficient information about CPA and were willing to be educated on how to diagnose and report child abuse cases (81.5, 78.7 %, respectively). There were considerable disparities in respondents' knowledge and attitudes regarding the occurrence, signs of suspected cases, risk factors and reporting of CPA. Despite being aware of such cases, only a handful was reported. Enhancement in the education of Malaysian dental health care providers on recognising and reporting CPA is recommended.

  10. Efficacy of screening for high blood pressure in dental health care

    PubMed Central

    2011-01-01

    Background There is consensus on the importance of early detection and treatment of high blood pressure. Dental care is one of few medical services to which a considerable proportion of the general population comes for regular check-ups. We tested the effects of blood pressure screening in dental care centres with subsequent work-up of subjects screening positive in primary health care (PHCC). Methods Altogether 1,149 subjects 40-65 years old or 20-39 years old with body mass index >25, and with no previously known hypertension, who came for a dental examination had their blood pressure measured with an Omron M4® automatic blood pressure reading device. Subjects with systolic blood pressure readings above 160 mmHg or diastolic above 90 mmHg were referred to their PHCC for a check up. Outcome data were obtained by scrutiny of PHCC and hospital patient records for hypertension diagnoses during the three years following screening. Results 237 (20.6%) subjects screened positive. Of these, 230 (97.1%) came to their PHCC within the 3-year follow-up period, as compared with 695 (76.2%) of those who screened negative (p < 0.0001). Of those who screened positive, 76 (32.1%) received a diagnosis of hypertension, as compared with 26 (2.9%) of those who screened negative. Sensitivity was 79.1%, specificity 84.8% and positive predictive value 30.1%. The number of subjects needed to screen to find one case of hypertension was 18. Conclusions Co-operation between dental and primary care for blood pressure screening and work-up appears to be an effective way of detecting previously unknown hypertension. PMID:21450067

  11. Differences Among Older Adults in the Types of Dental Services Used in the United States

    PubMed Central

    Manski, Richard J.; Hyde, Jody Schimmel; Chen, Haiyan; Moeller, John F.

    2016-01-01

    The purpose of this article is to explore differences in the socioeconomic, demographic characteristics of older adults in the United States with respect to their use of different types of dental care services. The 2008 Health and Retirement Study (HRS) collected information about patterns of dental care use and oral health from individuals aged 55 years and older in the United States. We analyze these data and explore patterns of service use by key characteristics before modeling the relationship between service use type and those characteristics. The most commonly used service category was fillings, inlays, or bonding, reported by 43.6% of those with any utilization. Just over one third of those with any utilization reported a visit for a crown, implant, or prosthesis, and one quarter reported a gum treatment or tooth extraction. The strongest consistent predictors of use type are denture, dentate, and oral health status along with dental insurance coverage and wealth. Our results provide insights into the need for public policies to address inequalities in access to dental services among an older US population. Our findings show that lower income, less wealthy elderly with poor oral health are more likely to not use any dental services rather than using only preventive dental care, and that cost prevents most non-users who say they need dental care from going to the dentist. These results suggest a serious access problem and one that ultimately produces even worse oral health and expensive major procedures for this population in the future. PMID:27284127

  12. Dental plan premiums in the Affordable Care Act marketplaces trended downward from 2014 through 2016.

    PubMed

    Nasseh, Kamyar; Vujicic, Marko

    2017-04-01

    Pediatric dental benefits must be offered in the health insurance marketplaces created under the Affordable Care Act. The authors analyzed trends over time in premiums and the number of dental insurers participating in the marketplaces. The authors collected dental benefit plan data from 35 states participating in the federally facilitated marketplaces in 2014, 2015, and 2016. For each county, they counted the number of issuers offering stand-alone dental plans (SADPs) and medical plans with embedded pediatric dental benefits. They also analyzed trends in premiums. From 2014 through 2016, the number of issuers of stand-alone dental plans and medical plans with embedded pediatric dental benefits either did not change or increased in most counties. Average premiums for low-actuarial-value SADPs declined from 2014 through 2016. The increase in the number of issuers of stand-alone dental plans and medical plans with embedded dental benefits may be associated with lower premiums. However, more research is needed to determine if this is the case. Affordable dental plans in the marketplaces could induce people with lower incomes to sign up for dental benefits. Newly insured people could have significant oral health needs and pent-up demand for dental care. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  13. Measuring quality of dental care: Caries prevention services for children.

    PubMed

    Herndon, Jill Boylston; Tomar, Scott L; Catalanotto, Frank A; Rudner, Nancy; Huang, I-Chan; Aravamudhan, Krishna; Shenkman, Elizabeth A; Crall, James J

    2015-08-01

    The authors conducted a study to validate the following 3 evidence-based, process-of-care quality measures focused on dental caries prevention for children with an elevated risk of experiencing caries: sealants for 6- to 9-year-olds, sealants for 10- to 14-year-olds, and topical fluoride. Using evidence-based guidelines, the Dental Quality Alliance developed measures for implementation with administrative data at the plan and program levels. To validate the measures, the authors used data from the Florida and Texas Medicaid programs and Children's Health Insurance Programs and from national commercial dental benefit plans. Data were extracted from 414 randomly selected dental office records to validate the use of administrative data to accurately calculate the measures. The authors also assessed statistically significant variations in overall measure performance. Agreement between administrative data and dental records was 95% for sealants (κ = 0.82) and 90% for topical fluoride (κ = 0.78). Sensitivity and specificity were 90.7% and 88.5% for topical fluoride and 77.8% and 98.8% for sealants, respectively. Variation in overall measure performance was greatest for topical fluoride (χ(2) = 5,887.1; P < .01); 18% to 37% of children with an elevated risk of experiencing caries received at least 2 topical fluoride applications during the reporting year. Although there was greater variation in performance for sealants for 6- to 9-year-olds (range, 21.0-31.3%; χ(2) = 548.6; P < .01) compared with sealants for 10- to 14-year-olds (range, 8.4-11.1%; χ(2) = 22.7; P < .01), overall sealant placement rates were lower for 10- to 14-year-olds. These evidence-based, caries prevention process-of-care quality measures can be implemented feasibly and validly using administrative claims data. The measures can be used to assess, monitor, and improve the proportion of children with an elevated risk of experiencing dental caries who receive evidence-based caries prevention

  14. Population ageing and dental care.

    PubMed

    Harford, Jane

    2009-04-01

    Population ageing is a fact in both developed and developing countries. The concern about population ageing largely arises from the combination of a greater number of older people requiring greater amounts of healthcare services and pensions, and relatively fewer people working to pay for them. Oral health and dental care are important aspects of health and health care. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Traditionally, economic studies of ageing have focused on the fiscal implications of ageing, projecting the increased burden on health and welfare services that accompanies ageing. It assumed that ageing is the major driver of recent changes and those past trends will simply be amplified by faster population ageing in the future. Less work has been done to understand other past drivers of increased healthcare spending and their implications for the future. The conclusion of these reports is usually that population ageing is unaffordable with current policy settings. They have proposed policies to deal with population ageing which focused on increasing workforce participation and worker productivity to increase the tax base and reducing entitlements. However, the affordability question is as much political as a numerical. There are no clearly articulated criteria for affordability and little opportunity for public discourse about what citizens are willing to pay in taxes to support an ageing population. While the reports do not necessarily reflect public opinion, they will certainly shape it. Predicting the future for oral health is more fraught than for general health, as oral health is in the midst of an epidemiological transition from high rates of edentulism and tooth loss to low rates. Changes in the pattern of dental expenditure in the past do not mirror the experience of rapid increases in per capita expenditure on older age groups as regards general health. Dentistry

