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Objective: In the United States, adult dental benefits are optional in the state‐managed, public insurance program, Medicaid. States also have the option to adapt their Medicaid program via waivers which pair healthy behaviour incentives (HBI) with cost‐sharing. These waivers have proven ineffective, but the empirical evidence has ignored differences between states. This study aims to evaluate the impact of four state's HBI Medicaid waiver on dental visits among low‐income adult population subject to incentives and cost‐sharing requirements by the HBI waiver. Methods: Analysing biannual data from the Behavioural Risk Factor Surveillance System's Oral Health module (2008–2018) with a Difference‐in‐Differences design, this study estimated the effect of a Healthy Behaviour Incentive waiver on the probability of visiting the dentist in the past year. The three states that implemented an HBI Waiver (Indiana, Michigan and Wisconsin) were analysed separately. Secondary outcomes included being uninsured and having all teeth extracted. Matrix Completion methods accounted for dynamic treatment and tested for non‐common trends. Inference was based on randomization inference tests. Results: Only in Michigan was an HBI waiver consistently associated with a significant increase in the probability of a dental visit (Est. = 5.6%‐points, p =.01). There was little convincing evidence that HBI waivers were associated with being uninsured or having all teeth extracted. Conclusions: Between 2010 and 2019, many states have implemented an HBI waiver, each with a different approach to incentivizing dental visits. These implementation differences may explain the heterogeneous effects by state. More work is needed to evaluate how Medicaid waivers impact health outcomes in low‐income populations. [ABSTRACT FROM AUTHOR]

Background This study investigates the association between dental insurance, income, and dental care access for Canadian children and youth aged 1 to 17 years. It contributes to a baseline understanding of oral health care use before the implementation of the Canadian Dental Care Plan (CDCP). Data and methods This study used data from the 2019 Canadian Health Survey on Children and Youth (n=47,347). Descriptive statistics and logistic regression models were employed to assess the association of dental insurance, adjusted family net income, and other sociodemographic factors on oral health care visits and costrelated avoidance of oral health care. Results A large percentage of children under the age of 5 had never visited a dentist (79.8% of 1-year-olds to 16.4% of 4-year-olds). Overall, 89.6% of Canadian children and youth aged 5 to 17 had visited a dental professional within the past 12 months: 93.1% of those who were insured and 78.5% of those who were uninsured. Insured children and youth had a 4.5% cost-related avoidance of dental care, contrasting with 23.3% for uninsured children and youth. After adjustment for sociodemographic variables, children and youth with dental insurance were nearly three times more likely (odds ratio [OR]: 2.94; 95% confidence interval [CI]: 2.60 to 3.33) to have visited a dental professional in the past 12 months than uninsured children and youth. Having dental insurance (OR: 0.19; 95% CI: 0.16 to 0.21) was protective against barriers to seeing a dental professional because of cost. There was a strong income gradient for both dental service outcomes. Interpretation The study emphasizes the significant association of dental insurance and access to oral health care for children and youth. It highlights a significant gap between insured and uninsured children and youth and points out the influence of sociodemographic and income factors on this disparity. [ABSTRACT FROM AUTHOR]

