Cost Of Dental Treatment Research Articles

Eritrean Refugees' and Asylum-Seekers' Attitude towards and Access to Oral Healthcare in Heidelberg, Germany: A Qualitative Study.

Oral health concerns in Eritrean refugees have been an overlooked subject. This qualitative study explored the access of Eritrean refugees and asylum-seekers (ERNRAS) to oral health care services in Heidelberg, Germany, as well as their perceptions and attitudes towards oral health care. It involved 25 participants. We employed online semi-structured interviews (n = 15) and focus group discussions (n = 2). The data was recorded, transcribed, and analysed, using thematic analysis. The study found out that most of the participants have a relatively realistic perception and understanding of oral health. However, they have poor dental care practices, whilst a few have certain misconceptions of the conventional oral hygiene tools. Along with the majority’s concerns regarding psychosocial attributes of poor oral health, some participants are routinely consuming Berbere (a traditional spice-blended pepper) to prevent bad breath. Structural or supply-side barriers to oral healthcare services included: communication hurdles; difficulty in identifying and navigating the German health system; gaps in transculturally, professionally, and communicationally competent oral health professionals; cost of dental treatment; entitlement issues (asylum-seekers); and appointment mechanisms. Individual or demand-side barriers comprised: lack of self-sufficiency; issue related to dental care beliefs, trust, and expectation from dentists; negligence and lack of adherence to dental treatment follow-up; and fear or apprehension of dental treatment. To address the oral health burdens of ERNRAS, it is advised to consider oral health education, language-specific, inclusive, and culturally and professionally appropriate healthcare services.

Periodontal health awareness and behavior among Iraqi university lecturers in non medical colleges

A positive correlation between periodontal health and the level of education have been documented, however, the relationship between education level and periodontal health awareness and related health behavior have not been thoroughly considered.Aim of the study: aim of the present study is to estimate the periodontal health awareness and behavior among Iraqi university lecturers in non medical colleges. and to correlate the findings in the light of their level of education. Materials and methods: a population Sample of 352 university lecturers (176 females & 176 males) from different non medical colleges in Baghdad city has been randomly selected for this research. They were asked to complete a self assessment questionnaire designed for the estimation of periodontal health awareness and behavior . this questionnaire has three domains with 19 questions.Results: one of the most important finding of this study is the low percentage (27%) of the sample whom attribute periodontal diseases to bacteria , the results also showed that (47.4%) of them consider the bleeding on brushing as an indication of presence of periodontal disease, (47.7%) of the participants brush their teeth twice a day, (24.2%) of them have use the Floss & picks as an additional daily measures, only (26.1%) of them regularly visit their dentists, about half of the participants (52.8%) were satisfied by the dental health services provided by public and private clinics in Iraq and (82.4%) of them think that the cost of dental treatment in Iraq is too high. Conclusions: Results of this research revealed that acceptable percentages of the sample for both genders have the basic knowledge required for maintaining proper periodontal health, but these percentages are still far from that expected for this high social class. On the other hand, most of the participants seem to be satisfied with the dental health services that was provided by public and private sectors in Iraq . However, the majority of them think that the cost of dental treatment in Iraq is too high.

Cost analysis of prosthetic rehabilitation in young patients with Amelogenesis imperfecta

