Oral Health,Dental Insurance and Dental Service use in Australia

This study uses data from the 2004–2006 Australian National Survey of Adult Oral Health and a simultaneous equation framework to investigate the interrelationships between dental health, private dental insurance and the use of dental services. The results show that insurance participation is influenced by social and demographic factors, health and health behaviours. In turn, these factors affect the use of dental services, both directly and through insurance participation. Our findings confirm that affordability is a major barrier to visiting the dentist for oral health maintenance and treatment. Our results suggest that having supplementary insurance is associated with some 56 percentage points higher probability of seeing the dentist in the general population. For those who did not have private insurance cover, we predict that conditional on them facing the same insurance conditions, on average, having insurance would increase their visits to the dentist by 43 percentage points. The uninsured in the survey have lower income, worse oral health and lower rates of preventive and treatment visits. Copyright © 2015 John Wiley & Sons, Ltd.     

The Effect of Dental Insurance on the Use of Dental Care for Older Adults: A Partial Identification Analysis

We evaluate the impact of dental insurance on the use of dental services using a potential outcomes identification framework designed to handle uncertainty created by unknown counterfactuals—that is, the endogenous selection problem—and uncertainty about the reliability of self‐reported insurance status. Using data from the health and retirement study, we estimate that utilization rates of adults older than 50 years would increase from 75% to around 80% under universal dental coverage. Copyright © 2014 John Wiley & Sons, Ltd.     

Peer Reviewed: Social Disparities in Dental Insurance and Annual Dental Visits Among Medically Insured Patients With Diabetes: the Diabetes Study of Northern California (DISTANCE) Survey

Introduction

People with diabetes are at increased risk of periodontal disease and tooth loss. Healthy People 2010 set a goal that 71% or more of people with diabetes should have an annual dental exam.

Methods

We assessed dental insurance and annual dental visits among dentate respondents from the Diabetes Study of Northern California (DISTANCE) Survey cohort (N = 20,188), an ethnically stratified, random sample of patients with diabetes aged 30 to 75 years receiving medical care from Kaiser Permanente Northern California. We calculated predicted probabilities for an annual dental visit (PPADV) by using regression models that incorporated age, sex, education level, annual household income, and self-reported race/ethnicity, stratified by whether the respondent had dental insurance.

Results

Among 12,405 dentate patients, 9,257 (75%) had dental insurance. Annual dental visits were reported by 7,557 (82%) patients with dental insurance and 1,935 (61%) patients without dental insurance. The age-sex adjusted odds ratio for an annual dental visit was 2.66 (95% confidence interval, 2.33-3.03) for patients with dental insurance compared to those without dental insurance. For patients with dental insurance, the PPADV was 71% or more for all except those with the lowest household income. In contrast, for those without dental insurance, the PPADV was less than 71% for all except those with the most education or the highest income. We found some racial/ethnic subgroups were more likely than others to take advantage of dental insurance to have an annual dental visit.

Conclusions

Patients with diabetes in this managed care population who lacked dental insurance failed to meet the Healthy People 2010 goal for an annual dental visit. An increased effort should be made to promote oral health among people with diabetes.     

Merchandising Dental Care Products Through Dental Practitioners

Abstract

This study examines the marketing of dental care products through dental practitioners' offices. This paper reports the findings of an experimental study designed to explore the role of price and brand names on consumers' attitude and intention to purchase. The results reveal favorable attitudes and intentions to purchase dental care products through the dentist's office.     

刷牙方法与牙线的使用对牙菌斑控制的研究

目的 了解习惯刷牙法(hahitual method)、水平颤动法(Bass method)、旋转法(Rolling stroke method)等3种不同刷牙方法与牙线的使用对牙菌斑的清除效果，以便有效地加强学生口腔卫生健康教育。方法 抽取安徽医科大学79名口腔专业四年级学生，按班级不同分别采用Bass刷牙法、Rolling刷牙法和习惯法分为3个组，比较3种刷牙方法对菌斑清除情况，同时比较同一种方法对A、B、C、D4个象限及前后牙区域的菌斑清除情况；检查牙线对牙菌斑清除情况。结果 Rolling刷牙组的菌斑清除率明显优于其他2种刷牙组的菌斑清除率；A、B、c、D4个象限的菌斑清除率差异无显性，前牙区的菌斑清除率明显优于后牙区；牙线对清除邻面菌斑效果较佳。结论 Rolling刷牙法有利于对牙面牙菌斑的清除，刷牙时应注意加强后牙区的菌斑清除，积极推广使用牙线。     