  15. Assessing the Need for Anesthesia and Sedation Services in Kuwaiti Dental Practice

    PubMed Central

    Abdulwahab, Mohammad; Al-Sayegh, Fatima; Boynes, Sean G; Abdulwahab, Hawra; Zovko, Jayme; Close, John

    2010-01-01

    The objective of this study was to examine the public health relevance of the prevalence of dental fear in Kuwait and the resultant barrier that it creates regarding access to dental care. The study analysis demonstrated a high prevalence of dental fear and anxiety in the Kuwaiti population and a perceived need for anesthesia services by dental care providers. The telephone survey of the general population showed nearly 35% of respondents reported being somewhat nervous, very nervous, or terrified about going to the dentist. In addition, about 36% of the population postponed their dental treatment because of fear. Respondents showed a preference to receive sedation and anesthesia services as a means of anxiety relief, and they were willing to go to the dentist more often when such services were available. People with high fear and anxiety preferred to receive some type of medication to relieve their anxiety. In conclusion, the significance and importance of the need for anesthesia services to enhance the public health of dental patients in Kuwait has been demonstrated, and improvements are needed in anesthesia and sedation training of Kuwaiti dental care providers. PMID:20843223

  16. Dental care knowledge and practice of a group of health workers in benin city, Nigeria.

    PubMed

    Amuh, Vo; Okojie, Oh; Ehizele, Ao

    2014-09-01

    The correlation between knowledge of dental care knowledge and its practice varies among the different health professionals. The aim of the following study is to assess the knowledge and practice of health workers in a private medical health facility on dental care. A descriptive cross-sectional study was carried out on the health workers in Faith Medical Center, Benin City, Nigeria. A self-administered questionnaire, containing 31 open and closed questions was used for data collection to assess their knowledge and practice of dental care. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 (Chicago, IL, USA) and WIN PEPI software version 11.15. None of the respondents had a poor knowledge of dental care, but majority had poor practice. The pattern of distribution of knowledge and practice of dental care observed in this study was not significantly affected by age, gender, occupation and working experience. The entire respondents knew that bleeding from the gum is not normal and 96.2% (75/78) gave correct causes of bleeding gums. Majority 88.5% (69/78) also knew that tooth decay is not normal, but fewer 66.6% (52/78) knew the correct causes of tooth decay. Only 37.2% (29/75) of the respondents took correct action after experiencing a toothache (i.e., consulting a dentist for proper management) and majority 80.8% (63/78) and 76.1% (60/78) still make use of toothpicks, which is considered as potentially harmful and frequently consume cariogenic diet respectively. There is a good knowledge of dental care, but poor oral health practices among the studied health workers. Oral health education to correct their improper practices is therefore highly advocated.

  17. Letter from America: UK and US state-funded dental provision.

    PubMed

    Currie, R B; Pretty, I A; Tickle, M; Maupomé, G

    2012-12-01

    Current UK and US economic conditions have re-focussed attention on the need to deliver dental care with limited finance and resources. This raises hard questions determining which services will be offered and what they should achieve to satisfy public demands and needs. We consider impending dental health reforms in the US and UK within the context of contemporary experiences to identify issues and delivery goals for the two nations. The paper provides a brief history and background of the development of social dental care models in the UK and US, highlighting some differences in state-funded delivery of dental care. SHIFTING DEMAND: From the 1950s, demand for dental treatment has increased and acquired a more complex composition growing from predominantly surgical and restorative treatment to encompass preventive care and cosmetic services. PRIORITISING CARE ACCORDING TO NEED: Despite improvements in general health and technology, inequalities in access and utilisation of dental care are still experienced, primarily by groups with low socio-economic status. DELIVERY: BALANCING RESOURCES, DEMAND AND NEED: In developing and delivering reform agendas, much can be learned from previous policy interventions. Pressures of cost, coverage, and capacity, besides demand versus need must be carefully considered and balanced to deliver quality service and value for users and taxpayers. Ethical and moral consideration should be given to making services needs-driven to address high treatment requirements rather than the high care demands of the worried well. This challenge brings the additional political pressure of convincing many of the voters (and subsequent complainers) that their demands may be less important than the needs of others.

  18. Transmission of blood-borne pathogens in US dental health care settings

    PubMed Central

    Cleveland, Jennifer L.; Gray, Shellie Kolavic; Harte, Jennifer A.; Robison, Valerie A.; Moorman, Anne C.; Gooch, Barbara F.

    2016-01-01

    Background During the past decade, investigators have reported transmissions of blood-borne pathogens (BBPs) in dental settings. In this article, the authors describe these transmissions and examine the lapses in infection prevention on the basis of available information. Methods The authors reviewed the literature from 2003 through 2015 to identify reports of the transmission of BBPs in dental settings and related lapses in infection prevention efforts, as well as to identify reports of known or suspected health care–associated BBP infections submitted by state health departments to the Centers for Disease Control and Prevention. Results The authors identified 3 published reports whose investigators described the transmission of hepatitis B virus and hepatitis C virus. In 2 of these reports, the investigators described single-transmission events (from 1 patient to another) in outpatient oral surgery practices. The authors of the third report described the possible transmission of hepatitis B virus to 3 patients and 2 dental health care personnel in a large temporary dental clinic. The authors identified lapses in infection prevention practices that occurred during 2 of the investigations; however, the investigators were not always able to link a specific lapse to a transmission event. Examples of lapses included the failure to heat-sterilize handpieces between patients, a lack of training for volunteers on BBPs, and the use of a combination of unsafe injection practices. Conclusions The authors found that reports describing the transmission of BBPs in dental settings since 2003 were rare. Failure to adhere to Centers for Disease Control and Prevention recommendations for infection control in dental settings likely led to disease transmission in these cases. Practical Implications The existence of these reports emphasizes the need to improve dental health care personnel's understanding of the basic principles and implementation of standard precautions through the

  19. Utilization of services and referrals through dental outreach programs in rural areas of India. A two year study.

    PubMed

    Asawa, Kailash; Bhanushali, Nikhil V; Tak, Mridula; Kumar, Dola Rama Venkata; Rahim, Muhammad Furqon Bin Abd; Alshahran, Obaid Abdullah; Divakar, Darshan Devang

    2015-01-01

    Oral health care services are often sparse and inconsistent in India therefore it is often difficult for poor people to get access to the oral health care services. The approach by dental institutions with the help of community outreach programs is a step ahead in overcoming this situation. The study was conducted to evaluate the number of patients, disease pattern and the services provided in the outreach programmes and also effectiveness of patient referral. A retrospective study was conducted and the data were obtained from records of outreach programs conducted, in last 2 years by Pacific Dental College and Hospital. The data were analysed using descriptive statistics for the computation of percentages Chi-square test was applied to know the association of effectiveness of referral with age and gender. Confidence level and level of significance was fixed at 95% and 5% respectively. A total of 22982 individuals in the age group of 4-80 years attended the outreach program. Dental caries (42.3%), periodontal diseases (63.2-69.0%) and dental fluorosis (33.7-35.0%) were commonly observed diseases. Effectiveness of referral was significantly high among the middle age adults and females (P<0.05). The effectiveness of referral was highly improved in 2013 after establishment of certain guidelines and strategies. The approaches by dental institutions with the help of community outreach programs can spread awareness and disseminate treatment and thereby enhancing access to care and eliminating access to care within the rural communities.