Objectives: Children and adolescents with amelogenesis imperfecta (AI) have extensive treatment needs, but costs have not been explored previously. We calculated the costs of prosthetic rehabilitation and analyzed whether costs of treatment begun in early adolescence are lower compared with in early adulthood. Methods: Data from the dental records of 25 patients with AI and 25 age- and sex-matched controls were analyzed. Patients were followed for a mean period of 12.3 ± 1.5 years. Number of dental visits, dental treatment costs, and indirect costs were calculated during three time periods, before, during and after prosthetic therapy. Swedish national reference prices for general and specialist dental care were used. Results: The mean number of visits was significantly higher in the AI group: 43.3 ± 19.7 (controls: 17.5 ± 19.8; p < .001). Mean total costs were 8.5 times higher for patients with AI: €16,257 ± 5,595 (controls: €1,904 ± 993). Mean number of crowns made in patients with AI was 12 ± 7 (range 1 − 31). Indirect costs were significantly higher in the AI group and constituted 22% of the total costs. After crown therapy, costs between groups ceased to differ significantly. Calculations of total costs in the hypothetical scenario (discount rate at 3% annually) were €18,475 for prosthetic rehabilitation began at age 12 years compared with €20,227 if treatment began at 20 years of age. Conclusions: Prosthetic rehabilitation costs for children and adolescents with AI can be high. Early crown therapy is associated with lower costs and a lower number of dental visits. Clinical ImplicationsEarly crown therapy in children and adolescents with severe AI is a cost-reducing treatment associated with few complications and reduced need of dental care during adolescence compared with treatment begun at age 20.

Возможности оптимизации финансового обеспечения страховой стоматологической помощи льготному контингенту населения южного региона Кыргызстана

The results of studying of the Pregnant Women Oral cavity condition Indicators in the Southern region of the Kyrgyzstan and determining the Average cost of dental treatment are presented. On 100% prevalence of dental caries, DMFT Index — 2.2, the most frequently and intensively affected were women 20–29 years old (84%). The incidence of caries and its complications in the first molars was 55%. The average cost of treating one patient was 309.2 soms. The data can be used for planning payments for pregnant women, as a preferential contingent in Compulsory health insurance.

Perception of patients regarding periodontal disease and its management

Objective: To assess the perception of patients regarding periodontal diseases and their management coming to University Dental Hospital, the University of Lahore. Methodology: This study was descriptive correctional in nature. Data was collected with the help of a questionnaire. A pilot study with the sample size of 100 participants was conducted in University Dental hospital, University of Lahore. Results: 42% participants reported that they had any treatment for gum disease such as scaling and root planning (deep cleaning). 58% participants reported that experience as unpleasant. The reason for this as per the participants was the cost of dental treatment in the last visit (44%). 84% participants perceived that scaling as cleaning of teeth. 66% participants reported that scaling can cause sensitivity. Majority of patients (52%) reported their oral health as fair. Conclusion: A modified self-report questionnaire represents a valuable and adequate tool for the screening and surveillance of periodontitis at the population level.

Exploring the opinions of secondary school students on the strengths and weaknesses of the school dental service in Selangor, Malaysia: a qualitative study

BackgroundThe Malaysian School Dental Service (SDS) was introduced to provide systematic and comprehensive dental care to school students. The service encompasses promotive, preventive, and, curative dental care. This study aimed to undertake a process evaluation of the SDS based on the perspectives of government secondary school students in Selangor, Malaysia.MethodsThe study adopted a qualitative approach to explore the opinions of secondary school students on the SDS implementation in their schools. Data from focus group discussions involving Form Two (14-year-olds) and Form Four (16-year-olds) students from the selected schools were transcribed verbatim and coded using the NVivo software before framework method analysis was conducted.ResultsAmong the strengths of the SDS were the convenience for students to undergo annual oral examination and dental treatment without having to visit dental clinics outside the school. The SDS also reduced possible financial burdens resulting from dental treatment costs, especially among students from low-income families. Furthermore, SDS helped to improve oral health awareness. However, the oral health education provided by the SDS personnel was deemed infrequent while the content and method of delivery were perceived to be less interesting. The poor attitude of the SDS personnel was also reported by the students.ConclusionThe SDS provides effective and affordable dental care to secondary school students. However, the oral health promotion and education activities need to be improved to keep up with the evolving needs of the target audience.

Economic evaluation of the Midwifery Initiated Oral Health-Dental Service programme in Australia

ObjectivesTo critically evaluate the cost-effectiveness of the Midwifery Initiated Oral Health-Dental Service (MIOH-DS) designed to improve oral health of pregnant Australian women. Previous efficacy and process evaluations of MIOH-DS showed...

