Living the Challenges of a Pandemic Through the Succour and Strength of Science

Access to dental care in Saudi Arabia is a challenge due to the lack of proper distribution of the dental workforce. Teledentistry is the field of dentistry that helps to receive and provide dental service remotely using digital platforms. It can facilitate access to dental care, especially in underserved regions. The implication of teledentistry needs to address the concerns of dental professionals to ensure effective teledentistry application in dental practice. This review aimed to explore the literature about the perception, awareness, and knowledge of dental professionals about teledentistry in Saudi Arabia. Peer-reviewed literature was searched in databases including Web of Science, Scopus, PubMed, and Google Scholar with no time limits using the keywords: “Teledentistry”, “Dental Telemedicine”, “Saudi Arabia”, “Perception”, “Knowledge”, “Awareness”. We identified 7 relevant studies. All of them were after the breakthrough of the COVID-19 pandemic. Two studies targeted all dental professionals while another two studies investigated the dentists. Undergraduate dental students were investigated by one study as well as postgraduates. One study focused on both undergraduate and postgraduate dental students. Our review found that the perception, knowledge, awareness, and attitude of Saudi dental professionals are positive. Many studies pointed out that the dental professionals in Saudi Arabia are practicing teledentistry and are open to learn and get more knowledge about it. Teledentistry got more attention during the post-COVID19 time by Saudi dental professionals. Structured and sustainable models and education pogroms are recommended to utilize the benefits of teledentistry in Saudi Arabia.

Association between local spatial accessibility of dental care services and dental care quality

Background The aim of our study was to evaluate the allocation of dental resources and explore access to dental care in Taiwan. In addition, we tried to understand the spatiotemporal characteristics of dental care quality and analyze the relationship between dental care quality and areas with deficiencies in dental resources. Methods The study used a two-step floating catchment area to calculate the dental resources accessibility and explore the spatiotemporal distributions of dental care quality. The association between dental care quality and spatial accessibility was analyzed using a spatial error model. Results Most areas with deficient dental resources and lower dental care quality were remote townships, agricultural towns, or aging towns with spatial clustering. The quality of children's preventive dental care had increased over time. Most highly urbanized areas had higher dental care quality. The quality of some dental care types such as children's preventive care and full-mouth calculous removal was associated with higher accessibility. Conclusions Understanding the spatiotemporal distribution of both dental care accessibility and quality can assist in allocation of dental care resources. Adequate dental resources may elevate dental care quality. Suggestions include policies to balance dental resources and routinely monitor improvement in areas with deficient dental care.

SARS-CoV-2: Overview and Its Impact on Oral Health

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its virulent variants causing coronavirus disease 2019 (COVID-19) COVID-19 has spread rapidly worldwide, and is highly contagious. A comprehensive search was conducted for the most current published information about SARS-CoV-2, COVID-19, and oral health. Clinical studies, case reports, in vivo studies, and any current published evidence on SARS-CoV-2 and COVID-19 were included in this review. Survival against SARS-CoV-2 infection may be partially dependent on periodontal health, good oral hygiene, and access to dental care. Optimum oral health, maintaining good systemic health, and elimination of smoking habits may be beneficial for the prevention and management of COVID-19 infections.

Exploring Variation of Coverage and Access to Dental Care for Adults in 11 European Countries: A Vignette Approach

Background: Oral health has received increased attention over the past few years coupled with rising awareness on the impact of limited dental care coverage for oral health and general health and well-being. The purpose of the study was to compare the statutory coverage and access to dental care for adult services in 11 European countries using a vignette approach.Methods: We used three patient vignettes to highlight the differences of the dimensions of coverage and access to dental care (coverage, cost-sharing and accessibility). The three vignettes describe typical care pathways for patients with the most common oral health conditions (caries, periodontal disease, edentulism). The vignettes were completed by health services researchers knowledgeable on dental care, dentists, or teams consisting of a health systems expert working together with dental specialists.Results: Completed vignettes were received from 11 countries, including Bulgaria, Estonia, France, Germany, Republic of Ireland (Ireland), Lithuania, the Netherlands, Poland, Portugal, Slovakia and Sweden. While emergency dental care, tooth extraction and restorative care for acute pain due to carious lesions are covered in most responding countries, root canal treatment, periodontal care and prosthetic restoration often require cost-sharing or are entirely excluded from the benefit basket. Regular dental visits are also limited to one visit per year in many countries. Beyond financial barriers due to out-of-pocket payments, patients may experience very different kinds of physical barriers to access dental care. Major access barriers to public dental care represent the limited availability of contracted dentists especially in rural areas and the unequal distribution and lack of specialised dentists.Conclusions: According to the results, statutory coverage of dental care varies across European countries while access barriers are largely similar. Many dental services require substantial cost-sharing in most countries which in turn leads to high out-of-pocket spending. The individual socioeconomic status is thus a main determinant for access to dental care, but also other factors such as geography, age and comorbidities can inhibit access and affect outcomes. Moreover, coverage in most oral health systems is targeted at treatment and less at preventative oral health care.

Oral Health in Communities and Neighborhoods (OHICAN) Pilot Project: The Burden of Poor Oral Health

Poor oral health afflicts many low-income and other vulnerable populations. Lack of access to oral health can lead to unnecessary tooth decay, periodontal disease, pain, and the advancement of oral cancer. The absence of preventive care often leads to unnecessary and expensive visits to hospital-based emergency departments to address the pain of dental disease but not the causal conditions. The consequences on inequitable access to dental care are significant for individuals, families and communities. The OHICAN pilot project looked to address the lack of equitable access to care by creating new points of access, training medical providers to perform oral exams and apply fluoride when indicated, thus increasing the oral health workforce, utilizing technology to bridge clinical practice, education, training and research, educating stakeholders to allow dental hygienists to provide preventive care under general supervision, and creating business models that will assist others who seek to create a dental home for those they serve. Social, political and economic forces all contribute to varying degrees in terms of equity in healthcare. The work of OHICAN was designed to create a blueprint for potential solutions to these issues in order to foster oral health equity. Changes to improve access to dental care can take place in a relatively short period of time when all who care and are impacted by this continued unmet oral health need work together.

Access to Dental-Care Services in Jazan, Saudi Arabia: A Scoping Review

<b><i>Introduction:</i></b> The construct of dental access adopted in this study uses the following 4 main dimensions: opportunity for access, realized access or utilization, equity, and outcome. <b><i>Aims:</i></b> The principal aims of this study were to identify various indicators used in the literature to measure each dimension of access in Saudi Arabia, to summarize and map the range of existing research with policy implications, to identify gaps in research, and to consider implications for future research. <b><i>Methods:</i></b> This scoping review was conducted using the PubMed, Scopus, and Google Scholar databases, as well as manually. Additional relevant publications were identified by manually searching the reference list of the included studies. Data were extracted based on the 4 dimensions of the access framework. <b><i>Results:</i></b> The search strategy yielded 230 studies, of which 16 were included after full-text revision. Of the 4 domains, the most explored and in all included studies were realized access, but no differentiation was made by the authors between initial utilization and continued engagement. <b><i>Conclusions:</i></b> An overview of different policy suggestions has been provided. In particular, we recommend making better use of teledentistry, improving referral services between dentists and physicians, and offering more education on dental prevention in schools’ health-service sites.

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

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.