scholarly journals Barriers and Facilitators of Dental Care in African-American Seniors: A Qualitative Study of Consumers’ Perspective

2020 ◽  
Vol 11 (1) ◽  
pp. 23-33
Author(s):  
Richie Kohli ◽  
Sonya Howk ◽  
Melinda M. Davis
Keyword(s):  
African American ◽  
Oral Health ◽  
Qualitative Study ◽  
Low Income ◽  
Dental Care ◽  
Insurance Coverage ◽  
Barriers And Facilitators ◽  
Dental Services ◽  
Cross Sectional ◽  
Free Care

Objective: To identify African-American seniors’ perceptions of the barriers and facilitators to their dental care. Materials and Methods: In this cross-sectional qualitative study, we conducted in-depth interviews with 16 community-based, self-identified African-American seniors from March 2017 to August 2017 in Oregon. We coded data in ATLAS.ti and used thematic analysis to identify emergent themes within the social ecological framework and a cross-case comparative analysis to explore variation by participant characteristics. Results: Regardless of dental insurance status, cost and perceived urgency of treatment were the primary drivers of participant’s ability and interest in seeking dental care. Participants identified four solutions to improve oral health care in African-American seniors: affordable/free care and vouchers for dental work, better oral health education at a younger age, onsite community dental services, and navigators who can educate patients about insurance and dental providers who see low-income patients. Conclusions: Oral health decisions by African-American seniors were primarily driven by cost and perceived urgency irrespective of insurance coverage. Affordable dental care, early intervention, on-site services, and navigation may help to address key barriers and reduce oral health disparities faced by African-Americans.

Patients Attendance for Emergency Dental Services in Mures County

2018 ◽  
Vol 69 (8) ◽  
pp. 2115-2120
Author(s):  
Kinga Dorner ◽  
Bernadette Kerekes Mathe ◽  
Andreea Bors ◽  
Cristina Molnar Varlam ◽  
Vanda Roxana Nimigean ◽  
...  
Keyword(s):  
Emergency Care ◽  
Low Income ◽  
Dental Care ◽  
Dental Health ◽  
Insurance Coverage ◽  
Economic Recession ◽  
Dental Services ◽  
Private Practices ◽  
Emergency Interventions ◽  
The Government

In Romania dental health services are provided mainly through user pays private practices and there is a limited reimbursement of dental services from the government. The economic recession lead to substantial lack of insurance coverage for oral health care of low-income population. The aim of this six-year retrospective study was to assess the prevalence of patients requesting public dental emergency care and to determine the characteristics of dental affections for which emergency interventions were requested in Tirgu-Mures, Romania. During the analyzed period, a total number of 38610 patients were treated in the Emergency Dental Office of Mures County Emergency Hospital. Of the total number of treated emergency patients 8017 (20.76%) were children and 30593 (79.25%) were adults. Significantly more adults requested emergency care than children (p[0.0001). Out of the investigated adults 3051 (9.98%) were aged 60 years or over. The high demand for emergency dental care reflects that dental care in private practices is unaffordable to socially disadvantaged patients and also the need for community based public dental care in Tirgu-Mures.

Strategies to improve access to and uptake of dental care by people experiencing homelessness in Australia: a grey literature review

2020 ◽  
Vol 44 (2) ◽  
pp. 297
Author(s):  
Jacqueline Goode ◽  
Ha Hoang ◽  
Leonard Crocombe
Keyword(s):  
Oral Health ◽  
Dental Care ◽  
Service Providers ◽  
Grey Literature ◽  
Homeless People ◽  
Dental Service ◽  
Dental Services ◽  
Free Care ◽  
Improve Access

Objectives The poor oral health of Australians experiencing homelessness negatively affects their quality of life. Better oral health is associated with having annual dental check-ups. Because there is limited peer-reviewed literature describing strategies that improve access to and uptake of dental care by homeless people, in this study we searched the grey literature to discover what strategies are used. Methods The Informit database and Google and Bing search engines were searched using the keywords ‘homeless and oral and dental services’. Bing and Google were searched unrestricted by site and Google was searched for sites ending in ‘org.au’. Searches were restricted to Australia from June 2008 to June 2018. The first 300 websites were read, and those describing or linking to pages describing a strategy that improved access to or uptake of dental care were included in the study. The content of the webpages was evaluated and summarised, with common strategies reported as a narrative description. Results Nineteen programs were described. Common strategies were providing free care, in-reach care, outreach care and the need to work closely with support organisations. Conclusions To improve access to and uptake of dental care by people experiencing homelessness, dental services need to be free and organised in collaboration with support organisations. What is known about the topic? The peer-reviewed literature describing strategies used to improve access to and uptake of dental care by people experiencing homelessness in Australia is limited. The authors could only locate two such studies, one based in Melbourne and one in Brisbane. Both programs had a similar aim, but used different strategies to achieve it, suggesting a lack of consensus about the best way to encourage dental visiting by people experiencing homelessness. What does this paper add? This paper used the grey literature to describe common strategies used in Australia to improve access to and uptake of dental care by people experiencing homelessness. What are the implications for practitioners? Dental service providers aiming to increase access to and uptake of dental care by people experiencing homelessness need to work collaboratively with support organisations and provide care free of charge.

