“Does this dental mob do eyes too?”: perceptions and attitudes toward dental services among Aboriginal Australian adults living in remote Kimberley communities

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.

Faktor yang Berhubungan dengan Pemanfaatan Pelayanan Kesehatan Gigi dan Mulut di Puskesmas Karanganyar Purbalingga Jawa Tengah: Studi tentang Faktor Pengetahuan, Pendidikan, Pekerjaan, Pendapatan, dan Aksesibilitas

Utilization of dental and oral health services cover the health service and the usage of facilities. This study was aimed to determine and to analyze the relationship between knowledge, education, income, occupation, and accessibility of dental care utilization and oral health services at Karang- anyar health centers of Purbalingga. This was an analytical survey study with a cross sectional design. There were 185 respondents of the working area of Karanganyar health center selected by consecutive sampling. Data were collected by using a validated questionnaire. Data were analyzed by using chi-square test followed by logistic regression test. The results showed that there were 76.8% of respondents who used dental care and oral health services in the three last months before pandemic Covid-19; 35% of respondents had no work; 69.2% had low level of education; 81.21% had high level of knowledge; 83.2% had low income; and 85.1% clarified that the accessibility was not reachable. The chi-square test showed a significant correlation between levels of knowledge (p=0.02), income (p=0.04), education (p=0.012) and dental care utilization as well as oral health services. The logistic regression test showed that knowledge (OR=0.569 (95%CI:0.358-0.903) was the most dominant correlated to dental care utilization and oral health services. In conclusion, levels of knowledge, income, and education had significant relationships with dental care utilization and oral health services at Karanganyar health center.Keywords: knowledge; income; education; dental care utilization and oral health servicesAbstrak: Pemanfaatan pelayanan kesehatan gigi dan mulut mencakup pelayanan dan penggunaan fasilitas pelayanan kesehatan gigi dan mulut. Penelitian ini bertujuan untuk mengetahui dan menganalisis hubungan antara pengetahuan, pendapatan, pendidikan, pekerjaan, dan aksesibilitas terhadap pemanfaatan pelayanan kesehatan gigi dan mulut di Puskesmas Karanganyar Kabupaten Purbalingga. Jenis penelitian ialah survei analitik dengan desain potong lintang. Sampel penelitian ialah 185 masyarakat di wilayah kerja Puskesmas Karanganyar, dipilih secara consecutive sampling. Pengambilan data dilakukan dengan menggunakan kuisioner yang sudah divalidasi. Data dianalisis menggunakan uji chi-square dilanjutkan dengan uji regresi logistik. Hasil penelitian mendapatkan bahwa responden yang memanfaatkan pelayanan kesehatan gigi dan mulut tida bulan terakhir sebelum pandemi covid-19 sebanyak 76,8%; tidak bekerja 35%; pendidikan rendah 69,2%; tingkat pengetahuan tinggi 81,1%; pendapatan rendah 83,2%; dan 85.1% menyatakan aksesibilitas tidak terjangkau. Hasil uji chi-square menunjukkan hubungan bermakna antara tingkat pengetahuan (p=0,02), pendapatan (p=0,04), pendidikan (p=0,012) terhadap pemanfaatan pelayanan kesehatan gigi dan mulut. Hasil uji regresi logistik menunjukkan bahwa faktor pengetahuan OR=0,569 (95% CI:0,358-0,903) yang paling dominan berhubungan dengan pemanfaatan pelayanan kesehatan gigi dan mulut. Simpulan penelitian ini ialah tingkat pengetahuan, pendapatan, pendidikan memiliki hubungan bermakna dengan pemanfaatanpelayanan kesehatan gigi dan mulut di Puskesmas Karanganyar.Kata kunci: pengetahuan; pendapatan; pendidikan; pemanfaatan pelayanan kesehatan gigi dan mulut

Inequality and Inequity in the Use of Oral Health Services in Australian Adults

Objective: Social determinants drive disparities in dental visiting. This study aimed to measure inequality and inequity in dental visiting among Australian adults. Methods: Data were obtained from the National Study of Adult Oral Health (2017 to 2018). Participants were Australian adults aged ≥30 y. The outcome of interest was dental visiting in the last 12 mo. Disparity indicators included education and income. Other sociodemographic characteristics included age, gender, Indigenous status, main language, place of birth, residential location, health card and dental insurance status, and individual’s self-rated and impaired oral health. To characterize inequality in dental service use, we examined bivariate relationships using indices of inequality: the absolute and relative concentration indexes and the slope and relative indexes of inequality. Inequalities were depicted through concentration curves. Indirect standardization with a nonlinear model was used to measure inequity. Results: A total of 9,919 Australian adults were included. Bivariate analysis showed a gradient by education and income on dental visiting, with 48% of those with lowest educational attainment/income having not visited a dentist in the last 12 mo. The concentration curves showed pro–low education and pro–poor income inequalities. All measures of absolute and relative indices were negative, indicating that from the bottom to the top of the socioeconomic ladder (education and income), the prevalence of no dental visiting decreased: absolute and relative concentration index estimates were approximately 2.5% and 5.0%, while the slope and relative indexes of inequality estimates were 14% to 18% and 0.4%, respectively. After need standardization, the group with the highest education or income had almost 1.5-times less probability of not having a dental visit in the previous year than those with the lowest education or income. Conclusion: The use of oral health services exhibited socioeconomic inequalities and inequities, disproportionately burdening disadvantaged Australian adults. Knowledge Transfer Statement: The results of this study can be used by policy makers when planning a dental labor force in relation to the capacity of supply dental services to 1) reduce the inequality and inequity in the use of oral health services and 2) meet identified oral health needs across the Australian population, which is important for preventive dental care.

