Dental needs, demands and patterns of service utilization in a selected Malaysian urban population

Factors affecting children's adherence to regular dental attendance: a systematic review

BACKGROUND

Parents' adherence to regular dental attendance for their young children plays an important role in improving and maintaining children's oral health. The authors conducted a systematic review to determine the factors that influence parental adherence to regular dental attendance for their children.

TYPE OF STUDIES REVIEWED

The authors searched nine electronic databases to May 2013. They included quantitative and qualitative studies in which researchers examined factors influencing dental attendance in children 12 years or younger. The authors considered all emergency and nonemergency visits. They appraised methodological quality through the Health Evidence Bulletins Wales methodological quality assessment tool.

RESULTS

The authors selected 14 studies for the systematic review. Researchers in these studies reported a variety of factors at the patient, provider and system levels that influenced dental attendance. Factors identified at the patient level included parents' education, socioeconomic status, behavioral beliefs, perceived power and subjective norms. At the provider level, the authors identified communication and professional skills. At the system level, the authors identified collaborations between communities and health care professionals, as well as a formal policy of referring patients from family physicians and pediatricians to dentists.

PRACTICAL IMPLICATIONS

Barriers to and facilitators of parents' adherence to regular dental attendance for their children should be identified and considered when formulating health promotion policies. Further research is needed to investigate psychosocial determinants of children's adherence to regular dental visits.

Utilization of public and private dental services in Sibu, Sarawak: a sociodemographic appraisal and types of treatment received

This study investigated the sociodemographic profiles of patients attending public and private dental clinics and the types of treatment received. Patients (n=454) were interviewed using a structured questionnaire at two public and four private clinics in Sibu District, Sarawak. Generally, Chinese (74.7%), females (60.0%) and urban dwellers (83.7%) were more likely to visit the dentist. Both clinics had more females and more Chinese but private clinics had a lower percentage of female attendees (53.1% versus 67.0%) but a higher percentage of Chinese (85.0% versus 64.5%). Private attendees were younger (mean age of 31.0 years compared to 41.0 years) and from higher income households (median value of MR 2,000 versus MR 900) than public attendees. Treatments were mostly curative and a third of the visits were associated with painful conditions. Age (p=0.006), gender (p=0.003), ethnicity (p<0.001) and household income (p<0.001) were associated with the type of clinic visited. Choice of clinic was not related to having painful conditions (p=0.970). To ensure a more affordable and equitable distribution of oral healthcare, health planners need to identify disparities in the utilization of services and differences between public and private attendees.

Needs and demands for dental care in patients attending the University Dental Hospital in Sri Lanka

AIMS

To determine the needs and demands for dental care in patients visiting a university dental hospital.

DESIGN

A cross-sectional study of first visit patients.

SETTING

The University Dental Hospital in Peradeniya, Sri Lanka.

PARTICIPANTS

A total of 849 first visit patients.

METHODS

The main complaint of each patient was recorded and was considered as a measure of demand for dental care. Tooth based and orthodontic treatment needs were assessed using the WHO basic methods. Periodontal treatment need was assessed by the periodontal treatment needs system. Need for prosthetic care was also assessed.

RESULTS

Thirty per cent and 23% of patients demanded treatment for decayed teeth and toothache respectively. Nearly 34%, 27% and 17% of patients needed surgical, restorative and periodontal care respectively for the main complaint. Of those seeking care, 94% needed treatment other than what was required for the main complaint. The predominant normative treatment need was for periodontal care (77%) whilst 47% needed restorations or extractions.

CONCLUSION

Normative needs of patients demanding treatment were high and many had demanded treatment before acute symptoms had developed. However, delays in seeking care were evident. Further studies are needed to identify factors for delay in obtaining care.