Disparities in Unmet Dental Need and Dental Care Received by Pregnant Women in Maryland

To examine prenatal dental care needs, utilization and oral health counseling among Maryland women who delivered a live infant during 2001–2003 and identify the factors associated with having a dental visit and having an unmet dental need during pregnancy. Pregnancy Risk Assessment Monitoring System is an ongoing population based surveillance system that collects information of women’s attitudes and experiences before, during, and shortly after pregnancy. Logistic regression was used to model dental visits and unmet dental need using predictor variables for Maryland 2001–2003 births. Less than half of all women reported having a dental visit and receiving oral health advice during pregnancy. Twenty-five percent of women reported a need for dental care, of which 33 % did not receive dental care despite their perceived need. Multivariate modeling revealed that racial minorities, women who were not married and those with annual income <$40,000 were least likely to have a dental visit. Women who were not married, had low annual income, were older than 40 years of age, had an unintended pregnancy and received prenatal care later than desired were most likely to have an unmet dental need during pregnancy. Despite reported needs and existing recommendations to include oral health as a component of prenatal care, less than half of pregnant women have a dental visit during their pregnancy. One-third of women with a dental problem did not have a dental visit highlighting the unmet need for dental care during pregnancy.     

Dental public health

The dental profession has prime responsibility for the care of oral health problems in the U.S. Medicine has essentially relinquished responsibility for that part of the body. Dental public health primarily evolved from within the dental profession and it is unique in that a special area in public health was created to address the problems of a particular part of the body. Although one may not think of the major dental diseases--dental caries and periodontal disease--as particularly serious ones, the magnitude of the problem, as evidenced by the universality of the diseases and the extensive levels of untreated pathology, results in a public health problem of major proportions. The field has been expanding in scope and complexity with more emphasis being placed on the total dental care delivery system and its impact on oral health status. The concept of oral health has a very different meaning and value for people in different cultures and socio-economic classes. The prevalent philosophy in the U.S. places the prime responsibility for dental health on the individual.     

Association Between Dentist–Dental Hygienist Communication and Dental Treatment Outcomes

Communication between physician and patient is critical in all fields of medicine, and various types of communication exist in healthcare settings. Cooperation among healthcare professionals is thought to be essential in providing high-quality services. Dental hygienists are key team members in the provision of dental care, and are known to play an important role in the health of their patients. This study aimed to determine the effect of communication between dentists and hygienists on patient satisfaction. Study subjects were dentists, patients, and dental hygienists, and we examined how dentist–dental hygienist communication affected patient outcome indices. A significant difference was observed only for satisfaction in terms of meeting expectations (p = 0.035). Results for patient satisfaction indicated significant differences in explanatory behavior in dentist–dental hygienist evaluations (p = 0.001). The results showed improved health and reduced fear, indicating significant differences for the dentist–dental hygienist evaluations in explanation behavior (p = 0.016). Our evaluation of the effects of dentist–dental hygienist communication on patient outcomes indicated a significant correlation, suggesting that inter-professional communication in the field of dentistry affects patient satisfaction.     

口腔综合保健对儿童龋齿发病率的影响

目的观察口腔综合保健对儿童龋齿发病率的影响,探讨口腔保健在儿科保健中的作用。方法选择我院2010年1月-2011年1月儿科保健门诊的300例儿童,随机分为实验组和对照组各i50例。实验组给予健康教育、饮食干预、牙齿窝沟封闭、氟离子透入等口腔综合保健,对照组不采取干预措施。所有儿童均随访i2个月,对2组儿童龋齿发生情况进行比较。结果实验组在随访6个月、12个月时龋齿的发病率分别为2．0％和3．3％,对照组分别为6．7％和12．0％,2组比较差异有统计学意义（p〈0．05或p〈0．01）。结论口腔综合保健可降低儿童龋齿的发生率,应在儿科保健中进一步推广应用。     

An Examination of Retail Dental Practices versus Private Dental Practices Using an Importance-Performance Analysis

Using an importance-performance approach, private dental patrons and retail dental patrons were contrasted in terms of their assessments of their expectations and perceptions toward various dental practice attributes or characteristics. Results suggest that while differences across attributes exist, expectations and perceptions of most of the key dimensions of quality service, reputation and competence are not distinguishing characteristics between the two dental patron groups. The only variations are with the importance of a friend's recommendation and the importance and performance regarding the hours of operation. These results provide some insights and interesting debate concerning the image and general marketing practice of private dentists and retail dental facilities.     

