scholarly journals Wider Dental Care Coverage Associated with Lower Oral Health Inequalities: A Comparison Study between Japan and England

2020 ◽  
Vol 17 (15) ◽  
pp. 5539
Author(s):  
Kanade Ito ◽  
Noriko Cable ◽  
Tatsuo Yamamoto ◽  
Kayo Suzuki ◽  
Katsunori Kondo ◽  
...  
Keyword(s):  
Oral Health ◽  
Educational Attainment ◽  
Dental Care ◽  
Social Inequalities ◽  
Health Care Systems ◽  
Relative Index ◽  
Health Related ◽  
Care Systems ◽  
Natural Teeth ◽  
Index Of Inequality

Countries with different oral health care systems may have different levels of oral health related inequalities. We compared the socioeconomic inequalities in oral health among older adults in Japan and England. We used the data for adults aged 65 years or over from Japan (N = 79,707) and England (N = 5115) and estimated absolute inequality (the Slope Index of Inequality, SII) and relative inequality (the Relative Index of Inequality, RII) for edentulism (the condition of having no natural teeth) by educational attainment and income. All analyses were adjusted for sex and age. Overall, 14% of the Japanese subjects and 21% of the English were edentulous. In both Japan and England, lower income and educational attainment were significantly associated with a higher risk of being edentulous. Education-based SII in Japan and England were 9.9% and 26.7%, respectively, and RII were 2.5 and 4.8, respectively. Income-based SII in Japan and England were 9.2% and 14.4%, respectively, and RII were 2.1 and 1.9, respectively. Social inequalities in edentulous individuals exist in both these high-income countries, but Japan, with wider coverage for dental care, had lower levels of inequality than England.

scholarly journals Persistent Socioeconomic Inequality in Child Dental Caries in England despite Equal Attendance

2019 ◽  
Vol 5 (2) ◽  
pp. 185-194 ◽  
Author(s):  
V. Ravaghi ◽  
D.S. Hargreaves ◽  
A.J. Morris
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Dental Care ◽  
Socioeconomic Inequalities ◽  
Limited Information ◽  
Dental Services ◽  
Relative Index ◽  
The Past ◽  
Dental Attendance ◽  
Index Of Inequality

Introduction: Despite a decline in the prevalence of dental caries among children in England and ongoing arrangements for the provision of free dental care up to the age of 18 y, there is limited information on the pattern and trend of socioeconomic inequalities in dental caries and dental attendance. Methods: We estimated the magnitude of deprivation-related inequalities for dental caries and dental attendance in young children, using publicly available data and 2 regression-based summary measures of inequalities: slope index of inequality and relative index of inequality. Results: We found no significant absolute or relative inequalities in dental attendance across English areas in the past decade, while there were persistent absolute and relative inequalities in dental caries. Socioeconomic inequalities in dental caries decreased between 2007 and 2012; thereafter, the relative inequalities increased. Conclusions: The apparent widening inequality in child dental caries in England despite equal access to dental care is a challenge for policy makers. Knowledge Transfer Statement: While caries prevalence among English children has declined over the past decade, there has been an increase in socioeconomic inequalities in oral health despite there being no inequality in dental attendance. This has implications for the development of oral health strategy and planning dental services.

From Chronic Emergency to Development: An Analysis of the Health of the Urban Poor in Luanda, Angola

1992 ◽  
Vol 22 (2) ◽  
pp. 349-363 ◽  
Author(s):  
Najmi Kanji ◽  
Trudy Harpham
Keyword(s):  
Urban Poor ◽  
Structural Adjustment ◽  
Health Care Systems ◽  
Infant Mortality Rate ◽  
African Countries ◽  
Rapid Urbanization ◽  
Intestinal Infections ◽  
Health Related ◽  
Care Systems ◽  
Sub Saharan

There is a dearth of published literature on health care systems in Angola. Like many sub-Saharan African countries, Angola is experiencing rapid urbanization. The authors provide an analysis of the health status, environmental health conditions, and health-related behavior of the urban poor in Luanda, Angola. Although data are patchy and rarely disaggregated to reveal severe conditions in the shanty towns, a grave picture emerges. An average infant mortality rate of 104/1,000, with malaria and intestinal infections the main causes of death in children under 1 year old, reflects the poor environmental conditions, which are worsening as urbanization continues at a rapid rate. Use of health services is limited; for example, 50 percent of women give birth at home, mainly unassisted, and only 28 percent of children are covered by measles immunization (as validated by card). A discussion of existing health strategies, programs, and their constraints is set in the context of the future possibilities of the ending of the 15-year war and the introduction of structural adjustment policies.

