Free Dental Care Research Articles

Pattern of tooth loss in recipients of free dental treatment at the University Hospital of Amman, Jordan.

The aim of this study is to document reasons for tooth loss in disadvantaged Jordanians who seek free dental care at the University Hospital/Dental Clinics. A 4-year (1998-2001) prospective study was undertaken involving 2200 randomly selected patients from this subpopulation. Of their 3069 lost teeth, 46.9% were lost due to caries and its sequel; 18% were lost because of periodontal disease; 8% were lost for a combination of caries and periodontal disease; 19.4% for pre-prosthetic reasons; 4% for orthodontic reasons; 2.8% for eruption problems and 0.7% due to trauma. Logistic regression analysis for reasons of tooth loss in this sector revealed that caries and its sequel was the predominant cause of tooth loss in patients <or=40 years of age whereas periodontal extractions were predominant for the above 40-year-old group. In addition, the most frequently extracted teeth, due to caries, were lower first and second molars while lower incisors were most commonly extracted for periodontal disease. Premolars were extracted for orthodontic reasons, upper incisors for trauma, third molars for eruption problems and canines for pre-prosthetic reasons. In conclusion, dental caries was the main reason for removal of teeth in adults attending the University of Jordan free dental casualty clinic. Therefore, in order to reduce the rate of dental extractions in this sector of the Jordanian population, efforts should focus on prevention and treatment of caries. Efforts should also be made to change the values and beliefs of this sector towards the importance of natural dentition.

The dental care pathway of welfare recipients in Quebec

In Quebec (Canada), the utilization of dental care services varies greatly from one social class to another: whereas the well-to-do visit the dentist often for check-ups, those most in need demonstrate a “wait-and-see” attitude. The objective of our research was to describe the dental care pathway of the underprivileged when confronted with symptoms, and to understand how this pathway might be interrupted and possibly lead to tooth extractions. We arranged 16 one-on-one interviews with adult Montrealers who had experienced a dental problem during the 12 months preceding the interview. These participants, 9 women and 7 men aged between 30 and 48, lived in great poverty: all were welfare recipients, and as such, enjoyed the benefits of a government programme that entitled them to free basic dental care. During the interviews, the interviewers asked the participants to describe their latest dental problem and their subsequent behaviour. The dental care pathway of our participants was characterized by a strategy of adapting to the symptoms. This process of adapting, which can last several months, is essentially an individual process in which the individuals often resort to self-medication to soothe their pain. They decide to visit a dentist when the pain is too great and self-medication is no longer effective. Once this decision is made, their dental care pathway may nevertheless be interrupted in two ways: first, in the failure to find a dentist, and second, later, in the failure to complete treatments that are not covered by the welfare program, such as endodontic treatment. The fragmented character of these dental care pathways refers us to two features of accessibility: financial accessibility and acceptability. With regard to financial accessibility, our study shows that the public coverage intended for welfare recipients presents major gaps. As for acceptability , our participants are strongly critical of the dental profession, and develop a culture of rejection of it.

Disordered gambling among university-based medical and dental patients: A focus on Internet gambling.

The authors evaluated gambling behaviors, including Internet gambling, among patients seeking free or reduced-cost dental or health care. Three hundred eighty-nine patients at university health clinics completed a questionnaire that included the South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. Blume, 1987). All respondents had gambled in their lifetimes, with 70% gambling in the past 2 months. On the basis of SOGS scores, 10.6% were problem gamblers, and 15.4% were pathological gamblers. The most common forms of gambling were lottery, slot machines, and scratch tickets. Internet gambling was reported by 8.1% of participants. Compared to non-Internet gamblers, Internet gamblers were more likely to be younger, non-Caucasian, and have higher SOGS scores. This study is among the first to evaluate the prevalence of Internet gambling and suggests that people who gamble on the Internet are likely to have a gambling problem. Results also illuminate the need to screen patients seeking health care services for gambling problems.

RACIAL/ETHNIC VARIATIONS OF PRACTICING DENTISTS

In recent years, the dental school population has changed from being predominantly white male to a more diverse racial and ethnic makeup. Noting this change in the student population, the American Dental Association undertook an in-depth study of the various racial/ethnic groups. Questionnaires were sent to approximately 8,000 dentists nationwide. Samples were drawn for each of the following racial/ethnic groupings: white, black, Hispanic, Native American and Asian. The survey instrument asked questions about personal characteristics, work and private practice issues, household and practice income, and patient characteristics; it also asked for dentists' opinions. A final adjusted response rate of 57.0 percent was achieved. The majority of all dentists responded that they were "very satisfied" with their profession, but the survey found variations in patient mix, employment history and provision of free or discounted care. The survey examined dentists by race/ethnicity to identify differences and similarities. Cultural and ethnic minorities are the fastest growing segment of the U.S. population. As the profession becomes more diverse, practice patterns will affect the overall dental profession. Dentists' racial/ethnic backgrounds may change the provision of care as patient mix varies, with each dentist group treating a specific group of patients in regard to family income, racial/ethnic background and subgroups for whom they offer free or reduced-rate dental care.

