Experiences Of Oral Health Care Research Articles

A qualitative study of home-visiting oral health care experience in vulnerable populations

A qualitative study of home-visiting oral health care experience in vulnerable populations

"I lost my first tooth here": Syrian former refugees' experiences of oral healthcare in Dunedin, New Zealand.

Oral health conditions are highly prevalent among former refugees; however, little is known about their experiences of accessing dental care. We aimed to explore Syrian former refugees' experiences of oral healthcare in New Zealand. Thirty-nine Syrian former refugees resettled in Dunedin, New Zealand participated in nine focus group discussions. The interviews were audio-recorded, transcribed verbatim and thematically analysed. Almost all participants reported motivation to care for their teeth but multiple factors facilitated or hindered their ability to address their oral health needs, including financial factors, communication issues and dental care provider cultural safety. Most participants arrived with high expectations of New Zealand's health system. Oral healthcare providers and policymakers need to expect and accept their patients' past experiences and emotions, and consider their cultures, languages and backgrounds.

Barriers to oral health care for transgender and gender nonbinary populations

BackgroundDespite health disparities and barriers to medical care being well documented in the literature, transgender and gender nonbinary (TGNB) people’s experiences and expectations with regard to oral health care remain understudied. The authors examined gender identity–related factors influencing experiences in the dental setting, aspects of subjective oral health, and avoidance of oral health care. MethodsOne-hundred eighteen TGNB people aged 13 through 70 years completed a 32-item questionnaire designed for this study. Data analysis relied on descriptive methods and bivariate comparisons using a conventional P < .05 statistical significance criterion. Qualitative description analysis was used to identify emerging themes from responses to an open-ended question. ResultsOne-third of participants reported misgendering (that is, had been addressed by their incorrect name and pronouns in the dental setting). Although refusal of oral health care was rare in this sample of TGNB participants, more than one-half felt that their usual source of oral health care was not equipped to provide gender-appropriate care. Participants’ avoidance due to gender identity was significantly associated with measures of self-reported suboptimal oral health. Common themes related to participants’ oral health care experiences included gender insensitivity, awkward interactions, avoidance of care, and lack of gender-affirming providers. ConclusionsDiscrepancies between TGNB patients’ expectations and actual experiences suggest that their needs are often unmet in the dental setting, possibly contributing to gender identity–associated dental avoidance and oral health disparities. Practical ImplicationsAlthough these results need to be verified in larger and more diverse samples, they provide actionable information for improvement to this population’s oral health and management.

MEASURING PATIENT EXPERIENCE OF ORAL HEALTH CARE: A CALL TO ACTION

Surveys to measure patients' experiences of health care are common practice in general medical care to improve patient centered care. However, such questionnaires are not consistently used to capture the patient's experience of oral health care. Because patient experience is an important component of oral health care, there is an urgent need to measure it in the oral health care setting. The purpose of this article is to illustrate the need for patient experience measurement in oral health care, highlight the challenges such measurement in this setting faces, and provide a set of next steps to advance care experience measurement for dental patients. We conducted a comprehensive review of the literature examining patient experience measurement in medical and oral health care. This focused on studies aimed at understanding the current measurement landscape and existing measurement tools. We also gathered additional information and perspectives through discussions with key informants and stakeholders. There is a critical need for patient experience measurement in oral health care. To develop a program to measure patient experiences of oral care, the following should be done: (1) convene stakeholders and get their buy-in; (2) develop a patient experiences of oral health conceptual framework; (3) develop a survey tool that captures key aspects of patient experiences of oral health; (4) pilot the survey tool; (5) assess the survey tool...s psychometric properties; and (6) refine and finalize the survey tool. To advance the measurement of the quality of oral health care, we outline a stepwise methodology that captures dental patient experiences of oral health care.

Dental diaspora: oral health care attitudes and experiences in culturally and linguistically diverse mothers in Australia

