Barriers to Dental Care in Individuals with Special Healthcare Needs in Qatif, Saudi Arabia: A Caregiver's Perspective

Caregiver's Oral Health Knowledge, Attitudes, and Practices Toward Special Needs Children, Zimbabwe

INTRODUCTION

Children with special health care needs (CSHCN) rely heavily on their caregivers. Therefore, caregivers must possess adequate oral health knowledge, attitudes, and practices (KAP) to maintain the oral health of CSHCN.

OBJECTIVES

To assess caregivers' oral health KAP toward CSHCN.

METHODS

A cross-sectional study using convenience sampling was conducted. Data from 295 caregivers attending support group meetings in Harare Province were analyzed using STATA, with p < 0.05 considered statistically significant.

RESULTS

Most caregivers were aged 31-40, with cerebral palsy being the most common disability. Caregivers' oral health knowledge and practices were satisfactory, while their attitudes were good. Significant associations were found between caregivers' oral health knowledge and educational level (p = 0.001), and between oral health attitude and both educational level and employment status (p = 0.001, p = 0.003, respectively).

CONCLUSIONS

Caregivers generally had a positive attitude. However, their knowledge about oral health and their practical application of this knowledge was fair. This could be due to a lack of sufficient information or skills to effectively implement good oral health practices.

Disparities in periodontitis risk and healthcare use among individuals with disabilities in Korea: a retrospective cohort study

BACKGROUND

We analyzed the relationship between disability status and periodontal disease, focusing on disparities in healthcare utilisation, including outpatient visits and hospitalisation rates, among disability types and severities.

METHODS

This study used data from the National Health Insurance Service(NHIS) of Korea, which includes comprehensive records of the insured population. We examined 966,200 individuals with disabilities, grouped into five categories, and applied propensity score matching to compare with a matched control population. Periodontal disease was defined by the Korean Classification of Diseases criteria, and we used chi-square tests, t-tests, multivariate logistic regression, and negative binomial regression.

RESULTS

Individuals with disabilities had higher odds of hospitalisation for periodontitis (OR: 3.83, 95% CI = 3.59-4.08) but lower odds for outpatient visits (OR: 0.68, 95% CI = 0.68-0.69) and dental treatments (OR: 0.73, 95% CI = 0.72-0.73) compared to those without disabilities. The highest hospitalisation rates were among those with mental health disabilities (OR: 13.70, 95% CI = 12.26-15.30). Severe disabilities were associated with increased hospitalisation rates (OR: 7.14, 95% CI = 6.66-7.66) and fewer outpatient visits and treatments.

CONCLUSION

Individuals with mental health disabilities or severe disabilities experience greater risks of hospitalisation for periodontitis and attend fewer outpatient visits and treatments. Targeted interventions are needed to improve dental care access and reduce disparities.

Navigating Barriers to Dental Care for Patients with Down Syndrome: A Scoping Review of Challenges and Strategies

OBJECTIVE

Access to dental care is critical for overall health, yet individuals with Down Syndrome (DS) face numerous barriers, including communication difficulties, insufficiently trained professionals, and financial constraints leading to poor oral health outcomes. These obstacles are compounded by a shortage of specialized services and geographic disparities that limit access to appropriate care. This scoping review aimed to explore the existing literature about these barriers and to identify strategies to enhance dental care for this vulnerable population.

METHODS

This scoping review followed the Systematic Reviews and Meta-Analyses extension for Scoping Review guidelines. A comprehensive search was conducted across PubMed, Scopus, and Web of Science focusing on peer-reviewed studies published in English within the last 10 years that examined barriers and strategies related to patients with DS. To ensure methodological rigor, eligible studies were independently screened and reviewed by two reviewers. Any disagreements were resolved through discussion, and if consensus could not be reached, a third reviewer made the final decision. Data were extracted using a standardized form. The extracted data were analyzed and synthesized to identify and categorize barriers and strategies across different studies.

RESULTS

The initial search yielded 58 articles, with 42 remaining after duplicates were removed. Following titles and abstracts screening, 13 studies were considered for full-text review, and 6 studies met the inclusion criteria. These studies, published between 2015 and 2023, primarily employed cross-sectional designs and identified key barriers, including challenges in maintaining oral hygiene, limited access to specialized dental services, and behavioral and sensory difficulties affecting dental care for children with DS. Strategies to overcome these barriers included enhancing dental professional training, developing tailored care approaches, and integrating preventive dental programs into broader health initiatives.

CONCLUSIONS

This review highlights significant, persistent barriers to dental care for children with DS. By emphasizing the need for enhanced dental professional training, personalized care approaches, and integrated preventive programs, this review provides a framework for improving dental care accessibility for this population. Addressing these barriers can lead to better oral health outcomes and improved overall well-being for children with DS.

A Global Provision of Preventive Oral Health Measures for Children With Special Needs: A Scoping Review

BACKGROUND

Policymakers should consider the preventive measures provided to children with special health care needs (CSHCN) to reduce inequalities in dental treatment measures. This scoping review aimed to develop a conceptual framework regarding preventive measures and barriers to implementing them to find the gap in knowledge and the lack of a comprehensive framework of studies published in this area.

