Walker, Mary; Gadbury-Amyot, Cynthia; Liu, Ying; Kelly, Patricia; Branson, Bonnie
2015-01-01
Objectives. We evaluated the effect of an alternative dental workforce program—Kansas’s Extended Care Permit (ECP) program—as a function of changes in oral health. Methods. We examined data from the 2008 to 2012 electronic medical records of children (n = 295) in a Midwestern US suburb who participated in a school-based oral health program in which preventive oral health care was delivered by ECP dental hygienists. We examined changes in oral health status as a function of sealants, caries, restorations, and treatment urgency with descriptive statistics, multivariate analysis of variance, Kruskal–Wallis test, and Pearson correlations. Results. The number of encounters with the ECP dental hygienist had a statistically significant effect on changes in decay (P = .014), restorations (P = .002), and treatment urgency (P = .038). Based on Pearson correlations, as encounters increased, there was a significant decrease in decay (–0.12), increase in restorations (0.21), and decrease in treatment urgency (–0.15). Conclusions. Increasing numbers of encounters with alternative providers (ECP dental hygienists), such as with school-based oral health programs, can improve the oral health status of low-income children who would not otherwise have received oral health services. PMID:26180957
Determinants of Demand in the Public Dental Emergency Service.
Matsumoto, Maria Sa; Gatti, Marcia An; de Conti, Marta Hs; de Ap Simeão, Sandra F; de Oliveira Braga Franzolin, Solange; Marta, Sara N
2017-02-01
Although dental emergencies are primarily aimed at pain relief, in practice, dental emergency services have been overwhelmed by the massive inflow of patients with less complex cases, which could be resolved at basic levels of health care. They frequently become the main gateway to the system. We investigated the determinant factors of demand at the Central Dental Emergency Unit in Bauru, São Paulo, Brazil. The questionnaire was applied to 521 users to evaluate sociodemographic profile; factors that led users to seek the service at the central dental emergency; perception of service offered. About 80.4% of users went directly to the central dental emergency, even before seeking basic health units. The reasons were difficulty to be attended (34.6%) and incompatible time (9.8%). To the perception of the necessity of the service, responses were problem as urgent (78.3%) and pain was the main complaint (69.1%). The profile we found was unmarried (41.5%), male (52.2%), white (62.8%), aged 30 to 59 (52.2%), incomplete basic education (41.6%), family income up to 2 minimum wages (47.4%), and no medical/dental plan (88.9%). It was concluded that the users of central dental emergency come from all sectors of the city, due to difficult access to basic health units; they consider their complaint urgent; and they are satisfied with the service offered. To meet the profile of the user urgency's service so that it is not overloaded with demand that can be fulfilled in basic health units.
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.
Expect the Best for Your Child's Dental Home
ERIC Educational Resources Information Center
Casamassimo, Paul
2007-01-01
Too many parents of children with special healthcare needs come upon dental care for their child out of necessity or urgency. In order to make the relationship most beneficial, the preferred way is to establish a Dental Home during the child's infancy. The Dental Home is the oral health corollary of the Medical Home concept that the American…
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.
Castañeda, Heide; Carrion, Iraida V; Kline, Nolan; Tyson, Dinorah Martinez
2010-12-01
Few studies have engaged issues of social class and access related to dental health care policy from an ethnographic perspective. The state of Florida in the US has one of the poorest records in the nation for providing dental care for low-income children, falling especially short for Medicaid-enrolled children. In this paper, we discuss unmet dental health needs of children in migrant farmworker families. Although one of the most marginalized populations, most are eligible for Medicaid and are thus covered for dental services. However, serious disparities have been linked to the lack of access through the public insurance system. This study was informed by participant observation at dental clinics and a Migrant Head Start Center and interviews with dental health providers (n = 19) and migrant farmworker parents (n = 48) during 2009. Our results indicate that some typical factors associated with poor oral health outcomes, such as low dental health literacy, may not apply disproportionately to this population. Instead, we argue that structural features and ineffective policies contribute to oral health care disparities. Dental Medicaid programs are chronically underfunded, resulting in low reimbursement rates, low provider participation, and a severe distribution shortage of dentists within poor communities. We characterize the situation for families in Florida as one of "false hope" because of the promise of services with neither adequate resources nor the urgency to provide them. The resulting system of charity care, which leads dentists to provide pro bono care instead of accepting Medicaid, serves to only further persistent inequalities. We provide several recommendations, including migrant-specific efforts such as programs for sealants and new mothers; improvements to the current system by removing obstacles for dentists to treat low-income children; and innovative models to provide comprehensive care and increase the number of providers. Copyright © 2010 Elsevier Ltd. All rights reserved.
A First Nations voice in the present creates healing in the future.
MacKinnon, Melanie
2005-01-01
This paper discusses the urgency for change and improvements in health policy determined by the exploding demographics and inequities in the health status of First Nation people. A historical overview of health services for First Nation clients was conducted as set out through government legislation and health and social policies. Until WWII ended, the federal government provided assistance to First Nations through Indian Affairs branches of several departments. This responsibility was gradually transferred to National Health and Welfare. In 1962, the federal government established a Medical Services Branch, later renamed First Nations and Inuit Health Branch, and mandated to provide services to First Nation clients, which fell outside the provincial jurisdiction of health care. Initially centered on public health priorities, services have expanded to include primary health care, dental, mental health, environmental health, home and continuing care, and Non-Insured Health Benefits. The Romanow Report substantiated the urgency for health policy improvements voiced by many First Nations. However, it generalized Aboriginal issues in health care on a national front. Furthermore, its recommendations were specific to health care providers and delivery models and did not address the social and spiritual determinants of health, which are fundamental to a First Nations' holistic approach. Health planners must think holistically, considering traditional and westernized medicine, First Nations' values, priorities and government systems, and present and evolving health systems. Universities, health authorities, provinces and the federal government are continually developing new research and health models, which will also need consideration. Further, the imperative of involving community-level input must be recognized.
47 CFR 80.1131 - Transmissions of urgency communications.
Code of Federal Regulations, 2013 CFR
2013-10-01
... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...
47 CFR 80.1131 - Transmissions of urgency communications.
Code of Federal Regulations, 2012 CFR
2012-10-01
... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...
47 CFR 80.1131 - Transmissions of urgency communications.
Code of Federal Regulations, 2011 CFR
2011-10-01
... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...
47 CFR 80.1131 - Transmissions of urgency communications.
Code of Federal Regulations, 2010 CFR
2010-10-01
... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...
47 CFR 80.1131 - Transmissions of urgency communications.
Code of Federal Regulations, 2014 CFR
2014-10-01
... communications. (a) In a terrestrial system the announcement of the urgency message must be made on one or more... transmitted through the maritime mobile-satellite service. (b) The urgency signal and message must be... the mobile unit carrying the mobile station or mobile earth station. (h) The urgency call format or...
Application of teledentistry in oral medicine in a community dental service, N. Ireland.
Bradley, M; Black, P; Noble, S; Thompson, R; Lamey, P J
2010-10-23
Currently, patients with oral medicine conditions from all areas of Northern Ireland are referred by dentists and doctors to a small number of specialist services: predominantly, the Regional Oral Medicine Consultant at the School of Dentistry, Belfast. On receipt of the referral the consultant makes an assessment of the urgency of the case and the patient is placed on a waiting list. Until the recent implementation of waiting list initiatives (Elective Access Protocol, Department of Health, N. Ireland, 2006), patients remained on the waiting list for long periods of time. Analysis of these patient profiles highlights that many need both multiple treatment and review appointments of their chronic conditions, and consequently remain in the hospital system for significant periods of time. This increases the waiting time for these services. The idea of using teledentistry to triage referrals, and its potential as a tool to support locally based treatment, poses an alternative approach to the management of oral medicine referrals. It may be of particular interest to practitioners in rural locations where distance from the regional centre is significant. In 2005, to test this theory, a prototype teledentistry system was set up as part of a service improvement scheme by the Community Dental Service of the Homefirst Legacy Trust (now Northern Trust) in partnership with the Oral Medicine Department at the School of Dentistry, Royal Group of Hospitals Legacy Trust (now Belfast Trust). This paper describes the feasibility study.
Oral health status of New Hampshire Head Start children, 2007-2008.
Anderson, Ludmila; Martin, Nancy R; Burdick, Arnie; Flynn, Regina T; Blaney, David D
2010-01-01
We report on the baseline prevalence and severity of dental caries of children enrolled in the New Hampshire Head Start program during the 2007-2008 school year. We selected a random cluster sample of 607 children aged 3-5 years attending 27 Head Start centers across the state. Four volunteer dentists provided oral examinations and determined the presence of untreated dental caries, caries experience, and treatment urgency. Overall, 40 percent of the participating children had experienced dental caries, and 31 percent had at least one untreated decayed tooth. Approximately 22 percent of the children had evidence of maxillary anterior caries, 23 percent were in need of dental care, and < 1 percent needed urgent care. The prevalence of dental caries is comparable with that reported by Head Start programs elsewhere. The prevalence of caries affecting maxillary anterior teeth is higher. Further studies should examine state-specific barriers to dental care among this population.
Caries-based treatment need assessment by clinical dental nurses in Anguilla, British West Indies.
Adewakun, Adenike Adejoke; Amaechi, Bennett Tochukwu
2005-09-01
To determine the ability of dental nurses in Anguilla to assess treatment need following training in WHO criteria. Sixty-six randomly selected schoolchildren aged 6, 9, 12, 14, 15 and 17 years. Point prevalence study involving three different groups of schoolchildren [n = 20 (C0), 23 (D1), 23 (D2)] and four plaster casts comprising 52 extracted teeth (T0). Tooth- and person-based inter and intra-examiner agreement. The only three government dental nurses in Anguilla were trained and calibrated by a benchmark dentist in June 2000 using WHO criteria. Tooth-based Treatment Need and person-based Treatment Urgency were assessed during 466 evaluations involving 1,733 teeth. Examiner agreement levels were compared during two calibration exercises (T0, C0) and two duplicate examinations (D1 and D2). The treatment components were classified as preventive (diet modification, prophylaxis, OHI, sealants); restorative (restorations, pulp care and crowns); and rehabilitative (tooth removal). All scores presented are Kappa scores. Substantial agreement was obtained at T0 (0.614-0.764), and almost perfect agreement at C0(0.832-0.872), D1(0.917-0.954) and D2(0.966-0.977). Almost perfect reliability occurred at C0(0.963-0.991) and D1(0.971-0.992) while perfect reliability was attained by all examiners at D2(1.0). Substantial and almost perfect agreement was obtained for all treatment modalities irrespective of caries prevalence and severity. Agreement levels increased as the survey progressed. Perfect agreement was obtained for all categories of treatment urgency. Dental nurses in Anguilla can validly and reliably assess treatment need provided training is adequate, of realistic duration and they are involved in all aspects of the exercise.
Parent perspectives and reasons for lower urgency paediatric presentations to emergency departments.
Freed, Gary L; Allen, Amy R; Turbitt, Erin; Nicolas, Caroline; Oakley, Ed
2016-04-01
The age band with, by far, the greatest number of ED presentations is children 0-4 years, with other paediatric age bands also among the highest. As the majority of these presentations are for lower urgency conditions, we sought to determine why parents seek ED care for their child for lower urgency conditions. A survey study of 1150 parents or guardians of children with lower urgency conditions (triage category 4 or 5) presenting to the EDs of three public general and one paediatric specialty hospital in metropolitan Melbourne. Fewer than half of parents (43%) attempted to make an appointment with a general practitioner (GP) for their child prior to presenting to the ED. Two-thirds of those who did contact a GP were instructed by their GP to go to the ED for their lower urgency condition. Few attempted to contact a nurse telephone triage service or after-hours GP service. The current magnitude and the growth of lower urgency paediatric ED presentations is a strain on the health care system. Efforts to educate parents regarding the suitability and availability of GP appointments can be the cornerstone of an initial strategy to address this issue. However, efforts to address the high rates of GP referral to EDs for low urgency presentations will be more vexing to develop, yet no less important. They will require addressing fundamental issues in both current GP care for children and the training of GP registrars. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Development of an approach to facilitate optimal equipment replacement : technical summary.
DOT National Transportation Integrated Search
1999-10-01
The objective of the study was to determine a way or ways to assign an urgency rating to equipment that was currently in service but in need of replacement. This urgency rating must in some manner took into account the various costs associated with r...
Dental utilization by children in Hispanic agricultural worker families in California
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
Predictors of Urgency of Out-of-Home Placement Needs.
ERIC Educational Resources Information Center
Kobe, Frank H.; And Others
1991-01-01
Interviews with 137 primary caregivers with developmentally disabled family members (ages 2-62) on waiting lists for out-of-home placement found that caregiver stress was a significant predictor of the urgency of placement need. Behavior problems of the disabled person were almost as important. Lack of support services was correlated with…
Philips, H; Van Bergen, J; Huibers, L; Colliers, A; Bartholomeeusen, S; Coenen, S; Remmen, R
2015-10-01
In some European countries telephone triage (TT) during out-of-hours primary care showed to be safe and effective. Other countries, such as Belgium, may not have trained auxiliary personnel while their national health services want to establish TT. To compare urgency levels assessed by secretaries and general practitioners in one general practice cooperative in Belgium. Percentage of correct-, under-, and over-triage were calculated in total and per reason for encounter. Inter-rater agreement was investigated. The secretaries correctly triaged (same urgency level) 77% of the telephone calls, under-triaged 10% and over-triaged 13%.'Shortness of breath', 'skin cuts', 'chest pain', 'feeling unwell' and 'syncope' were often under-triaged. Before introducing TT, auxiliary staff should be trained and protocols should be used.
[Organisation of emergency medicine in France].
Braun, Françis
2015-01-01
The French emergency medicine infrastructure (structures de médecine d'urgence) ensures patients care from the very location of the distress to the appropriate hospital department: medical care in the field, by hospital clinical teams (the services mobiles d'urgence et de réanimation [SMUR]), is a key characteristic of our medical emergency response system. Response to medical distress revolves around information about not only the location and characteristics of the medical need, but also the availability of adapted hospital services. Gathering and transmitting this information is the prerogative of the service d'aide médicale d'urgence (SAMU) and its telephone dispatch center (Centre 15). For patients coming directly to the hospital, the emergency room (ER), a former underfunded and neglected hospital service, has become a key point of access. The ER is now responsible, after providing immediate first line care, to guide the patient through the care system. As such they are equipped with short term hospitalization units designed to enable up to 24h patient observation before orientation. This ensemble, networked at the level of a health territory, ensures the quality, safety, and efficacy that the population is entitled to demand.
42 CFR 410.24 - Limitations on services of a doctor of dental surgery or dental medicine.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 2 2014-10-01 2014-10-01 false Limitations on services of a doctor of dental surgery or dental medicine. 410.24 Section 410.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Medical and Other Health Services § 410.24 Limitations on services of a doctor of dental surgery or dental...
42 CFR 410.24 - Limitations on services of a doctor of dental surgery or dental medicine.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 2 2010-10-01 2010-10-01 false Limitations on services of a doctor of dental surgery or dental medicine. 410.24 Section 410.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Medical and Other Health Services § 410.24 Limitations on services of a doctor of dental surgery or dental...
42 CFR 410.24 - Limitations on services of a doctor of dental surgery or dental medicine.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 2 2012-10-01 2012-10-01 false Limitations on services of a doctor of dental surgery or dental medicine. 410.24 Section 410.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Medical and Other Health Services § 410.24 Limitations on services of a doctor of dental surgery or dental...
42 CFR 410.24 - Limitations on services of a doctor of dental surgery or dental medicine.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 2 2011-10-01 2011-10-01 false Limitations on services of a doctor of dental surgery or dental medicine. 410.24 Section 410.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Medical and Other Health Services § 410.24 Limitations on services of a doctor of dental surgery or dental...
42 CFR 410.24 - Limitations on services of a doctor of dental surgery or dental medicine.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 2 2013-10-01 2013-10-01 false Limitations on services of a doctor of dental surgery or dental medicine. 410.24 Section 410.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Medical and Other Health Services § 410.24 Limitations on services of a doctor of dental surgery or dental...
48 CFR 46.407 - Nonconforming supplies or services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... or services. (a) The contracting officer should reject supplies or services not conforming in all... must reject supplies or services when the nonconformance is critical or major or the supplies or services are otherwise incomplete. However, there may be circumstances (e.g., reasons of economy or urgency...
48 CFR 46.407 - Nonconforming supplies or services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... or services. (a) The contracting officer should reject supplies or services not conforming in all... must reject supplies or services when the nonconformance is critical or major or the supplies or services are otherwise incomplete. However, there may be circumstances (e.g., reasons of economy or urgency...
Dental Workforce Availability and Dental Services Utilization in Appalachia: A Geospatial Analysis
Feng, Xue; Sambamoorthi, Usha; Wiener, R. Constance
2016-01-01
Objectives There is considerable variation in dental services utilization across Appalachian counties, and a plausible explanation is that individuals in some geographical areas do not utilize dental care due to dental workforce shortage. We conducted an ecological study on dental workforce availability and dental services utilization in Appalachia. Methods We derived county-level (n = 364) data on demographic, socio-economic characteristics and dental services utilization in Appalachia from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) using person-level data. We obtained county-level dental workforce availability and physician-to-population ratio estimates from Area Health Resource File, and linked them to the county-level BRFSS data. The dependent variable was the proportion using dental services within the last year in each county (ranging from 16.6% to 91.0%). We described the association between dental workforce availability and dental services utilization using ordinary least squares regression and spatial regression techniques. Spatial analyses consisted of bivariate Local Indicators of Spatial Association (LISA) and geographically weighted regression (GWR). Results Bivariate LISA showed that counties in the central and southern Appalachian regions had significant (p < .05) low-low spatial clusters (low dental workforce availability, low percent dental services utilization). GWR revealed considerable local variations in the association between dental utilization and dental workforce availability. In the multivariate GWR models, 8.5% (t-statistics >1.96) and 13.45% (t-statistics >1.96) of counties showed positive and statistically significant relationships between the dental services utilization and workforce availability of dentists and dental hygienists, respectively. Conclusions Dental workforce availability was associated with dental services utilization in the Appalachian region; however, this association was not statistically significant in all counties. The findings suggest that program and policy efforts to improve dental services utilization need to focus on factors other than increasing the dental workforce availability for many counties in Appalachia. PMID:27957773
47 CFR 80.1109 - Distress, urgency, and safety communications.
Code of Federal Regulations, 2010 CFR
2010-10-01
... SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS... communications include: navigational and meteorological warnings and urgent information; ship-to-ship safety...
47 CFR 80.1109 - Distress, urgency, and safety communications.
Code of Federal Regulations, 2014 CFR
2014-10-01
... SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS... communications include: navigational and meteorological warnings and urgent information; ship-to-ship safety...
47 CFR 80.1109 - Distress, urgency, and safety communications.
Code of Federal Regulations, 2012 CFR
2012-10-01
... SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS... communications include: navigational and meteorological warnings and urgent information; ship-to-ship safety...
47 CFR 80.1109 - Distress, urgency, and safety communications.
Code of Federal Regulations, 2013 CFR
2013-10-01
... SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS... communications include: navigational and meteorological warnings and urgent information; ship-to-ship safety...
47 CFR 80.1109 - Distress, urgency, and safety communications.
Code of Federal Regulations, 2011 CFR
2011-10-01
... SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS... communications include: navigational and meteorological warnings and urgent information; ship-to-ship safety...
Reforming the mission of public dental services.
Wright, F A C; List, P F
2012-10-01
Australia has a complex history of providing public dental services to its communities. From the early days of Colonial settlement, the provision of dental care to the Australian public has largely been driven and influenced by organized groups and associations of dentists. The Constitution of Australia, under Section 51 xxiii A, allows for the Commonwealth to provide for medical and dental services. Unlike the United Kingdom, however, dental services have not been embedded into a universal national health service agenda. In 1974, that the Australian Government through the Australian School Dental Program provided the first funding and national direction for public dental services - and that, limited to children. The Commonwealth Dental Health Program 1993-1997 was the second national endeavor to provide public dental services, this time to financially disadvantaged adults. Since that time, public dental service responsibility has been shuttled between States/Territories and the Commonwealth. A new paradigm for public dental services in Australia requires strong Commonwealth leadership, as well as the commitment of State and Territories and the organized dental profession. The National Health and Hospitals Reform Commission provided the most recent scenario for a radical change in mission. This paper canvases the competing roles of strategic, functional, and structural issues in relationship to social network and policy issues, which must be recognized if Australians truly seek to reform public dental services. © 2012 John Wiley & Sons A/S.
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.
38 CFR 17.166 - Dental services for hospital or nursing home patients and domiciled members.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services as...
38 CFR 17.166 - Dental services for hospital or nursing home patients and domiciled members.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services as...
38 CFR 17.166 - Dental services for hospital or nursing home patients and domiciled members.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services as...
38 CFR 17.166 - Dental services for hospital or nursing home patients and domiciled members.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services as...
38 CFR 17.166 - Dental services for hospital or nursing home patients and domiciled members.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services as...
Chalmers, Jane M.; Kuthy, Raymond A.; Momany, Elizabeth T.; Chi, Donald L.; Bacon, Robert A.; Lindgren, Scott D.; Askelson, Natoshia M.; Damiano, Peter C.
2012-01-01
Purpose To determine dental utilization and type of dental services for Medicaid enrolled adults identified as having intellectual and developmental disabilities (IDD). Methods Using Iowa claims data, identified adults who met any of five IDD criteria for inclusion during calendar year 2005. Service utilization rates, including use of preventive dental, routine restorative, and complex restorative services, were determined. Results Approximately 60% of adults with IDD had at least one dental visit in 2005. Of adults with at least one dental visit, 83% received a preventive service, 31% a routine restorative service, and 16% a complex dental service. Those age 65 and older had fewer preventive dental services than other age groups. Conclusion In Iowa, dental utilization for adults 22-64 years of age with IDD was reasonably high (64%) in 2005, but individuals over age 65 had lower utilization (45%). PMID:21235610
Hill, H; Birch, S; Tickle, M; McDonald, R; Brocklehurst, P
2017-06-01
To assess the efficiency of service provision in the Community Dental Services and its determinants in the North-West of England. 40 Community Dental Services sites operating across the North-West of England. A data envelopment analysis was undertaken of inputs (number of surgeries, hours worked by dental officers, therapists, hygienists and others) and outputs (treatments delivered, number of courses of treatment and patients seen) of the Community Dental Services to produce relative efficiency ratings by health authority. These were further analyzed in order to identify which inputs (determined within the Community Dental Services) or external factors outside the control of the Community Dental Services are associated with efficiency. Relative efficiency rankings in Community Dental Services production of dental healthcare. Using the quantity of treatments delivered as the measure of output, on average the Community Dental Services in England is operating at a relative efficiency of 85% (95% confidence interval 77%- 99%) compared to the best performing services. Average efficiency is lower when courses of treatment and unique patients seen are used as output measures, 82% and 68% respectively. Neither the input mix nor the patient case mix explained variations in the efficiency across Community Dental Services. Although large variations in performance exist across Community Dental Services, the data available was not able to explain these variations. A useful next step would be to undertake detailed case studies of several best and under-performing services to explore the factors that influence relative performance levels. Copyright© 2017 Dennis Barber Ltd.
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.
47 CFR 80.333 - Stations in the maritime mobile-satellite service.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 5 2010-10-01 2010-10-01 false Stations in the maritime mobile-satellite... SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress, Alarm, Urgency and Safety Procedures § 80.333 Stations in the maritime mobile-satellite service. The...
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.
Miranda, Camila Dal-Bó Coradini; Peres, Marco Aurélio
2013-11-01
This study aimed to estimate the prevalence of dental services utilization by adults and to identify associated socioeconomic, demographic, behavioral, and self-awareness factors. A cross-sectional population-based study was conducted with adults living in the urban area of Florianópolis, Santa Catarina State, Brazil, in 2009. Associations were tested between use of dental services and predisposing, enabling, and needs-based variables. Multivariate analysis was conducted using Poisson regression with estimates of prevalence ratios and was stratified by place of last dental appointment. Prevalence of dental services utilization was 66% (95%CI: 62.9-70.7). Dental visits were 20% more frequent among women and 72% more frequent among individuals with more schooling (the latter in both public and private dental services). Individuals with private dental plans used dental services 13% more than those without. Schooling was the most important variable in predicting utilization. The study's results show the importance of monitoring associated factors in order to promote more equitable use of dental services.
The demand for preventive and restorative dental services.
Meyerhoefer, Chad D; Zuvekas, Samuel H; Manski, Richard
2014-01-01
Chronic tooth decay is the most common chronic condition in the United States among children ages 5-17 and also affects a large percentage of adults. Oral health conditions are preventable, but less than half of the US population uses dental services annually. We seek to examine the extent to which limited dental coverage and high out-of-pocket costs reduce dental service use by the nonelderly privately insured and uninsured. Using data from the 2001-2006 Medical Expenditure Panel Survey and an American Dental Association survey of dental procedure prices, we jointly estimate the probability of using preventive and both basic and major restorative services through a correlated random effects specification that controls for endogeneity. We found that dental coverage increased the probability of preventive care use by 19% and the use of restorative services 11% to 16%. Both conditional and unconditional on dental coverage, the use of dental services was not sensitive to out-of-pocket costs. We conclude that dental coverage is an important determinant of preventive dental service use, but other nonprice factors related to consumer preferences, especially education, are equal if not stronger determinants. Copyright © 2013 John Wiley & Sons, Ltd.
Dental caries experience and use of dental services among Brazilian prisoners.
Cavalcanti, Alessandro Leite; Rodrigues, Iris Sant Anna Araujo; de Melo Silveira, Ingrid Thays; de Oliveira, Thaliny Batista Sarmento; de Almeida Pinto, Magaly Suenya; Xavier, Alidianne Fabia Cabral; de Castro, Ricardo Dias; Padilha, Wilton Wilney Nascimento
2014-11-25
This ross-sectional study involving 127 male prisoners evaluates the use of dental services and dental caries among Brazilian inmates. Data were collected by interview and clinical examination. Sociodemographic and sentencing information as well as use of dental services, self-reported dental morbidity, self-perception, and oral health impacts were investigated. The mean DMFT index value was 19.72. Of the components, the decayed component showed the highest mean value (11.06 ± 5.37). Statistically significant association was found between DMFTs with values from 22 to 32 and oral health satisfaction (p = 0.002), difficulty speaking (p = 0.024), shame of talking (p = 0.004) and smiling (p < 0.001). Regarding the use of dental services, 80% had their last dental appointment less than one year ago, with most visits occurring in prison (80%), with restorative treatment (32%), followed by dental pain (26.4%), being the main reasons for such appointments. Most prisoners used dental services provided by the prison. Although restorative treatment has been the main reason for the use of dental services, "decayed" and "missing" components contributed to the high mean DMFT index.
42 CFR 440.100 - Dental services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 4 2012-10-01 2012-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
42 CFR 440.100 - Dental services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 4 2011-10-01 2011-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
42 CFR 440.100 - Dental services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 4 2010-10-01 2010-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
42 CFR 440.100 - Dental services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 4 2013-10-01 2013-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
42 CFR 440.100 - Dental services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 4 2014-10-01 2014-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
Strategies for service-learning assessment in dental hygiene education.
Burch, Sharlee
2013-10-01
A large body of literature exists on the instructional pedagogy known as service-learning. Service-learning is a teaching and learning approach characterized by the dental hygiene student's practical application of academic studies and occurs within a community setting, to the benefit of both the student and community. Dental hygiene educators use service-learning to enhance student knowledge and application of oral health curriculum. This manuscript reports on the importance of service-learning assessment to the National Dental Hygiene Research Agenda as well as the future of the profession of dental hygiene and the successful strategies in service-learning evaluation available for utilization by dental hygiene educators.
A Prototype Mobile Application for Triaging Dental Emergencies
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
A prototype mobile application for triaging dental emergencies.
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.
Dental services advertising: does it affect consumers?
Sanchez, P M; Bonner, P G
1989-12-01
Dental services advertising appears to be increasing. Despite their negative attitude toward advertising, as many as 20% of all dentists may now be advertising to meet changing conditions in a highly competitive market. Research on dental services advertising has provided a useful starting point for developing dental advertising strategies. However, it affords little understanding of how consumers may respond to the many types of information provided in dental services advertisements. The authors extend knowledge in this area by examining consumer response to dental advertising in an experimental setting.
38 CFR 52.170 - Dental services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Dental services. 52.170... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.170 Dental services. (a) Program... (2) By arranging for transportation to and from the dental services. (b) Program management must...
38 CFR 52.170 - Dental services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Dental services. 52.170... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.170 Dental services. (a) Program... (2) By arranging for transportation to and from the dental services. (b) Program management must...
38 CFR 52.170 - Dental services.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Dental services. 52.170... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.170 Dental services. (a) Program... (2) By arranging for transportation to and from the dental services. (b) Program management must...
38 CFR 52.170 - Dental services.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Dental services. 52.170... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.170 Dental services. (a) Program... (2) By arranging for transportation to and from the dental services. (b) Program management must...
38 CFR 52.170 - Dental services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Dental services. 52.170... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.170 Dental services. (a) Program... (2) By arranging for transportation to and from the dental services. (b) Program management must...
Collaboration Between Medical Providers and Dental Hygienists in Pediatric Health Care.
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.
2018-01-01
Background Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen’s behavioural model. Methods Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Results Predisposing (OR = 0.89; 95% CI 0.81–0.97) and enabling (OR = 0.90; 95% CI 0.85–0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Conclusions Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services. PMID:29420660
Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro
2018-01-01
Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.
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.
Oral impacts on daily performances and recent use of dental services in schoolchildren.
Monsantofils, Monica; Bernabé, Eduardo
2014-11-01
To explore whether oral impacts on daily performances are related to recent use of dental services among children and whether oral impacts on specific daily performances are more strongly related to recent use of dental services. Data from a cross-sectional survey, including 805 11-12-year-old children attending four randomly selected schools in Lima (Peru), were used. The child version of the oral impacts on daily performances (Child-OIDP) was used to assess prevalence, intensity, and extent of oral impacts. Use of dental services was assessed by self-reports of last dental visit and reason for the visit. Associations of the prevalence, intensity, and extent of oral impacts with use of dental services were tested in logistic regression models. Children with oral impacts were 1.99 (95% CI: 1.17-3.37) times more likely to have used dental services recently than their counterparts. The intensity and extent of oral impacts were linearly associated with children's use of dental services. Difficulties in eating were the only type of oral impacts on daily performances associated with use of dental services, independent of children's demographic characteristics, and impacts on other performances. Oral impacts on daily performances were related to recent use of dental services among these schoolchildren. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
A prospective study of the validity of self-reported use of specific types of dental services.
Gilbert, Gregg H; Rose, John S; Shelton, Brent J
2003-01-01
The purpose of this study was to quantify the validity of self-reported receipt of dental services in 10 categories, using information from dental charts as the "gold standard." The Florida Dental Care Study was a prospective cohort study of a diverse sample of adults. In-person interviews were conducted at baseline and at 24 and 48 months following baseline, with telephone interviews at six-month intervals in between. Participants reported new dental visits, reason(s) for the visit(s), and specific service(s) received. For the present study, self-reported data were compared with data from patients' dental charts. Percent concordance between self-report and dental charts ranged from 82% to 100%, while Kappa values ranged from 0.33 to 0.91. Bivariate multiple logistic regressions were performed for each of the service categories, with two outcomes: self-reported service receipt and service receipt determined from the dental chart. Parameter estimate intervals overlapped for each of the four hypothesized predictors of service receipt (age group, sex, "race" defined as non-Hispanic African American vs. non-Hispanic white, and annual household income < 20,000 US dollars vs. > or = 20,000 US dollars), although for five of the 10 service categories, there were differences in conclusions about statistical significance for certain predictors. The validity of self-reported use of dental services ranged from poor to excellent, depending upon the service type. Regression estimates using either the self-reported or chart-validated measure yielded similar results overall, but conclusions about key predictors of service use differed in some instances. Self-reported dental service use is valid for some, but not all, service types.
Dental Caries Experience and Use of Dental Services among Brazilian Prisoners
Leite Cavalcanti, Alessandro; Araujo Rodrigues, Iris Sant´Anna; de Melo Silveira, Ingrid Thays; Sarmento de Oliveira, Thaliny Batista; de Almeida Pinto, Magaly Suenya; Cabral Xavier, Alidianne Fabia; Dias de Castro, Ricardo; Nascimento Padilha, Wilton Wilney
2014-01-01
This ross-sectional study involving 127 male prisoners evaluates the use of dental services and dental caries among Brazilian inmates. Data were collected by interview and clinical examination. Sociodemographic and sentencing information as well as use of dental services, self-reported dental morbidity, self-perception, and oral health impacts were investigated. The mean DMFT index value was 19.72. Of the components, the decayed component showed the highest mean value (11.06 ± 5.37). Statistically significant association was found between DMFTs with values from 22 to 32 and oral health satisfaction (p = 0.002), difficulty speaking (p = 0.024), shame of talking (p = 0.004) and smiling (p < 0.001). Regarding the use of dental services, 80% had their last dental appointment less than one year ago, with most visits occurring in prison (80%), with restorative treatment (32%), followed by dental pain (26.4%), being the main reasons for such appointments. Most prisoners used dental services provided by the prison. Although restorative treatment has been the main reason for the use of dental services, “decayed” and “missing” components contributed to the high mean DMFT index. PMID:25429680
38 CFR 51.170 - Dental services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Dental services. 51.170... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.170 Dental services. (a) A facility... and emergency dental services to meet the needs of each resident; (b) A facility may charge a resident...
38 CFR 51.170 - Dental services.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Dental services. 51.170... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.170 Dental services. (a) A facility... and emergency dental services to meet the needs of each resident; (b) A facility may charge a resident...
38 CFR 51.170 - Dental services.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Dental services. 51.170... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.170 Dental services. (a) A facility... and emergency dental services to meet the needs of each resident; (b) A facility may charge a resident...
38 CFR 51.170 - Dental services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Dental services. 51.170... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.170 Dental services. (a) A facility... and emergency dental services to meet the needs of each resident; (b) A facility may charge a resident...
38 CFR 51.170 - Dental services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Dental services. 51.170... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.170 Dental services. (a) A facility... and emergency dental services to meet the needs of each resident; (b) A facility may charge a resident...
Demand for Dental Services in Shiraz, Iran, 2013.
Jahromi, Negin Nassaji; Jafari, Abdosaleh; Kavosi, Zahra; Shokrpour, Nasrin; Sajjadnia, Zahra; Ravangard, Ramin
This cross-sectional and descriptive-analytic study aimed to estimate the demands for the use of dental services by Shirazi inhabitants in Iran from June 2013 to October 2013. Six hundred eighty subjects older than 18 years were selected from among the people living in Shiraz, using a multistage sampling method. The collected data were analyzed using SPSS 16.0 and Stata 11.0. The results showed that the factors affecting the number of referrals to the dental services centers and the use of these services included the age groups of 28 to 37 and 38 to 47 years, household expenses per month, and having supplementary health insurance coverage (P < .05). According to the results, in order to improve access to dental services and increase the probability of utilizing such services by people in need, the researchers recommend that the authorities should design and develop basic and supplementary health insurance plans to cover different types of dental services, allocate subsidies to dental health services, and increase the knowledge of all the people in different age groups about adherence to dental health principles and prevention of oral and dental diseases.