BackgroundGlobally oral health care is unequally accessible or utilised within culturally and linguistically diverse (CALD) migrant communities. Yet much remains unknown about CALD mothers and their oral healthcare experiences in Australia. Hence, this paper explores the oral health care attitudes and experiences of CALD mothers within the Australian context with the broader objective to reduce oral health inequalities.MethodsQualitative semi-structured interviews were conducted from a social constructivism paradigm. Participants were foreign country born, spoke language/s other than English and have a child. Purposive snowball sampling and recruitment was conducted through CALD organisations and social media. Participants were interviewed for their attitudes and experiences to dental care and frequency of utilisation in Australia and the home country. Interviews were transcribed verbatim and grounded analysis (Strauss and Corbin) performed. Researcher bias was reduced through reflexivity and triangulation.ResultsThe participants (n = 33) included 20 CALD mothers born in India and 13 from either China, Fiji, Nepal, Macedonia and Israel. The theme, experiences with health workforce personnel revealed positive attitudes toward CALD providers from similar cultural and/or linguistic backgrounds. We coin these CALD providers as the ‘dental diaspora’. The dental diaspora facilitated CALD mothers through culture and/or language factors, alleviating cost barriers and flexibility in appointments. Dental travel to the home country was affirmed, however family visitation was the foremost reason for travel.ConclusionThe findings suggest that the dental diaspora plays a significant role in promoting oral health care utilisation for first generation CALD mothers in Australia. This paper brings to light the phenomenon of the ‘dental diaspora’ as an essential health workforce that contributes to addressing inequities in oral healthcare utilisation within CALD migrant communities. Universal health coverage in oral health is further affirmed, as aligned to the WHO policy context.

Parents' oral health promotion efforts for their children with Down syndrome and the children's oral health.

The study evaluated parents' oral health care experiences and practices for their children with Down syndrome and its effect on the child's teeth and gingiva's condition METHOD: 75 parents of children with Down syndrome between 0 and 16 years of age responded to 18-item bilingual questionnaire concerning their child's oral health status RESULT: Most parents rated their child's teeth and gingiva health as good. There is no correlation found between experience score and practice score (r=-0.057), and no correlation between practice score on the child's both teeth (r=-0.001) and gingiva's condition (r=0.031). The parental oral health care experience and practices for their children with Down syndrome are deemed sufficient. However, a tailor-made comprehensive oral health care for them is very advisable, thus eradicating the barriers and challenges.

"The pediatric dentist is different": A qualitative study of young children's caregivers' experiences of oral health care in the Galapagos Islands.

Little is known about factors influencing children's access to and use of oral healthcare services in the Galapagos Islands, a resource-limited setting. We sought to understand caregivers' experiences and factors influencing their children's use of dental services on San Cristobal Island in the Galapagos Archipelago. A community-based qualitative interview study was carried out among 25 caregivers of children aged 6months to 10 years. Participants were recruited via a random walk door-to-door approach in 10 neighborhoods, and interviews were conducted by a trained research assistant who is native of the Galapagos Islands. We employed a grounded theory-based qualitative data analysis based on inductive coding to identify and report major emerging themes and illustrative participant quotes. Two major themes emerged related to children's oral health care. Participants expressed their preference for care provided by paediatric versus general dentists and recognized the important role of school-based dental care programs, acknowledging their strengths and weaknesses. Participants' lived experiences were informative and helped improve our understanding of factors influencing children's use of dental services in the Galapagos Islands. Above and beyond their local relevance, these themes and insights are likely applicable to other global communities that experience similar barriers of access to oral healthcare services.

Food insecurity and oral health care experiences during pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System

BackgroundFood insecurity has emerged as a salient risk factor for poor oral health in adult populations. A separate area of research also details that both poor oral health and food insecurity during pregnancy can have adverse consequences for maternal and infant well-being. The authors examine the connection between food insecurity and women’s oral health care experiences during pregnancy. MethodsData from 2016 through 2019 came from the Pregnancy Risk Assessment Monitoring System (N = 21,080). Multivariable logistic regression analyses were used to assess the association between food insecurity and 6 indicators of oral health care experiences during pregnancy. ResultsFood-insecure women reported worse oral health care experiences during pregnancy, including being more likely to need to see a dentist for a problem, going to see a dentist for a problem, not receiving dental prophylaxis, not talking with an oral health care provider about dental health, not knowing it was important to care for teeth, and having unmet oral health care needs. ConclusionsFood-insecure women exhibit worse overall oral health outcomes and unmet oral health care needs during pregnancy. Practical ImplicationsConsidering the risk that both food insecurity and oral health problems pose for maternal and infant health, interventions that can reduce food insecurity and improve oral health and oral health care access among pregnant women are important steps in promoting greater health equity.

