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Journal of the American Dental... Aug 2020
Topics: American Dental Association; Calcium Hydroxide; Dental Care; Endodontics; Humans; United States
PubMed: 32718482
DOI: 10.1016/j.adaj.2020.06.012 -
Community Dental Health Aug 2021The number of persons with disabilities has increased and aged. Although it is important to maintain good oral health to extend healthy life expectancy, it is difficult...
OBJECTIVE
The number of persons with disabilities has increased and aged. Although it is important to maintain good oral health to extend healthy life expectancy, it is difficult for such people. This study aimed to analyze regional disparities in dental care provision systems for disabled people and to propose measures for the establishment of an appropriate system.
BASIC RESEARCH DESIGN
To examine regional disparities in dental care provision systems for persons with disabilities, the number of practicing dentists and dental clinics per 100,000 population, dentists certified by the Japanese Society for Disability and Oral Health, and institutions with certified dentists per 100,000 disabled persons for each prefecture were calculated. The Gini coefficient of each was also calculated to visualize and analyze regional disparities.
RESULT
The Gini coefficients were 0.09 and 0.07 for practicing dentists and dental clinics and 0.32 and 0.28 for the certified dentists and institutions with the certified dentists, respectively. Dental institutions for the disabled abounded in the three metropolitan areas: Tokyo, Aichi, and Osaka, and their density tended to be lower in northern and southern Japan. In prefectures with few such institutions, there was no correlation between the number of institutions and prefectural residents' income, and some prefectures had similar incomes but had many institutions.
CONCLUSION
The distribution of dental care to the disabled is highly uneven in Japan, therefore, a system needs to be established to address this issue.
Topics: Aged; Dental Care; Dentists; Disabled Persons; Humans; Japan; Oral Health
PubMed: 34223715
DOI: 10.1922/CDH_00004Oozawa05 -
Health & Social Care in the Community Nov 2022The Child Dental Benefits Schedule (CDBS) is an ongoing scheme administered through the Australian Government providing eligible children funding for clinical dental...
The Child Dental Benefits Schedule (CDBS) is an ongoing scheme administered through the Australian Government providing eligible children funding for clinical dental treatment. This study aimed to investigate the access of dental services across children's early childhood and examine whether the CDBS has improved access to dental care. The longitudinal study of Australian children is an ongoing cross-sequential cohort study with a representative sample of Australian children recruited in 2004. Birth (0-1 year) and kindergarten (4-5 years) cohorts were recruited through Medicare enrolment information at baseline and were representative of the Australian child population. Population-weighted longitudinal mixed effects Poisson models with individual identifiers as a random effect were used to assess the effect of Medicare dental schedules on reported dental attendance. Prior to the implementation of the CDBS for both cohorts, the birth cohort reported the lowest attendance rate at age 4-5. The introduction of the CDBS increased the rate of dental attendance for the low household income group by 8% (95% CI: 1%, 15%) after adjusting for confounders. The model provides evidence that dental attendance increased with age and the Indigenous population have 31% (95% CI: 4%, 55%) lower attendance rate after adjustment. The increase in reported access to dental services and favourable visiting patterns in low-income households during the operation of the CDBS provides some evidence that the schedule's primary aims to improve access to care in the child population are being met. Access to healthcare is multifaceted and the underutilisation of the schedule in the population warrants review of the schedule performance using other patient-centred indicators.
Topics: Aged; Child; Child, Preschool; Humans; Longitudinal Studies; Cohort Studies; Australia; National Health Programs; Dental Care
PubMed: 35332972
DOI: 10.1111/hsc.13803 -
AMA Journal of Ethics Jan 2022Access to dental care in mixed-race and predominantly African American wards in the District of Columbia (DC) was investigated in relation to community development.
BACKGROUND
Access to dental care in mixed-race and predominantly African American wards in the District of Columbia (DC) was investigated in relation to community development.
METHODS
This study used high-resolution geographic information system (GIS) tools to map all general dentistry and periodontal practice locations in DC wards. The spatial analysis contextualized each ward's land use and demographic data obtained from DC government reports.
FINDINGS
The analysis revealed inter-ward inequity in dental care access, which was measured by proximity to and number of dental clinics in each DC ward. Residents in affluent wards had access to many dental practices and superior amenities. Residents in wards poorly served by public transportation and with few resources had few, if any, dental clinics.
CONCLUSIONS
Dental practices are inequitably distributed across DC wards. DC policy should prioritize community development-specifically, resource allocation and community outreach-to promote health equity and improve access to and quality of dental care among residents of color.
Topics: Dental Care; District of Columbia; Geographic Information Systems; Health Promotion; Health Services Accessibility; Humans
PubMed: 35133727
DOI: 10.1001/amajethics.2022.41 -
PloS One 2023The affordability of dental care continues to receive attention in Canada. Since most dental care is privately financed, the use of dental care is largely influenced by...