METHOD

In this review, nine steps for scoping review were employed. Five electronic databases were searched: PubMed/Medline, EMBASE, Scopus, Web of Science, and EBSCO Host from January 2014 to January 2024. Thematic analysis was developed with the help of data extracted from the included articles, which were divided into categories. Finally, a litmap and conceptual map were developed according to the JBI manual for evidence synthesis.

RESULTS

After analyzing 129 articles that fulfilled inclusion criteria, 44 were included. Four main categories were identified, which were further divided into 19 subthemes. The four main categories were Interventional measures, perspectives of dentists and caregivers, barriers and unmet treatment needs, and Governmental policies. According to these themes, a conceptual map was developed to assess the needs of CSHCN that can help develop preventive measure policies. These policies can eventually help service providers develop proper treatment measures for these vulnerable groups.

CONCLUSION

This scoping review concludes that there is a need for an assessment of treatment needs for CSHCN, which can help develop policies. By analyzing parents' and dentists' perceptions, policymakers can make a policy to support these vulnerable children's oral health care needs. This approach will eventually reduce the barrier and inequality in oral health preventive services provided to CSHCN.

Special education teachers' involvement and perceived barriers to delivering oral health education for students with disabilities-A cross-sectional study

BACKGROUND

Dental caries is prevalent among children, including those with disabilities. Although the World Health Organization recommends school-based oral health promotion (OHP) programmes involving teachers, limited research has explored teachers' roles and perspectives.

AIM

To assess special education teachers' involvement and difficulties regarding oral health education (OHE), attitudes towards OHP and barriers to oral healthcare access for students with disabilities (SWDs).

DESIGN

This descriptive cross-sectional study, conducted in Al-Ahsa, Saudi Arabia, involved 264 special education teachers using a validated, self-administered questionnaire, and descriptive and analytical statistics were used for data analysis.

RESULTS

Only 39% of teachers incorporated OHE into their teaching, and just 20.8% received training for OHE delivery. Teachers showed strong support for integrating OHE into the curriculum (84.1%) and a no-sugar policy (78%). There was, however, less support for school-based toothbrushing (39%). OHE barriers included insufficient resources (56.1%), limited knowledge (29.2%) and misconceptions about primary teeth removal (47.4%). The three most common barriers to oral healthcare access were extended waiting lists (75.0%), long waiting times (73.1%) and fear of dental equipment (67.4%).

CONCLUSION

This study highlights the need for collaboration between healthcare professionals, educators and parents to enhance OHE and reinforce OHP for SWDs within special education and beyond.

Patient preferences and willingness to pay for dental services: a systematic review

BACKGROUND

Oral health is a fundamental aspect of overall well-being. However, dental diseases have a significant impact on access to care due to economic and social barriers. This systematic review of the literature on willingness to pay (WTP) for dental services aims to inform policy and planning by identifying the key factors influencing preferences.

METHODS

A systematic literature review was conducted using the following databases: PubMed, Embase, Web of Science core collection, Scopus, and Google Scholar. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were followed. Original studies on the preference and WTP for dental services published up to October 2023 were considered. Inclusion criteria included an active population aged ≥ 18 years and various methodological approaches to eliciting WTP, such as discrete choice experiment (DCE) and contingent valuation (CV) techniques. The quality of selected studies was assessed by using the ISPOR checklist.

RESULTS

A total of 45 articles were eligible for inclusion, indicating that WTP research was primarily based on convenience and non-probabilistic sampling. Mean WTP showed significant variation and was influenced by demographic factors (age, gender), socioeconomic conditions, insurance cover, and perceived need for dental care. The main attributes identified from the studies related to cost (out of pocket payment, price), service delivery, time, and treatment outcome.

CONCLUSIONS

The review underlined that demographic and socio-economic variable greatly influence WTP, implying the need for district policies to improve access to dental services. Future research should address the methodological limitations of the included studies and evaluate the potential for prospective studies to enhance understanding of patient preferences in dental care.

Facilitating oral healthcare for children with disabilities in the Kingdom of Saudi Arabia: a qualitative exploration of the perceptions of parents and professionals

BACKGROUND

Children with disabilities worldwide experience disparities in oral health. Parents and children encounter challenges in accessing quality dental care. Similar challenges are experienced in Saudi Arabia. This study aimed to explore the barriers and facilitators of oral healthcare for children with disabilities in Saudi Arabia.

METHODS

This was an ethnographic study. The sample size was 25 participants, comprising of 12 pediatric dentists and 13 parents of children with disabilities. Data were collected through in-depth interviews, employing a topic guide. A pre-defined analytical framework was developed from the study objectives and framework analysis used to analyse data.

RESULTS

The study identified significant barriers and facilitators to oral healthcare for children with disabilities. Barriers included long travel distances, inadequate clinic facilities, a shortage of specialist pediatric dentists, inefficiencies in referral systems, and financial constraints. Other challenges were related to physical barriers in clinics, cultural norms, and socioeconomic inequalities. Facilitators, though fewer, included personal connections, specialized disability friendly clinics, and the Priority Card Program, albeit with limited effectiveness. Suggestions for improvement highlighted the need for better training for dental professionals, enhanced clinic accessibility, and greater financial support for families.