Rural\u2013urban disparities in patient satisfaction with oral health care: a provincial survey

BackgroundIdentifying spatial variation in patient satisfaction is essential to improve the quality of care. Thus, the objective of this study was to investigate rural–urban disparities in patient satisfaction and to determine the factors that could influence satisfaction with oral health care.MethodsData from 1788 parents/caregivers of children who participated in the Quebec Ministry of Health clinical study were subject to secondary analysis. The Perneger model of patient satisfaction was used as the conceptual framework for the study. Satisfaction with oral health care was measured using the WHO-sponsored International Collaborative Study of Oral Health Outcomes (ICS-II). Explanatory variables included predisposing factors and enabling resources. Statistical analyses included descriptive statistics, as well as bivariate and linear regression models.ResultsIndividuals with higher income, dental insurance coverage, having a family dentist, reporting ease in finding a dentist, and having access to a private dental clinic were more satisfied with oral health care (p < 0.001). There were statistically significant differences between rural and urban Quebec residents in their ratings of patient satisfaction on four items, including dental office location (p = 0.013), dental equipment (p = 0.016), cost of dental treatment (p < 0.001), and cleanliness of dental office (p = 0.004), with greater satisfaction for urban dwellers. The multiple linear regression model showed that major determinants of patient satisfaction were being born in Canada, income ≥ 40,000$ CAD, having a family dentist, and having visited the dentist in the last year for regular checkups. However, ethnicity, having difficulty finding a dentist, and being in need of dental treatment negatively influenced patient satisfaction with oral health care.ConclusionsThese findings suggest that Quebec rural–urban disparity exists in patient satisfaction with care and that determinants of health influence this outcome. Intensive and powerful knowledge dissemination activities are needed to mobilize policymakers in implementing public health strategies to reduce this disparity.

Impact of non-restorative cavity control on proximal carious lesions of anterior primary teeth on the tooth survival and patient-centered outcomes (CEPECO 2): study protocol for a non-inferiority randomized clinical trial

BackgroundStudies have questioned the necessity of restoring cavitated carious lesion on primary teeth, once the control of biofilm is the most important factor to arrest these lesions. This randomized clinical trial aimed to compare the survival of teeth treated with a non-restorative cavity control (NRCC) compared to resin composite restorations (RCR) on proximal carious lesion in anterior primary teeth, as well as the impact of these treatments on patient-centered outcomes.MethodsA randomized clinical trial with two parallels arms (1:1) will be conducted. Children between 3 and 6 years old will be selected from the Center of Clinic Research of Pediatric Dentistry of Ibirapuera University (UNIB), a dental trailer (FOUSP) located on Educational Complex Professor Carlos Osmarinho de Lima, the Pediatric Dentistry Clinic of Santa Cecília University and from the Pediatric Dentistry Clinic of University Center UNINOVAFAPI. One hundred and forty-eight teeth will be randomly distributed in two experimental groups: (1) Selective removal of carious tissue and RCR; or (2) NRCC through cavity enlargement using a metallic sandpaper. The primary outcome will be tooth survival after 6, 12, 18 and 24 months. The duration and the cost of dental treatments will be considered for the estimation of the cost-effectiveness of the evaluated treatments. The discomfort reported by the participants will be measured after each treatment using the FIS scale. The participants’ satisfaction and perception of the parents/legal guardians will be evaluated through questionnaires. For the primary outcome, Kaplan–Meier’s survival and Long-Rank test will be used for comparison between the two groups. All the variables will be modeled by Cox regression with shared fragility. Significance will be considered at 5%.DiscussionThe NRCC could be an option to manage carious lesions on proximal surfaces of primary teeth, and the approach could be well accepted by the children and parents/legal guardians.Trial registration Clinicaltrials.gov registration: NCT03785730, Registered on December 18th 2018, first participant recruited 30/04/2019, https://clinicaltrials.gov/ct2/show/NCT03785730.Ethics Reference No: 91569118.8.0000.5597.Trial Sponsor: Universidade Ibirapuera.The Trial was prospectively registered.

Evaluating the Influence of COVID-19 Among Dental Practitioners After Lockdown.