Background. Financial protection is crucial for attaining universal health coverage. The inclusion of costly dental services in insurance plans poses a significant challenge for all parties involved in the insurance sector. This study aimed to investigate the challenges of covering dental services by complementary insurance in Iran during 2020–2021. Materials and Methods. This qualitative research was conducted in Iran during 2020–2021. A triangulation of methods and data sources were employed to achieve a comprehensive perspective. In-depth semistructured interviews were conducted on an individual basis, and all national documents, rules, regulations, and instructions pertaining to complementary dental insurance were thoroughly reviewed. Purposeful sampling was used to select participants from all stakeholder groups engaged in dental insurance coverage, including (1) health system policymakers, (2) insurers, (3) policyholders, (4) care providers (dentists), and (5) insured people. Six open-ended questions were formulated to explore various facets of dental insurance, including (1) development, (2) management, (3) population coverage, (4) premium calculation, (5) services coverage, and (6) payment and reimbursement mechanisms. With the consent of the participants, all interviews were recorded and transcribed verbatim. The gathered data were evaluated using a framework analysis approach in the MAXQDA20 software. Finally, the primary themes, each encompassing multiple subthemes, were identified and presented. Results. A total of 26 interviews were conducted with five groups of interviewees, and nine national documents were evaluated. Six themes were extracted, which included 18 codes from the interviews and seven codes from the documents. The extracted themes were as follows: (1) Insurance commitments and service coverage, (2) reimbursement system, (3) information system, (4) economic issues, (5) population coverage, and (6) regulation and supervision. The high cost of dental services was the most frequent challenge, followed by the insurance commitments and service coverage. Conclusions. The delivery of dental services through complementary insurance in Iran primarily faces economic and service coverage challenges. The resolution hinges on the collaboration between basic and complementary insurance sectors, the development of a unified information system for insured individuals, and the implementation of a risk-adjusted premium plan. [ABSTRACT FROM AUTHOR]

Over the years, Sri Lanka achieved excellent scores in health indicators relative to the national expenditure on health. However, due to several challenging situations such as the 2019 Easter bombings, COVID-19 pandemic and economic crisis, there was a depletion of the GDP as well as rising inflation. This created a humanitarian crisis for all socioeconomic groups. Among them, the health sector was widely affected, including healthcare providers and healthcare recipients. The objective of this study was to elaborate on the challenges faced in dental care delivery by private general dental practitioners and the impact on dental education for undergraduate and postgraduate dental students during the economic crisis. A descriptive cross-sectional survey-based questionnaire (n = 28) was conducted and assessed among the dental surgeons of various districts in Sri Lanka. An interviewer-based questionnaire was carried out via telephone conversation by the principal investigator of dental surgeons for those who managed and owned the respective dental clinic. Data from the computed questionnaires were analyzed using the SPSS Statistical Software Package (SPSS, Version 21). Descriptive statistics were expressed as frequency distributions and percentages. Based on the results, a significant decrease was observed in the number of patients requesting restorative dental procedures including implant crowns (36.29%), implant over dentures (35.63%), crowns (39.03%), bridges (49.12%), amalgam restorations (47.38%), composite restorations (42.11%) and dentures (49.69%). In surgical dental treatment, the extractions and surgical removal of teeth were reduced by 2.11% and 43.71%, respectively. The availability of dental materials such as light care composite (LCC) bonding, silver amalgam, impression materials and surgical consumables was reduced in the post-economic crisis situation compared to the pre-economic crisis status. Furthermore, dental laboratory charges per item, fees per procedure, salaries to support staff, utility bills including electricity and water, payments to government bodies, travelling costs to the clinic (for the doctor) and other expenses have increased in the post-economic period. [ABSTRACT FROM AUTHOR]

Copyright of Health Sciences Journal / Revista Ciências em Saúde is the property of Hospital de Clinicas de Itajuba - Associacao de Integracao Social de Itajuba and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aims: Many Afghans prefer Iran for migration due to the similarity of language and neighborhood. This study was conducted in order to evaluate the oral health status of the Afghan population living in Iran and the barriers to their access to dental services. Materials and Methods: By using a researcher-made questionnaire and with the help of 4 calibrated researchers (Iranian and Afghan); referred to dental centers. The self-made questionnaire included 14 questions about oral health status, as well as questions about barriers to accessing to dental services. Results: Out of 742 participants in the study, 461 people preferred the clinic to the dental office for economic reasons. 483 people found dentist based on their compatriots' opinion and 545 people were deprived of government dental services because they did not have Iranian citizenship. 691 people had problems in paying dental fees and 588 people said that they had their teeth extracted due to economic problems. 594 people felt that they were discriminated in receiving services, and 588 people stated that the reason for the visit was an emergency.35 people went to the dentist for a check-up and 87 people stated that it was difficult for them to find a dentist. 238 people were inclined to use supplementary insurance. The average DMFT in the Afghan population was 6.22. No significant relationship was found between the DMFT and gender and residence history. Conclusion: The level of oral health of immigrants is low and it is difficult for them to access dental services and insurance. The possibility of tooth extraction instead of keeping it is high in immigrants due to economic problems. [ABSTRACT FROM AUTHOR]

