Background: Oral health, coupled with rising awareness on the impact that limited dental care coverage has on oral health and general health and well-being, has received increased attention over the past few years. The purpose of the study was to compare the statutory coverage and access to dental care for adult services in 11 European countries using a vignette approach.
Methods: We used three patient vignettes to highlight the differences of the dimensions of coverage and access to dental care (coverage, cost-sharing and accessibility). The three vignettes describe typical care pathways for patients with the most common oral health conditions (caries, periodontal disease, edentulism). The vignettes were completed by health services researchers knowledgeable on dental care, dentists, or teams consisting of a health systems expert working together with dental specialists.
Results: Completed vignettes were received from 11 countries: Bulgaria, Estonia, France, Germany, Republic of Ireland (Ireland), Lithuania, the Netherlands, Poland, Portugal, Slovakia and Sweden. While emergency dental care, tooth extraction and restorative care for acute pain due to carious lesions are covered in most responding countries, root canal treatment, periodontal care and prosthetic restoration often require cost-sharing or are entirely excluded from the benefit basket. Regular dental visits are also limited to one visit per year in many countries. Beyond financial barriers due to out-of-pocket payments, patients may experience very different physical barriers to accessing dental care. The limited availability of contracted dentists (especially in rural areas) and the unequal distribution and lack of specialised dentists are major access barriers to public dental care.
Conclusions: According to the results, statutory coverage of dental care varies across European countries, while access barriers are largely similar. Many dental services require substantial cost-sharing in most countries, leading to high out-of-pocket spending. Socioeconomic status is thus a main determinant for access to dental care, but other factors such as geography, age and comorbidities can also inhibit access and affect outcomes. Moreover, coverage in most oral health systems is targeted at treatment and less at preventative oral health care.
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http://dx.doi.org/10.1186/s12903-022-02095-4 | DOI Listing |
Hemangiomas in the head and neck region, especially those that may impact the airway, require special attention perioperatively because of the potential for difficulties with airway management and bleeding control. This case report describes the management of a 31-year-old male with a large hemangioma of the tongue and pharynx undergoing surgical extraction of mandibular third molars under intubated general anesthesia. Despite taking precautions and avoiding traumatizing the hemangioma while securing the airway, massive bleeding occurred during the surgical extractions, which prompted emergent transfer for angiographic embolization and a stay in the intensive care unit until extubation.
View Article and Find Full Text PDFAdv Healthc Mater
December 2024
School of Chemical Engineering, University of Birmingham, Birmingham, B15 2TT, UK.
Current biomedical titanium alloys have been repurposed from other industries, which has contributed to several biologically driven implant failure mechanisms. This review highlights the added value that may be gained by building an appreciation of implant biological responses at the onset of alloy design. Specifically, the fundamental mechanisms associated with immune response, angiogenesis, osseointegration and the potential threat of infection are discussed, including how elemental selection can modulate these pivotal systems.
View Article and Find Full Text PDFSpec Care Dentist
December 2024
Faculty of Dentistry, University of Hong Kong SAR China, Hong Kong, China.
Background: Unmet caries treatment needs are prevalent among people with disability, partly due to difficulties of cooperation during conventional dental treatment. This cohort study compared atraumatic restorative treatment (ART), silver modified atraumatic restorative treatment (SMART), and conventional restorative treatment (CRT), in terms of feasibility and acceptability in patients referred for special care dentistry in a specialized university clinic.
Methods: Patients referred for dental restorative care were treated using either ART, SMART, or CRT approach.
J Public Health Dent
December 2024
U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Bureau of Primary Health Care (BPHC), Bethesda, Maryland, USA.
Objectives: This study examined the association of social determinants of health (SDOH) domains on oral health status.
Methods: We used the nationally representative 2022 Health Center Patient Survey and the 2021-2022 Area Health Resource File. We constructed seven domains on burden of SDOH disadvantage: (1) oral health behavior, (2) dental service use and access, (3) general health service use and access, (4) social, (5) economic, (6) contextual or physical environment, and (7) health condition indicators, and calculated a score per domain.
J Oral Maxillofac Surg
December 2024
Assistant Professor, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; Assistant Professor, Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA. Electronic address:
Background: Fibrous dysplasia/McCune-Albright syndrome (FD/MAS) is a genetic disorder, marked by bone lesions, often affecting the craniofacial skeleton. Pain is a prevalent yet heterogeneous symptom reported by patients with craniofacial FD. Effective treatments are currently lacking, posing a significant clinical challenge to patient care.
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