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1.
Gerodontology ; 40(2): 231-237, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35833357

RESUMEN

INTRODUCTION: People with impaired mobility face difficulty accessing dental care. One solution is portable dentistry, which includes delivering dental care in homes or residential institutions. Dentists, however, appear reluctant to offer such services. Our objective was to understand how dentists perceived portable dentistry and potential challenges to its implementation. METHODS: We conducted a qualitative descriptive study based on semi-structured interviews with a sample of dentists in Quebec, Canada. We employed a combination of maximum variation and snowball sampling strategies to recruit 14 participants. The interviews were conducted and audio-recorded through Zoom and lasted approximately 40 minutes. After transcribing them, we performed a thematic analysis with a combination of inductive and deductive coding. RESULTS: Despite perceiving portable dentistry as a valuable practice model, participants showed little interest in adopting this approach, arguing it was not every dentist's "job" to provide portable services. They believed portable dentistry must be financially burdensome and difficult to integrate into their daily work due to lack of time and portable equipment. Accordingly, participants considered it was the duty of governments, professional organisations overseeing dentistry education and practice, and dental schools to develop portable dentistry programs and hire dentists to deliver such services. CONCLUSIONS: To promote portable dentistry, it may be necessary to improve the knowledge and competencies of dentists, but also to challenge their professional identity as well as the current model of dental clinics as the standard of care delivery. To achieve this, we need strong leadership from dental schools, professional organisations and government.


Asunto(s)
Atención a la Salud , Odontólogos , Humanos , Quebec , Investigación Cualitativa , Odontología , Actitud del Personal de Salud
2.
Sante Publique ; 35(HS1): 163-171, 2023 12 01.
Artículo en Francés | MEDLINE | ID: mdl-38040640

RESUMEN

It is time to consider the protection of our environment as a major public health issue in oral medicine. Evidence shows that activities related to dental practice, such as patient transportation, use of rare materials and chemicals, or energy consumption, affect our ecosystems and contribute to the global degradation we are increasingly observing. The degradation of our environment is considered the greatest threat to our health. Exposure of oral tissues to multiple environmental factors can lead to pathological conditions. In addition to these direct effects, there are more complex phenomena, leading to co-deficits in the health of populations. The example of the sugar industry illustrates the systemic failures resulting in the double degradation of the environment and the health of individuals. Face with these dynamically interacting phenomena, human communities must consider systemic responses such as those described in this article. The dental community will need to do its part and consider global oral health as a central issue. This conceptual work will help define the innovations and action needed to ensure equitable practice that respects planetary limits.


Il est temps de considérer la protection de notre environnement comme un enjeu majeur de santé publique en médecine bucco-dentaire. Des données probantes montrent en effet que les activités liées à la pratique dentaire, comme le transport de patients, l'utilisation de matériaux rares, de produits chimiques, ou la consommation énergétique, affectent nos écosystèmes et contribuent aux dégradations planétaires que nous observons de plus en plus. Par rétroaction, la dégradation de notre environnement est considérée comme la plus grande menace pour notre santé. L'exposition des tissus de la sphère orale à de multiples facteurs environnementaux peut en effet conduire à des états pathologiques. À ces effets directs s'ajoutent des phénomènes plus complexes, induisant des co-déficits sur la santé des populations. L'exemple de l'industrie du sucre illustre les défaillances systémiques menant à la double dégradation de l'environnement et de la santé des individus. À ces phénomènes en interaction dynamique, les communautés humaines doivent envisager des réponses systémiques comme celles que nous décrivons dans cet article. La communauté dentaire devra faire sa juste part et considérer la santé orale planétaire comme un enjeu central. Ce travail conceptuel permettra de définir les innovations nécessaires et les actions adaptées pour garantir une pratique équitable et respectueuse des limites planétaires.