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.
Al-Hussyeen, Al Johara A.
2009-01-01
Objectives This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit. Subjects and methods Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh. Results Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P < 0.0001), while the most encouraging factor was the availability of friendly staff (P < 0.0001). The high cost of dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P < 0.0001), while the high quality of dental care was the most encouraging factor (P < 0.009). Students who made their visits because of pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P < 0.002), while they considered the high cost of dental care as discouraging factor for using dental services (P < 0.038). Students who visited the dentist for routine treatment gave the quality of dental care as encouraging for the use of dental clinics (P < 0.0001). Satisfaction with dental care was found to be significantly associated with high quality of dental care, convenient appointment, friendly staff, modern dental clinics and clinics recommended by friends. Conclusion Quality of dental care, reasonable fees for dental services and close location of dental clinics to students’ homes are encouraging factors for utilization of dental services. PMID:23960475
Al-Hussyeen, Al Johara A
2010-01-01
This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit. Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh. Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P < 0.0001), while the most encouraging factor was the availability of friendly staff (P < 0.0001). The high cost of dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P < 0.0001), while the high quality of dental care was the most encouraging factor (P < 0.009). Students who made their visits because of pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P < 0.002), while they considered the high cost of dental care as discouraging factor for using dental services (P < 0.038). Students who visited the dentist for routine treatment gave the quality of dental care as encouraging for the use of dental clinics (P < 0.0001). Satisfaction with dental care was found to be significantly associated with high quality of dental care, convenient appointment, friendly staff, modern dental clinics and clinics recommended by friends. Quality of dental care, reasonable fees for dental services and close location of dental clinics to students' homes are encouraging factors for utilization of dental services.
Dyson, K; Kruger, E; Tennant, M
2014-06-01
Embedding research capabilities and workforce development activities with clinical service entities promotes the development of sustainable, innovative, quality-focused oral health care services. Clinical and strategic governance is an important area of consideration for rural and remote dental services, posing particular challenges for smaller service structures. Sustaining remote area dental services has some significant complexities beyond those involved in urban service models. This study describes the sustaining structure of a remote area dental service with a decade of history. In the current climate, chief among these challenges may be those associated with dental workforce shortages as these impact most heavily in the public sector, and most particularly, in remote areas. As sustained workforce solutions come from developing a future workforce, an essential element of the workforce governance framework for remote dental service provision should be the inclusion of a student participation programme. Collaborative partnership approaches with Aboriginal health services promote the development and maintenance of effective, culturally sensitive dental services within rural and remote Aboriginal communities. Having sustained care for 10 years, this collaborative model of integrated research, education and service has demonstrated its effectiveness as a service model for Aboriginal communities in Western Australia. This descriptive study finds the core values for this success have been communication, clinical leadership, mentorship within effective governance systems all linked to an integrated education and research agenda. © 2014 Australian Dental Association.
38 CFR 17.163 - Posthospital outpatient dental treatment.
Code of Federal Regulations, 2014 CFR
2014-07-01
... dental treatment. 17.163 Section 17.163 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.163 Posthospital outpatient dental treatment. The Chief, Dental Service may authorize outpatient dental care which is reasonably necessary to complete treatment of a...
38 CFR 17.163 - Posthospital outpatient dental treatment.
Code of Federal Regulations, 2013 CFR
2013-07-01
... dental treatment. 17.163 Section 17.163 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.163 Posthospital outpatient dental treatment. The Chief, Dental Service may authorize outpatient dental care which is reasonably necessary to complete treatment of a...
38 CFR 17.163 - Posthospital outpatient dental treatment.
Code of Federal Regulations, 2012 CFR
2012-07-01
... dental treatment. 17.163 Section 17.163 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.163 Posthospital outpatient dental treatment. The Chief, Dental Service may authorize outpatient dental care which is reasonably necessary to complete treatment of a...
38 CFR 17.163 - Posthospital outpatient dental treatment.
Code of Federal Regulations, 2010 CFR
2010-07-01
... dental treatment. 17.163 Section 17.163 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.163 Posthospital outpatient dental treatment. The Chief, Dental Service may authorize outpatient dental care which is reasonably necessary to complete treatment of a...
38 CFR 17.163 - Posthospital outpatient dental treatment.
Code of Federal Regulations, 2011 CFR
2011-07-01
... dental treatment. 17.163 Section 17.163 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.163 Posthospital outpatient dental treatment. The Chief, Dental Service may authorize outpatient dental care which is reasonably necessary to complete treatment of a...
A review of the literature: the economic impact of preventive dental hygiene services.
Sharon, Stull C; Connolly, Irene M; Murphree, Kellie R
2005-01-01
The contributions of dental hygiene as a discipline of prevention, the inception of systemic fluoride in community water systems, the continual research conducted by the National Institute of Dental and Craniofacial Research (NIDCR), and the success of dental sealants have all contributed to the decrease in incidences of dental diseases. The prevalence of employer-based dental insurance must also be recognized as contributing to a substantial paradigm shift on the utilization of oral health preventive services. This review of the economic impact of oral health preventive services on the consumer and the private dental practice suggests that these services have had a significant impact. Dentistry's challenge remains to extend these considerable gains in oral health status to the 150 million U.S. citizens who do not have access to oral health care services identified in the 2000 Oral Health in America: A Report of the Surgeon General. Utilizing preventive, therapeutic, and educational aspects of dental hygiene services, reaching communities without fluoridation of the public water supply, and incorporating mass pediatric dental sealant programs analogous to immunization programs would improve the oral health status of underserved populations.
Machado, Luciene Petcov; Camargo, Maria Beatriz Junqueira; Jeronymo, José Carlos Milanez; Bastos, Gisele Alsina Nader
2012-06-01
To estimate the prevalence of regular use of dental care services by adults and older adults residing in vulnerable community and to identify associated factors. A population-based cross-sectional study was carried out with 3,391 adults and older adults residing in areas of social vulnerability in Porto Alegre, Southern Brazil, from July to December of 2009. A systematic sampling method was used the selection probability proportional to the population of each of the the 121 census sectors. The outcome for regular use of dental care services was defined as regular use of dental services, regardless of the presence of dental problems. A standardized questionnaire was administered, which included demographic, socioeconomic, type of dental care services, self-perception of dental health and self-perceived needs variables. A chi-square test for heterogeneity was used for bivariate analyses, and a Poisson regression with a robust variance and Wald tests were performed for the adjusted analysis. The prevalence of regular use of dental services was 25.7%. The prevalence was higher among people with >12 years schooling (PR 2.48 [95%CI:1.96;3.15]), higher income (PR 1.95[95%CI: 1.03;1.53]), use of private health services (PR 1.43 [95%CI: 1.20;1.71]),excellent self-perceived oral health (PR 4.44 [95%CI: 3.07;6.42]) and a self-perceived need for consultation related to routine checkup (RP 2.13 [95%CI: 1.54;2.96]). Inequalities were found in the regular use of dental services. Integrated approaches that raise awareness of oral health, improve self-care and expand access to dental services, may contribute to increase the use of dental services on a regular basis.
Income-Related Inequalities in Access to Dental Care Services in Japan.
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.
Zwetchkenbaum, Samuel; Oh, Junhie
2017-10-02
Under the Affordable Care Act (ACA) Medicaid expansion since 2014, 68,000 more adults under age 65 years were enrolled in Rhode Island Medicaid as of December 2015, a 78% increase from 2013 enrollment. This report assesses changes in dental utilization associated with this expansion. Medicaid enrollment and dental claims for calendar years 2012-2015 were extracted from the RI Medicaid Management Information System. Among adults aged 18-64 years, annual numbers and percentages of Medicaid enrollees who received any dental service were summarized. Additionally, dental service claims were assessed by provider type (private practice or health center). Although 15,000 more adults utilized dental services by the end of 2015, the annual percentage of Medicaid enrollees who received any dental services decreased over the reporting periods, compared to pre-ACA years (2012-13: 39%, 2014: 35%, 2015: 32%). From 2012 to 2015, dental patient increases in community health centers were larger than in private dental offices (78% vs. 34%). Contrary to the Medicaid population increase, the number of dentists that submitted Medicaid claims decreased, particularly among dentists in private dental offices; the percentage of RI private dentists who provided any dental service to adult Medicaid enrollees decreased from 29% in 2012 to 21% in 2015. Implementation of Medicaid expansion has played a critical role in increasing the number of Rhode Islanders with dental coverage, particularly among low-income adults under age 65. However, policymakers must address the persistent and worsening shortage of dental providers that accept Medicaid to provide a more accessible source of oral healthcare for all Rhode Islanders. [Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].
38 CFR 17.161 - Authorization of outpatient dental treatment.
Code of Federal Regulations, 2013 CFR
2013-07-01
... outpatient dental treatment. 17.161 Section 17.161 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.161 Authorization of outpatient dental treatment. Outpatient dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C...
38 CFR 17.161 - Authorization of outpatient dental treatment.
Code of Federal Regulations, 2011 CFR
2011-07-01
... outpatient dental treatment. 17.161 Section 17.161 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.161 Authorization of outpatient dental treatment. Outpatient dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C...
38 CFR 17.161 - Authorization of outpatient dental treatment.
Code of Federal Regulations, 2010 CFR
2010-07-01
... outpatient dental treatment. 17.161 Section 17.161 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.161 Authorization of outpatient dental treatment. Outpatient dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C...
38 CFR 17.161 - Authorization of outpatient dental treatment.
Code of Federal Regulations, 2014 CFR
2014-07-01
... outpatient dental treatment. 17.161 Section 17.161 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.161 Authorization of outpatient dental treatment. Outpatient dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C...
38 CFR 17.161 - Authorization of outpatient dental treatment.
Code of Federal Regulations, 2012 CFR
2012-07-01
... outpatient dental treatment. 17.161 Section 17.161 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.161 Authorization of outpatient dental treatment. Outpatient dental treatment may be authorized by the Chief, Dental Service, for beneficiaries defined in 38 U.S.C...
ERIC Educational Resources Information Center
Blum, Steven; Tuthill, Robert W.
1977-01-01
Results are presented of an undergraduate and graduate student survey investigating (1) the state of oral pathology of the students, (2) utilization of dental services during the fifteen-months preceeding the study, (3) perceptions and utilization of local dental services, and (4) attitudes toward emergency and routine dental services at the…
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.
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.
48 CFR 801.670-3 - Medical, dental, and ancillary service.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Medical, dental, and..., Contracting Authority, and Responsibilities 801.670-3 Medical, dental, and ancillary service. (a) When medical, dental, and ancillary services under $10,000 per authorization are not available from an existing...
42 CFR 483.55 - Dental services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 5 2014-10-01 2014-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
48 CFR 801.670-3 - Medical, dental, and ancillary service.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Medical, dental, and..., Contracting Authority, and Responsibilities 801.670-3 Medical, dental, and ancillary service. (a) When medical, dental, and ancillary services under $10,000 per authorization are not available from an existing...
48 CFR 801.670-3 - Medical, dental, and ancillary service.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Medical, dental, and..., Contracting Authority, and Responsibilities 801.670-3 Medical, dental, and ancillary service. (a) When medical, dental, and ancillary services under $10,000 per authorization are not available from an existing...
42 CFR 483.55 - Dental services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 5 2010-10-01 2010-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
42 CFR 483.55 - Dental services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 5 2012-10-01 2012-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
48 CFR 801.670-3 - Medical, dental, and ancillary service.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Medical, dental, and..., Contracting Authority, and Responsibilities 801.670-3 Medical, dental, and ancillary service. (a) When medical, dental, and ancillary services under $10,000 per authorization are not available from an existing...
48 CFR 801.670-3 - Medical, dental, and ancillary service.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Medical, dental, and..., Contracting Authority, and Responsibilities 801.670-3 Medical, dental, and ancillary service. (a) When medical, dental, and ancillary services under $10,000 per authorization are not available from an existing...
42 CFR 483.55 - Dental services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 5 2013-10-01 2013-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
42 CFR 483.55 - Dental services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 5 2011-10-01 2011-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
[Gingival health of adolescents and the utilization of dental services, state of São Paulo, Brazil].
Antunes, José Leopoldo Ferreira; Peres, Marco Aurélio; Frias, Antonio Carlos; Crosato, Edgard Michel; Biazevic, Maria Gabriela Haye
2008-04-01
To evaluate the association between gingival health conditions and dental service utilization. An epidemiological survey of the oral health of 1,799 adolescents was carried out in 35 cities of the state of São Paulo, in 2002. Gingival health was assessed through the prevalence of gingival bleeding on probing and dental calculus (community periodontal index), and dental occlusion was assessed through the dental aesthetic index. The utilization of dental services was measured by means of the dental care index (F/DMFT) for each city. Multilevel logistic regression analysis was used to adjust explanatory models to factors associated with the outcome variables of interest. The prevalence of gingival bleeding on probing was 21.5%, whereas dental calculus was prevalent in 19.4%. Male participants, who were either black or dark-skinned, lived in crowded homes, in rural areas, and showed schooling delay, were at a significantly higher risk than their respective counterparts. The following dental occlusion characteristics were also associated with unhealthy gum: incisor segment crowding, vertical anterior open bite, and antero-posterior molar relationship. Cities with a higher utilization of dental services showed a smaller proportion of adolescents with gingival bleeding and dental calculus. The utilization of dental services was significantly associated with better gingival health conditions (gingival bleeding and dental calculus). This association did not depend on contextual and individual sociodemographic characteristics or dental occlusion.
Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs.
Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra
2015-10-01
In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center. A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis. Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value <0.05 was kept as statistically significant. The services provided in public health center should be based on the felt need of the population to increase attendance as well as utilization of dental services, thereby increasing the oral health status of the population.
ERIC Educational Resources Information Center
Hale, Richard; Saville, Martin
2014-01-01
In the UK, the Civil Service Reform Plan is being implemented with urgency. This requires Civil Service departments and agencies to reform their structures and ways of working in order to deliver effective services in a climate of economic austerity and rapid social and technological change. Historically, Human Resource (HR) professionals have…
Carlisle, Karen; Larkins, Sarah; Croker, Felicity
2017-01-01
The oral health of rural Australians continues to lag behind that of those living in metropolitan areas. Research has shown that people living in rural areas are more likely to suffer from dental caries (decay), visit the dentist less often and have poorer access to oral health services. The purpose of the study was to examine hospitalisations for dental conditions and utilisation of public dental services in three rural communities in Queensland compared with the whole of Queensland. Aggregated hospitalisation data for dental conditions and counts of public outpatient service data were requested for residents of three rural communities in Queensland and for the whole of Queensland for the calendar year 2013. Hospitalisation rates per 1000 and risk ratios were calculated to examine the risk of hospitalisation for dental procedures for those living in the selected rural communities and the rest of Queensland. Data were grouped by gender, age and Indigenous status and comparisons made between Queensland and the rural communities. Outpatient service data were converted to percentage of all services delivered to allow comparisons between groups of different sizes. Population data were grouped into age cohorts and compared with the proportion of public oral health services delivered to each age cohort. Residents of the rural communities were twice as likely to be hospitalised and children aged 0-14 years living in the communities were three times more likely to be hospitalised for dental conditions compared to residents of the rest of Queensland. Outpatient oral service data showed that the proportion of services delivered to children aged up to 14 years living in the rural communities was less than the whole of Queensland. Interestingly, in one rural community where the public dental service was open to all, the distribution of public oral health services aligned with the age distribution of the population. The study showed that residents of these rural communities 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.
Income Inequality and Use of Dental Services in 66 Countries.
Bhandari, B; Newton, J T; Bernabé, E
2015-08-01
This study explored the association between income inequality and use of dental services and the role that investment in health care plays in explaining that association. We pooled individual-level data from 223,299 adults, 18 years or older, in 66 countries, who participated in the World Health Organization (WHO) World Health Surveys with country-level data from different international sources. Income inequality was measured at the national level using the Gini coefficient, and use of dental services was defined as having received treatment to address problems with mouth and/or teeth in the past year. The association between the Gini coefficient and use of dental services was examined in multilevel models controlling for a standard set of individual- and country-level confounders. The individual and joint contributions of 4 indicators of investment in health care were evaluated in sequential modeling. The Gini coefficient and use of dental services were inversely associated after adjustment for confounders. Every 10% increase in the Gini coefficient corresponded with a 15% lower odds of using dental services (odds ratio: 0.85; 95% confidence interval: 0.70-0.99). The association between the Gini coefficient and use of dental services was attenuated and became nonsignificant after individual adjustment for total health expenditure, public expenditure on health, health system responsiveness, or type of dental health system. The 4 indicators together explained 80% of the association between the Gini coefficient and use of dental services. This study suggests that more equal countries have greater use of dental services. It also supports the mediating role of investment in health care in explaining that association. © International & American Associations for Dental Research 2015.
Raittio, Eero; Kiiskinen, Urpo; Helminen, Sari; Aromaa, Arpo; Suominen, Anna Liisa
2015-06-01
In Finland, a major oral healthcare reform (OHCR), implemented during 2001-2002, opened the public dental services (PDS) and extended subsidies for private dental services to entire adult population. Before the reform, adults born earlier than 1956 were not entitled to use PDS nor did they receive any reimbursements for their private dental costs. We aimed to examine changes in the income-related inequality and inequity in the use of dental services among the adult Finns after the reform. Representative data from Finnish adults born in 1970 or earlier were gathered from three identical postal surveys concerning the use of dental services and subjective perceptions of oral health. Those surveys were conducted before the OHCR in 2001 (n = 1907) and after the OHCR in 2004 (n = 1629) and 2007 (n = 1509). We used concentration index and its decomposition to analyse income-related inequality and inequity in the use of dental services and factors associated with them. Results showed that pro-rich inequality and inequity in the overall use of dental services narrowed from 2001 to 2004. However, between 2004 and 2007, pro-rich inequality and inequity widened, so it returned to a rather similar level in 2007 as it had been in 2001. Most of the pro-rich inequality and inequity were related to regular dental visiting habit and income level. While there was pro-poor inequality and inequity in the use of PDS, there was pro-rich inequality and inequity in the use of private dental services throughout the study years. It seems that income-related inequality and inequity in the use of dental services narrowed only temporarily after the reform. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Expanded function allied dental personnel and dental practice productivity and efficiency.
Beazoglou, Tryfon J; Chen, Lei; Lazar, Vickie F; Brown, L Jackson; Ray, Subhash C; Heffley, Dennis R; Berg, Rob; Bailit, Howard L
2012-08-01
This study examined the impact of expanded function allied dental personnel on the productivity and efficiency of general dental practices. Detailed practice financial and clinical data were obtained from a convenience sample of 154 general dental practices in Colorado. In this state, expanded function dental assistants can provide a wide range of reversible dental services/procedures, and dental hygienists can give local anesthesia. The survey identified practices that currently use expanded function allied dental personnel and the specific services/procedures delegated. Practice productivity was measured using patient visits, gross billings, and net income. Practice efficiency was assessed using a multivariate linear program, Data Envelopment Analysis. Sixty-four percent of the practices were found to use expanded function allied dental personnel, and on average they delegated 31.4 percent of delegatable services/procedures. Practices that used expanded function allied dental personnel treated more patients and had higher gross billings and net incomes than those practices that did not; the more services they delegated, the higher was the practice's productivity and efficiency. The effective use of expanded function allied dental personnel has the potential to substantially expand the capacity of general dental practices to treat more patients and to generate higher incomes for dental practices.
Qualitative assessment of the dental health services provided at a dental school in Kerman, Iran.
Rad, Maryam; Haghani, Jahangir; Shahravan, Arash; Khosravifar, Ali
2009-01-01
Increasing the quality of the services provided in a Dental School can raise the satisfaction level of patients and consequently increase the level of their oral health. This study was conducted to evaluate the quality of dental care and services provided to patients referred to a Dental School in Kerman, Iran. In this qualitative study, face-to-face, in-depth interviews were conducted with 41 participants [25 patients (P), 5 nurses (N), 6 dental academic staff (AS), and 5 dental students (S)]. Then, the interviews were transcribed and analyzed, using content analysis of data. Data analysis in qualitative research involves breaking down the data and searching for codes and categories that are then reassembled to form themes. Both positive and negative themes emerged. Positive themes included: good infection control, service accessibility, patient appointments and visits were not assigned on merit, precise examinations, and comprehensive treatment plans. Negative themes included: long wait time, lack of options to pass waiting time, such as newspapers and television, an insufficient number of nurses, and not enough professors for supervision. In addition, the results of this study show that the patients and dental staff have high expectations in relation to dental services, and that implementation of these expectations would increase the overall satisfaction with and the quality of the level of services. Finally, some recommendations for improving services in the Kerman Dental School were given to the managing team of the Dental School.
Maxey, Hannah L; Norwood, Connor W; Liu, Ziyue
2016-09-01
To determine whether and to what extent the state policy environment for the dental hygiene workforce affects the availability of dental services at Federally Qualified Health Centers (FQHCs). We examined data drawn from the Uniform Data System on 1,135 unique FQHC grantees receiving community health center funding from the U.S. Health Center program between 2004 and 2012. The Dental Hygiene Professional Practice Index was used to quantify variations in state policy environment. We then examined the influence of state policy environment on the availability of dental care through generalized linear mixed-effects models. Approximately 80% of FQHCs reported delivering dental services. We consistently observed that FQHCs with favorable levels of state support had the highest proportion of FQHCs that delivered dental services, even more so than FQHCs with extremely high support. FQHCs located in the most restrictive states had 0.28 the odds of delivering dental services as did those located in the most supportive states. The state policy environment for the dental hygiene workforce is likely associated with the availability of dental services at FQHCs. The greatest proportion of FQHCs delivering dental services was found in states with policy provisions supporting professional independence in public health settings. Nevertheless, additional research is needed to understand the specific mechanism by which these policies affect FQHCs. © 2016 The Authors. Journal of Public Health Dentistry published by Wiley Periodicals, Inc. on behalf of American Association of Public Health Dentistry.
Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003-2008.
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.
Guidance for commissioning NHS England dental conscious sedation services: a framework tool.
Howlett, Paul
2014-01-01
Conscious sedation is an integral part of modern day dental care and should be delivered through a high quality, effective and evidence-based approach. Commissioning of NHS dental services in England is currently under review by NHS England and the National Dental Commissioning Group. This group has identified the management of vulnerable people including anxious patients, as one of its priorities. The Society for the Advancement of Anaesthesia in Dentistry (SAAD) believes this provides an opportunity to influence the commissioning of NHS conscious sedation services. With this aim in mind,"Guidance for Commissioning NHS England Dental Conscious Sedation Services: A Framework Tool" was developed. This guidance proposes a common approach to the organisation of NHS dental conscious sedation services in England, advocating the provision of Tier 1 and Tier 2 services in all regions. Its ethos is a"hub and spoke" model of service delivery with patient assessment delivered by experienced and well trained dental sedationists at its core. In line with the recent Francis Report fundamental standards for all aspects of dental conscious sedation practice are outlined, supported by a robust and predictable quality assurance process. This work has been shared with key stakeholders in NHS England including the Chief Dental Officer and the Head of Primary Care Commissioning.
Tickle, M; Moulding, G; Milsom, K; Blinkhorn, A
2000-10-14
To measure the relationship between tooth decay, contact with dental services and deprivation at electoral ward level. The study was carried out in 1998 in Ellesmere Port in the North West of England. All children younger than six years resident in Ellesmere Port registered with GDS services and those using CDS services were matched against the HA population register to identify unregistered children. Rates for children aged 3-5 years 'in contact' with primary dental care services, whether CDS or GDS, were calculated at ward level. One calibrated examiner examined all 5-year-old children in Ellesmere Port and dmft scores were calculated at ward level. Ward deprivation was measured using the Jarman score. Bivariate linear regressions at ward level were performed in turn between: dmft and Jarman score; rates for 3-5-year-olds in contact with dental services and Jarman score; and dmft and rates for 3-5-year-olds in contact with dental services. A significant linear relationship was observed between dmft and Jarman score (P=0.02, R2 = 0.43). Significant inverse relationships were found between rates for 3-5-year-olds in contact with dental services and Jarman score (P=0.001, R2 = 0.67), and also between dmft and rates for 3-5-year-olds in contact with dental services (P=0.002, R2 = 0.65). A strong inverse relationship was found between dental caries and contact with primary dental care services at electoral ward level. This relationship needs to be explored over a wider geographical area to establish if it is consistent and independent of deprivation.
The Effect of Teaching Experience on Service-Learning Beliefs of Dental Hygiene Educators
ERIC Educational Resources Information Center
Burch, Sharlee Shirley
2013-01-01
The purpose of this non-experimental causal-comparative study was to determine if service-learning teaching experience affects dental hygiene faculty perceptions of service-learning benefits and barriers in the United States. Dental hygiene educators from entry-level dental hygiene education programs in the United States completed the Web-based…
38 CFR 17.165 - Emergency outpatient dental treatment.
Code of Federal Regulations, 2012 CFR
2012-07-01
... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...
38 CFR 17.165 - Emergency outpatient dental treatment.
Code of Federal Regulations, 2013 CFR
2013-07-01
... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...
38 CFR 17.165 - Emergency outpatient dental treatment.
Code of Federal Regulations, 2010 CFR
2010-07-01
... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...
38 CFR 17.165 - Emergency outpatient dental treatment.
Code of Federal Regulations, 2011 CFR
2011-07-01
... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...
38 CFR 17.165 - Emergency outpatient dental treatment.
Code of Federal Regulations, 2014 CFR
2014-07-01
... dental treatment. 17.165 Section 17.165 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.165 Emergency outpatient dental treatment. When outpatient emergency dental care is provided, as a humanitarian service, to individuals who have no established eligibility...
Using Registered Dental Hygienists to Promote a School-Based Approach to Dental Public Health
Wellever, Anthony; Kelly, Patricia
2017-01-01
We examine a strategy for improving oral health in the United States by focusing on low-income children in school-based settings. Vulnerable children often experience cultural, social, economic, structural, and geographic barriers when trying to access dental services in traditional dental office settings. These disparities have been discussed for more than a decade in multiple US Department of Health and Human Services publications. One solution is to revise dental practice acts to allow registered dental hygienists increased scope of services, expanded public health delivery opportunities, and decreased dentist supervision. We provide examples of how federally qualified health centers have implemented successful school-based dental models within the parameters of two state policies that allow registered dental hygienists varying levels of dentist supervision. Changes to dental practice acts at the state level allowing registered dental hygienists to practice with limited supervision in community settings, such as schools, may provide vulnerable populations greater access to screening and preventive services. We derive our recommendations from expert opinion. PMID:28661808
The contribution of social and environmental factors to race differences in dental services use.
Eisen, Colby H; Bowie, Janice V; Gaskin, Darrell J; LaVeist, Thomas A; Thorpe, Roland J
2015-06-01
Dental services use is a public health issue that varies by race. African Americans are less likely than whites to make use of these services. While several explanations exist, little is known about the role of segregation in understanding this race difference. Most research does not account for the confounding of race, socioeconomic status, and segregation. Using cross-sectional data from the Exploring Health Disparities in Integrated Communities Study, we examined the relationship between race and dental services use. Our primary outcome of interest was dental services use within 2 years. Our main independent variable was self-identified race. Of the 1408 study participants, 59.3% were African American. More African Americans used dental services within 2 years than whites. After adjusting for age, gender, marital status, income, education, insurance, self-rated health, and number of comorbidities, African Americans had greater odds of having used services (odds ratio = 1.48, 95% confidence interval 1.16, 1.89) within 2 years. Within this low-income racially integrated sample, African Americans participated in dental services more than whites. Place of living is an important factor to consider when seeking to understand race differences in dental service use.
Factors affecting dental service quality.
Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia
2015-01-01
Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.
Dental responsibility loadings and the relative value of dental services.
Teusner, D N; Ju, X; Brennan, D S
2017-09-01
To estimate responsibility loadings for a comprehensive list of dental services, providing a standardized unit of clinical work effort. Dentists (n = 2500) randomly sampled from the Australian Dental Association membership (2011) were randomly assigned to one of 25 panels. Panels were surveyed by questionnaires eliciting responsibility loadings for eight common dental services (core items) and approximately 12 other items unique to that questionnaire. In total, loadings were elicited for 299 items listed in the Australian Dental Schedule 9th Edition. Data were weighted to reflect the age and sex distribution of the workforce. To assess reliability, regression models assessed differences in core item loadings by panel assignment. Estimated loadings were described by reporting the median and mean. Response rate was 37%. Panel composition did not vary by practitioner characteristics. Core item loadings did not vary by panel assignment. Oral surgery and endodontic service areas had the highest proportion (91%) of services with median loadings ≥1.5, followed by prosthodontics (78%), periodontics (76%), orthodontics (63%), restorative (62%) and diagnostic services (31%). Preventive services had median loadings ≤1.25. Dental responsibility loadings estimated by this study can be applied in the development of relative value scales. © 2017 Australian Dental Association.
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.
Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B
2017-08-01
This study examined differences in health risks and workplace outcomes among employees who utilized preventive dental services compared with other employees. A retrospective observational study of employees of a large financial services corporation, with data from health risk appraisal questionnaires, medical claims, pharmacy claims, and dental claims. Employees with no dental claims were significantly more likely to have a variety of health risk factors (such as obesity and tobacco use), health conditions (such as diabetes), absenteeism, and lost on-the-job productivity, and were significantly less likely to be compliant with clinical preventive services compared with those with preventive dental claims. Employees with preventive dental claims had fewer health risks and medical conditions and better health and productivity measures. Study employees underutilized free dental care; employers should incorporate preventive dental care awareness into their worksite wellness programs.
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.
[Local government and public dental health services: an analysis of inequality in use].
Soares, Felipe Fagundes; Chaves, Sônia Cristina Lima; Cangussu, Maria Cristina Teixeira
2015-03-01
The aim of this study was to identify factors associated with the use of primary and specialized public dental health services and private services. A population-based household survey was conducted in two cities of Bahia State, Brazil. Key informants provided data on socioeconomic variables and use of dental health services. Organization of the local public dental health service was ranked as worse versus better. Univariate and multivariate polytomous logistic regression was performed. Of the total of 1,290 individuals, 38.76% used private services, 33.80% used public primary care, and 17.29% used both primary care and the Center for Dental Specialties. Less use of both primary care and specialized public services was associated with lower education (OR = 1.47; 95%CI: 1.03-2.10) and worse organization of services (OR = 1.74; 95%CI: 1.22-2.48), when compared to the exclusive use of primary care. The study showed inequality in the use of dental services, even when comparing more homogeneous groups, namely users of public services.
Dental services utilization by women of childbearing age by socioeconomic status.
Kaylor, Mary B; Polivka, Barbara J; Chaudry, Rosemary; Salsberry, Pamela; Wee, Alvin G
2010-04-01
For women of childbearing age, oral health not only affects their physical and psychological well-being but also that of their children. This study used the 2003-2004 Ohio Family Health Survey (N = 9,819) to examine dental need and utilization by women in Ohio. Predisposing, enabling, and need variables were examined as they effect dental health service utilization by women of childbearing age at different socioeconomic status (SES) levels. The proportion of women in the low SES group self reporting a dental need (18%) was 3 times that of the proportion of women in the higher SES group with a self reported need (6%). Results of bivariate analysis showed that having a dental visit in the past year varied significantly by SES, race, insurance status, provider density, and need. A racial disparity in dental service utilization was noted in the bivariate analysis of the middle SES group. While dental need and type of dental coverage varied by SES, both were significantly associated with utilization of dental services within all 3 SES categories in the logistic regressions. These results suggest that measures need to be implemented to meet the goal of increasing access and utilization of dental health services by low-income populations.
Hammersmith, Kimberly J; Lee, Jessica Y
2009-01-01
Dental providers are increasingly challenged in communicating with patients with limited English proficiency (LEP). Accordingly, the purpose of the study was to examine methods of communicating with patients with LEP in North Carolina (NC) safety-net dental clinics as perceived by dental staff. An anonymous, 36-item, cross-sectional survey was distributed to representatives of 68 NC safety-net dental clinics. Question domains included: a) a perceived need for language services; b) methods of language services provided; c) perceptions of dental staff about dental care experiences for patients with LEP; and d) perceived legal and financial roles in providing language services. Of the 68 clinics, 55 responded (81 percent). All clinics reported treating patients with LEP, and 93 percent of clinics reported a need for providing language services. Many clinics used multiple methods to provide language services. Some clinics reported differences in treatment recommendations (13 percent), treatment provided (19 percent), and visit length (61 percent) for patients with LEP. All responded that additional costs are incurred to treat patients with LEP, and only 69 percent of responding clinics recognized legal obligations of treating patients with LEP. There is a reported need for language services in NC safety-net dental clinics. These services often resulted in additional costs to the dental clinic. To maintain the quality of care and to comply with legal requirements related to dental patients with LEP, additional funding sources might be required to recruit multilingual staff, support language services in dental clinics, and provide language skills training for practicing dentists. Additionally, studies are suggested to measure the perception of the effectiveness of communication methods of patients with LEP.
You, Jianing; Zheng, Chuhua; Lin, Min-Pei; Leung, Freedom
2016-02-01
This study examined the influence of impulsive friendship group contexts on nonsuicidal self-injury (NSSI) and how peer group impulsivity (i.e. negative urgency and premeditation) moderated the individual level relationship between depression and NSSI among 1701 Chinese secondary school students (1147 females). Participants were assessed twice over a 6-month interval. After controlling for direct socialization effects for NSSI, multilevel analysis indicated that friendship group negative urgency exerted a significant influence on NSSI. Additionally, friendship group premeditation weakened the relation between individual depression and NSSI, while friendship group negative urgency strengthened the relation between depression and NSSI. The results suggest the contribution of indirect peer influence effects to NSSI. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Service-learning's impact on dental students' attitude towards community service.
Coe, J M; Best, A M; Warren, J J; McQuistan, M R; Kolker, J L; Isringhausen, K T
2015-08-01
This study evaluated service-learning programme's impact on senior dental students' attitude towards community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students' attitude towards community service that will eventually lead into providing care to the underserved. Two surveys (pre- and post-test) were administered to 105 senior dental students. For the first survey (post-test), seventy-six students of 105 responded and reported their attitude towards community service immediately after the service-learning programme completion. Three weeks later, 56 students of the 76 responded to the second survey (retrospective pre-test) and reported their recalled attitude prior to the programme retrospectively. A repeated-measure mixed-model analysis indicated that overall there was improvement between pre-test and post-test. Scales of connectedness, normative helping behaviour, benefits, career benefits and intention showed a significant pre-test and post-test difference. An association between attitude towards community service and student characteristics such as age, gender, ethnicity and volunteer activity was also examined. Only ethnicity showed an overall significant difference. White dental students appear to have a differing perception of the costs of community service. The service-learning programme at VCU School of Dentistry has positively impacted senior dental students' attitude towards community service. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Service-learning’s Impact on Dental Students’ Attitude toward Community Service
Coe, J. M.; Best, A. M.; Warren, J. J.; McQuistan, M. R.; Kolker, J. L.; Isringhausen, K. T.