CONCLUSION

Accessibility of dental care for children with disabilities in Saudi Arabia remains a significant challenge due to systemic barriers and individual-level obstacles. The study underscores the need for policy reforms, enhanced professional training, and the improvement of physical and financial accessibility to dental services. Addressing these issues through comprehensive educational programs and targeted interventions is essential for reducing oral health disparities and improving care for children with disabilities.

Oral Health Care for Individuals With Special Needs: Practices and Challenges Among General Practitioners in Saudi Arabia

INTRODUCTION

A vital component of public health that needs a lot of attention is oral health care for people with special needs. The phrase "special needs" describes a wide range of issues pertaining to behavior, development, health, and emotions that require specific medical and educational support. These individuals often present with complex oral health care needs that require specialized knowledge and skills. Despite their significant numbers, access to quality oral health care for this group remains a critical concern.

OBJECTIVES

The objective of this study was to evaluate the practices and challenges faced by general practitioners (GPs) in delivering oral health care to individuals with special needs.

METHODS

The sample size of this study consisted of 380 GPs. Informed consent was obtained from the participants, and they were informed that their responses and personal information would be kept confidential. A cross-sectional survey in English was prepared using Google Forms. The survey comprising 19 questions was distributed among a sample drawn from various regions of Saudi Arabia. Participants were selected to ensure representation from different practice settings, including private clinics, government hospitals, and university clinics.

RESULT

A significant portion of participants (271, 71.3%) reported lacking formal training in dental care for individuals with special needs. Furthermore, 277 (72.9%) expressed low confidence in their ability to provide care for these patients. Additionally, 342 (90%) acknowledged that the challenges in treating patients with special needs significantly impact their ability to deliver effective care. Moreover, 326 (85.8%) indicated insufficient access to the necessary resources and support, pointing to critical gaps in the provision of dental services for individuals with special needs.

CONCLUSION

The findings of this study showed that GPs encounter significant challenges in treating individuals with special needs in daily clinical settings. These challenges contribute to insufficient training of GPs in the field, limited resources provided, and inadequate support. The majority of participants in this study believe that a lack of professional guidelines, trained support staff, and continuing education opportunities contribute significantly to the challenges they face in delivering oral health care to individuals with special needs.

The Barriers in Using Oral Health Services of People Aged 18 or Over in Danang in 2023: A Cross-sectional Study

AIMS

This study aims to identify the barriers associated with access to oral health services among individuals aged 18 or over in Danang city.

MATERIALS AND METHODS

A cross-sectional descriptive study using a self-completed questionnaire with 29 questions built on the theoretical framework of Jean-Frederic Levesque and the modified dental anxiety scale (MDAS) was conducted on 386 people aged 18 years and older living in Danang city through face-to-face interviews. The study responses were closed after achieving the target sample size, with the sample collection period recorded as 3 months from October 2023 to January 2024. Data were analyzed using SPSS 20.0 software. Factors influencing the decision to use dental services among individuals who have either never used or have used oral care services more than 12 months ago were analyzed in univariate analysis and multivariate logistic regression analysis.

RESULTS

The proportion of participants who have either never utilized dental services or had last used them more than 12 months ago was 57.5%. Factors linked to the decision to seek dental care include personal dental hygiene practices, knowledge of oral health, accessibility to information, recommendations from peers, the process of scheduling appointments, examination duration, and income level, with odds ratio (OR) of 2.011-15.394 (p < 0.05).

CONCLUSION

A large proportion of adults in Danang lack the habit of utilizing dental care services. The prevalent barriers include physical accessibility to dental facilities (such as locating, scheduling, and arranging appointments), affordability, and a deficiency in individual skills and knowledge regarding the importance of regular oral healthcare.

CLINICAL SIGNIFICANCE

The analysis of factors such as knowledge of oral health and service accessibility provides crucial insights for developing strategies to enhance community engagement in oral care. The clinical translational value of this research lies in its potential to support the development of more effective educational programs and healthcare policies, thereby encouraging regular oral health practices and improving the oral health of the community. How to cite this article: Khuong APV, Pham DA, Nguyen HTM, et al. The Barriers in Using Oral Health Services of People Aged 18 or Over in Danang in 2023: A Cross-sectional Study. J Contemp Dent Pract 2024;25(11):1009-1014.

Refraining from seeking dental care among the Sámi in Sweden: a cross-sectional study

BACKGROUND

While equity in health care is the core of the Swedish health system, social inequalities in accessing health care, particularly regarding dental care, exist. There is however no information on how the Sámi population is affected. This study aimed to assess the prevalence and risk factors for refraining from seeking dental care among the Sámi in Sweden.

METHODS

A Sámi sample was constructed from three pre-existing registers. Among the 9,249 invitations for individuals aged 18-84 years old, 3,779 answered the survey during February-May 2021. We first calculated frequencies and proportions of the independent variables in terms of socio-economic, socio-demographic, and cultural-related factors as well as the outcome, refraining from dental care. Then, we summarized the magnitude of the association between the independent variables and self-reported refrain from dental care with the prevalence difference (PD) using the 95% confidence interval (95% CI) for inferential purposes.