Asunto(s)
Ecosistema , Salud Bucal , Humanos , Salud Pública , Salud Global
3.
J Can Dent Assoc ; 87: l5, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-34343068

RESUMEN

BACKGROUND: This study aimed to describe dental care provision and the perceptions of dentists in Nova Scotia, Canada, during 1 week of the COVID-19 pandemic, shortly after the closing down of non-emergency, in-person care. METHODS: A survey was distributed to all 542 registered dentists in Nova Scotia, asking about dental care provision during 19-25 April 2020. Most answers were categorical, and descriptive analyses of these were performed. Data from the 1 open-ended question were analyzed using an inductive approach to identify themes. RESULTS: The response rate was 43% (n = 235). Most dentists (181) provided care but only 13 provided in-person care. From the open-ended question, 4 concerns emerged: communication from the regulatory authority; respondents' health and that of their staff; the health of and access to care for patients; and the future of their business. CONCLUSION: Most respondents remained engaged in non-in-person dental care using various modes. They expressed concerns about their health and that of their staff and patients as well as about the future of their practice. PRACTICAL IMPLICATIONS: Dentists and dental regulatory authorities should engage in discussions to promote the health of dental staff and patients and quality of care during the chronic phase of the pandemic.


Asunto(s)
COVID-19 , Pandemias , Actitud del Personal de Salud , Atención Odontológica , Odontólogos , Humanos , Nueva Escocia/epidemiología , Pautas de la Práctica en Odontología , SARS-CoV-2 , Encuestas y Cuestionarios
4.
Gerodontology ; 38(3): 276-288, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33484003

RESUMEN

BACKGROUND: Delivering dental care to patients in their home or residential institutions is known as "portable dentistry". The demand for portable dental services is on the rise, but dentists remain reluctant to adopt portable practices. OBJECTIVES: To explore the literature on portable dental services and understand (a) the process of planning and delivering portable dental services and (b) the benefits and challenges of portable dentistry for service providers and patients. METHODS: A systematic scoping search was conducted. We retrieved 3994 documents, 28 of which were included in the final synthesis. Three authors read the papers and conducted thematic content analyses independently. RESULTS: We present a synthesis of the literature and proposed a model of portable dentistry containing three levels with the patient is at the centre surrounded by concentric rings representing the dentist (dental team) and society. At each of these levels, our model is further subdivided into three components: 1) organisation of the service; 2) arrival and set-up of the service; and 3) delivery of the service. In addition, each level includes 1) human factors, which are related either to the dental professional or the patient; 2) non-human factors, which refer to either the equipment or the physical environment; and 3) financial factors, which are related to cost and remuneration. CONCLUSIONS: We propose a model for portable dentistry that dentists and dental educators interested in this practice should find useful.


Asunto(s)
Atención Odontológica , Odontólogos , Humanos
5.
Am J Public Health ; 105(11): 2312-7, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26378836

RESUMEN

OBJECTIVES: We investigated the perspectives of people using a wheelchair and their difficulties in accessing dental services. METHODS: Our participatory research was on the basis of a partnership between people using a wheelchair, dental professionals, and academic researchers. Partners were involved in a committee that provided advice at all stages of the project. Our team adopted a qualitative descriptive design. Between October 2011 and October 2012 we conducted semistructured individual interviews with 13 adults who lived in Montreal, Québec, Canada, and used a wheelchair full time. We audio-recorded and transcribed verbatim interviews, and we interpreted data using an inductive thematic analysis. RESULTS: Oral health is of heightened importance to this group of people, who tend to use their mouth as a "third hand." We identified successive challenges in accessing dental services: finding a dentist and being accepted, organizing transportation, entering the building and circulating inside, interacting with the dental staff, transferring and overcoming discomfort on the dental chair, and paying for the treatments. CONCLUSIONS: Governments, dental professional bodies, dental schools, and researchers should work with groups representing wheelchair users to improve access to dental services.


Asunto(s)
Atención Odontológica/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Salud Bucal , Silla de Ruedas , Adolescente , Adulto , Anciano , Accesibilidad Arquitectónica/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Quebec , Transportes , Adulto Joven
6.
Int J Equity Health ; 14: 41, 2015 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-25926031