2014-01-01
Introduction This study evaluated service-learning program’s impact on senior dental students’ attitude toward community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students’ attitude toward community service that will eventually lead into providing care to the underserved. Materials and methods Two surveys (pre and post-test) were administered to 105 senior dental students. For the first survey (post-test), seventy six students out of 105 responded and reported their attitude toward community service immediately after the service-learning program completion. Three weeks later, fifty six students out of the 76 responded to the second survey (retrospective pre-test) and reported their recalled attitude prior to the program retrospectively. Results A repeated-measure mixed-model analysis indicated that overall there was improvement between pre-test and post-test. Scales of connectedness, normative helping behavior, benefits1, career benefits, and intention showed a significant pre-test and post-test difference. An association between attitude toward community service and student characteristics such as age, gender, ethnicity, and volunteer activity was also examined. Only ethnicity showed an overall significant difference. White dental students appear to have a differing perception of the costs of community service. Conclusions The service-learning program at VCU School of Dentistry has positively impacted senior dental students’ attitude toward community service. PMID:25142286
Increased Use of Dental Services by Children Covered by Medicaid: 2000–2010
Ku, Leighton; Sharac, Jessica; Bruen, Brian; Thomas, Megan; Norris, Laurie
2013-01-01
This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done. PMID:24753975
Increased use of dental services by children covered by Medicaid: 2000-2010.
Ku, Leighton; Sharac, Jessica; Bruen, Brian; Thomas, Megan; Norris, Laurie
2013-01-01
This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done.
Mantonanaki, Magdalini; Koletsi-Kounari, Haroula; Mamai-Homata, Eleni; Papaioannou, William
2013-04-01
To assess dental caries and use of dental services experience in 5-year-old children attending public kindergartens in Attica, Greece and to examine the influence of certain socioeconomic factors and living conditions as well as dental behaviours and attitudes. In this cross-sectional study, a random and stratified sample of 605 Greek children was examined using decayed, missing, filled tooth surfaces and simplified debris indices. The use of dental services was measured by children's dental visits (any dental visit up to the age of 5 years). Care Index was also calculated. Risk indicators were assessed by a questionnaire. Zero-inflated Poisson and Logistic Regression Analysis were generated to test statistical significant associations. The prevalence of dental caries was 16.5%. Care Index was 32% and dental visits were reported for the 84% of the children. Medium Socio-Economic Level (SEL) was associated with no detectable caries. High SEL was related to decreased decayed, missing, filled teeth values, while female gender and rented houses had the opposite effect. The age of the mother (35-39 years) and the higher SEL were related to higher levels of dental services use. It is suggested that there are differences in the experience of dental caries and use of dental services among preschool children in Attica, which are related to demographic, socioeconomic factors and living conditions. Dental public polices should focus on groups with specific characteristics in order to improve oral health levels of disease-susceptible populations. © 2013 FDI World Dental Federation.
[Different forms of payment systems for dental services and their impact on care].
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.
Hassan, Ali H; Amer, Hala A; Maghrabi, Abdulhamaid A
2005-01-01
The objectives of this research were to assess the quality of dental services delivered in King Abdulaziz University and highlight the necessary recommendations that would improve it. The methods used were live photographs illustrating the structure of dental services of the faculty presented in the clinic buildings, waiting places, equipments, instruments and supplies, as well as the comfort and privacy. Review of official records of the faculty for the number, qualifications and training of the dental staff and auxiliary personnel, as well as the process of care (starting from patient registration until completion of treatment). Records also demonstrated the access and utilization of services delivered in the various departments, the quality of these services and of infection control measures and procedures. The results revealed the high quality of services delivered through evaluating the structure and process of care in the university dental clinics. Dental services of King Abdulaziz University conform to high quality standards, with implementation of some changes for improvement and development.
New Partnerships for Learning: Meeting Professional Information Needs
ERIC Educational Resources Information Center
Gannon-Leary, Pat; Carr, James
2010-01-01
This paper has been prompted by the challenges created by recent proposed reforms to social care services in the UK services which are being "modernised", a term ubiquitous in policy documents but difficult to define with confidence. Government modernisation and e-government programmes highlight with renewed urgency the need for social…
47 CFR 80.323 - Information furnished by an acknowledging station.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 5 2010-10-01 2010-10-01 false Information furnished by an acknowledging station. 80.323 Section 80.323 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress, Alarm, Urgency and Safety Procedures § 8...
Utilization of dental care: An Indian outlook
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
Dental insurance and dental service use by U.S. women of childbearing age.
Kaylor, Mary Beth; Polivka, Barbara J; Chaudry, Rosemary; Salsberry, Pamela; Wee, Alvin G
2011-01-01
Oral health has a significant effect on health, and for women, poor oral health can lead to poor birth outcomes and can affect their child's health. Nursing interventions to improve the oral health of at-risk women have the potential to increase maternal and child systemic and oral health. The identification of women at a high risk for poor oral health is a necessary to develop and evaluate these interventions. This study examined the factors related to dental insurance and dental service use for women of childbearing age in the United States. A secondary analysis of the 2003-2004 National Health and Nutrition Examination Survey was completed to examine the predisposing, enabling, and need variables associated with dental insurance status and dental service use in a representative random sample of 1,071 women. The results showed that over 40% of women had no dental insurance. Women with less education, lower income, and dental need were significantly less likely to have dental insurance. Dental utilization by the uninsured was low and a racial/ethnic disparity was noted. A lack of dental insurance and dental service utilization is a significant concern. Nurses working with low-income women should educate the population about oral health and advocate for policies to increase dental insurance coverage. © 2011 Wiley Periodicals, Inc.
Peres, Marco Aurélio; Peres, Karen Glazer; de Barros, Aluísio Jardim Dornellas; Victora, Cesar Gomes
2007-02-01
To investigate the influence of family socioeconomic trajectories from childhood to adolescence on dental caries and associated behaviours. Population-based birth cohort. Representative sample of the population of subjects born in 1982 in Pelotas, Brazil. Adolescents (n = 888) aged 15 years old were dentally examined and interviewed. Dental caries index (DMFT), care index (F/DMFT), tooth brushing, flossing and pattern of dental services use. Adolescents who were always poor showed, in general, a worse pattern of dental caries, whereas adolescents who never were poor had a better pattern of dental caries. Adolescents who had moved from poverty in childhood to non-poverty in adolescence and those who had moved from non-poverty in childhood to poverty in adolescence had similar dental pattern to those who were always poor except for the pattern of dental services use, which was higher in the first group. In all groups girls had fewer carious teeth, better oral hygiene habits and higher dental services use than boys. Poverty in at least one stage of the lifespan has a harmful effect on dental caries, oral behaviours and dental services use. Belonging to upwardly mobile families between childhood and adolescence only contributed to improved dental care.
Hayran, Osman; Mumcu, Gonca; Sur, Haydar; Yildirim, Celal; Söylemez, Didem; Atli, Hakki
2004-01-01
This study investigates the attitudes of dentists, residents, and patients on the financing of dental services in Turkey. In this descriptive study, randomly selected groups of 860 dentists, 641 patients, and 866 residents from 9 provinces of Turkey were interviewed. Their agreement on various statements on financing issues of dental services were recorded and analyzed. Eighty-two percent of the dentists, 83.8 percent of the patients, and 76.4 percent of the residents agreed that "governments should finance all dental services." The majority of the dentists (83.6%), patients (74.7%), and residents (84.4%) stated that patients should pay a copayment for their dental treatment. Survey results indicate that the current financing system of dental services in Turkey is not satisfactory either for the providers or for the users.
Cheng, M L; Si, Y
2017-05-09
It has been reported that children's oral health conditions are correlated with their attendance to dental health services. Evaluating the influencing factors of utilization of dental services for children may give ways to improve the services per se, and furtherly the children's oral health. The present review retrieved and summarized domestic and foreign studies on the utilization of oral health services for children based on the Andersen behavior model. It was concluded that the utilization of dental services for children was affected by demographic characteristics, social structure, health belief, family factors, community factors and perceived/evaluated needs. To improve the utilization of dental services for children, effort should be made by means of changing caregivers' health belief, developing oral health insurance system, setting up regular oral health resources and increasing the financial support for oral health services by government.
76 FR 14600 - Dental Conditions
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-17
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 3 RIN 2900-AN28 Dental Conditions AGENCY: Department of... its adjudication regulations regarding service connection of dental conditions for treatment purposes... Administration (VBA) of service connection of dental conditions for the purpose of establishing eligibility for...
77 FR 4469 - Dental Conditions
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-30
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 3 RIN 2900-AN28 Dental Conditions AGENCY: Department of... rule the proposal to amend its adjudication regulations regarding service connection of dental... Veterans Benefits Administration (VBA) for service connection of dental conditions for the purpose of...
Community dental clinics: providers' perspectives.
Wallace, Bruce B; MacEntee, Michael I; Harrison, Rosamund; Hole, Rachelle; Mitton, Craig
2013-06-01
Not-for-profit community dental clinics attempt to address the inequities of oral health care for disadvantaged communities, but there is little information about how they operate. The objective of this article is to explain from the perspective of senior staff how five community dental clinics in British Columbia, Canada, provide services. The mixed-methods case study included the five not-for-profit dental clinics with full-time staff who provided a wide range of dental services. We conducted open-ended interviews to saturation with eight senior administrative staff selected purposefully because of their comprehensive knowledge of the development and operation of the clinics and supplemented their information with a year's aggregated data on patients, treatments, and operating costs. The interview participants described the benefits of integrating dentistry with other health and social services usually within community health centres, although they doubted the sustainability of the clinics without reliable financial support from public funds. Aggregated data showed that 75% of the patients had either publically funded or no coverage for dental services, while the others had employer-sponsored dental insurance. Financial subsidies from regional health authorities allowed two of the clinics to treat only patients who are economically vulnerable and provide all services at reduced costs. Clinics without government subsidies used the fees paid by some patients to subsidize treatment for others who could not afford treatment. Not-for-profit dental clinics provide dental services beyond pain relief for underserved communities. Dental services are integrated with other health and community services and located in accessible locations. However, all of the participants expressed concerns about the sustainability of the clinics without reliable public revenues. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Parker, Eleanor J; Misan, Gary; Richards, Lindsay C; Russell, Angela
2005-01-01
The oral health of the Indigenous community in South Australia's mid-north has been a concern for some years. There has been a history of under-utilisation of available dental services by the local community. This is in part due to the services not meeting their cultural and holistic health care needs. The Indigenous community resolved to establish a culturally sensitive dental service within the Aboriginal Health Service already operating in Port Augusta in South Australia's mid-north. To achieve this, a partnership between Pika Wiya Health Service Incorporated, the South Australian Dental Service, the University of Adelaide Dental School and the South Australian Centre for Rural and Remote Health was formed. The aim of the project partners was to establish a culturally sensitive, quality dental service that caters to the needs of the Indigenous community serviced by Pika Wiya Health Service Inc. This article describes the process of planning and implementing the first stage of this project.
The moral foundations of scientific ethics and responsibility.
Camenisch, P F
1996-02-01
Any significant involvement of AADR/IADR in ensuring responsible research among their members must be grounded in a widely accepted consensus that there are good moral reasons for such involvement. One important source of such reasons is AADR/IADR's identity as a scientific research, a professional, and a dental association. These identities and the commitments to society and to clients implicit in them generate several mutually reinforcing reasons for taking responsibility for the reliability of members' research. With regard to scientific research, these reasons arise from what it means to do such research, and from the various ways the larger society supports that activity. With regard to the professional dimension, the reasons arise from what it means to be a profession in this society and can be best seen in relation to the four major characteristics of professions. With regard to AADR/IADR's being a dental profession, such reasons arise from dental researchers' specific role in the dental family of professions' goal of delivering optimal care to the clients of practitioners. The clients' perspective, specifically the need to be able to trust that one will receive the best care possible, is a final source for such reasons. Two current issues, the sharing of findings and commercial/industrial support for research, give new urgency to this question of the Association's role in ensuring responsible research.
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.
Ganavadiya, R; Chandrashekar, Br; Goel, P; Hongal, Sg; Jain, M
2014-05-01
India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries (adding each of these terms in a sequential order). Based on the review of the programs successfully implemented in developed countries, we propose a model to cater to the basic oral health needs of an extensive underserved population in India that may be pilot tested. The increasing dental manpower can best be utilized for the promotion of oral health through mobile and portable dental services. The professional dental organizations should have a strong motive to translate this into reality.
Income inequality, disinvestment in health care and use of dental services.
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.
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 also added to the challenges in implementing the Dental RECUR protocol during the recruitment phase. ISRCTN24958829 (date of registration: 27 September 2013), Current protocol version: 5.0.
Predictors of Dental Care Use: Findings from the National Longitudinal Study of Adolescent Health
Okunseri, Christopher; Okunseri, Elaye; Garcia, Raul I.; Visotcky, Alexis (Dye); Szabo, Aniko
2013-01-01
Objective To examine longitudinal trends and associated factors in dental service utilization by adolescents progressing to early adulthood in the United States. Data Source The National Longitudinal Study of Adolescent Health from Waves I (1994-95), II (1996), III (2001-2002) and IV (2007-2008). Study Design This is a retrospective, observational study of adolescents' transition to early adulthood. We obtained descriptive statistics and performed logistic regression analyses to identify the effects of baseline and concurrent covariates on dental service utilization from adolescence to early adulthood over time. Principal Findings Dental service utilization within the prior 12 months peaked at age 16 (72%), gradually decreased until age 21 (57%), and thereafter remained flat. Whites and Asians had a 10-20 percentage points higher proportion of dental service utilization at most ages compared to Blacks and Hispanics. Dental service utilization at later follow-up visits was strongly associated with baseline utilization with OR= 10.7, 2.4 and 1.5 at the 1-year, 7-year and 13-year follow-ups respectively. These effects decreased when adjusted for current income, insurance and education. Compared to Whites, Blacks were consistently less likely to report any dental examination. Conclusion Dental service utilization was highest in adolescents. Gender, education, health insurance and income in young adulthood were significant predictors of reporting a dental examination. Blacks had lower odds of reporting a dental examination either as adolescents or as young adults. PMID:23850156
Clow, K E; Fischer, A K; O'Bryan, D
1995-01-01
The authors construct a theoretical model of the antecedents of expectations for dental services by analyzing survey responses from 240 dental patients. The patients' image of the dentist, tangible cues, situational factors, and patient satisfaction with prior service encounters have the greatest influence on expectations of service, whereas marketing variables, such as price and advertising, appear to have no effect.
An emergency dental service for students: 4-year findings.
Sinclair, J; Wilson, N H
1997-06-01
To describe the arrangements for the provision of emergency dental services for students at the University of Manchester and to report data collected during the first four and a half years of the student emergency dental services (SEDS) unit based at the University Dental Hospital of Manchester. Data pertaining to every student attending SEDS since its inception were collected by means of questionnaire including provision to record diagnoses, treatment needs and the emergency care provided. The incidence of dental emergencies within the student population served by SEDS has been found to be 39 emergencies per 1000 students per annum, with the service being most heavily used by overseas students. Caries, pulpal pathology and failed restorations account for 46 per cent of the presenting emergencies, with pericoronitis (19 per cent) and other emergencies of periodontal origin (14 per cent) being common place. It is concluded that a student emergency dental service may be found to be an important element of student medical and related welfare services.
Eaton, Kenneth A; Pitts, Nigel B
2009-04-01
Over the years, several members of the staff of the Dental Health Services Research Unit (DHSRU) at Dundee have published papers in Primary Dental Care. Furthermore, its Director, Professor Nigel Pitts, together with Drs Jan Clarkson and Gail Topping have co-edited a number of the Faculty of General Dental Practice (UK)'s standards manuals and contributed to others. It had been suggested to the Unit by several parties that, having been in funded existence for some 30 years, it would be appropriate to mark this anniversary with a conference to explore 'Dental Health Services Research: After 30 years, what was the impact, what have we learned and where are we going?' So, following a range of consultations, the conference was convened at the West Park Conference Centre in Dundee with a mixed audience representing both dental research and dental practice.
38 CFR 3.381 - Service connection of dental conditions for treatment purposes.
Code of Federal Regulations, 2011 CFR
2011-07-01
... dental conditions for treatment purposes. 3.381 Section 3.381 Pensions, Bonuses, and Veterans' Relief... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for treatment purposes. (a) Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses...
38 CFR 3.381 - Service connection of dental conditions for treatment purposes.
Code of Federal Regulations, 2010 CFR
2010-07-01
... dental conditions for treatment purposes. 3.381 Section 3.381 Pensions, Bonuses, and Veterans' Relief... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for treatment purposes. (a) Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses...
Acculturation and Dental Service Use Among Asian Immigrants in the U.S.
Luo, Huabin; Wu, Bei
2016-12-01
The objective of this study was to assess dental service utilization across different Asian immigrant groups and to examine the relationship between acculturation and dental service utilization among Asian immigrants in the U.S. Data were from the 2013 and 2014 National Health Interview Surveys. Multiple logistic regression models were used to examine the association between acculturation and having a dental visit in the previous 12 months, controlling for predisposing, enabling, and need factors. Acculturation was measured by length of stay in the U.S., English language proficiency, and U.S. citizenship. The sample was 2,948 adult Asian immigrants who were dentate. Data were analyzed in 2016. Dental service utilization varied across Asian immigrant groups. High English proficiency and longer length of stay were significantly associated with having a dental visit (p<0.05). In the final model, after adding enabling factors-dental insurance and family income levels-length of stay in the U.S. (≥5 years) remained significant, whereas English language proficiency was not a significant correlate of having a dental visit. Length of stay in the U.S. is a significant factor affecting dental service utilization among Asian immigrants. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Extending Medicare coverage to medically necessary dental care.
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.
Kikui, Miki; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro
2015-01-01
Abstract There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t‐test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t‐test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population. PMID:29744141
Kikui, Miki; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro
2015-12-01
There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t -test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t -test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population.
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
Utilization of emergency services for non-traumatic dental disease.
Da Silva, Keith; Kunzel, Carol; Yoon, Richard K
2013-01-01
To identify and characterize children who utilize emergency dental services for non-traumatic dental disease. Caregivers of children under 12 years old who seek out emergency services for the treatment of non-traumatic dental disease will be surveyed regarding their child's current oral health status. Patient's clinical data will be obtained and they will be further followed for a period of 2 months to determine if they follow-up with recommendations for comprehensive dental care. One hundred and ninety-eight people participated in the study (97% response rate). Eighty-three percent of the children were diagnosed with dental caries. Seventy-four percent of patients of record presented with an emergency at least once before and 73% had a history of one or more broken appointments. Patients with a history of previous emergency visits (OR = 3.45, CI = 2.05, 5.81) or a history of missed appointments (OR = 2.21, CI = 1.42, 3.58) were significantly more likely to fail to return for comprehensive care (P < .01). This study shows that those who utilize emergency services more than once, or have a history of missed appointments are more likely to continue to utilize emergency dental services as their primary means for dental care.
Assessing the Need for Anesthesia and Sedation Services in Kuwaiti Dental Practice
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
Do general practice patients with and without appointment differ? Cross-sectional study.
Riedl, Bernhard; Kehrer, Simon; Werner, Christoph U; Schneider, Antonius; Linde, Klaus
2018-06-23
Even in practices with a comprehensive appointment system a minority of patients walks in without prior notice, sometimes causing problems for practice service quality. We aimed to explore differences between patients consulting primary care practices with and without appointment. Consecutive patients visiting five primary care practices without an appointment and following patients with an appointment were asked to fill in a four-page questionnaire addressing socio-demographic characteristics, the reason for encounter, urgency of seeing a physician, depressive, somatic and anxiety symptoms, personality traits, and satisfaction with the practice. Physicians also documented the reason for encounter and assessed the urgency. Data were analyzed using univariate and multivariate methods. Two hundred fifty-one patients without and 250 patients with appointment participated. Patients without appointment were significantly younger (mean age 44 vs. 50 years) and reported less often chronic diseases (29% vs. 45%). Also, reasons for encounter differed (e.g., 27% vs. 16% with a respiratory problem). Patients' ratings of urgency did not differ between groups (p = 0.46), but physicians rated urgency higher among patients without appointment (p < 0.001). In logistic regression analyses younger age, male gender, absence of chronic disease, positive screening for at least one mental disorder, low values on the personality trait openness for experience, a high urgency rating by the physician, and a respiratory or musculoskeletal problem as reason for encounter were significantly associated with a higher likelihood of being a patient without appointment. In this study, younger age and a high urgency rating by physicians were the variables most consistently associated with the likelihood of being a patient without appointment. Overall, differences between patients seeking general practices with a comprehensive appointment system without prior notice and patients with appointments were relatively minor.
Dental Assistant Specialist. (AFSC 98150).
ERIC Educational Resources Information Center
Eling, David R.
This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for dental assistant specialists. Covered in the individual volumes are an introduction to dental services (the mission and organization of medical/dental service, career ladder progressions, medical readiness/wartime training, and…
32 CFR 199.13 - TRICARE Dental Program.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 32 National Defense 2 2012-07-01 2012-07-01 false TRICARE Dental Program. 199.13 Section 199.13...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.13 TRICARE Dental... delivery and administration of the TRICARE Dental Program (TDP) of the Uniformed Services of the Army, the...
38 CFR 3.381 - Service connection of dental conditions for treatment purposes.
Code of Federal Regulations, 2013 CFR
2013-07-01
... dental conditions for treatment purposes. 3.381 Section 3.381 Pensions, Bonuses, and Veterans' Relief... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for... connection of a dental condition for treatment purposes after the Veterans Health Administration determines a...
38 CFR 3.381 - Service connection of dental conditions for treatment purposes.
Code of Federal Regulations, 2014 CFR
2014-07-01
... dental conditions for treatment purposes. 3.381 Section 3.381 Pensions, Bonuses, and Veterans' Relief... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for... connection of a dental condition for treatment purposes after the Veterans Health Administration determines a...
38 CFR 3.381 - Service connection of dental conditions for treatment purposes.
Code of Federal Regulations, 2012 CFR
2012-07-01
... dental conditions for treatment purposes. 3.381 Section 3.381 Pensions, Bonuses, and Veterans' Relief... Rating Considerations Relative to Specific Diseases § 3.381 Service connection of dental conditions for... connection of a dental condition for treatment purposes after the Veterans Health Administration determines a...
32 CFR 199.13 - TRICARE Dental Program.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 32 National Defense 2 2013-07-01 2013-07-01 false TRICARE Dental Program. 199.13 Section 199.13...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.13 TRICARE Dental... delivery and administration of the TRICARE Dental Program (TDP) of the Uniformed Services of the Army, the...
32 CFR 199.13 - TRICARE Dental Program.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 32 National Defense 2 2014-07-01 2014-07-01 false TRICARE Dental Program. 199.13 Section 199.13...) MISCELLANEOUS CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) § 199.13 TRICARE Dental... delivery and administration of the TRICARE Dental Program (TDP) of the Uniformed Services of the Army, the...
Improvements in dental care using a new mobile app with cloud services.
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.
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.
Pearson, N; Croucher, R; Marcenes, W; O'Farrell, M
1999-05-22
To assess the use of dental services, barriers to uptake of dental care and attitudes to regular dental examinations and the prevalence of tobacco and paan chewing habits in a group of Bangladeshi medical care users. Multi-centre cross-sectional study. Four general medical practices' waiting areas in Tower Hamlets. Bangladeshi adults aged 40 years and over. An interview schedule. The prevalence of tobacco smoking and paan chewing with or without the addition of tobacco. The use of dental services, barriers to the use of dental services and attitudes to regular dental examinations. Results were obtained from 158 subjects (response rate 85%). 25% of the whole sample had never visited a dentist. These were significantly (P < 0.05) more likely to be women, who also thought regular check-ups were of little value. In their use of health services 73% experienced language difficulties. 33% of the sample were tobacco smokers. Paan was chewed by 78% of the sample with significantly (P < 0.05) more females than males adding tobacco to their quid and chewing more frequently than males. There are considerable barriers to be overcome if dental practices are to be the site for oral cancer screening and oral health promotion in this population. There are sex differences in reported behaviour and attitudes about use of dental services and in tobacco and paan use in this Bangladeshi sample. Further research is needed to establish why this ethnic minority attend general medical practices but not general dental practices.
The procurement of NHS dental services--a guide.
Jones, C L; Rooney, E
2009-05-23
This paper gives an overview of the strategic background for procurement of NHS primary care dental services and an outline of the processes involved in procurement. The main aim is to bring procurement to the attention of a wider audience of dental practitioners and provide advice for potential primary care dental service providers. The move towards local procurement of healthcare services, including primary care dental services, has been shaped by a number of strategic Government publications and is supported by law. In line with other public bodies, the NHS is subject to the European Union and international rules regarding procurement and awarding contracts. Primary Care Trust (PCT) Dental Service Commissioners have to ensure that their procurement strategy is transparent and non-discriminatory so that all providers have an equal opportunity to compete for contracts. In order to successfully tender for future service provision contracts, dental practitioners not only need to be aware of the process of procurement and its associated legal requirements. It is also important that they have a grasp of the expectations of PCTs. Commissioning services via procurement is set to become more commonplace and it is likely, in time, that competition for some contracts will increase in intensity. The importance of researching proposals thoroughly and adopting a professional, businesslike approach to tendering cannot be understated as this maximises chance of success in the new commissioning environment.
A Naval Postgraduate Dental School Analysis Of Initial Endodontic Treatment
2016-06-30
A NAVAL POSTGRADUATE DENTAL SCHOOL ANALYSIS OF INITIAL ENDODONTIC TREATMENT by Alexander Kareem Desta, D.D.S. Lieutenant Commander, Dental Corps...United States Navy A thesis submitted to the Faculty of the Endodontic Graduate Program Naval Postgraduate Dental School Uniformed Services...Postgraduate Dental School Unifo1med Services University of the Health Sciences Bethesda, Maryland CERTIFICATE OF APPROVAL MASTER’S THESIS This is
Dental health-care service utilisation and its determinants in West Iran: a cross-sectional study.
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 insurance, should focus on mechanisms that can strengthen utilisation of preventive dental health-care services among disadvantaged households. © 2017 FDI World Dental Federation.
Expanding services in a shrinking economy: desktop document delivery in a dental school library.
Gushrowski, Barbara A
2011-07-01
How can library staff develop and promote a document delivery service and then expand the service to a wide audience? The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated.
Ganavadiya, R; Chandrashekar, BR; Goel, P; Hongal, SG; Jain, M
2014-01-01
India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries (adding each of these terms in a sequential order). Based on the review of the programs successfully implemented in developed countries, we propose a model to cater to the basic oral health needs of an extensive underserved population in India that may be pilot tested. The increasing dental manpower can best be utilized for the promotion of oral health through mobile and portable dental services. The professional dental organizations should have a strong motive to translate this into reality. PMID:24971198
Randomized pilot study to disseminate caries-control services in dentist offices
Grembowski, David; Spiekerman, Charles; del Aguila, Michael A; Anderson, Maxwell; Reynolds, Debra; Ellersick, Allison; Foster, James; Choate, Leslie
2006-01-01
Background To determine whether education and financial incentives increased dentists' delivery of fluoride varnish and sealants to at risk children covered by capitation dental insurance in Washington state (U.S.). Methods In 1999, 53 dental offices in Washington Dental Service's capitation dental plan were invited to participate in the study, and consenting offices were randomized to intervention (n = 9) and control (n = 10) groups. Offices recruited 689 capitation children aged 6–14 and at risk for caries, who were followed for 2 years. Intervention offices received provider education and fee-for-service reimbursement for delivering fluoride varnish and sealants. Insurance records were used to calculate office service rates for fluoride, sealants, and restorations. Parents completed mail surveys after follow-up to measure their children's dental utilization, dental satisfaction, dental fear and oral health status. Regression models estimated differences in service rates between intervention and control offices, and compared survey measures between groups. Results Nineteen offices (34%) consented to participate in the study. Fluoride and sealant rates were greater in the intervention offices than the control offices, but the differences were not statistically significant. Restoration rates were lower in the intervention offices than the control offices. Parents in the intervention group reported their children had less dental fear than control group parents. Conclusion Due to low dentist participation the study lacked power to detect an intervention effect on dentists' delivery of caries-control services. The intervention may have reduced children's dental fear. PMID:16670027
Goettems, Marília L; Ardenghi, Thiago M; Demarco, Flávio F; Romano, Ana R; Torriani, Dione D
2012-10-01
The purpose of the study was to investigate the influence of a child's clinical condition; maternal characteristics such as dental anxiety and dental visit pattern; socioeconomic conditions; and maternal perception of the child's oral health-related quality of life (OHRQoL) on a child's use of dental care services. A cross-sectional study of 608 mother-child dyads was conducted during the Children's Immunization Campaign in Pelotas, Brazil. Mothers answered a questionnaire regarding their use of dental services, dental anxiety (Dental Anxiety Scale), socioeconomic status, and perception of their children's OHRQoL (the Early Childhood Oral Health Impact Scale). Clinical examination of the children was performed to assess dental caries (dmf-t). Associations between the above-mentioned factors and child use of dental services were assessed using Poisson regression models (prevalence ratio [PR]; 95% CI; P ≤ 0.05). The majority of children (79.3%) had never had a dental appointment and of the children who had visited a dentist, 55 (43.65%) presented with untreated dental caries at the time of examination. More than half the mothers (60.2%) did not visit a dentist regularly. In the final model, low schooling level of mothers (PR, 0.64) and irregular visits to a dentist by the mother (PR, 0.48) were factors because of which a child did not have a dental appointment. Children who had experienced pain (PR, 1.56), those who had poor OHRQoL (PR, 1.49), and older children (PR, 2.14) visited a dentist with higher frequency. Use of dental care services by preschool children was low, and treatment was neglected even among children who had visited a dentist. Children of mothers with low schooling level who do not visit a dentist regularly were at greater risk of not receiving dental care. Maternal perception of their child's oral health motivated visits to the dentist. © 2012 John Wiley & Sons A/S.
Providing Dental Services for People with Disabilities: Why Is It So Difficult?
ERIC Educational Resources Information Center
Waldman, H. Barry; Perlman, Steven P.
2002-01-01
This article examines why it is difficult for individuals with disabilities to obtain dental services. It discusses inadequate preparation of dentists, cultural norms that create social, attitudinal, economic, and environmental barriers, and limited participation in the Medicaid dental program. The need for changes in dental school curricula is…
Dental service trends for older US adults, 1998-2006.
Skaar, Daniel D; O'Connor, Heidi
2012-03-01
This study of the Medicare Current Beneficiary Survey (MCBS) updates trends in utilization of dental services between 1998 and 2006 for community-dwelling U.S. adults of age 65 years and older. Bivariate comparisons were made between dependent variables (annual dental visits and types of dental procedures) and independent variables (age, gender, race, income, education, population density, marital status, U.S. Census Bureau regions, and self-reported health). The estimated percentage of community-dwelling Medicare beneficiaries with a dental visit for the years studied increased from 45.0% in 1998 to 46.3% in 2006. The age group of respondents who were 85 years and older had the greatest percentage increase in dental visits. Those reporting visits with preventive procedures increased from 87.8% to 91.2% whereas those reporting visits with nonpreventive procedures declined from 63.9% to 58.4%. The prevalence of dental visits continues to trend upward for this population of older adults. Increasing delivery of preventive services will likely impact the future mix of dental services as U.S. adults live longer. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.
Reducing barriers to older persons' use of dental services.
Kiyak, H A
1989-06-01
In the United States elderly persons are the least likely of any age group to utilize dental services. With the increase in the elderly population and expansion of interest in their dental care, our understanding of the barriers to that care is particularly important. Studies have indicated that cost of treatment, fear of dentistry, functional independence and poor general health are of little significance in explaining the low utilization patterns of this age group. Perceived need seems to be the strongest predictor in deciding whether dental services are sought by an individual. Two programmes established by The University of Washington aimed to enhance the utilization of dental services by the elderly. One provided free screenings for over 65's on low incomes, coupled with a low cost dental care scheme. Although it was found that the convenient location of a dental clinic was a valuable incentive for the increased uptake of services, the difficulty remained one of patient perception of need. The second programme sought to overcome this latter problem by providing information on the importance of oral health to the independent elderly. This included a weekly class for small groups conducted by a health educator over a 6-week period together with a self-monitoring chart for each participant. It is anticipated that the heightened awareness aroused by this education programme will translate into perceived need and thus greater dental service utilization by the participants.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-21
... Cosmetic Surgery Services Furnished by Department of Defense Medical Treatment Facilities; Certain Rates... of the full cost of all services provided. The outpatient medical, dental, and cosmetic surgery... recovery from tortiously liable third persons for the cost of outpatient medical, dental, and cosmetic...
Access to Dental Services for People Using a Wheelchair
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
Code of Federal Regulations, 2010 CFR
2010-10-01
... and general conditions of use for the following types of radiotelephony: —Distress, urgency, safety, call and reply. —Working. —Public. —Private. ... FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME...
Determinants of Catastrophic Dental Health Expenditure in China
Liu, Xuenan; Gallagher, Jennifer Elizabeth; Zheng, Shuguo
2016-01-01
This study explored catastrophic health expenditure in China, due to out-of-pocket payments for dental care, and its associated individual- and contextual-level factors. We pooled data from 31,566 adults who participated in the third National Oral Health Survey with province-level data from different sources. We defined catastrophic dental health expenditure (CDHE) as payments for dental services and/or medication for dental problems during the last year that exceeded the 10% and 20% of the household income. The association of individual and contextual factors with catastrophic dental health expenditure was evaluated using two-level logistic regression models with individuals nested within provinces. Socioeconomic position (education and household income), household size and dental status (pain in teeth or mouth and number of teeth) were the individual-level factors associated with CDHE among the full sample of participants; and, also, among those who used dental services in the past year. Greater gross domestic product per capita was the only contextual factor associated with CDHE, and only at the lower income threshold. This study shows that out-of-pocket expenses for dental services may put a considerable, and unnecessary, burden on households’ finances. Our findings also help characterise those households more likely to face catastrophic expenditure on health if they have to pay for dental services. PMID:27977756
The uptake of dental services by elderly Germans.
