RESUMEN
AIM: This systematic review aims to assess effectiveness of oral health policies, recommendations and guidelines in safeguarding oral health of children with special healthcare needs during COVID-19. BACKGROUND: This systematic review evaluated the adaptation of global oral health policies for children with special healthcare needs (SHCN) during the COVID-19 pandemic, to provide evidence-based insights to inform policymakers and healthcare providers amid the ongoing global health crisis. The study focused on assessing the effectiveness of these adaptations in ensuring equitable access to quality dental care for this vulnerable group. METHODS: A PRISMA guided online search through LILIACS, PubMed, Scopus, COCHRANE and grey literature was conducted. The search strategy incorporated a combination of subject headings (MeSH terms) and free-text terms related to "oral health," "dental health," "policy," "effectiveness," "dental practice guidelines," "oral health policies," and "special care needs children." Eligibility criteria included oral health policies, recommendations and guidelines targeting individuals/children with special care needs. Both qualitative and quantitative studies published in English from 2008 to 2023 were included. RESULTS: Sixteen guidelines, recommendations and policies, from six authorities were identified. These documentations addressed six different areas mentioned broadly as comprehensive care, ethical considerations, preventive and therapeutic measures, equity, patient-centric treatment, and reducing disparities signaling a paradigm shift. International collaborations and standardization of guidelines indicated a unified approach. The review also emphasized on a commitment to continuous improvement through quality measurement, systematic referral management, and needs assessment. With the exception of two documents, the remaining guidelines did not address COVID-19 or provide specific adaptations for it. The lack of emphasis on individual condition was notable, as the guidelines generally took a more generalized approach toward individuals with special healthcare needs. CONCLUSIONS: In conclusion, this review assessed the impact of COVID-19 on oral healthcare for individuals with special needs. It underscores global and local efforts for equitable access, patient-centric care, and preventive measures. The lessons learned advocate for a resilient, inclusive healthcare framework capable of meeting diverse needs. PROSPERO REGISTRATION: CRD 42023452475.
Asunto(s)
COVID-19 , Política de Salud , Salud Bucal , SARS-CoV-2 , Humanos , COVID-19/prevención & control , Niño , Salud Bucal/normas , Salud Global , Atención Dental para Niños/normas , Atención Dental para Niños/organización & administración , Pandemias/prevención & control , Guías de Práctica Clínica como Asunto , Accesibilidad a los Servicios de Salud , Atención Dental para la Persona con Discapacidad/normas , Niños con DiscapacidadAsunto(s)
Atención Dental para Niños/normas , Atención Dental para la Persona con Discapacidad/normas , Adolescente , Citas y Horarios , Niño , Preescolar , Atención Odontológica Integral/normas , Atención Dental para Enfermos Crónicos/normas , Diagnóstico Bucal/normas , Humanos , Lactante , Derivación y ConsultaRESUMEN
This article proposes a model for quality evaluation of oral health care in children. The conceptual framework for the evaluation matrix consisted of evaluation studies on oral health care services in Brazil and other countries and a survey and review of prevailing public policies for children's health in Brazil. Two dimensions, Management and Provision, were evaluated in the quality of municipal management of pediatric oral health care. Management included two component dimensions, articulation and resources, while Provision included two more, "promotion and prevention" and "diagnosis and treatment". The evaluation matrix consisted of nine indicators in the Management dimension and nine in the Provision dimension. The indicators were elaborated in workshops with specialists. The model proved appropriate for application in municipalities with different population sizes and allows identifying the areas where managers should improve their actions.
Asunto(s)
Atención Dental para Niños/normas , Salud Bucal/normas , Atención Primaria de Salud/normas , Evaluación de Programas y Proyectos de Salud/métodos , Brasil , Niño , Servicios de Salud del Niño , Atención Dental para Niños/estadística & datos numéricos , Humanos , Programas Nacionales de Salud , Atención Primaria de Salud/estadística & datos numéricos , Garantía de la Calidad de Atención de Salud/métodos , Indicadores de Calidad de la Atención de SaludRESUMEN
O objetivo deste estudo foi propor um modelo para a avaliação da qualidade da atenção à saúde bucal da criança. O marco conceitual para a elaboração da matriz avaliativa foi composto por estudos de avaliação de serviços de atenção à saúde bucal no Brasil e em outros países, e levantamento e revisão das políticas públicas vigentes relacionadas à saúde da criança no Brasil. A qualidade da gestão municipal na atenção básica da saúde bucal infantil foi avaliada sob duas dimensões: Gestão e Provimento. Na primeira, foram dispostas duas subdimensões: articulação e recursos, e na segunda, mais duas subdimensões: promoção e prevenção, e diagnóstico e tratamento. A matriz de avaliação ficou composta por nove indicadores na dimensão de Gestão e nove na dimensão de Provimento. Os indicadores foram elaborados em oficinas com especialistas. O modelo tem condições de ser aplicado em municípios com diferentes portes populacionais, e permite identificar os pontos nos quais os gestores devem aperfeiçoar suas ações.
