The structure of dental services in the UK

2013 ◽  
Author(s):  
Blánaid Daly ◽  
Paul Batchelor ◽  
Elizabeth Treasure ◽  
Richard Watt
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Oral Health Care ◽  
Third Party ◽  
Dental Services ◽  
The Public ◽  
Annual Salary ◽  
Distribution Process ◽  
The Uk

This chapter will briefly describe how oral health care may be managed and organized and how health workers may be remunerated. This will be followed by a short outline of the ways in which oral health care is provided in the UK. A separate overview of dental care professionals (DCPs) is presented in this chapter. The reform of the NHS is ongoing, so this chapter discusses principles rather than detail. Since the devolution of health care to governments in Scotland, Wales, and Northern Ireland, variations in provision are occurring across the UK and some of these differences are highlighted. If oral health care is to be provided it has to be funded. The money has to be derived from the public and this can be either from individuals or from taxation. Within the UK there are a variety of ways in which oral health care is funded. Figure 19.1 shows the possible flows of money. The model that exists in the UK is in the main centred on routes 1 and 3, based on taxation, either direct or through national insurance contributions, and its subsequent allocation to various public-funded services, including dentistry. In Germany, the arrangement is slightly different in that third-party insurance groups are involved and a proportion of an individual’s annual salary is allocated to health care. A third model operates in the USA under the guise of managed care. Individuals buy into a care plan that is organized by a health care company, which subsequently contracts with dentists to provide a level of care. In route 2, the public pays the dentist directly for his or her services; this is a private arrangement. A third party may intervene to control pricing. For example, Dutch and Swedish adult dental care is now mostly in the private sector, but each year the profession negotiates the scale of fees with their government. The subsequent distribution process for paying oral care workers is illustrated in Figure 19.2. There are again three mechanisms: . . . 1 A purely private arrangement. . . . . . . 2 The state pays the total cost. . . .

scholarly journals 1013. Enhanced Oral Health Care Services for PLWHA - Midlands Region, South Carolina

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S535-S536
Author(s):  
Christina M Baello ◽  
Divya Ahuja ◽  
Norlica Finkley ◽  
Rajee Rao
Keyword(s):  
Health Care ◽  
South Carolina ◽  
Oral Health ◽  
Dental Care ◽  
Care Program ◽  
Oral Health Care ◽  
Care Patient ◽  
Inclusion Criteria ◽  
Dental Services ◽  
Health Care Program

Abstract Background An estimated 58- 64 % of people living with HIV/AIDS (PLWHA) do not receive regular dental care and this gap may be attributed to barriers related to cost, access to dental care, logistical issues, indifference to or fear of dental care.1,2 The Immunology Center at Prisma- University of South Carolina, School of Medicine is a Ryan White funded Part B Program that provides care to > 2400 PLWHA. Based on the perceived barriers, an enhanced oral health care program was implemented in 2018, wherein patients in need of dental care and meeting inclusion criteria are referred to contracted local general dentistry and specialty practices. Enhancements Dedicated Dental Services Coordinator (DSC) Facilitated transport to and from the dental clinic Annual budget of $2700 per patient Access to dental specialties (oral and maxillofacial surgery) Restorative services (crowns, dentures and root canals) Program Goals The ultimate goal of the oral health care program is to provide biannual dental prophylaxis and expanded restorative services to PLWHA. Inclusion criteria for referrals 1 Virological suppression over 6 months. (HIV Viral Load < 200 c/mL) 2 Adherence with HIV clinic appointments. Midlands Region, South Carolina Methods The DSC completes the following: monitoring of referrals, patient compliance to program inclusion criteria, linkage to dental care, payments for dental services, and coordination with case management. Results Between 2018 and 2019, 535 patients were referred to the oral health care program. Almost 75% 399 completed at least one dental clinic visit. The average number of visits for patients from their enrollment date (2018-2019 to December 2019 was 1.56, with an average of 8.08 services, and 1.13 prophylaxis visits with their oral health care provider. Patients were predominantly African American and male but were spread across a wide age spectrum and 8 counties. Nearly 94% of patients remained virologically suppressed during their oral health care treatment. Table 1: 2018-2019 Program Summary of Oral Health Care Table 2 & Figure 1: Oral Health Care Patients by Age Group, Figure 2: Oral Health Care Patient by Gender Table 3 & Figure 3: Oral Health Care Patients by Race and Ethnicity, Table 4 & Figure 4: Oral Health Care Patient by County Conclusion PLWHA have high rates of unmet oral health care needs and low utilization of oral health services. Adequate resources and coordination of care with local dentists can overcome traditional barriers and improve access to dental care. Abstract References Disclosures: All Authors: No reported disclosures

scholarly journals Factors influencing Oral Health and Utilization of Oral Health Care in an Indian Fishing Community, Mangaluru City, India