RESUMEN

BACKGROUND: Front line providers of care are frequently lacking in knowledge on and sensitivity to social and structural determinants of underprivileged patients' health. Developing and evaluating approaches to raising health professional awareness and capacity to respond to social determinants is a crucial step in addressing this issue. McGill University, in partnership with Université de Montréal, Québec dental regulatory authorities, and the Québec anti-poverty coalition, co-developed a continuing education (CE) intervention that aims to transfer knowledge and improve the practices of oral health professionals with people living on welfare. Through the use of original educational tools integrating patient narratives and a short film, the onsite course aims to elicit affective learning and critical reflection on practices, as well as provide staff coaching. METHODS: A qualitative case study was conducted, in Montreal Canada, among members of a dental team who participated in this innovative CE course over a period of four months. Data collection consisted in a series of semi-structured individual interviews conducted with 15 members of the dental team throughout the training, digitally recorded group discussions linked to the CE activities, clinic administrative documents and researcher-trainer field notes and journal. In line with adult transformative learning theory, interpretive analysis aimed to reveal learning processes, perceived outcomes and collective perspectives that constrain individual and organizational change. RESULTS: The findings presented in this article consist in four interactive themes, reflective of clinic culture and context, that act as barriers to humanizing patient care: 1) belief in the "ineluctable" commoditization of dentistry; 2) "equal treatment", a belief constraining concern for equity and the recognition of discriminatory practices; 3) a predominantly biomedical orientation to care; and 4) stereotypical categorization of publically insured patients into "deserving" vs. "non-deserving" poor. We discuss implications for oral health policy, orientations for dental education, as well as the role dental regulatory authorities should play in addressing discrimination and prejudice. CONCLUSION: Humanizing care and developing oral health practitioners' capacity to respond to social determinants of health, are challenged by significant ideological roadblocks. These require multi-level and multi-sectorial action if gains in social equity in oral health are to be made.


Asunto(s)
Actitud del Personal de Salud , Educación Continua en Odontología , Personeidad , Pobreza , Determinantes Sociales de la Salud , Humanos , Entrevistas como Asunto , Investigación Cualitativa , Quebec
7.
J Can Dent Assoc ; 81: f23, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26679337

RESUMEN

INTRODUCTION: The chronic shortage of dentists in rural communities may affect the quality of care provided to these communities. The aim of this study was to explore the knowledge and perspectives of Quebec's future dentists regarding rural dental practice and their career intentions. METHODS: We conducted a qualitative study at 2 major dental faculties using the interpretive description method. Purposeful maximum variation sampling and snowball techniques were used to recruit 4th-year dental students and specialty residents as study participants. Face-to-face, semi-structured, 60-90-minute interviews were conducted and audio-recorded. Qualitative data were analyzed using a thematic approach including interview debriefing, transcript coding, data display and interpretation. RESULTS: Of the 17 interviews, 10 were with women and 7 with men; the age range of participants was 22-39 years. Five major themes emerged from the interviews: awareness of access to oral health care in rural areas, image of rurality, image of rural dental practice, perceived barriers to and perceived enablers of rural dental practice. Students said that undergraduate dental education, financial rewards, professionalism, professional support and social media may positively affect their perspective on rural dental practice. CONCLUSIONS: There is a need to implement and support strategies known to increase dental students' knowledge of rural practice and their motivation to choose rural practice. Dental educators have an essential role to play in shaping professional character and encouraging apprenticeship to meet these goals.


Asunto(s)
Selección de Profesión , Servicios de Salud Rural/organización & administración , Estudiantes de Odontología/psicología , Adulto , Femenino , Humanos , Entrevistas como Asunto , Masculino , Investigación Cualitativa , Quebec
8.
BMC Health Serv Res ; 14: 472, 2014 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-25301021

RESUMEN

BACKGROUND: Dentists report facing difficulties and experiencing frustrations with people on social assistance, one of the social groups with the most dental needs. Scientists ignore how they deal with these difficulties and whether they are able to overcome them. Our objective was to understand how dentists deal with critical issues encountered with people on social assistance. METHODS: We conducted in-depth, semi-structured interviews with 33 dentists practicing in Montreal, Canada. The interview guides included questions on dentists' experiences with people on social assistance and potential strategies developed for this group of people. Analyses consisted of interview debriefing, transcript coding, and data interpretation. RESULTS: Dentists described strategies to resolve three critical issues: missed appointments (organisational issue); difficulty in performing non-covered treatments (biomedical issue); and low government fees (financial issue). With respect to missed appointments, dentists developed strategies to maximise attendance, such as motivating their patients, and to minimise the impact of non-attendance, like booking two people at the same time. With respect to biomedical and financial issues, dentists did not find any satisfactory solutions and considered that it was the government's duty to resolve them. Overall, dentists seem reluctant to exclude people on social assistance but develop solutions that may discriminate against them. CONCLUSIONS: The efforts and failures experienced by dentists with people on social assistance should encourage us to rethink how dental services are provided and financed.


