Private Dental Services Research Articles

The Impact of Statistical Thinking on Operational Performance and Managerial Decision-Making in Private Dental Service Organizations in the Southern Region of Saudi Arabia: An Empirical Investigation

Introduction: The literature has extensively addressed statistical thinking (STk) as a set of principles and concepts implemented within organizations to adopt a statistical perspective. This approach is frequently linked to the application of continuous improvement programs (CIPs), such as Six Sigma and Lean Six Sigma. This study examines whether implementing STk principles positively correlates with operational performance (OP) within private dental services organizations operating in the CIP framework. Methods: This empirical study investigated a sample of 34 organizations from the private sector. Structural equation modeling, specifically partial least squares, was used for data analysis. Results: Statistical significance for the outer model loadings was demonstrated. Mediating variables positively affect the constructs’ explanatory power, even when statistical techniques (STes) do not show direct associations. The model exhibited a significant degree of explanatory power. Further, it effectively captured the association among STes, OP, and decision-making (DM). In the multigroup analysis, only STes did not exhibit a statistically significant difference compared with the other components. Conclusion: The results provide evidence that CIPs are beneficial for applying STk principles and have a favorable effect on both OP and DM. This highlights the significance of CIPs, such as Six Sigma, Lean Six Sigma, and Total Quality Management, in a managerial context. This highlights the need to establish mechanisms that facilitate the dissemination and application of STk principles and STes to improve OP and DM in the dental services sector.

How an increase in income affects the use of dental care services among a low-income population: evidence from the Finnish basic income experiment

BackgroundPrevious research has shown that the use of dental care services has a significant socioeconomic gradient. Lower income groups tend to use dental care services less, and they often have poorer dental health than higher income groups. The purpose of this study is to evaluate how an increase in income affects the use of dental care services among a low-income population.MethodsThe study examines the causal effect of increasing cash transfers on the use of dental care services by utilizing unique register-based data from a randomized field experiment conducted in Finland in 2017–2018. The Finnish basic income experiment introduced an exogenous increase in the income of persons who previously received basic unemployment benefits. Register-based data on the study population’s use of public and private dental care services were collected both for the treatment group (N = 2,000) and the control group (N = 173,222) of the experiment over a five-year period 2015–2019: two years before, two years during, and one year after the experiment. The experiment’s average treatment effect on the use of dental care services was estimated with OLS regressions.ResultsThe Finnish basic income experiment had no detectable effect on the overall use of dental care services. However, it decreased the probability of visiting public dental care (-2.7% points, -4.7%, p =.017) and increased the average amount of out-of-pocket spending on private care (12.1 euros, 29.8%, p =.032). The results suggest that, even in a country with a universal public dental care coverage, changes in cash transfers do affect the dental care patterns of low-income populations.

Oral health through primary healthcare in a developed economy dominated by private dental practitioners: A leap forward in Hong Kong?

After two and a half decades of preparation, and prompted by advocacy from the World Health Organization in 2014, the Health Bureau of Hong Kong recently implemented the city's primary healthcare blueprint. Integrated within it is an approach to primary oral healthcare. This review provides a brief background and discusses the development of primary oral healthcare in Hong Kong – a developed economy in Asia dominated by private dental services.

Dental Hygienists' Awareness of Medication-Related Osteonecrosis of the Jaw in Private Dental Clinics in Japan.

Purpose: Medication-related osteonecrosis of the jaw (MRONJ) caused by bisphosphonates (BPs) and denosumab (Dmab) is still a major oral adverse event caused by cancer treatment and may be under-recognized by private dental services. With the aim of reducing the prevalence of MRONJ, this study, which is a pilot study for a planned future large-scale survey, compared knowledge about MRONJ between dental hygienists (DHs) in private dental clinics and those in cancer center hospitals. Methods: We conducted a questionnaire-based survey regarding MRONJ between 1 November 2023 and 31 January 2024 on DHs at a cancer base hospital and a private clinic in Saitama, Japan. We statistically analyzed the data collected using the χ2 test or Fisher's exact test with the level of significance set at 5%. Results: This study included 10 in-hospital and 53 private clinic DHs. The in-hospital DHs had appropriate knowledge of MRONJ. However, compared with the in-hospital DHs, although the private clinic DHs knew that BPs are used for osteoporosis, significantly fewer had knowledge of Dmab (p < .001) or knew that BPs and Dmab could also be used to treat cancer (both p < .001). In addition, few private clinic DHs were aware of MRONJ cases refractory to antibiotic treatment alone (p = .012). Conclusion: These findings suggest that private clinic DHs have less knowledge of MRONJ than those in cancer base hospitals.