Nitschke, I; Müller, F; Hopfenmüller, W
2001-12-01
The aim of the study was to assess the uptake of dental services by the old and very old population within the scope of the Berlin Aging Study (Berliner Altersstudie BASE). A multi-disciplinary structured interview was performed on 928 subjects, aged from 70 to 103 years of whom 516 persons volunteered to take part in a 14-session intensive protocol. Six representative study groups were matched for age and gender. Subjects were asked to recall the timing of their most recent dental visit. Data were validated by sending for dental records and compared with all study participants from the multi-disciplinary intake assessment. Data were related to age group, dental state, dementia and education. Reported last contact with dental services ranged from 2 weeks to 52 years (median 18 months) with a higher time lapse in the study groups aged 85 and older. Dentate subjects had seen their dentist more recently than edentate subjects. Higher education correlated with an increased dental utilisation. Subjective memory on the time lapse since the last dental appointment coincided in 13% of the subjects with available dental records (n=84), was misjudged between one and six months in 55%, and by more than six months in the remainder. Moderately or severely demented subjects who remembered their last dental appointment (n=48 of 70) showed no consistently different utilisation to healthy or mildly demented study participants. Edentate old and very old subjects show the least frequent utilisation of dental services. Data on motivation and barriers to care are needed to develop strategies to improve the use of dental services and thus promote oral health in late life.
General dental practitioner's views on dental general anaesthesia services.
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.
Oral hygiene practices and dental service utilization among pregnant women.
Boggess, Kim A; Urlaub, Diana M; Massey, Katie E; Moos, Merry-K; Matheson, Matthew B; Lorenz, Carol
2010-05-01
Daily oral hygiene and regular dental visits are important components of oral health care. The authors' objective in this study was to examine women's oral hygiene practices and use of dental services during pregnancy. The authors developed a written oral health questionnaire and administered it to 599 pregnant women. They collected demographic information, as well as data on oral hygiene practices and use of dental services during pregnancy. They used chi2 and multivariable logistic regression models to assess associations between oral hygiene practice and dental service use during pregnancy and to identify maternal predictor variables. Of the 599 participants, 83 percent (n=497) reported brushing once or twice per day. Twenty-four percent (n=141) reported flossing at least once daily; Hispanic women were more likely to floss than were white or African American women (28 percent [52 of 183] versus 22 percent [54 of 248] versus 19 percent [23 of 121], respectively, P<.001). Seventy-four percent (n=442) of the participants reported having received no routine dental care during pregnancy. Hispanic women were significantly less likely than were black or white women to receive routine dental care during pregnancy (13 percent versus 21 percent versus 36 percent, respectively, P<.001). The authors found that being older than 36 years, being of Hispanic race or ethnicity, having an annual income of less than $30,000, flossing infrequently and receiving no dental care when not pregnant were significantly associated with lack of routine dental care during pregnancy (adjusted odds ratios, 95 percent confidence intervals: 2.56 [1.33-4.92]; 2.19 [1.11-4.29]; 2.02 [1.12-3.65]; 1.86 [1.13-3.07]; and 4.35 [2.5-7.69], respectively). A woman's lack of receiving routine dental care when not pregnant was the most significant predictor of lack of receiving dental care during pregnancy. Racial, ethnic and economic disparities related to oral hygiene practices and dental service 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.
Social determinants of dental health services utilisation of Greek adults.
Pavi, E; Karampli, E; Zavras, D; Dardavesis, T; Kyriopoulos, J
2010-09-01
To identify the determinants of dental care utilisation among Greek adults, with a particular emphasis on socio-economic determinants. Data were collected through a national survey on health and health care services utilisation of a sample of 4,003 Greek adults stratified by geographic region, age and gender. A purpose made questionnaire was used during face-to-face interviews. A 2-stage model was developed to assess the impact of independent variables on dental utilisation likelihood and frequency. 39.6% (1,562) of Greek adults reported having visited a dentist within the last year. Among dental attenders, 32.6% reported prevention as the reason for visit. Statistically significant differences in dental care utilisation were observed in relation to demographic, socioeconomic and lifestyle factors. Logistic regression analysis showed that gender, age, income, education, place of residence, private insurance coverage and self-rated oral health are important determinants of dental services utilisation. Mean number of dental visits within previous year was 1.6. Results from Poisson regression analysis indicated that lower income level correlates to lower number of dental visits, while having visited for treatment (rather than for prevention) correlated to higher number of dental visits. Greek adults do not exhibit satisfactory dental visiting behaviour. Extent of care sought is associated with need for treatment rather than preventive reasons. The findings confirm the existence of socioeconomic inequalities in dental services utilisation among Greek adults.
Sensing the Urgency: Envisioning a Black Humanist Vision of Care in Teacher Education
ERIC Educational Resources Information Center
Knight, Michelle G.
2004-01-01
This article builds on the growing body of research on preparing African-American pre-service teachers for culturally diverse urban environments. I specifically focus on a two year qualitative case study of Amy, an African-American pre-service teacher, to highlight five themes of a Black humanist vision of care. These themes emphasize the…
ERIC Educational Resources Information Center
Golovanova, Inna I.; Lopareva, Tatyana A.
2016-01-01
The urgency of the examined issue is stipulated by inconsistency between social services commissioning to speak several foreign languages and inadequate implementation of these services in educational establishments of the country. The aim of the article is to justify the necessity to reconsider models of mastering the language and to alter…
How to Be Bullish on Marketing Child Care in a Challenging Economy.
ERIC Educational Resources Information Center
Wassom, Julie
1992-01-01
Discusses factors to consider when developing marketing strategies for building enrollment in child care programs. Factors are (1) focus on a market; (2) the impression of the service that is created in customers' minds; (3) the urgency of the advertising message; (4) perceived value of the service; and (5) cost effectiveness. (SM)
Methods of the Development Strategy of Service Companies: Logistical Approach
ERIC Educational Resources Information Center
Toymentseva, Irina A.; Karpova, Natalya P.; Toymentseva, Angelina A.; Chichkina, Vera D.; Efanov, Andrey V.
2016-01-01
The urgency of the analyzed issue is due to lack of attention of heads of service companies to the theory and methodology of strategic management, methods and models of management decision-making in times of economic instability. The purpose of the article is to develop theoretical positions and methodical recommendations on the formation of the…
Use of dental care by elderly Chinese immigrants in Canada.
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.
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.
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
Scannapieco, Frank A; Amin, Summar; Salme, Marc; Tezal, Mine
2017-03-01
To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts. A total of 2,516 residents were discharged between 2008 and 2012. From those, 259 (10.3%) utilized dental services at least once during their stay. Those who utilized dental services were significantly older at admission (78.5 vs. 82.0 years, p < 0.001), stayed longer (1.6 vs. 3.9 years, p < 0.001), more likely to be female (63.6 vs. 75.6%, p = 0.008), and less likely to be married (37.7 vs. 14.0%, p = < 0.001) compared to those who did not. Patients with endocrine, nutritional, metabolic, and immunity disorders, mental disorders, and circulatory system diseases were more likely to receive dental services. Dental services appear to be underutilized by residents of LTCF. Significant differences exist in demographic and health variables between residents who utilize these services compared to those who do not. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.
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.
Are larger dental practices more efficient? An analysis of dental services production.
Lipscomb, J; Douglass, C W
1986-01-01
Whether cost-efficiency in dental services production increases with firm size is investigated through application of an activity analysis production function methodology to data from a national survey of dental practices. Under this approach, service delivery in a dental practice is modeled as a linear programming problem that acknowledges distinct input-output relationships for each service. These service-specific relationships are then combined to yield projections of overall dental practice productivity, subject to technical and organizational constraints. The activity analysis reported here represents arguably the most detailed evaluation yet of the relationship between dental practice size and cost-efficiency, controlling for such confounding factors as fee and service-mix differences across firms. We conclude that cost-efficiency does increase with practice size, over the range from solo to four-dentist practices. Largely because of data limitations, we were unable to test satisfactorily for scale economies in practices with five or more dentists. Within their limits, our findings are generally consistent with results from the neoclassical production function literature. From the standpoint of consumer welfare, the critical question raised (but not resolved) here is whether these apparent production efficiencies of group practice are ultimately translated by the market into lower fees, shorter queues, or other nonprice benefits. PMID:3102404
Doughty, J; Stagnell, S; Shah, N; Vasey, A; Gillard, C
2018-01-01
Background The UK charity Crisis originated in 1967 as a response to the increasing numbers of homeless people in London, and the first Crisis at Christmas event for rough sleepers was established in 1971. Since then, Crisis has provided numerous services over the Christmas period to the most vulnerable members of society. One of these is the Crisis at Christmas Dental Service (CCDS) which provides emergency and routine dental care from 23-29 of December each year. The charity is entirely dependent on voluntary staffing and industry donations including materials and facilities. This paper aims to assess the impact of the service over the last six years of clinical activity from 2011-2016.Method Anonymised data were collected from the annual CCDS delivered over the last six consecutive years. Services included: dental consultations; oral hygiene instruction; scale and polishes; permanent fillings; extractions; and fluoride varnish applications. In addition, anonymised patient feedback was collected after each dental attendance.Results On average, 80-85% of the patients were male and the majority were between 21 and 60 years of age. The most common nationality was British (46%). Over the six-year data collection period intervention treatments (restorations and extractions) remained fairly consistent, while the number of fluoride varnish applications and oral hygiene instruction have increased. The majority of patients reported positive satisfaction with their treatment and would have recommended the service to others. Approximately 75% of patients did not regularly attend a dentist outside of Crisis and a similar proportion were given information on where to access year round dental services for homeless people in London. The majority of dental volunteers felt that they enjoyed the experience and would consider volunteering again for Crisis in the future.Conclusion The Crisis at Christmas Dental Service has emerged as a valuable asset to the portfolio of resources accessible to vulnerable, marginalised people over the Christmas period and exposes the high dental need of the homeless population of London.
Evolution of Policy Leading to the 2006 General Dental Service Contract and Some Possible Outcomes
ERIC Educational Resources Information Center
Downer, Martin C.; Drugan, Caroline S.
2007-01-01
Background and objective: This paper was designed to rehearse the evolution of policy for the UK NHS General Dental Service (and related services) since its inception in 1948, culminating in the establishment of a new contract for general dental practitioners in 2006. Methods: Information was abstracted from the literature, historical records,…
Preventive care and recall intervals. Targeting of services in child dental care in Norway.
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.
Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method.
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.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-27
... and other professional charges, including professional charges for anesthesia services and dental... charges for anesthesia services and dental services; pathology and laboratory charges; observation care...
Anderson, Ludmila; Martin, Nancy R; Kelly, Stephanie M; Brown, Heather A
2016-04-01
This study assessed the oral health status of older adults in randomly selected New Hampshire senior centers and congregate meal sites for the purpose of future planning, implementation and evaluation of targeted public health programs. A cross-sectional surveillance project was developed. Registered dental hygienists visually assessed denture use, number of natural teeth, teeth mobility, untreated caries, root fragments, gingivitis, need for care and treatment urgency among randomly selected active older adults living within New Hampshire communities. Altogether, 610 adults 60 years old and older attending 25 senior centers and congregate meal sites participated. Sixteen percent were edentulous and 42% reported having a removable upper or lower denture. Among edentulous adults, 5% had no dentures at all. Among 513 dentate participants, 22% had untreated caries, 14% had root fragments, 9% had gingivitis and 7% presented with obviously mobile teeth. Overall, 19% required early or urgent dental care. Differences were detected by sex, age group, urban versus rural location of the site and by the participation in a federal nutritional program for older adults. Baseline information about oral health needs of older adults in New Hampshire was gathered. Overall needs as well as existing oral health disparities will be addressed through the collaboration of public and private partners. Copyright © 2016 The American Dental Hygienists’ Association.
Baldani, Márcia Helena; Rocha, Juliana Schaia; Fadel, Cristina Berger; Nascimento, Antonio Carlos; Antunes, José Leopoldo Ferreira; Moysés, Samuel Jorge
2017-11-21
This cross-sectional study aimed to assess the association between the quality of primary health care (PHC) and the use of dental services by preschoolers served by the Family Health Strategy (FHS), controlling for socio-demographic determinants and perceived need. The sample encompassed 438 children aged 3-5 years, enrolled in 19 FHS facilities in Ponta Grossa, Paraná State, Brazil. Individual level variables were collected by interviewing parents or caregivers at home. They answered a questionnaire on socioeconomic conditions, oral hygiene habits and use of dental services. Parental perception of child's oral health related quality of life, as perceived need, was assessed by the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS). Normative need was assessed by oral examinations, according to guidelines standardized by the World Health Organization. The contextual level factor was defined as the extent of implementation of PHC in the facilities. Managers responded to PCATool-Brazil, a validated questionnaire which measures the extent of PHC. Dentists answered to a version of PCATool, which was adapted and pretested for dental services. Multilevel analysis, based on Andersen's behavioral model, fitted the adjustment of "having ever consulted a dentist" to contextual and individual covariates. We observed high prevalence of dental caries. Almost half of the sample had had dental appointments in life. Social gradients were observed for the use of dental services. Although it was not able to eliminate the impact of adverse social conditions, higher levels of PHC attributes in dental services favored the effective use of such services by low-income children.
Access to dental care among 15–64 year old people
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
Differences Among Older Adults in the Types of Dental Services Used in the United States
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
Hansen, I; Foldspang, A; Poulsen, S
2001-04-01
To evaluate the use of a national register for strategic management of dental health services for 0-17-year-old Danish children and to identify determinants for their use of the system as a strategic tool in management of the services. During the period December 1997 to January 1998, the leaders of 268 private and public dental services were mailed a self-administered postal questionnaire on their use of the dental health reporting system of the Danish National Board of Health, the so-called SCOR-system. Ninety-six percent responded. The questionnaire contained questions about the use of SCOR (dependent variable) and the following independent variables: 1) the dental service in the municipality; and 2) the leader of the dental service, including his/her assessment of and knowledge related to the SCOR-system. Information concerning other independent variables such as: 1) the population and the socio-economic, cultural and political environment of the municipality; and 2) dental morbidity was collected as antecedent data from various official sources. Seventy-seven percent of municipalities with public clinics and 68% of municipalities without public clinics used SCOR-tables for planning purposes and preventive intervention. Forty percent reported data for all age groups to the SCOR-system and 36% used non-obligatory special codes in order to monitor more specific questions. Use of SCOR data was positively associated with the dental health services being organized in public clinics, with a high number of public clinics in the municipality, and with a positive assessment among the dental leaders of the reporting system as a planning tool. Special codes for precavitated lesions and/or fissure sealants were used more frequently in municipalities where DMFS in 15-year-olds had decreased from 1995 to 1996. Otherwise no associations between dental health and use of the system could be demonstrated. SCOR is widely used as a strategic planning instrument concerning the Danish dental services for children and adolescents. The predictors associated with its use are partly structural characteristics of the municipality and its dental service and factors partly related to a leader's knowledge about and assessment of the system. These factors might be amenable to change through training of the users of the system.
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-to-practice gap which if not addressed has the potential to widen oral health inequalities across the life-course. Stakeholders were keen to collaborate and support action to improve the oral health of mothers and their infants with the over-riding priority being to develop inter-service relationships to promote seamless access to oral health care.
Expanding services in a shrinking economy: desktop document delivery in a dental school library
Gushrowski, Barbara A
2011-01-01
Question: How can library staff develop and promote a document delivery service and then expand the service to a wide audience? Setting: The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. Method: A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. Main results: IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Conclusion: Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated. PMID:21753911
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.
Dental therapists in general dental practices: an economic evaluation.
Beazoglou, Tryfon J; Lazar, Vickie F; Guay, Albert H; Heffley, Dennis R; Bailit, Howard L
2012-08-01
Dental access disparities are well documented and have been recognized as a national problem. Their major cause is the lack of reasonable Medicaid reimbursement rates for the underserved. Specifically, Medicaid reimbursement rates for children average 40 percent below market rates. In addition, most state Medicaid programs do not cover adults. To address these issues, advocates of better oral health for the underserved are considering support for a new allied provider--a dental therapist--capable of providing services at a lower cost per service and in low-income and rural areas. Using a standard economic analysis, this study estimated the potential cost, price, utilization, and dentist's income effects of dental therapists employed in general dental practices. The analysis is based on national general dental practice data and the broadest scope of responsibility for dental therapists that their advocates have advanced, including the ability to provide restorations and extractions to adults and children, training for three years, and minimum supervision. Assuming dental therapists provide restorative, extraction, and pulpal services to patients of all ages and dental hygienists continue to deliver all hygiene services, the mean reduction in a general practice costs ranges between 1.57 and 2.36 percent. For dental therapists treating children only, the range is 0.31 to 0.47 percent. The effects on price and utilization are even smaller. In addition, the effects on most dentists' gross income, hours of work, and net income are negative. The estimated economic impact of dental therapists in the United States on private dental practice is very limited; therefore, the demand for dental therapists by private practices also would probably be very limited.
[Association between preventive care provided in public dental services and caries prevalence].
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.
Canto, M T; Horowitz, A M; Goodman, H S; Watson, M R; Cohen, L A; Fedele, D J
1998-01-01
The purpose of this study was to evaluate outpatient veteran'í knowledge about risk factors for and signs of oral cancers, and their utilization of dental services. Patients receiving primary health care services were surveyed during August 1997. Primary health care services at three medical centres within the VA Maryland Health Care System (VAMHCS). A total of 135 outpatient veterans were interviewed. Questionnaire administered by trained interviewers. Fifteen percent of the sample were eligible for dental care at the VA, while over 40% of those veterans participating in the study were unaware of their VA eligibility for dental services. Fifty six percent of the total sample received dental services from a private dentist, while 13% reported they had no provider of dental care. Of those not eligible for dental care at the VA (n = 115), the majority (67%) received dental care from a private dentist. Current use of tobacco and alcohol was reported by 27% of the sample. Nonsmokers were more likely to visit the dentist in the previous year than smokers (OR = 2.39, 95% C.I. 1.11,5.12). Although 84% correctly identified tobacco use as a risk factor, only 39% correctly identified regular alcohol use as a risk factor. Veterans at higher risk for oral cancers were less likely to have visited the dentist in the previous year, and, overall, were ill informed and misinformed about these cancers.
Facing a moral dilemma--introducing a dental care insurance within the public dental service.
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.
[Validity of self-perceived dental caries as a diagnostic test and associated factors in adults].
Haikal, Desirée Sant'Ana; Roberto, Luana Leal; Martins, Andréa Maria Eleutério de Barros Lima; Paula, Alfredo Maurício Batista de; Ferreira, Efigênia Ferreira E
2017-08-21
This study aimed to analyze the validity of self-perceived dental caries and associated factors in a sample of 795 adults (35-44 years). The dependent variable was self-perceived dental caries, and the independent variables were combined in blocks. Three logistic models were performed: (1) all adults; (2) adults with a formal diagnosis of caries; and (3) adults without such caries. Self-perceived dental caries showed 77.7% sensitivity, 58% specificity, 65% accuracy, 52% positive predictive value, and 81% negative predictive value. In Model 1, self-perceived dental caries was associated with time of use of dental services, access to information, flossing, formal diagnosis of caries, self-perceived need for treatment, toothache, and dissatisfaction with oral health and general health. In Model 2, self-perceived dental caries was associated with time of use of dental services, self-perceived need for treatment, and dissatisfaction with oral health and general health. In Model 3, self-perceived dental caries was associated with time of use of dental services, access to information, flossing, self-perceived need for treatment, and dissatisfaction with oral health. Self-perceived dental caries showed limited utility as a diagnostic method.
Utilization of oral health care services among adults attending community outreach programs.
Kadaluru, Umashankar Gangadhariah; Kempraj, Vanishree Mysore; Muddaiah, Pramila
2012-01-01
Good oral health is a mirror of overall health and well-being. Oral health is determined by diet, oral hygiene practices, and the pattern of dental visits. Poor oral health has significant social and economic consequences. Outreach programs conducted by dental schools offer an opportunity for early diagnosis and treatment, dental health education, and institution of preventive measures. To assess the utilization of oral healthcare services among adults attending outreach programs. This study included 246 adults aged 18-55 years attending community outreach programs in and around Bangalore. Using a questionnaire we collected data on dental visits, perceived oral health status, reasons for seeking care, and barriers in seeking care. Statistical significance was assessed using the Chi-square test. In this sample, 28% had visited the dentist in the last 12 months. Males visited dentist more frequently than females. The main reason for a dental visit was for tooth extraction (11%), followed by restorative and endodontic treatment 6%. The main barriers to utilization of dental services were high cost (22%), inability to take time off from child care duties (19.5%), and fear of the dentist or dental tools (8.5%). The utilization of dental services in this population was poor. The majority of the dental visits were for treatment of acute symptoms rather than for preventive care. High cost was the main barrier to the utilization of dental services. Policies and programs should focus on these factors to decrease the burden of oral diseases and to improve quality of life among the socioeconomically disadvantaged.
Pavitt, Sue H; Baxter, Paul D; Brunton, Paul A; Douglas, Gail; Edlin, Richard; Gibson, Barry J; Godson, Jenny; Hall, Melanie; Porritt, Jenny; Robinson, Peter G; Vinall, Karen; Hulme, Claire
2014-01-01
Introduction In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards ‘blended contracts’ that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effectiveness of incentive-driven contracting of health providers is still emerging. The INCENTIVE Study aims to evaluate a blended contract model (incentive-driven) compared to traditional nGDS contracts on dental service delivery in practices in West Yorkshire, England. Methods and analysis The INCENTIVE model uses a mixed methods approach to comprehensively evaluate a new incentive-driven model of NHS dental service delivery. The study includes 6 dental surgeries located across three newly commissioned dental practices (blended contract) and three existing traditional practices (nGDS contracts). The newly commissioned practices have been matched to traditional practices by deprivation index, age profile, ethnicity, size of practice and taking on new patients. The study consists of three interlinked work packages: a qualitative study to explore stakeholder perspectives of the new service delivery model; an effectiveness study to assess the INCENTIVE model in reducing the risk of and amount of dental disease and enhance oral health-related quality of life in patients; and an economic study to assess cost-effectiveness of the INCENTIVE model in relation to clinical status and oral health-related quality of life. Ethics and dissemination The study has been approved by NRES Committee London, Bromley. The results of this study will be disseminated at national and international conferences and in international journals. PMID:25231492
32 CFR 700.924 - Medical or dental aid to persons not in the naval service.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 32 National Defense 5 2010-07-01 2010-07-01 false Medical or dental aid to persons not in the... OFFICIAL RECORDS The Senior Officer Present Contents § 700.924 Medical or dental aid to persons not in the naval service. The senior officer present may require the officers of the Medical Corps and Dental Corps...
32 CFR 700.924 - Medical or dental aid to persons not in the naval service.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 32 National Defense 5 2012-07-01 2012-07-01 false Medical or dental aid to persons not in the... OFFICIAL RECORDS The Senior Officer Present Contents § 700.924 Medical or dental aid to persons not in the naval service. The senior officer present may require the officers of the Medical Corps and Dental Corps...
32 CFR 700.924 - Medical or dental aid to persons not in the naval service.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 32 National Defense 5 2013-07-01 2013-07-01 false Medical or dental aid to persons not in the... OFFICIAL RECORDS The Senior Officer Present Contents § 700.924 Medical or dental aid to persons not in the naval service. The senior officer present may require the officers of the Medical Corps and Dental Corps...
32 CFR 700.924 - Medical or dental aid to persons not in the naval service.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 5 2011-07-01 2011-07-01 false Medical or dental aid to persons not in the... OFFICIAL RECORDS The Senior Officer Present Contents § 700.924 Medical or dental aid to persons not in the naval service. The senior officer present may require the officers of the Medical Corps and Dental Corps...
32 CFR 700.924 - Medical or dental aid to persons not in the naval service.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 32 National Defense 5 2014-07-01 2014-07-01 false Medical or dental aid to persons not in the... OFFICIAL RECORDS The Senior Officer Present Contents § 700.924 Medical or dental aid to persons not in the naval service. The senior officer present may require the officers of the Medical Corps and Dental Corps...
Aldallal, S N; Aldallal, F N; Khajah, A S
2017-03-24
Objective To perform an evaluation of the information given to patients seeking emergency dental services during out-of-hours periods in Greater Manchester.Method This is a cross-sectional study. A list of all NHS dental practices in Greater Manchester was obtained from the NHS website. The investigators then accessed websites and voicemails of all practices to assess the information given to patients.Results The study shows that most practices have voicemail, which includes varying information on how to access emergency dental services during out-of-hours periods. Few of those included advice on the management of common dental emergencies. On the other hand, the majority of practices did not have websites. From those who included advice on how to access emergency dental services during out-of-hours periods on how to manage common dental emergencies on their websites, the information was easy to find.Conclusion The current information could be improved by ensuring the inclusion of essential details. Websites would help by including more details. In turn, this could help to reduce the number of inappropriate presentations to A&E departments.
Characteristics of dental clinics in US children's hospitals.
Ciesla, David; Kerins, Carolyn A; Seale, N Sue; Casamassimo, Paul S
2011-01-01
This study's purpose was to describe the workforce, patient, and service characteristics of dental clinics affiliated with US children's hospitals belonging to the National Association of Children's Hospital and Related Institutions (NACHRI). A 2-stage survey mechanism using ad hoc questionnaires sought responses from hospital administrators and dental clinic administrators. Questionnaires asked about: (1) clinic purpose; (2) workforce; (3) patient population; (4) dental services provided; (5) community professional relations; and (5) relationships with medical services. Of the 222 NACHRI-affiliated hospitals, 87 reported comprehensive dental clinics (CDCs) and 64 (74%) of CDCs provided data. Provision of tertiary medical services was significantly related to presence of a CDC. Most CDCs were clustered east of the Mississippi River. Size, workload, and patient characteristics were variable across CDCs. Most were not profitable. Medical diagnosis was the primary criterion for eligibility, with all but 1 clinic treating special needs children. Most clinics (74%) had dental residencies. Over 75% reported providing dental care prior to major medical care (cardiac, oncology, transplantation), but follow-up care was variable. Many children's hospitals reported comprehensive dental clinics, but the characteristics were highly variable, suggesting this element of the pediatric oral health care safety net may be fragile.
Interdisciplinary Community-Based Oral Health Program for Women and Children at WIC.
Gold, Jaana; Tomar, Scott L
2018-06-23
Objectives To evaluate the women, infants, and children (WIC) Oral Health Program in a county in Florida. Methods The non-traditional interdisciplinary program of the current study was designed to reach at-risk populations with untreated dental diseases and limited access to care; it provides oral health education, dental screenings, preventive dental services, and referrals for women, children, and families at WIC offices. We evaluated the health status of patients enrolled in the program and the services provided. Results From 2013 to 2016, the program provided dental screenings for 576 children and 180 women. Caries prevalence for 3-5 year olds was 46.0%. Only 6.6% (12/114) of pregnant women were eligible for comprehensive dental care under Medicaid (< 21 years). Further, 71.2% (47/66) of all pregnant women had unmet dental care needs. Conclusions for Practice Our results suggested that many children and women had untreated dental diseases and need preventive services and dental care. Also, many pregnant women were not covered by Medicaid. This program demonstrates that collaboration with the WIC program can improve access to oral health services for underserved populations.
Adeniyi, A A; Adegbite, K O; Braimoh, M O; Ogunbanjo, B O
2013-03-01
Satisfaction is important in dental care because satisfaction with care alleviates dental anxiety, influences patients' compliance and is an important indicator of quality of care. This study was designed to determine the factors that contribute to satisfaction with dental care among patients attending the Lagos State University (LASUTH) Dental Clinic. Across-sectional, descriptive questionnaire-based survey was conducted among adult patients attending the LASUTH Dental Clinic. The questionnaire, a modification of the Dental Satisfaction Questionnaire (DSQ), contained 19 items on a Likert-pattern scale with scores ranging from 0 to 4. The scores obtained for satisfaction with the dental services ranged from 19 to 75 with a mean of 55.30 +/- 11.55. The majority of respondents (305 or 87.4%) were satisfied with the services received. The items generating the highest and lowest mean satisfaction score were cleanliness/comfort of the facility and cost of services respectively. Long waiting time was the item respondents liked least about the services. There was a statistically significant relationship between the items assessing communication and respondent's gender (p = 0.001). The relationship between the overall satisfaction score and gender (p = 0.233), age category (p = 0.842) and educational status (p = 0.565) were not statistically significant. The results indicate a high level of satisfaction with services provided at the LASUTH Dental Clinic. However, there is need for improvement in communication with patients and reduction in waiting time.
McCaffrey, Eden S N; Chang, Samuel; Farrelly, Geraldine; Rahman, Abdul; Cawthorpe, David
2017-08-01
The effectiveness of a continuing education programme in paediatric psychopharmacology designed for primary healthcare providers was objectively measured based on the assumption that training would lead to measurable changes in referral patterns and established clinical measures of referred patients. Using established, valid and reliable measures of clinical urgency embedded in to a regional healthcare system since 2002, the referrals to child and adolescent psychiatric services of physicians who participated in the training (n=99) were compared pretraining and post-training, and to non-participating/untrained referring physicians (n=7753) making referrals over the same time period. Referrals were analysed for evidence of change based on frequencies and measures of clinical urgency. Participants of the training programme also completed standardised baseline and outcome self-evaluations. Congruent with participants self-reported evaluative reports of improved knowledge and practice, analysis of referral frequency and the clinical urgency of referrals to paediatric psychiatric services over the study period indicated that trained physicians made more appropriate referrals (clinically more severe) and reduced referrals to emergency services. Quantitative clinical differences as completed by intake clinicians blind to referrals from the study group designations were observed within the trained physician group pretraining and post-training, and between the trained physician group and the unexposed physician group. The results illustrate a novel model for objectively measuring change among physicians based on training in paediatric mental health management. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Medina-Solis, Carlo Eduardo; Maupomé, Gerardo; del Socorro, Herrera Miriam; Pérez-Núñez, Ricardo; Avila-Burgos, Leticia; Lamadrid-Figueroa, Hector
2008-01-01
To determine the factors associated with the dental health services utilization among children ages 6 to 12 in León, Nicaragua. A cross-sectional study was carried out in 1,400 schoolchildren. Using a questionnaire, we determined information related to utilization and independent variables in the previous year. Oral health needs were established by means of a dental examination. To identify the independent variables associated with dental health services utilization, two types of multivariate regression models were used, according to the measurement scale of the outcome variable: a) frequency of utilization as (0) none, (1) one, and (2) two or more, analyzed with the ordered logistic regression and b) the type of service utilized as (0) none, (1) preventive services, (2) curative services, and (3) both services, analyzed with the multinomial logistic regression. The proportion of children who received at least one dental service in the 12 months prior to the study was 27.7 percent. The variables associated with utilization in the two models were older age, female sex, more frequent toothbrushing, positive attitude of the mother toward the child's oral health, higher socioeconomic level, and higher oral health needs. Various predisposing, enabling, and oral health needs variables were associated with higher dental health services utilization. As in prior reports elsewhere, these results from Nicaragua confirmed that utilization inequalities exist between socioeconomic groups. The multinomial logistic regression model evidenced the association of different variables depending on the type of service used.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-26
...; physician and other professional charges, including professional charges for anesthesia services and dental... professional charges for anesthesia services and dental services; pathology and laboratory charges; observation...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-28
...; physician and other professional charges, including professional charges for anesthesia services and dental... professional charges for anesthesia services and dental services; pathology and laboratory charges; observation...
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-07
...; physician and other professional charges, including professional charges for anesthesia services and dental... professional charges for anesthesia services and dental services; pathology and laboratory charges; observation...
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.
Dental Care for Medicaid and CHIP Enrollees
... 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 ...
Morgans, Amee; Burgess, Stephen J
2011-08-01
Investigations into 'inappropriate' use of emergency health services are limited by the lack of definition of what constitutes a health emergency. Position papers from Australian and international sources emphasise the patient's right to access emergency healthcare, and the responsibility of emergency health care workers to provide treatment to all patients. However, discordance between the two perspectives remain, with literature labelling patient use of emergency health services as 'inappropriate'. To define a 'health emergency' and compare patient and health professionals perspectives. A sample of 600 emergency department (ED) patients were surveyed about a recent health experience and asked to rate their perceived urgency. This rating was compared to their triage score allocated at the hospital ED. No significant relationship was found between the two ratings of urgency (P=0.51). CONCLUSIONS; Differing definitions of a 'health emergency' may explain patient help-seeking behaviour when accessing emergency health resources including hospital ED and ambulance services. A new definition of health emergency that encapsulates the health professional and patient perspectives is proposed. An agreed definition of when emergency health resources should be used has the potential to improve emergency health services demand and patient flow issues, and optimise emergency health resource allocation.
Lin, Chienhung; Chao, Hailun
2012-09-25
The Taiwan government adopted National Health Insurance (NHI) in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan.
Nyamuryekung'e, Kasusu K; Lahti, Satu M; Tuominen, Risto J
2015-07-01
Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients' relative cost. DRC are the quantified average financial resources required for an adult Tanzanian's overall consumption per day. Tooth extractions were found to cost four times the DRC whereas restorations were 9-10 times the DRC. Studied facilities provided tooth extractions (100%), scaling (86%), fillings (79%), root canal treatment (46%) and fabrication of removable partial dentures (32%). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50% of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.
Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method
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
Duane, B; Lee, M Berners; White, S; Stancliffe, R; Steinbach, I
2017-10-27
Introduction National Health Service (NHS) England dental teams need to consider from a professional perspective how they can, along with their NHS colleagues, play their part in reducing their carbon emissions and improve the sustainability of the care they deliver. In order to help understand carbon emissions from dental services, Public Health England (PHE) commissioned a calculation and analysis of the carbon footprint of key dental procedures.Methods Secondary data analysis from Business Services Authority (BSA), Health and Social Care Information Centre (HSCIC) (now called NHS Digital, Information Services Division [ISD]), National Association of Specialist Dental Accountants (NASDA) and recent Scottish papers was undertaken using a process-based and environmental input-output analysis using industry established conversion factors.Results The carbon footprint of the NHS dental service is 675 kilotonnes carbon dioxide equivalents (CO2e). Examinations contributed the highest proportion to this footprint (27.1%) followed by scale and polish (13.4%) and amalgam/composite restorations (19.3%). From an emissions perspective, nearly 2/3 (64.5%) of emissions related to travel (staff and patient travel), 19% procurement (the products and services dental clinics buy) and 15.3% related to energy use.Discussion The results are estimates of carbon emissions based on a number of broad assumptions. More research, education and awareness is needed to help dentistry develop low carbon patient pathways.
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.
Examining dental expenditure and dental insurance accounting for probability of incurring expenses.