RESULTS

Overall, 17.5% of the participants refrained from seeking dental care despite self-reported need in the last three months, with almost the same proportion between men and women. Among the socio-demographic factors, being in the 30-44 years group (PD = 8.0; 95% CI: 3.59, 12.48), in the 45-64 group (PD = 7.3; 95% CI: 2.96, 11.61) and in the 65-84 group (PD = 5.4; 95% CI: 0.92, 9.78) as well as being divorced/widow-er (PD = 6.7; 95% CI: 2.73, 10.70) and unmarried (PD = 3.1; 95% CI: 0.23, 6.04) were statistically significantly associated with refraining from seeking dental care. Among the socio-economic variables, those in the middle-income quintile (PD = 5.3; 95% CI: 1.28, 9.35), in the poor (PD = 8.1; 95% CI: 3.64, 12.51) and poorest (PD = 8.0 95% CI: 3.48, 12.50) quintiles, and especially those experiencing economic stress once (PD = 9.2; 95% CI: 2.93, 15.48) and several times (PD = 26.5; 95% CI: 19.50, 33.43), were strongly associated with refraining.

CONCLUSIONS

Approximately one in six of the Sámi participating in this study refrained from seeking dental care despite self-reported need in the last three months. Those who experienced economic difficulties were the most affected group. To achieve equity in dental health care in Sweden, policies removing economic barriers to access dental health care should be implemented.

Accessibility of Patients With Special Healthcare Needs to Dental Care in the Eastern Province of Saudi Arabia: A Multicentre Study From Perspective of Caregiver and Dental Care Providers

Dental care accessibility is subject to a dentist's qualification, practice and intention to treat patients, regardless of whether those patients have special healthcare needs (SCN) and should receive treatment in a dental setting. This multicentre study aimed to evaluate the characteristics of patients with SCN, their access to dental care and behaviour towards dental care from their caregiver's perspective. In addition, the perspective of dental care providers who care for patients with SCN and the factors affecting the provision of treatment was also appraised. The Eastern Province of Saudi Arabia served as the site of this cross-sectional study from 1 February 2020 to 31 January 2022. Caregivers of 272 patients with SCN, regardless of age and gender, were recruited in the study. The caregiver's proforma sought information on the demographic characteristics, type of disability, cooperation, medical history, occupation of the parent and patient's behaviour towards oral hygiene and dental healthcare. The second proforma had the dental care provider's perspective about the common disabilities, factors that affect the decision to provide treatment, difficulties patients face in getting their dental treatment and, from the dentist's experience, recommendations to improve the access to dental care for patients with SCN. Statistical analysis was carried out by using SPSS version 22.0. The demographic features, caregiver's perception about oral healthcare accessibility and dental professional's point of view were presented as frequencies and percentages. Chi-square test was applied to compare the proportions. The majority of the caregivers were satisfied with the dental service providers (91.9%) for their patients with SCN. The dental care provider's survey results indicated a shortage of dentists (54.7%) in the region and other factors that pose challenges to special care, like the severity of the disability of patients with SCN (50%), family structure (46.7%), treatment cost (35.6%) and transportation (32.8%). Patients with SCN in Saudi Arabia had a high appraisal of access to dental care and were very satisfied with dental treatment results. However, the presence of a dental care provider in the same rehabilitation centre was a major concern. The severity of the disability and the patient's cooperation were the major factors that may have affected the decision of the dental care provider.

Oral Health Behaviour, Care Utilisation, and Barriers among Students with Disabilities: A Parental Perspective

BACKGROUND

Oral health is a critical component of overall well-being. However, students with disabilities (SWDs) face unique challenges in maintaining oral hygiene and accessing dental care. This study aims to explore oral health behaviours, dental care utilisation, and barriers to accessing dental care among SWDs in Al-Ahsa, Saudi Arabia, from the perspectives of their parents.

METHODS

A descriptive cross-sectional study was conducted among parents of SWDs in Al-Ahsa, Saudi Arabia. Data were collected using a validated questionnaire covering oral health behaviours, dental care utilisation, and barriers to care. The sample size was determined based on the SWDs population in the region. Data were analysed using descriptive and analytical statistics, with significant associations identified at p < 0.05.

RESULTS

Findings revealed that 45.7% of SWDs brushed irregularly, with only 16.8% brushing twice a day or more. Dental flossing was reported by just 4.3% of SWDs. Emergency-based dental visits were common (51.9%), and 29.5% of SWDs had never visited a dentist. Significant associations were found between maternal education and tooth brushing frequency (p = 0.004) and between parental education and the frequency of dental visits (p = 0.035). The most reported barriers included fear of treatment (47.1%), difficulty finding willing dentists (45.5%), and long wait times for appointments (44.7%).

CONCLUSIONS

The study emphasises the pressing need for targeted interventions to improve oral hygiene practices and enhance accessibility to dental services for SWDs.

Oral Health-related Quality of Life of Children with Special Health Care Needs in Riyadh: A Cross-sectional Study

PURPOSE

To assess children's OHRQoL and associated factors among a sample of children with special needs in Riyadh, Saudi Arabia.