Introduction: Variation in dentists' provision of types of dental services based on patients' insurance may impact population access to comprehensive care. The aim of this study was to describe differences in the types of services provided to adult patients with Medicaid versus private insurance among private practice general dentists. Methods: The data source was a 2019 survey of private practice dentists in Iowa, and the study sample included general dentists with current or recent participation in Iowa's Medicaid program for adults (n = 264). Bivariate analyses were used to compare differences in the types of services provided to privately insured and publicly insured patients. Results: Dentists reported the greatest differences in services provided to patients with public versus private insurance for prosthodontic procedures, including complete dentures, removable partial dentures, and crown and bridge services. Endodontic services were the least frequently provided category of services provided by dentists for both patient groups. Patterns were generally similar among both urban and rural providers. Conclusion: Access to dental care for Medicaid members should be evaluated not only on the proportion of dentists who see new Medicaid patients but also on the types of services dentists provide to this population. [ABSTRACT FROM AUTHOR]

Background. American adults delay dental care more than any other healthcare service. Unfortunately, the COVID-19 pandemic may have stalled efforts to address dental service delays. Early evidence has suggested substantial declines in dental service visits in the early phase of the pandemic; however, our study is among the first to measure within-person changes from 2019 to 2020 and conduct subgroup analyses to examine if changing dental patterns were mediated by exposure to the pandemic, risk of adverse COVID-19 outcomes, or dental insurance. Methods. We analyzed a National Health Interview Survey panel of individuals initially surveyed in 2019, with subsequent follow-up in 2020. The outcomes included dental service access measures and the interval of a most recent dental visit. By constructing a probability-weighted linear regression model with fixed-effects, we estimated the average within-person change from 2019 to 2020. Robust standard errors were clustered within each respondent. Results. From 2019 to 2020, adults reported a 4.6%-point reduction in the probability of visiting the dentist (p < 0.001). Significantly higher declines were found in Northeast and West regions compared to Midwest and South regions. We find no evidence that declining dental services in 2020 were associated with more chronic diseases, older age, or lack of dental insurance coverage. Adults did not report more financial or nonfinancial access barriers to dental care in 2020 compared to 2019. Conclusions. The long-term effects of the COVID-19 pandemic on delayed dental care warrant continued monitoring as policymakers aim to mitigate the pandemic's negative consequences on oral health equity. [ABSTRACT FROM AUTHOR]

Background and Aims. Patients' perspectives and preferences are considered an essential influencing factor for healthcare utilization. This study is one of the first to investigate patient preference for dental services across socioeconomic and demographic indicators in Iran. Materials and Methods. This cross-sectional study was conducted through telephone interviews with adult residents in Mashhad and Kerman cities. A representative sample was selected by stratified random sampling. A valid structured questionnaire was used for data collection, including people's preference toward dental care services in terms of dental settings, choosing a general or specialist dentist, prevention or treatment, and the preferable gender of the dentist. Factors potentially associated with preferences included gender, age, educational level, job, monthly income, house size, family number, insurance coverage, dental insurance, type of insurance, and social class in the city were investigated. Results. 1475 individuals participated in the study [response rate 63%]. Our findings showed higher preferences for private offices (50.6%), specialist dentists (76.2%), treatment services (40.8%), and no specific gender preference for the dentist (60.6%). Their preferences were significantly influenced by age range, social class, insurance status, dental insurance, and type of insurance. Income, household size, level of education, and job were not statistically significant with none of the preferences. Conclusions. Socioeconomic and demographic factors' correlation with people's preferences was observed. Efforts are needed to promote preventive care demand in deprived regions. Moreover, increasing financial resources allocated to preventive care and covering preventive dental services in insurance plans are recommended. [ABSTRACT FROM AUTHOR]