Clinical activities at dental premises after the COVID-19 lockdown period or post-COVID-19 are likely to be a challenge for all practicing dentists. To assess the impact of the COVID-19 pandemic on dentists and change in dental practice following lockdown, a total of 1150 participants were approached through online survey forms registered on www.surveys.google. A link containing details of the questionnaire and a consent form was sent to dentists through emails and social media forums. The questionnaire included 3 domains comprising of seventeen questions. The first section focused on demographics. The second section inquired about the change in dental practice, that is, clinical hours, use of PPE, type of treatment, and patient flow. The third section investigated the impact of COVID-19 on dentistry. Means, standard deviation, and percentages were calculated using descriptive statistics. Chi-square was used to find an association between different variables. The response rate was 87%. Demographic factors revealed participants aged from 20.45 to 40.55 years. The data showed around 89.6% (896) of dentists have altered their clinical working hours post lockdown and, approximately, 59.7% (597) of dentists provided only emergency treatments. 88.1% (881) of the dentists wore PPE during dental procedures. Overall, a huge negative impact of the COVID-19 pandemic was observed among practicing dentists in terms of the dental supply chain, cost, and availability of dental equipment, treatment cost, and bill payments.COVID-19 pandemic compromised dental care. Though dentists were taking precautionary measures and have changed their practice according to the guidelines provided by the ADA and World Health Organization, they were still experiencing monetary loss due to decrease patient influx post lockdown.

Predicting the Cost of Dental Care Using a Probability Model

This paper uses survey data to present a probability model that allows dental offices to predict patient costs. The quantitative model is useful for developing and accepting capitation rates. It accounts for whether the care is initial care or maintenance care, the type of dental care (such as operative, prosthetics, or periodontics), and different age groups, all of which affect the cost of dental treatment.

Attitude, practices and experience of dental professionals during COVID-19 pandemic: A cross-sectional survey from Gujarat, India

Introduction: Coronavirus disease (COVID-19) is a declared public health emergency of international concern. Occupational Safety and Health Administration (OSHA) classified health-care professionals and exposure risk to coronavirus (COVID-19), identifying dental professionals in the very high-risk group due to the specificity of dental procedures and instrumentations used. Guidelines from relevant authorities suggested providing only emergency and urgent dental treatment during the pandemic which has led majority of dental practice to stop, thus instilling anxiety in the dental professionals. A study to assess the attitude, practice and experience of dental professionals from Gujarat state during the COVID-19 pandemic was planned. Materials and Methods: An online questionnaire consisting of 32 questions using Google Form was distributed to 315 dental professionals. Data obtained were analysed using the Statistical Package for the Social Sciences 22.0. Descriptive statistical analysis was used to describe variables. Chi-square test was used to find a significant association between parameters, and P < 0.05 was considered statistically significant. Results: Overall, 194 dental professionals (104 general dentists and 90 specialists) filled the questionnaire. Nearly half of the participants (49.5%) said that personal protective equipment (PPE) is uncomfortable while performing dental procedures. The majority of them (86.6%) insisted on increasing the cost of dental treatments. Regarding new practices adapted during the pandemic, 53 dental professionals (27.3%) did not find teledentistry effective in resolving the patient's problem. Only 75 dental professionals (38.7%) followed all the screening criteria for patients. Fifty-nine participants (30.4%) got the COVID-19 test for patients requiring the aerosol-generating procedure. While 125 participants (64.4%) performed aerosol-generating procedures either in urgent/emergency cases or elective cases, only 115 (59.3%) used full PPE with an appropriate mask. One hundred and thirty-seven (70.6%) of them reported a decrease in income during the pandemic, while 74 (38.1%) suffered from anxiety and depression. Conclusion: Dental health-care providers are at the highest risk of contracting COVID-19. Thus, they should execute proposed precautionary measures more diligently. Regular training and screening of dental professionals should be undertaken by state regulatory bodies. Adapting and adhering to change in work protocols by dental professionals will ensure not only their safety but also their patients. The emergence of COVID-19 has been great learning for the field of dentistry, and the dental practice is going to change for the better.