scholarly journals Factors Associated With Access to Dental Services of Adults With Physical Disabilities in Thailand

2018 ◽  
Vol 10 (8) ◽  
pp. 163 ◽  
Author(s):  
Nithimar Sermsuti-anuwat ◽  
Sathirakorn Pongpanich
Keyword(s):  
Oral Health ◽  
Dental Care ◽  
Independent Living ◽  
Physical Disabilities ◽  
Community Dwelling ◽  
Binary Logistic Regression Analysis ◽  
Dental Services ◽  
Cross Sectional ◽  
Factors Associated ◽  
Dental Appointment

OBJECTIVES: To determine factors associated with access to dental services of community-dwelling adults with physical disabilities in Thailand.METHODS: This cross-sectional study was conducted at the Center of Independent Living, community club for individuals with disabilities in Pathum Thani province, Thailand, in February 2018. Individual participants were interviewed by a trained interviewer using a structured questionnaire that consisted of (1) questions on demographic characteristics and (2) adapted questions that were based on the modified Penchansky and Thomas’s dimensions of access (accessibility, availability, acceptability, affordability, accommodation and awareness). Enter method of binary logistic regression analysis was used.RESULTS: We included 198 individuals with physical disabilities. Most participants had not attended dental care services in the previous 12 months (77.3%) and gave negative responses for all questions regarding the dimensions of access. Although we did not observe any statistically significant differences in age and the six dimensions of access between participants who had attended at least one dental appointment and those who had not, in multivariate analysis, we found a statistically significant association indicated that participants who had education < primary were 3.35 times more likely to had not attended at least one dental appointment (p = 0.002).CONCLUSION: Our findings have uncovered factors associated with access to dental services of community-dwelling adults with physical disabilities in Thailand. Individuals with physical disabilities are in need of oral health education programs regarding proper oral health behaviors such as regular dental services attendance, appropriate oral hygiene practices and dental care benefits. 

scholarly journals Inequality in access to dental services in a market-based dental care system. A population study from Norway 1975-2018

2021 ◽  
Author(s):  
Nan Jiang ◽  
Jostein Grytten ◽  
Jonas Minet Kinge
Keyword(s):  
Confidence Interval ◽  
Low Income ◽  
Dental Care ◽  
Concentration Index ◽  
Adult Population ◽  
National Income ◽  
Income Group ◽  
Dental Services ◽  
Cross Sectional ◽  
Privately Financed

Objective: To examine income-related inequalities in access to dental services from 1975 to 2018. In Norway, dental care services for adults are privately financed. This might lead to income-related inequalities in access to dental services. However, over the last decades Norwegians have experienced a rapid growth in income, including people with lower income. This may have led to improved access to dental services for these people. Therefore, inequalities in access to dental services may have become less over the last decades. Research design: This was a prospective study. Statistics Norway collected samples of cross-sectional health survey data for the following years: 1975, 1985, 1995, 2002, 2008, 2012 and 2018. For each sample, individuals 20 years and older were drawn randomly from the non-institutionalized adult population using a two-stage stratified cluster sample technique. Inequalities were measured using the concentration index. The dependent variable was use of dental services during the last year and the key independent variable was equalized household income. Results: The concentration index for inequalities in use of dental services according to income decreased from 0.10 (95% confidence interval = 0.09, 0.11) in 1975 to 0.04 (95% confidence interval = 0.03, 0.05) in 2018. The decrease was particularly large from 2002 to 2012. This was a period with a large growth in gross national income. Conclusion: People with a low income had a marked increase in their purchasing power from 1975 to 2018. This coincided with an increase in demand for dental care for this low-income group.

scholarly journals Predictors of the Demand for Dental Appointments in Primary Health Care: A National Cross-Sectional Study

2021 ◽  
Author(s):  
Estêvão Azevedo Melo ◽  
Livia Fernandes Probst ◽  
Luciane Miranda Guerra ◽  
Elaine Pereira Silva Tagliaferro ◽  
Alessandro Diogo De-Carli ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Dental Care ◽  
Dental Services ◽  
Cross Sectional ◽  
Primary Health ◽  
The Individual ◽  
Dental Appointment

