scholarly journals A scope of practice comparison of two models of public oral health services for Aboriginal people living in rural and remote communities

2021 ◽  
Author(s):  
Kylie Gwynne ◽  
Katrina Poppe ◽  
Debbie McCowen ◽  
Yvonne Dimitropoulos ◽  
Boe Rambaldini ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jilen Patel ◽  
Angela Durey ◽  
Steven Naoum ◽  
Estie Kruger ◽  
Linda Slack-Smith

Abstract Background Australian Aboriginal and Torres Strait Islander people continue to experience significant disparities in oral health and there remains an urgent need to improve services to rural and remote communities. Quantitative research has typically been used to highlight the disease burden and severity experienced by those living in remote communities, but this data does little to explore the lived reality and psychosocial nuances that impact on care. The Kimberley region of Western Australia is home to over 150 Aboriginal communities spread out across 400,000 square kilometres. The success and sustainability of oral health services to these remote communities relies on respect and reciprocity achieved through shared knowledge, decision making and involvement of Aboriginal people in discussions around oral health services and their delivery. This, study aimed to investigate the perceptions and attitudes toward dental services among Aboriginal Australian families living in remote Kimberley communities. Methods Semi-structured interviews and yarning circles were carried out following purposive sampling of Aboriginal adults living in the East Kimberley region of Western Australia. Interviews were recorded, transcribed, and analysed guided by a constructivist grounded theory approach. Results In total, 80 community members participated in the yarning process. Enablers to care included: promotion of existing services, integration with primary health services, using mobile dental services and volunteers to extend care. Barriers to care included transportation, cost of treatment, the complexity of appointment systems and shame associated with health-seeking behaviours. Conclusions Reassessing the prevailing operative model of dental care to remote Aboriginal communities is warranted to better address the overwhelming structural barriers that impact on oral health. Integration with existing primary health services and schools, the use of mobile units to extend care and increasing community engagement through clinical yarning are recommended in improving the current state of dental services to communities in the Kimberley.


2019 ◽  
Vol 25 (4) ◽  
pp. 317
Author(s):  
Jacqueline M. Martin-Kerry ◽  
Martin Whelan ◽  
John Rogers ◽  
Anil Raichur ◽  
Deborah Cole ◽  
...  

The aim of this study is to determine where Aboriginal people living in Victoria attend public oral health services; whether they access Aboriginal-specific or mainstream services; and the gap between dental caries (tooth decay) experience in Aboriginal and non-Aboriginal people. Analysis was undertaken on routinely collected clinical data for Aboriginal patients attending Victorian public oral health services and the distribution of Aboriginal population across Victoria. Approximately 27% of Aboriginal people attended public oral health services in Victoria across a 2-year period, with approximately one in five of those accessing care at Aboriginal-specific clinics. In regional Victoria, 6-year-old Aboriginal children had significantly higher levels of dental caries than 6-year-old non-Aboriginal children. There was no significant difference in other age groups. This study is the first to report where Aboriginal people access public oral health care in Victoria and the disparity in disease between Aboriginal and non-Aboriginal users of the Victorian public oral healthcare system. Aboriginal people largely accessed mainstream public oral healthcare clinics highlighting the importance for culturally appropriate services and prevention programs to be provided across the entire public oral healthcare system. The findings will guide development of policy and models of care aimed at improving the oral health of Aboriginal people living in Victoria.


10.2196/11471 ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. e11471 ◽  
Author(s):  
Rona Macniven ◽  
Kate Hunter ◽  
Michelle Lincoln ◽  
Ciaran O’Brien ◽  
Thomas Lee Jeffries Jr ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Helena Rodrigues Galvão ◽  
Angelo Giuseppe Roncalli

Abstract Background This study aimed to assess the trend in income-related inequalities in oral health services utilization by the Brazilian population from 1998 to 2013. This period represents a timeline that includes different stages of implementation of the National Oral Health Policy. Methods The design was based on repeated cross-sectional surveys using secondary data from household-based studies carried out in Brazil in 1998, 2003, 2008, and 2013. The dependent variable was “having access to a dentist appointment at least once in a lifetime (yes/no).” Monthly household per capita income, based on Brazil’s minimum wage, was included as the main independent variable. To measure the inequalities in oral health access related to economic position, the following complex indexes based on regression were used: (a) the slope index of inequality (SII) and (b) the relative index of inequality (RII). Results There was a reduction in the percentage of individuals who never had a dentist appointment for all age groups and income classifications. In general, there was a reduction trend in absolute inequality for all age groups (p < 0.001). The relative inequality and reduction trend were different between the age groups studied. Conclusions The National Oral Health Policy was very important for expanding free of charge, public access to dental appointment. However, despite policy implementation, there continues to be high levels of inequality in access to dental consultation. Assessing which strategies are necessary to overcome this challenge is discussed.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F R Santos ◽  
E P Carvalho ◽  
S R A Oliveira ◽  
R S Moreira

Abstract Background The latest national oral health survey showed a high prevalence of the need for dental prostheses between the Brazilian elderly. To classify this need, normative (clinical) and subjective (self-reported) criteria must be considered since patients' self-perception takes into account social and functional issues that arise with oral health problems. Few studies investigate the agreement between these criteria, as well as its determinants. Thus, this study aimed to investigate the accuracy of the need for the use of total dental prosthesis and factors associated with the agreement between criteria. Methods Cross-sectional study, carried out in three municipalities in the Metropolitan Region of Recife, with a random sample of 816 elderly people from 65 to 74 years old. The dependent variable was the accuracy, calculated by the agreement between the self-reported and the normative need for a total dental prosthesis, and the independents were assembled in three blocks (socioeconomic/demographic, access to oral health services and self-perceived oral health). Hierarchical logistic models were conducted for total upper prosthesis (TUP) and total lower prosthesis (TLP). Results The self-perception of the need for prosthetic use presented an accuracy of 75.9% (95% CI = 72.8-78.7%) for TUP and 78.6% (95% CI = 75.6-81.3%) for TLP. In the multiple analysis, the accuracy for TUP and TLP needs holds an association with the variables: family income, age and time since the last dental appointment. Conclusions In conclusion, the self-perception of need for dental prosthesis demonstrates potential applicability for the elderly, presenting notable accuracy values. It suggests that studies based on patients' self-reports should be stimulated, aiming for the evaluation and validation of self-reported criteria in different contexts and cultures. Furthermore, the identification of accuracy associated factors can help to build more meaningful questions to be used in future surveys. Key messages The use of the self-reported need for total dental prosthesis may be feasible when considering lower cost, reduced time of execution and ease of use in population epidemiological surveys. Application of self-reporting as an epidemiological tool for planning and monitoring oral health services, incorporating it in the form of indicators for oral health surveillance.


2021 ◽  
pp. 238008442110119
Author(s):  
M. McNally ◽  
L. Rock ◽  
M. Gillis ◽  
S. Bryan ◽  
C. Boyd ◽  
...  

Background: The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work. Methods: Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic. Results: Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic. Conclusions: A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings. Knowledge Transfer Statement: The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.


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