Home care aides’ attitudes to training on oral health care

This study investigated home care aides’ (HCAs) oral health care experience, knowledge, and their intention to receive professional training, to explain and predict factors of their intention to receive such training. This cross-sectional study collected data through a structured questionnaire. HCAs affiliated with home care agencies in Taichung, Taiwan were recruited through purposive sampling. A total of 487 questionnaires were distributed from September to December 2015 with 280 valid responses collected (57.4%).This study predicted the factors of HCAs’ intention to receive oral health care training through a decision tree analysis. The decision tree model classified the respondents with an accuracy of 77.5%. The optimal predictor variable was oral health care knowledge (χ2 = 66.662, p < 0.0001). Among the low-scoring respondents on oral health care knowledge, 76.4% were classified in the “uninterested” group, whereas 84.8% of the high scorers were classified in the “interested” group. The second best predictor variable was whether oral health care is part of the job responsibility (χ2 = 7.979, p = 0.007). Among those who answered Yes, 92.9% were in the interested group, as were 76.5% of those who answered No. It is recommended to add “disease and oral care-related content” and “safety protection, assessment, and usage of oral care tools during practical oral care process” to the oral healthcare training course content for HCAs in order to improve HCAs’ oral healthcare knowledge and oral care skills. These research findings are valuable and may be taken into account in the future development of the in-service educational training of oral healthcare for HCAs.

Odontología Materno Infantil

En la ciudad de Sao Paulo, el día 21 de Agosto de 2014, bajo la coordinación del Prof. Fabián Calixto Fraiz, se inició la exposición de los programas de Odontología Materno Infantil de siete países de América Latina: Argentina, Chile, Méjico, Paraguay, Perú, Uruguay y Venezuela. A partir de los relatos de los representantes de cada asociación quedó evidente que las experiencias de atención en salud bucal materno infantil en América Latina presentan gran diversidad de estrategias, protocolos y actividades. Esas especificidades responden a las distintas coyunturas sociales, económicas, culturales, políticas y administrativas de cada pais. Se por un lado reconocer esa rica diversidad permitirá la formulación de propuestas que atiendan las demandas locales con mayor eficiencia y eficacia, por otro lado, identificar los desafíos semejantes y encontrar los puntos de confluencia en nuestra practica permitirá la formulación de propuestas integradoras. Las experiencias relatadas indican que las estrategias de atención materno-infantil exigen avances conceptuales, los cuales emergieran de la profunda y constante reflexión sobre el papel de la odontología en el campo de la promoción y educación en salud, asistencia y formación de recursos humanos para el abordaje transdisciplinar para ese grupo poblacional.

Failure on all fronts: Qualitative analysis of the oral health care experience in individuals with intellectual disability.

To explore the oral health care experience of individuals with intellectual disability and their families. A qualitative approach utilising face-to-face semi-structured interviews with parents of individuals with intellectual disability. All interviews were audio recorded and transcribed verbatim, and Qualitative Framework Analysis was used to present the results. Twenty-six parents of 26 individuals with intellectual disability were interviewed. The interviewees were 10 males and 16 females, and their average age was 46.4 ± 11.2years (range 28-66). The average age of individuals with intellectual disability was 17.9 ± 9.2years (range 6-48), and there were 11 (42.3%) males and 15 (57.7%) females. The interviewees reported that challenges to oral health care do occur on multiple levels: (a) home environment; (b) primary dental care; (c) secondary dental care facilities; (d) health and education policies and systems; and (e) societal views on individuals with intellectual disability. Individuals with intellectual disability and their families are being failed at multiple levels of oral health care, leaving parents feeling frustrated, isolated, and sometimes helpless. Collaborative efforts are needed to train families to prevent oral health disease at home, establish better primary and secondary oral health care systems, and overcome wider cultural, social, and economic barriers.

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

To explore barriers to planned dental visiting, investigating how barriers interlink, how they accumulate and change, and how individuals envisage overcoming their combination of barriers through personal strategies. An ethnographic study was conducted of adult urgent dental care attenders who did not have a dentist, including 155hours of nonparticipant observations, 97 interviews and 19 follow-up interviews in six urgent dental care settings. Data were analysed using constant comparison, first identifying barriers and personal strategies to overcome them, and subsequently analysing interlinks between barriers and personal strategies. Accounts of barriers to planned dental visiting encompassed multiple barriers, which related to socioeconomic circumstances as well as experiences of oral health care. Barriers were multi-layered and more difficult to overcome when occurring together. Personal strategies to overcome diverse barriers often hinged on increasing importance of oral health to individuals, yet this was not always sufficient. The combination of barriers participants experience was dynamic, changing due to personal, family, or employment circumstances, and with increasing severity of barriers over time. Over time, this could lead to higher cost, and additional barriers, particularly embarrassment. Barriers to planned dental visiting are complex, multi-layered and change over time, constituting a 'web of causation'. This adds a novel perspective to the literature on barriers to dental visiting, and requires that researchers, dental practitioners and policy makers remain open to barriers' interlinked effects, changes in primacy among individual patients' barriers, and their accumulation over time to better support uptake of planned dental visiting.