Abstract Background Aiming to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide, it is necessary that public dental services act in an integrated manner within the Health System, particularly with the primary care services. However, even inside availability scenarios in health care, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. The aim of the present study was to evaluate the predictors of the demand for dental care in Primary Health Care Units (PHC) with Oral Health Teams (OHTs). Methods The present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB, Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user requested a dental appointment at the Health Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome. Results In the final model, of the variables at the individual level, the patient's age over 43 years (OR = 2.03, 95% CI: 1.96–2.10) was the one that had the greatest effect on the outcome. In turn, among the contextual variables related to the teams, the ones with the greatest effect on the outcome were 'oral health teams that assisted no more than a single family health team' (OR = 1.29, 95% CI: 1.23–1.36) or 'those in which the dental form constitutes the user's medical record' (OR = 1.21, 95% CI: 1.15–1.26) were predictors of the demand for a dental appointment in Primary Health Care. Conclusion It can be concluded that individual and contextual issues interfere in the demand for dental care. Oral health planning must consider an active search for patients with profiles that do not favor the spontaneous demand for oral health care, such as being older, male gender and non-white ethnicity. It is also concluded that the oral health teams that worked in line with the Brasil Sorridente guidelines are the teams most often sought after by the users.

scholarly journals Co-producing an intervention for tobacco cessation and improvement of oral health among diabetic patients in Bangladesh

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masuma Pervin Mishu ◽  
Helen Elsey ◽  
Arup Ratan Choudhury ◽  
Shahana Dastagir ◽  
Saeed Khan ◽  
...  
Keyword(s):  
Oral Health ◽  
Tobacco Cessation ◽  
Tobacco Consumption ◽  
Barriers And Facilitators ◽  
Diabetic Patients ◽  
Cross Sectional Survey ◽  
Dental Services ◽  
Cross Sectional ◽  
Dental Clinics ◽  
Cessation Intervention

Abstract Background Tobacco consumption is a major risk factor for many diseases including diabetes and has deleterious effects on oral health. Diabetic patients are vulnerable to developing certain oral conditions. So far, no studies have attempted to co-develop a tobacco cessation intervention to be delivered in dental clinics for people with diabetes in Bangladesh. Aim To co-produce a tobacco cessation intervention for people with diabetes for use in dental clinics in Bangladesh. Objectives To assess: (1) tobacco use (patterns) and perceptions about receiving tobacco cessation support from dentists among people with diabetes attending the dental department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) who smoke or use smokeless tobacco (ST) (2) current tobacco cessation support provision by the dentists of the dental department of BIRDEM (3) barriers and facilitators of delivering a tobacco cessation intervention at a dental clinic, and (4) to co-produce a tobacco cessation intervention with people with diabetes, and dentists to be used in the proposed context. Methods The study was undertaken in two stages in the dental department of BIRDEM, which is the largest diabetic hospital in Bangladesh. Stage 1 (July–August 2019) consisted of a cross-sectional survey among people with diabetes who use tobacco to address objective 1, and a survey and workshop with dentists working in BIRDEM, and consultations with patients to address objectives 2 and 3. Stage 2 (January 2020) consisted of consultations with patients attending BIRDEM, and a workshop with dentists to co-produce the intervention. Result All survey participants (n = 35) were interested in receiving tobacco cessation support from their dentist. We identified important barriers and facilitators to deliver tobacco cessation intervention within dental services. Barriers reported by dentists included lack of a structured support system and lack of training. As a facilitator, we identified that dentists were willing to provide support and it would be feasible to deliver tobacco cessation intervention if properly designed and embedded in the routine functioning of the dental department of BIRDEM. Through the workshops and consultations at stage 2, a tobacco cessation intervention was co-developed. The intervention included elements of brief cessation advice (using a flipbook and a short video on the harmful effects of tobacco) and pharmacotherapy. Conclusion Incorporation of tobacco cessation within dental care for people with diabetes was considered feasible and would provide a valuable opportunity to support this vulnerable group in quitting tobacco.

scholarly journals A Cross-Sectional Analysis of Oral Health Spending Over the Lifespan in Commercial and Medicaid Insured Populations

2021 ◽  
Author(s):  
Eric Tranby ◽  
Julie Frantsve-Hawley ◽  
Myechia Minter-Jordan ◽  
James Thommes ◽  
Matt Jacob ◽  
...  
Keyword(s):  
Oral Health ◽  
Oral Cancer ◽  
Dental Care ◽  
Care Delivery ◽  
Health Spending ◽  
Dental Service ◽  
Fee For Service ◽  
Cross Sectional ◽  
Medical Spending ◽  
Ibm Watson

Background: Life course theory creates a better framework to understand how oral health needs and challenges align with specific phases of the lifespan, care models, social programs, and changes in policy. Methods): Data are from the 2018 IBM Watson Multi-State Medicaid Marketscan Database (31 million claims) and the 2018 IBM Watson Dental Commercial and Medicare Supplemental Claims Database (45 million claims). Analysis compares per enrollee spending fee-for-service dental claims and medical spending on dental care from ages 0 to 89. Results: Dental utilization and spending are lower during the first 4 years of life and in young adulthood than in other periods of life. Stark differences in the timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations. Conclusions: This unique lifespan analysis of the U.S. multi-payer dental care system demonstrates the complexities of the current dental service environment and a lack of equitable access to oral healthcare. Practical Implications: Health policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the lifespan.

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.

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