Dental Care

Vujicic, Marko; Bernabé, Eduardo; Neumann, Daniela; Quiñonez, Carlos; Mertz, Elizabeth

doi:10.1142/9789813140516_0003

Cited by 3 publications

(6 citation statements)

References 45 publications

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“…A total of US$298 billion are spent worldwide every year to cover the direct treatment costs associated with common oral conditions; a figure that represents 4.6% of health expenditure globally [21]. Most dental services are provided by private dentists to patients and are financed and delivered largely separate from medical services [22]. Out-of-pocket expenses make up a significant proportion of total dental expenditure, even in countries with high private dental insurance coverage like the Unites States [23].…”

Section: Introductionmentioning

confidence: 99%

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

2017

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BackgroundDental care is extremely costly and beyond most people means in developing countries. The primary aim of this study was to determine the impact of out-of-pocket payments for dental care on household finances in 40 low and middle income countries. A second aim was to compare the burden of payments for dental care with that for other health services.MethodsWe used data from 174,257 adults, aged 18 years and above, who reported their total and itemized household expenditure in the past four weeks as part of the World Health Surveys. The financial burden on households was measured using the catastrophic health expenditure (CHE) and impoverishment approaches. A household was classified as facing CHE if it spent 40% or more of its capacity to pay, and as facing impoverishment if it fell below the country-specific poverty line after spending on health care was subtracted from household expenditure. The odds of experiencing CHE and impoverishment due to expenditure on dental care were estimated from two-level logistic regression models, controlling for various individual- and country-level covariates.ResultsHouseholds that paid for dental care had 1.88 (95% Confidence Interval: 1.78-1.99) greater odds of incurring CHE and 1.65 (95% CI: 1.52–1.80) greater odds of facing impoverishment, after adjustment for covariates. Furthermore, the impact of paying for dental care was lower than that for medications or drugs, inpatient care, outpatient care and laboratory tests but similar to that of health care products, traditional medicine and other health services.ConclusionHouseholds with recent dental care spending were more likely to use a large portion of their disposable income and fall below the poverty line. Policy makers ought to consider including dental care as part of universal health care and advocate for the inclusion of dental care coverage in health insurance packages.

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Section: Introductionmentioning

confidence: 99%

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

2017

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“…The differences in the extent and coverage of public dental services in these countries and associated barriers in access could potentially explain our findings. For example, in the UK, the NHS offers universal dental coverage at subsidized rates along with treatment at no cost to certain vulnerable groups such as children, pregnant women, and welfare-assistance recipient [ 11 , 12 ], which may explain the low level of inequality overall. Only 5% of Americans have public dental coverage, with over a third of the population having no access to dental insurance [ 11 , 29 ], which may explain why the US has the worse inequality overall.…”

Section: Discussionmentioning

confidence: 99%

“…For example, in the UK, the NHS offers universal dental coverage at subsidized rates along with treatment at no cost to certain vulnerable groups such as children, pregnant women, and welfare-assistance recipient [ 11 , 12 ], which may explain the low level of inequality overall. Only 5% of Americans have public dental coverage, with over a third of the population having no access to dental insurance [ 11 , 29 ], which may explain why the US has the worse inequality overall. In Canada, despite a largely privatised oral healthcare system, there is availability of provincial programs to social assistance recipients, their dependents, and some seniors [ 30 ], which may explain lower inequality in comparison to the US.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, Canada, the US and the UK differ in terms of their healthcare and oral healthcare systems. Both Canada and the UK have a national system of universal health insurance covering hospital and physician care, yet Canada excludes oral healthcare and the UK does not [ 11 ] ( Table 1 ). Despite the rise of private practice in the UK, the National Health Service (NHS) remains the dominant provider of dental care at subsidized rates to all citizens, with patients contributing about half of total oral healthcare expenditure [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…While in Canada and the US, dental care is largely privatised, financed primarily by employment-based insurance, with limited contributions from government. Most dental care in Canada and the US is delivered in private settings on a fee-for-service basis, while the majority of care in the UK is delivered by the NHS in community and hospital settings under payment models that have changed over time, with some care delivered in private practices on a fee-for-service basis [ 11 ]. Ultimately, while it is known that sociopolitical context and the features of an oral healthcare system are bound to impact oral health and oral health inequality, no analysis has compared the magnitude of inequality for clinical oral health indicators within and between these three countries.…”