COVID-19: a novel coronavirus and a novel challenge for oral healthcare.

ObjectivesExplore how to manage oral healthcare during the COVID-19 outbreak.Materials and methodsIn order to solve oral healthcare during the COVID-19 outbreak, our hospital has taken effective measures: build a team of experts, which provide a 24-h hotline, online video consultation, and online training and push popular science articles on WeChat. For the treatment of emergency patients aside from routine epidemic prevention measures, some special measures for oral treatment need to be added.ResultsFrom January 23, 2020, to March 2, 2020, a total of 3035 patients received oral therapy during the COVID-19 epidemic in our hospital. To our knowledge, no oral health worker or patient has been infected with COVID-19 due to oral treatment, and no patients have complained about the suspension of treatment by complaints hotline.ConclusionCOVID-19 is a novel challenge for oral healthcare. Attention should be paid to oral healthcare during the outbreak of COVID-19.Clinical relevanceThese experiences of oral healthcare can be used as a reference by stomatological hospitals and oral clinics during public health emergencies.

Understanding the transgender patient

Understanding the transgender patient

“I just want to be treated like a normal person”: Oral health care experiences of transgender adolescents and young adults

BackgroundTransgender and gender nonconforming (TGNC) people continue to experience health care disparities despite increasing visibility and acceptance. As far as is known, no information exists regarding their experiences with oral health care providers. In this study, the authors intended to understand how TGNC adolescents and young adults interface with their oral health care providers. MethodsA total of 36 participants, including patients 14 through 24 years of age and their caregivers, were recruited from the Transgender Health Clinic at the Cincinnati Children’s Hospital, Cincinnati, Ohio. Interviews were conducted using a semistructured interview guide. All interviews were transcribed verbatim, coded, and analyzed for major themes using grounded theory methodology. ResultsOverall, participants reported positive experiences with their oral health care providers. Those with negative experiences reported that the problems were corrected rapidly. Some participants reported issues processing insurance. Several indicated that stress and anxiety related to gender identity could be reduced via use of certain strategies. ConclusionsTGNC adolescents and young adults have minimal difficulty receiving oral health care. Oral health care providers can make minor modifications to intake forms and office design to improve patient experience and reduce stress and anxiety related to gender identity in the health care setting. Practical ImplicationsAlthough TGNC adolescents and young adults may not need oral health care specific to their identity, taking steps to provide a safe and comfortable treatment setting can improve patient experience for this vulnerable population.

Development of an app for the dental care of Deaf people: Odontoseñas

Most Deaf people are often illiterate and communicate via sign language, hindering their dental care, causing high levels of oral morbidity and feelings of unfairness by the dental staff. To achieve effective communication between the dentist and the Deaf patient using an app. Focus group were conducted by a team comprising dentists, Chilean Sign Language (ChSL) interpreters, Deaf people and a software programmer to identify the most prevalent and important phrases used during dental care. A Minimum Viable Product App including draft videos in SL were developed and evaluated by external teams through in-office simulations and surveys. Evaluation by Deaf people and dentists was carried out using the Dental Visit Satisfaction Scale and System Usability Scale, respectively. Improvements were made in each cycle, until reaching agreement for a final (release) version. Thirteen ChSL videos were recorded and incorporated in the App Odontosenas. The overall usability of the software scored 96 points over 100. The overall satisfaction of Deaf people without the software was 21, and with the software was 29 over 30. Odontosenas gives relevant information about dental care, facilitating diagnosis, treatment and improving oral health care experience for the Deaf patient.

The Convergence Factors Affecting on Incremental Oral Health Care Experience in Some Local Adults

The Convergence Factors Affecting on Incremental Oral Health Care Experience in Some Local Adults

The mouth as a site of structural inequalities; the experience of Aboriginal Australians.

