Frequency of visits and examinations in the Public Dental Service in Finland – a retrospective analysis, 2001–2013

Linden, Jari; Josefsson, Kim; Widström, Eeva

doi:10.1186/s12903-017-0436-8

Cited by 15 publications

(14 citation statements)

References 8 publications

(6 reference statements)

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“…Our finding that having dental insurance was associated with a greater likelihood of seeking future dental care was consistent with research from other countries, including studies from Korea [ 41 ] and Finland [ 42 ] showing an increase in dental visit attendance after a nationwide expansion in public dental insurance coverage. In the U.S., only about 7% of adults have public dental insurance (provided through Medicaid) and about 60% have private dental insurance, usually obtained through their employer or on the individual insurance market [ 43 ].…”

Section: Discussionsupporting

confidence: 91%

Factors associated with future dental care utilization among low-income smokers overdue for dental visits

et al. 2018

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BackgroundSmokers are at increased risk of oral disease. While routine dental care can help prevent and treat oral health problems, smokers have far lower rates of dental care utilization compared with non-smokers. We sought to better understand which factors may facilitate or hinder dental care utilization among low-income smokers participating in a randomized intervention trial in order to inform future intervention planning.MethodsThis is a secondary analysis of data collected between 2015 and 2017 as part of the OralHealth4Life trial. Participants were eligible callers to the Louisiana, Nebraska, and Oregon state tobacco quitlines who had no dental appointment in the prior or upcoming six months. We examined the association between participants’ baseline characteristics and their receiving professional dental care between baseline and the 6-month follow-up survey.ResultsParticipants were racially diverse (42% non-White) and two-thirds had an annual household income under $20,000. Most (86.7%) had not had a dental cleaning in more than one year. Commonly cited barriers to dental care included cost (83.7%) and no dental insurance (78.1%). Those with dental insurance were more likely to see a dentist at follow-up (RR 1.66). Similarly, those reporting a dental insurance barrier to care were less likely to see a dentist at follow-up (RR 0.69); however, there was no significant utilization difference between those reporting a cost barrier vs. those who did not. After controlling for these financial factors, the following baseline characteristics were significantly associated with a higher likelihood of dental care utilization at 6 months: higher motivation (RR 2.16) and self-efficacy (RR 1.80) to visit the dentist, having a disability (RR 1.63), having a higher education level (RR 1.52), and having perceived gum disease (RR 1.49). Factors significantly associated with a lower likelihood of dental care utilization included being married (RR 0.68) and not having a last dental cleaning within the past year (RR 0.47).ConclusionsOur findings provide important insight into factors that may facilitate or deter use of professional dental care among low-income smokers. This information could inform the development of future interventions to promote dental care utilization.Trial registrationClinicalTrials.gov: NCT02347124; registered 27 January 2015.

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Section: Discussionsupporting

confidence: 91%

Factors associated with future dental care utilization among low-income smokers overdue for dental visits

et al. 2018

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“…The trend towards increasing total numbers of treatment measures among the “healthy young” is worrying, especially when politically there has been a desire to improve adults’ access to the PDS. An earlier study showed that the young were five times more likely to be examined in the PDS than adult patients although they were three times less likely to be in need of care [16]. A law enacted in 2011 requires two dental examinations before a child reaches 7 years old and three more examinations before the age of 18 years [17].…”

Section: Discussionmentioning

confidence: 99%

“…Almost all the young people in Finland (99%) use the PDS [6]. Throughout the study period, the annual coverage (proportion of the population that attended the PDS) of children and adolescents was high, around 75% [16]. During the study period, the number of dental hygienists doubled (+ 97.9%) and the number of dentists did not change (− 0.0%).…”

Section: Discussionmentioning

confidence: 99%

Children and adolescents´ dental treatment in 2001–2013 in the Finnish public dental service

