The relative patient costs and availability of dental services, materials and equipment in public oral care facilities in Tanzania.

BACKGROUND: Patient charges and availability of dental services influence utilization of dental services. There is little available information on the cost of dental services and availability of materials and equipment in public dental facilities in Africa. This study aimed to determine the relative cost and availability of dental services, materials and equipment in public oral care facilities in Tanzania. The local factors affecting availability were also studied. METHODS: A survey of all district and regional dental clinics in selected regions was conducted in 2014. A total of 28/30 facilities participated in the study. A structured interview was undertaken amongst practitioners and clinic managers within the facilities. Daily resources for consumption (DRC) were used for estimation of patients' relative cost. DRC are the quantified average financial resources required for an adult Tanzanian's overall consumption per day. RESULTS: Tooth extractions were found to cost four times the DRC whereas restorations were 9-10 times the DRC. Studied facilities provided tooth extractions (100%), scaling (86%), fillings (79%), root canal treatment (46%) and fabrication of removable partial dentures (32%). The ratio of tooth fillings to extractions in the facilities was 1:16. Less than 50% of the facilities had any of the investigated dental materials consistently available throughout the year, and just three facilities had all the investigated equipment functional and in use. CONCLUSIONS: Dental materials and equipment availability, skills of the practitioners and the cost of services all play major roles in provision and utilization of comprehensive oral care. These factors are likely to be interlinked and should be taken into consideration when studying any of the factors individually.

Análise do custo de materiais de biossegurança utilizados em restaurações dentárias diretas / Cost analysis of biosafety materials used in direct dental restorations

O custo dos materiais faz parte do cálculo do valor dos honorários odontológicos. As resinas compostas são materiais usualmente utilizados em restaurações dentárias diretas de dentes posteriores. O objetivo desse trabalho foi determinar e analisar o valor total do custo dos materiais de biossegurança utilizados em restaurações dentárias diretas em resina composta. O cálculo dos custos foi baseado no método de sistema de custeio variável. A lista dos materiais foi obtida por meio de consulta a uma banca juízes e baseada nos padrões de excelência comprovados na literatura para atendimento em equipe. Os valores dos materiais foram obtidos de uma média dos valores consultados no mercado fornecedor. O custo encontrado para a biossegurança foi de R$.8,85. Desse valor, os equipamentos de proteção individual (EPI) descartáveis para a equipe e paciente representaram 56,72%. Os valores encontrados podem ser utilizados no cálculo do valor final do procedimento restaurador, auxiliando na gestão de serviços odontológicos públicos ou privados...

The cost of the materials is part of the calculation of the value of dental fees. The composite resins are materials commonly used in direct posterior dental restorations. The aim of this study was to determine and to assess the total value of the cost of the biosafety materials used in composite resin posterior dental restorations. The calculation of costs was based on the method of variable costing system. A list of the materials was obtained by a panel of experts and based on the excellence standards established in the literature for dental team care. The values of the materials were obtained from an average of the values founded in the supplier market. The founded cost was R$.8.85 (in Brazilian current coin) for biosafety materials. Of this value, the personal protective equipment (PPE) disposable products for the team and patient accounted for 56.72 %. These values might be used in the calculation of the final value of the restorative procedure, aiding in the management of public or private dental care services...

Cost analysis of periodontitis management in public sector specialist dental clinics.

BACKGROUND: The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components. METHODS: Five specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N = 165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€ = MYR4). RESULTS: A total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P = 0.003). Higher costs were expended as disease severity increased (ANOVA, P = 0.022) and for patients requiring surgeries (ANOVA, P < 0.001). Providers generally spent most on consumables while patients spent most on transportation. CONCLUSIONS: Cost of providing dental treatment for periodontitis patients at public sector specialist settings were substantial and comparable with some non-communicable diseases. These findings provide basis for identifying potential cost-reducing strategies, estimating economic burden of periodontitis management and performing economic evaluation of the specialist periodontal programme.

Methods and preliminary findings of a cost-effectiveness study of glass-ionomer-based and composite resin sealant materials after 2 yr.

