Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach

Winkelmann, Juliane; Rossi, Jesús Gómez; Schwendicke, Falk; Dimova, Antoniya; Atanasova, Elka; Habicht, Triin; Kasekamp, Kaija; Gandré, Coralie; Or, Zeynep; McAuliffe, Úna; Murauskienė, Liubovė; Kroneman, Madelon; Jong, Judith de; Kowalska-Bobko, Iwona; Badora-Musiał, Katarzyna; Motyl, Sylwia; Augusto, Gonçalo Figueiredo; Pažitný, Peter; Kandilaki, Daniela; Löffler, Lubica; Lundgren, Carl; Janlöv, Nils; Ginneken, Ewout van; Panteli, Dimitra

doi:10.1186/s12903-022-02095-4

Cited by 29 publications

(25 citation statements)

References 37 publications

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“…Compatibility is also patient-specific, e.g., due to allergies [ 62 ]. Other reasons do not allow for a clear assessment, because it can take different values (e.g., low out-of-pocket payments) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although there is broader coverage of dental care treatments in Germany compared to other countries [ 9 , 10 ], oral health outcomes are not superior in countries such as Spain and the Netherlands [ 11 ]. Therefore, identifying factors that determine decision-making on dental treatments can help to understand patients’ perspective and their decisions regarding their choice of dental treatments.…”

Section: Introductionmentioning

confidence: 99%

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Reasons for (not) choosing dental treatments—A qualitative study based on patients’ perspective

2022

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Oral health is increasingly seen as a public health challenge due to the remarkable prevalence of oral diseases worldwide, the impact on general health, and health consequences that can arise for individuals. Compared to other health services, oral health services are usually not fully covered by statutory health insurance, which is seen as one reason in decision-making on dental treatments. Nevertheless, patients’ reasons for treatment decisions are not well understood although they can provide valuable insights. The objective of this study was to identify reasons of choice for dental treatments and to explore patients’ view on cost coverage in Germany. We conducted four focus group interviews with a total of 27 participants. The interviews were audiotaped and transcribed verbatim. Data was analyzed performing conventional content analysis. As part of a qualitative analysis, subcategories and categories were formed from identified reasons using an inductive approach. Our study supports and expands research in exploring patients’ decision-making on dental treatments. It highlights a variety of 53 reasons of choice for dental treatments from patients’ perspective, split in two categories “health care service”, and “dentist & dental office”. First category includes reasons regarding dental care performance (subcategories: “preconditions”, “treatment”, “costs”, and “outcomes”). Second category demonstrates reasons regarding dentists, office structures and processes (subcategories: "professional skills", "social skills", "office staff & equipment", and "office processes”). Reasons named “most important” by the participants are out-of-pocket payments, dentists’ training, and a relationship of trust between patient and dentist. Although the participants use incentive measures to lower financial burden, several perceived challenges exist. Identified reasons for choosing dental treatments provide a basis for further studies to quantify the relevance of these reasons from patients’ perspective. Based on this, the various reasons identified can be considered in future policies to improve patients’ utilization behavior, which can range from improved information sources to increased incentive measures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reasons for (not) choosing dental treatments—A qualitative study based on patients’ perspective

2022

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“…The importance of consolidating oral health within primary health care systems and universal health coverage programmes has been described in the Lancet Issue on Oral Health (2019) ( 75 ). Coverage on dental benefits by health system has been restricted in most countries ( 76 , 77 ).…”