Teledentistry is a broad term that allows for patient care to be digitized and delivered through multiple modalities. Teledentistry can be facilitated via many innovative technologies, thus allowing patients to engage in dental care regardless of physical and structural constraints of the dentist's availability, creating equity through the availability of auxiliary dental team members. This manuscript lays out some of the ways that policymakers and payers can facilitate a digital transformation of care and allow teledentistry to enhance the way dental practitioners can develop systems of care for both today and the future of dentistry. [ABSTRACT FROM AUTHOR]

This study assessed the longitudinal impact of early preventive dental visits on the number of dental operative procedures in a prevention-oriented pediatric dental practice. Inclusion criteria consisted of patients zero to four years of age with at least two years of preventive services provided by the practice. Early preventive visits were the intervention and dental operative procedures were the assessed outcome. The goal was to determine if preventive visits at an early age decreased the number of operative procedures needed by the patient. The patients were divided into two groups: those with older siblings in the practice and those without older siblings in the practice. A secondary outcome was to compare these two patient groups to determine if a child who had older siblings previously treated in this preventive practice had better outcomes than those without siblings in the practice. ANCOVA tests were used to compare the average number of operative procedures in two age groups (<2 years and ≥2 years), and for those with and without dental insurance, in addition to children being younger sibling versus children without sibling, adjusting for the effect of covariates. The study sample consisted of 363 pediatric patients. Patients' age at first visit ranged from 0 to 4 years old (mean = 2.13; SD = 1.15). The average number of operative procedures per year increased as the age at first visit increased (p < 0.05). The average number of operative procedures in two age groups (<2 years and ≥2 years) differed (p < 0.05) with those whose age at first visit ≥2 years experiencing more dental operative procedures than the younger group. The average number of operative procedures was similar between younger siblings (mean = 1.91; SD = 7.44) and children without siblings (mean = 1.54; SD = 2.1) (p > 0.05). The difference in the average number of operative procedures in children with insurance (mean = 1.59; SD = 5.25) and children without insurance (mean = 1.58; SD = 2.38) was non-significant (p > 0.05). More dental cleaning examinations were associated with fewer dental operative procedures (p < 0.05). These findings demonstrate that dental examinations before two years of age and more dental cleaning examinations lead to a decrease in the number of dental operative procedures needed by children. [ABSTRACT FROM AUTHOR]

While racial/ethnic oral health inequities have been documented for many years in the United States, the potential role of racism has not been examined until recently. In fact, the common practice has been to attribute racial/ethnic disparities in oral health to low socioeconomic position and/or the lack of access to care. In contrast, racism is considered a fundamental cause of a broad range of adverse health outcomes for racial/ethnic minorities. Emerging evidence on oral health suggests that racism can affect access to oral health and clinical decision‐making by acting as a social determinant of health (SDoH). Specifically, SDoHs may affect access to quality dental care due to the lack of dental insurance, low dentist‐population ratio in racial/ethnic minority communities and the lack of diversity in the dental profession. We describe potential mechanisms through which racism can affect important SDoHs that are essential to oral health equity, outline recommendations to mitigate its existing negative effects and propose interventions to minimize pathogenic effects of racism on oral health outcomes in the population. [ABSTRACT FROM AUTHOR]