2017 ◽  
Vol 8 (4) ◽  
pp. 321-326
Author(s):  
Mithun BH Pai ◽  
Ashwini Rao ◽  
Sumeet Bhatt ◽  
Guru R Rajesh ◽  
Vijayendra Nayak
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Oral Health Care ◽  
Fishing Community ◽  
Periodontal Health ◽  
Dental Services ◽  
Factors Influencing ◽  
Gender Education ◽  
Utilization Of Dental Services

ABSTRACT Aim The aim of this study was to assess factors influencing the oral health and utilization patterns of oral health services by fishermen community in Mangaluru city, Karnataka, India. Materials and methods A house-to-house survey was conducted among 840 individuals in fishermen population. Oral health status was evaluated by employing the World Health Organization basic oral health survey form. A self-administered questionnaire was used to assess patterns of utilization of dental services and their sociodemographic details. Results Mean decayed, missing, and filled teeth (DMFT) of the population was 3.78 ± 6.02 and prevalence of caries and periodontal conditions was 55 and 99% respectively. About 55% participants had never visited a dentist. Age, gender, and education of the respondents showed significant associations with DMFT status. Periodontal health showed significant association with age, gender, education, and income of the respondents. Visit to the dentist was associated with age, gender, education, and dental caries. The major barrier recognized in seeking dental care was the perception of not having any dental problem. Conclusion The dental care utilization was poor, and majority of the dental visits were for tooth extraction. Lack of perceived oral health care need was the main barrier to the utilization of dental services. Clinical significance The fishing population had high dental caries and poor periodontal health due to low utilization of dental care. How to cite this article Bhatt S, Rajesh GR, Rao A, Shenoy R, Pai MBH, Nayak V. Factors influencing Oral Health and Utilization of Oral Health Care in an Indian Fishing Community, Mangaluru City, India. World J Dent 2017;8(4):321-326.

Programs and Policies Targeted to Improve Access to Dental Care for Low Income Adults and Children in the US: An Integrative Literature Review

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Davis AL ◽  
◽  
Zare H ◽  
Kanwar O ◽  
McCleary R ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Literacy ◽  
Literature Review ◽  
Low Income ◽  
Dental Care ◽  
Oral Health Care ◽  
Oral Health Literacy ◽  
The Us ◽  
Access To Dental Care

Objective: The authors conducted an integrative literature review of recent studies that explored the impact of interventions implemented in the U.S. that focused on improving access to dental care for low-income and vulnerable populations. Methods: The authors conducted an integrative literature review of studies published between 2012-2018 that addressed six oral health policy spheres. 1) Community-based dental access programs; (2) Medicaid reimbursement and expansion; (3) Student loan support; (4) Oral health services in non-traditional settings and dental residency programs; (5) Programs to improve oral health literacy; and (6) Use of dental therapists. Results: The authors included 39 articles for qualitative synthesis. Numerous public health initiatives and programs exist in the US aimed at increasing access to quality oral health care. Medicaid expansion, increased Medicaid fee-for-service reimbursement rates, and state loan repayment programs have demonstrated some success in improving access among underserved populations. A diversified dental workforce, with community dental health workers and mid-level providers like dental therapists, as well as interprofessional training of nurses and primary-care physicians in oral health have also shown positive impacts in advancing health equity. Further studies are needed to understand how oral health literacy programs can affect access and utilization of dental services. Conclusions: Improvements to the oral health care safety net will require a holistic and multifaceted approach in order to reduce oral health disparities. Policy levers should work, not in isolation, but rather in complementary fashion to one another.

scholarly journals ‘The public rely on me a lot’: Rural pharmacists’ perspectives on their roles in oral health care

2019 ◽  
Author(s):  
Ha Hoang ◽  
Tony Barnett ◽  
Mark Kirschbaum ◽  
Stephanie Dunbar ◽  
Rita Wong
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Oral Health Care ◽  
The Public

scholarly journals Human Resources for Oral Health Care in South Africa: A 2018 Update

2019 ◽  
Vol 16 (10) ◽  
pp. 1668 ◽  
Author(s):  
Ahmed Bhayat ◽  
Usuf Chikte
Keyword(s):  
South Africa ◽  
Health Care ◽  
Oral Health ◽  
Public Sector ◽  
Oral Care ◽  
Oral Health Care ◽  
Health Care Facilities ◽  
Care Providers ◽  
Care Needs ◽  
The Public