A realist evaluation of policy interventions to reduce public subsidies of private dental care in Finland.

The Finnish dental care market operates as a dual system, divided between a regulated, affordable public sector and a less regulated, more expensive private sector that receives public subsidies. In 2015 and 2016, two policy interventions were introduced to reduce these subsidies for private dental services. The aim of this study was to evaluate the impact of these policy changes on the dental care market. This study was a realist evaluation. Context-Intervention-Mechanism-Outcome-configurations were applied to elicit an initial program theory (IPT) for the policy interventions. The IPT allowed a complicated system to be reduced to the main components, allowing for better understanding of the underlying mechanisms and the chain of events started by the interventions. The resulting hypotheses about the chain of events and outcomes were tested against a dataset collected from the Social Insurance Institution of Finland (SII) registries on public and private dental visits in the cities of Espoo, Helsinki and Oulu during the years 2010-2016. The used dataset consisted of N = 17 111 625 dental procedures or N = 8 139 990 individual visits (which can include several procedures) at a public (n = 9 097 407 procedures, n = 4 083 475 visits) or a private (n = 8 014 218 procedures or n = 4 056 515 visits) dental clinic. The system was studied during three time periods related to the two interventions in 2015 and in 2016. Changes were evaluated by statistically analysing changes in several key metrics: mean subsidy, mean out-of-pocket price, mean (non-subsidized) price, number of patients treated, number of professionals, procedures per professional, Case-Mix adjusted procedures per professional, patient-to-professional ratio, total procedures. The 2015 and 2016 reductions to the subsidization of private dental care reduced the average subsidies paid to the private dental sector by 49% [-49.1, -38.8]. A 26% [25.2, 26.7] increase in the out-of-pocket price paid in the private sector was observed. Over the 2 years, 12.2% of patients left the private sector and an increase of 13% was observed in the number of patients treated in the public sector. The public sector increased its number of dental care professionals by 2.3% and the patient-to-professional ratio increased by 9.9% over the 2 years, while the private sector lost 4.6% of its dental care professionals and increased its prices by 4.0% [3.5, 4.5]. The policy changes had tangible effects on both the private and public sectors of the Finnish dental care market. By reducing subsidies, the private sector became more expensive for patients, causing many to transition to the public sector for their dental needs. While the public sector increased its capacity to accommodate the rise in patients, the demand still outpaced the growth in professionals, hinting at capacity or resource constraints in the public sector. The results also show initial evidence that contrary to the objectives, the policy changes increased the cost to the public sector as subsidized patient cared for in the private sector costs less to the government than treating that same patient in the public sector.

DENTTECH: ЦИФРОВАЯ ТРАНСФОРМАЦИЯ РЫНКА СТОМАТОЛОГИЧЕСКИХ УСЛУГ

This article presents results of the analysis of the market of dental services. The current level of digital transformation of this market is analyzed in detail. The trend of development of this direction in the market of private dental services is indicated. The difference between the established concept of digital dentistry and DentTech is established. Examples of the results of the digital transformation of the industry in related industries are given.

Analysis and Evaluation of Dental Caries in a Mexican Population: A Descriptive Transversal Study.

A cross-sectional, descriptive, and observational study was carried out in 552 individuals who underwent a complete cariogenic clinical examination in different populations of the state of Yucatan. All individuals were evaluated after providing informed consent and with the consent of their legal guardians for those under legal age. We used the caries measurement methods described by the World Health Organization (WHO). Prevalence of caries, DMFT, and dft indexes were measured. Other aspects were also studied, such as oral habits and the use of public or private dental services. The prevalence of caries in permanent dentition was 84%. Moreover, it was found to be statistically related to the following variables: place of residence, socioeconomic level, gender, and level of education (p < 0.05). For primary teeth, the prevalence was 64% and there was no statistical relation with any of the variables studied (p > 0.05). Regarding the other aspects studied, more than 50% of the sample used private dental services. There is a high need for dental treatment in the population studied. It is necessary to develop prevention and treatment strategies considering the particularities of each population, driving collaborative projects to promote better oral health conditions in disadvantaged populations.