Section: Introductionmentioning

confidence: 99%

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Oral health inequality in Canada, the United States and United Kingdom

et al. 2022

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The objective of this study was to quantify the magnitude of absolute and relative oral health inequality in countries with similar socio-political environments, but differing oral health care systems such as Canada, the United States (US), and the United Kingdom (UK), in the first decade of the new millennium. Clinical oral health data were obtained from the Canadian Health Measures Survey 2007–2009, the National Health and Nutrition Examination Survey 2007–2008, and the Adult Dental Health Survey 2009, for Canada, the US and UK, respectively. The slope index of inequality (SII) and relative index of inequality (RII) were used to quantify absolute and relative inequality, respectively. There was significant oral health inequality in all three countries. Among dentate individuals, inequality in untreated decay was highest among Americans (SII:28.2; RII:4.7), followed by Canada (SII:21.0; RII:3.09) and lowest in the UK (SII:15.8; RII:1.75). Inequality for filled teeth was negligible in all three countries. For edentulism, inequality was highest in Canada (SII: 30.3; RII: 13.2), followed by the UK (SII: 10.2; RII: 11.5) and lowest in the US (SII: 10.3; and RII: 9.26). Lower oral health inequality in the UK speaks to the more equitable nature of its oral health care system, while a highly privatized dental care environment in Canada and the US may explain the higher inequality in these countries. However, despite an almost equal utilization of restorative dental care, there remained a higher concentration of unmet needs among the poor in all three countries.

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Providing dental insurance can positively impact oral health outcomes in Ontario

Zivkovic

Aldossri

Gomaa

et al. 2020

BMC Health Serv Res

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Background: Universal coverage for dental care is a topical policy debate across Canada, but the impact of dental insurance on improving oral health-related outcomes remains empirically unexplored in this population. Methods: We used data on individuals 12 years of age and older from the Canadian Community Health Survey 2013-2014 to estimate the marginal effects (ME) of having dental insurance in Ontario, Canada's most populated province (n = 42,553 representing 11,682,112 Ontarians). ME were derived from multi-variable logistic regression models for dental visiting behaviour and oral health status outcomes. We also investigated the ME of insurance across income, education and age subgroups. Results: Having dental insurance increased the proportion of participants who visited the dentist in the past year (56.6 to 79.4%, ME: 22.8, 95% confidence interval (CI): 20.9-24.7) and who reported very good or excellent oral health (48.3 to 57.9%, ME: 9.6, 95%CI: 7.6-11.5). Compared to the highest income group, having dental insurance had a greater ME for the lowest income groups for dental visiting behaviour: dental visit in the past 12 months (ME highest: 17.9; 95% CI: 15.9-19.8 vs. ME lowest: 27.2; 95% CI: 25.0-29.3) and visiting a dentist only for emergencies (ME highest: -11.5; 95% CI: − 13.2 to − 9.9 vs. ME lowest: -27.2; 95% CI: − 29.5 to − 24.8).Conclusions: Findings suggest that dental insurance is associated with improved dental visiting behaviours and oral health status outcomes. Policymakers could consider universal dental coverage as a means to support financially vulnerable populations and to reduce oral health disparities between the rich and the poor.

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Dental Care

Cited by 3 publications

References 45 publications

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries

Oral health inequality in Canada, the United States and United Kingdom

Providing dental insurance can positively impact oral health outcomes in Ontario

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