BACKGROUND
The affordability of dental care continues to receive attention in Canada. Since most dental care is privately financed, the use of dental care is largely influenced by insurance coverage and the ability to pay-out-of pocket.
OBJECTIVES
i) to explore trends in self-reported cost barriers to dental care in Ontario; ii) to assess trends in the socio-demographic characteristics of Ontarians reporting cost barriers to dental care; and iii) to identify the trend in what attributes predicts reporting cost barriers to dental care in Ontario.
METHODS
A secondary data analysis of five cycles (2003, 2005, 2009-10, 2013-14 and 2017-18) of the Canadian Community Health Survey (CCHS) was undertaken. The CCHS is a cross-sectional survey that collects information related to health status, health care utilization, and health determinants for the Canadian population. Univariate and bivariate analyses were conducted to determine the characteristics of Ontarians who reported cost barriers to dental care. Poisson regression was used to calculate unadjusted and adjusted prevalence ratios to determine the predictors of reporting a cost barrier to dental care.
RESULTS
In 2014, 34% of Ontarians avoided visiting a dental professional in the past three years due to cost, up from 22% in 2003. Having no insurance was the strongest predictor for reporting cost barriers to dental care, followed by being 20-39 years of age and having a lower income.
CONCLUSION
Self-reported cost barriers to dental care have generally increased in Ontario but more so for those with no insurance, low income, and aged 20-39 years.
Topics: Humans; Young Adult; Adult; Ontario; Self Report; Cross-Sectional Studies; Oral Health; Insurance Coverage; Dental Care
PubMed: 37418457
DOI: 10.1371/journal.pone.0280370 -
Journal of Dental Research Jul 2021It is important for dental care professionals to reliably assess carbon dioxide (CO) levels and ventilation rates in their offices in the era of frequent infectious...
It is important for dental care professionals to reliably assess carbon dioxide (CO) levels and ventilation rates in their offices in the era of frequent infectious disease pandemics. This study was to evaluate CO levels in dental operatories and determine the accuracy of using CO levels to assess ventilation rate in dental clinics. Mechanical ventilation rate in air change per hour (ACH) was measured with an air velocity sensor and airflow balancing hood. CO levels were measured in these rooms to analyze factors that contributed to CO accumulation. Ventilation rates were estimated using natural steady-state CO levels during dental treatments and experimental CO concentration decays by dry ice or mixing baking soda and vinegar. We compared the differences and assessed the correlations between ACH and ventilation rates estimated by the steady-state CO model with low (0.3 L/min, ACH) or high (0.46 L/min, ACH) CO generation rates, by CO decay constants using dry ice (ACH) or baking soda (ACH), and by time needed to remove 63% of excess CO generated by dry ice (ACH) or baking soda (ACH). We found that ACH varied from 3.9 to 35.0 in dental operatories. CO accumulation occurred in rooms with low ventilation (ACH ≤6) and overcrowding but not in those with higher ventilation. ACH and ACH correlated well with ACH ( = 0.83, = 0.003), but ACH was more accurate for rooms with low ACH. Ventilation rates could be reliably estimated using CO released from dry ice or baking soda. ACH was highly correlated with ACH ( = 0.99), ACH ( = 0.98), ACH ( = 0.98), and ACH ( = 0.98). There were no statistically significant differences between ACH and ACH or ACH. We conclude that ventilation rates could be conveniently and accurately assessed by observing the changes in CO levels after a simple mixing of household baking soda and vinegar in dental settings.
Topics: Carbon Dioxide; Dental Care; Humans; Ventilation
PubMed: 33973494
DOI: 10.1177/00220345211014441 -
JDR Clinical and Translational Research Oct 2019To examine trends and variations in billed and paid amounts for preventive dental procedures by race/ethnicity, age, and sex in Wisconsin dental Medicaid.
OBJECTIVE
To examine trends and variations in billed and paid amounts for preventive dental procedures by race/ethnicity, age, and sex in Wisconsin dental Medicaid.
METHODS
We analyzed data from the 2001 to 2013 Wisconsin Medicaid claims database for preventive dental procedures for children and adults. Billed and paid amounts for preventive dental procedures were aggregated over a visit and adjusted for inflation based on the Medical Care Consumer Price Index produced by the Bureau of Labor Statistics for 2013. Quantile regression was used to examine the trends over time and the effect of patient demographics.
RESULT
At the 50th and 75th percentiles, the overall billed amounts for preventive dental procedures were $84.97 and $105.53, and the paid amounts were $35.80 and $41.66, respectively. At the 75th percentile, there was a $2.24 increase per year in the billed amount and a $26.88 overall increase from 2001 to 2013. In the paid amount, there was a $1.34 decrease per year for an overall $16.07 decrease from 2001 to 2013. Billed and paid claims for racial/ethnic minority enrollees were $1 to $3 higher per visit at the 75th percentile when compared with those of Whites. Regarding the billed:paid ratio, White, African American, and Hispanic enrollees had values of 50% to 52%, whereas American Indians had the lowest value at 47.7%. At the 75th percentile, children aged 10 to 19 y had significantly higher billed ($26.73) and paid ($9.92) amounts than did adults aged 20 to 69 y.