This article proposes a model for quality evaluation of oral health care in children. The conceptual framework for the evaluation matrix consisted of evaluation studies on oral health care services in Brazil and other countries and a survey and review of prevailing public policies for children's health in Brazil. Two dimensions, Management and Provision, were evaluated in the quality of municipal management of pediatric oral health care. Management included two component dimensions, articulation and resources, while Provision included two more, "promotion and prevention" and "diagnosis and treatment". The evaluation matrix consisted of nine indicators in the Management dimension and nine in the Provision dimension. The indicators were elaborated in workshops with specialists. The model proved appropriate for application in municipalities with different population sizes and allows identifying the areas where managers should improve their actions.
El objetivo fue proponer un modelo para la evaluación de la calidad de la atención a la salud oral de los niños. El marco conceptual para la preparación de la matriz de evaluación estuvo integrado por los estudios de evaluación de la atención a los servicios de salud bucal en Brasil y otros países, y la encuesta y la revisión de las políticas públicas actuales relacionadas con la salud infantil en Brasil. La calidad de la gestión municipal en la atención primaria de la salud oral de los niños se evaluó en dos dimensiones: Gestión y Disposición. En la primera, se disponen dos subdimensiones: coordinación y recursos, y la segunda tiene dos sub-dimensiones más: promoción y prevención, y diagnóstico y tratamiento. La matriz de evaluación se compone de nueve indicadores del tamaño de Gestión y nueve en el tamaño de la Disposición. Los indicadores fueron desarrollados en los talleres con expertos. El modelo es capaz de ser aplicado a los municipios con diferentes tamaños de población, e identifica los puntos en los que los gerentes deben mejorar.
Asunto(s)
Niño , Humanos , Atención Dental para Niños/normas , Salud Bucal/normas , Atención Primaria de Salud/normas , Evaluación de Programas y Proyectos de Salud/métodos , Brasil , Servicios de Salud del Niño , Atención Dental para Niños/estadística & datos numéricos , Programas Nacionales de Salud , Atención Primaria de Salud/estadística & datos numéricos , Garantía de la Calidad de Atención de Salud/métodos , Indicadores de Calidad de la Atención de SaludAsunto(s)
Anestesia Dental/normas , Atención Dental para Niños/normas , Adolescente , Anestesia Local , Niño , Preescolar , Humanos , LactanteAsunto(s)
Humanos , Adolescente , Niño , Anestesia Dental/métodos , Anestesia Local/normas , Atención Dental para Niños/normas , Administración Tópica , Anestésicos Locales/farmacología , Bloqueo Nervioso/métodos , Hipersensibilidad a las Drogas/prevención & control , Sociedades Odontológicas/normas , Vasoconstrictores/farmacologíaAsunto(s)
Humanos , Adolescente , Niño , Anestesia Dental/métodos , Anestesia Local/normas , Atención Dental para Niños/normas , Vasoconstrictores/farmacología , Anestésicos Locales/farmacología , Sociedades Odontológicas/normas , Administración Tópica , Bloqueo Nervioso/métodos , Hipersensibilidad a las Drogas/prevención & controlRESUMEN
This commentary focuses on the condition of dental neglect (DN) in children in the UK. It is divided into three sections: the first section defines DN in children and its consequences, the second section discusses who may be responsible for dental diseases in children as a result of neglect and the third section proposes a holistic approach to address DN in children in the UK.
Asunto(s)
Atención Dental para Niños/normas , Accesibilidad a los Servicios de Salud/normas , Odontología Preventiva/normas , Salud Pública/normas , Adolescente , Niño , Maltrato a los Niños/diagnóstico , Maltrato a los Niños/prevención & control , Preescolar , Atención Dental para Niños/organización & administración , Femenino , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Lactante , Masculino , Odontología Preventiva/organización & administración , Reino UnidoRESUMEN
PURPOSE: The purpose of this study was to survey the alternative behavior management techniques that might be utilized by pediatric dentists in place of hand over mouth exercise (HOME) after its elimination from the clinical guidelines of the American Academy of Pediatric Dentistry (AAPD). METHODS: A questionnaire was electronically mailed to 2,600 AAPD members. The survey included items related to HOME alternatives after the elimination, concerns with its use, and if the elimination had affected access to care for children. RESULTS: Seven hundred four respondents (30%) completed the survey. Voice control was the first alternative, and minimum/moderate sedation was the second most common. Three hundred fifty respondents (50%) believed that HOME is an acceptable behavior management technique, and 290 (41%) believed it should be continued to be recognized by the AAPD. Only 7% believed that HOME elimination affected access to care for some children. CONCLUSION: Advanced behavior management techniques will be utilized more by pediatric dentists after the elimination of the hand over mouth exercise from the American Academy of Pediatric Dentistry's clinical guidelines.