Some problems of dental treatment. Part 2. Treatment avoidance: some differences between regular and irregular patients

Analysis of questionnaire data obtained from 54 irregular patients and 56 regular patients attending the Dental Department of the Lower Hutt Hospital and private practices in Lower Hutt and Wellington, New Zealand indicates that irregular patients are more anxious about dental treatment, value natural teeth less and find dental treatment more unpleasant than do regular patients. These and other survey findings on dental service utilization and dental anxiety suggest that the dental profession has a good deal of control over the way the public utilizes dental services. Most international surveys have found that less than 60 per cent of the population visits the dentist regularly, so there appears to be the potential for a substantial increase in regular use of dental services by the public. But, it is also likely that the longer an individual is remiss in regular dental care and the more teeth are lost, the more difficult conversion to regular visits will be.

Perceived need and use of oral health services among adolescents and adults in Tanzania

The perceived need and use of oral health services among adolescents and adults in Tanzania were studied. One region from each of the country's five zones was chosen at random. Final sample selection (n = 1061) was done in the main towns of the selected regions. Participants were interviewed using a structured questionnaire which dealt with perceived need for dental treatment and use of oral health services and several demographic variables. Frequency tables were computed and analyzed. Odds ratios were calculated based on 2 x 2 tables and logistic regression models. The majority, 82% (95% CI: 79-85%) had sought treatment due to pain or for tooth extraction. Perceived need, dissatisfaction with own oral health status and use of oral health services were slightly more frequent among women. Bleeding gums had no explanatory value on the dependent variables. The strongest explanatory variable in a logistic regression model for perceived need and dissatisfaction with own oral health status was previous dental treatment with an estimated odds ratio of 6.4 (95% CI: 4.7-8.7) and 7.2 (95% CI: 5.3-9.9), respectively. People living nearest a treatment facility tended to use the services more [odds ratio 1.3 (95% CI: 0.8-2.1)]. A very strong relation between previous dental problems and use of oral health services was found, namely an odds ratio of 68.8 (95% CI: 39.0-121.4). The findings in the study may be useful in the attempts to implement Tanzania's National Plan for Oral Health.

Investigation of delay in utilization of government dental services in Malaysia

Although delays in seeking dental care among patients are frequently observed in daily practice, this problem has never been investigated in other utilization studies. This study attempts to establish the magnitude and severity of the problem of delay in a delivery system where cost is not a major barrier to utilization. 555 users of Government dental services were interviewed. Only 37% of them came promptly within 6 days of perceiving a dental need. The majority (63%) had delayed their dental visit for more than 1 week. In fact, the highest frequency of delay was for more than 1 month. Prompt attendance was found to be associated with people who regularly came for asymptomatic check-ups. In contrast, more than 50% of those who thought they needed fillings and extractions had delayed their visit for more than a month. The main causes of delays were attributed to work commitments and the lack of perceived need for urgent care. Barriers related to transport or financial problems were ranked very low. The implications of these findings are discussed.

Other dental treatment needs in patients who requested removable partial dentures

The aims of this study were to determine the dental and periodontal status and the associated treatment needs, other than that for prosthetic care, in patients who requested removable partial dentures. Forty-six patients who had never worn removable partial dentures before were examined for plaque index, tooth status, gingival index, loss of periodontal attachment and tooth mobility. Prior to prosthetic treatment, 15% of the teeth needed conservative treatment and 1% needed extractions. From the periodontal point of view, 65% of the teeth needed some form of related therapy, and 2% of the teeth were at risk of extraction due to advanced mobility.

Dental treatment demands among patients in Tanzania

The dental treatment demands of 824 patients attending regional dental clinics were recorded. Overall 86% of the patients sought treatment for pain, ranging from 77% to 97% in the different clinics. Caries was the main cause of pain. The proportion of patients with demands for aesthetics was 5%, prosthetics 2%, and check up 3%. The data indicated a need for emergency care. The type of curative treatment needed, mainly extractions, could well be performed by dental auxiliaries. Since the data was collected from patients among whom many visited the clinics in the late stages of painful oral diseases, it is assumed that it reflects only the tip of an iceberg that represents a much larger dormant demand (want) for emergency care among the population. Any strategy aiming to be effective in improving oral health should at least meet the emergency dental needs of the population. Consequently there is a definite need of data on dental treatment demands and wants for adequate planning of dental health care systems in their infancy in countries with limited financial resources.