Oral Health Care Services Research Articles

Needs and Barriers to Access Oral Healthcare Services among the Rural Population in Chengalpattu, Tamil Nadu, India: A Cross-sectional Study

Introduction: Disparities in dental service utilisation are substantial and pervasive worldwide. The healthcare services required to address health concerns and the services actually offered are at odds. Rural residents have poor oral health, and they frequently neglect to adopt good oral hygiene habits. Aim: To assess the oral health needs and barriers in accessing oral healthcare services among the rural population in Pulipakkam, Chengalpattu district, Tamil Nadu, India. Materials and Methods: A cross-sectional door-to-door study was conducted in Pulipakkam, Chengalpattu district, in association with Karpaga Vinayaga Institute of Dental Science, Madhuranthagam, Tamil Nadu, India. The study duration was six months, from March 2022 to August 2022. A total of 436 subjects from the rural population were included, and a structured questionnaire consisting of two domains, totalling 27 questions (24 closed-ended and three open-ended questions), was prepared and distributed among the study participants to assess the need (15 questions) and barriers (12 questions) in accessing oral healthcare. The questionnaire was administered in the local (Tamil) language. Additionally, seven demographic data questions were included, and descriptive statistics were performed for the demographic variables. Inferential statistics were used to assess needs and barriers. The World Health Organisation (WHO) oral health assessment questionnaire 2013 was used to assess dental caries and periodontal disease. The Chi-square test was carried out using Statistical Package for the Social Sciences (SPSS) version 20.0 for inferential statistics. The p-value<0.05 was considered statistically significant. Results: The mean age of the study participants was 53.6±2.02 years, and 402 (92%) were married, while 34 (7.8%) were unmarried. Among the total population (N=436), the perceived need was 217 (49.8%), and the barrier was 399 (91.5%). There was no statistically significant difference in the distribution of dental caries among the population with and without perceived need (p=0.909) and with and without barriers to accessing oral healthcare (p=0.542). The majority (N=261, 89.4%) of the population with periodontal diseases (N=292) reported having barriers in accessing oral healthcare services, and there was a statistically significant difference in the distribution of periodontal diseases among the rural population with and without barriers to accessing oral healthcare (p=0.027*). Conclusion: According to the study findings, oral diseases affect individuals who have no needs or barriers, suggesting that they are unaware of their oral health. It is therefore important to increase oral health awareness among rural people.

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil.

This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients' histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil's Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

Trends in patient visits at a university dental hospital prior and during the COVID-19 pandemic: a cross-sectional study

The oral health sector was affected during the COVID-19 pandemic due to risks associated with dentist-patient proximity as well as generation of aerosols. Government containment policies limited access to oral healthcare services while patients demonstrated reluctance to attend. We aimed to describe trends in new patient visits at a University Dental Hospital prior and during the pandemic. In this two-part census and analytical cross-sectional study at the University of Nairobi Dental Hospital in Nairobi, Kenya, 6,486 digital records of new patients registered between June 2019 and July 2021 were evaluated. A national lockdown during the pandemic led to a decline of 8.6% of new patients over the two-year period. While 3,529 new patients visited before (June 2019 to March 2020), 2,957 visited during the pandemic (August 2020 to July 2021). Fewer patients came from outside the Nairobi conurbation and percentage complaints of pain and swelling increased during the pandemic. Post-pandemic policies should promote regular service utilization and promote alternative clinical teaching methodologies.

Evaluation of Barriers to Access Treatment for Gum Disease: A Cross-sectional Study

This study identified the specific factors which influence the treatment of gum disease. Specifically, the aims are to examine i) the differences in the prevalence of self-reported periodontitis treatment in 2011–2012 and 2017–2018, ii) the association between the background characteristics of respondents and treatment of gum disease, iii) the effects of the background characteristics on the treatment of gum disease and iv) reasons for the lack of access to dental care in 2011–2012 and 2017–2018. Data from the National Health an Nutrition Examination Survery (NHANES) oral health questionnaires 2011-2012 and 2017-2018 were used. NHANES is a periodic survey conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This data represents a stratified, multistage probability sample of the civilian noninstitutionalized population in the 50 United States U.S) and the District of Columbia. Binary multivariable logistic regression was used to examine the socioeconomic predictors of self-reported therapy for gum disease. Compared to 2011-2012, more participants accessed oral health care services during 2017-2018, resulting in fewer people seeking treatment for gum disease. Affordability and lack of dental health insurance were the primary reasons for not receiving treatment for gum disease. Compared with Whites, Asians were more likely to report having had treatment, followed by Hispanics and Blacks. Increasing oral health services for the elderly could improve access to care related to periodontal disease in this cohort of patients. In addition, the expansion of dental coverage with reduced out-of-pocket expenditure could improve access to dental services and overall health.

