Challenges impeding integration of oral health into primary health care

Abstract

Les obstacles à l'intégration de la santé bucco-dentaire aux soins de santé primaires RÉSUMÉ Les services de soins de santé primaires en République islamique d'Iran sont parvenus avec succès à traiter le nombre élevé de cas de maladies transmissibles. Néanmoins, il semblerait qu'ils soient moins performants dans la prise en charge des maladies bucco-dentaires de la mère et de l'enfant. La présente étude avait pour objectif d'examiner les obstacles à l'intégration de la santé bucco-dentaire aux services de soins de santé primaires. Il s'agissait d'une étude de recherche qualitative comprenant des groupes de discussion et des entretiens. Cinq groupes de discussion ont été tenus. Il réunissaient des sages-femmes, des médecins de famille, des agents de soins de santé primaires en milieu rural, des dentistes suppléants, et des dentistes en santé publique. Des entretiens individuels ont également été organisés avec des experts membres du corps enseignant des domaines concernés, des gestionnaires en charge de la planification et de la coordination et des responsables politiques. D'autre part, des entretiens approfondis ont été menés auprès de femmes enceintes dans quatre établissements de soins de santé primaires. Des cassettes audio ont été retranscrites à la suite de chaque session, et une analyse thématique qualitative a été menée sur les données recueillies. L'analyse des données a fait ressortir quatre types de problèmes principaux liés à des facteurs d'ordre environnemental et organisationnel, et concernant la formation des praticiens et les programmes scolaires. La présente étude permet une compréhension plus détaillée des obstacles à l'intégration des services de santé bucco-dentaires aux soins de santé primaires. ABSTRACT The primary healthcare (PHC) services in the Islamic Republic of Iran have succeeded in addressing high levels of communicable diseases; however, they seem less able to deal with maternal and paediatric oral diseases. The aim of this study was to examine problems in integrating oral health services into PHC. This was a qualitative research study comprising focus group discussions and interviews. Five focus-group discussions were held with midwives, family healthcare practitioners, rural PHC workers, duty-service dentists, and public health dentists. Also, individual interviews were organized with experts of faculty members in related fields, informant managers and policy makers, and in-depth interviews were done with pregnant women in four PHC centres. Audiotapes were transcribed following each session, and then a qualitative thematic analysis was carried out on gathered data. Data analysis resulted in 4 main themes relating to the challenges: environmental, educational, organizational and school-based programme factors. This study provides a clearer understanding of the challenges of integrating oral health services into PHC. ‫األولية‬ ‫الصحية‬ ‫الرعاية‬ ‫يف‬ ‫الفم‬ ‫صحة‬ ‫إدماج‬ ‫تعوق‬ ‫التي‬ ‫التحديات‬

The impact of pregnancy on women’s oral health-related quality of life: a qualitative investigation

“…Domains such as “dentists’ refusal to treat pregnant women”, “negative feelings toward pregnancy”, and “concerns about fetal health” are in line with the results of previous studies related to oral health issues in pregnant women. Another qualitative study conducted in Iran reported the dentists’ avoidance of treating pregnant women [ 33 ]. In this report, the dentists’ fear of “legal consequences of potential complaints about their practice” was mentioned as the reason for this issue [ 33 ].…”

“…Another qualitative study conducted in Iran reported the dentists’ avoidance of treating pregnant women [ 33 ]. In this report, the dentists’ fear of “legal consequences of potential complaints about their practice” was mentioned as the reason for this issue [ 33 ]. In a qualitative study among pregnant adolescent women in the United States of America, one of the main themes was “believing myths and having misconceptions about oral health” [ 27 ].…”

Community-based interventions to reduce dental caries among 24-month old children: a pilot study of a field trial

“…These interventions reinforced later when their child reached 6, 12, and 18 months of age. Interventions were designed based on covering the existing gaps that obtained from a qualitative study [ 22 ], and included nutritional and behavioral messages that we extracted from nutritional and behavioral oral health recommendations from WHO and also American Academy of Pediatric Dentistry oral health guideline for infants and toddlers [ 23 – 25 ]. The educational content has been approved by Community Oral Health Department, Shahid Beheshti University of Medical Sciences.…”

Effect of Oral Health Promotion Interventions On Pregnant Women Dental Caries: A Field Trial

“…Questionnaire was lled by a Dental Public Health PhD candidate via face-to-face interviews with mothers at intervals similar to oral examinations. This questionnaire was used in research team's previous study on mothers oral health status (17) and included demographic questions such as mother's age, educational background, family size, and income, and some oral health behavior questions including daily frequency of tooth brushing, ossing and sweets consumption habits and also asking if they had a dental visit in the last 6 months. After completing oral examinations and interviews, all the study participants were given a tube of uoridated tooth paste and a tooth brush.…”