Effects of Early Dental Office Visits on Dental Caries Experience

Objectives. We determined the association between timing of a first dentist office visit before age 5 years and dental disease in kindergarten.Methods. We used North Carolina Medicaid claims (1999–2006) linked to state oral health surveillance data to compare caries experience for kindergarten students (2005–2006) who had a visit before age 60 months (n = 11 394) to derive overall exposure effects from a zero-inflated negative binomial regression model. We repeated the analysis separately for children who had preventive and tertiary visits.Results. Children who had a visit at age 37 to 48 and 49 to 60 months had significantly less disease than children with a visit by age 24 months (incidence rate ratio [IRR] = 0.88; 95% confidence interval [CI] = 0.81, 0.95; IRR = 0.75; 95% CI = 0.69, 0.82, respectively). Disease status did not differ between children who had a tertiary visit by age 24 months and other children.Conclusions. Medicaid-enrolled children in our study followed an urgent care type of utilization, and access to dental care was limited. Children at high risk for dental disease should be given priority for a preventive dental visit before age 3 years.Early childhood caries, or tooth decay in children younger than 6 years, is the most common chronic disease among children. Its prevalence increased to 28% among 2- to 4-year-old children between 1988 to 1994 and 1999 to 2004, and its impact on children is becoming better known.1,2 Tooth decay can impair young children’s overall health, speech, growth, and school performance; it can also negatively affect families’ quality of life.2–6Because of concern about the impact of dental disease on overall health and the stagnant rate of dental care use over the past decade, Healthy People 2020 identified the annual use of dental care for every person aged 2 years and older as 1 of 24 leading health indicators.7 Dental use was selected from as many as 1200 objectives as a high-priority health issue.Early childhood tooth decay is preventable and largely reversible in its early stages through self-care, use of professional services, and exposure to community interventions such as water fluoridation.8,9 During dental visits, children can receive an assessment for disease risk, early detection and treatment services, preventive care such as fluoride therapy, and anticipatory guidance.8,10–12 To ensure exposure to prevention early in life, professional organizations recommend that children have a dental home by 12 months of age.10,12–14 North Carolina Medicaid, along with Medicaid in most other states, also recommends a first dental visit by age 12 months; however, North Carolina Medicaid does not require a visit until age 3 years because of a limited supply of dentists.Despite evidence that professional preventive dental care leads to good oral health outcomes, no strong evidence indicates the most effective age for the first visit. A previous study found no difference in the severity of disease at age 6 to 7 years between children whose first dental visit occurred before age 2 years and those who were aged 2 to 5 years at their first visit.15 Another study found that early dentist visits that included prevention were associated with fewer treatments from the time the children were aged zero to 5 years.16 Three studies found no relationship between early visits and dental costs or treatment use,17–19 but one found that children with existing disease who received preventive services earlier had fewer subsequent treatments and expenditures.19Previous studies on the age of the first dental visit have primarily focused on treatment and cost outcomes, with conflicting results. It is unclear from studies on treatment outcomes whether children with early visits have differences in disease status. Unlike medical claims, dental claims do not include diagnosis codes, so the extent of disease cannot be determined from claims files alone. We combined claims files with public health surveillance files of oral health status to estimate the effect of the timing of the first dental visit on dental disease history and untreated disease in kindergarten students in North Carolina.     