Journal of Basic & Clinical Medical Sciences

Oral health is one of the significant indicators determining the population’s overall health and well-being status. Good oral health is a fundamental human right irrespective of demographic differences. Therefore, this study compared the barriers to accessing oral healthcare facilities among males and females living in peri-urban communities. This comparative cross-sectional study was conducted in the peri-urban communities of Sargodha. Using the random number method, this study used a simple random sampling technique to identify 320 houses; 160 males and 160 females who met the inclusion and exclusion criteria were interviewed. Data were analyzed using descriptive statistics and a chi-square test. The results showed that more males (78.13%) were users of dental services than females (53.75%); however, a meagre number of both genders were making regular visits to oral healthcare facilities. Expensive treatment was one of the significant barriers to visiting oral healthcare facilities for males (85.00%) and females (75.63%). Moreover, time shortage was a significant barrier, mainly reported by almost three-fourths of the males (72.50%), but fewer females (20.63%) considered it a vital barrier (p < 0.05). Furthermore, for both genders, various barriers varied widely, including fear of the dentist, avoiding treatment, lack of awareness, family pressure to avoid visiting clinics, and reliance on home remedies (p < 0.05). Therefore, this study concluded that more males than females visit oral healthcare services. However, most males and females do not visit oral healthcare facilities for regular checkups but for any oral health problem ailment. Both males and females make out-of-pocket expenditures to afford oral health services. Males preferred private oral healthcare facilities, whereas females preferred public healthcare facilities to provide oral healthcare services. Males and females observed the cost of treatment for oral healthcare issues, shortage of time, and fear as the key barriers to accessing oral healthcare facilities.

Oral health care services for community-dwelling older people with dementia: A scoping review.

To assess whether, and if so, which oral health care services for community-dwelling older people with dementia are available. Oral health in people with dementia is poor compared with people without dementia. Although multiple oral health care interventions have previously been studied for older people living in nursing homes, little is known about interventions or services for community-dwelling older people with dementia. A literature search was performed in the databases Pubmed, Embase and CINAHL. The following search terms were used: "Dementia", "Oral health", "Dental health services" and "Older person". The term "dental health services" was intended to be an as broad as possible construct because limited search results were expected. The search generated 1624 unique references, of which seven studies were eligible for inclusion (four cohort studies, one cross-sectional study, and two qualitative studies). The included studies described two actual oral health care services: a telephone help line on oral health and dementia, and a mobile geriatric dental programme in adult day health centres. A need was found for services and strategies specific to community-dwelling older people with dementia. One identified solution was an intervention with individually tailored daily oral hygiene self-care supported by the informal caregiver. Furthermore, increasing accessibility of oral health care professionals with treatment at other locations than their own practices, better collaboration between health care professionals and preventive oral health care are highly necessary. There is limited evidence on the availability of oral health care services for community-dwelling older people with dementia, while a need was found for oral health care services that focus on good accessibility, oral hygiene self-care, preventive strategies and collaboration among health care professionals.