Health Status in Patients with Access to Free Dental Care in San Jose

Health Status in Patients with Access to Free Dental Care in San Jose

Efficiency of fluoride programs in the light of reduced caries levels in young populations

Since the late 1930s, when the efficacy of fluoride in caries prevention was first detected, various efficient methods for fluoride delivery have been developed. Nowadays, fluoride is used for caries prevention on a global scale, the most widely used methods being fluoridated toothpaste and water fluoridation. The latter is a typical community-based prevention method, whereas the former method relies on individual motivation. The goal of an efficient community-based fluoride program is to maintain a constant low level of fluoride in as many mouths as possible at as low a cost as possible. Initially, water fluoridation and other community-based programs were highly efficient, but nowadays in societies in which the major part of the population is using fluoride toothpaste and caries levels are low, population-based programs show a low efficiency. As an example, even though water fluoridation was withdrawn in Kuopio, there have been no dramatic effects on the dental health of children and youths. In societies with well-attended, community-based, free dental health care for children and youths, the dental motivation of individuals is, in general, very high and the use of fluoride for caries prevention may be taken care of at the individual level.

Dental Health Promotion for Adolescents in Africa

Poor dental health in adults is usually due to poor dental care in childhood. The World Health Organization (WHO) and International Federation have defined objectives for dental health that will allow monitoring of progress in different countries. The WHO has encouraged all countries to develop programs of dental health promotion and education adapted to local conditions. health depends on oral hygiene nutrition continuous intake of fluoride and use of dental services. The main measures recommended are fluoridation of water salt and milk; reduced consumption of sweets and sugar; encouragement of dental hygiene practices and provision of regular dental care in schools or workplaces; and adoption of legislation to make some preventive measures mandatory. 12 African countries had national dental health programs by 1993. But dental health is seldom integrated into national health education policies and promotion of dental health usually results from local or regional initiatives at the instigation of professional associations. health promotion programs in Morocco Kenya Madagascar Ivory Coast Benin and Tanzania are briefly described. Moroccos IEC (information education and communication) program includes radio and television spots and various forms of written promotion. The Kenyan Association provides free dental care in schools and a media campaign during Dental Health Action Month. offices have been established in some 15 schools in a pilot program in Madagascar and dental education and screening benefited 27000 schoolchildren in the Ivory Coast between 1983 and 1996. Benin and Tanzania have opted for dental health promotion through primary health care programs. Few African countries have adopted community measures like fluoridation of the water supply. The WHO recommends promotion of traditional methods of dental hygiene where appropriate.

Subsidized dental care for young men: its impact on utilization and dental health.

An important part of Norwegian welfare policy is provision of free dental care for children up to the age of 18. After that age some counties have introduced a public subsidy scheme for young people aged 19-20 years, where 75% of their dental care expenses are covered. After the age of 21, all patients have to pay the costs for dental care themselves. The focus of the present work was to examine the effect that the public subsidy scheme for young adults had on demand for dental care, and its effect on dental health. The analyses were performed on 2 extensive sets of survey data. The major finding was that the public subsidy scheme had no effect on demand for dental care. In addition, there was no relationship between whether these young adults were covered by the subsidy scheme and dental health.

Comparing dental utilization of U.S. Army soldiers with their employed civilian cohorts

In fall 1992, a random, worldwide sample of 5474 enlisted and 4036 officer, active duty, U.S. Army personnel was surveyed on dental utilization. Overall survey response rate was 62%. After weighting the data to reflect the population, dental utilization rates of military personnel were compared with their employed civilian cohorts in the U.S. population. Results show that, regardless of race or gender, over 80% of U.S. Army personnel have seen a dentist within the past year. Controlling for age, gender, and race, active duty U.S. Army personnel have dental utilization rates that greatly exceed their employed civilian cohorts. The results suggest that access barriers to dental care present in the civilian population, especially for minorities, are greatly diminished in the U.S. Army. The results suggest that access to free care may be a potent stimulus to utilization of dental services among military or civilian personnel. Further, access to free dental care should be emphasized in recruiting and retaining U.S. military personnel.

Dental insurance and the oral health of preschool children

Using data from the Rand Health Insurance Experiment, the effects of cost-sharing plans on the health of the primary teeth in 264 children aged 3 to 5 years were investigated. From six areas in the United States, families were assigned at random to different dental and medical insurance plans. The plans varied in the amount of required cost sharing. Families participated in the study for 3 (70%) or 5 (30%) years. Children covered by the plan (requiring no cost sharing) had significantly fewer decayed teeth and deft (decayed, extracted, and filled teeth) at the end of the study than did children covered by the cost-sharing plans. No differences existed among plans in the number of extracted and restored teeth. Children of middle- and low-income families benefited most from having access to free dental care.

