The Impact of Dementia on Oral Health and Dental Care, Part 1: Setting the Scene for Dental Care Provision

2020 ◽  
Vol 9 (2) ◽  
pp. 24-30 ◽  
Author(s):  
Kathryn Kerr ◽  
Charlotte Curl ◽  
Andrew Geddis-Regan
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Dental Care ◽  
Care Provision ◽  
Care Environment ◽  
Oral Pain ◽  
Key Issues ◽  
Definition Of ◽  
The Uk ◽  
The Impact

There are over 850,000 people living with dementia in the UK and this figure is expected to rise to over a million by 2021. Increasingly, oral healthcare professionals in primary care will see more patients affected by dementia at varying stages of the disease, and it is therefore crucial that they have a basic understanding of the disease and how these patients can be managed in a primary care environment. The first article in this series of two provides a definition of dementia and describes the symptoms of the disease along with the key issues related to oral health, such as oral pain. Oral pain can have far reaching consequences, but identifying it can be problematic, particularly in the latter stages of the disease. This article will therefore cover how to diagnose pain in patients with dementia. Information is also provided about how to make dental surgeries more ‘dementia friendly’.

scholarly journals Primary care consultations in the UK between 2006 and 2015: An analysis of electronic health records

2017 ◽  
Author(s):  
Benjamin Eaton
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Medical Science ◽  
Care Provision ◽  
Health Records ◽  
Healthcare Needs ◽  
Economic Recessions ◽  
The 2008 Financial Crisis ◽  
The Uk ◽  
The Impact

Primary care accounts for the majority of patient contact within the NHS. Over time medical science and healthcare needs change, which may lead to differences in how patients are treated in primary care for good or ill. In this study over 700 million consultations were analysed over a 10 year period between 2006 and 2015 inclusively to examine the trends in how people access primary care. The number of consultations per person per year initially increased in the first two years from 5.81 to 5.92, an increase of 0.11(0.10 to 0.12 95% CI) before declining to 3.7 by 2015, a decrease of 2.21 from the peak in 2008(2.20 to 2.23 95% CI). Consultations were increasingly handled by health care assistants instead of Nurses and GPs, and increased slightly in duration for all types of staff. This reduction in number of consultations is theorized to be a consequence of the 2008 financial crisis and its aftermath, further research is recommended on the impact of economic recessions and austerity policies on health care provision.

scholarly journals The Impact of Oral Health Training for Primary Care Clinicians: A Systematic Review

2019 ◽  
Vol 51 (3) ◽  
pp. 251-261 ◽  
Author(s):  
Kathleen Dwiel ◽  
Martell A. Hesketh ◽  
Jessica L. Alpert ◽  
Jacqueline Cellini ◽  
Kristen Goodell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Oral Health ◽  
Dental Care ◽  
Evaluation Framework ◽  
Practice Change ◽  
Care Practice ◽  
Clinician Training ◽  
Primary Care Clinicians ◽  
The Impact

Background and Objectives: Despite recent improvements in access to health care, many Americans still lack access to dental care. There has been a national focus on interprofessional education and team-based care to work toward the integration of services including dental care into primary care. The purpose of this systematic review is to understand the impact of implementing oral health curricula in primary care training on measurable changes in primary care practice. Methods: Researchers utilized a two-step process, first a scoping review and then using the PRISMA systematic review method to develop inclusion and exclusion criteria around audience, curricula, and outcomes to identify practice change due to oral health education curricula delivered in primary care clinician training. Researchers assessed titles, abstracts, and full texts and abstracted data for the review. Results: Researchers reviewed 2,749 articles and found 12 meeting the systematic review criteria. The reported outcomes and evaluations differed for each of the 12 studies identified. Over 40% utilized self-reporting. Seven of the included studies tracked outcomes by checklists embedded in electronic health records changes to well-child visit forms, or chart audits, one of which also tracked billing reimbursements. Conclusions: Oral health curricula for primary care clinicians are too heterogeneous to determine the effects on practice behavior. Future research should focus on developing a clear evaluation framework for measuring practice level changes in primary care settings as a result of implementing an oral health curriculum.

scholarly journals Primary care consultations in the UK between 2006 and 2015: An analysis of electronic health records

2017 ◽  
Author(s):  
Benjamin Eaton
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Medical Science ◽  
Care Provision ◽  
Health Records ◽  
Healthcare Needs ◽  
Economic Recessions ◽  
The 2008 Financial Crisis ◽  
The Uk ◽  
The Impact