Investigating the Scope and Costs of Dental Treatment Provided Under General Anaesthesia Among Children With Congenital Heart Disease

Previous data indicates that children with congenital heart disease (CHD) have poorer oral health compared to unaffected children. Apart from adverse health outcomes, poor oral health results in substantial financial costs as children with CHD often require dental management under general anaesthesia (GA). Our aim was to identify the types of dental treatment provided under GA for children with CHD and quantify the costs within a publicly funded tertiary paediatric hospital setting.

Front-of-Package Food Labeling to Reduce Caries: Economic Evaluation

Front-of-package food labeling (FoPFL) is increasingly advocated as an effective intervention to facilitate behavior changes toward healthier food purchasing and consumption, particularly in relation to products with added sugar. The present study assessed the potential caries-related impacts of FoPFL, using Germany as an example. The outcomes of interest were caries lesions prevented, dental treatment costs avoided, productivity loss reductions, and disability-adjusted life years (DALYs) averted. The baseline consumption of added sugar was derived from the German National Nutrition Survey. The reduction in sugar intake due to FoPFL was modeled according to estimates from a recent meta-analysis. Microsimulations were performed for 500,000 individuals and over a time horizon of 10 y. Deterministic and probabilistic sensitivity analyses were performed to check the robustness of results. For the period from 2017 to 2027, FoPFL was identified to prevent 2,370,715 (95% confidence interval [CI], 2,062,730–2,678,700) caries lesions and avert 677.62 (95% CI, 589.59–765.65) DALYs. Treatment cost savings amounted to €175.67 million (95% CI, €152.85–€198.49), and productivity losses reduced by €27.33 million (95% CI, €23.78–€30.88). Sensitivity analyses showed that the magnitude of the effects is highly dependent on consumers’ response to FoPFL. Our findings suggest that FoPFL has the potential to substantially reduce caries increment, caries-related morbidity, and economic burden. In addition, our study allows for the inclusion of oral health estimates in overall health estimates for sugar-related food labeling. Before prioritizing a strategy to tackle sugar consumption, decision makers should carefully consider all relevant context-specific factors and implementation costs.

Stratification of the equivalent for dental treatment cost estimation among victims with maxillofacial trauma injuries occurred after road-traffic accidents

The article represents the results of data analytical processing considering the equivalent for dental treatment cost estimation among victims of traffic accidents with dental and maxillofacial injuries, and analyzes the objective association level of this criterion with the parameters of the approaches used for expert assessment of maxillofacial trauma injuries. Objective of the study is to analyze the equivalent for dental treatment cost values among victims of traffic accidents with dental and maxillofacial trauma injuries, and to establish an objective level of associations of this criterion with the parameters of the approaches used for expert assessment of maxillofacial trauma injuries. The design of the work included analytical processing of data obtained from previously conducted studies of retrospective and prospective nature, related to the economic component of patients’ rehabilitation due to the maxillofacial injuries occurred after road traffic accidents. The studied parameters were: the cost of treatment, duration of hospitalization, the criterion used to assess traumatic injuries of the maxillofacial region, correlation values relating trauma characteristics with the final cost of treatment and duration of hospitalization, statistical reliability of the relationships between the studied indicators of previously conducted research. Research methods: analytical, prognostic assessment, regression analysis. Current approaches used for expert severity assessment of the maxillofacial trauma injuries occurred after road accidents characterized by limited opportunities to predict and stratify the costs associated with the necessary future dental treatment of victims, but provide a sufficient level of objectification of functional and structural disorders. The increase of the expert severity assessment criteria of maxillofacial trauma injuries, in particular FISS and MFISS scores, is associated with an increase in the cost of appropriate comprehensive treatment and the potentially required duration of hospitalization, but these associations are characterized by uneven patterns of statistical dependences, and an increase in FISS and MFISS indicators beyond certain limit levels provokes a sharp advance in the cost of treatment due to the need for a longer hospitalization of the patient.

