Non-financial  barriers in oral health care: a qualitative study of patients receiving opioid maintenance treatment and professionals’ experiences

Abstract Background People with substance use disorders often have poor oral health, which can negatively impact their quality of life. Since 2005, patients receiving opioid maintenance treatment (OMT) in Norway have been eligible for free oral health care services offered through public oral health clinics. Despite a large need for oral health services amongst patients in OMT, figures suggest that the use of these services is low amongst this patient group. It has been unclear which barriers that contribute to this. This qualitative study explores the underlying barriers to the use of oral health care services amongst patients in OMT, from the perspective of the patients as well as dental health care workers (DHW). Methods Through a combination of focus group interviews and individual interviews, data were collected from 63 participants; 30 patients in OMT and 33 DHW. Thematic analysis identified key themes for the use (or not) of oral health care services amongst patients in OMT. Results Both individual and structural barriers prevent OMT patients from using the free oral health care services offered to them. These barriers include struggling to attend appointments, anxiety and fear of dentists, discrepancies between patients’ expectations and the services offered and perceived stigma. OMT patients’ lack of information regarding their rights and access to oral health services was also a barrier, as was DHWs’ lack of knowledge and information of the OMT system and what they can offer patients. Conclusions OMT patients face several barriers in accessing and using oral health care services. However, through a number of relatively simple measures, it is possible that the use of oral health services amongst OMT patients can be increased.

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Effect of referral for dental service on dental-service utilization by primary school children aged 8 to 11 years in Enugu, Nigeria

Brazilian Journal of Oral Sciences ◽

10.20396/bjos.v15i2.8648767 ◽

2017 ◽

Vol 15 (2) ◽

pp. 151 ◽

Cited By ~ 2

Author(s):

Nneka Kate Onyejaka ◽

Morenike Oluwatoyin Folayan ◽

Nkiruka Folaranmi

Keyword(s):

Health Care ◽

Oral Health ◽

Health Services ◽

Health Care Services ◽

Oral Health Care ◽

Dental Service ◽

Care Services ◽

Oral Health Services ◽

Study Participants ◽

Referral Letters

Aim: To determine how one dental education session and referral of study participants aged 8-11 years would affect utilization of oral-health care services. Methods: This descriptive prospective study recruited 1,406 pupils aged 8-11 years from randomly selected primary schools in Enugu metropolis. All pupils received one oral-health education and referral letters for treatment. Data were collected on the pupils’ socio-demographic profile, family structure, and history of oral-health care utilization in the 12 months preceding the study and within 12 months of receipt of referral letter. The effect of these factors as predictors of past and recent dental service utilization was determined using logistic regression. Results: Only 4.3% of the study participants had ever used oral-health services in the 12 months prior to the study. Within 12 months of issuing the referral letters, 9.0% of pupils used the oral-health services. Children from middle (AOR: 0.46; CI: 0.29-0.73; p=0.001) and low socioeconomic strata (AOR: 0.21; CI: 0.11-0.39; p<0.001) and those living with relatives/guardians (AOR: 0.08, CI: 0.01-0.56; p=0.01) were still less likely to have utilized oral-health services. Conclusions: Referral of children for oral-health care increased the number of children who utilized oral health care services.

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Socio-demographic profile of child and adolescent users of oral health services in Victoria, Australia

Cadernos de Saúde Pública ◽

10.1590/0102-311x00083613 ◽

2014 ◽

Vol 30 (9) ◽

pp. 1903-1911 ◽

Cited By ~ 4

Author(s):

J Rodrigo ◽

Hanny Calache ◽

Martin Whelan

Keyword(s):

Health Care ◽

Oral Health ◽

Health Services ◽

Health Care Services ◽

Social Inequalities ◽

Secondary Analysis ◽

Well Being ◽

Oral Health Care ◽

Sample Mean ◽

Oral Health Services

The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.

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Experience of Caregivers Caring for Children with Cerebral Palsy in Accessing Oral Health Care Services: A Qualitative Study

Archives of Orofacial Sciences ◽

10.21315/aos2019.14.2.381 ◽

2019 ◽

Vol 14 (2) ◽

pp. 133-146

Author(s):

Datu Mohd Amyril Abduludin ◽

◽

Normastura Abd Rahman ◽

Munirah Mohd Adnan ◽

Azlina Yusuf ◽

...