Primary care accounts for the majority of patient contact within the NHS. Over time medical science and healthcare needs change, which may lead to differences in how patients are treated in primary care for good or ill. In this study over 700 million consultations were analysed over a 10 year period between 2006 and 2015 inclusively to examine the trends in how people access primary care. The number of consultations per person per year initially increased in the first two years from 5.81 to 5.92, an increase of 0.11(0.10 to 0.12 95% CI) before declining to 3.7 by 2015, a decrease of 2.21 from the peak in 2008(2.20 to 2.23 95% CI). Consultations were increasingly handled by health care assistants instead of Nurses and GPs, and increased slightly in duration for all types of staff. This reduction in number of consultations is theorized to be a consequence of the 2008 financial crisis and its aftermath, further research is recommended on the impact of economic recessions and austerity policies on health care provision.

Trends in oral health

2013 ◽  
Author(s):  
Blánaid Daly ◽  
Paul Batchelor ◽  
Elizabeth Treasure ◽  
Richard Watt
Keyword(s):  
Oral Health ◽  
Periodontal Disease ◽  
Diagnostic Criteria ◽  
Dental Care ◽  
Dental Trauma ◽  
Well Being ◽  
Oral Diseases ◽  
National Surveys ◽  
The Uk ◽  
The Impact

In the introduction to Chapter 1 it was stressed that in order to decide whether a disease is a public health problem it is important to be able to answer some key questions about it. Is the disease widespread? Is it on the increase? What individuals or groups appear to be susceptible? Do we know what causes it? Can it be prevented? What is the impact of the disease on the individual and society? The epidemiology of oral diseases can provide some detailed answers to these important questions. This chapter will present a brief overview of trends in oral diseases for children and adults in the UK. It will focus on periodontal disease, oral cancer, and dental caries, but there is also a brief section on dental trauma and erosion. Dentofacial anomalies, per se, are not diseases but will be included here, as their prevalence and incidence have implications for dental care because of the impact on social and psychological well-being. The impact on health will be presented. The problems of oral health inequality will be reviewed and the implications of trends in oral diseases for dental care in the UK will be discussed. There are many surveys describing the oral health of children and adults in the UK, with decennial national surveys of both groups since 1973. Scotland has not participated in the two most recent surveys, children in 2003 and adults in 2009. In these surveys all dental examiners are trained and calibrated, so that the diagnostic criteria are consistent and national trends can be identified. See Chapter 5 for a brief description of the importance of standardization of diagnostic criteria. In addition, the British Association for the Study of Community Dentistry (BASCD) undertakes surveys of the oral health of children within the districts of the UK; again, examiners are trained and calibrated and changes in trends in oral health across smaller areas can be monitored at shorter intervals than in the 10-yearly national surveys. Details of these surveys, including diagnostic criteria, can be found at http://www.bascd.org/oral-health-surveys. Current concepts in relation to periodontal disease have changed considerably in the last 20–30 years. The traditional ‘progressive’ disease model has been replaced by the ‘burst theory’. That is, periodontal diseases have short ‘bursts’ of activity followed by long periods of remission and healing (Goodson et al. 1982; Socransky et al . 1984).

scholarly journals Social and Behavioral Factors, Oral Health, and Dental Care Utilization

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 799-800
Author(s):  
Bei Wu ◽  
Stephen Shuman ◽  
Elisa Ghezzi
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Oral Health ◽  
Health Outcomes ◽  
Dental Care ◽  
Care Utilization ◽  
Behavioral Factors ◽  
Dental Care Utilization ◽  
The Impact ◽  
The U.S

Abstract Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.

scholarly journals COVID-19 Pandemic: The Urgent Dental Hub experience from a primary care perspective

2021 ◽  
Vol 10 (3) ◽  
pp. 41-45
Author(s):  
Zohaib Khwaja ◽  
Awais Ali ◽  
Manraj Rai
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Dental Care ◽  
Specialist Care ◽  
Health Message ◽  
Face To Face ◽  
General Dental Practitioner ◽  
Public Health Message ◽  
The Uk

In response to the nationwide lockdown on 23 March 2020 in the UK, urgent dental hubs (UDHs) were established in the community to provide emergency dental care. Consecutive referrals to a primary care UDH were prospectively analysed over a one-month period, from 18 May 2020 to 18 June 2020. Of 400 referrals received, the most common were in relation to pain (87%). In 63% neither a radiograph nor photograph was provided with the referral. Seventy percent of patients were telephone triaged within 24 hours of receipt of referral. Fifty-three percent of referrals were accepted for face-to-face treatment, of which 69% were treated by extraction. Of rejected referrals (n=179; 45%), 79% were due to symptoms having settled or being manageable by the time of triage. A small number of referrals were redirected for specialist care. Referrals that were accepted were more likely to have been prescribed antibiotics and less likely to have been referred by the general dental practitioner (GDP) they regularly saw (p <0.01). Patients that were older and those that identified themselves as not having a regular GDP were less likely to have been referred to an UDH. The quality of referrals was poor and there may be a role for virtual consultations moving forwards. We found pre-referral antimicrobial prescriptions were high and a confused public health message may have been sent.