  20. Lack of dental insurance is correlated with edentulism.

    PubMed

    Simon, Lisa; Nalliah, Romesh P; Seymour, Brittany

    2015-01-01

    The correlation between insurance status and edentulism has not previously been reported in a population with known access to a dentist, and little is known about patient demographics in corporate dental settings. This study investigated patient demographics of a former dental franchise in Chicopee, Massachusetts, and examined a correlation between dental insurance and edentulism in this group. The correlation of edentulism with age, gender, and dental risk factors (diabetes, temporomandibular disorder, trouble with previous dental work, or oral sores and ulcers) was also examined. This was a retrospective case study. Age, gender, and presence of dental risk factors were recorded from the patient medical history intake form. Dentate status was recorded from patient odontograms. Dental insurance status was obtained from billing records. Data was aggregated and deidentified. Descriptive and bivariate statistics and logistic regression models were used to identify associations (p-value ≤ 0.05 significance). Of 1,123 records meeting inclusion criteria, 52.54 percent of patients had dental insurance, 26.27 percent had at least one dental risk factor, and 18.17 percent were edentulous. Age and insurance status were significantly correlated with edentulism. Correcting for age, individuals without insurance were 1.56 times as likely to be edentulous. This case study provides insight into patient demographics that might seek care in a corporate setting and suggests that access to a dentist alone may not be adequate in preserving the adult dentition; dental insurance may also be important to health. As the corporate dental practice model continues to grow, these topics deserve further study.

  1. A Guide to Dental Care for the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) Under Medicaid.

    ERIC Educational Resources Information Center

    Lindahl, Roy L.; Young, Wesley O.

    This guide has been developed to assist administrators, providers of dental care, and others involved in carrying out the dental care provisions of the EPSDT program (Early and Periodic Screening, Diagnosis, and Treatment Program). It is intended to assist in the development of programs concerned with the unique characteristics of dental diseases…

  2. Retention of underrepresented minority students in dental school: one dental schools story.

    PubMed

    Lacy, Ernestine S; Miller, Barbara H; Hornback, Sheryl A; McCann, Ann L; Reuben, Jayne S

    2011-01-01

    There is a large disparity between the proportions of African-Americans, Hispanics, and Native Americans in the general population and in the dental profession. While these underrepresented minorities (URMs) as a group make up almost 30% of the United States population, they constitute only about 6% of the nation's dentists. Eliminating this disparity is important in addressing access to care for underrepresented groups. Texas A&M Health Science Center Baylor College of Dentistry (TAMHSC-BCD) enrolled greater numbers and proportions of URM students than any other non-minority school from 2006-2010. Strategies used to achieve this level of diversity include a Whole File Review process; career awareness activities for elementary, junior high and high school students; and academic enrichment programs for college students and college graduates. Retaining and graduating URM students is just as important as enrolling them. TAMHSC-BCD's retention rate over the last five years is 95.7% for all students and 92.5% for URM students. A wide range of services aids in the retention process. These services are available to all students and include monitoring of students' academic performance followed up with academic advisement as appropriate, peer tutoring, an alternative five-year curriculum, professional psychological counseling, professional learning assessments, social support; and mentoring through student organizations. The retention program at TAMHSC-BCD can serve as a model for other dental and other health professions schools seeking ways to ensure the academic success of their URM students. The more of these students we enroll and graduate, the more the problem of access to dental care is addressed.

  3. Factors Discriminant of Dental Health Care Behavior Orientation in Southwest Cultures.

    ERIC Educational Resources Information Center

    Solis, Enrique, Jr.

    The study identified, among a multiplicity of demographic and psycho-social variables, the factors which discriminate between preventively and symptomatically oriented individuals regarding dental health care for both self (mother) and her children; determined if a relationship exists between orientation to medical care in general and dental…

  4. An examination of periodontal treatment, dental care, and pregnancy outcomes in an insured population in the United States.

    PubMed

    Albert, David A; Begg, Melissa D; Andrews, Howard F; Williams, Sharifa Z; Ward, Angela; Conicella, Mary Lee; Rauh, Virginia; Thomson, Janet L; Papapanou, Panos N

    2011-01-01

    We examined whether periodontal treatment or other dental care is associated with adverse birth outcomes within a medical and dental insurance database. In a retrospective cohort study, we examined the records of 23,441 women enrolled in a national insurance plan who delivered live births from singleton pregnancies in the United States between January 1, 2003, and September 30, 2006, for adverse birth outcomes on the basis of dental treatment received. We compared rates of low birthweight and preterm birth among 5 groups, specifying the relative timing and type of dental treatment received. We used logistic regression analysis to compare outcome rates across treatment groups while adjusting for duration of continuous dental coverage, maternal age, pregnancy complications, neighborhood-level income, and race/ethnicity. Analyses showed that women who received preventive dental care had better birth outcomes than did those who received no treatment (P < .001). We observed no evidence of increased odds of adverse birth outcomes from dental or periodontal treatment. For women with medical and dental insurance, preventive care is associated with a lower incidence of adverse birth outcomes.

  5. Factors associated with health care access and outcome.

    PubMed

    Paek, Min-So; Lim, Jung-Won

    2012-01-01

    This study aims to (1) assess ethnic differences in health care access and health outcome between Asian Americans and whites and between Asian American subgroups, (2) examine effects of cultural factors, and (3) investigate moderating effects of health risk behaviors between cultural characteristics and health care access and outcome. Data were derived from the 2007 California Health Interview Survey. Asian Americans (n = 4,462) and whites (n = 4,470) were included. There were significant ethnic differences in health care access and health perception between Asian Americans and Whites and across Asian American subgroups. Health risk behaviors moderated relationships between cultural factors and health care access and outcome. Findings reveal that ethnicity affects an individual's health care access and health perception, and their health behaviors are an important factor that may improve or worsen outcomes. This study may increase our knowledge base of research and interventions to enhance ethnic minority populations' health care accessibility and perceptions.

  6. Strategic management and organizational behavior in dental education: reflections on key issues in an environment of change.

    PubMed

    Dunning, David G; Durham, Timothy M; Lange, Brian M; Aksu, Mert N

    2009-06-01

    With issues such as shrinking revenue, access to care, faculty workloads, and graying faculty, dental schools are faced with difficult challenges that fall to dental school deans to manage. Do dental school deans have the organizational skill sets and ethical frameworks necessary to address the challenges now facing dental schools? The purpose of this article is to pose questions and suggestions regarding some of the key issues in dental colleges today and to stimulate discussion in the dental community about needed changes in dental education.

  7. Socioeconomic inequalities in the use of dental care services in Europe: what is the role of public coverage?

    PubMed

    Palència, Laia; Espelt, Albert; Cornejo-Ovalle, Marco; Borrell, Carme

    2014-04-01

    The aim of this study was to analyse inequalities in the use of dental care services according to socioeconomic position (SEP) in individuals aged ≥50 years in European countries in 2006, to examine the association between the degree of public coverage of dental services and the extent of inequalities, and specifically to determine whether countries with higher public health coverage show lower inequalities. We carried out a cross-sectional study of 12 364 men and 14 692 women aged ≥50 years from 11 European countries. Data were extracted from the second wave of the Survey of Health, Ageing and Retirement in Europe (SHARE 2006). The dependent variable was use of dental care services within the previous year, and the independent variables were education level as a measure of SEP, whether services were covered to some degree by the country's public health system, and chewing ability as a marker of individuals' need for dental services. Age-standardized prevalence of the use of dental care as a function of SEP was calculated, and age-adjusted indices of relative inequality (RII) were computed for each type of dental coverage, sex and chewing ability. Socioeconomic inequalities in the use of dental care services were higher in countries where no public dental care cover was provided than in countries where there was some degree of public coverage. For example, men with chewing ability from countries with dental care coverage had a RII of 1.39 (95%CI: 1.29-1.51), while those from countries without coverage had a RII of 1.96 (95%CI: 1.72-2.23). Women without chewing ability from countries with dental care coverage had a RII of 2.15 (95%CI: 1.82-2.52), while those from countries without coverage had a RII of 3.02 (95%CI: 2.47-3.69). Dental systems relying on public coverage seem to show lower inequalities in their use, thus confirming the potential benefits of such systems. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Factors associated with patients' satisfaction in Brazilian dental primary health care.