Oral health care-seeking behaviour and influencing factors among 18-34 years old women in Kochi, India

Background: Oral health, though an integral part of general health, is accorded low priority and remains an issue of neglect. Women during their reproductive years suffer from various oral problems that warrant timely utilization of care. Understanding factors affecting health-seeking behavior is necessary. The objective of this study was to determine the personal level and system-level factors that affect utilization of oral health care among 18-34 year-old women visiting a dental health care facility.Methods: A cross-sectional questionnaire-based study was conducted among 18-34 year old women. Participants were recruited using convenience sampling from a tertiary dental health care facility. A Chi-square test was used to determine the association of sociodemographic variables on factors affecting the utilization of oral care.Results: A total of 194 responses were obtained. The mean age of study participants was 27.1±5.2 years. Around 62% of women suffered from multiple dental problems in the past year of which tooth decay and swelling of gums were most common. About 68% of them sought treatment with a dentist. Half of the respondents were themselves responsible for making health care decisions. 55% of the participants reported barriers in availing dental care. The cost of dental treatment, fear of pain, and lack of time were the most commonly reported barriers.Conclusions: Oral health-seeking behaviour among women was found to be good with regard to dental attendance. Personal level barriers were greater than system-level barriers in availing dental care.

Features of the pricing policy in the dental market of Ukraine

Dental care is one of the most popular and market-oriented type of care provided to the population. It is developing rapidly, offering advanced medical technologies on the market. But some issues such as market competition in the health services sector, social partnership in dental services delivery to the population are not fully considered. There are some difficulties in analyzing dental market in Ukraine due to the presence of some problems: lack of official information about amount of dental services; incomplete coverage of information about production of dental services by statistics; a large part of the market for dental services are individuals – entrepreneurs, who are not obliged to publicly information about their commercial results (much of the producers in dentistry (at least 50 %) is in the shadow sector). The aim of the article is to investigate the current state of price aspects of the market of dental services in Ukraine. The article identifies the main problems in the market of dental services in Ukraine, the characteristics of medical services and factors that affect the formation of prices for these services, and also the aspects that consumers are guided with in choosing a medical institution in today’s competitive environment. In paper we analyzed price and non-price factors of demand for dental services, compared prices for dental services in private and public institutions, calculated their average value. Using standard deviation, we calculated how significant are the differences in prices for dental services within the industry. The cost of dental treatment in Ukraine depends on many factors: the orientation of the clinic, its form of ownership, popularity and competence of specialists. After performing the analysis, we saw that the prices for the same service differ significantly and vary depending on the company. Therefore, the dental market is characterized by the emergence of a large number of private dental institutions, where prices range significantly. In these conditions, the issues of modern management and marketing in dentistry have become especially relevant. To ensure the effective functioning of all subjects of the dental market, it is necessary to form their information field, within which they would exchange information about their activities, provide effective communication and work to create and maintain a positive reputation. Therefore, taking into account the current difficult epidemiological, economic and social situation in Ukraine, it is obvious that the health care sector needs constant improvement.

Incidence and pattern of dental emergencies and their management during Covid-19 pandemic : An experience of Nepali dentists working during lock down