Toward More Patient-Centered and Prevention-Oriented Oral Health Care

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 ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Disease Prevention ◽  
Care Delivery ◽  
Health Care Systems ◽  
Oral Care ◽  
Oral Health Care ◽  
Patient Centered ◽  
Care Systems ◽  
European Union Member States

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.

scholarly journals A Consensus-Based Set of Measures for Oral Health Care

2017 ◽  
Vol 96 (8) ◽  
pp. 881-887 ◽  
Author(s):  
F. Baâdoudi ◽  
A. Trescher ◽  
D. Duijster ◽  
N. Maskrey ◽  
F. Gabel ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Routine Data ◽  
Oral Health Care ◽  
Care Providers ◽  
Patient Centered ◽  
Dental Practitioners ◽  
Care Systems

Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more patient-centered and prevention-oriented oral health care. To accomplish this, an intermediate objective was to develop a comprehensive list of topics that a range of stakeholders would perceive as valid, important, and relevant for describing oral health and oral health care. A 4-stage approach was used to develop the list of topics: 1) scoping of literature and its appraisal, 2) a meeting of experts, 3) a 2-stage Delphi process (online), and 4) a World Café discussion. The aim was to create consensus through structured conversations via a range of stakeholders (general dental practitioners, patients, insurers, and policy makers) from the Netherlands, Germany, the United Kingdom, Ireland, Hungary, and Denmark. The study was part of the ADVOCATE project, and it resulted in a list of 48 topics grouped into 6 clusters: 1) access to dental care, 2) symptoms and diagnosis, 3) health behaviors, 4) oral treatments, 5) oral prevention, and 6) patient perception. All topics can be measured, as they all have a data source with defined numerators and denominators. This study is the first to establish a comprehensive and multiple-stakeholder consented topic list designed for guiding the implementation of transparent and explicit measurement of routine data of oral health and oral health care. Successful measurement within oral health care systems is essential to facilitate learning from variation in practice and outcomes within and among systems, and it potentiates improvement toward more patient-centered and prevention-oriented oral health care.

scholarly journals Removable Partial Dentures for Older Adults

2020 ◽  
Vol 9 (3) ◽  
pp. 34-39
Author(s):  
Tim Friel ◽  
Sarah Waia
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Oral Health ◽  
Acrylic Resin ◽  
Population Replacement ◽  
Related Quality ◽  
Health Related ◽  
Natural Teeth ◽  
Partially Dentate

Improvements in oral health including increased retention of natural teeth have given rise to a partially dentate older population. Replacement of missing natural teeth is important to improve function, aesthetics and quality of life for this patient group. A variety of options are available to replace missing teeth in partially dentate older adults, including fixed, removable and implant retained prostheses. This article will discuss the provision of removable partial dentures including treatment planning and denture design. When planning removable partial dentures, careful attention must be paid to stabilising the patient prior to delivering any prosthesis. Partial dentures should be designed to minimise the potential for plaque accumulation with carefully designed metal based frameworks. Acrylic resin can also be utilised with attention to detail to minimise the risk of damage to delicate supporting tissues. Removable dentures have the advantage that they can be readily added to in the event of further tooth loss which may be particularly relevant for older adults. Partial dentures which optimise support, retention and stability can function very successfully and significantly improve patients’ oral health related quality of life.

scholarly journals Estimate of Impact on the Oral Health-Related Quality of Life of Older Thai People by the Provision of Dentures through the Royal Project

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Patcharawan Srisilapanan ◽  
Narumanas Korwanich ◽  
Sutha Jienmaneechotchai ◽  
Supranee Dalodom ◽  
Nontalee Veerachai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Older People ◽  
Health Related Quality ◽  
Oral Impact ◽  
Related Quality ◽  
Health Related ◽  
Natural Teeth ◽  
Oral Impacts

Purpose.To estimate the impact of the provision of dentures to Thai older people by the Royal Project on their oral health-related quality of life.Methods.A purposive cross-sectional study of a sample of 812 subjects was conducted. The Oral Impacts on Daily Performances (OIDP) measure was used to assess the oral health-related quality of life.Results.Four groups of older people with different tooth types were studied. 216 (26.6%) had natural teeth (NT). 189 (23.3%) had natural and replaced teeth (NRT). 167 (20.6%) had below the minimum number of teeth but had no dentures (Edent) and 240 were edentate with complete dentures provided by the Royal Project (ECD) (29.6%). Overall, 36.5% had at least one oral impact. Eating was the most affected oral impact. When compared to the group with natural teeth (NT), the Edent group was significantly more likely to report having impacts on eating OR = 6.5 (3.9–10.9), speaking clearly OR = 43.7 (12.7–15.07), emotional stability OR = 16.5 (6.0–45.6), and social contacts OR = 4.6 (2.2–9.5) (p<0.001).Conclusion.Those who are edentulous are much more likely to have an oral impact on their daily performances than those provided dentures. Provision of dentures may lead to improvement of considerable oral impacts.