    PubMed

    Aldosari, Muath Abdullah; Tavares, Mary Angela; Matta-Machado, Antônio Thomaz Gonzaga; Abreu, Mauro Henrique Nogueira Guimarães

    2017-01-01

    To assess factors associated with patients' satisfaction with the treatment by dentists in primary health care (PHC) in Brazil. The dataset was part of a nationwide cross-sectional survey for evaluating PHC teams conducted by the Brazilian Ministry of Health. Patients from each of 16,202 oral health teams were interviewed. In addition to sociodemographic information, the questionnaire included information about patient experience domains: access and booking of dental appointments, bonding and accountability, welcoming of the patient, and their perception of dental facilities. The dependent variable was the answer to the question 'From 0 to 10, how would you grade your satisfaction with treatment received from the dentist?' Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios and corresponding 95% confidence interval. The mean patient satisfaction was 9.4 (±2.3). Higher patient satisfaction with PHC was associated with lower education and the patient's perception of the clinic conditions. Moreover, higher satisfaction was associated with positive reception and hospitality, enough time for treatment, and instructions that met patients' needs. Lower satisfaction with PHC was associated with patients who have jobs compared to those who do not work. Patient satisfaction is increased with friendly and understanding PHC staff. Moreover, meeting patient expectations by taking time to understand the needs and giving the right instructions is associated with higher satisfaction.

  9. Access to timely formal dementia care in Europe: protocol of the Actifcare (ACcess to Timely Formal Care) study.

    PubMed

    Kerpershoek, Liselot; de Vugt, Marjolein; Wolfs, Claire; Jelley, Hannah; Orrell, Martin; Woods, Bob; Stephan, Astrid; Bieber, Anja; Meyer, Gabriele; Engedal, Knut; Selbaek, Geir; Handels, Ron; Wimo, Anders; Hopper, Louise; Irving, Kate; Marques, Maria; Gonçalves-Pereira, Manuel; Portolani, Elisa; Zanetti, Orazio; Verhey, Frans

    2016-08-23

    Previous findings indicate that people with dementia and their informal carers experience difficulties accessing and using formal care services due to a mismatch between needs and service use. This mismatch causes overall dissatisfaction and is a waste of the scarce financial care resources. This article presents the background and methods of the Actifcare (ACcess to Timely Formal Care) project. This is a European study aiming at best-practice development in finding timely access to formal care for community-dwelling people with dementia and their informal carers. There are five main objectives: 1) Explore predisposing and enabling factors associated with the use of formal care, 2) Explore the association between the use of formal care, needs and quality of life and 3) Compare these across European countries, 4) Understand the costs and consequences of formal care services utilization in people with unmet needs, 5) Determine the major costs and quality of life drivers and their relationship with formal care services across European countries. In a longitudinal cohort study conducted in eight European countries approximately 450 people with dementia and informal carers will be assessed three times in 1 year (baseline, 6 and 12 months). In this year we will closely monitor the process of finding access to formal care. Data on service use, quality of life and needs will be collected. The results of Actifcare are expected to reveal best-practices in organizing formal care. Knowledge about enabling and predisposing factors regarding access to care services, as well as its costs and consequences, can advance the state of the art in health systems research into pathways to dementia care, in order to benefit people with dementia and their informal carers.

  10. Dentists' partnership of Michigan's Calhoun County: a care model for uninsured populations.

    PubMed

    Higbea, Raymond J; Palumbo, Charles H; Pearl, Samantha A; Byrne, Mary Jo; Wise, Jill

    2013-09-01

    Community leaders in Calhoun County, Michigan, identified access to dental care as an acute local need and in early 2007 organized Calhoun County Dentists' Partnership. A group of stakeholders developed a program centered on local dentists who donated a designated number of office visits per month to care for uninsured county residents. Residents enrolled in the program were required to attend an oral health class; receive a dental screening, cleaning, and dental x-rays by a dental hygienist; and complete a designated number of hours of community service before seeing a dentist. Since the program's 2007 inception, approximately 4,000 people have received dental services valued at approximately $510,000. In turn, program participants provided more than 57,000 hours of community service. The program is credited with reducing the number of patients presenting to a local hospital emergency department for dental pain by 70 percent between 2006 and 2012. Similar programs are now under way in thirteen other communities in the Midwest, which shows that such local initiatives, volunteerism, and community organization can address dental care access needs.

  11. Listening to the Patient: Women Veterans' Insights About Health Care Needs, Access, and Quality in Rural Areas.

    PubMed

    Brooks, Elizabeth; Dailey, Nancy K; Bair, Byron D; Shore, Jay H

    2016-09-01

    Many work to ensure that women veterans receive appropriate and timely health care, yet the needs of those living in rural areas are often ignored. This is a critical oversight given the multitude of reports documenting rural access problems and health disparities. Lacking this, we are unable to plan for and evaluate appropriate care for this specific group. In this project, we spoke with rural women veterans to document service needs and quality of care from their perspective. Rural women veterans' views about health care access and quality were ascertained in a series of five, semistructured focus groups (n = 35) and completion of a demographic questionnaire. Content analysis documented focus-group themes. Participants said that local dental, mental health, and gender-specific care options were needed, as well as alternative healing options. Community-based support for women veterans and interaction with female peers were absent. Participants' support for telehealth was mixed, as were requests for gender-specific care. Personal experiences in the military impacted participants' current service utilization. Action by both Veterans Affairs and the local community is vital to improving the health of women veterans. Service planning should consider additional Veterans Affairs contracts, mobile health vans, peer support, and enhanced outreach. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  12. Enhancing Dental Students' Understanding of Poverty Through Simulation.

    PubMed

    Lampiris, Lewis N; White, Alex; Sams, Lattice D; White, Tiffany; Weintraub, Jane A

    2017-09-01

    Dental students should develop an understanding of the barriers to and frustrations with accessing dental care and maintaining optimal oral health experienced by persons with limited resources rather than blaming the patient or caregiver. Developing this understanding may be aided by helping students learn about the lives of underserved and vulnerable patients they will encounter not only in extramural rotations, but throughout their careers. The aim of this study was to determine if dental students' understanding of daily challenges faced by families with low income changed as a result of a poverty simulation. In 2015 and 2016, an experiential poverty simulation was used to prepare third-year dental students at one U.S. dental school for their upcoming required community-based rotations. In 2015, United Way staff conducted the simulation using the Missouri Community Action Poverty Simulation (CAPS); in 2016, faculty members trained in CAPS conducted the simulation using a modified version of the tool. In the simulation, students were assigned to family units experiencing various types of hardship and were given specific identities for role-playing. A retrospective pretest and a posttest were used to assess change in levels of student understanding after the simulation. Students assessed their level of understanding in five domains: financial pressures, difficult choices, difficulties in improving one's situation, emotional stressors, and impact of community resources for those living in poverty. The survey response rates in 2015 and 2016 were 86% and 74%, respectively. For each of the five domains, students' understanding increased from 58% to 74% per domain. The majority reported that the exercise was very valuable or somewhat valuable (74% in 2015, 88% in 2016). This study found that a poverty simulation was effective in raising dental students' understanding of the challenges faced by low-income families. It also discovered that framing the issues in the