MATERIALS AND METHODS

A sample of 6- to 12-year-old children was obtained using convenience sampling from rehabilitation centers. Data were collected through a questionnaire and dental examination. The questionnaire included items related to the children's and their families' characteristics, oral health-related quality of life scales (Parental-Caregivers Perceptions Questionnaire [P-CPQ] and Family Impact Scale [FIS]), perceived health status, and dental care utilisation. Clinical examination was performed by a trained and calibrated dentist. The data were analysed using SPSS; descriptive and inferential data analyses were also performed using SPSS.

RESULTS

The mean P-CPQ was 1.10 ± 0.74, and the mean FIS was 1.39 ± 0.88. There was a statistically significant correlation between P-CPQ and caries (r = 0.36, p = 0.02). After controlling for confounders, caries was associated with poor P-CPQ (B = 0.06, p = 0.024). Compared to low-income families, higher-income families had better P-CPQ (4000-8000 SAR: B = -1.36, p = 0.001).

CONCLUSION

Poor oral health-related quality of life in Saudi children is associated with caries and low income. Preventive measures addressing social determinants are vital to control caries and promote oral health in children with special health-care needs.

Influence of maternal attention-deficit hyperactive disorder on child dental neglect - An analytical cross-sectional study

BACKGROUND

Attention-deficit hyperactivity disorder (ADHD) is a condition that is characterized by symptoms such as inattentiveness, hyperactivity, and impulsivity. The influence of mothers with ADHD and their attitude towards their wards' oral health has not been explored in the Indian scenario.

AIM

The aim of this study was to assess the prevalence of ADHD in mother-child dyads in western Tamil Nadu and the mothers' dental neglect toward their children.

METHODOLOGY

The prevalence of ADHD in mothers and children was assessed using the Adult ADHD Self-report Scale screener and ADHD Rating Scale, respectively. The Child Dental Neglect Scale (CDNS) was used to assess dental neglect in children. The responses were recorded on a Likert scale and statistical analyses were done.

RESULTS

The prevalence of ADHD in mothers and children was 10.65% and 10.57%, respectively. The impulsivity and hyperactivity type of ADHD was commonly seen in both the mothers and their children. Mothers without ADHD felt that their children maintained their oral health well. Mothers with ADHD deferred the needed dental treatment for their children.

CONCLUSION

Mothers with ADHD have four times more risk of having children with ADHD. Maternal ADHD influences their child's oral health. Child dental neglect was more prevalent among mothers with ADHD.

Dental treatments in patients with special needs provided by university medical center in Southern Taiwan: a retrospective study

OBJECTIVES

We perform special-need dental treatment at outpatient department (OPD), under general anesthesia (GA) when necessary, and provide domiciliary dental care. We aim to evaluate the profile and the characteristics of special needs patients (SNPs).

MATERIALS AND METHODS

We consecutively enrolled 3117 SNPs from January 1, 2019 to December 31, 2022. Eighty patients with rare or genetic diseases were excluded. Demographic data were retrospectively collected.

RESULTS

There were totally 3037 SNPs (mean age: 48.2 years; range, 1-100; male-to-female ratio, 1.5); 89.1% (n = 2705) SNPs received dental care at the OPD (OPD-SNPs), 7.9% (n = 239) received dental treatment under GA, and 3.0% (n = 93) received domiciliary dental care. Among those SNPs who received dental treatment under GA (n = 239), 91.2% (n = 218) were mental/intellectual disabled, and most underwent cavity filling (69.5%) and dental extractions (56.5%). OPD-SNPs with mental/intellectual disabilities (n = 1340) received significantly more items of dental treatment than those without (n = 1365). SNPs with more severe disabilities received more fluoride application and ultrasonic scaling (both p < 0.001, trend tests). Interestingly, among OPD-SNPs with mental/intellectual disabilities (n = 1340), more severe patients received more fluoride application (p < 0.001) and ultrasonic scaling (p < 0.001) but fewer root canal treatment (p = 0.007, trend test).

CONCLUSIONS

GA benefited SNPs with more dental procedures, including invasive items. SNPs with mental/intellectual disabilities can tolerate more measures and SNPs with more severe mental/intellectual disabilities received more preventive measures but less invasive measures. Similarly, more severe SNPs with other disabilities received more preventive measures but not invasive measures.

CLINICAL RELEVANCE

Our findings may provide useful information for special needs dentists and for doctor-patient communication.

Impact of income and financial subsidies on oral health care utilization among persons with disabilities in Singapore

BACKGROUND/AIM(S)

Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore.

METHODS

Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD.

RESULTS

Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08-1.52), 1.48 (95% CI 1.14-1.92) and 1.36 (95% CI 1.09-1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies.

CONCLUSION

Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.

The Barrier to Accessing Dental Healthcare Services Among the Institutionalized Visually Impaired Adults: A Qualitative Study

Many studies have focused on the overall oral health of people with visual impairment, but there is a dearth of studies on the barriers to accessing dental healthcare services among institutionalized visually impaired people. Therefore, the current study aims to assess the barriers to accessing dental healthcare services among institutionalized visually impaired people.