Asunto(s)
Actitud del Personal de Salud , Relaciones Dentista-Paciente , Odontólogos , Economía en Odontología , Asistencia Médica , Adulto , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Quebec , Adulto Joven
9.
Trials ; 25(1): 267, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38627819

RESUMEN

BACKGROUND: Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies enhance oral healthcare access by the elderly. Despite promising in vitro reports on digital denture materials, evidence from randomized clinical trials (RCTs) is lacking to verify their performance. This cross-over RCT will investigate whether 3D-printed implant-retained mandibular overdentures (IMO) are more satisfactory for edentulous seniors than those made through traditional methods. METHODS/DESIGN: We will recruit 26 completely edentulous participants (any sex/gender) based on the following eligibility criteria: age ≥ 60 years, no tooth extraction in the past 12 months, two implants in the lower jaw, and need for new dentures in both jaws. Each participant will receive two denture pairs, either manufactured by 3D printing or traditionally, to be worn in a random order. A timeline of 3 months with each denture pair will be considered for outcome assessment (total: 6 months). Patient satisfaction with dentures will be measured by the McGill Denture Satisfaction Questionnaire. We will evaluate other patient-reported outcomes (including oral health-related quality of life) as well as clinician-assessed quality and cost. At the end of the trial, participants will choose which denture pair they wish to keep and interviewed about their experiences with the 3D-printed IMO. The quantitative and qualitative data will be incorporated through an explanatory mixed-methods strategy. A final quantitative assessment will happen after 12 months with the preferred IMO to assess the long-term performance and maintenance needs. DISCUSSION: This mixed-methods RCT will explore patient experiences with 3D-printed IMOs, aiming to assess the potential for altering clinical practice and dental public health policies. Our results will inform policies by showing whether 3D printing offers comparable outcomes at lower costs, facilitating greater access to oral care for the elderly. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06155630, Registered on 04 December 2023. https://classic. CLINICALTRIALS: gov/ct2/show/NCT06155630.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Humanos , Anciano , Persona de Mediana Edad , Prótesis de Recubrimiento , Flujo de Trabajo , Mandíbula/cirugía , Satisfacción del Paciente , Impresión Tridimensional , Prótesis Dental de Soporte Implantado , Ensayos Clínicos Controlados Aleatorios como Asunto
10.
BMC Health Serv Res ; 13: 464, 2013 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-24192504

RESUMEN

BACKGROUND: In Canada, the prevalence of oral diseases is very high among people on social assistance. Despite great need for dental treatment, many are reluctant to consult dental professionals, arguing that dentists do not welcome or value poor patients. The objective of this research was thus to better understand how dentists perceived and experienced treating people on social assistance. METHODS: This descriptive qualitative research was based on in-depth semi-structured interviews with 33 dentists practicing in Montreal, Canada. Generally organized in dentists' offices, the interviews lasted 60 to 120 minutes; they were digitally recorded and later transcribed verbatim. The interview transcripts were coded with NVivo software, and data was displayed in analytic matrices. Three members of the research team interpreted the data displayed and wrote the results of this study. RESULTS: Dentists express high levels of frustration with people on social assistance as a consequence of negative experiences that fall into 3 categories: 1) Organizational issues (people on social assistance ostensibly make the organization of appointments and scheduling difficult); 2) Biomedical issues (dentists feel unable to provide them with adequate treatment and fail to improve their oral health); 3) Financial issues (they are not lucrative patients). To explain their stance, dentists blame people on social assistance for neglecting themselves, and the health care system for not providing adequate coverage and fees. Despite dentists' willingness to treat all members of society, an accumulation of frustration leads to feelings of powerlessness and discouragement. CONCLUSIONS: The current situation is unacceptable; we urge public health planners and governmental health agencies to ally themselves with the dental profession in order to implement concrete solutions.


