Increasing Use of Dental Services by Children, but Many Are Unable to Secure Needed Care

National studies indicate that an increasing proportion of children are receiving needed oral health care. However, this increase is not uniform throughout all populations of youngsters. Overall national study findings regarding the use of dental services mask the fact that, a significant subset of low-income, minority, medically and developmentally compromised and socially vulnerable children continue to lack access to care and suffer significant and consequential dental and oral disease. In addition, these same children will face continued difficulties in securing needed care as they reach their early adult years.

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

Journal of Dentistry & Oral Disorders ◽

10.26420/jdentoraldisord.2021.1166 ◽

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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Financing Oral Health Care for Low-Income Adults Living with HIV/AIDS

Public Health Reports ◽

10.1177/00333549121270s211 ◽

2012 ◽

Vol 127 (2_suppl) ◽

pp. 82-86 ◽

Cited By ~ 2

Author(s):

Helene Bednarsh ◽

David A. Reznik ◽

Carol R. Tobias

Keyword(s):

Health Care ◽

Oral Health ◽

Low Income ◽

Oral Health Care ◽

Living With Hiv ◽

Hiv Aids

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A health-promoting community dental service in Melbourne, Victoria, Australia: protocol for the North Richmond model of oral health care

Australian Journal of Primary Health ◽

10.1071/py17007 ◽

2017 ◽

Vol 23 (5) ◽

pp. 407 ◽

Cited By ~ 2

Author(s):

Martin Hall ◽

Bradley Christian

Keyword(s):

Health Care ◽

Oral Health ◽

Disease Management ◽

Healthcare Delivery ◽

Oral Health Care ◽

Oral Health Status ◽

Dental Service ◽

Oral Disease ◽

The North ◽

Health Promoting

Despite the best efforts and commitment of oral health programs, there is no evidence that the current surgical output-based model of oral health care is delivering better oral health outcomes to the community. In fact, Australian evidence indicates the oral health of the community could be getting worse. It is now well-understood that this traditional surgical model of oral health care will never successfully manage the disease itself. It is proposed that a health-promoting, minimally invasive oral disease management model of care may lead to a sustainable benefit to the oral health status of the individual and community groups. The aim of this paper is to describe such a model of oral health care (MoC) currently being implemented by the North Richmond Community Health Oral Health (NRCH-OH) program in Melbourne, Victoria, Australia; this model may serve as a template for other services to re-orient their healthcare delivery towards health promotion and prevention. The paper describes the guiding principles and theories for the model and also its operational components, which are: pre-engagement while on the waitlist; client engagement at the reception area; the assessment phase; oral health education (high-risk clients only); disease management; and reviews and recall.

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Oral Health Knowledge of Pregnant Women on Pregnancy Gingivitis and Children's Oral Health

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.39.2.n66w635638w643n7 ◽

2015 ◽

Vol 39 (2) ◽

pp. 105-108 ◽

Cited By ~ 2

Author(s):

C Zhong ◽

KN Ma ◽

YS Wong ◽

Y So ◽

PC Lee ◽

...

Keyword(s):

Health Care ◽

Early Childhood ◽

Oral Health ◽

Pregnant Women ◽

Early Childhood Caries ◽

Health Knowledge ◽

Oral Health Care ◽

Oral Disease ◽

Children’S Oral Health ◽

Childhood Caries

Objective: Pregnancy gingivitis and early childhood caries remain prevalent in Hong Kong. The aim of this study was to assess pregnant women's knowledge and beliefs related to pregnancy gingivitis and children's oral health. Study design: An outreach survey was carried out in a clinic that provided antenatal examination. A written oral health questionnaire related to pregnancy gingivitis and early childhood caries was administered to pregnant women. Of the 106 pregnant women who enrolled in the study, 100 completed the questionnaires. Results: Among the 100 subjects, only 39% correctly identified that hormonal changes contribute to pregnancy gingivitis. Only 36% identified red and swollen gums as signs of gingivitis. Furthermore, 53% of the surveyed pregnant women were not sure about the amount of toothpaste to administer to a child aged 18 months to 5 years. Almost 50% assumed that a replanted avulsed tooth would probably not survive within a short extra-alveolar period of less than 60 minutes. Conclusion: Prenatal women generally lack knowledge of a common oral disease that occurs during pregnancy and of what constitutes adequate oral health care for children. Oral health care education should be implemented as part of a prenatal care program.

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

Frontiers in Oral Health ◽

10.3389/froh.2021.667867 ◽

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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Accessibility to oral health care of precarious and non precarious populations in Côte d’Ivoire

European Journal of Public Health ◽

10.1093/eurpub/ckz186.002 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A D Sangare ◽

M Samba ◽

G D Meless ◽

J C Guinan ◽

J F Traore ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Access To Care ◽

Cote D'ivoire ◽

Dental Care ◽

Côte D’Ivoire ◽

Social Protection ◽

Oral Health Care ◽

Health Care Use ◽

Protection Mechanisms

Abstract Introduction The purpose of any health system is to guarantee access to care for the entire population served. However, the socio-economic insecurity situation of people in precarious situations, raises the problem of their access to oral health care considered to be expensive. The objective of this study was to compare the dental status and modalities of oral health care use by people in precarious situations to group of non-precarious population in Abidjan, in Côte d’Ivoire. Methods The cross-sectional study was conducted at the University Hospital Center of Treichville. It concerned all users of the dental office of this hospital. Subjects in precarious situations were identified using a screening tool. Was considered to be in a precarious situation, a person living with less than 1.5 USD/day, having no fixed address, looking for a job, having no health insurance or having difficulties in dealing with medical and pharmaceutical costs. We have identified variables for the modalities of oral health care use and follow-up. The frequencies of these variables were calculated and comparisons were made between subjects in precarious and non- precarious situations using the Chi2 test. Results 256 people participated in the study. The tool for identifying precariousness made it possible to distinguish 128 subjects classified in precarious situations and 128 others in non- precarious situations. The number of missing teeth in people in precarious situations was twice as high as in non-precarious subjects. Renunciation of dental care was more common in the precarious group (46%) than in the non- precarious group (32%). Absenteeism rates at the first two appointments were higher among the precarious (54%) than among the not precarious (46%). Conclusions These results show the need to sensitize the population on the importance of oral health and the establishment of social protection mechanisms to ensure greater accessibility to care for people in precarious situations. Key messages Improving the oral health of populations, especially vulnerable population groups, requires the establishment of social protection mechanisms to remove the financial barrier to access to care. Educating the public about the importance of oral health for overall good health is essential to improving the use of dental care.

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Disparities in Access to Oral Health Care

Annual Review of Public Health ◽

10.1146/annurev-publhealth-040119-094318 ◽

2020 ◽

Vol 41 (1) ◽

pp. 513-535 ◽

Cited By ~ 6

Author(s):

Mary E. Northridge ◽

Anjali Kumar ◽

Raghbir Kaur

Keyword(s):

Health Care ◽

Oral Health ◽

Low Income ◽

Safety Net ◽

The United States ◽

Oral Health Care ◽

Oral Diseases ◽

Patient Centered ◽

Obesity And Diabetes ◽

Centered Care

In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.

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