Keyword(s):

Health Care ◽

Cerebral Palsy ◽

Oral Health ◽

Qualitative Study ◽

Health Care Services ◽

Oral Health Care ◽

Care Services ◽

Children With Cerebral Palsy

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Reopening Oral Health Services during the COVID-19 Pandemic through a Knowledge Exchange Coalition

JDR Clinical & Translational Research ◽

10.1177/23800844211011985 ◽

2021 ◽

pp. 238008442110119

Author(s):

M. McNally ◽

L. Rock ◽

M. Gillis ◽

S. Bryan ◽

C. Boyd ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Services ◽

Return To Work ◽

Health Care Providers ◽

Online Survey ◽

Knowledge Exchange ◽

Oral Health Care ◽

Care Providers ◽

Oral Health Services

Background: The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work. Methods: Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic. Results: Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic. Conclusions: A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings. Knowledge Transfer Statement: The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.

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Oral health care services in Europe

Journal of Public Health ◽

10.1007/bf02962506 ◽

2001 ◽

Vol 9 (2) ◽

pp. 112-121 ◽

Cited By ~ 1

Author(s):

Dorthe Holst ◽

Aubrey Sheiham ◽

Poul Erik Petersen

Keyword(s):

Health Care ◽

Oral Health ◽

Health Care Services ◽

Oral Health Care ◽

Care Services

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Oral Health Care Services in India

International Journal of Pharmaceutical Research ◽

10.31838/ijpr/2021.13.01.590 ◽

2021 ◽

Vol 13 (01) ◽

Keyword(s):

Health Care ◽

Oral Health ◽

Health Care Services ◽

Oral Health Care ◽

Care Services

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The Effect of Physician Oral Health Services on Dental Use and Expenditures under General Anesthesia

JDR Clinical & Translational Research ◽

10.1177/2380084419870128 ◽

2019 ◽

Vol 5 (2) ◽

pp. 146-155 ◽

Cited By ~ 1

Author(s):

B.D. Meyer ◽

R. Wang ◽

M.J. Steiner ◽

J.S. Preisser

Keyword(s):

Health Care ◽

Early Childhood ◽

Oral Health ◽

Health Services ◽

General Anesthesia ◽

Early Childhood Caries ◽

Dental Treatment ◽

Oral Health Care ◽

Oral Health Services ◽

The Impact

Background: Despite early evidence touting the effectiveness of physician-provided oral health services (POHS), recent evidence suggests these services might have little impact on caries-related outcomes in children. General anesthesia (GA) is often used to treat early childhood caries and may be considered the most extreme utilization outcome. We sought to assess the impact of POHS utilization on dental GA utilization and expenditures. Methods: We used the Medicaid claims of a birth cohort of children born in 2008 in North Carolina ( N = 32,558) to determine the impact of POHS on dental utilization and expenditures under GA for individual children. Children were followed until their eighth birthday. We analyzed the association of the number of prior POHS visits with visit-specific outcomes of dental treatment under GA using population-averaged models fit with generalized estimating equations with exchangeable working correlation structure. Results: Children with 2 or more previous POHS visits had reduced odds of GA (odds ratio [OR] = 0.93; confidence interval [CI], 0.87–0.99; P = 0.029) and expenditures ($114; CI,−$152.61 to −$75.19; P < 0.001) compared to those without physician-provided oral health visits, adjusting for age, sex, race/ethnicity, and geographic residence. Dental expenditures did not differ between POHS and non-POHS subjects at non-GA visits. Conclusions: POHS decreased the odds of having dental GA treatment and dental expenditures at GA visits. The role of physicians in oral health care can reduce the impact on the most severe outcome—treatment under general anesthesia. Knowledge Transfer Statement: The results of this study have important financial implications for state Medicaid programs and disease management programs trying to mitigate the costs of treating early childhood caries under general anesthesia. Children who receive physician oral health care are less likely to use and more likely to save money on general anesthesia to complete dental treatment.

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