  13. SOCIO-ECONOMIC INEQUALITIES IN THE USE OF DENTAL CARE SERVICES IN EUROPE: WHAT IS THE ROLE OF PUBLIC COVERAGE?

    PubMed Central

    Palència, Laia; Espelt, Albert; Cornejo-Ovalle, Marco; Borrell, Carme

    2013-01-01

    Objectives The aim of this study was to analyse inequalities in the use of dental care services according to socio-economic position (SEP) in individuals aged ≥50 years in European countries in 2006, and to examine the association between the degree of public coverage of dental services and the extent of inequalities, and specifically to determine whether countries with higher public health coverage show lower inequalities. Methods We carried out a cross-sectional study of 12,364 men and 14,692 women aged ≥50 years from 11 European countries. Data were extracted from the second wave of the Survey of Health, Ageing and Retirement in Europe (SHARE 2006). The dependent variable was use of dental care services within the previous year, and the independent variables were education level as a measure of SEP, whether services were covered to some degree by the country’s public health system, and chewing ability as a marker of individuals’ need for dental services. Age-standardised prevalence of the use of dental care as a function of SEP was calculated, and age-adjusted indices of relative inequality (RII) were computed for each type of dental coverage, sex, and chewing ability. Results SEP inequalities in the use of dental care services were higher in countries where no public dental care cover was provided than in countries where there was some degree of public coverage. For example, men with chewing ability from countries with dental care coverage had a RII of 1.39 (95%CI:1.29–1.51), while those from countries without coverage had a RII of 1.96 (95%CI:1.72–2.23). Women without chewing ability from countries with dental care coverage had a RII of 2.15 (95%CI:1.82–2.52), while those from countries without coverage had a RII of 3.02 (95%CI:2.47–3.69). Conclusions Dental systems relying on public coverage seem to show lower inequalities in their use, thus confirming the potential benefits of such systems. PMID:23786417

  14. Limited impact on health and access to care for 19- to 25-year-olds following the Patient Protection and Affordable Care Act.

    PubMed

    Kotagal, Meera; Carle, Adam C; Kessler, Larry G; Flum, David R

    2014-11-01

    The Patient Protection and Affordable Care Act (PPACA) allowed young adults to remain on their parents' insurance until 26 years of age. Reports indicate that this has expanded health coverage. To evaluate coverage, access to care, and health care use among 19- to 25-year-olds compared with 26- to 34-year-olds following PPACA implementation. Data from the Behavior Risk Factor Surveillance System and the National Health Interview Survey, which provide nationally representative measures of coverage, access to care, and health care use, were used to conduct the study among participants aged 19 to 25 years (young adults) and 26 to 34 years (adults) in 2009 and 2012. Self-reported health insurance coverage. Health status, presence of a usual source of care, and ability to afford medications, dental care, or physician visits. Health coverage increased between 2009 and 2012 for 19- to 25-year-olds (68.3% to 71.7%). Using a difference-in-differences (DID) approach, after adjustment, the likelihood of having a usual source of care decreased in both groups but more significantly for 26- to 34-year-olds (DID, 2.8%; 95% CI, 0.45 to 5.15). There was no significant change in health status for 19- to 25-year-olds compared with 26- to 34-year-olds (DID, -0.5%; 95% CI, -1.87 to 0.87). There was no significant change for 19- to 25-year-olds compared with 26- to 34-year-olds in the percentage who reported receiving a routine checkup in the past year (DID, 0.3%; 95% CI, -2.25 to 2.85) or in the ability to afford prescription medications (DID, -0.4%; 95% CI, -2.93 to 1.93), dental care (DID, -2.6%; 95% CI, -5.61 to 0.61), or physician visits (DID, -1.7%; 95% CI, -3.66 to 0.26). There was also no change in the percentage who reported receiving a flu shot (DID, 1.9; 95% CI, -1.93 to 4.93). Insured individuals were more likely to report having a usual source of care and a recent routine checkup and were more likely to be able to afford health care than uninsured individuals

  15. Why do we need an oral health care policy in Canada?

    PubMed

    Leake, James L

    2006-05-01

    Although health care is a right of citizenship, severe inequities in oral health and access to care persist. This paper provides information on the financing, organization and delivery of oral health services in Canada. It concludes that dental care has largely fallen out of consideration as health care. The increasing costs of dental insurance and disparities in oral health and access to care threaten the system"s sustainability. The legislation that allows the insured to receive tax-free care and requires all taxpayers to subsidize that expenditure is socially unjust. Unless an alternative direction is taken, dentistry will lose its relevance as a profession working for the public good and this will be followed by further erosion of public support for dental education and research. However, never before have we had the opportunity presented by high levels of oral health, the extensive resources already allocated to oral health care, plus the support of other organizations to allow us to consider what else we might do. One of the first steps would be to establish new models for the delivery of preventive measures and care that reach out to those who do not now enjoy access.

  16. Dental care and treatments provided under general anaesthesia in the Helsinki Public Dental Service.

    PubMed

    Savanheimo, Nora; Sundberg, Sari A; Virtanen, Jorma I; Vehkalahti, Miira M

    2012-10-27

    Dental general anaesthesia (DGA) is a very efficient treatment modality, but is considered only in the last resort because of the risks posed by general anaesthesia to patients' overall health. Health services and their treatment policies regarding DGA vary from country to country. The aims of this work were to determine the reasons for DGA in the Helsinki Public Dental Service (PDS) and to assess the role of patient characteristics in the variation in reasons and in the treatments given with special focus on preventive care. The data covered all DGA patients treated in the PDS in Helsinki in 2010. The data were collected from patient documents and included personal background: age (<6, 6-12, 13-17, 18-68), gender, immigration, previous conscious sedation and previous DGA; medical background; reasons for DGA and treatments provided. Chi-square tests, Fisher's exact test, and logistic regression modelling were employed in the statistical analyses. The DGA patients (n=349) were aged 2.3 to 67.2 years. Immigrants predominated in the youngest age group (p<0.001) and medically compromised patients among the adults (p<0.001) relative to the other age groups. The main reason for DGA was extreme non-cooperation (65%) followed by dental fear (37%) and an excessive need for treatment (26%). In total, 3435 treatments were performed under DGA, 57% of which were restorations, 24% tooth extractions, 5% preventive measures, 5% radiography, 4% endodontics and the remaining 5% periodontics, surgical procedures and miscellaneous. The reasons for DGA and the treatments provided varied according to age, immigration, previous sedation and DGA and medical background. The logistic regression model showed that previous sedation (OR 2.3; 95%CI 1.3-4.1; p=0.005) and extreme non-cooperation (OR 1.7; 95%CI 0.9-3.2; p=0.103) were most indicative of preventive measures given. Extreme non-cooperation, dental fear and an excessive need for treatment were the main reasons for the use of

  17. When and Why Parents Seek Dental Care for Children under 36 Months.

    PubMed

    Volpato, Luiz Evaristo Ricci; Palti, Dafna Geller; Lima, Jose Eduardo de Oliveira; Machado, Maria Aparecida de Andrade Moreira; Aranha, Andreza Maria Fabio; Bandeca, Matheus Coelho; Pedro, Fabio Luis Miranda; Borges, Alvaro Henrique

    2013-08-01

    The aim was to analyze an infant preventive program determining at what age parents take their children for their first dental visit and the reasons why they do it. A total of 844 children aged from 0 to 36 months, enrolled in the program of oral health maintenance of the Baby Clinic, participated in this study. During the first dental visit, the parents were inquired about the reasons that led them to enroll their children in the program. One trained investigator identified this reasons on the records and classified them according to the following scores: orientation/prevention, caries treatment, malpositioned teeth, dental trauma, tooth color alterations and others. Orientation/prevention was the most prevalent reason from 0-6 months to 25-30 months of age, and at the age 30-36 months, the reason caries/treatment overcame orientation/prevention, becoming the most prevalent reason in that age group. The third place was occupied by dental trauma. The mean age parents seek for dental care to their children was 14, 92 months. This study showed a preferentially preventive/educational profile for the children. However, lots of parents still take children to the dentist preferentially for curative instead of preventive treatment. How to cite this article: Volpato LE, Palti DG, Lima JE, Machado MA, Aranha AM, Bandeca MC, Pedro FL, Borges AH. When and Why Parents Seek Dental Care for Children under 36 Months. J Int Oral Health 2013; 5(4):21-25.