Dental health of men in the Royal Navy 1978–80

SummarySince there have been few reports of the dental health status of armed service personnel, a survey was undertaken of 742 men in the Royal Navy/Royal Marines over the same period as the Adult Dental Health Survey of the United Kingdom in 1978. Free comprehensive dental care is available to armed service personnel in contrast to UK civilians who have poorer access and have to pay a share of the cost of dental care. It was thus possible to compare the effectiveness of two systems for maintaining adult dental health. Comparisons of dental health of men in the RN/RM and the UK were made for four 10 year age groups between 16 and 54 years. Edentulousness was much less common in the RN/RM reaching a maximum of 5% compared with 27% in the UK at age 45–54 years. The mean number of decayed teeth in dentate males in the RN/RM was 0.8 teeth or less in all 4 age-groups. The total DMFT was similar in the two groups except in the oldest 10 year age group where the RN/RM males had 2.3 sound teeth more than their civilian counterparts. The results suggest that although RN/RM men keep their teeth and have decayed teeth filled, any preventive care is masked by the high level of disease already present by early adulthood and the inability of the DMFT index to detect further treatment of teeth.

Prevalence of juvenile periodontitis in Finland.

The prevalence of juvenile periodontitis was studied in Finland, in an ethnic group representing a uniform Caucasoid population. The study population consisted of the 16-year-old subjects in the county of Uusimaa, population approximately 1,000,000. The screening study was based on the well-organized national dental care service which provides free dental care for all, up to the age of 17. Bitewing radiographs taken of all subjects at the age of 16 were used as the basic material for screening for juvenile periodontitis. Altogether 8,096 pairs of bitewing radiographs were available from the 16-year-old subjects born in 1960-61, representing 56% of the total age group. The radiographs were examined by the author and 28 cases were singled out for thorough clinical and radiographic examination. The following criteria were set for juvenile periodontitis: -- The patient must be in good general health -- Radiographically detectable bone loss more than 2 mm must be demonstrated around more than one tooth -- Local irritants must not be commensurate with the bone loss. Eight cases among the 8,096 subjects fulfilled these criteria giving a prevalence of 0.1%. With 95% confidence this gives an estimate between 0.06 and 0.26%.

A retrospective longitudinal study of caries prevalence during and 7 years after free dental care at school in Finland.

ABSTRACT The objective of the study was to evaluate the benefit left from free dental care at public school after an average time interval of 7 years (mean: 7.03 years). The school dental service given to 66 Army recruits was extracted from their respective school dental care records, and then compared with the caries situation at the time of their military service. The results showed that the average number of 10.42 filled and extracted tooth surfaces at the end of school dental care had increased to a score of 36.72 DMFS 7 years later. The increase was significantly higher than expected on the basis of the average caries development between ages 7 and 15 years. Of the teeth filled during school dental care, only 26% were in no need of additional treatment, 15% had been properly retreated afterwards and the rest were either decayed (35%), retreated and redecayed (13%) or extracted (11%). Of the teeth that had been given root canal treatment at school, 27% had been extracted within the following 7 years. The caries situation was worst in the group of recruits who had had free dental care for the longest period of time. It was concluded that constant free repair of the teeth does not seem to give long term relief from the caries problem.

General Health and Dental Hygiene in Mexico

IN a recent paper (Bol. Of. San. Panamericana, 21, 643 ; 1942) read before the Third Medico-Dental Convention at Mexico City, Dr. Miguel E. Bustamante discusses the development of public health dentistry in Mexico. At the present time the Department of Sanitary Specialization, which is maintained jointly by the Public Health Department and the International Health Division of the Rockefeller Foundation, provides free dental care by the supply of full-time dentists. There are dental services connected with the school health services in forty cities, and in the Federal District dental clinics in dispensaries of the Ministry of Public Assistance are open to adults. In 1940 there were 31 dentists working exclusively for the coordinated services of the various States, and the Public Health Welfare and Education Departments employ an even larger number in the Federal District. Within recent years dentists have collaborated with doctors, sanitary engineers, nurses and laboratory workers in the task of preventive medicine instead of confining themselves to the treatment of patients already suffering from infections of the mouth. The increased interest taken in dental hygiene is shown by the attention given to the patient's previous diseases, the chemical composition of his drinking water, the kind of food he eats and, in the case of children, the health condition of the parents, and the diet of the child from an early age. Prenatal hygiene followed by correct child nutrition and prevention of contagious diseases such as measles, whooping-cough and smallpox, greatly contribute to dental hygiene.