口腔诊疗车的研制

本文介绍了口腔诊疗车的研制背景、研制技术思路、技术原理及实现方法、基本功能和作业能力等。该车的研制成功，有效地提高了我军战时口腔诊疗的随行保障能力。     

Dental practice settles refusal-to-treat allegations

In April 1999, following accusations of discrimination and unfair treatment against patients and potential patients with HIV, a Massachusetts dental practice agreed to pay $20,000 in civil penalties, and to provide free dental care to HIV-positive patients who lack dental insurance. The suit cited incidences of HIV-positive patients being denied services at the practice and being routinely referred to hospitals where, they were told, they would receive better care. The dentist in the case, Dr. Guillermo Recinos, did not admit liability. According to the Boston Globe, Recinos' dental license expired in March 1998 and has not been renewed.     

2006年济南市口腔诊疗机构器械消毒现状调查

[目的]规范口腔诊疗器械消毒,切断交叉感染途径。[方法]对口腔诊疗机构器械消毒情况进行全面监督检查,对检查中发现的问题限期整改。[结果]济南市二级以上综合医院、专业口腔医院和较大规模诊所合法执业率均为100.0%,小规模诊所合法执业率为96.2%;二级以上综合医院及专业口腔医院器械消毒合格率为82.6%,较大规模诊所合格率为93.7%,小规模诊所合格率为5.9%。[结论]济南市部分口腔诊疗机构仍存在不少问题,必须加大监督检查力度,保证各项消毒措施落实到位。     

Dental care of institutionalized elderly in Singapore

Previous studies have identified considerable barriers to dental care and unmet dental needs among institutionalized elderly. This study examined physical and financial arrangements for dental care of institutionalized elderly in Singapore. Chief administrators of the 68 homes for the elderly in Singapore were interviewed. Results showed that 48 homes (70.7%) assumed responsibility for arranging dental care and providing access to treatment facilities for its ambulant residents while only 33 homes (48.5%) had similar arrangements for semi- and non-ambulant residents. Four of the homes (5.9%) reported having in-house dental facilities while the rest arranged for its residents to be treated either in public dental facilities (44.2%) or in private dental offices (20.6%). Type of sponsorship of the homes and ambulatory status were closely associated with the type of arrangement for dental care. Over 64.6% of homes (44) required residents to be fully responsible for the costs of their dental care. The availability of subsidies for residents' dental costs was found to be associated with the type of sponsorship and type of arrangement for care. Lack of physical access and financial constraints were found to be potential problems in the utilization of dental services in this population group.     

Parental Attendance at a School Dental Program: Its Impact Upon the Dental Behavior of the Children

The Okanagan dental health team invited parents of kindergarten children to attend an educational and brush-in session of the school dental program. This included actively participating in the brush-in. In four school districts, data were compiled comparing children whose parents attending with children whose parents did not. Behavioral variables compared included dental visits, routine oral hygiene, and the use of fluoride paste and rinse at the sessions. Dental exams both a priori and a posteriori allowed an assessment of the dentition and gingival tissue of both groups. Results showed a significantly greater improvement in both the dental behavior and dental health of the children whose parents attended the session. These results give valid evidence to the advantage of involving parents in a school based dental program.     

北大口腔医院新门诊大楼制作口腔边台研究

结合我院口腔边台的制作工作,介绍了口腔边台的定义及放置原则,并且详细介绍了在采购过程中需求调研、初步方案、方案确定和方案实施四个主要工作阶段,希望能为同行提供一些借鉴作用。     

江苏省12岁学生龋病与氟牙症患病现状

目的了解江苏省12岁学生龋病及氟牙症的患病现状,为开展学校口腔卫生保健提供参考依据。方法采用多阶段、分层、等容量、随机抽样的方法,抽取江苏省城乡12岁学生792人,男、女各半进行调查。结果12岁年龄组恒牙患龋率和龋均（xDMFT）分别为27.02%和0.47,女性患龋率和xDMFT均显著高于男性（P值均〈0.05）。龋齿充填率为4.61%,其中城市为7.73%,农村仅为0.62%,差异有统计学意义（P〈0.01）。氟牙症患病率为23.39%,氟牙症指数（Fci）为0.33,其中铜山地区最高为1.12,显著高于其他样本地区（P〈0.01）。结论江苏省12岁学生龋病流行状况与全国第2次口腔健康调查（1995）结果相比,患龋率和龋均较低,龋齿的充填率较低;铜山为氟牙症流行地区。应加强口腔预防保健工作和开展学校口腔卫生服务,以提高龋病的治疗率。高氟区应改水除氟。