Oral health taking a back seat at primary health centers of Bangalore urban district, India - A situation analysis

Utilization of dental health services and its associated factors among adult population in Ernakulam district, Kerala, India: A mixed-method analysis

Background

There exists a high burden of oral diseases. Yet, the utilization of oral health care remains low. Understanding how, when, and why/why not individuals utilize dental healthcare resources is essential for planning health services and developing policies as it reflects the population's oral health needs, helps allocate resources efficiently, and formulate policies that are tailored to address their needs.

Objectives

To assess the utilization of dental health services and its associated factors along with barriers and facilitators among adults residing in Ernakulam district, Kerala, using the Anderson healthcare model for healthcare utilization.

Methods

A mixed-method study was conducted among adults aged 18 years and above in urban and rural wards of Ernakulam district using the cluster sampling method. Univariate and multivariate analysis were used for the quantitative part, and thematic analysis was used for the qualitative aspect. The total sample size was 544.

Results

The dental healthcare utilization was 15.4 ± 2.9 % among the study participants. Age and education were associated with dental healthcare utilization. The level of education, pain, and self-consciousness of oral diseases were independent predictors. Barriers identified were negative attitudes, financial restraints, and difficulty in access, while facilitators were trust in service providers, availability of services, and a positive attitude.

Conclusion

Utilization was poor despite the perceived need for oral health care. This was affected by several personal and system-level facilitators and barriers.

A scoping review exploring oral health inequalities in India: a call for action to reform policy, practice and research

INTRODUCTION

Reduction in health inequalities and providing universal access to health care have been identified as two important global milestones by the World Health Organization for countries to achieve by 2030. Therefore, recognizing the magnitude of oral health inequalities in India has become a pressing priority to improve access to dental care within the country. This scoping review was conducted with the aim of reviewing, collating and analysing the current knowledge base on oral health inequalities in India.

METHODOLOGY

The scoping review followed Arksey and O'Malley's approach, and reporting was performed in accordance with the PRISMA-ScR guidelines. A systematic search was conducted on Scopus, PubMed, Web of Science, and EMBASE to identify literature addressing one or more dimensions of oral health inequalities in India, published in English between January 2002 and April 2022. The data were charted, and qualitative analysis was performed to derive themes, highlighting the key concepts emerging from this review.

RESULTS

In accordance with the eligibility criteria, a total of 71 articles retrieved through database search and backward citation search were included in this scoping review. The major themes ranged from individual to diverse sociodemographic factors acting as barriers to and facilitators of access to dental care. Deficiencies in human resources for oral health, along with a wide diversity in dental service provision and dental education were other major themes contributing to inequality. Subsequently, this has resulted in recommendations on restructuring the dental workforce and their development and modifications in oral health care policies and practices. The qualitative synthesis demonstrates the intertwined nature of the multiple factors that influence the goal of achieving an affordable, accessible, extensive and inclusive oral healthcare system in India.

CONCLUSIONS

This comprehensive review provides a broad perspective on oral health inequalities in India, providing valuable insights for both researchers and policymakers in this area and guiding their efforts towards achieving universal oral health coverage in the Indian context.

A proposed classification for orthodontic practice in India

Aim and Background:

Dental practice is blooming in India with many conventional and advanced setups providing orthodontic services. Orthodontics as a specialty has come to the forefront, as awareness of orthodontic therapy has increased. It is important to classify any health practice to understand, compare, and research the implications of various organizational setups in the country. It should possess the ability to chart the similarities and distinctions between different setups for ease of communication and patient awareness. Presently, there is no defined system that classifies the type of orthodontic practice in the country. Lack of any classification of the organizational setups makes it impossible to categorize or compare the various setups for research purpose, recognition of the dental personnel and facilities provided. This article aims to propose a simple 3-stage classification to orthodontic practices in India.

Technique:

Three-stage classification of orthodontic practice in group, type, and subtype gives a comprehensive coverage to all types of orthodontic setups in India. The group explains the center in three levels based on the armamentarium and services provided. The type explains the center in five levels based on ownership and scope of providing care. Finally, the subtype explains the availability and qualification of the operating personnel.

Conclusion and Significance:

This classification aims to provide a tool for communication and recording the levels of orthodontic care possible at any given center. It also facilitates continued study of its impact on practice efficacy and patient awareness.

My experience as an educator, motivational, and collaborative dental professional in India

The oral health delivery strategies are taking back seat in the universal health coverage scheme in India. This paper highlights the personal experience of a dental professional from India as an educator, motivator, and collaborator to nullify or minimize social policy challenges faced by medical health providers in the administrative cadre to strengthen the oral care delivery model in the health services department in Kerala state. The author has nevertheless persisted with positive educational, motivational, and collaborative approaches with medical health providers in the administrative cadre, general cadre, and specialty cadre in the health services department in Kerala state to change the current climate.