scholarly journals Assessing the contribution of the dental care delivery system to oral health care disparities

2014 ◽  
Vol 75 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Nadereh Pourat ◽  
Ronald M Andersen ◽  
Marvin Marcus
2016 ◽  
Vol 5 (3) ◽  
pp. 547
Author(s):  
RamandeepSingh Gambhir ◽  
Ashish Vashist ◽  
Swati Parhar ◽  
RamandeepKaur Sohi ◽  
PuneetSingh Talwar

2021 ◽  
pp. 238008442110126
Author(s):  
J.L.P. Protudjer ◽  
C. Billedeau ◽  
K. Hurst ◽  
R. Schroth ◽  
C. Stavropoulou ◽  
...  

Introduction: Rates of periodontal disease and tooth loss are increased in individuals with rheumatoid arthritis (RA). Understanding factors that contribute to the increased burden of periodontal disease in RA is critical to improving oral health and arthritis outcomes. Objectives: To determine the perceptions held by people with RA relating to their oral health, to identify patient-centered priorities for oral health research, and to inform optimal strategies for delivering oral health knowledge. Methods: Semistructured interviews were conducted with patients with RA. Recorded interview transcripts were iteratively reviewed to reveal surface and latent meaning and to code for themes. Constructs were considered saturated when no new themes were identified in subsequent interviews. We report themes with representative quotes. Results: Interviews were conducted with 11 individuals with RA (10 women [91%]; mean age, 68 y), all of whom were taking RA medication. Interviews averaged 19 min (range, 8 to 31 min) and were mostly conducted face-to-face. Three overall themes were identified: 1) knowledge about arthritis and oral health links; 2) oral health care in RA is complicated, both in personal hygiene practices and in professional oral care; and 3) poor oral health is a source of shame. Participants preferred to receive oral health education from their rheumatologists or dentists. Conclusions: People with RA have unique oral health perceptions and experience significant challenges with oral health care due to their arthritis. Adapting oral hygiene recommendations and professional oral care delivery to the needs of those with arthritis are patient priorities and are required to improve satisfaction regarding their oral health. Knowledge Translation Statement: Patients living with long-standing rheumatoid arthritis described poor oral health–related quality of life and multiple challenges with maintaining optimal oral health. Study findings indicate a need for educational materials addressing oral health maintenance for patients with rheumatic diseases and their providers.


Author(s):  
Davis AL ◽  
◽  
Zare H ◽  
Kanwar O ◽  
McCleary R ◽  
...  

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.


2016 ◽  
Vol 2 (1) ◽  
pp. 5-9 ◽  
Author(s):  
H. Leggett ◽  
D. Duijster ◽  
G.V.A. Douglas ◽  
K. Eaton ◽  
G.J.M.G. van der Heijden ◽  
...  

ADVOCATE (Added Value for Oral Care) is a project funded by the European Commission’s Horizon 2020 program, which aims to develop strategies for a system transition toward more patient-centered and prevention-oriented oral health care delivery within health care systems. This system should balance the restorative and preventive approaches in dental and oral health care. ADVOCATE is a partnership among 6 European Union member states, which involves collaboration among universities, state-funded health care providers, and private insurance companies in Denmark, Germany, Hungary, Ireland, the Netherlands, the United Kingdom, and Aridhia, a biomedical informatics company based in Scotland. There are 6 interrelated work packages, which aim to address the following objectives: 1) in-depth evaluation of oral health care systems in European Union member states to identify best system designs for oral disease prevention, 2) development of a set of measures to provide information on oral care delivery and oral health outcomes, 3) evaluation of a feedback approach in dental practice that aims to facilitate a change toward preventive oral health care delivery, and 4) economic evaluation of strategies to promote preventive oral health care and development of policy recommendations for oral health care systems. The project is novel in its use of data that are routinely collected by health insurance organizations, as well as the engagement of key stakeholders from dental teams, insurers, patients, and policy makers in guiding the development and progress of the project. This article outlines in detail the objectives and research methodology of the ADVOCATE project and its anticipated impact. Knowledge Transfer Statement: This commentary describes the development of policy options to promote a greater focus on disease prevention in general dental practice. The approach builds on identifying the comparative effectiveness of alternative incentive schemes, as well as methods to monitor clinical and patient-derived measures of success in creating health for patients. The article describes the development and application of the measures and the evaluation of their success in orienting clinical practice more toward disease prevention.


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