Dental hesitancy: a qualitative study of culturally and linguistically diverse mothers

BackgroundOral healthcare is paramount and inextricably linked to well-being. Yet, the evidence indicates that culturally and linguistically diverse (CALD) migrant communities have unequal access to mainstream dental services due to several barriers. The purpose of this study was to investigate the oral healthcare experiences, attitudes and barriers to oral healthcare utilisation in CALD mothers.MethodsA qualitative study with semi-structured interviews was conducted within a social constructivism epistemology. CALD mothers who identified as non-English speaking, foreign country born, with a child under 12, were recruited though purposive snowball sampling. Questions probed oral healthcare experiences, barriers, enablers, and attitudes. Verbatim typed transcripts were thematically analysed using grounded methodology.ResultsThirty-three CALD mothers participated; twenty from India, five from Fiji, four from China, two from Nepal and one each from Israel and Macedonia. Languages included Cantonese, Fiji-Hindi, Gujrati, Hebrew, Hindi, Kannada, Mandarin, Maharashtrian, Macedonian, Nepalese, Punjabi, Sanskrit, Telegu and Urdu. Cost was the foremost barrier to oral healthcare services, followed by Confidence in quality care for the provision of services and treatment. Confusion in navigating a public and private healthcare system was highlighted and Competing priorities took precedence. Complacency referred to ‘no need’ or lack of urgency in dental care. Subsequently, dental hesitancy (superordinate theme) described the patterning of data as comprising the five ‘C’ factors and was theorised as the dental hesitancy phenomenon to explain the occurrence of delay or avoidance in utilising dental care.ConclusionFindings highlight the utility of the dental hesitancy phenomenon unearthed within this study. CALD mothers explained five ‘C’ dimensions: cost, confidence, confusion, competing priorities and complacency as barriers to accessing timely dental care. Multisectoral collaboration between healthcare systems, universal health coverage and primary sector support is required to address dental hesitancy in CALD mothers. Further, this study contributes to the field of behavioural and social sciences in oral health and augments the literature on dental avoidance.

Pharmaceutical cost implications for oral healthcare interventions at a dental clinic in Windhoek, Namibia

Half of the world’s 7.9 billion population suffers from oral health conditions. Most are largely preventable and treatable but costs are often unaffordable especially in developing countries. The World Health Organization (WHO) resolved in 2021 to include oral healthcare interventions in universal healthcare coverage (UHC) programmes. Although the general expenditure on oral healthcare services has been reported by some countries, amounts spent on particularly pharmaceuticals have not been reported. This study aimed to report on the prevalence of different types of oral health diseases in patients attending a dental clinic in Windhoek (Namibia) and quantify the pharmaceutical expenditure incurred. Records for all patients who visited the dental clinic at KIRH during a six-month period (1 January 2021 to 30 June 2021) were reviewed. Costs associated with the respective pharmaceutical management options for the most common oral conditions were calculated based on the approximated cost for a single treatment course per patient.Pharmaceutical expenditure on oral diseases was approximately 0.4% of the hospital’s annual budget. From this, 94.6% was due to treatment of dental caries which had a 90.1% prevalence. Prevalence of dental caries among 13-19 years age group (9.5%) was lower than for 1-12 years (18.6%) and 20-64 years (68.2%). Cases for dental caries were fewer for the 65+ years age group (3.8% of total cases) but had the highest prevalence (95.2%) of dental caries then other age groups. The proportion of the pharmaceutical budget spent on treating oral diseases was 0.4%, of which 94.6% was due to dental caries. Promotion of oral healthcare among children may be instrumental in reducing the pharmaceutical costs associated with treatment of dental carries.

Socio-economic and health determinants of untreated Dental Caries Burden of a group of children in rural Sri Lanka

Introduction/Background: Dental caries is a result of complex interactions between an array of biological, social and environmental factors. Since dental diseases are the 4th most expensive disease to be treated, poor people may not have financial security to access for treatments of dental caries of their children unless free oral health care services are provided. The low socio-economic status is categorized as a risk factor for dental caries along with equally important life-style-related factors such as high refined sugar consumption and poor oral hygiene. Methodology: A descriptive cross-sectional study was conducted to explore the relationship between prevalence and the severity of untreated dental caries with selected socio-economic and health service factors. A multi stage cluster sampling technique was employed to select 479 Grade I school children attending to Government schools of Wellawaya MOH area. A self- administered questionnaire was used to collect socio- demographic information. Dental caries was recorded using dmft index and severity of untreated dental caries was recorded using pufa index. Data analysis was done using SPSS version 20.The relationship of prevalence and severity of untreated dental caries with soc-economic and health service factors was assessed using Chi -square test. Results: There was a significant differences of untreated dental caries prevalence among children by different levels of father’s education (p =0 .027) and levels of family income (p= 0.018) There was a significant difference of severity of untreated dental caries among children by different levels of father’s occupation (p=0.001) and family income (p= 0.013). Conclusion: Prevalence of untreated dental caries was significantly associated with father’s educational attainment. Severity of untreated dental caries of children was significantly associated with father’s occupational status. Moreover, prevalence and severity of untreated dental caries of children were significantly associated with family income there by demonstrating oral health inequality patterned by their socio-economic status.

