Exploring the Socio-Demographic Profile of Non-Completion in Public Oral Healthcare Services: A Cross-Sectional Study in Melbourne, Victoria

(1) Background: Completion of the full oral health course of care (CoC) is essential to prevent further deterioration of oral and overall health. Understanding these patterns, particularly in public oral healthcare services, is crucial for improving access to and the delivery of care. This study aims to identify the socio-demographic and clinical characteristics of adult patients who did not complete required dental treatments within a 12-month period at Monash Health Dental Services (MHDS), Melbourne, Victoria. (2) Methods: Data were collected on patients’ course of care (CoC), socio-demographic characteristics, and clinical information from the MHDS Titanium electronic database. This study represents a secondary data analysis from adult patients who attended MHDS between November 2022 and October 2023, excluding emergency dental care visits. Logistic regression analyzed the socio-demographic and clinical variables affecting CoC. (3) Results: Our findings identified several significant predictors of incomplete CoC; being a non-priority group, mental health clients, refugees, and identifying as Aboriginal or Torres Strait Islanders (OR = 1.41; 95% CI: 1.08–1.84). Conversely, speaking a language other than English increased the odds of completing treatment (OR = 0.85; 95% CI: 0.74–0.98). By age, patients in the 36-to-55- or the 56-to-75-year-old age groups were more likely to be in the incomplete group (OR = 1.65; 95% CI: 1.37–1.98; and OR = 1.43; 95% CI: 1.22–1.66, respectively). (4) Conclusions: This study identified predictors of discontinued care, emphasizing accessibility and equitable outcomes for users of public oral healthcare. The findings indicate that the predictors of course of care (CoC) completion differ from barriers to accessing care. This highlights key objectives in public health dentistry, focusing on improving accessibility and promoting equitable oral health outcomes for vulnerable populations

Additional file 1: of ‘We are all scared for the baby’: promoting access to dental services for refugee background women during pregnancy

Focus group guides. (DOCX 16 kb

Creating Value for Dental Visits in Public Health

Aim or Purpose: The “Value for Visits” approach, adapted from the Value Based Oral Health Care (VBOHC) Model was introduced by Monash Health Dental Services in 2020. The VBOHC model provides better oral health outcomes for MHDS‘ clients. The aim of this study was to assess the VBOHC model by reviewing and comparing courses of care outcomes before and after the model's implementation. Materials and Methods: All general courses of care (CoC) in 2019 and 2022 were audited, and a review of courses of care was conducted. The 2019 CoCs included solely patients whose treatment had begun prior to COVID-19 restrictions being imposed.Analysis involved investigating 10 CoCs for each clinician working at an MDHS dental clinic. The review did not include new staff (less than 3 months) or staff primarily working in the School Dental program. A thorough auditing was conducted into the ways in which general oral health care was provided to public patients. Results: In 2019 the total number of clients seen was 4240 with an average patient receiving 4.05 appointments over 6.37 months, and seeing 2.61 clinicians. In 2022, under the VBOHC model, the total number of clients seen was 5644. The average number of appointments to complete a CoC was 2.70 over 5.39 months. The number of clinicians seen was 1.10. Conclusions: Data showed that after implementation of the VBOHC model there was improvement in the efficiency of oral health care provision. Full implementation of the model would provide superior continuity of care, and overall better oral health outcomes for public dental patients

Protocol for the Hall Technique study: A trial to measure clinical effectiveness and cost-effectiveness of stainless steel crowns for dental caries restoration in primary molars in young children

BACKGROUND: The Hall Technique (HT) is a carious primary molar treatment that does not require local analgesia, carious tissue removal or tooth preparation. The carious lesions in carefully selected teeth are sealed with a stainless steel crown (preformed metal crown). The study aims are to determine the clinical effectiveness, acceptability and cost-effectiveness of the HT for management of carious lesions in young dental patients. METHODS/DESIGN: Children, aged 3-7years, with a primary molar tooth with a carious lesion extending no further than the middle third of dentine, with no signs or symptoms of pulp inflammation or infection, and attending one of three community agencies are recruited. Target sample size is 220. A control tooth with an intra-coronal restoration is sourced from the same mouth. The primary outcome is the period of time free from further treatment. The assessments are scheduled at 6, 12 and 24months. In addition to the clinical assessment, acceptability of the HT will be assessed via questionnaires among patients and their primary carers at baseline, 6, 12 and 24months. Cost-outcome description and cost-effectiveness analysis from healthcare provider and societal perspective will be conducted. DISCUSSION: The clinical effectiveness, acceptability and cost-effectiveness of the HT in the community dental setting will be evaluated. The results of this study will determine the implementation of HT in the management of dental caries in young children

‘We are all scared for the baby’: promoting access to dental services for refugee background women during pregnancy

BACKGROUND: Vulnerable populations such as people with refugee backgrounds are at increased risk of poor oral health. Given that maternal characteristics play a significant role in the development of dental caries in children, antenatal care offers an opportunity to both provide information to women about the importance of maternal oral health and accessing dental care. Although pregnant women are recognised for ‘priority’ care under Victorian state-government policy, rarely do they attend. This study aims to describe Afghan and Sri Lankan women’s knowledge and beliefs surrounding maternal oral health, barriers to accessing dental care during pregnancy, and to present the perspectives of maternity and dental service providers in relation to dental care for pregnant women. METHODS: One agency comprising both dental and maternity services formed the setting for the study. Using participatory methods that included working with bicultural community workers, focus groups were conducted with Afghan and Sri Lankan refugee background participants. Focus groups were also completed with midwives and dental service staff. Thematic analysis was applied to analyse the qualitative data. RESULTS: Four community focus groups were conducted with a total of 14 Afghan women, eight Sri Lankan women, and three Sri Lankan men. Focus groups were also conducted with 19 dental staff including clinicians and administrative staff, and with ten midwives. Four main themes were identified: perceptions of dental care during pregnancy, navigating dental services, maternal oral health literacy and potential solutions. Key findings included women and men’s perception that dental treatment is unsafe during pregnancy, the lack of awareness amongst both the midwives and community members of the potential impact of poor maternal oral health and the overall lack of awareness and understanding of the ‘priority of access’ policy that entitles pregnant women to receive dental care cost-free. CONCLUSION: This study highlights a significant policy-to-practice gap which if not addressed has the potential to widen oral health inequalities across the life-course. Stakeholders were keen to collaborate and support action to improve the oral health of mothers and their infants with the over-riding priority being to develop inter-service relationships to promote seamless access to oral health care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-015-0787-6) contains supplementary material, which is available to authorized users