  18. Oral cancer screening and dental care use among women from Ohio Appalachia.

    PubMed

    Reiter, P L; Wee, A G; Lehman, A; Paskett, E D

    2012-01-01

    Residents of Appalachia may benefit from oral cancer screening given the region's higher oral and pharyngeal cancer mortality rates. The current study examined the oral cancer screening behaviors and recent dental care (since dentists perform most screening examinations) of women from Ohio Appalachia. Women from Ohio Appalachia were surveyed for the Community Awareness Resources Education (CARE) study, which was completed in 2006. A secondary aim of the CARE baseline survey was to examine oral cancer screening and dental care use among women from this region. Outcomes included whether women (n=477; cooperation rate = 71%) had ever had an oral cancer screening examination and when their most recent dental visit had occurred. Various demographic characteristics, health behaviors and psychosocial factors were examined as potential correlates. Analyses used multivariate logistic regression. Most women identified tobacco-related products as risk factors for oral cancer, but 43% of women did not know an early sign of oral cancer. Only 15% of women reported ever having had an oral cancer screening examination, with approximately 80% of these women indicating that a dentist had performed their most recent examination. Women were less likely to have reported a previous examination if they were from urban areas (OR=0.33, 95% CI: 0.13-0.85) or perceived a lower locus of health control (OR=0.94, 95% CI: 0.89-0.98). Women were more likely to have reported a previous examination if they had had a dental visit within the last year (OR=2.24, 95% CI: 1.03-4.88). Only 65% of women, however, indicated a dental visit within the last year. Women were more likely to have reported a recent dental visit if they were of a high socioeconomic status (OR=2.83, 95% CI: 1.58-5.06), had private health insurance (OR=2.20, 95% CI: 1.21-3.97) or had consumed alcohol in the last month (OR=2.03, 95% CI: 1.20-3.42). Oral cancer screening was not common among women from Ohio Appalachia, with many

  19. Identification of early childhood caries in primary care settings.

    PubMed

    Nicolae, Alexandra; Levin, Leo; Wong, Peter D; Dave, Malini G; Taras, Jillian; Mistry, Chetna; Ford-Jones, Elizabeth L; Wong, Michele; Schroth, Robert J

    2018-04-01

    Early childhood caries (ECC) is the most common chronic disease affecting young children in Canada. ECC may lead to pain and infection, compromised general health, decreased quality of life and increased risk for dental caries in primary and permanent teeth. A multidisciplinary approach to prevent and identify dental disease is recommended by dental and medical national organizations. Young children visit primary care providers at regular intervals from an early age. These encounters provide an ideal opportunity for primary care providers to educate clients about their children's oral health and its importance for general health. We designed an office-based oral health screening guide to help primary care providers identify ECC, a dental referral form to facilitate dental care access and an oral health education resource to raise parental awareness. These resources were reviewed and trialled with a small number of primary care providers.

  20. Dentistry and dental education in the context of the evolving health care system.

    PubMed

    Anderson, Maxwell H

    2007-08-01

    This article is intended to stimulate dialogue within the intertwined dental practice and dental education communities about our evolving health care system and dentistry's role within this system as it reconfigures in response to a complex interplay of influences. The changing dental disease burden in the United States is analyzed with consideration of how evolution in disease prevalence influences societal need for dental services and the resulting potential impact on the types of services provided and the education of future dental practitioners. The article concludes with discussion of a potential future scenario for practice and education in which one or both of the two health abnormalities (dental caries and periodontal diseases) most closely associated with dentistry as an area of medical specialization go away as a consequence of transformational technologies.

  1. Health Care Access Among Deaf People.

    PubMed

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Mandating Education of Dental Graduates to Provide Care to Individuals with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Waldman, H. Barry; Perlman, Steven P.

    2006-01-01

    In 2004, The Commission on Dental Accreditation adopted new standards for dental and dental hygiene education programs to ensure the preparation of practitioners to provide oral health services for persons with special health care needs. The course of action leading to the adoption of the new standards, together with the continuing obstacles of…

  3. State governance versus dentists' autonomy - the case of Swedish dental care.

    PubMed

    Franzén, Cecilia

    2018-03-01

    A trend towards the state governance of healthcare through quality indicators and national clinical guidelines has been observed, and it is argued that this trend can be a challenge to the autonomy of healthcare professionals. In Sweden, these regulatory tools have been implemented in combination with subsidies for adult dental care that are based on guideline recommendations which serve to ensure that dental care is evidence-based and cost-effective. This paper aims to analyse the implications of these changes regarding dentists' autonomy and whether the government's political intentions can be fulfilled. The paper is based on documents from government authorities and professional theories. The financial control over Swedish dental care has been strengthened, and it can be argued that this is a step in the right direction from a societal point of view, as public resources are limited. Dentists' professional autonomy with their patients is not affected, which is appropriate, as patients should be treated according to their individual needs and expectations. This article shows that the state's governance does not directly detail dentists' work, which indicates a balance between state governance and dentists' autonomy. However, further research is required to get knowledge on Swedish dentists' view of the governance.

  4. Preventive aspects in children's caries treatments preceding dental care under general anaesthesia.

    PubMed

    Savanheimo, Nora; Vehkalahti, Miira M

    2008-03-01

    In Helsinki Public Dental Service (PDS) the Special Oral Health Care Unit (SOHCU) provides comprehensive dental treatments under general anaesthesia (GA). For the present study, all dental treatment given under GA for generally healthy children (n = 102) below 16 years of age (range 2.3-15.8) during a 1-year period and dental treatment and visits of these children in the preceding 2 years in Helsinki PDS was recorded in detail. These children were referred to the SOHCU because of serious difficulties in dental care due to large treatment needs or failures in psychological and chemical management, including sedation. To describe treatments given to generally healthy children under GA and to evaluate preventive aspects of their dental care in the preceding 2 years. The study was cross-sectional and retrospective. Data came from the patients' individual records. Treatments under GA included an average of 6.0 restorations (SD = 2.7, range 0-12) and 1.7 extractions (SD = 2.1, range 0-10). In the 2 preceding years, these children had visited dentist an average of 5.1 times (SD = 2.7, range 1-14) with an average of 2.4 restorations (SD = 1.9, range 0-12) and 0.5 extractions (SD = 1.4, range 0-10). Of the restorations made, 36% were temporary. Of all visits, those with an operative approach accounted for 35%, preventive for 37%, operative and preventive for 5%, and visits with total uncooperation for 23%. Of the children, 90% had at least one preventive visit. Children treated under conscious sedation in the preceding 2 years received less prevention (P = 0.02). Remaining without preventive measures was most likely for those children exhibiting visits with total uncooperation (odds ratio = 4.6; P = 0.004) and for those receiving numerous temporary fillings (odds ratio = 4.1; P = 0.0005). The uncooperative high-caries children pose a demanding challenge to PDS. The early identification of high-caries risk and efforts of intensive preventive care are in key position to

  5. Health Care Access among Deaf People

    ERIC Educational Resources Information Center

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  6. Dental negligence.

    PubMed

    Tay, C S

    2000-02-01

    Medical and dental errors and negligence are again in the spotlight in recent news report. Dead because of doctor's bad handwriting Prescribing drug overdoses Germ-infested soap pumps--infections in hospitals This articles explains dental negligence including dental duty of care and the standard of care expected of dentists in relation to the Bolam principle.

  7. Taking care of your vascular access for hemodialysis

    MedlinePlus

    ... blood through the access. This is called stenosis. Day-to-day Care of Your Vascular Access Following these guidelines ... pulse (also called thrill) in your access every day. Your health care provider will show you how. ...