E-health Implementation by Private Dental Service Providers in Bulawayo, Zimbabwe

E-health Implementation by Private Dental Service Providers in Bulawayo, Zimbabwe

The price of private dental services: results from a national representative survey of Ireland

IntroductionDental services in Ireland are delivered in a mixed public–private system but the majority of dental care is paid for out-of-pocket by individuals. Ireland is not unusual in the global context where public subsidisation for oral healthcare is limited in many countries. This is despite the fact that oral health plays an important role in well-being and despite international evidence on the negative impact of user fees on utilisation of beneficial healthcare. However, there has been little up-to-date assessment of the prices faced by individuals for a range of non-acute care services in Ireland, including dental care. This paper presents an up-to-date assessment of private dental prices in Ireland for a range of preventive, primary, and complex services based on a nationally representative survey.MethodsThe total sample size for the desk-based survey was 103, accounting for 6% of private dentists in Ireland, weighted to reflect the geographic distribution of dentists. Dentists were selected at random from the publicly available list of dentists participating in the Dental Treatment Benefit Scheme. The adult price of 10 different services covering core preventive, primary, and complex procedures were identified from public websites for the selected dental practices.ResultsResults showed that in addition to there being an uneven supply of dentists across the country, dental prices also vary with some notable variations by region and type of service. In particular, dental practices located in border counties, and those in rural areas typically show lower mean prices relative to non-border counties and urban areas. These factors need to be considered when planning how to reduce inequalities in access to oral health services in Ireland.

Differences in complete denture longevity and replacement in public and private dental services: A propensity score-matched analysis of subsidised dentures in adult Australians across 20years.

To examine the differences in treatment outcomes for patients who received subsidized complete dentures in private dental clinics and in public dental clinics over 20years in Victoria, Australia. Between 2000 and 2019, 187227 complete dentures were provided to eligible public patients by the Victorian public dental system. Of these, approximately 52% were provided to public patients in private clinics through the voucher system. Of the 97107 participants who received denture care in private clinics, 70818 were matched 1:1 by propensity score (PS) quantiles with participants who received denture care in public clinics. The PS matching balanced the characteristics between these two groups. Subsequently, a conditional logistic regression model investigated the binary outcome of denture replacement whilst a conditional Poisson regression modelled the number of years to denture replacement. A frailty Cox regression after PS matching investigated denture survival over time. Dentures provided in public clinics had a mean time to replacement of 5.5years (SD: 34.0) and 25.9% were replaced during the observation period. In the first year of denture service, incidence rate per person year (IR) for complete denture replacement in public clinics was 0.04 (95% CI: 0.04-0.04). Dentures provided in private clinics had a mean time to replacement of 6.5years (SD: 3.8) with 29.4% replaced during the observation period. In the first year of denture service, the IR for complete denture replacement in private clinics was 0.02 (95% CI: 0.02-0.02), which was less than half that of the public IR. Multivariate analyses found that although private dentures were more likely to be replaced during the observation period than those provided in the public sector (odds ratio [OR]: 1.31, 95% CI: 1.28-1.35, p<.001), they had greater longevity (incidence rate ratio [IRR]: 1.23, 95% CI: 1.23-1.24, p<.001). Longer longevity of private dentures was also supported by the frailty Cox regression showing that private dentures had a reduced hazard of denture replacement over time (better survival) in comparison to public dentures (hazard ratio [HR]: 0.94, 95% CI: 0.92-0.97, p<.001). Probabilistic sensitivity analysis supported the study findings. Increased denture longevity, higher rates of denture replacement and lower rates of early denture replacement were associated with receiving denture care in private clinics as compared with dentures provided in the public sector.

Family structure, sociodemographic factors and type of dental service associated with oral health literacy in the early adolescence.

The aim of this study was to evaluate associations between oral health literacy and family, sociodemographic and dental service characteristics in early adolescents. A cross-sectional study was conducted with 740 schoolchildren. The following variables were investigated using validated questionnaires: oral health literary (BREALD-30), sociodemographic characteristics, type of dental service and family functioning (FACES III). Associations were tested using robust Poisson regression analysis (α=5%). Higher oral health literacy was associated with the female sex (RR=1.09; 95%CI: 1.03-1.14), connected type of family cohesion (RR=1.12; 95%CI: 1.05-1.20), rigid (RR=1.14; 95%CI: 1.04-1.25) and structured (RR=1.11; 95%CI: 1.04-1.20) types of family adaptability, more than eight years of mother's schooling (RR=1.16; 95%CI: 1.10-1.22), age of caregiver more than 38 years (RR=1.07; 95%CI: 1.02-1.13) and the use of private dental services (RR=1.06; 95%CI: 1.01-1.12). The level of oral health literacy in early adolescents was associated with sex, family structure, mother's schooling, caregiver's age and type of dental service used.

Delivery of Health Care by Spanish Dental Hygienists in Private and Public Dental Services during the COVID-19 De-Escalation Phase (June 2020): A Cross-Sectional Study.

Background: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists’ work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. Material and Methods: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. Results: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). Conclusions: Dental hygienists’ return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors.