Access to oral health care for children with fetal alcohol spectrum disorder: a cross-sectional study

BackgroundIndividuals with developmental disabilities, including Fetal Alcohol Spectrum Disorder (FASD), often suffer from poorer oral health than the general population as they experience challenges with accessing care. However, few studies have investigated access to oral health care specific to children diagnosed with FASD. Thus, the objective of this cross-sectional study is to examine the use of oral health care services by children diagnosed with FASD in Saskatchewan, Canada, and to identify perceived barriers that affect their access to oral health care.MethodsParents or caregivers for children with FASD under the age of 16 were recruited through community organizations. Between July 2020 and January 2021, 189 participants completed a 64-item questionnaire that assessed sociodemographic characteristics, oral health care utilization, and perceived barriers to care.ResultsMost children (85%) had visited the dentist within the last 24 months. 55% of children had required sedation for some treatment. 43% of caregivers experienced frustration trying to access care for their child. Common barriers were cost (63%), location (55%), the child’s behaviour (78%) and caregiver anxiety (60%). 35% of caregivers believed their dentist lacked adequate knowledge of FASD. Univariate analysis reveals that income, caregiver education, residence location, and insurance status were significantly associated with reporting barriers. Multivariate logistic regression analysis reveals that caregivers who reported a high school education (OR=1.23; 95% CI 1.03 – 1.38); or public insurance (OR=1.33; 95% CI 1.24 – 1.42) or out-of-pocket payments (OR=1.37, 95% CI 1.20 – 1.46); or rural (OR=1.19, 95% CI 1.07 – 1.26) or remote (OR=1.23; 95% CI=1.12 – 1.31) residences were more likely to report difficulties accessing oral health care.ConclusionOur findings indicate that children with FASD experience various barriers to accessing oral health care. Social determinants of health were significant variables that increased likelihood of barriers. Like other vulnerable populations, cost and clinic location are notable barriers. Oral health care providers’ assessment and management of children with FASD are noteworthy for future research.

Students’ appraisal of a preparedness model for the provision of oral health care during a pandemic

BackgroundThe COVID-19 pandemic has impacted the provision of oral health care worldwide, prompting the discussion of preparedness. This study aimed to perform an initial appraisal of the usability, spatial representation, and clarity of a newly developed preparedness model from the perspective of senior undergraduate dental students at the University of British Columbia, Vancouver, Canada, enrolled in the 2020-21 academic year. Answers were analyzed thematically via an inductive coding process between March and June 2021.ResultsAll the 111 students in years 3 (#55) and 4 (#56) appraised the preparedness model, generating more than 200 pages of text. Four main themes were identified across the essays: streamlined depiction, information-based approach, adaptability to an ever-changing situation, and room for improvement. Although the majority of students appraised the model as being useful in fostering information-seeking behaviour, few students disagreed with the model’s portrayal and made further suggestions.ConclusionsPreparedness models can better guide oral health care providers during a health crisis such as a pandemic. The recently developed preparedness model was appraised as useful by senior undergraduate dental students, although alternative portrayals of the model were suggested. A comprehensive assessment of the newly developed model (and of its variations) is warranted to better support oral health care service delivery during a pandemic.

Assessing the Change in Pattern of Dental Visits and Treatment Performed at Primary Care Centre (PCC) in Selangor During the Pre-pandemic and During COVID-19 Pandemic

Emerging of Coronavirus disease 2019 (COVID-19) has affected the delivery of healthcare services, including oral healthcare services. All dental procedures generate aerosol, and droplet from infected patients may lead to virus transmission [1]. Thus, dental visits and treatment during COVID-19 outbreak in primary care were restricted to only emergency cases. Dental visits provide a true picture of utilisation of dental services. Utilisation of dental services is vital for an individual life because underutilisation can lead to poor oral health. This study sought to explore and elucidate the changing pattern of dental visits and treatment performed in Primary Care Centres (PCC) during the pre-pandemic and COVID-19 pandemic.
 
