Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting

Abstract

The purpose of this study was to identify predictors and/or factors associated with medically compromised patients seeking dental care in the oncology dental support clinic (ODSC) at the University of Missouri-Kansas City (UMKC) School of Dentistry. An 18-item survey was mailed to 2,541 patients who were new patients to the clinic from 2006 to 2011. The response rate was approximately 18% (n = 450). Analyses included descriptive statistics of percentages/frequencies as well as predictors based on correlations. Fifty percent of participants, 100 females and 119 males, identified their primary medical diagnosis as cancer. Total household income (p < .001) and the importance of receiving dental care (p < .001) were significant factors in relation to self-rated dental health. Perceived overall health (p < .001) also had a significant association with cancer status and the need for organ transplants. This study provided the ODSC at UMKC and other specialty clinics with vital information that can contribute to future planning efforts.

Characteristics of Patients Discontinuing Care

“…Of note, measures of provider–patient interaction and its perceived quality are absent from these surveys, although patients drawn to the dental school setting may find these qualities more important than patients who seek care in a conventional dental setting [8]. While the attributes of dental school patients have been previously described, the studies have focused on specific groups, such as those with mental illness, substance abuse disorders, cancer, or hypertension [9,10,11,12]. Income and enrollment in insurance have previously been documented to predict the receipt of preventive dental services in the dental school setting; however, to our knowledge, this is the first study assessing the factors that lead dental school patients to depart from this care model [36].…”

“…Previous studies on patients seeking care in DSCs have focused on the prevalence of specific medical conditions or have been adapted from consumer surveys used in other settings that do not address issues of quality and provider interaction [8,9,10,11,12]. The current pilot study is a retrospective analysis of the case disposition form at the Harvard School of Dental Medicine.…”

Appropriate and necessary oral care for people with cancer: guidance to obtain the right oral and dental care at the right time

“…Given the complexities of oral and dental care that may be unique in oncology, the need to understand the cancer diagnosis and stage, the treatment provided or planned, the prognosis of cancer treatment, the complications of therapy and the impact of the medical issues that continue following cancer therapy, and the identification of experienced and knowledgeable dental providers in the community may be a challenge [59,73]. The financial difficulties are also significant, even when dental insurance is available, due to the extensive and complex needs and even more challenging when dental insurance is limited or not available [62,71]. The definition of "medically necessary oral/dental care" and other means of funding the costs of care are not well defined.…”

“…When a suspicious condition is observed, the need to achieve diagnosis and the implications of the results should be discussed with the patients in order to promote understanding and compliance [70]. Oral squamous cell carcinoma (OSCC) patients require a dentist to discuss their oral health/teeth, chewing/eating, pain in head and neck, saliva, swallowing, and speech as their major concerns [11,71]. This is also important in terms of dental maintenance, because an appropriate dental care plan shall be constructed on individual patient basis with careful analysis of the risks and the benefits of dental intervention [7].…”