Background: Thailand has encountered an imbalanced dentist distribution and an internal brain drain of dentists from public to private health care facilities. To tackle these challenges, the compulsory service (CS) program, which has been initially implemented for physicians, was extended for dentists.Method: This policy and workforce document review describes the background, development, and policy implementation of the CS program in Thailand during the past three decades. Outcomes after policy implementation and future directions are also discussed. The information was gathered from the relevant policy and workforce documents available from 1961 to 2021.Results: In Thailand, junior dentists, specifically newly graduates, have to enroll in the CS program by working as oral health practitioners in public hospitals for at least 3 years. Dentists must pay a maximum fine of 400 000 baht (~ 12 571 USD) if they wish to skip the program. This fine is lowered according to the number of attending years in the program. CS program conditions are related to each university's admission track. The CS enrolled dentists receive several financial and non-financial benefits, including educational, employment-related, and living provisions. Altogether, successive Thai governments have launched directive policies to increase dentist distribution in rural areas and their retention in public hospitals. These policies have been implemented in 3 stages: (1) increase production of new dentists, (2) allocation of newly dental graduates to public hospitals, and (3) provide benefits for working in public hospitals.Conclusion: During the past three decades, several public policies have been implemented to improve dentist retention and distribution to public hospitals across Thailand, particularly in rural areas. The present CS program may not completely resolve the oral health inequalities because the dentist retention rate in public hospitals depends on multi-dimensional considerations. Further modifications on the CS program and future well-planned policies are needed. [ABSTRACT FROM AUTHOR]

Objectives: Oral health plays an important role in the general well‐being of older adults, yet older adults experience unique barriers to dental care. In the United States, almost two‐thirds of older adults are dentally uninsured – a reflection of the exclusion of dental benefits from Medicare. The aim of this study was to investigate potential predictors of having a dentist among older adults receiving services funded through the Iowa Department on Aging (IDA). Methods: This was a cross‐sectional analysis on a convenience sample (n = 2692) of adults age 65+ who completed a required survey to determine eligibility to receive services from the IDA. Data from questionnaires completed between March and December 2017 were used to generate multivariable logistic regression models that identified predictors of having a dentist. The dependent variable, having a dentist, was gathered by self‐report in the survey. Explanatory variables eligible for inclusion in the models included demographic and geographic factors, indicators of access to dental care, and factors related to activities of daily living. Results: Fewer than half (46.2%) of the respondents reported having a dentist. In the final regression model, individuals with dental insurance were more than twice as likely to have a dentist than those without insurance. Conversely, individuals with a tooth/mouth problem and who need help with housekeeping and with transportation were significantly less likely to have a dentist than their counterparts. Conclusions: These results align with known insurance‐related barriers and identify certain activities of daily living that might influence older adults' ability to access care. The finding that individuals with oral health problems were less likely to have a dentist underscores the need to reduce barriers to care for this population. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The purpose of the study was 1) to assess the periodontal condition of a population of early menopausal women and 2) to investigate the relationship between these and other variables such as demographics, oral hygiene and clinical variables. Material and Methods: A cross sectional study was developed at the outpatient section of a gynaecology department of a hospital in Seville, Spain, during one year. A sample of 67 menopausal women were periodontally evaluated. The periodontal variables studied were plaque index (PI), probing bleeding index (PBI), gingival level (GL), probing depth (PD) and clinical attachment level (CAL). The relationship with other demographic variables, oral hygiene and clinical variables were evaluated too. The statistical test used was ANOVA with post hoc test Bonferroni, multiple regression analysis and ANCOVA. The significance level was p<0.05. Results: The mean of PI was 69.3±3.07%. The PI was statistically significantly increased when frequency of brushing was lower (p<0.025) and previous dental care was less frequent (p<0.0033). The mean of PBI was 36.5±3.35%. The PBI was significant in relation to higher tobacco consumption (p<0.024) and a less frequent previous dental care (p<0.014). The mean of GL showed a gingival retraction of -0.83±0.07mm. The GL was significantly reduced in hypertensive patients (p<0.017), in those on antihypertensive treatment (p<0.0097) and in those who had had more than two previous pregnancies (p<0.0358). The mean of CAL was 3.24±0.1mm. The CAL was significantly reduced in individuals who smoked five to 20 cigarettes a day (p<0.005). The mean of PD was 2.5±0.05mm. This PD was correlated significantly with smoking five to 20 cigarettes a day (p<0.0003). [ABSTRACT FROM AUTHOR]

