Unmet Dental Care Need in West of Iran: Determinants and Inequality

Purpose The purpose of this study was to assess the self-perceived need, seeking and use of dental care and its main determinants in Kurdistan province, Iran. Design/methodology/approach A total of 1,056 adults in Kurdistan province were included in this cross-sectional study. Multistage sampling approach was used to select the samples. Data on sociodemographic characteristics, economic status, self-perceived need, seeking and use of dental care were collected using a self-administrated questionnaire. Multivariate logistic regression model was used to assess factors affecting the use of dental care. In addition, socioeconomic inequality relating to dental care needs and use of dental care were examined using concentration curve and concentration index. Findings In this study, unmet dental care need was 62.7%. There was a perceived need for dental care among 13.7% (n = 145) of the participants in the past month, with only 39.3% (n = 57) seeking the care. The most important reasons for unmet dental care need were “Could not afford the cost” and “Insurance did not cover the costs.” Multivariate logistic regression showed that supplementary insurance status and household economic status were identified as main determinants affecting dental care-seeking behavior. The result of concentration index revealed that seeking dental care was more concentrated among the rich, whereas the perceived dental care need is more prevalent among the poor. Originality/value This study demonstrated that the prevalence of unmet dental care needs is high in the study setting. Also, financial barrier was identified as the main determinant of unmet dental care needs.

Associations between Dental Checkups and Unmet Dental Care Needs: An Examination of Cross-Sectional Data from the Seventh Korea National Health and Nutrition Examination Survey (2016–2018)

To identify gender- and age-related associations between adult dental checkups and unmet dental care needs, we analyzed data of 14,000 participants, from the Seventh Korea National Health and Nutrition Examination Survey (2016–2018). Data were collected via self-report questionnaires and interviews. The complex sample chi-square test and multiple logistic regression analysis indicated that 31.7% of participants had unmet dental care needs. Within the previous 12 months, 56.5% did not undertake dental checkups, and 29.3% did not use a dental service. Odds ratios (ORs) of the unmet dental needs were 8.87 (confidence interval (CI) = 7.80–10.09, p < 0.001) for those who did not use dental services and 1.28 (CI = 1.13–1.44, p < 0.001) for those who did not have dental checkups. Significant age-dependent associations between those not receiving dental checkups and the rate of unmet dental care included men and women aged 50–59 years and women ≥70 years. However, unmet dental care needs for men aged ≥70 years not undergoing dental checkups were not statistically significant (p = 0.311). Overall, it was found that the use of dental service and dental checkups were the influencing factors for unmet dental care needs.

Impact of Long Working Hours and Shift Work on Perceived Unmet Dental Need: A Panel Study

This study investigates whether workers with long working hours as well as shift workers perceive higher unmet dental care needs, and whether there is a gender difference in the associations. We used the Korea Health Panel (2009, 2011–2014) involving 20,451 person-wave observations from 5567 individuals. Perceived unmet dental care needs was defined when the participants reported that they perceived a need for dental treatment or check-up but had failed to receive dental care services during the past year. Fixed effects logit models were applied to examine how changes in weekly working hours or shift work status were linked to changes in perceived unmet dental needs within each individual. Among participants, 15.9–24.7% reported perceived unmet dental needs and the most common reason was time scarcity. We found that long working hours (>52 h/week) was significantly associated with perceived unmet dental needs due to time scarcity in both men (OR = 1.42, 95% CI 1.13–1.78) and women (OR = 1.35, 95% CI 1.03–1.79) compared workers working 40–52 h per week. Shift work was also a significant risk factor, but only in women (OR = 1.57, 95% CI 1.06–2.32). These findings provide evidence for labor policies to reduce working hours in order to improve access to dental care services.

Dental Care for a Child with Congenital Hydrocephalus: A Case Report with 12-Month Follow-Up

Hydrocephalus affects the central nervous system as a result of progressive ventricular dilatation from the accumulation of cerebrospinal fluid in the brain’s lateral ventricles. This paper reports on the oral characteristics of a child with congenital hydrocephalus, discusses her complex dental care needs, and presents dental management of this case. Despite the complex and challenging dental needs, this child received dental treatment in a chairside approach without general anesthesia. A thorough knowledge of the patient’s medical condition, together with expert clinical skills, was indispensable for managing the child and improving the quality and length of her life.