METHODS

A qualitative study design was conducted over the course of 10 months among institutionalized visually impaired individuals. A semi-structured interview was conducted among the participants. Interviews were audio-recorded, transcribed, translated, and qualitatively analyzed using MAXQDA software, version 22.0 (VERBI Software, Berlin).

RESULTS

A total of 20 participants participated in the study. Three levels were used to classify the investigated barriers: the individual's level, which pertains to the obstacles they encountered in receiving oral health care and their viewpoints on the way that care is provided; the interpersonal degree and the system level, in order to determine the broader components and their impact.

CONCLUSION

This study gives insight into the problems people have in assessing the dental services and facilities available. Three levels were used to identify the barriers among the study participants. Six themes emerged in the study that described their problems, which affected their mental health directly.

Estimating the magnitude of different barriers to dental care for special needs patients: A systematic review

Quite often, it is seen that the number of special care individual in the dental OPD/clinics is quite low, as compared to their population. This can be due to specific barriers that restrict them in availing dental treatment. Our aim was to identify different barriers to dental care of persons with special needs through a systematic review and to quantify them. A systematic review was carried out according to PRISMA guidelines. PubMed data was searched with predefined keywords leading to retrieval of 576 records. Full length studies published in English language from 2010 onwards with mention of proportion of persons citing a barrier to dental care were included. Three studies published in peer reviewed journals from other data sources were also identified while retrieving the full length texts. Out of a total of 576 PubMed and three additional records, a total of 22 studies were included in the systematic review. Cost, communication, physical facilities, fear/uncooperativeness, unawareness, distant location/inaccessibility, unwilling dentist, transportation, and difficulty in getting appointment were identified as nine major barriers. Pooled proportions for different barriers ranged from 22.75% (Accessibility; 95%CI = 19.96-25.54) to 44.35% (Communication; 95% CI = 32.63-56.07A). There was a high heterogeneity across different studies for both fixed effects and random effects models. Communication, physical facilities, and unawareness were identified as the three most common barriers showing minimum heterogeneity in random effects model.

Transforming Dental Care in Saudi Arabia: Challenges and Opportunities

This comprehensive review examines the dental healthcare system in Saudi Arabia, tracing its evolution, current status, and persisting challenges. The system has evolved significantly due to government initiatives and technological integration, yet it grapples with issues like professional shortages, financial constraints, and disparities in access. Despite improvements in accessibility, geographic and socio-economic disparities persist, and oral health promotion remains limited. The integration of technology faces resistance, and specialized care for people with disabilities requires targeted strategies. Cultural and social factors influence oral health, and the system's response to the COVID-19 pandemic showcases adaptability and patient-centered approaches. Addressing these challenges is crucial for ensuring equitable and effective oral health service delivery in Saudi Arabia.

Factors associated with dental interns and professors perception of the management of disabled patients: A cross-sectional study under multivariable analysis

Background

Patients with disabilities experience oral health inequalities, including increased disease prevalence and unmet healthcare needs. The aim of this study was to assess factors associated to the perceived management of patients with physical disabilities among dental interns and professors at a university located in the capital city and a branch in a province in Peru.

Methods

This cross-sectional, observational, and analytical study included 100 dental interns and 75 Peruvian dental professors and was conducted from January to April 2022. A validated perception scale was used to evaluate the management of disabled patients. For the statistical analysis, the study employed Pearson's chi-square test and Fisher's exact test, along with a Poisson regression model that used robust variance. The adjusted prevalence ratio (APR) was utilized to evaluate perception while taking into account factors such as gender, age, marital status, origin, professional experience, previous treatment of a patient with physical disability, and previous cohabitation with a disabled patient. The significance level was set at p < 0.05.

Results

The 86 % of dental interns and 88 % of dental professors had a poor perception of managing disabled patients, with no significant association between them (p = 0.698). Male and female dental interns displayed significant differences in perception (p = 0.004), while no other variables showed significant differences (p < 0.05). Conversely, dental professors displayed significant differences in all variables analyzed (p < 0.05). In dental interns, gender was found to be the only influential variable, with females having a 41 % higher likelihood of perceiving disabled patient management poorly compared to males (APR = 1.41; 95 % CI: 1.04-1.91) (p = 0.028). However, gender was not found to be a significant factor for dental professors (p = 0.449).

Conclusion

The majority of dental interns and professors had a poor perception of managing disabled patients, with no significant differences observed between them. Moreover, gender significantly influenced the perception of managing patients with physical disabilities among dental interns specifically. On the other hand, neither age, marital status, origin, professional experience, previous treatment of a patient with physical disability, nor previous cohabitation with a disabled patient were found to be associated factors among dental interns and professors.

Enhancing interprofessional education readiness in undergraduate dental students: a scenario-based peer learning programme

BACKGROUND

Interprofessional Education (IPE) is an educational approach that brings together students from different healthcare professions to foster collaborative learning and teamwork. Before integrating IPE into the curriculum of health preprofessional students, it is necessary to increase their readiness for IPE. Dentistry increasingly values interprofessional collaboration and teamwork for enhanced patient care and healthcare team competencies, an emphasis also echoed by recent dental education authorities. The aim of this quasi-experimental research was to assess the influence of Scenario Based Learning Peer Learning (SBPL) programme, which involved scenarios necessitating interprofessional communication, on the readiness for IPE among a cohort of undergraduate dental students studying within the framework of the European Higher Education Area (EHEA).