Assistência odontológica para idosos durante a pandemia da COVID-19: Uma perspectiva brasileira

Aim: This study evaluated the need for dental assistance of elderly people during the COVID-19 outbreak. Methodology: This online observational survey included Brazilian elderly aged ≥ 60 years, with internet access from all Brazil's regions. They completed questionnaires regarding sociodemographic characteristics, general health, COVID fear (scale FCV-19S), and dental assistance. Data were tabulated and analyzed using descriptive and inferential analysis (α = 5%). Results: Overall, 705 elderly people completed the questionnaire. Most volunteers needed dental assistance (58.6%) although only 31.3% visited a dental office, reporting a dental urgency. Elderly had elective appointments (96.3%) in private dental services (95.9%), mostly accompanied during dental assistance (81.6%), without the need to wait (50.7%). Prosthodontic and restorative interventions were the most required procedures. In the dental office, the fear of being contaminated by COVID-19 existed in 53.9%, while the risk of being contaminated was considered medium (46%). Elderly from Northern, Northeastern, and Central-Western, with low educational level, previous COVID-19 diagnosis, and with highest FCV-19S scores had more fear of contamination in the dental office (all p &lt;0.05). In Northern, Northeastern, and Southeastern Brazil, elderly with worse educational levels, and those with greatest FCV-19S scores (all p &lt;0.05) considered the risk of being contaminated in dental offices. Conclusions: Finally, Brazilian elderly people still need dental assistance during the outbreak. Low-educational levels, previous COVID-19 diagnosis, fear of COVID-19, and highly affected Brazilian regions exhibited increased fear of being contaminated in the dental office, which may prevent them from seeking help.

A survey of the prevalence and predictors of workplace bullying towards the dental hygienist.

Given the lack of research within dentistry as it relates to workplace bullying (WPB), the purpose of this study was to explore the prevalence of WPB and predictors of WPB for dental hygienists in clinical practice. Cross-sectional survey research was used with a convenience sample of dental hygienists (n=943) providing patient care to explore WPB. Ninety-three per cent of participants resided in the United States, and 6.9% lived internationally. The survey was shared via social media on Facebook and Instagram group pages, specifically dental focussed. The validated Negative Acts Questionnaire-Revised (NAQ-R) was used to measure the exposure WPB using descriptive, correlation, chi-square and Mann-Whitney U. The completion rate was 81% (n=765). Results showed 21% of participants had experienced WPB now and then, 9.4% several times a week and 2.9% almost daily. Predictors for WPB included highest degree earned (p=-0.03), US (United States) region of residence (p=0.001), clinical setting (private practice vs. dental service organization) (p<0.001), clinical years of experience (p=0.002) and work status (full- or part-time) (p=0.02). The findings confirmed WPB has been experienced by 1 in 5 clinical dental hygienists. Dental hygienists in their early years are more likely to have reported workplace bullying than those with more years of practice. WPB is not a new phenomenon, but given the prevalence observed in dental hygiene participants, employers need to be active in preventing and managing bullying to create and maintain an effective dental team and positive work environment.

Avoidance of dental appointment due to cost and consequences for oral health-related quality of life: 25-yr follow-up of Swedish adults.

We explored how socio-demographic and personal characteristics contribute to avoidance of dental appointment due to cost over time from age 55 (in 1997) to 75 (in 2017) and assessed the implications for oral health-related quality of life. In 1992, 6346 residents born in 1942 consented to participate in a prospective questionnaire survey, and 3060 (48.2%) of them completed postal follow-ups every fifth year until 2017. Oral health-related quality of life was assessed using the Oral Impact on Daily Performance inventory. The frequency of avoidance of dental appointment due to cost declined from 7.0% (in 1997) to 5.4% (in 2017), whereas the frequency of oral impacts declined from 26.0% in 2007 to 24.0% in 2017. Generalized Estimating Equation models revealed that avoidance of dental appointments due to cost was more likely reported in 1997 (OR: 1.5: 1.2-1.8) than in 2017, more likely in low educated people, and less likely in those using private dental care services. Avoidance of dental appointment due to cost was associated with impaired oral health-related quality of life. Social inequalities in avoidance of dental appointment due to cost and oral impacts did not vary across time but persisted into older ages despite the dental health care reforms that had been implemented.