Asunto(s)
Control de la Conducta/métodos , Ansiedad al Tratamiento Odontológico/terapia , Atención Dental para Niños/métodos , Odontología Pediátrica/métodos , Restricción Física/métodos , Control de la Conducta/psicología , Preescolar , Atención Dental para Niños/psicología , Atención Dental para Niños/normas , Humanos , Histeria/terapia , Restricción Física/psicología , Sociedades OdontológicasRESUMEN
This research considers whether fear of dental treatment among children is linked with a prior (negative) experience with local anaesthesia or with psychological functioning. Furthermore, the study investigated whether these factors play a role in anxious behaviour before and during a local anaesthetic injection. In this study 128 children between the ages of 4 and 11 took part. With the help of video recordings, the anxious behaviour before and during the local anaesthetic injection was scored using the Venham-scale. During the treatment one of the child's parents or guardians was asked if the child had previously been given a local anaesthetic injection (experience). The fear of dental treatment and the child's psychological functioning were measured using the parents' version of the 'Dental Subscale' of the 'Children's Fear Survey Schedule' and the 'Strengths and Difficulties Questionnaire' respectively. Results showed a correlation between on one hand fear of dental treatment and on the other hand anxious behaviour before and during a local anaesthetic injection and psychological functioning. Furthermore, results indicated that children with fear of dental treatment exhibited more fearful behaviour before and during an injection with local anaesthetic. Only in the case of children whose psychological functioning was reduced there was a significant relationship between experience with local anaesthesia and fearful behaviour prior to the injection of a local anaesthetic.
Asunto(s)
Anestesia Dental/psicología , Anestesia Local/psicología , Ansiedad al Tratamiento Odontológico/psicología , Atención Dental para Niños/psicología , Atención Dental para Niños/normas , Inyecciones/psicología , Síntomas Afectivos/psicología , Niño , Conducta Infantil , Preescolar , Femenino , Humanos , Masculino , Psicología Infantil , Grabación en VideoAsunto(s)
Atención a la Salud/normas , Reembolso de Seguro de Salud/normas , Seguro de Salud/normas , Odontología Pediátrica/normas , Atención Primaria de Salud/normas , Adolescente , Niño , Preescolar , Atención Odontológica Integral/economía , Atención Odontológica Integral/normas , Atención a la Salud/economía , Atención Dental para Niños/economía , Atención Dental para Niños/normas , Atención Dental para la Persona con Discapacidad/economía , Atención Dental para la Persona con Discapacidad/normas , Economía en Odontología/normas , Personal de Salud , Política de Salud , Humanos , Lactante , Beneficios del Seguro/economía , Beneficios del Seguro/normas , Seguro Odontológico/economía , Seguro Odontológico/normas , Seguro de Salud/economía , Reembolso de Seguro de Salud/economía , Salud Bucal/normas , Odontología Pediátrica/economía , Odontología Preventiva/economía , Odontología Preventiva/normas , Atención Primaria de Salud/economía , Sociedades Odontológicas/normas , Estados UnidosAsunto(s)
Cariostáticos/administración & dosificación , Atención Odontológica Integral/normas , Atención Dental para Niños/normas , Fluoruros/administración & dosificación , Odontología Pediátrica/normas , Adolescente , Niño , Preescolar , Atención Dental para la Persona con Discapacidad/normas , Caries Dental/prevención & control , Esquema de Medicación , Política de Salud , Humanos , Lactante , Salud Bucal/normas , Sociedades Odontológicas/normas , Estados UnidosAsunto(s)
Anestesia Dental/métodos , Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Atención Dental para Niños/métodos , Odontología Pediátrica/métodos , Adolescente , Anestesia Dental/clasificación , Anestesia Dental/normas , Anestesia Local/normas , Anestésicos Locales/clasificación , Niño , Preescolar , Atención Dental para Niños/normas , Atención Dental para la Persona con Discapacidad/métodos , Atención Dental para la Persona con Discapacidad/normas , Política de Salud , Humanos , Lactante , Salud Bucal/normas , Aceptación de la Atención de Salud , Odontología Pediátrica/normas , Sociedades Odontológicas/normas , Estados UnidosRESUMEN
AIM: To draw up a program for coordination of dental care for children with special needs between the Course at the Universidad Complutense de Madrid (UCMC) (Specialisation in holistic dental care for children with special needs), and the Disabled Children's Oral Health Unit (DCOHU) within the Madrid Health Service (SERMAS). MATERIAL AND METHODS: UCMC Protocol for children with special needs. Design of a clinical pathway based on consensus amongst the professionals involved. RESULTS: Algorithm for dental care for children with special needs. Matrix covering all activities and timing for full dental diagnosis in such patients (general health, oral health and behaviour) to facilitate proper referral of patients requiring general anaesthesia. Inclusion in the matrix of those responsible for each activity. CONCLUSIONS: Improved team work (University - primary health care) in patient evaluation, in provision of information to parents and guardians and in health care quality. From the teaching point of view, students learn to adopt a systematic approach in the decision-making process.