Knowledge of Five Different Types of Indonesian Health Workers Regarding Oral Health Services for Pregnant Women

Background: Oral health care for pregnant women is often not provided by five health professionals in Indonesia: dentist, general practitioner, gynaecologist, promotion health officer, and midwives. While pregnant women also neither seek nor receive oral health treatment, even with apparent oral disease signs. This condition might occur due to a lack of understanding regarding the importance of oral health care for a healthy pregnancy. Objective: This study aimed to determine the knowledge of five different types of Indonesian health workers regarding oral health services for pregnant women. Methods: A cross-sectional study was conducted on a population of five types of health workers in Indonesia. The sampling technique used was non-probability sampling with consecutive sampling technique from August until September 2019. The sample size was 191 health workers; calculation of sample size was conducted using the survey population to estimate the population proportion formula. The research data was collected using Google® Form questionnaire, which consisted of questions regarding regulations and socialisation about the oral health of pregnant women, the minimum number of visits of pregnant women to health service facility during pregnancy, the necessity for oral health examination during pregnancy, oral health treatment package for pregnant women, advisory for pregnant women to have an oral health examination, maternal and child health manual book. The questionnaire was distributed online to the five types of health workers in Indonesia. Data were analysed using Microsoft® Excel and presented in tabular form. Results: Nine out of thirteen knowledge criteria were in the 'less' category, which means 69% of health workers lacked knowledge regarding oral health services for pregnant women. Likewise, the number of respondents who knew the correct knowledge was found in 9 of the 13 criteria, indicated that only a small proportion of health workers had adequate knowledge regarding oral health services for pregnant women. Conclusion: Five different types of Indonesian health workers are not knowledgeable enough regarding the importance of oral health services for pregnant women. Only a small portion of Indonesia's health workers have adequate knowledge regarding appropriate oral health services for pregnant women.

Oral Health & Dentistry in Bhutan: call for actions to address a public health urgency

Introduction: Bhutan’s healthcare approach in achieving the sustainable development goal 3 (SDG 3) has been largely through primary healthcare as enshrined in the universal health coverage (UHC). Bhutan has forged a unique primary healthcare model in which oral health is integrated in its primary care initiatives. The Oral Health program under the Department of public health was established in 1999 with clear line objectives. The program has achieved commendable successes over the years. However, with changing needs, enhancing and mainstreaming of oral health and dentistry in the country must be accorded a top priority. This is particularly important as the Oral Health Policy and service standards were drafted fourteen years ago in 2007. The 2021 World Health Orgnization (WHO) agreement “to provide basic oral health services to all”, to which Bhutan is signatory, needs to be strictly implemented. Therefore, oral health dialogue was conducted to deliberate on the oral health systems in the country with experts from the field who were from within and outside Bhutan. This oral health policy dialogue generated important themes such as strategic and competent workforce, capacity development, need to transform oral health services in more people centric ways and mainstreaming oral health in other health policies.

During the COVID-19 pandemic, oral health services including routine treatment may continue but must follow established international and South African protocol

The South African Dental Association (SADA) hereby responds to the statement released by the World Health Organization (WHO): Considerations for the provision of essential oral health services in the context of COVID-19, on 7th August 2020. After careful consideration and in consultation with workstreams working in various protocols regarding the provision of oral health services during the COVID-19 pandemic, SADA respectfully yet strongly disagrees with the World Health Organization's (WHO) recommendation to delay "routine" dental care in certain situations due to COVID-19. A blanket statement such as the recent one by the WHO cannot, therefore, be supported. It is without a doubt that oral health is integral to overall health and neglect and delay of certain treatments may lead to extensive damage and increased financial implications to correct. Consequently, dentistry is essential healthcare, because of its role in evaluating, diagnosing, preventing or treating oral diseases, which can adversely affect systemic health. Each country is at a different stage of the pandemic and each country has to respond appropriately based on its assessment of its unique situation.

Influence of Sociodemographic Factors, and the Coverage and Offer of Health Services on Mortality Due to Oral and Oropharyngeal Cancer in Brazil: A 20-year Analysis

Background: To investigate the influence of sociodemographic factors and variables related to oral health services in oral and oropharyngeal cancer mortality in Brazil. Results: The mortality rate was higher in men than in women; the Southeast and South regions had the highest rates, which increased with age. Regarding APC analysis, men aged 57 years or more and those born from the 1920s to 1955, presented the highest mortality rate, while women born between the 1920s and the 1930s had a higher rate ratio. Kaplan-Meier survival curves and Cox regression showed that black men living in the Midwest region had the lowest survival rate. Considering the correlations, the North and Northeast regions presented mortality rates inversely proportional to FPDC and NSTB, while the Southeast presented it only to FPDC. Conclusions: The sociodemographic variables analyzed exhibited an influence on mortality and survival rates in relation to oral and oropharyngeal cancer. Regarding the oral health services, it was observed that preventive and diagnostic procedures are not being performed, which may be exacerbating the increase in the mortality rates observed.