 This retrospective record review of dental visits and treatment was conducted by retrieving the Monthly Workload State Report of Dental Officer (PG 207) and Dental Therapist (PG 206) at the Oral Health Division in Selangor from January 2018 to December 2021. The data was the total number of each month’s dental visit and treatment performed. A descriptive analysis was reported in frequency, percentage, and graph. Chi-Square was used to test the association with the significance level set at p˂0.05, was carried out in OpenEpi online software.
 
 During pre and pandemic COVID-19, dental visits at the PCC were higher among schoolchildren (67.0%), followed by adults (24.3%) and antenatal mothers (2.6%). The most common dental treatment recorded during the pre-pandemic was filling (85.5%), and tooth extraction (27.3%). The changing pattern of dental visits and treatment given was observed during the pandemic. The spiking points identified were correlated with changes in policies implemented nationwide during the MCO phase, as declared by the National Security Council. The number of dental visits was low (14.4%) during MCO 2. Due to the closure of schools in MCO 2 in January 2021, the number of dental visits was found to be low. There is an association in the number of dental visits with the phase of MCO (p˂0.01).
 
 The pattern of dental visits and treatments performed changed during the pandemic. The number of dental visits and dental treatment performed at the PCC was reduced during the pandemic, particularly in the Movement Control Order (MCO) phase in Selangor.

Impact of COVID-19 Pandemic Lockdown on Clinical Dental Practice in Nigeria

Background: The COVID-19 pandemic has had profound effects on oral healthcare services globally. Objective: The main objective of this study was to determine the impact of COVID -19 pandemic lockdown on clinical dental practice in Nigeria and discuss how adverse impact could be mitigated. Methods: A cross-sectional self-administered pre-tested questionnaire-based survey of consenting dental practitioners from different States and geopolitical zones in Nigeria was employed for the study. Study participants were recruited by non-random convenience sampling. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 105 out of 142 respondents completed and returned the survey questionnaire giving a response rate of 74%. While only about 47% of respondents in public sector practice had their clinics shut down, all the respondents in private sector practice (100%) had their clinics closed down during the pandemic lockdown and the difference was statistically significant (p=0.000). Majority of respondents in private sector practice (65.4%) experienced income loss compared to 24.1% of respondents in public sector practice and this difference was also statistically significant (p=0.000). Conclusion: The COVID-19 pandemic was associated with government instituted lockdown periods with attendant scaling down or outright closure of dental clinical practices in Nigeria. The private sector practice bore the brunt of the adverse impacts of the pandemic lockdown in terms practice shutdowns and attendant economic losses. The adverse impact of COVID-19 pandemic lockdown on clinical dental practice could be mitigated by the incorporation of teledentistry into routine dental practice.

Association of service use with subjective oral health indicators in a freedom of choice pilot.

A freedom of choice pilot provided access to private oral health care services without queuing and with fixed public service-fees for participants in Tampere region, Finland in 2018-2019. The aim of this study was to investigate how use of oral health care services differed by demographics, socioeconomic status, dental fear, and self-reported oral health in this pilot. SMS-messages including a link to online questionnaire were sent to participants who had booked an appointment, and to those who had not booked an appointment despite registering to pilot. We categorized participants to (1) those who had booked their first appointment before receiving SMS (visitors), (2) those who booked an appointment after receiving the SMS-message (late-visitors), and (3) those who had not booked an appointment during pilot (nonvisitors). We used regression analysis to estimate the association of age, gender, dental fear, economic situation, Oral Health Impact Profile-14-severity (oral health-related quality of life [OHRQoL]), self-reported oral health and need for oral health care (exposures) with oral health care service use during the pilot (outcome). Out of 2300 participants, 636 (28%) responded. Late-visitors were more likely older and reported more likely need for oral health care, poorer oral health and OHRQoL than visitors or nonvisitors. Nonvisitors were younger and had better OHRQoL than the others. The differences in the service use by gender, economic situation, and dental fear were small. Service use during the pilot depended on the subjective oral health. Our findings highlight the potential of reminders in increasing care use among those with perceived need for services.