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 dental service expenditures than uninsured adults. The analytical approach adopted in this study is useful for estimating effects on dental expenditure when a variable is associated with both the probability of visiting for care, and with the types of services received. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Shortt, Jake; Polizzotto, Mark N; Waters, Neil; Borosak, Marija; Moran, Martine; Comande, Mary; Devine, Alexandra; Jolley, Damien J; Wood, Erica M
2009-11-01
Careful planning is essential to ensure blood availability during shortages. Triaging supply is one proposed strategy; however, few data concerning the urgency of transfusion are available to inform planning. This study sought to determine the proportion of red blood cells (RBCs) used for clinically urgent indications. A total of 5132 RBC units were randomly selected at point of production and distributed into general statewide inventory over a 9-month period. These selected units carried case report forms, for completion at the point of hospital issue for transfusion. Completed forms were returned to the blood service for collation and analysis, capturing information on indication and clinical urgency of supply, including use for potentially deferrable elective surgery. Data from 5052 RBC units indicated that 95.6% were transfused. Approximately one-third of transfused units were used to support surgery, one-third for hematology/oncology, and one-third for other medical and miscellaneous indications. Where used for surgery, 25.7% (95% confidence interval [CI], 23.4%-28.0%) were for elective procedures, although urgency of surgery was unknown in 17.1% (95% CI, 15.2%-19.2%) of cases. Supply for nonurgent medical indications and elective surgery only accounted for 9.8% (95% CI, 9.0%-10.6%) of use, with 53.4% (95% CI, 52.0%-54.8%) of RBCs required within 24 hours. The majority of RBCs are transfused with a high degree of clinical urgency, with only a minor proportion required to support elective surgery.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 1 2013-10-01 2013-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 1 2011-10-01 2011-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 1 2012-10-01 2012-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 1 2014-10-01 2014-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 1 2010-10-01 2010-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
Bayat, Fariborz; Vehkalahti, Miira M; Murtomaa, Heikki; Tala, Heikki
2010-02-01
To investigate patients' reasons for selecting a dental clinic given their choice of free or highly-subsidized dental services. The study was based on cross-sectional data obtained through phone interviews with adults in Tehran, Iran. The present study included those entitled to free or highly-subsidized dental services (n = 726). The data covered the patients' awareness of subsidized dental services and type of dental clinic for their most recent visit and their reasons for selecting that clinic. Awareness of subsidized dental services was dichotomized as being either aware or unaware of such subsidy. The type of clinic was dichotomized as providing either free or highly-subsidized (FHS) or fully out-of-pocket paid (FOP) services. Free format answers about the subjects' reasons for selecting a particular clinic were later sub-grouped as: convenient access, good technical aspects, good interpersonal aspects, low or reasonable fees, recommendation by a friend, and no reason. Socio-demographic status was based on background. Data analysis included the chi-square test and logistic regression model. Of the subjects (n = 726), 60% were women and 58% were under 35 years of age. The subjects' mean age was 33.5 years with no difference by gender (P = 0.24) and the majority had public insurance (91%). Of all the subjects, 60% selected FOP. Good interpersonal aspects were the strongest reason for selecting FOP (OR = 4.6), follow by good technical aspects (OR = 2.3). Those subjects who were unaware of their benefit had 4.6 times the odds of selecting FOP. Despite the opportunity to use highly-subsidized dental services, good interpersonal and good technical aspects lead patients to select private dentists and to pay fully out of pocket.
Providing dental care for the patient with autism.
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.
Access to dental public services by disabled persons.
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 services has increased in Fortaleza, the lack of accessibility of health units and their surroundings does not promote the treatment of people with disabilities. Cultural, organizational, architectural, geographical, and communication barriers constrain the demand for and use of oral dental care services by this social segment.
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 disseminated to other care organizations as publicly insured clients are increasingly served by large practice organizations. ClinicalTrials.gov NCT02312921 6 December 2014. The Robert Wood Johnson Foundation and Advantage Dental Services, LLC, are supporting the evaluation.
Antoft, P; Rambusch, E; Antoft, B; Christensen, H W
1999-06-01
To compare caries experience among young Danish men in 1972, 1982 and 1993; and on the same occasions to describe relationship between their utilisation of regular dental care and social status, as well as the relationship between their caries experience, utilisation of dental services and social status. During their routine health examinations in 1972, 1982 and 1993 all recruits enlisted in the Danish Air Force were subjected to an additional oral examination combined with a structured socio-dental questionnaire. Identical methods were applied in each of the three surveys. Dental clinics at air bases in Denmark. 4,103 male military recruits, aged 18 to 25 years. Caries was registered in accordance with the WHO Basic Methods 1971. The questionnaire provided information on age, place of residence during childhood, social origin, and patterns of utilisation of dental services. The findings indicated a considerable decrease in average caries experience from 16.6 DMFT in 1972 to 11.8 in 1982 and 6.2 in 1993. The results further documented markedly increased availability of public school dental health services, the coverage rising from 33% in 1972 to 65% in 1982 and 100% in 1993, as well as moderately increased utilisation of regular dental care with private practitioners, rising from 71% in 1972 to 86% in 1982 and 84% in 1993. In 1993 as in 1982 and 1972, recruits who used the public school dental health services and also received regular dental care after their school leaving age showed the lowest average caries experience. The findings indicate a marked decrease in average caries experience and an increased utilisation of dental services among Danish young men from 1972 to 1993. However, in 1993 the least privileged social group continued to maintain the highest average caries experience and the lowest rate of utilisation of regular dental care.
2018-04-26
Postgraduate Dental School and Uniformed Services University of the Health Sciences Postgraduate Dental College Lt Col Jarom J. Ray, DDS, Endodontics...Residency Program Director, Wilford Hall Ambulatory Surgical Center and Uniformed Services University of the Health Sciences Postgraduate Dental College
Vujicic, Marko; Yarbrough, Cassandra
2017-03-01
To estimate premium and out-of-pocket costs for child dental care services under various dental coverage options offered within the federally facilitated marketplace. We estimated premium and out-of-pocket costs for child dental care services for 12 patient profiles, which vary by dental care use and spending. We did this for 1039 medical plans that include child dental coverage, 2703 medical plans that do not include child dental coverage, and 583 stand-alone dental plans for the 2015 plan year. Our analysis is based on plan data from the Center for Consumer Information and Insurance Oversight and Data.HealthCare.Gov. On average, expected total financial outlays for child dental care services were lower when dental coverage was embedded within a medical plan compared with the alternative of a stand-alone dental plan. The difference, however, in average expected out-of-pocket spending varied significantly for our 12 patient profiles. Older children who are very high users of dental care, for example, have lower expected out-of-pocket costs under a stand-alone dental plan. For the vast majority of other age groups and dental care use profiles, the reverse holds. Our results show that embedding dental coverage within medical plans, on average, results in lower total financial outlays for child beneficiaries. Although our results are specific to the federally facilitated marketplace, they hold lessons for both state-based marketplaces and the general private health insurance and dental benefits market, as well. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
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.
Federal role in dental public health: dental care for special populations.
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.
Comparison of Two Methods of Obtaining Digital Orthodontic Models: Direct vs. Indirect
2013-05-17
companies whose materials are discussed in this article. DEPARTMENT OF THE AIR FORCE AIR FORCE POST GRADUATE DENTAL SCHOOL ORTHODONTIC FLIGHT 2133...Orthodontic Residency Program Air Force Post Graduate Dental School Date: 06/06/13 Uniformed Services University of the Health Sciences Manuscript...Science in Oral Biology 3. School/Department/Center: Air Force Postgraduate Dental School (AFPDS), Tri- Service Orthodontic Dental School 4. Phone: (210
Dental Diamond Rotary Instruments. Test and Evaluation
1983-09-01
Gov’t. agencies only; Critical Technology; Test and Evaluation; 19 NOV 1982. Other requests shall be referred to Dental Investigation Service, School of... DENTAL DIAMOND ROTARY INSTRUMENTS Test and Evaluation Cad D. Foster, Major, USAF, DC Joseph M. Powell, Colonel, USAF, DC John M. Young, Colonel, USAF...19 November 1982. Other requests for this document must be referred to the Dental Investig tion Service, USAF School of Aerospace Medicine. SUBJECT TO
Patient satisfaction in Dental Healthcare Centers.
Ali, Dena A
2016-01-01
This study aimed to (1) measure the degree of patient satisfaction among the clinical and nonclinical dental services offered at specialty dental centers and (2) investigate the factors associated with the degree of overall satisfaction. Four hundred and ninety-seven participants from five dental centers were recruited for this study. Each participant completed a self-administered questionnaire to measure patient satisfaction with clinical and nonclinical dental services. Analysis of variance, t-tests, a general linear model, and stepwise regression analysis was applied. The respondents were generally satisfied, but internal differences were observed. The exhibited highest satisfaction with the dentists' performance, followed by the dental assistants' services, and the lowest satisfaction with the center's physical appearance and accessibility. Females, participants with less than a bachelor's degree, and younger individuals were more satisfied with the clinical and nonclinical dental services. The stepwise regression analysis revealed that the coefficient of determination (R (2)) was 40.4%. The patient satisfaction with the performance of the dentists explained 42.6% of the overall satisfaction, whereas their satisfaction with the clinical setting explained 31.5% of the overall satisfaction. Additional improvements with regard to the accessibility and physical appearance of the dental centers are needed. In addition, interventions regarding accessibility, particularly when booking an appointment, are required.
Patient satisfaction in Dental Healthcare Centers
Ali, Dena A.
2016-01-01
Objectives: This study aimed to (1) measure the degree of patient satisfaction among the clinical and nonclinical dental services offered at specialty dental centers and (2) investigate the factors associated with the degree of overall satisfaction. Materials and Methods: Four hundred and ninety-seven participants from five dental centers were recruited for this study. Each participant completed a self-administered questionnaire to measure patient satisfaction with clinical and nonclinical dental services. Analysis of variance, t-tests, a general linear model, and stepwise regression analysis was applied. Results: The respondents were generally satisfied, but internal differences were observed. The exhibited highest satisfaction with the dentists’ performance, followed by the dental assistants’ services, and the lowest satisfaction with the center's physical appearance and accessibility. Females, participants with less than a bachelor's degree, and younger individuals were more satisfied with the clinical and nonclinical dental services. The stepwise regression analysis revealed that the coefficient of determination (R2) was 40.4%. The patient satisfaction with the performance of the dentists explained 42.6% of the overall satisfaction, whereas their satisfaction with the clinical setting explained 31.5% of the overall satisfaction. Conclusion: Additional improvements with regard to the accessibility and physical appearance of the dental centers are needed. In addition, interventions regarding accessibility, particularly when booking an appointment, are required. PMID:27403045
US Army Armor Reference Data in Three Volumes. Volume I. The Army Division.
1981-01-01
dental treatment ASSIGNMENT Organic Armored Division, TOE 17 (d) Optometrc services CAPABILITIES a Provides the following combat service support to a...Support Command. Infantry Division (Mechaniied TOE 29-ft 1 Provides expedient dental treatment CAPABILITIES a Provides medical staff services, including g...administration, and supervision of and f Provides expedient dental treatment plan, mrt division level ol4 uii novel medicaf support rendered by
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.
42 CFR 410.20 - Physicians' services.
Code of Federal Regulations, 2011 CFR
2011-10-01
...) of the Act. (2) A doctor of dental surgery or dental medicine. (3) A doctor of podiatric medicine. (4... list, provided by CMS, of plastic and dental surgeries that may be covered by Medicare and that have an..., surgery, consultations, and home, office, and institutional calls. (b) By whom services must be furnished...
Reasons for attending dental-care services in Ouagadougou, Burkina Faso.
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
2012-01-01
Background The Taiwan government adopted National Health Insurance (NHI) in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. Methods This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Results Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. Conclusions The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan. PMID:23009095
Children's use of dental services in the five Nordic countries
Virtanen, Jorma I; Berntsson, Leeni T; Lahelma, Eero; Köhler, Lennart; Murtomaa, Heikki
2007-01-01
Background An increase in the use of general practitioner services for children has taken place since the 1980s in the Nordic countries, but little is known about the use of dental services during this time. Aim To compare differences in children's use of dental services in the five Nordic countries and to analyse changes over time from the 1980s to the 1990s. Methods The participants were 20 500 children aged 2–17 years from Denmark, Finland, Iceland, Norway and Sweden. Cross‐sectional population surveys using random samples comprising 3000 children in each country were conducted in 1984 and 1996. Changes over time in the use of dental services were studied in each country by age, sex, level of parental education and living area. Results The prevalence of children's utilisation of dental services varied between 60% and 34% in 1984, and between 42% and 30% in 1996. A clear change towards decreasing utilisation over time (p<0.05) was found in all countries except Finland, where utilisation increased statistically significantly (p<0.05). Odds ratios (1984 = 1.00) for the changes ranged between 0.66 (95% confidence interval 0.58 to 0.75) in Sweden and 0.71 (0.62 to 0.81) in Iceland, while the corresponding figure was 1.32 (1.16 to 1.48) in Finland. In 1996, children from families with the lowest education in Finland and Norway used dental services more frequently than children from families with higher education. Conclusion Children's use of dental services decreased significantly in four of the five Nordic countries between the mid‐1980s and the mid‐1990s. PMID:18000131
[Access to oral health services in children under twelve years of age in Peru, 2014].
Hernández-Vásquez, Akram; Azañedo, Diego; Díaz-Seijas, Deysi; Bendezú-Quispe, Guido; Arroyo-Hernández, Hugo; Vilcarromero, Stalin; Agudelo-Suárez, Andrés A
2016-01-01
The aim of the study was to explore the patterns of dental health services access in children under twelve years of age in Peru. Data from 25,285 children under 12 years who participated in the Demographic and Family Health Survey of 2014 were reviewed. An exploratory spatial analysis was performed to project the proportions of children with access to dental health services, according to national regions, type of health service and urban or rural place of residence. The results show that of the total sample, 26.7% had access to dental health services in the last six months, 39.6% belonged to the age group 0-4 years, 40.6% lived in the Andean region and 58.3% lived in urban areas. The regions of Huancavelica, Apurimac, Ayacucho, Lima and Pasco had the highest percentages of access nationwide. In conclusion, there is low access to dental health services in the population under 12 years of age in Peru. The spatial distribution of access to dental health services allows regions to be identified and grouped according to similar access patterns, in order to better focus public health actions.
Holde, Gro Eirin; Baker, Sarah R; Jönsson, Birgitta
2018-07-01
To utilise Andersen's behavioural model for health services' use as the theoretical framework to examine direct and indirect relationships between population characteristics, oral health behaviours and periodontitis and oral health impacts. The model was tested in a general adult population (n = 1,886) in Norway, using structural equation modelling. Socioeconomic status, sense of coherence (SOC), dental anxiety, perceived treatment need, oral health behaviours and oral health impact profile (OHIP-14) were collected through questionnaire. Periodontal examinations consisted of full-mouth recordings. Andersen's model explained a large part of the variance in use of dental services (58%) and oral health-related impacts (55%), and to a less extent periodontitis (19%). More social structure and stronger SOC was related to more enabling resources, which in turn was associated with more use of dental services. More use of dental services was related to more periodontitis and more periodontitis was associated with increased oral health impacts. A stronger SOC was associated with less oral impacts. There was no association between use of dental services and oral health impacts. The result demonstrated complex relationships between population characteristics, oral health-related behaviours and oral health outcomes. Socioeconomic factors and smoking were main predictors of periodontitis. Regular dental visiting habits did not, however, reduce the likelihood of periodontitis. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Barriers encountered using skill-mix to deliver caries prevention in dental practices.
Hatim, Eman; Kendall, Nick
2012-04-01
This opinion paper provides an analysis of the barriers and successes experienced when developing and implementing a pilot scheme to deliver caries prevention using skill-mix in the National Health Service (NHS) General Dental Services. A training programme was initiated to develop the skills of extended duties dental nurses to deliver fluoride varnish to patients in selected dental practices in Croydon, London, UK. In the light of the evaluation of this programme, a recommendation is made that similar preventive schemes should be delivered in the future within the NHS dental contract.
[Factors associated with oral health habits and use of dental services by adolescents].
Davoglio, Rosane Silvia; Aerts, Denise Rangel Ganzo de Castro; Abegg, Claídes; Freddo, Silvia Letícia; Monteiro, Lisiane
2009-03-01
This was a cross-sectional study of 1,170 seventh-grade adolescents from the municipal public school system in Gravataí, Rio Grande do Sul State, Brazil, investigating the association between socio-demographic, psychosocial, and lifestyle factors and oral health habits and use of dental services. Data were analyzed by Cox regression, modified for cross-sectional studies. Females showed higher frequency of brushing, as did adolescents that reported not feeling alone or discriminated. Daily flossing was associated with higher socioeconomic status (SES), use of private dental services, parental understanding, and lack of feeling of loneliness. Frequency of annual dental visits was higher among individuals with higher SES. Preventive dental checkups were more frequent among individuals with higher SES, those who felt understood by their parents, and those who did not habitually eat candy. Oral health habits were associated with family SES and psychosocial factors except for frequency of annual dental visits. As for lifestyle, low candy consumption had a positive impact on reasons for use of dental appointments.
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.
Pavitt, Sue H; Baxter, Paul D; Brunton, Paul A; Douglas, Gail; Edlin, Richard; Gibson, Barry J; Godson, Jenny; Hall, Melanie; Porritt, Jenny; Robinson, Peter G; Vinall, Karen; Hulme, Claire
2014-09-17
In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards 'blended contracts' that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effectiveness of incentive-driven contracting of health providers is still emerging. The INCENTIVE Study aims to evaluate a blended contract model (incentive-driven) compared to traditional nGDS contracts on dental service delivery in practices in West Yorkshire, England. The INCENTIVE model uses a mixed methods approach to comprehensively evaluate a new incentive-driven model of NHS dental service delivery. The study includes 6 dental surgeries located across three newly commissioned dental practices (blended contract) and three existing traditional practices (nGDS contracts). The newly commissioned practices have been matched to traditional practices by deprivation index, age profile, ethnicity, size of practice and taking on new patients. The study consists of three interlinked work packages: a qualitative study to explore stakeholder perspectives of the new service delivery model; an effectiveness study to assess the INCENTIVE model in reducing the risk of and amount of dental disease and enhance oral health-related quality of life in patients; and an economic study to assess cost-effectiveness of the INCENTIVE model in relation to clinical status and oral health-related quality of life. The study has been approved by NRES Committee London, Bromley. The results of this study will be disseminated at national and international conferences and in international journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
38 CFR 17.160 - Authorization of dental examinations.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Authorization of dental... MEDICAL Dental Services § 17.160 Authorization of dental examinations. When a detailed report of dental examination is essential for a determination of eligibility for benefits, dental examinations may be...
38 CFR 17.160 - Authorization of dental examinations.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Authorization of dental... MEDICAL Dental Services § 17.160 Authorization of dental examinations. When a detailed report of dental examination is essential for a determination of eligibility for benefits, dental examinations may be...
38 CFR 17.160 - Authorization of dental examinations.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Authorization of dental... MEDICAL Dental Services § 17.160 Authorization of dental examinations. When a detailed report of dental examination is essential for a determination of eligibility for benefits, dental examinations may be...
38 CFR 17.160 - Authorization of dental examinations.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Authorization of dental... MEDICAL Dental Services § 17.160 Authorization of dental examinations. When a detailed report of dental examination is essential for a determination of eligibility for benefits, dental examinations may be...
38 CFR 17.160 - Authorization of dental examinations.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Authorization of dental... MEDICAL Dental Services § 17.160 Authorization of dental examinations. When a detailed report of dental examination is essential for a determination of eligibility for benefits, dental examinations may be...
Barnett, T; Hoang, Ha; Stuart, J; Crocombe, L; Bell, E
2014-12-01
People who have limited access to dental care may present to non-dental health practitioners for dental treatment and advice. This review synthesised the available evidence regarding the use of non-dental health practitioners for oral health problems and the services provided by non-dental health practitioners to manage such presentations. PubMed and CINAHL databases were searched using key search terms to identify all relevant quantitative and qualitative English-language studies published between 1990 and March 2014. Snowballing techniques were then applied whereby the reference lists of retrieved articles were searched for other relevant citations. Grey literature was searched via Google using the same search terms to identify unpublished work and government reports. Of the 43 papers which met the review criteria, 25 papers reported on the use of non-dental health practitioners for oral health problems and 18 on dental care education and training for non-dental health practitioners. Four reports were located from the grey literature on the involvement of non-dental health practitioners in the management of oral health care. The review of literature showed that both children and adults utilise non-dental health practitioners for oral health problems. Despite this, Emergency Department medical staff, medical practitioners and pharmacists generally lacked training and knowledge in the maragement of oral health. Services from non-dental health practitioners mainly focussed on children. The literature on education and training for non-dental health practitioners was limited.
Compendium of Dental Residents’ Research Projects and Literature Reviews - 1990
1991-03-01
AL-SR-1991-0001 AD-A236 272 COMPENDIUM OF DENTAL RESIDENTS’ RESEARCH PROJECTS AND LITERATURE REVIEWS 1990 CDTIC JNO 6INSi3 Samuel P. Davis...USAF Dental Investigation Service Armstrong Laboratory Human Systems Division (AFSC) 91-01146 Brooks Air Force Base, TX 78235-5000 .,....,,.,,.l. ltfl 91...L, / 041 4li NOTICES This interim special report was submitted by personnel of the Dental Investigation Service, Clinical Sciences Division
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.
DeMattei, Ronda R; Allen, Jessica; Goss, Breanna
2012-06-01
Children with special health care needs face many barriers to oral care and are at high risk for oral disease. School nurses are in a unique position to promote oral wellness in this vulnerable population. Collaboration between school nurses and dental hygiene faculty resulted in the formation of a partnership between a university-based dental hygiene program and two special education districts in rural southern Illinois. Senior dental hygiene students participated in a school-based service-learning project that provided dental examinations, preventive services, and education to children with special health care needs. Evidence-based behavioral interventions were used to teach children to comply with oral procedures. School nurses mentored dental hygiene students in behavior management of children. Dental exams were provided to 234 children from four special education schools with the majority receiving cleanings and fluoride.
[Use of dental services by preschool children in Canela, Rio Grande do Sul State, Brazil].
Kramer, Paulo Floriani; Ardenghi, Thiago Machado; Ferreira, Simone; Fischer, Laura de Almeida; Cardoso, Luciana; Feldens, Carlos Alberto
2008-01-01
The aim of this study was to assess the use of dental services and age at first dental visit in preschool children in Canela, Rio Grande do Sul State, Brazil. A representative sample of under-five children was surveyed on National Children's Vaccination Day. Children's parents completed questionnaires containing socio-demographic data and age at first dental visit. Data were analyzed using multiple logistic regression. 192 children were examined. 13.3% of the sample had already visited the dentist at least once, but only 4.3% had their first dental visit by one year of age. The number of children who had already visited a dentist increased with age. Girls showed higher odds of having visited a dentist (OR = 1.46; 95%CI: 1.01-2.1). Public health strategies are needed to determine the effectiveness of health promotion and improve the use of dental services by preschool children.
AlKindi, N A; Nunn, J
2016-04-22
Access to health services is a right for every individual. However, there is evidence that people with disabilities face barriers in accessing dental health. One of the reasons associated with this is the unclear referral pathway existing in the Irish dental health service. The appropriate assignment of patients to relevant services is an important issue to ensure better access to healthcare. This is all the more pertinent because there are only a few trained dental practitioners to provide dental treatment for people with disabilities, as well as even fewer qualified specialists in special care dentistry. The aim of this part of the study was to assess the use of the BDA Case Mix Model to determine the need for referral of patients to specialist dental services, and to determine any association between patient complexity and the need for adjunct measures, such as sedation and general anaesthesia for the management of people with disabilities and complex needs. A retrospective analysis of dental records using the BDA Case Mix Model.Results The results showed that patients with different levels of complexities were being referred to the special care dentistry clinic at the Dublin Dental University Hospital. The results also showed that the need for supportive adjunct measures such as sedation and general anaesthesia was not necessarily the main reason for referring patients to specialist services. The assessment with the BDA Case Mix Model was comprehensive as it looked at many factors contributing to the cases' complexity. Not all categories in the Case Mix Model had significant association with the need for an adjunct.Conclusion The BDA Case Mix Model can be used to measure the need for supportive adjunct measures, such as sedation and general anaesthesia.
Fund allocation within Australian dental care: an innovative approach to output based funding.
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.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-21
... OFFICE OF MANAGEMENT AND BUDGET Fiscal Year 2010 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by Department of Defense Medical Treatment Facilities; Certain Rates Regarding... recovery from tortiously liable third persons for the cost of outpatient medical, dental and cosmetic...
Dental care access among individuals with Down syndrome: a Malaysian scenario.
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.
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
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.
Knowledge, practice and utilization of dental services among pregnant women in the north of Jordan.
Malkawi, Zain A; Tubaishat, Reem S
2014-05-01
The aim of this study was to evaluate women's oral hygiene knowledge, practice, and use of dental services during pregnancy in the north of Jordan. Voluntary sample of 154 pregnant women of 18 to 40 years old were invited to participate in the study. They were asked to read a self-designated questionnaire and a cover letter which explained the purpose of the study. The questionnaire addressed self-reported demographics, knowledge, practice and use of dental services during pregnancy. Data were statistically analyzed using Chi-square test to determine statistically significant differences across knowledge, practice and use of dental services during pregnancy. The sample included 29.3% aged 20 to 24 years old; 33.1% having bachelor degree; and 66.9% were housewives. The majority of study sample 68.2% knew they need dental consultation during pregnancy; however, 39.5% received dental consultation during pregnancy. Majority 62.4% brushed their teeth regularly; however, 73.2% does not use auxiliary dental hygiene devices. Majority 44.5% visited dentist, when they feel pain. Statistically significant association were found between educational level and knowledge about need to dental consultation during pregnancy (p = 0.012); educational level and knowledge about link between pregnancy and periodontal diseases (p = 0.01); and economic status and use of auxiliary dental hygiene devices during pregnancy (p = 0.040). Pregnant women brushed their teeth regularly and visited dentist occasionally. Income was significantly associated with increase use of auxiliary dental hygiene devices. Educational level was significantly associated with mothers' knowledge about the need for consultation and possible link between pregnancy and periodontal diseases.
Description and Documentation of the Dental School Dental Delivery System.
ERIC Educational Resources Information Center
Chase, Rosen and Wallace, Inc., Alexandria, VA.
A study was undertaken to describe and document the dental school dental delivery system using an integrated systems approach. In late 1976 and early 1977, a team of systems analysts and dental consultants visited three dental schools to observe the delivery of dental services and patient flow and to interview administrative staff and faculty.…
Drummond, B K; Gaffney, M; Marshall, K
2016-12-01
Prior to the introduction of the Southern District Health Board's reconfigured Community Oral Health Service in Otago, a project was undertaken with parents to investigate their knowledge, understanding and views of the historical School Dental Service and of the Community Oral Health Service that was being introduced. Focus groups were run during 2011 in ten selected schools (parents with children in years 1-8) across two areas in Otago to represent ur ban and rural settings and to represent parents who were already travelling to dental services. Parents valued the traditional School Dental Service in Otago highly, generally agreeing that the service based in schools was accessible and convenient for parents and children. Rural parents who had always taken their children to dental appointments viewed it as a normal process, accepting that there could not be a service located in every school. Parents were aware that facilities were out-of-date. They highlighted the challenges of locating therapists since they started moving from school to school in the later 1990s and felt it was difficult for children seeing different therapists at each recall. There were diverse views on the proposed new system. Some parents felt that school-aged children should go to dental clinics on their own or with peers, while other parents welcomed the opportunity to attend when their child was having health care. It appears that the Community Oral Health Services should have an ongoing process to seek the views of parents and children about the service.
Arpalahti, I; Järvinen, M; Suni, J; Pienihäkkinen, K
2012-02-01
The aim of this study was to analyse how dental hygienists and in-service trained dental nurses accepted new health promotion programmes, how did they experience them in practice, and how did these programmes affect their attitudes to work. The subjects were all the dental hygienists and in-service trained dental nurses (n = 28) involved in health promotion of small children. Education and written instructions on two new programmes had been given to the professionals in two areas of Vantaa and those in the third area used the routine programme. The transtheoretical model (TTM) was selected as the theoretical framework for counselling. A structured questionnaire of 31-35 items was sent to all subjects. Independent samples Mann-Whitney U and Fisher's exact tests were used as statistical methods. The response rate was 89%. All respondents felt that the work they had carried out had always been important during their working career. Twenty-one of 25 respondents reported that the instructions and education were suitable for oral health promotion. The respondents within the new programmes felt they had advanced more as health professionals (P = 0.020) and acquired more confidence from the education (P = 0.018) compared with the routine programme. The new programmes for small children were well accepted by the dental hygienists and the in-service trained dental nurses, and the majority of them gained some new practices for their work. © 2011 John Wiley & Sons A/S.
Albert, David A; Sadowsky, Donald; Papapanou, Panos; Conicella, Mary L; Ward, Angela
2006-01-01
Background Chronic medical conditions have been associated with periodontal disease. This study examined if periodontal treatment can contribute to changes in overall risk and medical expenditures for three chronic conditions [Diabetes Mellitus (DM), Coronary Artery Disease (CAD), and Cerebrovascular Disease (CVD)]. Methods 116,306 enrollees participating in a preferred provider organization (PPO) insurance plan with continuous dental and medical coverage between January 1, 2001 and December 30, 2002, exhibiting one of three chronic conditions (DM, CAD, or CVD) were examined. This study was a population-based retrospective cohort study. Aggregate costs for medical services were used as a proxy for overall disease burden. The cost for medical care was measured in Per Member Per Month (PMPM) dollars by aggregating all medical expenditures by diagnoses that corresponded to the International Classification of Diseases, 9th Edition, (ICD-9) codebook. To control for differences in the overall disease burden of each group, a previously calculated retrospective risk score utilizing Symmetry Health Data Systems, Inc. Episode Risk Groups™ (ERGs) were utilized for DM, CAD or CVD diagnosis groups within distinct dental services groups including; periodontal treatment (periodontitis or gingivitis), dental maintenance services (DMS), other dental services, or to a no dental services group. The differences between group means were tested for statistical significance using log-transformed values of the individual total paid amounts. Results The DM, CAD and CVD condition groups who received periodontitis treatment incurred significantly higher PMPM medical costs than enrollees who received gingivitis treatment, DMS, other dental services, or no dental services (p < .001). DM, CAD, and CVD condition groups who received periodontitis treatment had significantly lower retrospective risk scores (ERGs) than enrollees who received gingivitis treatment, DMS, other dental services, or no dental services (p < .001). Conclusion This two-year retrospective examination of a large insurance company database revealed a possible association between periodontal treatment and PMPM medical costs. The findings suggest that periodontitis treatment (a proxy for the presence of periodontitis) has an impact on the PMPM medical costs for the three chronic conditions (DM, CAD, and CVD). Additional studies are indicated to examine if this relationship is maintained after adjusting for confounding factors such as smoking and SES. PMID:16914052
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/
Competence profiles in undergraduate dental education: a comparison between theory and reality.
Koole, Sebastiaan; Van Den Brulle, Shani; Christiaens, Véronique; Jacquet, Wolfgang; Cosyn, Jan; De Bruyn, Hugo
2017-07-11
Competence profiles are purposed to provide a blueprint in support to develop and/or benchmark the learning outcomes of undergraduate dental curricula. This study aims to investigate whether a competence profile as proposed by academic- and clinical experts is able to represent the real clinical reality. A questionnaire was developed including questions about gender and age, perception about required competences, and educational organisation and was distributed among Flemish dentists via email and on paper during a symposium. The data was analysed using descriptive statistics, Chi-square and non-parametric Mann-Whitney U-tests. A total of 312 questionnaires were completed (=6.5% of dentist population, with similar gender and age characteristics). All competences in the European competence profile were rated between 7.2 and 9.4 on a 10-point scale. In dentists under 50 years, females rated the importance of identifying/managing anxiety and abnormal patient behaviour; and promoting/improving oral health as significantly higher than males. In dentists of 50 years and above, females rated 8 competences significantly higher than males, including obtaining/recording a complete history; identifying/managing anxiety and abnormal patient behaviour; obtaining/interpreting radiography; identifying temporomandibular and associated disorders; identifying orthodontic needs; awareness of own limitations/when to refer; managing dental urgencies; and basic-life-support/defibrillation. Clinical practice management was most frequently reported as additional competence to address in dental education. Furthermore, the respondents suggested an undergraduate dental curriculum based on 34% theoretical education, 26% preclinical skills training, and 40% clinical education and 86% agreed with a duration of 5 years. Finally, the respondents also illustrated the dynamic nature of dentistry including a reduction of amalgam fillings, a shift from individual practice to group practices, an increased administrative load, and more assertive patients. Findings in the present study suggest the validation of the proposed competences for graduating European dentists within the clinical reality of dental professionals in daily practice. Nevertheless, the results have also demonstrated heterogeneity regarding gender and age within the dentist population and emphasised a continuously evolving dental profession and required competences. Hence, to maintain high quality of dental care, a strategy should be developed in which dental curricula are continuously benchmarked against an evolving clinical reality.
The funding of community health center dental programs in California.
Hilton, Irene V
2009-05-01
The financing of dental services in community health centers, CHCs, is a mystery to most dentists in private practice, and this lack of knowledge has resulted in misconceptions that hamper mutual support. This review seeks to explain and demystify how CHC dental clinics remain financially viable. The mechanisms of financing dental care in CHCs are described including types of revenues received, financing constraints unique to CHCs and how services to indigent patients are funded.
Norderyd, Johanna; Faulks, Denise; Molina, Gustavo; Granlund, Mats; Klingberg, Gunilla
2018-01-01
The UN Convention on the Rights of the Child gives all children right to the highest standard of services for treatment and rehabilitation. For children with disabilities, sedation and general anaesthesia (GA) are often indicated for dental treatment; however, accessibility to this varies. The International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) enables a biopsychosocial description of children undergoing dental treatment. To investigate conscious sedation and GA in children with complex disabilities and manifest caries and analyse how caries, child functioning, and dental service organisation relate to dental GA (DGA), comparing Argentina, France, and Sweden using the ICF-CY. Quantitative, cross-sectional; data collected through structured interviews, observation, and dental records. Sedation and DGA were common. Children with limitations in interpersonal interactions and relationships were more likely to have had DGA (OR: 5.3, P = 0.015). Level of caries experience was strongly correlated with experience of DGA. There were significant differences between countries regarding caries prevalence, sedation, DGA, and functional and environmental factors. Although caries experience and child functioning are important, dental health service organisation had the most impact on the incidence of DGA, and for the use of conscious sedation, for children with complex disabilities. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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.
The types and management of dental trauma during military service in Finland.
