Disentangling a web of causation: An ethnographic study of interlinked patient barriers to planned dental visiting, and strategies to overcome them

Zande, Marieke M. van der; Exley, Catherine; Wilson, Samantha; Harris, Rebecca

doi:10.1111/cdoe.12586

Cited by 19 publications

(28 citation statements)

References 46 publications

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“…The respondents were asked to rate the truthfulness of each statement on a Likert scale of four (1 for "not true for me at all", 2 for "somewhat true", 3 for "mostly true", and 4 for "definitely true"). As seeking healthcare was linked to fear and confidence in the level of provided care [25,27], these two items were developed for the purpose of the present study following FIVE format. A group of four dental public health experts approved the appropriateness of the items in estimating fear to seek dental care during the pandemic.…”

Section: Fear To Seek Dental Carementioning

confidence: 99%

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Fear Factor in Seeking Dental Care among Saudis during COVID-19 Pandemic

Ibrahim

Alibrahim

Madani

et al. 2021

IJERPH

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The recent coronavirus disease of 2019 (COVID-19) pandemic led to major lifestyle changes. The present study sought to assess factors associated with fear to seek dental care during COVID-19 pandemic in Saudi Arabia. This cross-sectional study was conducted during the COVID-19 outbreak in 2020. An online questionnaire was filled by a convenient sample of adult Saudi residents through mobile instant messaging application. The following measures were collected: sociodemographic characteristics, fear of COVID-19 using validated Fears of Illness and Virus Evaluation scale, fear to seek dental care, perceived health status, and COVID-19 experience. There were 826 participants involved in this study (541 females and 285 males, mean age: 38.8 ± 13.29 years). Fear to seek dental care was significantly higher among females, younger age groups, people who perceived poor general and oral health, and people who perceived high risk of contracting the virus in dental clinics. After controlling for confounders, fear to seek dental care was significantly higher among the age group of 35–44 years, those who perceived high and moderate risk of COVID-19 infection in dental clinics, and among participants who reported untreated dental conditions. Fear that Others Get Sick, Fear of the Impact on Social Life, and Behaviors Related to Illness and Virus Fears were significantly associated with high levels of fear to seek dental care. Within the study’s limitations, fear of COVID-19 negatively impacted the study population’s willingness to seek dental treatment. Factors such as age, perceived risk of COVID-19 infection in dental clinics, and untreated dental conditions were associated with fear to seek dental care.

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Section: Fear To Seek Dental Carementioning

confidence: 99%

“…Adverse health outcomes can be expected because of the fear from such outbreaks, which may affect the accessibility and willingness of seeking treatment. Another factor associated with the healthcare seeking behavior is the level of confidence in the provided service [23,25].…”

Section: Introductionmentioning

confidence: 99%

Fear Factor in Seeking Dental Care among Saudis during COVID-19 Pandemic

Ibrahim

Alibrahim

Madani

et al. 2021

IJERPH

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“…Reasons such as stigma, shame, helplessness, low self-esteem, lack of income and health insurance, dental fear/anxiety/phobia, and restlessness in the dental waiting environment contribute to underutilization [21,22]. In addition, individuals who have experienced a mental health disorder may have confusion and difficulty recalling instructions, fostering mistrust between dental providers and patients [21,23]. Also, individuals with poor mental health are more likely to belong to low-socioeconomic groups, be unemployed, and have substantial comorbidities, and these factors could contribute to and exacerbate the underutilization of dental services [24].…”

Section: Discussionmentioning

confidence: 99%

Association Between Mental Health and Oral Health Status and Care Utilization

Tiwari

Kelly

Randall

et al. 2022

Front. Oral. Health

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Studies have shown that mental health and oral health may be correlated, with associations demonstrated between mental health problems and tooth loss, periodontal disease, and tooth decay. The COVID-19 pandemic had alarming implications for individuals' and communities' mental and emotional health. This study examined the associations between mental health status, oral health status, and oral healthcare utilization and highlighted the impact of COVID-19 on mental health. Additionally, this study examines specific sociodemographic factors that may amplify oral health disparities. A nationally representative survey was conducted to capture attitudes, experiences, and behaviors related to oral health, mental health, and unmet oral health needs. Eighteen percent of respondents were categorized as having poor mental health. Visiting the dentist in the last year was more common amongst individuals with good mental health. From the logistic regression model, mental health status, age group, race/ethnicity, education, and last dental visit were all significantly associated with of oral health status. Mental health status, age group, and income groups were all significantly associated with unmet oral health need. Future work should focus on the mental-oral health association, including determining ways to improve oral healthcare utilization and oral health status among people with poorer mental health.

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“…A brief psychological intervention (the RETURN intervention) has been developed to be delivered to adults attending dental services for urgent care which aims to promote planned dental visiting. The intervention has been developed using extensive qualitative work [ 16 ] and with patient and public involvement to identify salient barriers to planned dental care. This work also helped to develop appropriate imagery and narrative for the intervention material, including video stories from local people which accord with the ‘in group’ identity of the population targeted.…”

Section: Introductionmentioning

confidence: 99%

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: study protocol for the RETURN randomised controlled trial

Harris

Lowers

Hulme

et al. 2022

Trials

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Background People with disadvantaged backgrounds are less likely to visit the dentist for planned care, even though they have disproportionately poorer oral health. They are correspondingly more likely to experience dental problems and use urgent dental care, general practices and Accident and Emergency departments, which not only makes meeting their needs expensive, but, since these services often rely on prescriptions rather than addressing the clinical cause, can contribute to antimicrobial resistance. Methods The RETURN intervention has been developed with substantial community co-production, to be delivered opportunistically in urgent dental care settings. This brief intervention is delivered by dental nurses and involves material relevant to the ‘in-group’ targeted. The material includes booklets relating to barriers to planned dental visiting with corresponding short video clips featuring local people and including a modelling element. Dental nurses are trained to have supportive and non-judgemental conversations, assisting patients to set personal goals and action plans, which are reinforced in a follow-up text within a few weeks. A randomised controlled trial will be undertaken in 3 types of sites: dental practices delivering urgent care (a) within working hours, (b) out of hours, and (c) in a Dental Hospital. The trial will recruit 1180 adult urgent dental care users over 12 months, who have not visited a dentist for a planned care appointment for 2 years or more and do not have a dentist who they visit for routine care. It aims to investigate the effectiveness and cost-effectiveness of the intervention and to explore whether the intervention has different effects across the socio-economic gradient. Participants will be followed up at 6, 12 and 18 months after randomisation. Co-primary outcomes are attendance at a dental practice for planned care within 12 months and self-reported oral health-related quality of life at 12 months. Discussion This is a pragmatic trial, evaluating the effectiveness of the intervention under the usual condition in which it might be applied. Since dental practices work as independent contractors to the NHS, this brings implementation and fidelity challenges which will be explored and described in embedded qualitative work. Trial registration ISRCTN registry identifier ISRCTN84666712. Registered 12/04/2021.

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Disentangling a web of causation: An ethnographic study of interlinked patient barriers to planned dental visiting, and strategies to overcome them

Cited by 19 publications

References 46 publications

Fear Factor in Seeking Dental Care among Saudis during COVID-19 Pandemic

Fear Factor in Seeking Dental Care among Saudis during COVID-19 Pandemic

Association Between Mental Health and Oral Health Status and Care Utilization

Behavioural intervention to promote the uptake of planned care in urgent dental care attenders: study protocol for the RETURN randomised controlled trial

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