Evaluation of a dental society-based ABCD program in Washington state

Is it cost-beneficial to society? Measuring the economic worth of dental residency training

This study estimated whether continued programming of a highly specialized four-year dentistry residency training in Saudi Arabia was cost-beneficial. We utilized a purposive sampling to administer a survey to trainees in major cities. Additionally, we used publically available market information about general practitioners. We employed Benefit-Cost Analysis accounting approach as a conceptual framework. Using general practitioners as the base category, we grouped overall social analytical perspectives into resident trainees and rest of society. The residency program was cost-beneficial to trainees, realizing an estimated return of SR 4.07 per SR 1 invested. The overall societal return was SR 0.98 per SR 1 invested, slightly shy of a bang for the buck, in part because the public sector largely runs the training. Benefits included increased earnings and enhanced restorative dentistry skills accruing to trainees; increased charitable contributions and programming-related payments accruing to programs and the public; and practice-related payments accruing to governmental, professional, and insurance agencies. Rest of society, notably government underwrote much of the cost of programming. A sensitivity analysis revealed the results were robust to uncertainties in the data and estimation. Our findings offer evidence to evaluate whether continued residency training is cost-beneficial to trainees and potentially to overall society.

How health professionals perceive and experience treating people on social assistance: a qualitative study among dentists in Montreal, Canada

BACKGROUND

In Canada, the prevalence of oral diseases is very high among people on social assistance. Despite great need for dental treatment, many are reluctant to consult dental professionals, arguing that dentists do not welcome or value poor patients. The objective of this research was thus to better understand how dentists perceived and experienced treating people on social assistance.

METHODS

This descriptive qualitative research was based on in-depth semi-structured interviews with 33 dentists practicing in Montreal, Canada. Generally organized in dentists' offices, the interviews lasted 60 to 120 minutes; they were digitally recorded and later transcribed verbatim. The interview transcripts were coded with NVivo software, and data was displayed in analytic matrices. Three members of the research team interpreted the data displayed and wrote the results of this study.

RESULTS

Dentists express high levels of frustration with people on social assistance as a consequence of negative experiences that fall into 3 categories: 1) Organizational issues (people on social assistance ostensibly make the organization of appointments and scheduling difficult); 2) Biomedical issues (dentists feel unable to provide them with adequate treatment and fail to improve their oral health); 3) Financial issues (they are not lucrative patients). To explain their stance, dentists blame people on social assistance for neglecting themselves, and the health care system for not providing adequate coverage and fees. Despite dentists' willingness to treat all members of society, an accumulation of frustration leads to feelings of powerlessness and discouragement.

CONCLUSIONS

The current situation is unacceptable; we urge public health planners and governmental health agencies to ally themselves with the dental profession in order to implement concrete solutions.

Preventive dental service utilization for Medicaid-enrolled children in New Hampshire: a comparison of care provided by pediatric dentists and general dentists

In this study, we compared preventive dental utilization through visits to a pediatric dentist (PD) vs. visits to a general dentist (GD) among Medicaid-enrolled children in New Hampshire (n = 12,964). Dental claims were analyzed using conditional logistic regression models. After adjusting for covariates, children seen by a PD were 51% more likely to have received fluoride treatment, 26% more likely to have had at least two dental examinations, and 19% more likely to have received a sealant than children seen by a GD. Overall, our results suggest that children seen by a PD were more likely to have received preventive services than those seen by a GD. Because Medicaid-enrolled children are at increased risk for poor oral health, policies should be enacted to ensure that high-risk children receive appropriate and regular prevention-oriented dental care.

Receipt of preventive dental care among special-needs children enrolled in Medicaid: a crisis in need of attention

Although not widely recognized, tooth decay is the most common childhood chronic disease among children ages five to seventeen. Despite higher rates of dental caries and greater needs, low-income minority children enrolled in Medicaid are more likely to go untreated relative to their higher income counterparts. No research has examined this issue for children with special needs. We analyzed Medicaid enrollment and claims data for special-needs children enrolled in the District of Columbia Medicaid program to evaluate receipt of recommended preventive dental care. Use of preventive dental care is abysmally low and has declined over time. Enrollment in managed care rather than fee for service improves the likelihood that special-needs children receive recommended preventive dental services, whereas residing farther from the Metro is an impediment to receipt of dental care.