To describe the current oral health care needs and the number and category of dental personnel required to provide necessary services in South Africa (SA). This is a review of the current disease burden based on local epidemiological studies and the number of oral health personnel registered with the Health Professions Council of South Africa (HPCSA). In SA, oral health services are rendered by oral hygienists, dental therapists, dentists, and dental specialists. Dental caries remains one of the most prevalent conditions, and much of them are untreated. The majority of oral care providers are employed in the private sector even though the majority of the population access the public sector which only offers a basic package of oral care. The high prevalence of caries could be prevented and treated by the public sector. The infrastructure at primary health care facilities needs to be improved so that dentists performing community service can be more effectively utilized. At present, SA requires more dental therapists and oral hygienists to be trained at the academic training institutions.

scholarly journals Oral health care-seeking behaviour and influencing factors among 18-34 years old women in Kochi, India

2020 ◽  
Vol 7 (11) ◽  
pp. 4478
Author(s):  
Nija M. A. ◽  
Geethu Gireesh ◽  
Minu Maria Mathew ◽  
Ramanarayanan Venkitachalam
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Dental Health ◽  
Oral Health Care ◽  
System Level ◽  
Health Seeking ◽  
Factors Affecting ◽  
Dental Health Care ◽  
Personal Level

Background: Oral health, though an integral part of general health, is accorded low priority and remains an issue of neglect. Women during their reproductive years suffer from various oral problems that warrant timely utilization of care. Understanding factors affecting health-seeking behavior is necessary. The objective of this study was to determine the personal level and system-level factors that affect utilization of oral health care among 18-34 year-old women visiting a dental health care facility.Methods: A cross-sectional questionnaire-based study was conducted among 18-34 year old women. Participants were recruited using convenience sampling from a tertiary dental health care facility. A Chi-square test was used to determine the association of sociodemographic variables on factors affecting the utilization of oral care.Results: A total of 194 responses were obtained. The mean age of study participants was 27.1±5.2 years. Around 62% of women suffered from multiple dental problems in the past year of which tooth decay and swelling of gums were most common. About 68% of them sought treatment with a dentist. Half of the respondents were themselves responsible for making health care decisions. 55% of the participants reported barriers in availing dental care. The cost of dental treatment, fear of pain, and lack of time were the most commonly reported barriers.Conclusions: Oral health-seeking behaviour among women was found to be good with regard to dental attendance. Personal level barriers were greater than system-level barriers in availing dental care.

scholarly journals School Based Tooth Brushing and Annual Silver Diammine Fluoride Application as a Highest Priority Package for Achieving Universal Oral Health Care for Cambodian Children

2021 ◽  
Vol 2 ◽  
Author(s):  
Bathsheba Turton ◽  
Jilen Patel ◽  
Chanthyda Sieng ◽  
Ranuch Tak ◽  
Callum Durward
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Primary Teeth ◽  
Descriptive Analysis ◽  
Oral Health Care ◽  
Adverse Outcomes ◽  
Mixed Dentition ◽  
Dental Services ◽  
Middle Income ◽  
Carious Lesions

Background: Achieving Universal Oral Health Care among Low-to Middle-Income settings is challenging and little literature exists around exploring what a “Highest Priority Package” of care might look like in the context of oral health. The Healthy Kids Cambodia (HKC) program differs from most conventional school dental services in that the initial package of care that is offered is daily toothbrushing with 1,500 ppm fluoride toothpaste (DTB) together with the topical application of Silver Diamine fluoride (SDF) for management of lesions in primary teeth.Aim: To examine tooth level outcomes for 8- to 10-year old children from two schools that performed DTB with application of SDF at differing time-points.Design: This was an observational cohort study that examined lesion progression among children in late mixed dentition at two schools. Data were collected using the dmft and pufa indices. Both schools received materials and training for DTB at baseline. School One received SDF at baseline while School Two received SDF after 9-months. Intraoral examinations were performed and the presentation of primary teeth with cavitated carious lesions were compared at baseline and 12 m. If a tooth was still caries-active or had become pulpally involved, this was considered to be an unacceptable outcome. Descriptive analysis was performed the chi-squared test was used to examine differences in the proportion of teeth with unacceptable outcomes by school membership.Results: Of the 521 children recruited, 470 (90.2%) were followed. Where there was a delay in SDF application (School 2) there was a three times greater chance of an unacceptable outcome. Ten percentage of primary teeth in School One and 33% of primary teeth in the School Two had unacceptable outcomes.Conclusion: The present study offers data on expected effect sizes that might inform future step-wedged clinical trials to validate an oral health Highest Priority Package of care for Cambodian children. The delivery of a package of care that includes both DTB and SDF can prevent adverse outcomes, such as dental infections, in primary teeth with carious lesions.

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