Antikainen, Atte; Patinen, Pertti; Päkkilä, Jari; Tjäderhane, Leo; Anttonen, Vuokko
2018-04-01
All Finnish males must attend compulsory military service that lasts from 6 months to 1 year. About 25 000 males (approximately 80% of each age cohort) and 400 volunteer females complete the service annually. The aim of the study was to investigate the types of dental trauma occurring among Finnish conscripts during their military service. The article also focused on how dental trauma is treated in the Finnish Defence Forces. All dental records in the Defence Forces' patient register concerning dental trauma during the years 2011 and 2012 were analysed by tooth number, treatment procedures and number of visits. According to the patient register, 361 conscripts suffered an oral trauma during their military service; thus, the average annual incidence was 7.2 trauma per 1000 conscripts. A total of 483 teeth were traumatized in the 2-year period. The most frequently traumatized teeth were the maxillary central incisors (61%), and the most common findings were enamel or enamel-dentin fractures (63% of all findings). Severe trauma was not common, and the most severe ones occurred during off-duty hours. The most common treatment was direct filling (n = 189 patients). Only 53 patients had soft tissue injuries (bruises, wounds). Among patients with dental trauma, the mean number of visits to the Defence Forces' dental clinic was 1.9. Great variation exists in recording findings concerning dental and oral trauma. Minor trauma is common. In all cases, recording trauma and treatments should be performed carefully. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Baldani, Marcia Helena; Mendes, Yasmine Bittencourt Emílio; Lawder, Juliana Aparecida de Campos; de Lara, Ana Paula Ingles; Rodrigues, Michelli Marta Azevedo da Silva; Antunes, Jose Leopoldo Ferreira
2011-01-01
To assess the role of the individual determinants on the inequalities of dental services utilization among low-income children living in the working area of Brazilian's federal Primary Health Care program, which is called Family Health Program (FHP), in a big city in Southern Brazil. A cross-sectional population-based study was performed. The sample included 350 children, ages 0 to 14 years, whose parents answered a questionnaire about their socioeconomic conditions, perceived needs, oral hygiene habits, and access to dental services. The data analysis was performed according to a conceptual framework based on Andersen's behavioral model of health services use. Multivariate models of logistic regression analysis instructed the hypothesis on covariates for never having had a dental visit. Thirty one percent of the surveyed children had never had a dental visit. In the bivariate analysis, higher proportion of children who had never had a dental visit was found among the very young, those with inadequate oral hygiene habits, those without perceived need of dental care, and those whose family homes were under absent ownership. The mechanisms of social support showed to be important enabling factors: children attending schools/kindergartens and being regularly monitored by the FHP teams had higher odds of having gone to the dentist, even after adjusting for socioeconomic, demographic, and need variables. The conceptual framework has confirmed the presence of social and psychosocial inequalities on the utilization pattern of dental services for low-income children. The individual determinants seem to be important predictors of access.
[Race and the use of dental health services by the elderly].
Souza, Eliane Helena Alvim de; Oliveira, Pierre Andrade Pereira de; Paegle, Ana Claudia; Goes, Paulo Sávio Angeiras de
2012-08-01
We analyze if race can be considered a limiting factor in the use of dental services by the elderly. This study is of an analytical nature, with the use of secondary data collected by the National Survey of Oral Health in 2003. Those examined who declared themselves as being white, brown or black in the 65 to 74-year-old age bracket were included. The sample was composed of 5,108 elderly people: 2,575 whites and 2,533 blacks. Of the whites, 3.8% stated that they had never been to the dentist, while this figure was 7.8% for the blacks. Even after the adjustment for interception for prosthetics and dental pain, the chance of elderly blacks not having used dental services at least once in their life is 0.62 OR less than for elderly whites. Of those who used the services, 21.2% of the elderly whites visited the dentist in the last year, while for elderly blacks the figure was 14.2%, in the adjusted model for interception for prosthetics and dental pain the OR was 0.60. All the relations were statistically significant (p<0,001). Race is a limiting factor in the use of dental services by the elderly and even after the adjustments the elderly blacks continue to manifest greater resistance to the use of oral health services.
NASA Astrophysics Data System (ADS)
Shimura, Akitoshi; Aizono, Takeiki; Hiraiwa, Masashi; Sugano, Shigeki
A QoS management technique based on an autonomous decentralized mobility system, which is an autonomous decentralized system enhanced to provide mobile stations with information about urgent roadway situations, is proposed in this paper. This technique enables urgent messages to be flexibly and quickly transmitted to mobile stations by multiple decentralized base stations using dedicated short range communication. It also supports the easy addition of additional base stations. Each station autonomously creates information-delivery communities based on the urgency of the messages it receives through the roadside network and the distances between the senders and receivers. Each station dynamically determines the urgency of messages according to the message content and the speed of the mobile stations. Evaluation of this technique applied to the Smart Gateway system, which provides driving-assistance services to mobile stations through dedicated short-range communication, demonstrated its effectiveness and that it is suitable for actual systems.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false VA Dental Insurance..., Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.169 VA Dental... Dental Insurance Program (VADIP) provides premium-based dental insurance coverage through which...
Code of Federal Regulations, 2014 CFR
2014-07-01
... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false VA Dental Insurance..., Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.169 VA Dental... Dental Insurance Program (VADIP) provides premium-based dental insurance coverage through which...
Dissatisfaction with the dental services and associated factors among adults.
Roberto, Luana Leal; Martins, Andréa Maria Eleutério de Barros Lima; Paula, Alfredo Maurício Batista de; Ferreira, Efigênia Ferreira E; Haikal, Desirée Sant' Ana
2017-05-01
This study aimed to identify factors associated with dissatisfaction with dental services among adults. It analyzed 830 adult participants of an epidemiological survey of oral health. The dependent variable was dissatisfaction with the dental service, and the independent ones were selected according to the theoretical model set forth by Andersen and Davidson (1997). Estimates were corrected by the sample design effect, and Binary Logistic Regression was carried out. It was found that about 11% of adults were dissatisfied with the dental service. In the final model, dissatisfaction with dental services was lower among older adults (OR = 0.559) and among smokers (OR = 0.332). On the other hand, it was higher among adults who self-perceived their chewing as negative (OR = 2,804), who self-perceived some discomfort in the mouth and head and neck region (OR = 2.065), and among those who did not have access to information on how to avoid oral problems (OR = 3.020). Therefore, the services need to access the perceptions and expectations expressed by users, and provide information in appropriate quantity and quality, in the context of "health literacy" in order to achieve greater satisfaction among its users.
Navy Dental Corps: ninety years ... and forward.
Woofter, Dennis D; Peters, Andrew; Kvaska, Greg; Turner, Carol I; Peters, Robert J; Shaffer, Richard G; Sobocinski, Andre B
2003-01-01
The Navy Dental Corps is responsible for ensuring the readiness of America's sailors and marines and optimizing their oral health. This article traces the history from the 1912 Act of Congress authorizing thirty "assistant dental surgeons" as the first Navy Dental Corps through service around the world. Navy dentists have seen service in every war and action in the past ninety years, reaching a peak of seven thousand officers and eleven thousand technicians in World War II. The Navy Dental Corps has served in the Korean and Vietnam Wars, Beirut, Somalia, Haiti, 9/11, Desert Storm, Desert Shield, and Operation Iraqi Freedom.
Economic models for prevention: making a system work for patients
2015-01-01
The purpose of this article is to describe alternative means of providing patient centered, preventive based, services using an alternative non-profit, economic model. Hard to reach, vulnerable groups, including children, adults and elders, often have difficulties accessing traditional dental services for a number of reasons, including economic barriers. By partnering with community organizations that serve these groups, collaborative services and new opportunities for access are provided. The concept of a dental home is well accepted as a means of providing care, and, for these groups, provision of such services within community settings provides a sustainable means of delivery. Dental homes provided through community partnerships can deliver evidence based dental care, focused on a preventive model to achieve and maintain oral health. By using a non-profit model, the entire dental team is provided with incentives to deliver measurable quality improvements in care, rather than a more traditional focus on volume of activity alone. Examples are provided that demonstrate how integrated oral health services can deliver improved health outcomes with the potential to reduce total costs while improving quality. PMID:26391814
Christensen Brydges, Sarah; Gwozdek, Anne E
2011-01-01
The Boys & Girls Club of America (BGCA) requires a health curriculum be taught. With the assistance of the University of Michigan (UM) Dental Hygiene program, these requirements have been addressed at the Huron Valley Boys & Girls Club (HVBGC) through dental hygiene students presenting oral health education to club members throughout the year. This study assessed the outcomes and benefits of the service learning initiative between the UM Dental Hygiene Program and the HVBGC from both the students' and staffs' perceptions. Three surveys were distributed: one to the HVBGC staff, one to UM's Dental Hygiene class of 2012 (with no service learning experience at the HVBGC) and one to UM Dental Hygiene classes of 2010 and 2011 (most of whom had experience at the HVBGC). Qualitative and quantitative data were collected and evaluated. The respondents from the class of 2012 were less knowledgeable about the BGCA and access to care issues. The members of the classes of 2010 and 2011, 79% of whom had HVBGC experience, identified they had benefitted from this service learning experience. The HVBGC staff survey indicated a high level of satisfaction with the student presentations and felt their curricular requirements were being met. Future topics of safety, orthodontics and gardening/nutrition were identified. This study indicates the service learning initiative has been beneficial for both the UM Dental Hygiene students and the HVBGC. Future studies should use a longitudinal design to obtain baseline and post-service learning data.
Ergonomic design for dental offices.
Ahearn, David J; Sanders, Martha J; Turcotte, Claudia
2010-01-01
The increasing complexity of the dental office environment influences productivity and workflow for dental clinicians. Advances in technology, and with it the range of products needed to provide services, have led to sprawl in operatory setups and the potential for awkward postures for dental clinicians during the delivery of oral health services. Although ergonomics often addresses the prevention of musculoskeletal disorders for specific populations of workers, concepts of workflow and productivity are integral to improved practice in work environments. This article provides suggestions for improving workflow and productivity for dental clinicians. The article applies ergonomic principles to dental practice issues such as equipment and supply management, office design, and workflow management. Implications for improved ergonomic processes and future research are explored.
Ju, Xiangqun; Spencer, A John; Brennan, David S
2017-06-01
To examine age, period and cohort factors of dentists in relation to diagnostic, preventive and total dental services over time in Australia. The Longitudinal Study of Dentists' Practice Activity (LSDPA) was designed to monitor dental practice activity and service provision in Australia. Participating dentists were sampled randomly from the dental registers in Australia from 1983 to 1984, and dental services provision was collected by mailed questionnaire with a log of dental services provided over one or two typical days. The data collection has been repeated every 5 years until 2009-2010. Sample supplementation of newly registered dentists occurred at successive waves. This study focused on diagnostic, preventive and total services. The time trends in the mean rates of the services were described using a standard cohort table, and negative binomial regression was applied to estimate age, period and cohort effects. The response rates were 73%, 75%, 74%, 71%, 76% and 67% in 1983, 1988, 1993, 1998, 2003 and 2009, respectively. The mean rates of diagnostic, preventive and total services increased between 1983 and 2009 across all age groups. The period effect showed a higher rate of diagnostic (rate ratios [RR]: 1.21 in 1993 to 1.80 in 2009), preventive (RR: 1.19 in 1988 to 1.85 in 2009) and the total service (RR: 1.08 in 1988 to 1.39 in 2009) over time, compared with the reference group of 1983. Older cohorts had a lower rate, and the younger cohorts had a higher rate of diagnostic, preventive and the total number of services over the study period. The highest rate of diagnostic (RR=2.53), preventive (RR=2.44) and the total service (RR=1.52) was in those aged 25-29 years in 1983 compared with the reference group of 30-34 years in 1983. Trends in dental services provision can be associated with age, period and cohort effects. The study found the rate of diagnostic, preventive and total services increased over time. Meanwhile, an increasing rate of diagnostic, preventive and the total services was observed when moving from older cohorts to younger cohorts among Australian dentists suggesting a sustained shift towards these services into the future. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Brief report: personality correlates of susceptibility to peer influence in adolescence.
Stautz, Kaidy; Cooper, Andrew
2014-06-01
Adolescents show a heightened susceptibility to peer influence compared to adults. Individual differences in this susceptibility exist, yet there has been little effort to link these with broader personality processes. Reward sensitivity and impulsive behaviour are also heightened in adolescence and could affect the tendency to be influenced by peers. This study examined associations between self-reported resistance to peer influence, facets of reward sensitivity and impulsivity, and subjective social status in a sample of 269 British sixth form students (mean age 16.79). Multiple regression analyses showed that negative and positive urgency were significantly negatively associated with resistance to peer influence. The relationship between negative urgency and resistance was moderated by subjective social status, such that individuals reporting low status showed a stronger negative relationship. Results suggest that a susceptibility to peer influence is linked with a tendency to act impulsively when in heightened emotional states. Adolescents high in negative urgency who feel lower in their social hierarchy may be particularly vulnerable. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Brokmann, Jörg C; Rossaint, Rolf; Müller, Michael; Fitzner, Christina; Villa, Luigi; Beckers, Stefan K; Bergrath, Sebastian
2017-07-01
Prehospital hypertensive emergencies and urgencies are common, but evidence is lacking. Telemedically supported hypertensive emergencies and urgencies were prospectively collected (April 2014-March 2015) and compared retrospectively with a historical control group of on-scene physician care in the emergency medical service of Aachen, Germany. Blood pressure management and guideline adherence were evaluated. Telemedical (n=159) vs conventional (n=172) cases: blood pressure reductions of 35±24 mm Hg vs 44±23 mm Hg revealed a group effect adjusted for baseline differences (P=.0006). Blood pressure management in categories: no reduction 6 vs 0 (P=.0121); reduction ≤25% (recommended range) 113 vs 110 patients (P=.2356); reduction >25% to 30% 13 vs 29 (0.020); reduction >30% 12 vs 16 patients (P=.5608). The telemedical approach led to less pronounced blood pressure reductions and a tendency to improved guideline adherence. Telemedically guided antihypertensive care may be an alternative to conventional care especially for potentially underserved areas. ©2017 Wiley Periodicals, Inc.
Hogan, Dianna; Arthaud, Greg; Goodman, Iris; Pattison, Malka; Sayre, Roger G.; Shapiro, Carl; Van Horne, Bea
2009-01-01
The production, location, use, and value of ecosystem services have become an important factor in resource management. Decisions relating to resource conservation and restoration, as well as development, require an understanding of the services provided by natural systems and the response of these systems to natural and human-induced change. Increased demands for development and the resulting pressures on ecosystem services have lent urgency to the need for an improved understanding of the value of natural capital. However, resource management decisions are often made without considering the importance and value of services resulting from natural systems.
Periodontal conditions and service utilization behaviors in a low income adult population.
Hanson, Wesley L; Persson, G Rutger
2003-01-01
Dental services utilization varies and access to periodontal therapy is not uniform. The objectives were to study an adult population of Medicaid eligible subjects in the Kitsap County, State of Washington, USA: (1) to assess their oral health status, specifically periodontal conditions, and (2) to assess their use of dental services and behavioral beliefs in relation to dental diseases. 1500 randomly selected eligible households were invited to a cost-free dental examination. The Periodontal Screening and Recording (PSR) index and six bitewing x-ray films were obtained. Subjects responded to a service utilization questionnaire. A telephone interview was performed with 100 randomly selected eligible subjects to assess their behavioral beliefs about dentistry. 132 (8.8%) of the contacted subjects responded while only 4.5% came to the clinical examination. The mean age of the subjects was 35.0 years (S.D. +/- 13.6, range 18 to 78 years) and 73.4% were women. Bleeding on probing was found in 82.8%, and 7.8% of the subjects had teeth with suppurating gingival conditions. Supra, or sub-gingival calculus could be identified in 95.3% of the subjects. Probing depths > 5.5 mm (not accounting for surfaces of third molars) were found in 11.3%, and radiographic evidence of vertical defects > or = 3 mm in 47% of the subjects. Tooth decay in need of urgent dental care was found in 75% of the subjects. Cost (63.2%) and lack of dental insurance (51.3%) were primary factors for not seeking care but 48.7% had no desire to enroll in a "no cost" dental therapy program. Dental fear was an obstacle to care in only 2.6% of the subjects. Primary barriers to the utilization of dental services in low income, uninsured populations were: (1) a pre-occupation with other daily issues, financial being the greatest, (2) an attitude of waiting for a problem to occur before seeking dental care, (3) that tooth extraction is the solution or only available treatment option.
Matos, D L; Lima-Costa, M F; Guerra, H L; Marcenes, W
2001-01-01
A cross-sectional study was conducted in Bambuí, Minas Gerais, to identify factors associated with regular use of dental services. Participants were interviewed with a structured questionnaire and previously validated questions. 999/1,221 (81.8%) randomly selected individuals aged > 18 years participated in the Bambuí dental survey. Of these, 654 out of 656 individuals who had at least one natural tooth and had visited a dentist during their lifetime participated in the study. Results adjusted by multiple logistic regression showed that regular use of dental services was significantly related to having > 8 and 4-7 years of schooling (OR = 9.90; 95% CI = 2.90-33.77 and OR = 3.87; 95% CI = 1.11-13.51, respectively), having a preference for restorative treatment rather than extraction (OR = 4.91; 95% CI = 2.23-10.79), having no present need of dental treatment (OR = 4.87; 95% CI = 3.17-7.49), and belief that visiting the dentist prevents tooth decay and gum disease (OR = 1.73; 95% CI = 1.13-2.65). The results show that regular use of dental services was related to factors distributed in the Andersen and Newman model (1973) explaining use of dentistry services.
Survey of dental radiographic services in private dental clinics in Damascus, Syria.
Salti, L; Whaites, E J
2002-03-01
To perform a radiographic survey of private dental clinics in Damascus, Syria using a postal questionnaire to produce recommendations for improving the quality of dental radiographic services and education in Syria. Three hundred private dental clinics in Damascus were surveyed using a postal questionnaire (in English and Arabic) containing 27 questions on demographic information, equipment, techniques, selection criteria, frequency of examinations, and undergraduate/ postgraduate education. Two hundred and two (67%) dentists responded of which 95% graduated in Syria. The results showed a general lack of knowledge and understanding of dental radiography. Sixty four per cent did not know the kVp setting of their equipment, 73% used D-speed film, 57% did not use film holders and beam aiming devices, 25% did not use a viewing box. In addition, 45% of known equipment operated at 50 kVp or less and 16% was over 20 years old. No meaningful selection criteria existed with a wide variation in type and frequency of radiographs used for different clinical conditions. Syrian undergraduate training in dental radiology was minimal and there was no postgraduate education in the speciality. Several areas of the radiographic service in Damascus fall short of current recommendations on good practice. Recommendations are made to improve the service, the quality of undergraduate education and to establish postgraduate education.
Dentistry and dental education in the context of the evolving health care system.
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.
Dental care of autistic children within the non-specialized Public Dental Service.
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.
Managing pediatric dental trauma in a hospital emergency department.
Mitchell, Jonathan; Sheller, Barbara; Velan, Elizabeth; Caglar, Derya; Scott, Joanna
2014-01-01
The purpose of this study was to: (1) examine types of dental trauma presenting to a hospital emergency department (ED); (2) describe the medical services provided to these patients; and (3) quantify time spent during ED encounters for dental trauma emergencies. Records of 265 patients who presented to the ED with dental trauma over a three-year period were reviewed. Demographics, injury types, triage acuity, pain scores, and dental/medical treatment and times were analyzed. Patient demographics and injury types were similar to previous studies. Eighty-two percent of patients received mid-level triage scores; 41 percent of patients had moderate to severe pain. The most frequently provided medical services were administration of analgesics and/or prescriptions (78 percent). The mean times were: 51 minutes waiting for a physician; 55 minutes with dentists; and 176 minutes total time. Higher triage acuity and pain levels resulted in significantly longer wait times for physician assessment. Dental evaluation, including treatment, averaged 32 percent of time spent at the hospital. A dental clinic is the most efficient venue for treating routine dental trauma. Patients in this study spent the majority of time waiting for physicians and receiving nondental services. Most patients required no medical intervention beyond prescriptions commonly used in dental practice.
Milsom, K; Tickle, M; Jenner, A; Moulding, G
1999-01-09
To clarify the function of the school based dental inspection. For representatives of the Community Dental Service, General Dental Service and Hospital Dental Service to identify an agreed set of criteria for the referral of children following school dental inspection. Qualitative research methodology used to establish a consensus for the inclusion of referral criteria following dental screening. Ellesmere Port, Cheshire, England. A Delphi technique was used to establish a consensus amongst the study participants on the inclusion of nine possible criteria for referral following dental screening. All participants scored each criterion in the range 1-9, with a score of 1 indicating that referral of individuals with the condition should definitely not take place, and a score of 9 indicating referral should definitely take place. Referral criteria were accepted only if they achieved a group median score of 7 or more, with an interquartile range of three scale points, with the lower value being no less than 7. Four of the nine possible criteria met the agreed group standard for inclusion: 'Sepsis', 'Caries in the secondary dentition', 'Overjet > 10 mm', and 'Registered & caries in the permanent dentition'. It is possible to agree clear criteria for the referral of children following the school dental inspection.
Pervez, Anushey; Kinney, Janet S; Gwozdek, Anne; Farrell, Christine M; Inglehart, Marita R
2016-09-01
In 2005, Public Act No. 161 (PA 161) was passed in Michigan, allowing dental hygienists to practice in approved public dental prevention programs to provide services for underserved populations while utilizing a collaborative agreement with a supervising dentist. The aims of this study were to assess how well dental and dental hygiene students and faculty members and practicing dental hygienists have been educated about PA 161, what attitudes and knowledge about the act they have, and how interested they are in additional education about it. University of Michigan dental and dental hygiene students and faculty members, students in other Michigan dental hygiene programs, and dental hygienists in the state were surveyed. Respondents (response rate) were 160 dental students (50%), 63 dental hygiene students (82%), 30 dental faculty members (26%), and 12 dental hygiene faculty members (52%) at the University of Michigan; 143 dental hygiene students in other programs (20%); and 95 members of the Michigan Dental Hygienists' Association (10%). The results showed that the dental students were less educated about PA 161 than the dental hygiene students, and the dental faculty members were less informed than the dental hygiene faculty members and dental hygienists. Responding dental hygiene faculty members and dental hygienists had more positive attitudes about PA 161 than did the students and dental faculty members. Most of the dental hygiene faculty members and dental hygienists knew a person providing services in a PA 161 program. Most dental hygiene students, faculty members, and dental hygienists wanted more education about PA 161. Overall, the better educated about the program the respondents were, the more positive their attitudes, and the more interested they were in learning more.
1992-12-31
procedure codes 9973 and 9974), and the unit cost to the Fort Sam Houston DENTAC ($.79). Expenditures on dental handpieces were estimated using the guidance...life span after which it is due for replacement. The effects of steam sterilization on dental handpieces decreases their life span substantially... handpieces should be sterilized between patients. ADA 18 May, 1992. 12. Reddy, T.G. Director, Dental Services, US Army Health Services Command
ERIC Educational Resources Information Center
Iritani, Katherine M.
2009-01-01
In this statement, Katherine M. Iritani, Acting Director, Health Care reports that dental disease remains a significant problem for children in Medicaid. Although dental services are a mandatory benefit for the 30 million children served by Medicaid, these children often experience elevated levels of dental problems and have difficulty finding…
Current Topics and Trends in Military Dental Research: A Tri-Service Panel Discussion
2016-05-09
59 MDW/SGVU SUBJECT: Professional Presentation Approval 9MAY2016 1. Your paper, entitled Current Topics and Trends in Military Dental Research: A...submitted for review and approval.) NIA 6. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED: CURRENT TOPICS AND TRENDS IN MJLITA RY DENTAL RESEARCH: A...Excellence 2 \\.J •:• Overview U.S. AIR FORCE • Current topics and trends in military dental research: A tri-service panel discussion • US Army/DTRD
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.
Following the drill: the search for a dentist.
Motes, W H; Huhmann, B A; Hill, C J
1995-01-01
The authors identify strategically useful distinctions between the activities of potential patients in search of specialized vs. routine dental services. Survey findings question the advisability of assuming (1) that what occurs in the search process for routine dental care will automatically be mirrored in the process for more specialized services and (2) that potential patients use the same specific sources of information--both between (e.g., physicians vs. dentists) and within (e.g., specialized dental care vs. routine dental care) existing health care typologies.
Shelley, A; Mackie, I
2001-10-01
This case study describes the management of Callum, an anxious 7-year-old boy with extensive caries. Callum's dental care was carried out in a general dental practice in the North of England under the terms of the National Health Service. A preventive programme was carried out in conjunction with the restorative philosophy according to guidelines published by the Dental Practice Board in 1997.
Dental data of the Athens 2004 Olympic and Paralympic Games.
Vougiouklakis, G; Tzoutzas, J; Farmakis, E-T; Farmakis, E-E; Antoniadou, M; Mitsea, A
2008-11-01
The Athens University, School of Dentistry, accepted the challenge to organize the Dental Health Services in the Athens 2004 Olympic and Paralympic Games in order to provide the best quality of oral health services to the athletes, coaches, escort members and Olympic Village personnel. Data from the whole activity protocol of the Athens 2004 Games Dental Health Services - the reception, admission and treatment protocols, the facilities and the infrastructure, the number of cases treated per specialty and the experience gained - were recorded. During the Olympic Games, there were more than 1400 dental cases in more than 650 patients, elite athletes, escort members, coaches and staff of the Olympic Village. Among them 313 fillings, 100 root canal therapies, 57 mouthguards and 9 dental trauma cases were treated. During the Paralympic Games, there were more than 240 dental cases in more than 220 patients. Among them 73 fillings, 12 root canal therapies, 21 extractions and 3 dental trauma cases were treated. In such events, highly trained dentists are needed and if possible, specialized in operative dentistry or endodontics. The role of team dentist seems to be of great importance.
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.
Dentists' partnership of Michigan's Calhoun County: a care model for uninsured populations.
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.
21 CFR 872.4920 - Dental electrosurgical unit and accessories.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental electrosurgical unit and accessories. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4920 Dental electrosurgical unit and accessories. (a) Identification. A dental electrosurgical unit and accessories is an AC-powered...
21 CFR 872.4920 - Dental electrosurgical unit and accessories.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Dental electrosurgical unit and accessories. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4920 Dental electrosurgical unit and accessories. (a) Identification. A dental electrosurgical unit and accessories is an AC-powered...
21 CFR 872.4920 - Dental electrosurgical unit and accessories.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Dental electrosurgical unit and accessories. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4920 Dental electrosurgical unit and accessories. (a) Identification. A dental electrosurgical unit and accessories is an AC-powered...
21 CFR 872.4920 - Dental electrosurgical unit and accessories.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Dental electrosurgical unit and accessories. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4920 Dental electrosurgical unit and accessories. (a) Identification. A dental electrosurgical unit and accessories is an AC-powered...
21 CFR 872.4920 - Dental electrosurgical unit and accessories.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Dental electrosurgical unit and accessories. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4920 Dental electrosurgical unit and accessories. (a) Identification. A dental electrosurgical unit and accessories is an AC-powered...
Maintenance of an Adequate Dental Hygiene Education System.
ERIC Educational Resources Information Center
Ley, Eugene; And Others
1984-01-01
Administrative decisions about the future of dental hygiene programs are often based on inadequate information about employment trends and about the importance of the dental hygienist in dental practices. Studies indicate that demand for dental hygiene services will remain high in the 1980s. (Author/MLW)
Holmes, Richard D; Steele, Jimmy G; Donaldson, Cam; Exley, Catherine
2015-09-01
The aim of this research was to explore and synthesise learning from stakeholders (NHS dentists, commissioners and patients) approximately five years on from the introduction of a new NHS dental contract in England. The case study involved a purposive sample of stakeholders associated with a former NHS Primary Care Trust (PCT) in the north of England. Semi-structured interviews were conducted with 8 commissioners of NHS dental services and 5 NHS general dental practitioners. Three focus group meetings were held with 14 NHS dental patients. All focus groups and interviews were audio recorded and transcribed verbatim. The data were analysed using a framework approach. Four themes were identified: 'commissioners' views of managing local NHS dental services'; 'the risks of commissioning for patient access'; 'costs, contract currency and commissioning constraints'; and 'local decision-making and future priorities'. Commissioners reported that much of their time was spent managing existing contracts rather than commissioning services. Patients were unclear about the NHS dental charge bands and dentists strongly criticised the contract's target-driven approach which was centred upon them generating 'units of dental activity'. NHS commissioners remained relatively constrained in their abilities to reallocate dental resources amongst contracts. The national focus upon practitioners achieving their units of dental activity appeared to outweigh interest in the quality of dental care provided. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Bahramian, Hoda; Mohebbi, Simin Z; Khami, Mohammad Reza; Quinonez, Rocio Beatriz
2018-05-10
Pregnant women are vulnerable to a wide range of oral health conditions that could be harmful to their own health and future child. Despite the usefulness of regular dental service utilization in prevention and early detection of oral diseases, it is notably low among pregnant women. In this qualitative study, we aimed to explore barriers and facilitators influencing pregnant women's dental service utilization. Using a triangulation approach, we included pregnant women (n = 22) from two public health centers, midwives (n = 8) and dentists (n = 12) from 12 other public centers in Tehran (Iran). Data was gathered through face-to-face semi-structured interviewing and focus group discussion methods. The analysis of qualitative data was performed using conventional content analysis with MAXQDA10 software. Reported barriers of dental service utilization among pregnant women were categorized under emerging themes: Lack of knowledge and misbelief, cost of dental care, physiological changes, fear and other psychological conditions, time constraint, dentists' unwillingness to accept pregnant women treatment, cultural taboos and lack of interprofessional collaboration. Solutions proposed by dentists, midwives and pregnant women to improve dental care utilization during pregnancy were categorized under three themes: Provision of knowledge, financial support and establishing supportive policies. Understanding perceived barriers of dental service utilization during pregnancy can serve as baseline information for planning and formulating appropriate oral health education, financial support, and legislations tailored for lower income pregnant women, midwives and dentists in countries with developing oral health care system.
Orrell, Catherine; Haberer, Jessica E.
2017-01-01
Introduction The purpose of this study is to understand engagement with and availability of dental services among people living with HIV in a low-income community of South Africa. Methods In depth qualitative interviewing was used to collect data, which was analyzed using an inductive content analytical approach. The study was conducted in Gugulethu, a township community located outside of Cape Town, South Africa. Local public sector health services provided free of charge are the main source of primary health and dental care for this population. Participants included South African adults (age 18–35) recently diagnosed with HIV who had a CD4 count >350 cells/mm3. Results Many participants had little to no experience with dental care, did not know which health care providers are appropriate to address oral health concerns, were not aware of available dental services, utilized home remedies to treat oral health problems, harbored many misperceptions of dental care, avoided dental services due to fear, and experienced poverty as a barrier to dental services. Conclusions Our findings suggest that integration of oral healthcare into medical care may increase patient knowledge about oral health and access to care. Leveraging the relatively robust HIV infrastructure to address oral disease may also be an effective approach to reaching these participants and those living in resource poor communities generally. PMID:29272290
Use of dental services by immigration status in the United States.
Wilson, Fernando A; Wang, Yang; Stimpson, Jim P; McFarland, Kimberly K; Singh, Karan P
2016-03-01
There is limited research with mixed findings comparing differences in oral health outcomes and the use of dental services by immigration status. The authors conducted a study by reviewing nationally representative data to describe differences in dental care among noncitizens, naturalized citizens, and US-born citizens in the United States. The authors used nationally representative data from the 2008-2012 Medical Expenditure Panel Survey to examine dental care for US-born citizens, naturalized citizens, and noncitizens 18 years and older. Total analytical sample size was 98,107 adults. They used multivariate logistic regression to model dental service use adjusting for confounding factors. Naturalized citizens and noncitizens were significantly less likely to have at least 1 dental visit within 12 months (39.5% and 23.1%, respectively) compared with US-born citizens (43.6%; P < .001). Among users, a smaller proportion of comprehensive examination visits were for naturalized citizens and noncitizens (75.9% and 71.4%, respectively) compared with US-born citizens (82.8%; P < .01). Noncitizen visits to dentists were also more likely to involve tooth extraction compared with those of US-born citizens (11.3% versus 8.8%; P < .01). Multivariate logistic regression suggests both non- and naturalized citizens had lower adjusted odds of having a comprehensive examination compared with US-born citizens during a visit (P < .01). Noncitizens and naturalized citizens had a lower rate of dental service use, and noncitizens were more likely to have had tooth extraction compared with US-born citizens. Increased outreach efforts tailored to noncitizens and naturalized citizens who are at high risk of experiencing dental problems are needed, particularly to address misperceptions on the necessity of preventive dental visits. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.
Petersen, Poul Erik; Kjøller, Mette; Christensen, Lisa Bøge; Krustrup, Ulla
2004-01-01
This study analyzes the current profile of dentate status and use of dental health services among adults in Denmark at the turn of the millennium, assesses the impact on dentate status of sociodemographic factors and use of dental health services in adulthood and in childhood, and highlights the changes over time in dental health conditions among adults. Finally, the intention of the study was to evaluate the Danish dental health care system's level of achievement of the official goals for the year 2000 as formulated by the World Health Organization and the National Board of Health. The subjects of this study included a national representative sample of 16,690 Danish citizens aged 16 years and older (response rate=74.2%). A subsample (n=3,818) took part in a survey of dental care habits in childhood and prevalence of removable dentures; 66 percent of persons selected responded. Personal interviews were used to collect information on dentate status, use of dental health services and living conditions; data on dental care habits in childhood and prevalence of removable dentures were collected by self-administered questionnaires. In all, 8 percent of interviewed persons were edentulous, while 80 percent had 20 or more natural teeth. At age 65-74 years, 27 percent were edentulous and 40 percent had 20 teeth or more; 58 percent wore removable dentures. Dentate status and prevalence of dentures were highly related to educational background and income, particularly for older age groups. Among persons interviewed, 80 percent paid regular dental visits and visits were most frequent among persons of high education and income. At age 35-44 years 95 percent had participated in regular dental care in childhood compared to 49 percent of 65-74-year-olds. Multivariate analyses revealed that sociobehavioral factors had significant effects on dentate status. Compared to similar studies carried out in 1987 and 1994, the present survey indicates a positive trend of improved dentate status in adult Danes in general and regular use of dental health services increased considerably over time. The WHO goals for better dental health by the year 2000 were achieved for 35-44-year-olds, whereas the goal of more people with functional dentitions at age 65 years or older was not achieved. It remains a challenge to the Danish dental health system to help even out the social inequalities in dental health.
2006-06-02
The Department is publishing this final rule to implement sections 711 and 715 of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (NDAA for FY05), Public Law 108-375. Specifically, that legislation makes young dependents of deceased Service members eligible for enrollment in the TRICARE Dental program when the child was not previously enrolled because of age, and authorizes post-graduate dental residents in a dental treatment facility of the uniformed services under a graduate dental education program accredited by the American Dental Association to provide dental treatment to dependents who are 12 years of age or younger and who are covered by a dental plan established under 10 U.S.C. 1076a. This adopts the interim rule published on September 21, 2005 (70 FR 55251).
The Life-and-Death Factor: Focus on Healthcare Facilities
ERIC Educational Resources Information Center
Dessoff, Alan
2009-01-01
With economic pressures restricting campus budgets and healthcare policy issues capturing national attention, facilities managers at university-affiliated hospitals and other healthcare entities say they feel more urgency than ever to provide cost-effective services to patients, providers, medical researchers, and students. Managing facilities at…
Pregnancy and oral health: utilisation of dental services during pregnancy in northern Greece.