scholarly journals Pacing Forward in the Face of Fragility: Lessons From African Institutions and Governments' Response to Public Health Emergencies

2021 ◽  
Vol 9 ◽  
Author(s):  
Byron Bitanihirwe ◽  
Derrick Ssewanyana ◽  
Ismael Ddumba-Nyanzi
Keyword(s):  
Public Health ◽  
Social Inequalities ◽  
Health Care Systems ◽  
Well Being ◽  
Public Health Emergencies ◽  
Economic Diversity ◽  
Western Africa ◽  
The Face ◽  
Care Systems ◽  
Sustainable Health

Africa is home to 54 United Nation member states, each possessing a wealth of ethno-cultural, physiographic, and economic diversity. While Africa is credited as having the youngest population in the world, it also exhibits a unique set of “unfortunate realties” ranging from famine and poverty to volatile politics, conflicts, and diseases. These unfortunate realities all converge around social inequalities in health, that are compounded by fragile healthcare systems and a lack of political will by the continent's leaders to improve smart investment and infrastructure planning for the benefit of its people. Noteworthy are the disparities in responsive approaches to crises and emergencies that exist across African governments and institutions. In this context, the present article draws attention to 3 distinct public health emergencies (PHEs) that have occurred in Africa since 2010. We focus on the 2013–2016 Ebola outbreak in Western Africa, the ongoing COVID-19 pandemic which continues to spread throughout the continent, and the destructive locust swarms that ravaged crops across East Africa in 2020. Our aim is to provide an integrated perspective on how governments and institutions handled these PHEs and how scientific and technological innovation, along with educational response played a role in the decision-making process. We conclude by touching on public health policies and strategies to address the development of sustainable health care systems with the potential to improve the health and well-being of the African people.

scholarly journals Oral health-related quality of life among 12-year-olds

2020 ◽  
Vol 19 ◽  
pp. e207981
Author(s):  
Eduardo José Pereira Oliveira ◽  
Fabíola Bof de Andrade
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Social Inequalities ◽  
Minas Gerais ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Independent Variables ◽  
Related Quality ◽  
Health Related

Aim: To assess oral health-related quality of life (OHRQoL) and associated factors among the 12-year-old population of the state of Minas Gerais, Brazil. Methods: Cross-sectional data from the SB-Minas Gerais 2012 study were used. The presence of poor OHRQoL was assessed using the Oral Impact on Daily Performance (OIDP) and its dimensions (physical, psychological and social domains). Independent variables included sociodemographic factors and variables related to the use of dental care and oral health conditions. The association between the outcomes and the independent variables were tested using logistic regression and the results reported as odds ratio with 95% confidence interval. Results: Prevalence of poor OHRQoL was 31.4%; the psychological domain was the most affected (22.6%). Pain and dissatisfaction with oral health were associated with poor OHRQoL on overall OIDP and all its domains. Non-whites had greater poor OHRQoL than whites on overall OIDP and physical domain. Conclusion: Self-perceived oral health and social inequalities were associated with poor OHRQoL.

scholarly journals Trends in socioeconomic inequalities in the prevalence of functional dentition among older people in Brazil

2018 ◽  
Vol 34 (10) ◽  
Author(s):  
Fabiola Bof de Andrade ◽  
Jose Leopoldo Ferreira Antunes
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Socioeconomic Inequalities ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Relative Index ◽  
Functional Dentition ◽  
Natural Teeth ◽  
Index Of Inequality ◽  
Position Measure

The objective of this research was to evaluate trends in socioeconomic inequalities in the prevalence of functional dentition among community-dwelling older adults in Brazil. This was a cross-sectional study with data from the last two SBBrasil Project surveys conducted in 2003 and 2010. Functional dentition was defined as the presence of 20 or more natural teeth and was assessed during the clinical examination of dentition status. Schooling was used as the socioeconomic position measure. Socioeconomic inequality was measured using two complex measures; the slope index of inequality (SII) and the relative index of inequality (RII). The prevalence of functional dentition was 10.8% (95%CI: 8.1-14.2) in 2003 and 13.6% (95%CI: 11.1-16.5) in 2010. The prevalence of functional dentition increased significantly over the educational rank in both years. Absolute inequalities were significant for both years and remained unaltered between 2003 and 2010. Significant relative inequality in the prevalence of functional dentition was found in both years of the survey. Socioeconomic inequalities in the prevalence of functional dentition among older adults in Brazil persisted significantly between both national oral health surveys.

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