Variations in the provision and cost of oral healthcare in 11 European countries: a case study

Eaton, Kenneth A; Ramsdale, Martin; Leggett, Heather; Csikar, Julia; Vinall, Karen; Whelton, Helen; Douglas, Gail

doi:10.1111/idj.12437

Cited by 17 publications

(12 citation statements)

References 9 publications

(10 reference statements)

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“…Most of the non-responders did not contribute for no explicit reason or due to the absence of a reward, as observed in similar studies [ 4 ]. Sociodemographic data of the participants showed a similar gender distribution compared to the dental population in Germany and Europe ( Table 1 ) [ 24 , 25 ]. The majority of the survey participants were dentists with no specialization (general practitioners), currently practicing in their own practice with a work experience of more than 20 years ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Conrad

Retelsdorf

Attia

et al. 2020

IJERPH

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Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study evaluated German dentists’ preferred AP treatment decisions and the influencing factors for selecting tooth retention by initial/repeated surgical/non-surgical root-canal treatment (RCT) or extraction with/without prosthetic replacement. Through an online-survey, participants (n = 260) rated different treatment options for four case scenarios with AP in anterior/posterior teeth without/with previous RCT. Statistical analysis included the Friedman test for intra-case comparisons and Chi-squared test for factor-associations (p ≤ 0.05). Tooth retention using initial/repeated RCT was ranked first in all scenarios and rated as (very) appropriate by most participants, while implant-supported crowns (ISC) and apicoectomy had the second ratings. ISC were preferred more on posterior teeth or previous root-canal-treated teeth. Rating levels of treatment options displayed significant differences for all case scenarios. Posterior tooth retention by RCT demonstrated a significant association with work experience. Tooth retention with previous RCT displayed a significant correlation with dentists’ privately insured patients. Most dentists preferred tooth preserving with initial/repeated RCT, while others selected non-evidence-based choices. This reflects a lack of consensus of AP treatment decisions in Germany. Fixed treatment guidelines and further evaluation of treatment–decision-correlated factors are recommended for correct treatment planning.

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Section: Discussionmentioning

confidence: 99%

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Conrad

Retelsdorf

Attia

et al. 2020

IJERPH

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“…Oral health status varies between countries. The utilisation of oral and dental health services for patients is affected by both individual factors and local or national policies which may be part of the overall country specific National Health Policies ( 82 ). In our previous study, the number of monthly oral ulcers, filled teeth, frequency of tooth brushing and dental visits are found to be high in patients from UK compared with those in patients from Turkey ( 83 ).…”

Section: Oral Health and Disease Coursementioning

confidence: 99%

“…As Oral Health policies and systems to deliver oral health care varies widely between different among countries ( 82 ), the delivery of care may be reliant on an “out of pocket payment system” with minimal income to cover costs incurred. Clues to these background factors may be found in careful questioning.…”

Section: Promotion Of Oral Health As An Etiologic Factor In Behçet's Diseasementioning

confidence: 99%

Oral Health and Its Aetiological Role in Behçet's Disease

Mumcu

Fortune

2021

Front. Med.

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Behçet's disease (BD) is a chronic multi-systemic inflammatory disorder characterised by oro-genital ulcers, cutaneous manifestations, ocular, vascular, neurologic and gastrointestinal involvement. Complex interactions operating on the genetic background e.g.(HLA51), of infectious and other environmental agents, together with immune dysregulation impacts on the pathogenesis of BD. This suggests that the environmental factors triggering immune responses may activate clinical manifestations in genetically susceptible individuals. Since oral health forms the basis of all general health both dental and systemic, it is an important component of both Dentistry and Medicine. Oral ulcers are the most common clinical manifestation of oral mucosal health. Changes in the oral environment consequently acts as an infective and immune trigger. In this review, complex interactions between the oral ulcers, the oral microbiome and immune responses together with the course of oral and systemic disease manifestations in BD are discussed in the context of the aetiologic role of oral health.

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“…The developments described only concern the Netherlands and therefore cannot be compared automatically with developments in other countries. After all, legal frameworks differ between countries, as do the ways in which these framework affect the provision of care [50,51]. However, the description of specific developments in the Netherlands in recent years may provide insights for other countries.…”

Section: Restrictionsmentioning

confidence: 99%

Developments in oral health care in the Netherlands between 1995 and 2018

2020

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Background: Over the past several decades, changes in legislation and regulations have been implemented in oral health care in the Netherlands. In 1995, for example, a major transformation in the funding of oral health care was implemented, after which most oral health care for adults was no longer covered by national insurance. In 1997, the Individual Healthcare Professions Act, in which the authorizations of care providers were described, was established. The Healthcare Quality, Complaints and Disputes Act, established in 2016, concerns the accountability of professional behavior. Regulations concerning employment have changed several times since 1995. These changes have affected the work and practice situation of oral health care providers. Methods: Data from many publicly available sources were gathered and combined with internal reports mainly derived from the Data Stations project of the Royal Dutch Dental Association. This project was established in 1995 and, since its initiation, 6716 dentists have participated an average of 6.7 times. Results: Between 1995 and 2018, nearly all professional groups in oral health care increased, particularly those of dental hygienists and prevention assistants. The number of dental practices decreased, but practices got larger in terms of dental units, number of patients, and personnel. The percentage of inhabitants visiting oral health care professionals remained unchanged, but the type of care provided moved towards more prevention. Oral health care providers exploited new opportunities to enhance and express their professional behavior. Conclusions: Oral health care in the Netherlands has evolved in recent years toward more collaboration in teams, and professions have established institutions to promote the quality and safety of care. Greater emphasis has been placed on prevention of dental diseases. These processes were influenced by new legislation and regulations, demographic changes within professional groups, and other social developments.

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Variations in the provision and cost of oral healthcare in 11 European countries: a case study

Abstract: It was apparent that there are wide variations between EU Member States in the manner in which oral healthcare is delivered, its cost and the extent to which the cost of treatment is subsidised from state funds or through private insurance.

Cited by 17 publications

References 9 publications

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Oral Health and Its Aetiological Role in Behçet's Disease

Developments in oral health care in the Netherlands between 1995 and 2018

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