Dinas, Konstantinos; Achyropoulos, Vassilios; Hatzipantelis, Emmanouel; Mavromatidis, Georgios; Zepiridis, Leonidas; Theodoridis, Theodoros; Dovas, Dimitrios; Tantanasis, Theoharis; Goutzioulis, Fotios; Bontis, John
2007-01-01
Recent studies have shown that gingivitis and periodontal infection during pregnancy represent an independent risk factor for pre-term birth. However, little is known about the prevalence and correlates of dental attendance during pregnancy. During the first 3 days postpartum, an anonymous questionnaire was administered to 425 women in order to explore their dental condition and utilisation of dental health services during pregnancy, as well as their perceptions on the potential associations between dental care during pregnancy and pregnancy outcomes. Almost half of the respondents (46.8%) reported symptoms of gingivitis during their pregnancy. Pregnancy gingivitis was independently associated with non-Greek ethnicity (p=0.008), multiparity versus primiparity (p<0.005), lower economic class versus middle and upper classes (p=0.001), and the lack of routine primary dental care (p=0.005). Some 27.3% reported a visit to the dentist during their pregnancy. The majority (72.2%) believed that dental treatment during pregnancy might have a negative affect on pregnancy outcome. The presence of pregnancy gingivitis and the belief that dental treatment during pregnancy is safe were both independently associated with visiting a dentist during pregnancy (p<0.0005 for both). Despite the increased prevalence of dental problems among pregnant women, few women seek dental services in this population, which can be primarily attributed to women's erroneous beliefs regarding the safety of dental examination. Therefore, there is an imperative need to offer oral health education and develop preventive programs for women of reproductive age.
Dental technology services and industry trends in New Zealand from 2010 to 2012.
Alameri, S S; Aarts, J M; Smith, M; Waddell, J N
2014-06-01
To provide a snapshot of the New Zealand dental technology industry and influencing factors. Developing an understanding of the commercial dental laboratory environment in New Zealand can provide insight into the entire dental industry. A web-based survey was the primary method for data collection, with separate questionnaires used for dental laboratory owners and dental technician employees. The mean net income for dental laboratory owners in New Zealand was similar to that of the United Kingdom, at $40.50 per hour. Clinical dental technicians are the highest paid employees, with a mean of $33.49 per hour. The mean technical charge for complete dentures was $632.59; including clinical services, it was $1907.00. The mean charge for a porcelain-fused-to-metal (PFM) crown was $290.27. Dental laboratory owners expressed fear about the possibility of losing dental clients to overseas laboratories due to the availability and cheap charge of offshore work. Only 25.4% of dental laboratories surveyed had computer-aided design (CAD) facilities, and even fewer (7.9%) had computer-aided manufacturing (CAM) systems. Clinical dental technology appears to be prospering. The dental technology industry appears to be adapting and remains viable, despite facing many challenges.
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 health care patterns in Sudan.
Oral health in children investigated by Social services on suspicion of child abuse and neglect.
Kvist, T; Annerbäck, E-M; Dahllöf, G
2018-02-01
Child abuse and neglect (CAN) are likely to have negative consequences on health; however, for oral health, studies on associated outcomes are sparse. The purpose of this study was to assess oral health and oral health behaviors in relation to suspected CAN among children being investigated by the Swedish Social Services. The material comprised data from the Social Services and dental records; the sample, 86 children and 172 matched controls. The children in the study group had a higher prevalence of dental caries than the control group; in addition, levels of non-attendance and dental avoidance were high, as was parental failure to promote good oral health. We found four factors that, taken together, indicated a high probability of being investigated because of suspected CAN: prevalence of dental caries in primary teeth, fillings in permanent teeth, dental health service avoidance, and referral to specialist pediatric dentistry clinics. If all four factors were present, the cumulative probability of being investigated was 0.918. In conclusion, there is a high prevalence of dental caries, irregular attendance, and a need for referral a pediatric dental clinic among Swedish children under investigation due to suspected CAN. Social context is an important factor in assessing the risk of developing dental caries, the inclination to follow treatment plans, and the prerequisites for cooperation during treatment. Routinely requesting dental records during an investigation would provide important information for social workers on parental skills and abilities to fulfill the basic needs of children. Copyright © 2017 Elsevier Ltd. All rights reserved.
Jang, Young-Eun; Kim, Chun-Bae; Kim, Nam-Hee
2017-01-01
Health insurance reduces the economic burden of diseases and enhances access to medical services. This study compared, among social classes, the utilization of preventive dental service before and after health insurance covered dental scaling. We analyzed time-series secondary data for 3 175 584 participants from 253 survey areas nationwide in the Community Health Survey (2009-2014) in Korea. The weighted proportion of participants who underwent dental scaling was defined as the scaling rate. Data regarding demographic and socioeconomic characteristics were collected. Scaling rates continuously increased over the 6-year period, particularly in 2014. College graduates had significantly higher scaling rates. Monthly income and scaling rate were positively related. Differences by education decreased over time. Differences by income were particularly high between 2012 and 2014. For women, the temporal rate was 2 times higher for professionals than for the unemployed. Despite increased dental scaling rates since the health coverage change in 2013, socioeconomic differences persist.
Trends in Dentistry and Dental Education.
ERIC Educational Resources Information Center
Valachovic, Richard W.; Weaver, Richard G.; Sinkford, Jeanne C.; Haden, N. Karl
2001-01-01
Compiled from many of the surveys that the American Dental Education Association routinely publishes, along with data from surveys conducted by the American Dental Association and U.S. Department of Health and Human Services, presents statistical tables and descriptive text on trends among dental patients, among dental practitioners, and in dental…
38 CFR 17.164 - Patient responsibility in making and keeping dental appointments.
Code of Federal Regulations, 2013 CFR
2013-07-01
... making and keeping dental appointments. 17.164 Section 17.164 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.164 Patient responsibility in making and keeping dental appointments. Any veteran eligible for dental treatment on a one-time completion basis only and...
38 CFR 17.164 - Patient responsibility in making and keeping dental appointments.
Code of Federal Regulations, 2010 CFR
2010-07-01
... making and keeping dental appointments. 17.164 Section 17.164 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.164 Patient responsibility in making and keeping dental appointments. Any veteran eligible for dental treatment on a one-time completion basis only and...
32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).
Code of Federal Regulations, 2013 CFR
2013-07-01
... 32 National Defense 2 2013-07-01 2013-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...
21 CFR 872.3070 - Dental amalgam, mercury, and amalgam alloy.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental amalgam, mercury, and amalgam alloy. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3070 Dental amalgam, mercury, and amalgam alloy. (a) Identification. Dental amalgam is a device that consists of a combination of...
38 CFR 17.164 - Patient responsibility in making and keeping dental appointments.
Code of Federal Regulations, 2012 CFR
2012-07-01
... making and keeping dental appointments. 17.164 Section 17.164 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.164 Patient responsibility in making and keeping dental appointments. Any veteran eligible for dental treatment on a one-time completion basis only and...
38 CFR 17.164 - Patient responsibility in making and keeping dental appointments.
Code of Federal Regulations, 2011 CFR
2011-07-01
... making and keeping dental appointments. 17.164 Section 17.164 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.164 Patient responsibility in making and keeping dental appointments. Any veteran eligible for dental treatment on a one-time completion basis only and...
32 CFR 732.16 - Emergency care requirements.
Code of Federal Regulations, 2010 CFR
2010-07-01
... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...
21 CFR 872.6390 - Dental floss.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental floss. 872.6390 Section 872.6390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6390 Dental floss. (a) Identification. Dental floss is a...
32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).
Code of Federal Regulations, 2012 CFR
2012-07-01
... 32 National Defense 2 2012-07-01 2012-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...
21 CFR 872.3070 - Dental amalgam, mercury, and amalgam alloy.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Dental amalgam, mercury, and amalgam alloy. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3070 Dental amalgam, mercury, and amalgam alloy. (a) Identification. Dental amalgam is a device that consists of a combination of...
21 CFR 872.6390 - Dental floss.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Dental floss. 872.6390 Section 872.6390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6390 Dental floss. (a) Identification. Dental floss is a...
21 CFR 872.6390 - Dental floss.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Dental floss. 872.6390 Section 872.6390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6390 Dental floss. (a) Identification. Dental floss is a...
21 CFR 872.3070 - Dental amalgam, mercury, and amalgam alloy.
Code of Federal Regulations, 2012 CFR
2012-04-01
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Dental amalgam, mercury, and amalgam alloy. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3070 Dental amalgam, mercury, and amalgam alloy. (a) Identification. Dental amalgam is a device that consists of a combination of...
21 CFR 872.3070 - Dental amalgam, mercury, and amalgam alloy.
Code of Federal Regulations, 2013 CFR
2013-04-01
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Dental amalgam, mercury, and amalgam alloy. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3070 Dental amalgam, mercury, and amalgam alloy. (a) Identification. Dental amalgam is a device that consists of a combination of...
32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).
Code of Federal Regulations, 2014 CFR
2014-07-01
... 32 National Defense 2 2014-07-01 2014-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...
32 CFR 732.16 - Emergency care requirements.
Code of Federal Regulations, 2013 CFR
2013-07-01
... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...
21 CFR 872.6390 - Dental floss.
Code of Federal Regulations, 2011 CFR
2011-04-01
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Dental floss. 872.6390 Section 872.6390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6390 Dental floss. (a) Identification. Dental floss is a...
21 CFR 872.6390 - Dental floss.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Dental floss. 872.6390 Section 872.6390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6390 Dental floss. (a) Identification. Dental floss is a...
38 CFR 17.164 - Patient responsibility in making and keeping dental appointments.
Code of Federal Regulations, 2014 CFR
2014-07-01
... making and keeping dental appointments. 17.164 Section 17.164 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.164 Patient responsibility in making and keeping dental appointments. Any veteran eligible for dental treatment on a one-time completion basis only and...
32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).
Code of Federal Regulations, 2011 CFR
2011-07-01
... 32 National Defense 2 2011-07-01 2011-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...
32 CFR 732.16 - Emergency care requirements.
Code of Federal Regulations, 2011 CFR
2011-07-01
... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...
32 CFR 732.16 - Emergency care requirements.
Code of Federal Regulations, 2012 CFR
2012-07-01
... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...
32 CFR 732.16 - Emergency care requirements.
Code of Federal Regulations, 2014 CFR
2014-07-01
... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...
21 CFR 872.3070 - Dental amalgam, mercury, and amalgam alloy.
Code of Federal Regulations, 2014 CFR
2014-04-01
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Dental amalgam, mercury, and amalgam alloy. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3070 Dental amalgam, mercury, and amalgam alloy. (a) Identification. Dental amalgam is a device that consists of a combination of...
32 CFR 199.22 - TRICARE Retiree Dental Program (TRDP).
Code of Federal Regulations, 2010 CFR
2010-07-01
... 32 National Defense 2 2010-07-01 2010-07-01 false TRICARE Retiree Dental Program (TRDP). 199.22... TRICARE Retiree Dental Program (TRDP). (a) Purpose. The TRDP is a premium based indemnity dental insurance... and capabilities of the Uniformed Services overseas dental treatment facilities and a particular...
Curi, Davi Silva Carvalho; Figueiredo, Andreia Cristina Leal; Jamelli, Silvia Regina
2018-05-01
This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.
Costs of a school-based dental mobile service in South Africa.
Molete, M P; Chola, L; Hofman, K J
2016-10-19
The burden of untreated tooth decay remains high and oral healthcare utilisation is low for the majority of children in South Africa. There is need for alternative methods of improving access to low cost oral healthcare. The mobile dental unit of the University of the Witwatersrand (Wits) has been operational for over 25 years, providing alternative oral healthcare to children and adults who otherwise would not have access. The aim of this study was to conduct a cost-analysis of a school based oral healthcare program in the Wits mobile dental unit. The objectives were to estimate the general costs of the school based program, costs of oral healthcare per patient and the economic implications of providing services at scale. In 2012, the Wits mobile dental unit embarked on a 5 month project to provide oral healthcare in four schools located around Johannesburg. Cost and service use data were retrospectively collected from the program records for the cost analysis, which was undertaken from a provider perspective. The costs considered included both financial and economic costs. Capital costs were annualised and discounted at 6 %. One way sensitivity tests were conducted for uncertain parameters. The total economic costs were R813.701 (US$76,048). The cost of screening and treatment per patient were R331 (US$31) and R743 (US$69) respectively. Furthermore, fissure sealants cost the least out of the treatments provided. The sensitivity analysis indicated that the Wits mobile dental unit was cost efficient at 25 % allocation of staff time and that a Dental Therapy led service could save costs by 9.1 %. Expanding the services to a wider population of children and utilising Dental Therapists as key personnel could improve the efficiency of mobile dental healthcare provision.
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. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Jawad, Mohammed; Ingram, Sam; Choudhury, Imran; Airebamen, Anne; Christodoulou, Kostakis; Wilson Sharma, Amanda
2016-07-20
This study aimed to evaluate whether television-based dental health promotion initiatives in General Practice waiting rooms would increase patients' knowledge of and intentions to seek dental services. This cross-sectional survey of 2,345 patients attending 49 General Practices in Brent, northwest London, evaluated the 'Life Channel' - a series of six brief health promotion advertisements, including one dental health promotion advertisement, displayed over ten minutes on television in General Practice waiting rooms. Primary outcome measures were a self-reported gain in the knowledge to contact a National Health Service (NHS) and emergency dentist, and an intention to seek dental services, attributed to viewing the Life Channel. Among the 1,088 patients who did not know how to contact an NHS dentist prior to the survey, and the 1,247 patients who did not know how to contact an emergency dentist prior to the survey, 48.0 % (95 % CI 45.0-51.0 %) and 35.1 % (95 % CI 32.4-37.8 %) attributed the Life Channel to educating them how to do so, respectively. Among the 1,605 patients who did not have any intention to contact a dentist prior to the survey, 15.2 % (95 % CI 13.4-17.0 %) attributed the Life Channel to creating such an intention. We report adjusted odds ratios on sociodemographic disparities in this evaluation. Television-based dental health promotion may significantly increase knowledge of and intention to seek dental services in this sample in London. Television-based dental health promotion may appeal more to certain population groups. More research is needed to identify longer term outcomes of television-based health promotion.
Dental attendance among adult Finns after a major oral health care reform.
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/S. Published by John Wiley & Sons Ltd.
Simmer-Beck, M; Gadbury-Amyot, C; Williams, K B; Keselyak, N T; Branson, B; Mitchell, T V
2013-11-01
Academic service learning (ASL) provides the venue for dental hygiene education to take oral healthcare services directly into communities while at the same time promoting professional responsibility within the student bodies. The purpose of this study was to quantitatively examine the change in pre-existing attitudes and behaviours of dental hygiene students following the incorporation of ASL activities throughout a five-semester dental hygiene curriculum. Seventy-seven first-year dental hygiene students who participated in ASL from the graduating classes of 2008-2010 participated in the study. A survey instrument developed by Shiarella, based on Schwartz's Helping Behaviors Model, was used to assess students' attitudes towards community service. Additionally, questions were developed using Shinnamon's Methods and Strategies for Assessing Service-Learning in the Health Professions. Internal estimates of reliability for scales (Cronbach's α) were all >0.8. The results revealed statistically significant improvements over time in enhanced learning (P = 0.0001), self-awareness (P = 0.0001), sense of volunteerism (P = 0.013), impact on career choices (P = 0.001) and decrease in personal costs (P = 0.0001). There were no significant changes in other subscales over time. Further investigating these domains revealed minimal to no changes in attributes of service learning. Service learning integrated into the dental hygiene curriculum can enhance learning and improve students' self-awareness, sense of volunteerism, career choices and perception of personal costs. In concert with the literature on ASL, these experiences throughout the curriculum have potential for increasing students' awareness of community need and their roles as oral health professionals. © 2013 John Wiley & Sons A/S.
Barriers to dental care for children in Virginia with autism spectrum disorders.
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.
Maxey, Hannah L; Farrell, Christine; Gwozdek, Anne
2017-09-01
The health care system is undergoing transformation in which oral health is not only valued as an aspect of overall health, but health care delivery systems are aligning to better deliver total patient care. As a result of this transformation, education for many non-dental professionals incorporates oral health content to prepare them to practice in comprehensive delivery models. While some non-dental professionals already incorporate oral health care in their service, many opportunities exist for expansion of oral health care delivery by other non-dental professionals, including radiologic technicians, nursing staff, and human services professionals. As non-dental professionals take on expanded roles in oral health care, the dental hygiene workforce must be prepared to practice in settings with new types of professionals. Dental hygiene curricula should prioritize interprofessional education to best prepare these students for practice in evolved delivery models. This article was written as part of the project "Advancing Dental Education in the 21 st Century."
Martins, Andréa Maria Eleutério de Barros Lima; Jardim, Lorena Amaral; Souza, João Gabriel Silva; Rodrigues, Carlos Alberto Quintão; Ferreira, Raquel Conceição; Pordeus, Isabela Almeida
2014-01-01
This study aimed at identifying the prevalence of the negative evaluation of dental services among elderly Brazilians and at investigating whether the prevalence was higher among those using public or philanthropic provider services than among those paying privately or using private health plans. Additionally, factors associated with this negative assessment were identified. Interview and survey data were collected in the residences of participants by trained and calibrated examiners as part of a national epidemiological survey of oral health conditions of the Brazilian population in 2002/2003. The dependent variable was obtained in response to questions regarding whether the participant had ever used dental services, the frequency of use, and the quality of this service. Potential responses to the questions regarding the quality of service were very poor or poor, fair, and good or very good. The main independent variable was the system of health care used with potential responses being health plan or private, public, and philanthropic services. We conducted univariate (linear tendency χ2 test) and multiple descriptive analyses, and the partial proportional Odds model for ordinal logistic regression. Among the elderly, 196 (3.7%) evaluated the provided services negatively (very poor or poor). Participants with the following responses were more likely to evaluate the services negatively: those who had used public or philanthropic services, men, those with higher education, the ones who had not received information about preventing dental problems, those who perceived pain in their teeth and gums in the last six months, and those who self-reported their oral health and speech was poor. In conclusion, elderly Brazilian users of public and philanthropic services were more likely than users of private or insurance-based plans to evaluate their dental services negatively, regardless of the other investigated variables.
How Medicare Could Provide Dental, Vision, and Hearing Care for Beneficiaries.
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.
Tiller, S; Wilson, K I; Gallagher, J E
2001-09-01
To investigate the oral health status of adults on Sheffield's Learning Disability Case Register, and their reported use of dental services. A short questionnaire interview of subjects with learning disabilities or their carers followed by a standardised epidemiological examination, by one trained and calibrated examiner. Residential homes, day centres or community homes of people with learning disabilities in Sheffield. A 20% random sample of adults (18-65 years) on the register. A response rate of 209 (67%) was achieved, 62% (n=130) of whom were living in the community. People living in residential care were significantly older (43.2 years) than those based in the community (36.3 years) (P<0.05). Both groups had similar mean DMFT scores; however, adults living in the community had significantly more untreated decay (DT = 1.6) and poorer oral hygiene than their counterparts in residential care (DT = 0.7). Adults in residential care had significantly more missing teeth (MT = 10.1) than those in community care (MT = 7.5). General and community dental services were the main providers of dental care. Subjects living in the community were significantly less likely to have a dentist and to use community dental services than their residential counterparts; they were more likely to attend only when having trouble. Adults with learning disabilities living in the community have greater unmet oral health needs than their residential counterparts and are less likely to have regular contact with dental services. Commissioners and providers of dental services have a responsibility to ensure that the health of adults with learning disabilities is not compromised by 'normalisation'.
Luo, Huabin; Bell, Ronny A; Wright, Wanda; Wu, Qiang; Wu, Bei
2018-03-31
The authors assessed the trends of annual dental visits in dentate adults with diabetes or prediabetes or no diabetes, and assessed whether the racial and ethnic disparities in dental visits changed from 2004 through 2014. Data for this analysis came from the Behavioral Risk Factor Surveillance System, a US health survey that looks at behavioral risk factors that was developed by the Centers for Disease Control and Prevention in cooperation with state health departments. Respondents indicated whether they had a dental visit in the past 12 months. Weighted proportions were calculated for annual dental visits in adults by diabetes status, and trends were assessed by racial and ethnic groups. From 2004 through 2014, the proportion of annual dental visits declined from 66.1% to 61.4% (trend P = .02) in the diabetes group, 71.9% to 66.5% (trend P = .01) in the no diabetes group, and 66.0% to 64.9% (trend P = .33) in the prediabetes group. Age, income, and health insurance were moderators of the association between diabetes status and dental visits. Overall, the racial and ethnic disparity in dental visits did not change significantly during the period. Dental visits and services were less frequent in people with diabetes and prediabetes. Racial and ethnic disparities in use of dental services persisted during the observed period. All patients, especially those with diabetes, are encouraged to visit a dentist at least annually. It is important for health care providers, such as primary care physicians and dental care and public health professionals, to make concerted efforts to promote oral health care in diabetes management. Improving access to dental services is vital to achieving this goal. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.
The Public Attitude Towards Selecting Dental Health Centers
Moshkelgosha, Vahid; Mehrzadi, Mehrdad; Golkari, Ali
2014-01-01
Statement of the Problem: No published literature was found studying the people's reasons on why to choose or not to choose a dental care setting in south Iran, while understanding their attitude towards choosing their dental care center is consequential for planning a successful oral health care service system. Purpose: To determine the factors affecting how people of the city of Shiraz choose their dental health services. Materials and Method: A cross-sectional analytic study was designed. A self-administered questionnaire was produced, tested and then distributed among 570 multistage randomly selected parents of schoolchildren of the city of Shiraz. Independent t-test, paired t-test and Spearman correlation were used to analyze the factors influencing participants in choosing clinics for their esthetic and non-esthetic dental treatments. Results: 400 questionnaires were complete and analyzed. The recommendation from others was found to be the most encouraging factor to choose a dentist or a dental clinic. More importance was reported for various factors affecting participants' choice of dental clinic when seeking non-esthetic treatments, while recommendation and reputation of dentist/dental clinic played a vital role in esthetic treatments. The cost was more important for respondents living in more deprived districts (p= 0.05), for unemployed group (p< 0.001) and for those with less education (p< 0.001). Conclusion: Factors affecting people's choice for dental care proved to be highly complicated. Recommendation was found playing an important role. Dental patients consider various factors when looking for non-esthetic treatment but would go for the best possible when seeking esthetic treatments. Findings of this study indicate that patients’ choice and utilization of dental service can be improved if dental clinics provide high quality of dental care with reasonable fees. PMID:25191662
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.
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.
Private sector approaches to workforce enhancement.
Wendling, Wayne R
2010-06-01
This paper addresses the private practice model of dental care delivery in the US. The great majority of dental care services are delivered through this model and thus changes in the model represent a means to substantially change the supply and availability of dental services. The two main forces that change how private practices function are broad economic factors, which alter the demand for dental care and innovations in practice structure and function which alter the supply and cost of services. Economics has long recognized that although there are private market solutions for many issues, not all problems can be addressed through this model. The private practice of dentistry is a private market solution that works for a substantial share of the market. However, the private market may not work to resolve all issues associated with access and utilization. Solutions for some problems call for creative private - public arrangements - another form of innovation; and market-based solutions may not be feasible for each and every problem. This paper discusses these economic factors and innovation as they relate to the private practice of dentistry, with special emphasis on those elements that have increased the capacity of the dental practice to offer services to those with limited means to access fee-based care. Innovations are frequently described as new care delivery models or new workforce models. However, innovation can occur on an ongoing and regular basis as dental practices examine new ways to combine capital and human resources and to leverage the education and skill of the dentists to a greater number of patients. Innovation occurs within a market context as the current and projected economic returns reward the innovation. Innovation can also occur through private-public arrangements. There are indications of available capacity within the existing delivery system to expand service delivery. The Michigan Medicaid Healthy Kids Dental program is discussed as one example of how dental services to Medicaid insured children were effectively expanded using the private practice model.
Operations Handbook for Migrant Student Dental Services.
ERIC Educational Resources Information Center
Hansen, William E.; Resendez, Ignacio V.
Migrant Education and the Superintendent of Public Instruction in the state of Washington have brought several agencies together to provide low cost dental services to migrant children. The program, initiated in 1980 and serving 138 children that year, has focused on the provision of preventative and emergency services. Migrant Education has…
Multicultural Standardization and Validation of TEMAS, a Thematic Apperception Test.
ERIC Educational Resources Information Center
Costantino, Giuseppe; Malgady, Robert G.
Mental health clinical services research has emphasized the urgency of developing new psychometric instruments for non-biased psychological assessment of minority and non-minority children of diverse cultural groups in the United States. Background multicultural standardization and validation information is presented for Tell-Me-A-Story (TEMAS)--a…
Oliveira, Renata Francine Rodrigues de; Souza, João Gabriel Silva; Haikal, Desireé Sant'Ana; Ferreira, Efigênia Ferreira E; Martins, Andréa Maria Eleutério de Barros Lima
2016-11-01
The scope of this study is to establish the profile of elderly users of dental services provided by the Brazilian Unified Health System(SUS) and associated factors from the standpoint of equity. It involves an analytical cross-sectional study with hierarchical modeling conducted on the basis of a complex probabilistic sample of groups of the elderly (65-74 years of age) living in a densely populated Brazilian city. Independent variables were included relating to: socio-demographic characteristics, access to information on health, behaviors/health-care system and health outcomes. Descriptive, bivariate and multiple hierarchical analysis was performed. Of the 480 elderly persons included, 138 (31.2%) used dental services from the SUS. Use of these services was greater as per capita income and level of schooling decreased. It was lower among those who had not conducted exams of their own mouths (oral self-examinations) and higher among those individuals who used dental services for non-routine procedures. In addition, people whose relationship had been affected by oral health issues and a negative perception of their appearance used the SUS more frequently. The conclusion drawn is that the use of dental services of the SUS was most prevalent among the elderly living in precarious conditions.
Basic mechanisms of urgency: preclinical and clinical evidence.
Michel, Martin C; Chapple, Christopher R
2009-08-01
Urgency is the core symptom of the overactive bladder symptom complex, but the underlying mechanisms are not fully understood. To review clinical and experimental studies related to how bladder filling and urgency are sensed and what causes urgency and to discuss how this process affects potential therapeutic strategies. Review of published reports. The definition of urgency as a desire implies that it can only be assessed in cognitively intact patients and that animal studies have to rely on surrogate markers thereof, such as detrusor overactivity (DO); however, DO and urgency are not always associated. While the precise mechanisms of how urgency is sensed remain unclear, accumulating evidence suggests that they may differ from the physiologic sensation of bladder filling. Studies on the neurophysiology of urgency sensing are hampered by reliance on the surrogate marker DO. Functional brain imaging may help to understand the central neurophysiology, but, until now, it has not specifically focused on urgency. With regard to causes of urgency, multiple theories have been forwarded. While none of them has been proven, it should be noted that they are not mutually exclusive, and, in specific patients, different causes may be present. The development of improved therapeutic strategies against urgency will be helped by a better understanding of how urgency is perceived and the underlying causes. Rigorous use of existing definitions and the search for reliable surrogate markers will aid such attempts.
47 CFR 80.327 - Urgency signals and messages.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 5 2010-10-01 2010-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...
47 CFR 80.327 - Urgency signals and messages.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 5 2011-10-01 2011-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...
47 CFR 80.327 - Urgency signals and messages.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 47 Telecommunication 5 2012-10-01 2012-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...
47 CFR 80.327 - Urgency signals and messages.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 47 Telecommunication 5 2013-10-01 2013-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...
47 CFR 80.327 - Urgency signals and messages.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 47 Telecommunication 5 2014-10-01 2014-10-01 false Urgency signals and messages. 80.327 Section 80... Safety Procedures § 80.327 Urgency signals and messages. (a) The urgency signal indicates that the... vehicle, or the safety of a person. The urgency signal must be sent only on the authority of the master or...
A comparative study of the health care systems of Canada and Saudi Arabia: lessons and insights.
Qutub, Akram F; Al-Jewair, Thikriat S; Leake, James L
2009-10-01
Understanding the structure of a health care system is essential in improving public health policies and health outcomes. To describe and compare the health care systems of Canada and Saudi Arabia; to discuss possible lessons that could be learned from both for policy-making purposes. A comprehensive method was used to describe the national health care systems of both countries. For each country, the system is described by: context, ownership, delivery, financing, organisational structure, target groups, and comprehensiveness of services. In Canada, the Medicare system provides comprehensive medical services except for dental, optometric, chiropractic, pharmacologic and home care services. The dental care system is financed privately (94%) and is owned and delivered by private for-profit dental practitioners. In Saudi Arabia, the government sector is owned, delivered, and financed by the government and provides free comprehensive medical and dental services. The same services are provided by the private sector, but under governmental supervision. Among the relevant lessons: access to care, accountability, quality assurance, mix and reimbursement of providers. Canada can learn about different approaches to socialising the dental care system. Saudi Arabia can improve the implementation of quality assurance practices and management.
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.
38 CFR 17.162 - Eligibility for Class II dental treatment without rating action.
Code of Federal Regulations, 2011 CFR
2011-07-01
... dental treatment without rating action. 17.162 Section 17.162 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.162 Eligibility for Class II dental treatment without rating action. When an application has been made for class II dental treatment under § 17.161(b...
38 CFR 17.162 - Eligibility for Class II dental treatment without rating action.
Code of Federal Regulations, 2014 CFR
2014-07-01
... dental treatment without rating action. 17.162 Section 17.162 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.162 Eligibility for Class II dental treatment without rating action. When an application has been made for class II dental treatment under § 17.161(b...
38 CFR 17.162 - Eligibility for Class II dental treatment without rating action.
Code of Federal Regulations, 2013 CFR
2013-07-01
... dental treatment without rating action. 17.162 Section 17.162 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.162 Eligibility for Class II dental treatment without rating action. When an application has been made for class II dental treatment under § 17.161(b...
38 CFR 17.162 - Eligibility for Class II dental treatment without rating action.
Code of Federal Regulations, 2010 CFR
2010-07-01
... dental treatment without rating action. 17.162 Section 17.162 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.162 Eligibility for Class II dental treatment without rating action. When an application has been made for class II dental treatment under § 17.161(b...
38 CFR 17.162 - Eligibility for Class II dental treatment without rating action.
Code of Federal Regulations, 2012 CFR
2012-07-01
... dental treatment without rating action. 17.162 Section 17.162 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.162 Eligibility for Class II dental treatment without rating action. When an application has been made for class II dental treatment under § 17.161(b...
Bhatt, Sumeet; Gaur, Ambika
2018-06-04
The study was done to describe the dental caries experience and dental care utilization among Tibetan refugee-background children in Paonta Sahib, India. The study was conducted on 254 school children in a Tibetan settlement in Paonta Sahib. Examination was done as per World Health Organization Oral Health Assessment criteria (2013). Data on dental services utilization was obtained from the parents of children using a structured questionnaire. Oral examination of 254 school children aged 6-18 years revealed an overall dental caries prevalence of 79.5%. The dental caries experience was greater in the mixed dentition (84%) than secondary dentition (77.3%). The mean DMFT was associated with sex and dental visiting patterns. About 60% children had never visited a dentist before. The main reason for dental visit was tooth removal (43%). The prevalence of dental caries among Tibetan refugee-background school children was high and utilization of dental care was low. A comprehensive oral health program focusing on preventive care and oral health education is recommended.
2016-07-01
owner. ~ GARY S. MAYNE, Maj, USAF, DC Tri-Service Orthodontic Residency Program Air Force Post Graduate Dental School Uniformed Services University...APPROVED: __________________________________________ Drew W. Fallis, D.D.S., M.S., Dean, Air Force Post-Graduate Dental School iii...Air Force Postgraduate Dental School, Joint Base San Antonio-Lackland, San Antonio, Texas, USA). Inclusion criteria for the study were 1
From production to performance: solving the positioning dilemma in dental practice.
Armstrong, James; Pitt, Leyland; Berthon, Pierre
2006-09-01
Thriving dental practices are excellent at providing a warm personal experience or are efficient, fast and cost-effective. Those that that attempt to do both end up being mediocre at just about everything. Introducing ideas from dramaturgy and service simultaneity in the services marketing literature, the authors provide a model for the conceptualization and redesign of the dental practice. Successful dental practices will be those that concentrate on low customization of activities in the back office or high customization of activities in the front office.
[Problems of dental services in closed administrative units assessed by a survey of dentists].
Ujba, V V; Olesova, V N; Khavkina, E Yu; Novozemtseva, T N; Shmakov, A N; Chuyanova, E Yu
2015-01-01
The article presents the results of the survey of 150 dentists from 10 closed administrative units of FMBA health care system of Russia in connection with the dynamics of dental staff withdrawal and reduce of volume of preventive work in schools and factories. These problems were found to be associated with the lack of regulations on mandatory preventive dental examinations of workers with occupational hazards, low tariffs for dental services in obligatory medical insurance program, poor wages an lack of apartments for young dentists.
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.
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.
Hoptman, Matthew J.; Antonius, Daniel; Mauro, Cristina J.; Parker, Emily M.; Javitt, Daniel C.
2014-01-01
Objective Aggression in schizophrenia is a major societal issue, leading to physical harm, stigmatization, patient distress, and higher healthcare costs. Impulsivity is associated with aggression in schizophrenia, but it is multidetermined. The subconstruct of urgency is likely to play an important role in this aggression, with positive urgency referring to rash action in context of positive emotion, and negative urgency to rash action in context of negative emotion. Method We examined urgency and its neural correlates in 33 patients with schizophrenia or schizoaffective disorder and 31 healthy controls. Urgency was measured using the Urgency, Premeditation, Perseverance and Sensation Seeking scale. Aggressive attitudes were measured using the Buss Perry Aggression Questionnaire. Results Positive urgency, negative urgency, and aggressive attitudes were significantly and selectively elevated in patients (1.21< Cohen’s ds < 1.50). Positive and negative urgency significantly correlated with Aggression Questionnaire total score (rs>.48) and each uniquely accounted for a significant portion of the variance in aggression over and above the effect of group. Urgency measures correlated with reduced cortical thickness in ventral prefrontal regions including right frontal pole, medial and lateral orbitofrontal gyrus and inferior frontal gyri, and rostral anterior cingulate cortex. In patients, reduced resting state functional connectivity in some of these regions was associated with higher urgency. Conclusions Findings highlight the key role of urgency in aggressive attitudes in people with schizophrenia and suggest neural substrates of these behaviors. They also suggest behavioral and neural targets for interventions to remediate urgency and aggression. PMID:25073506
Inequalities in the use of dental services among adults in inner South East London.
Al-Haboubi, Mustafa; Klass, Charlotte; Jones, Kate; Bernabé, Eduardo; Gallagher, Jennifer E
2013-06-01
Improving access to National Health Service (NHS) dentistry is a public health issue that has been a focus for successive governments and policy makers in the UK. To inform this process, commissioners of services need to understand trends in service use and demands of the local population. This study explored inequalities in dental services use among adults in a socially deprived, ethnically diverse metropolitan area of London; satisfaction with services; and public views for improvement of services. Data from 695 adults were analysed for this study (56% of the eligible sample). Inequalities in dental services use and satisfaction with care according to sociodemographic factors were assessed in unadjusted and fully adjusted models. The proportion of participants who reported attending the dentist in the last 24 months was 69%, with inequalities according to social grade, ethnicity, sex and age but not according to borough of residence. The most common areas identified by respondents for service improvement were availability of dentists, affordability of care, and accommodation of services. Among those who visited the dentist in the last 24 months, 90% were satisfied with the quality of care provided. However, there were inequalities in satisfaction with care according to borough and reason for the last dental visit. © 2013 Eur J Oral Sci.