Why and when older people lose their teeth: A study of public healthcare patients aged 60 years and over in 2007-2015.

This register-based study on public sector patients aged 60 years and over assessed annual age-specific volume of and reasons for tooth extractions as well as changes in these across the period 2007-2015. Alongside the rapidly ageing population, the demand for public oral healthcare services is growing. Damaged teeth may induce a long-lasting inflammation burden in old age. Data used the electronic documentation of oral healthcare procedures recorded according to healthcare regulation. The study population consisted of all patients over 60 years of age (n=216 059) who were treated 2007-2015 in public oral health care available to all citizens of Helsinki, Finland. Data for the 9-year time series included reasons for tooth extractions and were aggregated by patient age into 5-year groups. Statistical analyses included rates and proportions, mean values, correlation coefficients and linear regression modelling. Extraction patients (n=48 623) were more likely in the older age groups: 21.8% in the age group 60-64 and 27.5% in the age group 90+. Mean number of tooth extractions among all patients was 0.4 per patient and 1.7 per extraction patient. Among all tooth extractions (n=82 677), main reasons were caries 29.5%, apical periodontitis 19.4%, tooth remnant 19.4% and periodontitis 18.0%. Tooth remnant predominated as extraction reason in the oldest age groups, while apical periodontitis displayed an upward trend by calendar year. Tooth extractions attributable to caries were common in all old-age groups, tooth remnant extractions were most common in older age groups, and apical periodontitis abounded as extraction reason during 2007-2015.

Role of Digital Media in Promoting Oral Health: A Systematic Review.

Oral disease has affected almost half of the world’s population, causing an enormous economic burden. To overcome this huge problem, oral health promotion is one of the most cost-effective methods. Digital media can play a pivotal role in achieving the goal of reducing this burden by providing a wider platform to reach out to the population even in the areas of deficit oral health care service.The aim of this systematic review is to assess the effectiveness of digital media in oral health promotion.The combinations of terms in the following two broad categories were used to search the literature on PubMed, Cochrane Library articles, WHO guidelines on oral health promotion through digital media, and Google Scholar: Intervention (digital media, Mobile phones, Text messages, social media, Cell phones, MHealth application, Telemedicine, Television, Videos) and Outcome (Oral Health education, Oral health, Oral health promotion, Oral health literacy, Oral health knowledge, Oral health attitude, Oral health practice, Oral hygiene improvement). The review was conducted in two phases, using the standardized checklist applicable to studies. Initially, abstracts were retrieved, followed by the assessment of the full papers against the review criteria.Among the selected studies, digital interventions helped in providing continuity of care and services in seven studies, eight addressed the increase in knowledge, attitude, and practice, and all the studies analyzed oral health needs.The findings concluded that digital media-based interventions can enhance oral health literacy and help in tackling this problem among different age groups.

Attitudes toward and knowledge of collaboration of dental and medical practice among medical students in Southern India: a cross-sectional questionnaire survey

Background: Enhancing oral health care services provided through inter-professional collaboration between medical and dental practitioner is important, and even essential. The purpose of this study is to assess the attitude toward and knowledge of medical-dental collaborative practice among medical students attending colleges in Southern India. Methods: A cross sectional questionnaire survey was conducted among medical students and interns of medical colleges in coastal South India with prior information and permission. The questionnaire consisted of 11 questions to assess attitude toward and knowledge of medical-dental collaborative practice. The demographic backgrounds of participants were also recorded. Chi square test was employed for data analysis. The responses obtained were correlated with age, gender and year of study of participants using Pearson’s correlation test Results: A total 250 questionnaires were distributed and 234 responses were appropriately completed. Most of the students agreed that oral health was an integral part of systemic health, however participants disagreed on attending compulsory rotation in dentistry at a statistically significant level (p<0.05), moreover participants did not agree with physicians having an active role in motivating their patients for regular dental check-up. 82% of the medical students believe that dental check-up should be included in health packages under health insurance. A statistically significant (p<0.05) difference was observed among 3 rd year & 4 th year students and interns and also it was found that female students provided more positive responses towards medical-dental collaboration. Conclusions: Even though medical students showed fairly positive attitudes and knowledge towards dentistry, the analysis within the study groups showed that knowledge and attitudes regarding the collaborative practice worsened over the academic years among the medical students. In order to destigmatize and foster interprofessional collaboration which would contribute to higher resource efficiency and the standard of care, continuing education in both the disciplines would be highly beneficial.