Section: Methodsmentioning

confidence: 99%

Sustainable development goals and ending ECC as a public health crisis

Saikia

Aarthi

Muthu

et al. 2022

Front. Public Health

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Early Childhood Caries (ECC) remains a global issue despite numerous advancements in research and interventional approaches. Nearly, 530 million children suffer from untreated dental caries of primary teeth. The consequences of such untreated dental caries not only limit the child's chewing and eating abilities but also, significantly impact the child's overall growth. Research has demonstrated that ECC is associated with nearly 123 risk factors. ECC has also been associated with local pain, infections, abscesses, and sleep pattern. Furthermore, it can affect the child's emotional status and decrease their ability to learn or perform their usual activities. In high-income countries, dental care continues to endorse a “current treatment-based approach” that involves high-technology, interventionist, and specialized approaches. While such approaches provide immediate benefit at an individual level, it fails to intercept the underlying causes of the disease at large. In low-income and middle-income countries (LMICs), the “current treatment approach” often remains limited, unaffordable, and unsuitable for the majority of the population. Rather, dentistry needs to focus on “sustainable goals” and integrate dental care with the mainstream healthcare system and primary care services. Dental care systems should promote “early first dental visits,” when the child is 1 year of age or when the first tooth arrives. The serious shortages of appropriately trained oral healthcare personnel in certain regions of the world, lack of appropriate technologies and isolation of oral health services from the health system, and limited adoption of prevention and oral health promotion can pose as critical barriers. The oral health care systems must focus on three major keystones to combat the burden of ECC−1. Essential oral health services are integrated into healthcare in every country ensuring the availability of appropriate healthcare accessible and available globally, 2. Integrating oral and general healthcare to effectively prevent and manage oral disease and improve oral health, 3. Collaborating with a wide range of health workers to deliver sustainable oral health care tailored to cater to the oral health care needs of local communities.

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“…The role of an early approach in the oral hygiene educational training, consultation, and scheduled visits, cannot only be considered as overly thorough with child's health but significantly preventing severe damage to teeth and reducing the economic burden on public health services and healthcare in general significantly ( 82 ). For example, in Europe in 2018, the economic impact of oral diseases, such as periodontitis, caused by poor hygiene monitoring, amounted to 2.52 billion €.…”

Section: Prevention Of Oral and Dental Disorders In Autistic Subjects...mentioning

confidence: 99%

Insights on dental care management and prevention in children with autism spectrum disorder (ASD). What is new?

Zerman

Zotti²,

Chirumbolo³

et al. 2022

Front. Oral. Health

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Autistic subjects represent a severe concern to dentistry due to the considerable difficulty in managing their oral health, maintaining routine toothbrushing, and preventing dental and periodontal problems. The social and economic burden of managing dental care in autism spectrum disorder (ASD) children is particularly cumbersome for families and public and private health expenditure, especially when children reach the dentist following a late diagnosis with evident oral health problems. An early diagnosis of ASD helps dentists better address these children's oral health. Unfortunately, insufficient attention is paid to the training and education of general pediatricians, dentists, and dental hygienists, allowing them to get to approach the different clinical aspects of ASD. Usually, children diagnosed with ASD are scheduled for dental appointments like their neurotypical peers, whereas their needs are typically complex and personalized. Scant attention is also devoted to these patients by commercial manufacturers of dental products and devices for oral hygiene and prevention of caries and periodontal diseases, leaving parents without the support and often failing when they address the oral health of autistic children. The difficulties of oral care do not derive simply from the behavior of ASD patients, as is commonly assumed, and therefore cannot be overcome solely by the patience and attention of parents and dentists. Genetics, dietary habits, sensory impairments, and cognition disorders are other causes contributing in various degrees to the impact on the mood and psychological reactions of autistic children towards dentists. How can we prevent teeth caries, periodontal disorders, and other oral health impairments by properly managing ASD children? This manuscript gives an up-to-date overview of these problems and helps to provide good remarks.

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Exploring variation of coverage and access to dental care for adults in 11 European countries: a vignette approach

Cited by 29 publications

References 37 publications

Reasons for (not) choosing dental treatments—A qualitative study based on patients’ perspective

Reasons for (not) choosing dental treatments—A qualitative study based on patients’ perspective

Sustainable development goals and ending ECC as a public health crisis

Insights on dental care management and prevention in children with autism spectrum disorder (ASD). What is new?

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