scholarly journals Understanding the impact of the COVID-19 pandemic on a socially deprived UK coastal town: a preliminary exploratory analysis of health and socioeconomic data

2021 ◽  
Author(s):  
Maddy French ◽  
Mark Spencer ◽  
Mike Walker ◽  
Afzal Patel ◽  
Neil Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Hospital Admissions ◽  
Exploratory Analysis ◽  
Social Outcomes ◽  
Socioeconomic Outcomes ◽  
Chi Squared ◽  
Service Activity ◽  
Indirect Impacts ◽  
The Uk ◽  
The Impact

Introduction In addition to the direct impact of COVID-19 infections on health and mortality, a growing body of literature indicates there are wide-ranging indirect impacts of the COVID-19 pandemic and associated public health measures on population health and wellbeing. Exploring these indirect impacts in the context of a socially deprived UK coastal town will help identify priority areas to focus COVID-19 recovery efforts on. Methods Data on primary care diagnosis, hospital admissions, and several socioeconomic outcomes between 2016 and Spring 2021 in the UK town of Fleetwood were collected and analysed in an exploratory analysis looking at pre- and post- COVID-19 patterns in health and social outcomes. Weekly and monthly trends were plotted by time and differences between periods examined using Chi-squared and t-tests. Results Initial falls in hospital admissions and diagnoses of conditions in primary care in March 2020 were followed by sustained changes to health service activity for specific diagnostic and demographic groups, including for chronic kidney disease and young people. Increases in the number of people receiving Universal Credit and children eligible for free school meals appear to be greater for those in the least deprived areas of the town. Discussion These exploratory findings provide initial evidence of the sustained impact of the pandemic across several health and social outcomes. Examining these trends in multivariate analyses will further test these associations and establish the strength of the medium term impact of the pandemic on the population of this coastal town. Advanced modelling of this data is ongoing and will be published shortly.

scholarly journals The situation of elderly with cognitive impairment living at home during lockdown in the Corona-pandemic in Germany

2020 ◽  
Author(s):  
Jochen René Thyrian ◽  
Friederike Kracht ◽  
Angela Nikelski ◽  
Melanie Boekholt ◽  
Fanny Schumacher-Schönert ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Cognitive Impairment ◽  
Health Care Provision ◽  
Social Activities ◽  
Care Provision ◽  
Convenience Sample ◽  
Personal Impact ◽  
The Impact ◽  
At Home

Abstract Background: The outbreak of the Corona virus is a challenge for health care systems worldwide. The aim of this study is to analyze a) knowledge about, and feelings related to the Corona-pandemic. Describe b) loneliness, depression and anxiety and, c) the perceived, immediate impact of the lockdown on frequency of social contacts and quality of health care provision of people with cognitive impairment during social distancing and lockdown in the primary care system and living at home in Germany. Methods: This analysis is based on data of a telephone-based assessment in a convenience sample of n=141 people with known cognitive impairment in the primary care setting. Data on e.g. cognitive and psychological status prior to the pandemic was available. Attitudes, knowledge about and perceived personal impact of the pandemic, social support, loneliness, anxiety, depression, change in the frequency of social activities due to the pandemic and perceived impact of the pandemic on health care related services were assessed during the time of lockdown. Results: The vast majority of participants are sufficiently informed about Corona (85%) and most think that the measures taken are appropriate (64%). A total of 11% shows one main symptom of a depression according to DSM-5. The frequency of depressive symptoms has not increased between the time before pandemic and lockdown in almost all participants. The sample shows minimal (65.0%) or low symptoms of anxiety (25%). The prevalence of loneliness is 10%. On average seven activities have decreased in frequency due to the pandemic. Social activities related to meeting people, dancing or visiting birthdays have decreased significantly. Talking with friends by phone and activities like gardening have increased. Utilization of health care services like day clinics, relief services and prescribed therapies have been reported to have worsened due to the pandemic. Visits to general practitioners decreased. Conclusions: The study shows a small impact of the pandemic on psychological variables like depression, anxiety and loneliness in the short-term in Germany. There is a decrease in social activities as expected. The impact on health care provision is prominent. There is a need for qualitative, in-depth studies to further interpret the results.

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