СТОМАТОЛОГИЧЕСКОЕ ЗДРАВООХРАНЕНИЕ В РОССИИ: СРАВНЕНИЕ ПОЛИСА ОБЯЗАТЕЛЬНОГО МЕДИЦИНСКОГО СТРАХОВАНИЯ И ЧАСТНЫХ УСЛУГ В СТОМАТОЛОГИЧЕСКОЙ ПРАКТИКЕ

Compulsory health insurance is an integral part of health care. Dental care is provided in two forms: private dental services and public dental services based on budget clinics. The purpose of this study is to study dental health in Russia by comparing the policy of compulsory medical insurance and private services in dental practice. During the study, dental health indicators were studied at three levels: indicators for monitoring the oral health of children and adolescents. In the second part, indicators for monitoring oral health in the General population were studied. In the third part, indicators for monitoring the quality of life of the oral cavity were studied. Statistical data processing included implementation of correlation analysis of the obtained data. The results show that social health insurance provides people with equal opportunities for dental services, and health care reforms have improved oral health. Thus, the data obtained indicate the need to Finance the health care system in view of improving the quality of dental care for children and adults, as well as through the introduction of primary and secondary prevention programs.

Uligheder i oral sundhed – teoretisk tilgang

Main topics The oral health impact of social determinants affecting all population groups is known universally. Variations exist by income, education, occupation, ethnic minority groups, environmental conditions, gender, families and children, and generations spanning from children to older people. Inequality in oral health tends to last from early childhood to older age. Social diversities in oral health and general health are comparable due to shared causal mechanisms. The financial burden related to use of private dental health services plays a powerful role in creation of inequality. Structural, psychosocial and political determinants are drivers in creation of inequalities. WHO give emphasis to intervention against social determinants in health; inequalities in health are unfair and can be reduced by the right mix of government policies.

Everyday experiences of people living with dementia and their carers relating to oral health and dental care.

Little is known about how community-dwelling people with dementia, as well as their carers, look after their oral health and use dental care. This exploratory study aimed to explore the beliefs, experiences and practices about oral health of people living with dementia and their carers. We used an ethnographic qualitative approach conducting face-to-face interviews at home with people living with dementia and/or carers. Interview data and field notes were analysed thematically using framework methods. We approached volunteers registered with the online UK. Join Dementia Research network from whom a total of 17 participants were recruited in 2018. Five interviews were conducted with carers alone, two with a person living with dementia alone, and five with a carer and person with dementia jointly. Three main themes emerged: oral health is not prioritised; access to dental care is shaped by increasing disability; and the importance of continuity of care. While people living with dementia and their carers may view oral health important once prompted, many reported difficulties in undertaking or assisting with daily self-care and accessing dental services, particularly as dementia progresses. We draw out implications for the organisation and delivery of public and private dental services.

Age-related variation in volume and content of restorative private dental care for adults in Finland in 2012–2017: A nationwide register-based observation

ObjectivesThis study assessed age-related variation in the volume and content of restorative dental care performed by private dentists for adults in Finland in 2012−2017. MethodsThis retrospective register-based observational study utilized the Social Insurance database of private dental services in 2012 and 2017, including all patients. The data were aggregated into 5-year age groups for 20–89-year-olds; those aged 90+ formed one group. A patient was one who had received at least one treatment, and a restoration patient one who received at least one restoration (direct/indirect), excluding prosthetic crowns. Attendance rate was the proportion of the population treated. Volume of restorative treatment was the proportion of restoration patients among all patients using private dental services. Content of restorative treatment was described as the number of teeth receiving restoration and the size of restoration (number of surfaces restored). Correlation coefficient demonstrated associations between age groups and numbers of restorations. ResultsRate of restoration patients was 64.8 % in 2012 and 61.1 % in 2017, the rate for individuals aged under 80 years in each calendar year being smaller than in previous years. Mean number of restorations received per patient was 1.59 in 2012 and 1.42 in 2017, increasing with age (r = 0.85 in 2012; r = 0.95 in 2017). Small restorations dominated; one to two surfaces were covered in 72.3 % and 75.5 % of restorations in 2012 and 2017, respectively. ConclusionsVolume and content of restorative dental care for adults vary by age and have decreased slightly over time. Clinical significanceRestorative treatments are a prominent part of dental care for adults. This paper sheds light on the entity of restorative dental care for adults visiting private dentists. Variation in restoration volume and content is shown according to patient’s age group, and changes are assessed across six years.

Private Dentistry after COVID-19 – A Clinician’s Personal Experience

Face to face dental care in the UK was largely suspended from March until June and beyond is very limited still in many cases. Both NHS and Private dental services in the four nations of the United Kingdom aligned with the government in lockdown and dental emergencies could be accessed face to face in specific urgent centres only (UDC’s). Return to dental practice has been challenging for the profession with a lack of clarity from regulators and a gulf between financial support of private practice (almost none) and National Health practice (at 100% of their contact value pre-COVID). Dramatic changes to the provision of dental care are likely to persist and the COVID crisis may precipitate significant change to both private and NHS dental services.