Preventive dental visiting: a critical interpretive synthesis of theory explaining how inequalities arise

Harris, Rebecca; Pennington, Andy; Whitehead, Margaret

doi:10.1111/cdoe.12268

Cited by 44 publications

(57 citation statements)

References 80 publications

(128 reference statements)

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“…Perceived importance of obtaining care and self-evaluation of oral health also stand out as micro-level influences of dental care seeking 18 . In the present study, higher B-ECOHIS score, indicating greater perceived impact of dental disease on quality of life, was associated with having ever gone to a dentist, but clinical dental status (dmft or trauma) was not.…”

Section: Discussionmentioning

confidence: 99%

Family Health Strategy associated with increased dental visitation among preschool children in Brazil

Feldens

Fortuna

Kramer

et al. 2018

Int J Paed Dentistry

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Section: Discussionmentioning

confidence: 99%

Family Health Strategy associated with increased dental visitation among preschool children in Brazil

Feldens

Fortuna

Kramer

et al. 2018

Int J Paed Dentistry

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“…Other health behavioural and lifestyle factors examined because of their in uence on oral health were: Khat chewing, sugar, tobacco and alcohol consumption (9, 38). Self-reported dental attendance, which refers to attending a recognised dental service provider, was also obtained to look at access to dental care and possible barriers to care (14,39).…”

Section: Instruments and Measuresmentioning

confidence: 99%

Dental caries experience in adults: a cross-sectional community survey within Ethiopia

Bogale¹,

Engida²,

Hanlon³

et al. 2020

Preprint

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Background Ethiopia is a large and diverse developing sub-Saharan African country with increasing prevalence of non-communicable diseases, including oral conditions. Oral health and dental care have been given little consideration, and there is limited information relating to population oral health and use of dental services in the country. The aim of this study was to examine the burden and impact of dental caries experience and investigate access to dental care amongst adults within Ethiopia. Methodology This community-based oral health survey is a baseline study for the ASSET - Health System Strengthening in sub-Saharan Africa project undertaken in the Butajira area, south-central Ethiopia. A stratified random sample of households and individuals were participated in the study. The survey was informed by the World Health Organization (WHO) Oral Health Survey Methods (5th ed.) at International Caries Detection and Assessment System (ICDAS) threshold 4 and the UK Adult Dental Health Survey 2009. Face-to-face interviews and clinical dental examinations were conducted. The data were analysed using descriptive statistics; and a binary logistic regression model was built to assess the association of dental caries and predictor variables: demographics, health behaviours, quality of life, dentition status and consequences of untreated caries data in adults (≥18 years).Result Most of the study population (n=626) were female (63.9%), married (71.4%) and Muslim (76.0%). Just over half (53.2%) lived in rural areas and many (44.4%) had no formal education. A majority (74.0%) reported never attending a dental service. Sixty percent (n=377) of the adults had experienced dental caries, 88.0% (n=332) of whom had untreated carious teeth. In the fully adjusted logistic regression model; increasing age, dental attendance and Khat chewing had a positive significant association with dental caries experience, whilst education status was negatively associated (p<0.05).Conclusion This study demonstrated a high burden of dental caries and considerable impact resulting from untreated disease in this population of adults. There was also evidence of social inequity and limited overall access to dental care, highlighting the need for health system strengthening.

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“…Our model suggest that the oral health needs of the 12-year-old total population would utilise 25-35% of current actual HROH in China, even if dental professionals endeavour to spend 90% of their working hours in providing direct clinical care; therefore, urgent action is required. Of course not everyone accesses dental care, either because of personal choice or higher level factors which act as barriers [37]. However, as the population of China increases it is very clear that HROH capacity is inadequate and even more so if dental professionals limit their clinical working hours to less than full time.…”

Section: Discussionmentioning

confidence: 99%

Meeting the oral health needs of 12-year-olds in China: human resources for oral health

et al. 2017

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BackgroundAn appropriate level of human resources for oral health [HROH] is required to meet the oral health needs of population, and enable maximum improvement in health outcomes. The aim of this study was to estimate the required HROH to meet the oral health needs of the World Health Organization [WHO] reference group of 12-year-olds in China and consider the implications for education, practice, policy and HROH nationally.MethodsWe estimated the need of HROH to meet the needs of 12-year-olds based on secondary analysis of the epidemiological and questionnaire data from the 3rd Chinese National Oral Health Survey, including caries experience and periodontal factors (calculus), dentally-related behaviour (frequency of toothbrushing and sugar intake), and social factors (parental education). Children’s risk for dental caries was classified in four levels from low (level 1) to high (level 4). We built maximum and minimum intervention models of dental care for each risk level, informed by contemporary evidence-based practice. The needs-led HROH model we used in the present study incorporated need for treatment and risk-based prevention using timings verified by experts in China. These findings were used to estimate HROH for the survey sample, extrapolated to 12-year-olds nationally and the total population, taking account of urban and rural coverage, based on different levels of clinical commitment (60-90%).ResultsWe found that between 40,139 and 51,906 dental professionals were required to deliver care for 12-year-olds nationally based on 80% clinical commitment. We demonstrated that the majority of need for HROH was in the rural population (72.5%). Over 93% of HROH time was dedicated to prevention within the model. Extrapolating the results to the total population, the estimate for HROH nationally was 3.16–4.09 million to achieve national coverage; however, current HROH are only able to serve an estimated 5% of the population with minimum intervention based on a HROH spending 90% of their time in providing clinical care.ConclusionsThe findings highlight the gap between dental workforce needs and workforce capacity in China. Significant implications for health policy and human resources for oral health in this country with a developing health system are discussed including the need for public health action.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4384-7) contains supplementary material, which is available to authorized users.

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Preventive dental visiting: a critical interpretive synthesis of theory explaining how inequalities arise

Cited by 44 publications

References 80 publications

Family Health Strategy associated with increased dental visitation among preschool children in Brazil

Family Health Strategy associated with increased dental visitation among preschool children in Brazil

Dental caries experience in adults: a cross-sectional community survey within Ethiopia

Meeting the oral health needs of 12-year-olds in China: human resources for oral health

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