The aim of this cross‐sectional study was to assess differences in caries experience according to socio‐economic status (SES) in a health‐care system with full coverage of dental costs for children up to the age of 18 yr. In 2011 and 2014, by performing hurdle negative binomial models, we obtained data on 3,022 children and young adults aged 5, 8, 11, 14, 17, 20, and 23 yr, living in four cities in the Netherlands. At all ages between 5 and 23 yr, the percentages of children with caries‐free dentitions were lower and mean caries experience were higher in low‐SES than in high‐SES participants. In 5‐yr‐old children with dmft > 0, mean caries experience was 3.6 in those with low SES and 2.3 in those with high SES. In 23‐yr‐old participants, these estimates were 6.8 and 4.4, respectively (P < 0.05). Low‐SES children have a greater risk of more caries experience than high‐SES children. Thus, in a system with full free paediatric dental coverage, socio‐economic inequality in caries experience still exists. Dental health professionals, well‐child care doctors and nurses, general practitioners, and elementary school teachers should collaborate to promote oral health at the community level, with specific targeting of low‐SES families. We further need policy measures to curtail, at community level, the increasing availability and consumption of highly processed, carbohydrate‐rich foods, with particular attention for low‐SES families. [ABSTRACT FROM AUTHOR]

The article discusses the Aligner technique in the treatment devices for medical effectiveness and digital positioning. Topics discussed include patient consultation, diagnostics and treatment planning which cannot be done without approval, initiation of the treatment with the dentists or maxillofacial orthopedists and supplementary dental insurance.

Objectives: To identify the predisposing, enabling, and need factors of the Andersen and Newman (A&N) model and their associations with the pattern of dental service utilization in a sample of people living with HIV (PLHIV) in British Columbia.Methods: Participants responded anonymously to a 40-item online questionnaire to explore the patterns of dental service utilization. Following the descriptive statistics, the associations between A&N model factors and main outcome variables (having a dental visit in the last year and reasons for the dental visit) were evaluated using simple and multiple logistic regression analyses.Results: Out of 600 potential PLHIV participants, 210 responded to the survey and 186 met the inclusion criteria. The experience of being discriminated against by dental professionals (P = 0.005), having dental anxiety (P < 0.001), not having dental insurance (P = 0.001), and having living condition difficulties (P = 0.004) were significantly associated with nonemergency dental visits. In multiple logistic regression analysis, dental anxiety (OR = 0.1; 95 percent CI 0.0; 0.4), having a regular dentist (OR = 3.7; 95 percent CI 1.1; 12.6), and visiting a dental office in the last year (OR = 21.6; 95 percent CI 6.1; 76.5) were the strongest predictors of dental service utilization in this study.Conclusions: Several predisposing, enabling, and need factors from the A&N model were associated with dental service utilization by PLHIV. In addition to various psychosocial barriers, a significant number of respondents reported experiencing stigma and discrimination from their oral care providers. [ABSTRACT FROM AUTHOR]

Background. Hispanics disproportionately experience preventable oral health conditions in the United States. This study aimed to determine the oral health knowledge (OHK) of Hispanic adults in Iowa to identify potential gaps in knowledge. Methods. This cross-sectional study included a convenience sample of self-identifying Hispanic adults. Data pertaining to oral health literacy and demographic, cultural, and dental characteristics were collected. OHK was assessed with the Conceptual Measure of Oral Health Knowledge, and it was categorized as low or high. Bivariate analyses and multiple logistic regression models were conducted to identify the variables related to OHK (P < .05). Institutional review board approval was obtained. Results. Three hundred thirty-eight participants completed the questionnaire, 68% of participants completed the questionnaire in Spanish, and 51% of all participants had low OHK. Participants were less likely to correctly answer questions pertaining to children's oral health, periodontal disease, and oral cancer. Low OHK was associated with having less than 12th grade education, lack of dental insurance, and preference for a Spanish-speaking oral health care provider. Conclusions and Practical Implications. OHK appears to be low in this population. Increasing OHK may help decrease oral health disparities and improve oral health outcomes. Furthermore, it is important that oral health care providers have an understanding of barriers that can impede patients' understanding of the health care system. Specifically, minority populations, such as Hispanics, may have a harder time because of certain cultural differences that exist among this ethnic group. [ABSTRACT FROM AUTHOR]