Linden¹,

Widström

Sinkkonen³

2019

BMC Oral Health

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Background The Public Dental Service (PDS) in Finland has catered for the overwhelming majority of the young for more than 50 years. They have had examinations, preventive measures and all other necessary treatment free of charge. This study aimed to survey the treatment needs and treatment measures provided for children and adolescents and changes in these during the period 2001–2013. Methods Using each person’s unique identifier, data on patients (< 18 years), their oral health (CPI > 2, D + d > 0) and treatment received in the period 2001–2013 were collected retrospectively from municipal databases in five PDS-units covering 320,000 inhabitants. The National Institute for Health and Welfare gave ethical approval. Permission to use local data was received from the Directors in the PDS units. Treatment measures were grouped into 14 categories and patients into three age categories (0–6 years, 7–13 years and 14–17 years). Trend analysis was used to test changes over time. Results About 40,000 children and adolescents visited the PDS each year and 2,488,805 treatment measures were provided for them during the entire study period. The proportion of those in need of treatment decreased from 44.4 to 33.2% during the study period. The most common treatment categories were examinations (613,753, 24.7%), orthodontics (499,033, 20.1%), preventive measures (372,473, 15.0%) and restorative treatment (355,325, 14.3%); these made up 74% of all treatment measures. During the study period, statistically highly significant ( p < 0.001***) increasing trends were found for examinations, anaesthesia and the total number of treatment measures, and a significant ( p < 0.001***) decreasing trend in restorative treatment were found for all the young. More preventive treatment measures were provided for those not in need of treatment compared with those in need of treatment. Conclusion Although children’s oral health had improved and restorative treatment provided had decreased, the total number of treatment measures increased. Healthy children received frequent examinations and high numbers of preventive treatment measures. Targeting treatment according to needs was not satisfactory.

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“…The results showed that from 2001 to 2013, the number of adults (18+ years) treated in the participating PDS-units increased by 81.5%. In 2001, the shares of young (<18 years) and adult patients were 51.5% and 48.5% respectively and in 2013 these were 36.8% and 63.2% [23]. This Overall, during the 13-year study period, most adults living in the local municipalities (77.5%) had visited the PDS on some occasion.…”

Section: Discussionmentioning

confidence: 82%

Adults´ dental treatment in 2001-2013 in Finnish Public Dental Service

Linden¹,

Widström²,

Sinkkonen³

2020

Preprint

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Background All adults over 17 years of age have access to the Public Dental Service after the Finnish Dental Care Reform in 2001-2002. This study aimed to survey the treatment needs and treatment measures provided for adult patients and changes in these during the period 2001–2013. Methods Using each person’s unique identifier, demographic data on dental visits during the period 2001 - 2013 were collected from municipal databases in five PDS-units covering 320,000 inhabitants. The numbers of visitors, those in need of basic periodontal or caries treatment (CPI >2 and D + d > 0) were calculated for three age groups. Treatment provided was also calculated in 13 treatment categories. Trend analyses were performed to study changes during the study period. Results Restorative treatments (968,772; 23.6%), examinations (658,394; 16.1%), radiographs taken (529,875; 12.9%) anaesthesia used (521,169; 12.7%) and emergency treatments (348,229; 8.5%) made up 73.8% of all treatment measures during the entire study period. Periodontal treatment (7.8%) and caries prevention (3.9%) made up a small part of the care provided and prosthetics and treatment of TMJ disorders were extremely uncommon (fewer than 1%). Treatments related to caries (restorative treatment, examinations, endodontics, emergencies, anaesthesia and radiographs) made up 60.4% of the dental personnel’s treatment time. During the study period, statistically significant increasing trends were found for radiographs (p<0.001***), anaesthesia (p=0.003**) and total number of treatments (p=0.009**). There was a slight decreasing trend in treatment need among the youngest adults (18-39years; p=0.033*). Conclusion Compared with the results of national epidemiological studies, insufficient periodontal treatment is provided and prosthetic treatment is almost totally neglected in the PDS. Rather, adults’ dental treatment concentrates on treatment of caries. The unmet needs may be due to tradition, inadequate treatment processes or a lack of resources or failed salary incentives.

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Frequency of visits and examinations in the Public Dental Service in Finland – a retrospective analysis, 2001–2013

Cited by 15 publications

References 8 publications

Factors associated with future dental care utilization among low-income smokers overdue for dental visits

Factors associated with future dental care utilization among low-income smokers overdue for dental visits

Children and adolescents´ dental treatment in 2001–2013 in the Finnish public dental service

Adults´ dental treatment in 2001-2013 in Finnish Public Dental Service

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