METHODS

This study investigates undergraduate dental students' readiness for IPE and the influence of SBPL programme on their readiness. Participants (n = 25) from 18 EHEA countries completed the Readiness for Interprofessional Learning Scale (RIPLS) before and after SBPL programme, held at the 70th European Dental Students' Association (EDSA) meeting. Data were analyzed using the Wilcoxon Signed Rank Test (p = 0.05).

RESULTS

After the SBPT programme, there was a statistically significant increase (p < 0.05) in the mean of the total scale, teamwork and collaboration, roles and responsibilities and professional identity subscale. In general, SBPL programme showed a constructive effect on interprofessional readiness. Although there was no statistically significant increase only in items 9,12,18 of the 19 items of the RIPLS, there was an increase in the averages in all except item 12.

CONCLUSION

Our research emphasizes the importance of diverse perspectives and IPE in the realm of dental education. Within the limits of this study, it showcases the efficacy of a brief half-day SBPL programme with interprofessional scenarios in enhancing participants' readiness. The programme notably enhanced dental students' readiness in grasping crucial aspects of IPE: teamwork and collaboration, professional identity, and roles and responsibilities. However, this study does not delve into the potential impact of a comprehensive, long-term curriculum integrating IPE principles. This gap underscores the need for further exploration into the sustained influence of IPE on the interprofessional skills of dental school graduates.

Training dental hygiene students to care for patients with disabilities

OBJECTIVE

The purpose of this study was to evaluate the impact of a novel training programme on dental hygiene students' knowledge, attitudes, and beliefs about caring for individuals with disabilities.

METHODS

A mixed methods approach was used. Students from five dental hygiene programmes based at community colleges completed a two-hour didactic training session to supplement their existing special care dentistry coursework. Students completed an original 14-item pretest and posttest before and after the training that assessed attitudes and beliefs, and two validated posttests that assessed knowledge. Afterwards, students completed a clinical rotation in an advanced care dental clinic at a local academic institution, gaining hands-on experience with equipment and patient treatment. Descriptive statistics were used to report training scores, types of services rendered, and modifications to treatment. Student comments about their experiences were assessed using thematic analysis.

RESULTS

Two hundred and ninety-four students completed didactic training, and 261 completed clinical rotations. Posttest scores indicated positive improvements in knowledge, attitudes, and beliefs. All students provided direct patient care. Sixty-nine percent treated patients with intellectual and developmental disabilities; 75% placed silver diamine fluoride or fluoride varnish. Altered patient positioning was used by 70.5%. Most students (95.4%) reported that their experience positively changed their attitudes towards caring for patients with disabilities in the future. Eight themes emerged, notably increased comfort and confidence, a willingness and desire to treat patients, the acquisition of new skills, and clinician behaviours of empathy and compassion towards others.

CONCLUSION

Training can help prepare dental hygiene students with the confidence and skills to address the oral health needs of individuals with disabilities.

Analysis of Health Profile and Treatment Needs of Patients with Special Health Care Needs at a Malaysian Teaching Hospital: A 6-Year Observation

Aims and Objectives

Special care dentistry (SCD) provides oral health care to disabled individuals in an environmental, cultural or social setting that supports their oral health. This study aimed to analyze the profiles of patients managed at an SCD clinic in a teaching hospital based on their sociodemographic background, medical condition or disability, dental diagnosis and treatment provided.

Materials and Methods

This retrospective audit study included patients seen from the clinic's inception in January 2017 until June 2022, retrieved from the faculty's record management system. The pattern of patients seen was arranged on an Excel sheet and analyzed using SPSS. Quantitative data were analyzed via descriptive analysis (frequency) and chi-square test (P < 0.05).

Results

A 220% surge in the number of patients treated between January 2017 and June 2022, from two to 91 years old, with more male patients seen. Most patients had an intellectual disability (49.7%), followed by medical compromised (16.4%) and genetic conditions or syndromes (12.0%). 43% of had caries, which is more prevalent in women, and 31.6% had periodontal disease, with the majority being between the ages of 21 and 40. Periodontal treatment accounted for most of the dental treatment (76.1%). Even though only a small percentage of endodontic therapy was performed (2.4%), a significant association was found between the treatment, gender and age group of patients seen in the clinic.

Conclusion

Considering their health profile, oral diagnosis and therapy, this study demonstrated the varied sorts of patients encountered in an SCD specialist clinic. This useful information will be beneficial in the development of a comprehensive care dentistry center for this community.

Oral care considerations for people with cystic fibrosis: a cross-sectional qualitative study

OBJECTIVES

To investigate the attitudes of adults with Cystic Fibrosis (CF) towards dental attendance and any perceived barriers to treatment.

METHODS

A cross sectional survey in the form of a structured, anonymous questionnaire was used to obtain information regarding adults with CF's feelings towards dentists and dental treatment. The final version of the questionnaire was based on a collaborative effort between researchers at Cork University Dental School and Hospital and Cystic Fibrosis (CF) patient advocates from CF Ireland. Participants were recruited via CF Ireland's mailing list and social media channels. The responses underwent descriptive statistical analysis and inductive thematic analysis.

