Anxiety and anger of homeless people coping with dental care.

OBJECTIVES: To reveal and describe from open-ended interviews how homeless people in Vancouver interpret, appraise and cope with dental care. METHODS: Audio-recorded interviews with 25 homeless people (18 men and 7 women; age range: 25-64 years), purposefully selected for a range of experiences, were transcribed and analysed inductively. The process of interpretive description drawing from the Behavioral Model for Vulnerable Populations and Lazarus's Theory of Emotions identified how participants appraised and coped with dental care. RESULTS: Four dominant themes emerged: barriers to care; service use; opinions on dental health; and improving dental services. Participants were anxious about the cost of dentistry and fearful of dentists. They got emergency dental care with difficulty, usually in hospital emergency departments although mostly they preferred self-treatment. They acknowledged the importance of dental health but felt stigmatized by their homelessness and visibly unhealthy mouths. They wanted accessible dental services with financial assistance from government, more widespread information about community dental clinics, and, notably among the Indigenous participants, less humiliating discrimination from dentists. CONCLUSIONS: Homeless people have difficulty coping with dental care. They believe that dentistry is frightening, humiliating and expensive, and governments are neither sympathetic to their disability nor willing to provide helpful information about community dental clinics or sufficient dental benefits for their needs.

A Model Pathway to Oral Health Care for Homeless People.

OBJECTIVES: This study aimed at developing a model pathway to use of oral health care by homeless people based on their own perceptions and experiences with oral health care and related services in Vancouver. METHODS: We applied Gelberg-Andresen's behavioural model for vulnerable populations to predict health care use and interviewed 25 homeless adults (18 men and 7 women; age range 25-64 years) to develop a model pathway of care. Data collection and thematic analysis were carried out concurrently and iteratively to construct the pathway, which aimed at mutual decision-making and organization of the care process. RESULTS: Thematic analysis identified 4 main themes: government-sponsored oral health programs, homeless support, oral health outreach initiatives and professional education. CONCLUSIONS: The model pathway helps to explain the factors that enable homeless people to access oral health care. It may also help dental teams foster positive care-seeking behaviour relevant to this vulnerable population so that oral disorders can be managed more sympathetically and effectively.

Impact of mood disorders on oral health-care utilization among middle-aged and older adults.

BACKGROUND: Good oral health improves quality of life and is an integral part of active aging. Similar to some other systemic diseases, mood disorders are more prevalent in middle to older ages and have an associated risk of developing poor oral health. Consequently, people with mood disorders need to have regular dental care. There is scarce evidence in Canada linking mood disorders to the use of professional oral care services. The purpose of this study was to investigate the association between mood disorders and utilization of oral health-care services in a population-based sample of middle aged and older adults in Canada. METHODS: Data were extracted from Canadian Community Health Survey - Healthy Aging, 2008. Multinomial logistic regression was used to investigate the association between mood disorders and oral care utilization, adjusted for the confounders. RESULTS: Among 30,354 respondents included in our sample, 2162 (6.9%) reported having mood disorders. After adjusting for age, sex, education, marital status, and dental insurance status, the respondents who had mood disorders had a significant increased odds of not visiting a dental professional in the past year (OR:1.21, 95% CI: 1.08-1.35). The association of never visiting a dental professional and mood disorders was even stronger (OR: 1.49, 95% CI: 0.91-2.46). CONCLUSION: Mood disorders were found to have a strong association with underutilization of oral care services among aging adults of Canada. Given the associated poor oral health risks for elderly with mood disorders, oral health planners should strengthen the implementation of surveillance programs directed toward better oral health for this disadvantaged subpopulation.

Fuzzy logic based expert system for the treatment of mobile tooth.

The aim of this research work is to design an expert system to assist dentist in treating the mobile tooth. There is lack of consistency among dentists in choosing the treatment plan. Moreover, there is no expert system currently available to verify and support such decision making in dentistry. A Fuzzy Logic based expert system has been designed to accept imprecise and vague values of dental sign-symptoms related to mobile tooth and the system suggests treatment plan(s). The comparison of predictions made by the system with those of the dentist is conducted. Chi-square Test of homogeneity is conducted and it is found that the system is capable of predicting accurate results. With this system, dentist feels more confident while planning the treatment of mobile tooth as he can verify his decision with the expert system. The authors also argue that Fuzzy Logic provides an appropriate mechanism to handle imprecise values of dental domain.