The article presents the views of several dentists on managed care in dentistry. One dentist says that many individuals are accepting some form of managed care or preferred-provider plan for their medical needs, but they are reluctant when it comes to dental care. He says that nearly 50% of the people in the U.S. avoid regularly visiting the dentist. He says that benefits packages offered by U.S. companies include very few options for fee-for-service medical care as well as dental care. He says that in the same way as insurance companies, managed dental care companies are in business to make money, and are motivated by profit. Another dentist talks about the dental benefits that are increasingly being directed to dental Health Maintenance Organizations (HMOs).

The article presents information on an increase in third party coverage for dental care in the U.S. It is reported that in 1977, 54.7 million Americans were covered by some form of prepaid plan, and by December 1982, the number had increased to 99 million. It is stated that insurance companies are in business for profit, and a dental insurance program is designed to make money for the company, and not to provide coverage for the patients' dental needs. The company and the insured enter into a contractual agreement, in which benefits are paid on the basis of the usual, customary, and reasonable (UCR) fee method. It is mentioned that in organized insurance management, a dentist plays an important role of providing accurate and complete diagnostic information.

Objective: To investigate the role of public dental care spending and insurance coverage on dental services utilization disparities among different Canadian jurisdictions.Methods: We utilized Canadian Institute for Health Information provincial/territorial per capita estimates for public dental care expenditure, public information on legislated dental care programs, and oral health data from the 2007-2008 Canadian Community Health Survey to make inferences regarding the relationship between dentist visits in the past 12 months and self-perceived oral health. We performed descriptive statistics and binary logistic regression analysis to determine the relationship between dentist visits and self-perceived oral health status at the provincial/territorial level and on stratified data based on three age groups - children (12-17 years), adults (18-64 years), and seniors (65 years and older).Results: Overall, the presence of the "inverse care law" in dental care at the provincial/territorial level was evident. However, in the Canadian territories, which had the highest per capita public dental care expenditure, individuals with poor oral health had the highest odds of visiting a dentist compared with other jurisdictions. In jurisdictions with public dental care programs for children and/or seniors, children and seniors with poor oral health were more likely to visit dentists.Conclusions: Jurisdictions with more public spending and greater population coverage for dental care appear to better cater to those with the highest oral health care needs. [ABSTRACT FROM AUTHOR]

In 2009 contract dental care was introduced into Sweden's Public Dental Service under a programme called Dental Care for Health ( DCH). Previous research has revealed a possible dilemma whereby dental care professionals had the role of insurance agent foisted upon them, as they were assigned the task of 'selling contracts'. Using qualitative interviews, this study explores how these professionals make sense of contract dental care today. Drawing on the concepts of occupational and organisational professionalism, in combination with the institutional logics perspective, we discern that dental care professionals are entangled in multiple rationalities when reasoning about and dealing with DCH. A professional logic comes into play over health issues and preventive care, while market and corporate logics are present in relation to selling contracts and taking responsibility for the financial aspects of DCH, all of which creates tensions in these professionals. Overall, dental care professionals in the welfare sector respond both to an organisational and an occupational professionalism. [ABSTRACT FROM AUTHOR]

The purpose of this study was to provide a forward-thinking assessment of the underlying factors likely to impact trends in dental care demand and the need for dental providers in 2020, 2025, and beyond. Dental workforce trends and their likely impact on the need for dentists are a function of predicted dental care demand, which will in turn be determined by the size and characteristics of our population size, economic outlook, the state of public and private dental care insurance, trends in dental care delivery, professionally determined dental care need, and population health beliefs. Projecting rates of dental care utilization far into the future is difficult because projections must be made using historical data, and established trends may not persist if there is structural change in the future. Nonetheless, when structural change occurs, it does not typically affect all aspects of the economy, so there is value in describing the likely future impact of current trends. This article was written as part of the project "Advancing Dental Education in the 21st Century." [ABSTRACT FROM AUTHOR]