  8. Herpes labialis and Nigerian dental health care providers: knowledge, attitudes, behaviors, and refusal to treat.

    PubMed

    Azodo, Clement Chinedu; Umoh, Agnes O

    2015-09-15

    The few existing studies on herpes labialis among health care workers have been predominantly among non-dental health care workers. The purpose of this study was to determine Nigerian dental health care providers' knowledge of, attitudes toward, preventive behaviors for, and refusal to treat patients with herpes labialis. This cross-sectional study was conducted among final-year dental students at the University of Benin, dental house officers, and residents at the University of Benin Teaching Hospital, Benin City, Nigeria. Data collection was via a self-administered questionnaire. Bivariate statistics and logistic regression were used to relate the dependent and independent variables. Of the 120 questionnaires distributed, 110 were completed and returned, giving a 91.7% retrieval rate. However, 15 of the returned questionnaires were discarded because they were improperly completed, leaving a total of 95 questionnaires for final analysis in this study. The majority of participants were over 28 years old (54.7%), male (67.4%), unmarried (66.3%), and postgraduate dental health care providers (51.6%). Less than half (43.2%) of participants demonstrated adequate overall knowledge of herpes labialis. About one-tenth (10.5%) and more than three-quarters (87.4%) of participants reported a positive attitude and performance of adequate preventive behaviors, respectively. A total of 16.8% of participants reported a high tendency to refuse treatment to patients with herpes labialis. Although not statistically significant, young, unmarried, male undergraduate participants reported a greater likelihood to refuse treatment to herpes labialis patients. We found a statistically significant positive correlation between attitude and refusal to treat patients with herpes labialis. However, marital status and the attitude of participants toward these patients emerged as the determinants for refusal to treat patients with herpes labialis. Data from this study revealed a high level of

  9. Perceived barriers to preventive dental care among Libyan dentists.

    PubMed

    Arheiam, Arheiam; Masoud, Ibtisam; Bernabé, Eduardo

    2014-01-01

    To explore the barriers to providing preventive dental care to patients, as perceived by Libyan dentists working in Benghazi. A cross-sectional, questionnaire-based survey was conducted among dentists working in Benghazi, Libya. All dentists registered with the Dental Association of Benghazi and with 2 or more years of practice were invited to participate. The questionnaire collected information on participants' demographic and professional characteristics as well as the patient-, practice- and dentist-related barriers to providing preventive dental care. Scores for each type of barrier were compared by demographic and professional characteristics in bivariate and multivariate analyses. One hundred and seventy five dentists returned the questionnaires (response rate: 79%) and 166 had complete information on all the variables selected for analysis (75%). The majority were females (70%), aged between 23 and 34 years (85%), was working in the public health sector (43%), and had up to 5 years of service (46%). Patient-related barriers were scored the highest, followed by practice- and dentist-related barriers. Dentists with mixed practice reported lower scores on patient- and practice-related barriers than those in public or private practice. Respondents were generally aware of the barriers to preventive dentistry and perceived the barriers as being more related to their patients than to their practices or themselves. However, these perceptions varied by practice sector.

  10. Perceived barriers to preventive dental care among Libyan dentists.

    PubMed

    Arheiam, Arheiam; Masoud, Ibtisam; Bernabé, Eduardo

    2014-01-01

    Aim To explore the barriers to providing preventive dental care to patients, as perceived by Libyan dentists working in Benghazi. Settings and design A cross-sectional, questionnaire-based survey was conducted among dentists working in Benghazi, Libya. Materials and methods All dentists registered with the Dental Association of Benghazi and with 2 or more years of practice were invited to participate. The questionnaire collected information on participants' demographic and professional characteristics as well as the patient-, practice- and dentist-related barriers to providing preventive dental care. Statistical analysis Scores for each type of barrier were compared by demographic and professional characteristics in bivariate and multivariate analyses. Results One hundred and seventy five dentists returned the questionnaires (response rate: 79%) and 166 had complete information on all the variables selected for analysis (75%). The majority were females (70%), aged between 23 and 34 years (85%), was working in the public health sector (43%), and had up to 5 years of service (46%). Patient-related barriers were scored the highest, followed by practice- and dentist-related barriers. Dentists with mixed practice reported lower scores on patient- and practice-related barriers than those in public or private practice. Conclusion Respondents were generally aware of the barriers to preventive dentistry and perceived the barriers as being more related to their patients than to their practices or themselves. However, these perceptions varied by practice sector.

  11. Dental care of elderly in nursing homes: perceptions of managers, nurses, and physicians.

    PubMed

    Chung, J P; Mojon, P; Budtz-Jørgensen, E

    2000-01-01

    Epidemiologic studies have shown that the oral health of residents in nursing homes is poor. This can be due to their impaired ability to maintain appropriate oral hygiene or to a lack of interest in oral care among those responsible for the care. The purpose of this study was to assess the attitudes of managers, caregivers, and physicians with regard to oral health care issues of their residents. A questionnaire sent to the managers of the 65 nursing homes in Geneva was returned by 47 (69%). According to the managers, 85% of the nursing homes organized transportation for the residents to a dental office; dental care with follow-up treatment was organized in 79% of the facilities; 68% of the facilities organized treatment for dental emergencies. Another questionnaire was distributed to 169 caregivers in 13 nursing homes. A majority had received no education in oral hygiene care of the residents. The caregivers did accept responsibility for oral hygiene care, but preferred to share it with a dentist responsible for the oral health care of the residents. Only 33% of the physicians indicated that they carried out a systematic examination of the oral cavity, and 20% agreed that the oral cavity might be an integrated part of the body. The majority of the physicians were in favor of more information on oral diseases and regular visits by a dentist; however, close collaboration with a dentist on oral health issues had a low priority.

  12. Implementing an infant oral care program.

    PubMed

    Ramos-Gomez, Francisco; Jue, Bonnie; Bonta, C Yolanda

    2002-10-01

    The American Academy of Pediatric Dentistry, American Dental Association, American Public Health Association, Association of State and Territorial Dental Directors, California Dental Association, and California Society of Pediatric Dentists currently recommend that children receive their first dental evaluation within the first year of life. Providing early care to children from ages 6 months to 5 years offers an opportunity to educate and inform parents about their children's oral health. Anticipatory guidance - counseling of parents by health providers about developmental changes that will occur in their children between health visits - for children's dental health is an important part of preventive care. It may be the most effective way to prevent problems that traditional infectious disease models have failed to address, such as early childhood caries. The model of anticipatory guidance is valuable for dental professionals because it emphasizes prevention of dental problems rather than restorative care. A comprehensive infant oral care program utilizes (1) oral health assessment at regularly scheduled dental visits, (2) risk assessments, (3) counseling sessions with parents during either regular dental visits or additional visits scheduled if a child is deemed at risk, (4) preventive treatment such as the application of fluoride varnish or sealants, and (5) outreach and incentives to reinforce attendance. Facilitating access to early and regular dental care is a crucial part of any effective intervention strategy, and intervention techniques should be tailored to the community being served.

  13. The association between demographic and oral health-related quality of life factors and dental care attendance among underprivileged older people.

    PubMed

    Zini, Avi; Vered, Yuval; Sgan-Cohen, Harold D

    2011-06-01

    In order to identify whether demographic and oral health-related quality of life factors are associated with dental care attendance among an underprivileged older population, a comparison was performed between people who have and have not attended dental care. A cross-sectional purposive sample of 344 older underprivileged people comprised the study population. The dependent variable was dental care attendance. The 14-item version of the Oral Health Impact Profile index (OHIP-14) was used as the independent variable, together with other social and general variables, using a structured interview. The variables that were significantly associated with dental care attendance were family status (not married, the highest attendance), dwelling location (living at home, the highest attendance), caregiver (family member, the highest attendance), place of birth (Western countries, the highest attendance) and income (pension, the highest attendance). Sex, welfare support, functional ability, education, age and OHIP-14 were not associated with dental care attendance. Attending dental care was not associated with oral health-related quality of life measured by OHIP-14. Several socioeconomic variables were strongly associated. © 2010 The Authors. Australasian Journal on Ageing © 2010 ACOTA.