Introduction: Corona Virus Disease-2019 (COVID-19) is highly contagious nature of disease which has spread all over the world in short span of time leading to significant number of death. WHO has declared pandemic and every nation is fighting with their all possible resources to control this disease. The impact of COVID-19 in dentistry is enormous. Most of the dental hospitals and clinic are providing emergency dental services only. So the aim of this research is to find out the nature of dental emergency during the initial month of lock down in Nepal. Additionally this research will try to find out the number of dental emergencies as well as perception of dentists on impact of COVID-19 on dentistry.&#x0D; Materials and Method : A set of electronic questionnaires were sent to 150 Nepal Medical Council registered Nepalese dentists out of which only 122 dentists responded. A consent was obtained prior to collecting data for research purpose. All the quantitative answers were recorded in SPSS spread sheet where as qualitative data were collected in Microsoft word. Descriptive statistics were applied to explain the responses whenever applicable.&#x0D; Result: Out of 122 respondents, maximum were from province 3 and 4 (50% and 34%). Almost half of the respondents were general dental practioners and similar percentage of respondents were working at dental/medical colleges and government centers. 90% of the doctors had consulted patients during lock down period. Average 5-20 cases were seen during the lock down by majority of doctors. Nearly 58% of the doctors had done only virtual consultation and most common emergency was dental pain(n= 92) and swelling( n= 37). Majority of the respondents thought that standard of dental disinfection and sterilization will increase after pandemic, however most of the dentists thought they will be using PPE for dental work and cost of dental treatment will be increased because of the added cost of extra precaution. 90% of the dentists believed that they are going to change the way they practice dentistry after they reopen their clinic.&#x0D; Conclusion: The most common type of dental emergency during lock down is dental pain ,swelling, dento-maxillofacial trauma and broken orthodontic appliances. Virtual dental consultation is gaining popularity among dentists in Nepal and Nepalese dentists are going to change the way of dental practice because of COVID-19.

Economic evaluations in water-fluoridation: a scoping review

BackgroundCommunity water fluoridation (CWF) is considered one of the 10 greatest public health achievements of the twentieth century and has been a cornerstone strategies for the prevention and control of dental caries in many countries. However, for decision-makers the effectiveness and safety of any given intervention is not always sufficient to decide on the best option. Economic evaluations (EE) provide key information that managers weigh, alongside other evidence. This study reviews the relevant literature on EE in CWF.MethodsA systematic database search up to August 2019 was carried out using MEDLINE, EMBASE, Cochrane Library, LILACS, Paediatric Economic Database Evaluation and National Health Service Economic Evaluation Database. The review included full economic evaluations on CWF programs, written in English, Spanish or Portuguese. The selection process and data extraction were carried out by two researchers independently. A qualitative synthesis of the results was performed.ResultsOf 498 identified articles, 24 studies met the inclusion criteria; 11 corresponded to cost-benefit analysis; nine were cost-effectiveness analyses; and four cost-utility studies. Two cost-utility studies used Disability-Adjusted Life Years,, one used Quality-Adjusted Tooth Years, and another Quality-Adjusted Life Years. EEs were conducted in eight countries. All studies concluded that water fluoridation was a cost-effective strategy when it was compared with non-fluoridated communities, independently of the perspective, time horizon or discount rate applied. Four studies adopted a lifetime time horizon. The outcome measures included caries averted (n = 14) and savings cost of dental treatment (n = 4). Most of the studies reported a caries reduction effects between 25 and 40%.ConclusionFindings indicated that CWF represents an appropriate use of communities’ resources, using a range of economic evaluation methods and in different locations. These findings provide evidence to decision-makers which they could use as an aid to deciding on resource allocation.

Barriers and enablers for dental care among dentate home-based older New Zealanders who receive living support.

To explore the structural, social and individual barriers to, and facilitators for, accessing dental services and remaining dentate, among a purposive sample of dentate home-based older people who receive living support (HBOPWRLS). Studies on the oral health of older people have largely been quantitative, while fewer studies have specifically explored the dental service utilisation patterns of dentate HBOPWRLS, especially in New Zealand. In early 2019, semi-structured interviews were conducted with a purposive sample of 40 dentate HBOPWRLS from one region of New Zealand. A parallel coding and thematic analysis of the interview data was conducted, based on the constant comparative method. Barriers to accessing dental services included the cost of dental treatment, negotiating transport issues, social isolation, traumatic childhood dental experiences, lack of role modelling for good oral health and hygiene, self-ageing and drawing upon discourses of older people, and health conditions impacting on mobility and access to oral health care. Facilitators for accessing dental services included having a support network, parental role models, healthy diet, knowledge of the link between oral and general health, dental clearances for surgery, not wanting dentures and having a strong dislike of them, and agency to resist dentists' advice to have a full extraction. The expense of dental care is a major barrier to HBOPWRLS accessing dental services at a life stage of reduced income. Strategies for boosting dental service access among socially isolated older people need further exploration.