The cost-effectiveness of glass-carbomer, conventional high-viscosity glass-ionomer cement (HVGIC) [without or with heat (light-emitting diode (LED) thermocuring) application], and composite resin sealants were compared after 2 yr in function. Estimated net costs per sealant were obtained from data on personnel time (measured with activity sampling), transportation, materials, instruments and equipment, and restoration costs for replacing failed sealants from a community trial involving 7- to 9-yr-old Chinese children. Cost data were standardized to reflect the placement of 1,000 sealants per group. Outcomes were the differences in the number of dentine caries lesions that developed between groups. The average sealant application time ranged from 5.40 min (for composite resin) to 8.09 min (for LED thermocured HVGIC), and the average cost per sealant for 1,000 performed per group (simulation sample) ranged from $US3.73 (for composite resin) to $US7.50 (for glass-carbomer). The incremental cost-effectiveness of LED thermocured HVGIC to prevent one additional caries lesion per 1,000 sealants performed was $US1,106 compared with composite resin. Sensitivity analyses showed that differences in the cost of materials across groups had minimal impact on the overall cost. Cost and effectiveness data enhance policymakers' ability to address issues of availability, access, and compliance associated with poor oral-health outcomes, particularly when large numbers of children are excluded from care, in economies where oral health services are still developing.

Knowing (and understanding) the key numbers for your practice.

Most dentists see accounting and bookkeeping as a necessary evil instead of a helpful tool. Yet the most financially successful and happy dentists understand the need for good financial management. Here's an overview that will help you better-understand the key numbers in your practice.

A dinâmica inovativa do subsistema de base mecânica, eletrônica e de materiais / The innovative dynamic of the mechanics, electronics and materials subsystem / La dinámica innovadora del subsistema de base mecánica, electrónica y de materiales

O subsistema de base mecânica, eletrônica e de materiais, um dos subsistemas do complexo produtivo da saúde, reúne diferentes atividades, usualmente agregadas na designada indústria de equipamentos e materiais médico-hospitalares e odontológicos, uma área estratégica para a saúde por representar uma fonte contínua de mudanças nas práticas assistenciais. Além de exercer influência na prestação de serviços de saúde, possui potencial de promover o adensamento do sistema nacional de inovação e de ampliar a competitividade da indústria como um todo, dado que articula tecnologias portadoras de futuro. Apesar do crescimento significativo dessa indústria no Brasil nos últimos anos, esses equipamentos e materiais têm apresentado um crescente déficit na balança comercial. Essa incompatibilidade entre as necessidades nacionais de saúde e a base produtiva e inovativa da indústria aponta fragilidades estruturais do subsistema. Utilizando o arcabouço da economia política, o objetivo do artigo foi discutir o desenvolvimento dessa indústria no Brasil e seus desafios.

The mechanics, electronics and materials subsystem, one of the subsystems of the health care productive complex, encompasses different activities, usually clustered in what is called the medical, hospital and dental equipment and materials industry. This is a strategic area for health care, since it represents a continuous source of changes in care practices, and influences the provision of health care services. It has, moreover, potential for promoting the progress of Brazil's system of innovation and for increasing the competitiveness of the industry as a whole, given that it articulates future technologies. Despite the significant growth of this industry in Brazil in recent years, such equipment and materials have been presenting a growing deficit in the balance of trade. This incompatibility between national health care needs and the productive and innovative basis of the industry points to structural fragilities in the system. Using the framework of political economy, the article aims to discuss the development of this industry in Brazil and its challenges.

OBJETIVO: El subsistema de base mecánica, electrónica y de materiales, uno de los subsistemas del complejo productivo de la salud, reúne diferentes actividades, usualmente agregadas en la designada industria de equipos y materiales médico-hospitalarios y odontológicos, un área estratégica para la salud por representar una fuente continua de cambios en las prácticas asistenciales. Además de ejercer influencia en la prestación de servicios de salud, posee potencial de promover la saturación del sistema nacional de innovación y de ampliar la competitividad de la industria como un todo, dado que articula tecnologías portadoras de futuro. A pesar del crecimiento significativo de esta industria en Brasil en los últimos años, los equipos y materiales han presentado un creciente déficit en la balanza comercial. Esta incompatibilidad entre las necesidades nacionales de salud y la base productiva e innovadora de la industria señalan fragilidades estructurales del subsistema. Utilizando el armazón de la economía política, el objetivo del artículo fue discutir el desarrollo de ésta industria en Brasil y sus desafíos.

Should dentists be concerned about the weight of their patients?

This opinion paper considers obesity and its relationship to dental practice. Twenty-three per cent of people in England are estimated to be obese, a figure that is predicted to continue rising. It follows that obese patients are frequently encountered in general dental practice. The authors review the links between obesity and dental health, the possible barriers and challenges to providing dental care for obese people, and how these may be overcome. They also report the findings of a London survey investigating the current provision of specialist dental services for obese patients who cannot be treated in a standard dental chair. Services across London were highly variable and in some areas no provision was identified. The implications of the rising prevalence of obesity for service planners and practitioners are also discussed.