  14. Dental Care for a Child with Cleft Lip and Palate

    MedlinePlus

    ... Volunteer Efforts Dental Care for a Child with Cleft Lip and Palate skip to submenu What We Do Cleft & Craniofacial ... version of this factsheet, click here How does cleft lip/palate affect the teeth? A cleft of the lip, ...

  15. Survey of Attitudinal Acceptance of a Children's Incremental Dental Care Program by Parents, Teachers and School Administrators. Final Report.

    ERIC Educational Resources Information Center

    Guess, L. Lynn; And Others

    This report presents an analysis of the attitudes of parents, teachers, and school administrators to the Chattanooga Incremental Dental Care Program. This project provided dental care in the public elementary schools at specific intervals of time to specific age groups in order to establish and maintain a state of oral health. Dental services were…

  16. Timely access to mental health care among women veterans.

    PubMed

    Brunner, Julian; Schweizer, C Amanda; Canelo, Ismelda A; Leung, Lucinda B; Strauss, Jennifer L; Yano, Elizabeth M

    2018-04-05

    Using survey data on (N = 419) patients at Department of Veterans Affairs (VA) clinics we analyzed women veterans' reports of timely access to VA mental health care. We evaluated problems that patients might face in obtaining care, and examined subjective ratings of VA care as a function of timely access to mental health care. We found that 59% of participants reported "always" getting an appointment for mental health care as soon as needed. In adjusted analyses, two problems were negatively associated with timely access to mental health care: (a) medical appointments that interfere with other activities, and (b) difficulty getting questions answered between visits. Average subjective ratings of VA ranged from 8.2-8.6 out of 10, and 93% of participants would recommend VA care. Subjective ratings of VA were higher among women who reported timely access to mental health care. Findings suggest that overall experience of care is associated with timely access to mental health care, and that such access may be amenable to improvements related to clinic hours or mechanisms for answering patient questions between visits. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. Utilization of dental care among patients with severe mental illness: a study of a National Health Insurance database.

    PubMed

    Teng, Po-Ren; Lin, Miao-Jean; Yeh, Ling-Ling

    2016-09-01

    The oral health of patients with severe mental illness is poor, in general, and this may be attributed, in part, to inadequate dental care. This study investigated dental care utilization among patients with severe mental illness using a national representative sample. This study used Taiwan's National Health Insurance Research Dataset for 2009. Patients with the diagnosis of severe mental illness (ICD-9-CM: 290-298) were recruited as the study sample, and others comprised the control. Any visit to a dentist was defined as positive in terms of dental care utilization. Regression analyses were applied to determine the odds of dental care utilization for each diagnostic entity of severe mental illness, compared with the general population and controlling for potential covariates. Only 40 % of 19,609 patients with severe mental illness visited the dentist within 12 months. This was significantly lower than the dental visit rate of 48.3 % for the control population (odds ratio [OR] = .72, 95 % confidence interval [CI] = .69-.74; P <0.0001). The odds of dental care utilization differed among the severe mental illness diagnostic categories; e.g., the odds were lowest among those with alcohol psychoses (OR = .54, CI = .43-.68), senile dementia (OR = .55, CI = .52-.59) and other organic psychoses (OR = .58, CI = .52-.65), and highest among those with mood disorder (OR = .89, CI = .85-.94), with schizophrenic patients occupying a mid-level position (OR = .63, CI = .59-.67). Patients with severe mental illness received less dental care than the general population. Health care providers and caregivers of patients with severe mental illness should encourage them to visit the dentist regularly, in order to improve the oral health of these vulnerable patient groups.

  18. The role of a bus network in access to primary health care in Metropolitan Auckland, New Zealand.

    PubMed

    Rocha, C M; McGuire, S; Whyman, R; Kruger, E; Tennant, M

    2015-09-01

    Background: This study examined the spatial accessibility of the population of metropolitan Auckland, New Zealand to the bus network, to connect them to primary health providers, in this case doctors (GP) and dentists. Analysis of accessibility by ethnic identity and socio-economic status were also carried out, because of existing health inequalities along these dimensions. The underlying hypothesis was that most people would live within easy reach of primary health providers, or easy bus transport to such providers. An integrated geographic model of bus transport routes and stops, with population and primary health providers (medical. and dental practices) was developed and analysed. Although the network of buses in metropolitan Auckland is substantial and robust it was evident that many people live more than 150 metres from a stop. Improving the access to bus stops, particularly in areas of high primary health care need (doctors and dentists), would certainly be an opportunity to enhance spatial access in a growing metropolitan area.

  19. The origins of Minnesota's mid-level dental practitioner: alignment of problem, political and policy streams.

    PubMed

    Gwozdek, Anne E; Tetrick, Renee; Shaefer, H Luke

    2014-10-01

    Using John Kingdon's agenda-setting model, this paper explores how Minnesota came to legislate a mid-level dental practitioner to its oral health workforce. Using a pluralist framework embracing the existence of various interests and convictions, this analysis highlights the roles of issue formation, agenda setting and politics in policymaking. Using Kingdon's agenda-setting model as a theoretical lens, and applying case study methodology, this paper analyzes how Minnesota came to legislate a mid-level dental practitione to its oral health workforce. Data have come from scholarly research, governmental and foundation agency reports, interviews with leaders involved in the mid-level dental practitioner initiative, news articles, and Minnesota statute. After 2 years of contentious and challenging legislative initiatives, the problem, policy and political streams converged and aligned with the compromise passage of a bill legalizing mid-level dental practitioner practice. The Minnesota Dental Therapist Law was the first-in-the-nation licensing law to develop a new dental professional workforce model to address access to oral health care. The Minnesota mid-level dental practitioner initiative demonstrates the important convergence and alignment of the access to oral health care problem and the subsequent collaboration between political interest groups and policymakers. Through partnerships and pluralist compromise, mid-level dental practitioner champions were able to open the policy window to move this legislation to law, enhancing the oral health workforce in Minnesota. Copyright © 2014 The American Dental Hygienists’ Association.

  20. The Origins of Minnesota's Mid-Level Dental Practitioner: Alignment of Problem, Political and Policy Streams.

    PubMed

    Gwozdek, Anne E; Tetrick, Renee; Shaefer, H Luke

    2015-06-01

    Using John Kingdon's agenda-setting model, this paper explores how Minnesota came to legislate a mid-level dental practitioner to its oral health workforce. Using a pluralist framework embracing the existence of various interests and convictions, this analysis highlights the roles of issue formation, agenda setting and politics in policymaking. Using Kingdon's agenda-setting model as a theoretical lens, and applying case study methodology, this paper analyzes how Minnesota came to legislate a mid-level dental practitione to its oral health workforce. Data have come from scholarly research, governmental and foundation agency reports, interviews with leaders involved in the mid-level dental practitioner initiative, news articles, and Minnesota statute. After 2 years of contentious and challenging legislative initiatives, the problem, policy and political streams converged and aligned with the compromise passage of a bill legalizing mid-level dental practitioner practice. The Minnesota Dental Therapist Law was the first-in-the-nation licensing law to develop a new dental professional workforce model to address access to oral health care. The Minnesota mid-level dental practitioner initiative demonstrates the important convergence and alignment of the access to oral health care problem and the subsequent collaboration between political interest groups and policymakers. Through partnerships and pluralist compromise, mid-level dental practitioner champions were able to open the policy window to move this legislation to law, enhancing the oral health workforce in Minnesota. Copyright © 2015 The American Dental Hygienists’ Association.