Background. The availability of dentists to care for Medicaid beneficiaries is a longstanding concern of many families and those who serve them in the dental profession as well as policy makers. Yet, little information beyond the number of enrolled dentists has been reliably determined. The American Dental Association (ADA) Health Policy Institute has called for more nuanced measures that better reflect dentistry's contribution to the care of Medicaid beneficiaries. Methods. The authors calculated percentages of general and pediatric dentists who enrolled in Medicaid, billed Medicaid, and treated Medicaid beneficiaries in each state for which data were available from the ADA's 2008 study, the Association of State and Territorial Dental Directors' 2013 report, and the 2013 federal Web site InsureKidsNow.org. To determine the number of primary dentists available to treat Medicaid beneficiaries, the ADA masterfile list of clinically active dentists was adjusted to remove nonpediatric dental specialists. Results. The authors determined that the ADA's 2015 analysis of dentists enrolled in Medicaid was the most rigorously assessed source for enrollment but did not report numbers of billing or treating dentists. Increasingly stringent metrics of participation are associated with considerable declines in dentist participation. They found the underlying data sources unreliable, inaccurate, and incomparable within and among states. Conclusions. The authors concluded that no consistent, comparable, ongoing source of dentist participation in Medicaid exists that reliably provides substantive information to the profession and policy makers. Practical Implications. Dentistry's ability to respond to policymakers' concerns about service to Medicaid beneficiaries depends on the development and implementation of a standardized, reliable, systematic, and ongoing method to measure meaningful participation. [ABSTRACT FROM AUTHOR]

Background: Few studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0-18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008.Methods: Medicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to examine the effect of living in DHPSAs and insurance type in relation to the number of procedures received.Results: Approximately 49 and 65 percent of children living in non-DHPSAs that were enrolled in Medicaid and DDW received at least one preventive dental procedure annually, respectively. Children in DDW non-DHPSA group had 1.79 times as many preventive, 0.27 times fewer complex restorative and 0.51 times fewer endodontic procedures respectively, compared to those in Medicaid non-DHPSA group. Children enrolled in DDW-DHPSA group had 1.53 times as many preventive and 0.25 times fewer complex restorative procedures, compared to children in Medicaid-DHPSA group.Conclusions: DDW enrollees had significantly higher utilization rates for preventive procedures than children in Medicaid. There were significant differences across Medicaid and DDW between non-DHPSA and DHPSA for most dental procedures received by enrollees. [ABSTRACT FROM AUTHOR]

The article discusses the impact of staffing shortages on dental practices due to the pandemic and the role of automated dental insurance verification in alleviating the burden on existing staff. Topics include the challenges of finding and hiring dental staff; the impact of staffing shortages on patient care and administrative tasks; and the benefits of automated dental insurance verification in terms of time and resource savings, staff efficiency, and patient satisfaction.

The article explores the various Action for Dental Health initiatives of the American Dental Association (ADA) that are designed to improve oral healthcare in the U.S. Topics mentioned include the emergency department referral models identified by the ADA including the Volunteer for Dental Care Program and the Voucher model, the expansion of community water fluoridation, and the educational programs for community dental health coordinator.

Clinical studies show that fewer than 25% of people who visit a dentist regularly are screened for oral cancer, and that the majority of oral cancers present at an advanced stage, when cure rates are already abysmal. This study explores the current status of oral cancer screening coverage among a variety of insurance providers in New York City. The study focuses on determining the coverage and frequency of the cluster of salient CDT (dental) codes surrounding oral cancer screenings. [ABSTRACT FROM AUTHOR]