Income-related inequalities in unmet dental care needs in Spain: traces left by the Great Recession

Background Dental health is an important component of general health. Socioeconomic inequalities in unmet dental care needs have been identified in the literature, but some knowledge gaps persist. This paper tries to identify the determinants of income-related inequality in unmet need for dental care and the reasons for its recent evolution in Spain, and it inquires about the traces left by the Great Recession. Methods Data from the EU-SILC forming a decade (2007–2017) were used. Income-related inequalities for three years were measured by calculating corrected concentration indices (CCI), which were further decomposed in order to compute the contribution of different factors to inequality. An Oaxaca-type decomposition approach was also used to analyze the origin of changes over time. Men and women were analyzed separately. Results Pro-rich inequality in unmet dental care needs significantly increased over time (CCI 2007: − 0.0272 and − 0.0334 for males and females, respectively; CCI 2017: − 0.0704 and − 0.0776; p < 0.001). Inequality showed a clear “pro-cycle” pattern, growing during the Great Recession and starting to decrease just after the economic recovery began. Gender differences only were significant for 2009 (p = 0.004) and 2014 (p = 0.063). Income was the main determinant of inequality and of its variation along time -particularly for women-, followed by far by unemployment –particularly for men-; the contributions of both were mainly due to changes in elasticites. Conclusions The Great Recession left its trace in form of a higher inequality in the access to dental care. Also, unmet need for dental care, as well as its inequality, became more sensitive to the ability to pay and to unemployment along recent years. To broaden public coverage of dental care for vulnerable groups, such as low-income/unemployed people with high oral health needs, would help to prevent further growth of inequality.

Leading Risk Factors of the Oral Cavity Health Violations in the Population of Ivano-Frankivsk Region

In Ukraine, as well as throughout the world, oral diseases remain an urgent medical and social problem. In the Ivano-Frankivsk region, the incidence of dental caries, periodontal disease, and oral cancer exceeds the same in the country, which made this study relevant. The purpose of the study was to identify risk factors for oral diseases in the population of Ivano-Frankivsk region and to supplement the information support of local authorities of territorial communities with the results of the study. Material and methods. We analyzed scientific sources (16 units), data from state, industry and regional statistics (13 units) in our study. The following methods were used: system approach and system analysis; generalizations; medical and statistical; graphics. Results and discussion. The obtained results showed that the living conditions of the population of the Ivano-Frankivsk region in 2018 were better than the average for Ukraine: household incomes for a month were by UAH 469.45 (4.96%) higher, non-monetary incomes in cash equivalent were by UAH 850.24 (98.2%) higher, which was favorable for maintaining oral health. However, in terms of education, the population of the region was generally inferior to the population of Ukraine (17.8% of people with higher education, 1.7% with basic higher education, 15.2% with incomplete higher education with corresponding indicators for the country 27%, 1.4% and 21%); the proportion of households that had access to Internet services at home was 53.0% in the region, 61.5% in Ukraine, which created risks to support the sanitary and hygienic literacy of the region's residents. The population of the region actively practiced behavioral risks in relation to oral diseases: the incidence rate of mental disorders and behavior due to alcohol consumption (83.87 per 100 thousand of population) exceeded the corresponding indicators in the industry (64.81 per 100 thousand of population), as well as the prevalence of these disorders (1574.88 and 1080.51 per 100 thousand of population, respectively); the intensity of smoking (51.9% of smokers smoked 11-20 cigarettes per day) exceeded the corresponding data for Ukraine (46%); household expenses for sweets were higher by 26.0% of similar expenses in Ukraine. Drinking water in the region has a fluoride deficiency (0-0.3 mg / l), which is one of the leading causes of tooth decay. In 17.9% of cases, household members of the region with dental care needs could not meet them due to the high cost of services. Conclusion. The risk factors for oral diseases of the population of the Ivano-Frankivsk region were identified: fluoride deficiency in drinking water, behavioral risks, and low level of affordability of dental care for the population. The obtained data can be taken into account when developing a regional program for the prevention of oral diseases and improving the organization of dental care for the population

Impact of COVID-19 on Dental Emergency Services in Cluj-Napoca Metropolitan Area: A Cross-Sectional Study

This study aimed to assess dental care needs in Cluj region during the State of Emergency, declared due to the COVID-19 pandemic, compared to the same period of the year 2019. A descriptive retrospective analysis was conducted, which retrieved patients seeking emergency dental services at the Emergency Department of County General Hospital and “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania, the only dental service available in April 2020. Recorded data cover the month of April 2020 and is compared with the same period of 2019. During April 2020, 724 patients received dental care, whereas only 160 patients were treated in April 2019 in the same facility. The number of patients with acute apical periodontitis, abscess, and acute pulpitis was significantly higher in 2020. The percentage of patients receiving sedative filling for the treatment of acute pulpitis in 2020 was significantly higher than in 2019, while the proportion of patients receiving pulpectomy was higher in 2019. The percentage of patients receiving endodontic drainage for the treatment of acute periapical periodontitis in 2020 was higher. This study demonstrates that the COVID-19 pandemic impacted the use of medical care services and could further impact the oral health and quality of life of patients.