Assembling, maintaining and servicing Space Station
NASA Technical Reports Server (NTRS)
Doetsch, K. H.; Werstiuk, H.; Creasy, W.; Browning, R.
1987-01-01
The assembly, maintenance, and servicing of the Space Station and its facilities are discussed. The tools and facilities required for the assembly, maintenance, and servicing of the Station are described; the ground and transportation infrastructures needed for the Space Station are examined. The roles of automation and robotics in reducing the EVAs of the crew, minimizing disturbances to the Space Station environment, and enhancing user friendliness are investigated. Servicing/maintenance tasks are categorized based on: (1) urgency, (2) location of servicing/maintenance, (3) environmental control, (4) dexterity, (5) transportation, (6) crew interactions, (7) equipment interactions, and (8) Space Station servicing architecture. An example of a servicing mission by the Space Station for the Hubble Space Telescope is presented.
Association of Dental Care with Adherence to HEDIS Measures
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
[Training and use of dental manpower resources in Mexico].
Hermosillo, G G; López Cámara, V; Alvarez Manilla, J M; García Cantú, M; Silva Olivares, H
1978-01-01
The introductory section describes the general situation of dental care in Mexico, analyzes the prevailing service model (including the kind of work done by the dental professional and the technology he employs), and briefly reviews the evolution of dentistry in the country. There follows an account of a series of new approaches to service and manpower training in experimental implementation since 1972 in the stomatology curriculum at the Xochimilco campus of the Metropolitan Autonomous University, at the National School of Professional Studies at Zaragoza, in the School of Dentistry of Nuevo León Autonomous University, Monterrey, and in the Dental Services at Ciudad Netzahualcóyotl. In each case, the background, characteristics, and objectives of the programs, and their evolution and prospects are described.
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.
Price, Matthew; Connor, Julie P; Allen, Holley C
2017-08-01
Childhood maltreatment increases the risk for posttraumatic stress disorder (PTSD) and comorbid substance use disorder (SUD). One pathway by which this occurs is through impaired emotion regulation. Past research has shown that negative urgency, a deficit in the regulation of negative emotions, is strongly related to PTSD in those with comorbid SUD. However, there is minimal research on the relation between positive urgency and PTSD in those with comorbid SUD. The current study investigated the association between childhood maltreatment, positive urgency, negative urgency, and PTSD symptoms among those with SUD. Results suggested that PTSD was associated with negative urgency and positive urgency overall. Childhood maltreatment did not moderate the association between negative urgency and PTSD. Childhood emotional abuse, emotional neglect, and sexual abuse moderated the relation between positive urgency and PTSD (ΔR 2 = .04 to .10). The association between PTSD and positive urgency was only significant at lower levels of emotional abuse and neglect. Future research should further examine the processing of positive emotions in those with PTSD and comorbid SUD. Findings might inform clinical interventions among populations exposed to childhood maltreatment to reduce or prevent the development of psychopathology. Copyright © 2017 International Society for Traumatic Stress Studies.
Trends in treatment performed in the Phelophepa Dental Clinic: 1995-2000.
Kroon, J; Prince, E; Denicker, G A
2001-10-01
Mobile clinics are a cost-effective method of meeting the dental needs of rural communities in South Africa. Phelophepa, the first primary health care train of its kind world-wide, provides eye care, education, medicine, basic health care and since June 1995 dental treatment to rural communities. All services are rendered by students under supervision of qualified staff. The aim of this study was to analyse and report the data for treatment performed in the dental clinic from June 1995 to May 2000. During its first five years of operation, dental services were provided at 183 towns in all provinces except Gauteng. Of the 42,073 patients treated during this time (an average of 229.9 per town), 67.4% were adults. 71.3% of the 103,283 procedures performed were extractions, 15.7% could be classified as preventive with the remaining 13% as restorative procedures. The average value of the service provided to each patient was R218.53. The exposure of dental, dental therapy and oral hygiene students to rural areas of South Africa serves the important purpose of sensitising students to the realities of oral diseases in these communities.
STIGMA AROUND HIV IN DENTAL CARE: PATIENTS' EXPERIENCES.
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.
Yavnai, Nirit; Rosen-Walther, Anda; Pery-Front, Yael; Aizenbud, Dror
2011-01-01
Over two million children around the world are living with AIDS. Oral health and oral manifestations, such as dental caries and periodontitis, are important issues requiring focus when treating these children. Descriptive data of a project conducted at Rambam Hospital, financed by the Israeli Ministry of Health, are presented in order to investigate and characterize dental treatment for HIV infected children. Thirty-seven infected children, most originating from the Ethiopian community, participated in the project between 2006 and 2011. A total of 724 dental procedures during 185 dental appointments were performed successfully. These children should be provided proactive preventive dental care, while health service providers should undergo further training on prevention and early identification and management of orofacial manifestations. All dental and medical personnel should be made aware of this service in order to refer HIV infected children who can greatly benefit from this special program.
Squillace, Joe
2013-01-01
Children in Medicaid/CHIP public coverage programs who reside in rural counties have limited access to dental care services. Shortages of dental professionals in rural areas impede utilization of dental care. Public and private initiatives are attempting to address this crisis. Missourians instituted deregulatory policies and invested in community-based initiatives. Using a Medicaid/CHIP claims administrative dataset from 2004 to 2007, this research explored patterns of utilization to assess the impact of these efforts. The number of participating private dental office providers declined over the study period, and the number of children utilizing clinics increased. Trends are being observed within the public health dental care market demonstrating clinics are replacing private dentists as providers of Medicaid/CHIP dental services. Allowing greater market entry through deregulation could provide states with greater improvements to their public dental health infrastructure. © 2012 American Association of Public Health Dentistry.
Traditional and emerging forms of dental practice. Cost, accessibility, and quality factors.
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
Olesova, V N; Uiba, V V; Novozemtseva, T N; Remizova, A A; Olesov, E E
The article analyzes the results of dental examination of employees with hazardous and normal working conditions in Atomenergomash enterprise with various dental care organization regimens and provides clear evidence of the effectiveness of serial attendances care in enterprise dental offices in terms of reduction in the dental treatment needs. Additional funding for departmental dental services was calculated by comparing the real cost of dental treatment and MHI tariffs allowing implementation of proposed dental care program.
Specialization and competition in dental health services.
Grytten, Jostein; Skau, Irene
2009-04-01
The number of specialists within dental health services has increased over the last few years. This raises the issue of how the services should be organized and funded. We describe the effect of one way of organizing the services, which is by relying on competition. In Norway, some oral specialists face real competition with general dental practitioners for the same patients (prosthetists, periodontists and endodontists), while other specialists do not (orthodontists and oral surgeons). The latter specialists have skills that give them exclusive possibilities to practice their profession. We find that competition can be effective for the specialists who experience real competition with general dental practitioners for patients. In situations where real competition does not exist, specialists can obtain market power and raise their fees. Our results are based on an analysis of a representative set of data from general dental practitioners and specialists in Norway. The specialities in which practitioners can exercise market power raise challenges related to the type of public policy that can reduce this market power in an appropriate way, and without involving too large costs for the authorities. (c) 2008 John Wiley & Sons, Ltd.
Perceptions of primary health care service users regarding dental team practices in Brazil.
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.
2007-09-25
This final rule implements section 702 of the John Warner National Defense Authorization Act for Fiscal Year 2007, Public Law 109-364. The rule provides coverage of contracted medical care with respect to dental care beyond that care required as a necessary adjunct to medical or surgical treatment. The entitlement of institutional and anesthesia services is authorized in conjunction with non-covered dental treatment for patients with developmental, mental, or physical disabilities or for pediatric patients age 5 or under. This final rule does not eliminate any contracted medical care that is currently covered for spouses and children. The entitlement of anesthesia services includes general anesthesia services only. Institutional services include institutional benefits associated with both hospital and in-out surgery settings. Patients with developmental, mental, or physical disabilities are those patients with conditions that prohibit dental treatment in a safe and effective manner. Therefore, it is medically or psychologically necessary for these patients to require general anesthesia for dental treatment.
Mariño, Rodrigo; Wright, Clive; Schofield, Margot; Calache, Hanny; Minichiello, Victor
2005-01-01
The authors discuss utilization of dental health services by older Greek and Italian immigrants in Melbourne, Australia. Their study involved 374 Greek and 360 Italian adults who completed a questionnaire and received an oral examination. Nearly 41% of Greek and 45% of Italian respondents had used dental services in the previous year. As barriers to care, Greek participants most often cited waiting lists and waiting time in the office. Italian participants most often identified cost, length of waiting lists and language barriers. Multivariate analyses associated recent use of dental services with number of teeth, oral health knowledge, age and occupation before retirement for both groups, as well as living arrangements among Greek participants and perceived barriers among Italian participants. Findings highlight the need for oral health promotion programs targeted toward older adults from immigrant populations and reductions of the structural barriers that prevent these adults from seeking oral health care.
Parker, E J; Misan, G; Shearer, M; Richards, L; Russell, A; Mills, H; Jamieson, L M
2012-01-01
Aboriginal Australian children experience profound oral health disparities relative to their non-Aboriginal counterparts. In response to community concerns regarding Aboriginal child oral health in the regional town of Port Augusta, South Australia, a child dental health service was established within a Community Controlled Aboriginal Health Service. A partnership approach was employed with the key aims of (1) quantifying rates of dental service utilisation, (2) identifying factors influencing participation, and (3) planning and establishing a program for delivery of Aboriginal children's dental services that would increase participation and adapt to community needs. In planning the program, levels of participation were quantified and key issues identified through semistructured interviews. After 3.5 years, the participation rate for dental care among the target population increased from 53 to 70 percent. Key areas were identified to encourage further improvements and ensure sustainability in Aboriginal child oral health in this regional location.
Response Error in Reporting Dental Coverage by Older Americans in the Health and Retirement Study
Manski, Richard J.; Mathiowetz, Nancy A.; Campbell, Nancy; Pepper, John V.
2014-01-01
The aim of this research was to analyze the inconsistency in responses to survey questions within the Health and Retirement Study (HRS) regarding insurance coverage of dental services. Self-reports of dental coverage in the dental services section were compared with those in the insurance section of the 2002 HRS to identify inconsistent responses. Logistic regression identified characteristics of persons reporting discrepancies and assessed the effect of measurement error on dental coverage coefficient estimates in dental utilization models. In 18% of cases, data reported in the insurance section contradicted data reported in the dental use section of the HRS by those who said insurance at least partially covered (or would have covered) their (hypothetical) dental use. Additional findings included distinct characteristics of persons with potential reporting errors and a downward bias to the regression coefficient for coverage in a dental use model without controls for inconsistent self-reports of coverage. This study offers evidence for the need to validate self-reports of dental insurance coverage among a survey population of older Americans to obtain more accurate estimates of coverage and its impact on dental utilization. PMID:25428430
The location of pain and urgency sensations during cystometry.
Veit-Rubin, Nikolaus; Cartwright, Rufus; Esmail, Alisha; Digesu, G Alessandro; Fernando, Ruwan; Khullar, Vikram
2017-03-01
The relationship between bladder pain and urinary urgency sensations is poorly understood. We analyzed the relationship between locations and intensities of urgency and pain sensations felt during filling cystometry. Participants completed the King's Health Questionnaire (KHQ) to indicate presence of bladder pain or urgency. During cystometry, participants scored the intensity of urgency and pain, both in the suprapubic and the urethral region, on a VAS scale of 0-10 at a baseline, at first desire, normal desire, strong desire to void, and at maximum cystometric capacity during filling. We allocated the participants to six groups; those reporting urgency or not, pain or not, both symptoms and neither. Friedman's Test was used to ascertain if all scores increased significantly, the Wilcoxon Signed Rank Test was used to demonstrate the difference between scores, and agreement for findings during cystometry was tested with Mann-Whitney U. A total of 68 women participated; 38 participants reported pain, 57 reported urgency, and 33 reported both symptoms. Pain and urgency scores significantly increased during cystometry (P < 0.0001). For participants reporting pain, suprapubic pain was rated significantly higher than urethral pain. Participants reporting both symptoms, felt more urgency than pain, and again pain more suprapubically than urethrally. Participants reporting only urgency scored suprapubic and urethral urgency similarly at all desires. Pain and urgency are well differentiated sensations and are felt at different locations although pain is seemingly easier localized. Neurourol. Urodynam. 36:620-625, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Hur, Won Sok; Kim, Joon Chul; Kim, Hyo Sin; Koh, Jun Sung; Kim, Sang Hoon; Kim, Hyun Woo; Cho, Su Yeon; Cho, Kang Jun
2016-11-01
To investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH). We retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups. In total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement. A preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH.
The Clinical Practice of Traditional and Nontraditional Dental Hygienists. Final Report.
ERIC Educational Resources Information Center
Boyer, E. Marcia
Information is presented on a study designed to gather details about the services provided by clinical dental hygienists in traditional and nontraditional settings. The 10 research topics addressed include: services provided by the clinical RDH in the traditional and nontraditional setting; time allocated for such services; how patients are…
32 CFR 728.22 - Members of other reserve components of the uniformed services.
Code of Federal Regulations, 2010 CFR
2010-07-01
... THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES... services. Consult current Army Regulation 40-3, Medical, Dental, and Veterinary Care, or Air Force... services. (a) Members of reserve components of the Coast Guard may be provided care the same as Navy and...
Dental Services for Migrant and Seasonal Farmworkers in US Community/Migrant Health Centers
ERIC Educational Resources Information Center
Lukes, Sherri M.; Simon, Bret
2006-01-01
Context: Migrant and seasonal farmworkers are recognized as a medically underserved population, yet little information on need, access, and services is available--particularly with regard to oral health care. Purpose: This study describes the facilities, services, staffing, and patient characteristics of US dental clinics serving migrant and…
ERIC Educational Resources Information Center
Lees, Carolyn; Poole, Helen; Brennan, Michelle; Irvine, Fiona
2017-01-01
Background: The government alongside other health and social care organisation have identified the need to improve the care provided for people with learning disabilities. Materials and Methods: This service evaluation aimed to explore the experiences of people with learning disabilities and their carers who accessed community dental services…
Koletsi-Kounari, H; Tzavara, C; Tountas, Y
2011-03-01
To investigate the association between certain socio-demographic characteristics, health-related lifestyle behaviors and the use of dental services in Greek adult population. A total of 1,005 adults from all the geographical areas of Greece were randomly selected and interviewed. Gender, age, place of residence, marital and socioeconomic status, educational level, obesity, smoking, physical inactivity, adherence to Mediterranean diet were recorded and associated with the use of dental services. Almost one half of the participants (47%) visited a dentist during the past 12 months. Only 31.7% of the visits were for a regular dental check up. Subjects belonging to high socioeconomic status were 1.86 times more likely to visit a dentist in the past 12 months, while those aged more than 56 years and with low educational level were less likely to visit a dentist in the past 12 months with odds ratios equal to 0.63 and 0.73, respectively. Physically inactive (OR = 0.59; 95% CI: 0.38-0.93) and obese subjects (OR = 0.48; 95% CI: 0.24-0.97) were less likely to visit the dentist for a regular dental check up. Additionally, high socioeconomic status and healthier diet were associated with greater likelihood for visiting the dentist for a regular dental check up. Socio-demographic factors including age, education and social status are strong determinants of dental health services utilization in Greece. In addition, health-related lifestyle behaviors and conditions such as healthy diet, physical activity and obesity might be good predictors of regular check up or symptomatic dental visits.
76 FR 38193 - National Institute of Dental & Craniofacial Research; Notice of Closed Meeting
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2011-06-29
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental.... Name of Committee: National Institute of Dental and Craniofacial Research Special Emphasis Panel... Officer, Scientific Review Branch, National Inst of Dental & Craniofacial Research, National Institutes of...
77 FR 59202 - National Institute of Dental & Craniofacial Research; Notice of Closed Meetings
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2012-09-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental... clearly unwarranted invasion of personal privacy. Name of Committee: National Institute of Dental and... Review Officer, Scientific Review Branch, National Institute of Dental & Craniofacial Research, National...
76 FR 28793 - National Institute of Dental & Craniofacial Research; Notice of Closed Meetings
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2011-05-18
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental..., Scientific Review Officer, Scientific Review Branch, National Inst of Dental & Craniofacial Research....nih.gov . Name of Committee: National Institute of Dental and Craniofacial Research Special Emphasis...
75 FR 52537 - National Institute of Dental & Craniofacial Research; Notice of Closed Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Dental and Craniofacial... Kelly, Scientific Review Officer, Scientific Review Branch, National Inst of Dental & Craniofacial...
Dental Disease: A Continuing Education Problem for the Disabled Individual.
ERIC Educational Resources Information Center
Callahan, William P.
1983-01-01
The author cites the incidence and types of dental diseases among disabled persons; discusses such contributing factors as low income and absence of comprehensive dental services; and describes a low-cost model interdisciplinary dental hygiene program involving special education, rehabilitation, and dentistry. (MC)
Longevity of Single-Tooth All-Ceramic CAD/CAM Restorations: A Meta-Analysis
2013-07-01
A thesis submitted to the Faculty of the Comprehensive Dentistry Graduate Program Naval Postgraduate Dental School Uniformed Services...Naval Postgraduate Dental School Uniformed Services University of the Health Sciences Bethesda, Maryland CERTIFICATE OF APPROVAL MASTER’S THESIS...This is to certify that the Master’s thesis of Katherine L. Cheng Lieutenant, Dental Corps, U.S. Navy has been approved by the Examining Committee for
2016-06-01
and John Yaccino, DDS Abstract Introduction: The Air Force Dental Service (AFDS) has established evidence-based treatment standards for endodontics...and cuspal coverage restorations (4-6). With this research, the Air Force Dental Service (AFDS) established evidence-based treatment standards for...endodontics to ensure Airmen receive high-quality, safe dental care (7). These standards are taught at the two Air Force (AF) Postgraduate Endodontic
2016-06-01
CTRAM). by Jared Cameron Beck, DMD Lieutenant Commander, Dental Corps United States Navy A Thesis submitted to the Faculty of the...Periodontics Graduate Program Naval Postgraduate Dental School Uniformed Services University of the Health Sciences in partial fulfillment of the...requirements for the degree of Master of Science in Oral Biology June 2016 Naval Postgraduate Dental School Uniformed Services
Analysis of Fractured Teeth Utilizing Digital Microscopy: A Pilot Study
2016-06-01
ANALYSIS OF FRACTURED TEETH UTILIZING DIGITAL MICROSCOPY: A PILOT STUDY by Thomas Gene Cooper, D.M.D., M.P.H. Lieutenant Commander, Dental Corps...United States Navy A thesis submitted to the Faculty of the Endodontic Graduate Program Naval Postgraduate Dental School Uniformed Services...Postgraduate Dental School Uniformed Services University of the Health Sciences Bethesda, Maryland CERTIFICATE OF APPROVAL MASTER’S THESIS This is to
Roberto, Luana Leal; Noronha, Daniele Durães; Souza, Taiane Oliveira; Miranda, Ellen Janayne Primo; Martins, Andréa Maria Eleutério de Barros Lima; Paula, Alfredo Maurício Batista De; Ferreira, Efigênia Ferreira E; Haikal, Desirée Sant'ana
2018-03-01
This study sought to investigate factors associated with the lack of access to information on oral health among adults. It is a cross-sectional study, carried out among 831 adults (35-44 years of age). The dependent variable was access to information on how to avoid oral problems, and the independent variables were gathered into subgroups according to the theoretical model for literacy in health. Binary logistic regression was carried out, and results were corrected by the design effect. It was observed that 37.5% had no access to information about dental problems. The lack of access was higher among adults who had lower per capita income, were dissatisfied with the dental services provided, did not use dental floss, had unsatisfactory physical control of the quality of life, and self-perceived their oral health as fair/poor/very poor. The likelihood of not having access to information about dental problems among those dissatisfied with the dental services used was 3.28 times higher than for those satisfied with the dental services used. Thus, decreased access to information was related to unfavorable conditions among adults. Health services should ensure appropriate information to their users in order to increase health literacy levels and improve satisfaction and equity.
The Effects of Distance to Dentists and Dentist Supply on Children's Use of Dental Care.
Wehby, George L; Shane, Dan M; Joshi, Adweta; Momany, Elizabeth; Chi, Donald L; Kuthy, Raymond A; Damiano, Peter C
2017-10-01
To examine the effects of distance to dentists and dentist supply on dental services use among children with Medicaid coverage in Iowa. Iowa Medicaid claims for enrolled children between 2000 and 2009. The study sample included 41,554 children (providing 158,942 child-year observations) who were born in Iowa between 2000 and 2006 and enrolled from birth in the Iowa Medicaid program. Children were followed through 2009. We used logistic regression to simultaneously examine the effects of distance (miles to nearest dentist) and county-level dentist supply on a broad range of dental services controlling for key confounders. Additional models only used within-child variation over time to remove unobservable time-invariant confounders. Distance was related to lower utilization of comprehensive dental exams (2 percent lower odds per 1 mile increase in distance), an effect that also held in models using within-child variation only. Dentist supply was positively related to comprehensive exams and other preventive services and negatively related to major dental treatments; however, these associations became smaller and insignificant when examining within-child changes except for other preventive services. Longer distance to dentists is a barrier for use of comprehensive dental exams, conditional on dentist supply. © Health Research and Educational Trust.
Mondor, Todd A; Finley, G Allen
2003-03-01
To examine the perceived urgency of 13 auditory warning alarms commonly occurring in the hospital operating room. Undergraduate students, who were naïve with respect to the clinical situation associated with the alarms, judged perceived urgency of each alarm on a ten-point scale. The perceived urgency of the alarms was not consistent with the actual urgency of the clinical situation that triggers it. In addition, those alarms indicating patient condition were generally perceived as less urgent than those alarms indicating the operation of equipment. Of particular interest were three sets of alarms designed by equipment manufacturers to indicate specific priorities for action. Listeners did not perceive any differences in the urgency of the 'information only', 'medium' and 'high' priority alarms of two of the monitors with all judged as low to moderate in urgency. In contrast, the high priority alarm of the third monitor was judged as significantly more urgent than its low and medium urgency counterparts. The alarms currently in use do not convey the intended sense of urgency to naïve listeners, and this holds even for two sets of alarms designed specifically by manufacturers to convey different levels of urgency.
Dental Sealants Prevent Cavities
... Digital Press Kit Read the MMWR Science Clips Dental Sealants Prevent Cavities Effective protection for children Language: ... more use of sealants and reimbursement of services. Dental care providers can Apply sealants to children at ...
2013-01-01
Background Few studies have investigated the relationships between HIV-related knowledge, fear of contagion in dental environments and Oral Impacts on Daily Performance (OIDP) among dental patients. Our objectives were to investigate the associations between HIV-related knowledge and fear of contagion in dental environments and OIDP among dental patients, and to evaluate whether those associations were modified by the frequency of dental service attendance. Methods A total of 1262 patients (mean age 30.7 years, 56.5% females) were recruited from the Khartoum Dental Teaching Hospital and the University of Science and Technology during March–July 2008. The participants underwent a full-mouth oral clinical examination and completed an interview in a face-to-face setting. Results Of the study participants, 41.4% had visited a dentist at least twice during the last 2 years, 96.2% had caries experience (DT > 0) and 79.1% reported oral impacts (OIDP > 0). The most frequently reported oral impacts were problems eating, sleeping and cleaning teeth. In total, 26.3% of the participants had HIV transmission knowledge, 75.6% knew people with HIV/AIDS and 58.7% perceived a high risk of cross-infection in dental environments. After adjusting for sociodemographic characteristics, frequency of dental service attendance and caries experience, patients who had high HIV-related information exposure, a positive attitude toward people with HIV/AIDS and a high perceived risk of cross-infection were more likely to report oral impacts, whereas patients who knew people with HIV/AIDS were less likely to report oral impacts. The association between OIDP and HIV transmission knowledge was modified by frequency of dental service attendance. Conclusions Dental patients who were informed about HIV and had a high HIV/AIDS risk perception were more likely to report impaired oral health-related quality of life than their less informed counterparts and those who perceived a low risk of contagion. The effect of HIV transmission knowledge on oral impacts was influenced by frequency of dental service attendance. PMID:23971974
Grytten, Jostein; Holst, Dorthe; Skau, Irene
2012-08-01
The aim of this study was to describe the effect of income on demand and utilization of dental services according to household income in the adult population. The data were collected using a questionnaire, which was sent to a random sample of Norwegians aged 20 years or older living at home, 1861 persons in total. Demand was measured according to whether the person had been to the dentist during the last year. Utilization was measured as expenditure for dental treatment for those who had been to the dentist during the last year. The independent variables were the respondents' household income, age, gender, education, dental status and the mean fee for a dental consultation in the municipality. In the first stage, we carried out a logistic regression analysis of the log odds of having demanded dental services during the last year. In the second stage, we carried out a multiple regression analysis of expenditure for dental treatment for those who had been to the dentist during the last year. Altogether, 80% of the respondents had been to the dentist during the last year. Demand during the last year varied most according to dental status. There was little difference between men and women. The results of the logistic regression showed that the probability of having been to the dentist was 0.82 for those with a household income of €25 000 and 0.85 for those with a household income of €100 000. Mean expenditure for dental treatment was €355. There was no statistically significant relationship between household income and expenditure for dental treatment. Differences in demand for dental services according to household income are small, and there are no differences in utilization according to income. The findings are interesting, because in a population in which people have to pay almost all the costs for dental treatment themselves, one would expect the income differences in demand and utilization to be greater. © 2012 John Wiley & Sons A/S.
Oral Health, Dental Insurance and Dental Service use in Australia.
Srivastava, Preety; Chen, Gang; Harris, Anthony
2017-01-01
This study uses data from the 2004-2006 Australian National Survey of Adult Oral Health and a simultaneous equation framework to investigate the interrelationships between dental health, private dental insurance and the use of dental services. The results show that insurance participation is influenced by social and demographic factors, health and health behaviours. In turn, these factors affect the use of dental services, both directly and through insurance participation. Our findings confirm that affordability is a major barrier to visiting the dentist for oral health maintenance and treatment. Our results suggest that having supplementary insurance is associated with some 56 percentage points higher probability of seeing the dentist in the general population. For those who did not have private insurance cover, we predict that conditional on them facing the same insurance conditions, on average, having insurance would increase their visits to the dentist by 43 percentage points. The uninsured in the survey have lower income, worse oral health and lower rates of preventive and treatment visits. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Dental manpower development in the Pacific: case study in the Republic of the Marshall Islands.
Tut, Ohnmar K; Langidrik, Justina R; Milgrom, Peter M
2007-03-01
This case study reports the ongoing progress and results of a manpower development program to expand indigenous dental personnel at four levels in the Republic of the Marshall Islands. The program was designed to: 1) increase the number of Marshallese students who successfully complete dentistry training; 2) recruit and train a group of Marshallese high school graduates in dental assisting for service in new preventive outreach programs within the community; 3) enhance the dental training of health assistants providing primary medical care to outer islands away from the main population centers of Majuro and Ebeye; and 4) provide in-service training on tooth decay prevention for Head Start teachers. The program resulted in the training of one Marshallese dentist and two Marshallese dental therapist, 16 primary care health aides who received oral health training for work in the outer island dispensaries, and 200 Head Start and kindergarten teachers who completed in-service training in oral health. Additional expertise was shared with other United States Affiliated Pacific Islands (USAPI) to enhance the dental workforce throughout the Pacific.
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.
Dental pain, use of dental services and oral health-related quality of life in southern Brazil.
Cavalheiro, Charles Henrique; Abegg, Claides; Fontanive, Victor Nascimento; Davoglio, Rosane Silvia
2016-08-18
This study aimed at assessing the relationship between dental pain and the reason for using dental services and oral health quality of life in people aged 50 to 74 years in southern Brazil. A cross-sectional population-based study was conducted with 720 individuals aged 50 to 74 years, living in three health districts in the city of Porto Alegre. Dental impacts on daily life and sociodemographic data were assessed using structured interviews. The Oral Impacts on Daily Performance - OIDP instrument was used to measure oral impacts. The information was analyzed by Poisson regression with robust variance adjustment, taking into account cluster sampling. Dental pain was present in 32.5% of those reporting an oral impact on their daily activities. Dental pain most frequently affected talking (37.6%), cleaning teeth and gums (37.0%) and enjoying the companionship of people (36.5%). After adjustments to the multivariate analysis, the reason for dental visits due to dental pain was found to have a high impact on daily activities [RP 1.68 (1.11 - 2.54].
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.
Bussières, Sylvain; Tanguay, Alain; Hébert, Denise; Fleet, Richard
2017-01-01
Access to health care in Canada's rural areas is a challenge. The Unité de Coordination Clinique des Services Préhospitaliers d'Urgence (UCCSPU) is a telemedicine program designed to improve health care in the Chaudiere-Appalaches and Quebec City regions of Canada. Remote medical services are provided by nurses and by an emergency physician based in a clinical unit at the Alphonse-Desjardins Community Health and Social Services Center. The interventions were developed to meet two objectives. The first is to enhance access to quality health care. To this end, Basic Life Support paramedics and nurses were taught interventions outside of their field of expertise. Prehospital electrocardiograms were used to remotely diagnose ST segment elevation myocardial infarction and to monitor patients who were en route by ambulance to the nearest catheterization facility or emergency department. Basic Life Support paramedics received extended medical authorization that allowed them to provide opioid analgesia via telemedicine physician orders. Nurses from community health centres without physician coverage were able to request medical assistance via a video telemedicine system. The second objective is to optimize medical resources. To this end, remote death certifications were implemented to avoid unnecessary transport of deceased persons to hospitals. This paper presents the telemedicine program and some results.
77 FR 59199 - National Institute of Dental & Craniofacial Research; Notice of Closed Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-26
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Dental and Craniofacial...., Scientific Review Officer, Scientific Review Branch, National Institute of Dental and Craniofacial, Research...
78 FR 56902 - National Institute of Dental & Craniofacial Research; Notice of Closed Meeting
Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-16
... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Dental... unwarranted invasion of personal privacy. Name of Committee: National Institute of Dental and Craniofacial... Review Officer, Scientific Review Branch, National Institute of Dental and Craniofacial Research, One...
77 FR 71605 - National Institute of Dental & Craniofacial Research; Notice of Closed Meetings
Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-03
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77 FR 2987 - National Institute of Dental & Craniofacial Research; Notice of Closed Meetings
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National dental waitlists: what would it take to reset to zero?
Dudko, Yevgeni; Kruger, Estie; Tennant, Marc
2016-06-01
Objective Over the years, long public dental waitlists across Australia have received much attention from the media. The issue for eligible patients, namely a further deterioration of dental health because of not being able to address dental concerns relatively quickly, has been the subject of several state and Federal initiatives. The present study provides a cost model for eliminating public dental waitlists across Australia and compares these results with the cost of contracting out public dental care to private clinics. Methods Waitlist data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual State or Territory Dental Health body. Average costs associated with employing key dental personnel and performance figures were used from previously published data to estimate the potential financial commitment and probable public benefits. Results The cost model suggests that, on average, it would be more than twice as expensive to contract the work out to private dental clinics as to treat eligible patients within public dental clinics. It is estimated that the cost of eliminating the legacy dental waiting lists (over 12 months) would be between A$50 and A$100million depending on the method adopted. The effort would require some 360 dental teams. Conclusion The design of the Australian public dental care system that is targeted at meeting the needs of eligible patients into the future, in addition to being effective and sustainable, must also offer a level of protection to the taxpayer. The ability to address waitlist backlog identified in the present study clearly would require a mix of service models depending on service availability at different locations. Further research is needed to optimise the mix of service providers to address community needs. What is known about the topic? Long public dental waitlists across Australia have received much attention from the media. The topic has been the subject of debate at the government level and, over the years, has seen an increase in allocation of public funds in an effort to address the policy needs. What does this paper add? This study calculates the actual number of people on the public dental waitlist, provides a detailed analysis of the distribution of the demand for the services and offers a cost model for resetting public dental waitlists across Australia. What are the implications for practitioners? This study carries no implications for individual practitioners at the clinical level. However, at the state and national levels, this model offers direction to a more cost-effective allocation of public funds and human resources.
Jones, C; Taylor, G; Morrant, A; Cook, G
1998-09-01
To chart paediatric dental general anaesthesia activity following implementation of the Poswillo Report recommendations and to characterise the relationship between dmft/DMFT and rates of paediatric dental general anaesthesia. An ecological study, using results of the NHS dental epidemiological surveys and routine NHS activity data. The general, community and hospital dental services. Former regional and district health authorities' residents. Correlations between the regional and district rates of dental general anaesthesia and dmft/DMFT from the NHS dental epidemiology surveys. About half of all paediatric dental general anaesthetics are carried out in the General Dental Service. There were significant correlations between regional mean dmft/DMFT and under 18 combined dental general anaesthesia rates in 1991/2 and 1992/3. In the North West Region there were significant correlations between 0-4-year-old district dental general anaesthesia rates and dmft of 5-year-old children in 1989/90 (r = 0.45, P < 0.05) and 0-17-year-old district dental general anaesthesia rates and 12-year-old DMFT (r = 0.49, P < 0.05) in 1992/3. The number of paediatric dental general anaesthetics provided since the Poswillo Report was implemented (1991) has increased in the last two years (1993/4 and 1994/5). District rates of dental general anaesthesia bore little relation to dental need as measured by dmft/DMFT, except in 1989/90 for 5-year-old children and in 1992/3 for 12-year-old children. This suggests dental general anaesthesia is not provided in response to dental needs at a district health authority level.
Sanwald, Alice; Theurl, Engelbert
2016-12-01
Dental services differ from other health services in several dimensions. One important difference is that a substantial share of costs of dental services-especially costs beyond routine dental treatment-is paid directly by the patient out-of-pocket. This study analyses the socio-economic determinants of out-of-pocket expenditure for dental services (OOPE) in Austria at the household level. Cross-sectional information on OOPE and household characteristics provided by the Austrian household budget survey 2009/10 was analysed. A two-part model (Logit/GLM) and one-part GLM was applied. The probability of OOPE is strongly affected by the life cycle (structure) of the household. It is higher for higher age classes, higher income, and partially higher levels of education. The type of public insurance has an influence on expenditure probability while the existence of private health insurance has no significant effect. In contrast to the highly statistically significant coefficients in the first stage, the covariates of the second stage remain predominantly insignificant. According to the results, the level of expenditure is driven mainly by the level of education and income. The results of the one-part GLM confirm the results of the two-part model. The results allow new insights into the determinants of OOPE for dental care. The household level turns out to be an adequate basis to study the determinants of OOPE, although caution should be applied before jumping to conclusions for the individual level.
Mental Health Awareness Month & Speak Up for Kids
ERIC Educational Resources Information Center
Cowan, Katherine C.
2012-01-01
May is National Mental Health Awareness Month. This is a great time to highlight the importance of mental wellness and school-based mental health services to children's positive learning and development. There is heightened urgency to the imperative to advance school-based mental health and school psychologists' expertise as essential to the…