CONCLUSION
The billed amount increased over time, and the paid amount decreased after adjustment for inflation. In addition, there was a wide gap between billed and paid amounts over time.
KNOWLEDGE TRANSFER STATEMENT
This study highlights clear differences between paid and billed amounts in Wisconsin dental Medicaid. The financial health of dental practices is dependent on appropriate reimbursement for dental services provided; thus, information of this nature could serve as a proxy performance measure for access to preventive dental care. Findings from this study could be used by policy makers and dental Medicaid program managers to develop outcome metrics to improve access to preventive dental services.
Topics: Adolescent; Adult; Aged; Child; Dental Care; Ethnicity; Humans; Medicaid; Middle Aged; Minority Groups; United States; Wisconsin; Young Adult
PubMed: 31013459
DOI: 10.1177/2380084419842533 -
BMC Oral Health Apr 2022This study used the Anderson Behavioral Model to assess the socioeconomic inequalities in dental services utilization among adults in Saudi Arabia, along with other...
BACKGROUND
This study used the Anderson Behavioral Model to assess the socioeconomic inequalities in dental services utilization among adults in Saudi Arabia, along with other predictors of utilization, to inform future planning of dental care services.
METHODS
This cross-sectional study was a secondary analysis using national data from the 2019 Kingdom of Saudi Arabia World Health Survey (KSAWHS). The survey consisted of two interviewer-administered questionnaires: one household and one individual interview. The questions covered predisposing factors (age, gender, marital status, nationality, education, employment), enabling factors (income, household wealth, area-based socioeconomic class, health insurance, eligibility for free governmental health care, transportation and region of residence) and self-reported need for dental treatment. The main outcome was dental utilization in the past year; predisposing, enabling and need factors were independent variables. Hierarchical logistic regression analyses identified significant predictors of dental utilization, applying survey weights to adjust for the complex survey design. Adjusted odds ratios with 95% confidence intervals and p values were reported in the final model.
RESULTS
The final dataset included 8535 adults (response rate = 95.4%). Twenty percent of adults had visited the dentist at least once in the past year (95% CI 18-21%). There were socioeconomic inequalities in dental utilization. High household income (OR 1.43, p = 0.043), second and middle household wealth status (OR 1.51, p = 0.003 and OR 1.57, p = 0.006) and access to free governmental health care (OR 2.05, p = 0.004) were significant predictors in the final regression model along with perceived need for dental treatment (OR 52.09, p < 0.001).
CONCLUSION
Socioeconomic inequalities in the utilization of dental services exist in Saudi Arabia. The need for treatment was the strongest predictor suggesting predominantly symptomatic attendance. Increasing awareness about the importance of preventive dental visits rather than symptomatic attendance could be an important policy implication to improve oral health and optimize dental care expenditure. Further research should explore the drivers for adults to seek preventive care in the absence of any recognized dental problems.
Topics: Adult; Cross-Sectional Studies; Dental Care; Humans; Income; Saudi Arabia; Socioeconomic Factors
PubMed: 35448991
DOI: 10.1186/s12903-022-02162-w -
International Journal of Environmental... Jul 2020COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19... (Review)
Review
COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 syndrome, the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency from China has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is via the inhalation of respiratory droplets, for example when patients talk, sneeze or cough. The ability of the virus to survive outside living organisms, in aerosol or on fomites has also been recognized. The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The aim of this paper is to provide practical advice for dentists based on the recent literature, which may be useful in reducing the risk of spreading COVID-19 during clinical practice.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Dental Care; Dentists; Humans; Infection Control; Mass Screening; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Practice Patterns, Dentists'; Professional Role; SARS-CoV-2
PubMed: 32630735
DOI: 10.3390/ijerph17134769 -
Primary Dental Journal Mar 2021Patient safety should be at the heart of any healthcare service. Systems, teams, individuals and environments must work in tandem to strive for safety and quality.... (Review)
Review
Patient safety should be at the heart of any healthcare service. Systems, teams, individuals and environments must work in tandem to strive for safety and quality. Research into patient safety in dentistry is still in the early stages. The vast majority of the research in this area has originated from the secondary care and academic fields. Approximately 95% of dental care is provided in the primary care sector. In this paper, we provide an overview of the evidence base for patient safety in dentistry and discuss the following aspects of patient safety: human factors; best practice; the second victim concept; potential for over-regulation and creating a patient safety culture. Through discussion of these concepts, we hope to provide the reader with the necessary tools to develop a patient safety culture in their practice.
Topics: Dental Care; Humans; Patient Safety; Primary Health Care; Safety Management
PubMed: 33722142
DOI: 10.1177/2050168420980990