RESULTS

A total of 71 people (33 Male: 38 Female) over the age of 18 living with CF in the Republic of Ireland responded to the survey. 54.9% of respondents were unhappy with their teeth. 63.4% felt that CF had an impact on oral health. 33.8% were anxious about attending their dentist. Respondents believed that CF has impacted on their oral health due to the medications and dietary requirements involved, as well as tiredness and other side effects of CF. Reasons for being anxious about attending the dentist included cross infection concerns, issues with the dentist, with tolerating treatment, and with the teeth themselves. Respondents wanted dentists to be aware of the practicalities of dental treatment for people with CF, especially their discomfort with lying back. They also want the dentist to be aware of the impact that their medication, treatment and diet has on their oral health.

CONCLUSIONS

Over one third of adults with CF reported anxiety about attending the dentist. Reasons for this included fear, embarrassment, cross infection concerns and problems with treatment, especially being in the supine position. Adults with CF want dentists to be aware of the impact that CF can have upon dental treatment and oral health care.

Risk Factors Associated with Children Receiving Treatment at Emergency Dental Clinics: A Case-Control Study

(1) Background: The process of managing children at the emergency dental clinic (ER-C) is a difficult challenge. This matched case-control study assessed risk factors associated with children visiting the ER-C compared to visits at the regular dental clinic (RD-C). (2) Methods: The participants included 421 children aged three to 12 years who were recruited at the ER-C (cases) and RD-C (controls) at King Abdulaziz University Dental Hospital, with each group matched for gender and age. A data-collection form was developed and validated in both Arabic and English, containing the following four sections: DMFT/dmft index, Frankl’s behaviour rating scale, Dental Neglect Scale, and Dental Care Barriers questionnaire. (3) Results: The ER-C (vs RD-C) group showed significantly more uncooperative behaviour (p = 0.002), a higher total mean dental neglect score (p = 0.003), and a higher dental barrier score (p < 0.001). Binary regression analysis showed that those making their first visit (AOR: 2.65, p < 0.001) and with higher dental barriers (AOR: 1.121, p < 0.001) were statistically significantly more associated with ER-C visitation. (4) Conclusion: These findings suggest that children who visit the ER-C are more prone to dental care barriers, uncooperative behaviour, and dental neglect, thus highlighting the importance of encouraging and planning their attendance to ensure optimal dental care.

Oral Health Status, Oral Health Behaviors, and Oral Health Care Utilization among Persons with Disabilities in Saudi Arabia

Various studies have indicated that persons with special needs may face several barriers to dental treatment, which increases the prevalence of oral diseases in this population. Moreover, these studies suggested that Saudis with special needs have a higher prevalence of oral diseases, such as dental caries and periodontal disease. The aim of this review is to synthesize evidence regarding the current status, trends in oral health behaviors, and oral health care utilization among these individuals, as well as to assess the quality of the literature. Furthermore, this review seeks to recommend directions for future research and oral health care policymaking. An electronic search was conducted using the following databases and registers: PubMed/Medline, Embase, ISI Web of Science, Scopus, ClinicalTrials.gov, and CENTRAL. Gray literature, which included conference proceedings and unpublished literature, was searched via the library services and Google/Google Scholar, and the quality of studies was assessed using the AXIS scale for cross-sectional studies. A total of 38 studies were included in this review, with the majority of the studies graded as 'low'. Within the limitations of this study, it can be concluded that individuals with special needs have limited access to oral health care, poor oral health status, and a general lack of awareness in regard to oral health. Therefore, nationwide surveys should be carried out to ascertain the actual extent of the oral inequities among individuals with special needs.

Caregivers’ Perception about the Relationship between Oral Health and Overall Health in Individuals with Disability in Qatif, Saudi Arabia: A Cross-Sectional Study

Background

In Saudi Arabia, there are many people with disabilities that do not receive adequate healthcare, especially in the field of dentistry.

Objective

This study focused on assessing caregivers' perception of the relationship between oral healthcare and the overall health status of individuals with special healthcare needs (SHCN) in Qatif, Saudi Arabia. Methodology Design. This cross-sectional study was conducted using a questionnaire that was divided into two sections. The first part included demographic information such as the age and gender of both the caregiver and the person with a disability and the type of disability. The second part investigated the systemic health of the individual with a disability and the caregivers' perception of the relationship between the management and treatment of systemic health and oral healthcare in relation to the overall health status. The results of descriptive analyses were summarized using frequency distribution tables. Bivariate analyses (chi-square test) were also performed. Significant differences were considered at a p value of 0.05. Setting. Initiated in school setting.

Results

A total of 186 caregivers participated in the study. As much as 83.3% agree that oral health affects overall health, and 48.9% agreed that untreated dental problems could affect cardiac health. Age was the only factor found to be significantly associated with caregiver perception as younger caregivers were more likely to rightly understand the relationship between oral health and general health (p < 0.05).

Conclusion

This study has shown the extent to which caregivers of individuals with special care needs to understand the role of oral health in the general health of an individual. Three-quarters of the caregivers agree that dental health affects overall health, and age is a factor that might influence this understanding.