To address the mouth as a site of structural inequalities looking through the lens of Aboriginal Australian experience. This is a critical review of published literature relevant to our objective. Criteria for selection included articles on: the social context of oral and general health inequalities for Aboriginal Australians; Aboriginal perceptions and meanings of the mouth and experiences of oral health care and the role of the current political-economic climate in promoting or compromising oral health for Aboriginal Australians. Evidence suggests oral health is important for Aboriginal Australians yet constrained by challenges beyond their control as individuals, including accessing dental services. Competing demands on limited budgets often led to oral health dropping off the radar unless there was an emergency. Structural (social, political and economic) factors often inhibited Aboriginal people making optimum health choices to prevent oral disease and access services for treatment. Factors included cost of services, limited education about oral health, intense advertising of sugary drinks and discrimination from service providers. Yet the literature indicates individuals, rather than structural factors, are held responsible and blamed for the poor state of their oral health. The current neoliberal climate focuses on individual responsibility for health and wellbeing often ignoring the social context. To avoid the mouth becoming an ongoing site for structural inequality, critically reviewing oral health policies and practices for whether they promote or compromise Aboriginal Australians' oral health is a step towards accountability-related oral health outcomes.

Oral health care experiences of people living with HIV in Kwazulu-Natal and Western Cape, South Africa

Purpose – The purpose of this paper is to ascertain the oral health experiences of people living with HIV/AIDS in the provinces of Kwazulu-Natal (KZN) and Western Cape (WC) in South Africa. Many studies have reported that people living with HIV have unmet needs for dental care and this study considered the various factors that affect the accessibility and utilisation of dental services as these factors are even more pertinent for the people living with HIV who have increased need for dental care. Design/methodology/approach – The participants were selected among HIV-positive people attending selected Community Health Centre and regional hospital HIV clinics in KZN and WC provinces. The sample consisted of people living with HIV that were 18 years or older and who had given written, informed consent. The sample (n=435) comprised mainly of black females in the age group 20-29 years. In total, 347 participants (79.8 per cent) had an oral health problem of which 83 per cent (n=288) received care. Findings – Of those that received care, 56.6 per cent (n=163) of the participants stated that the staff were aware of their HIV status. Almost a third of the participants who received care reported a negative experience at the clinic. If the participant lived in a metropolitan area, the participant was 3.647 times more likely to receive care than if the participant lived in a non-metropolitan area (p &lt; 0.01) If the participant earned R5,000 or less, the participant was 0.106 times less likely to receive care (p=0.048). If the participant lived 1-5 km from the clinic, the participant was 3.371 times more likely to receive care (p=0.015). Research limitations/implications – The results are specific to KZN and WC and cannot be extrapolated with caution to the rest of South Africa. However, to the best of the author’s knowledge, there is no other study that has compared differences in the use of oral health care services by people with HIV in South Africa and these results serve as an indication of some the important issues in this regard. Additionally, this study did not have a control group of HIV-negative people which would have enabled one to determine whether certain barriers were unique to people living with HIV. Practical implications – The study highlighted the barriers to care existing within the current public health system relative to the provision of oral health services for people living with HIV in KZN and WC. It was anticipated that by ascertaining the nature and extent of unmet needs and barriers to dental care for people living with HIV, measures can be put in place to remove or at least reduce the barriers to care and improve the quality of life for people living with HIV/AIDS in South African communities. Social implications – The high prevalence of oral health problems in people living with HIV makes it imperative for the DOH to make every attempt to remove barriers to oral health care and thereby secure equitable, affordable and accessible oral health care which is acceptable for people living with HIV and accountable to the greater society. Originality/value – This study emphasises the importance of embracing people that are being discriminated and marginalised by society such as people living with HIV to ensure that they feel a franchised member of society who can take the initiative to be in control of their own health and, with the necessary aid from public resources and societal support, join forces to reduce the public health burden and its impact on the socio-economic milieu.

The oral health care experiences of NSW Aboriginal Community Controlled Health Services

ObjectivesAboriginal people continue to experience a disproportionately heavy burden of oral disease. A range of oral health services may be available to Aboriginal communities, including those provided by Aboriginal Community Controlled Health Services (ACCHSs). This study explored the oral health care experiences and activities of ACCHSs to inform policy and program decision making. MethodsMixed methods, including an online survey and semi‐structured interviews with senior ACCHS staff, were used. Areas of inquiry included perceived community need for oral health care, oral health care models, accessibility of other oral health services and barriers to providing oral health care. Twenty‐nine NSW ACCHSs participated in the study. ResultsThe activities of NSW ACCHSs in oral health care are diverse and reflect the localised approaches they take to delivering primary health care. ACCHSs commonly face barriers in delivering oral health care, as do Aboriginal communities in accessing other oral health services. ConclusionNSW ACCHSs are important but under‐acknowledged providers of a range of oral health services to Aboriginal communities and are well placed to provide this care as part of their comprehensive primary health care model. ImplicationsACCHS roles in improving Aboriginal oral health would be strengthened by greater acknowledgement of their contributions and expertise and the development of transparent, long‐term funding policies that respond to community need.