Effects of universal oral healthcare coverage in an adult population: A long-term nationwide natural experiment.

A large and long-term natural experiment occurred in Finland from the late 1980s-2000, when adults' entitlement to subsidized oral healthcare was strongly dependent on the arbitrary classification based on their year of birth: people born in 1956 or later were entitled to subsidized care, while people born before 1956 were not. The aim of this study was to investigate the effect of this expanded universal oral healthcare coverage on service use and oral health outcomes. Data from annual nationally representative cross-sectional postal surveys among 15-64-year-olds between 1990 and 2014 were used. For this study, the following outcome variables were formed: experiencing toothache during the past month (yes/no), the number of missing teeth with three different thresholds (over 10, over 5 or at least 1 missing tooth), brushing more than once a day and the number of visits to the dentist. Regression discontinuity plots and bias-corrected local polynomial regression discontinuity estimators measuring the effect of the extended universal coverage on the outcomes at the year-of-birth cut-off of 1956 were generated separately from the data from 1990 to 2000 and from 2002 to 2014. Between 1990 and 2000, the number of visits to the dentist (0.2 visits, 95% CI, confidence intervals: -0.03; 0.43) and the proportion of those who visited the dentist during the past 12 months (4.2%, 95% CI: 0.1%; 8.3%) increased at the year-of-birth cut-off of 1956. There were minor drops (1.5%-1.9%) in the number of missing teeth across all thresholds (over 10, over 5, or at least 1 missing teeth) at the cut-off. Analyses with the data from the surveys from 2002 to 2014 showed that there were no discontinuities in these outcomes at the cut-off of 1956. Regression discontinuity estimates related to toothache experience and toothbrushing frequency were inconclusive due to high variability in the underlying data and the likely small effect of the more universal coverage on these outcomes. The current study provided evidence of the beneficial effects of universal oral healthcare coverage on the oral healthcare service use and teeth preservation from a large and long-term natural experiment occurred in Finland from the late 1980s to 2000.

Oral healthcare-seeking behavior during the COVID-19 lockdown period: A cross-sectional study from Eastern Saudi Arabia

ObjectiveTo assess oral healthcare-seeking behaviors during the COVID-19 lockdown period in eastern Saudi Arabia. MethodsA cross-sectional questionnaire-based study was conducted from October 2020 to December 2020 at Dental Clinic Complex, College of Dentistry, King Faisal University Al Ahsa, Saudi Arabia. Three hundred and sixty patients who visited the Dental Clinic Complex after relaxation of lockdown and consented to participate were included in this study. Participants were instructed to complete a questionnaire on oral health and dental care during the lockdown period, consisting of five sections. ResultsOut of 360 participants, 168 reported requiring dental help during the lockdown period; however, only 27 participants contacted a dentist to emergency advice on phone, and 102 participants visited a dentist. ​Most participants used ​toothpaste for sensitive teeth, followed by over-the-counter pain killers, and ​clove oil. In this regard, 72.8% of females used toothpaste for sensitive teeth. A considerable number of participants needed filling, followed by root canal treatment, ​denture repair, and dental extraction. Most participants were treated with pain killers, followed by antibiotics, and referral to a hospital. More than 80% of them expressed that regular visits to the dentist are beneficial. ConclusionA substantial proportion of participants sought oral health care during the lockdown period, mainly for restorative treatment. This was mostly achieved by visiting a dentist, or via telephone consultation to a lesser extent. Analgesics were the most common prescriptions, followed by antibiotics. Dental patients should be encouraged to regularly visit dentists to mitigate the drawbacks that lockdowns may cause in the provision of oral healthcare services.