Asunto(s)
Actitud del Personal de Salud , Odontólogos/psicología , Asistencia Pública , Adulto , Anciano , Citas y Horarios , Femenino , Administración Financiera , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Salud Bucal , Pobreza/psicología , Investigación Cualitativa , Quebec
11.
Sante Publique ; 25(3): 281-92, 2013.
Artículo en Francés | MEDLINE | ID: mdl-24007904

RESUMEN

INTRODUCTION: The main objective of the MaterniDent study was to determine the nature and frequency of dental problems experienced by pregnant women and their associated factors. The secondary objective was to determine the frequency of dental visits during pregnancy and to identify associated factors. METHODS: The MaterniDent study was a multicenter cross-sectional study conducted among 904 postpartum women in three French maternity wards. Data were collected using self-administered questionnaires. Measured variables included socio-demographic, health and behavioral characteristics. RESULTS: 57% of women reported having experienced at least one dental problem during pregnancy, while 20% had experienced dental pain during pregnancy. Multiparity, vomiting, soda consumption and increased sugar consumption during pregnancy were significantly associated with dental pain (p<0.05). 56% of women did not visit a dentist during pregnancy, 26% consulted a dentist for a perceived problem, and 18% visited a dentist for a check-up. Younger pregnant women and those without supplemental insurance were less likely to see a dentist for a preventive dental visit (p <0.05). DISCUSSION: A significant proportion of women experienced a dental problem during pregnancy, although they did not necessarily consult a dentist to treat the problem. Given the impact of oral diseases for both mother and child, prevention and professional dental care during pregnancy should be promoted.


Asunto(s)
Atención Odontológica/estadística & datos numéricos , Salud Bucal , Complicaciones del Embarazo/epidemiología , Adolescente , Adulto , Estudios Transversales , Femenino , Francia/epidemiología , Gingivitis/epidemiología , Humanos , Dolor/epidemiología , Embarazo , Encuestas y Cuestionarios , Enfermedades Dentales/epidemiología , Adulto Joven
12.
Disabil Rehabil ; : 1-10, 2023 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-37403705

RESUMEN

PURPOSE: Because people living with environmental sensitivities are poorly acknowledged in our society, we still know very little about their experiences navigating in the health care system, especially with respect to dental services. Our objective, therefore, was to describe their dental care pathway and better understand their experiences accessing oral health services. MATERIALS AND METHODS: A qualitative descriptive study was conducted in partnership with organizations supporting people with environmental sensitivities. Through a criterion sampling technique, 12 people living with environmental sensitivities in Quebec (Canada) were invited to participate in individual semi-structured interviews. These interviews lasted around 90 min and were transcribed to be thematically analysed. RESULTS: Participants faced major barriers accessing dental services and thus lived for long periods of time with unmet dental needs. Their dental care pathways were often delayed or even interrupted for several reasons. First because they were exposed to pollutants upon leaving their house, which rendered their trip to the dentist perilous. Second because dentists lacked knowledge about environmental sensitivities and seemed reluctant to accommodate them. CONCLUSIONS: We invite governments, dental professionals, and researchers to develop policies and clinical approaches for improving people living with environmental sensitivities' quality of life and access to dental services.IMPLICATIONS FOR REHABILITATIONAlthough environmental sensitivities are recognized as disability in several countries such as Sweden and Germany, people with these conditions face major barriers to access healthcare services.Dental professionals, for instance, are reluctant to acknowledge environmental sensitivities as a disability and seldom accommodate sufferers' special needs.We invite dentists to foster holistic and person-centered approaches and be receptive to the health conditions and needs of people with environmental sensitivities.Dentists could address oral health needs of people with environmental sensitivities by doing home-visits with portable dental equipment as this removes barriers related to their exposure to pollutants.

13.
Community Dent Oral Epidemiol ; 51(1): 71-74, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36749665

RESUMEN

Wicked problems exist in the realm of oral health research. Due to their inherent complexity, using qualitative or quantitative methods alone may not be adequate for resolving them. Mixed methods approaches combine qualitative and quantitative methods, and thus, can provide a powerful tool for understanding and solving complex problems in dental public health. However, using mixed methods does not come without its challenges. This commentary outlines four main tips for researchers to consider when applying mixed methods to their research projects.


Asunto(s)
Salud Bucal , Proyectos de Investigación , Humanos , Investigación Cualitativa
14.
Pediatr Dent ; 44(3): 192-197, 2022 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-35799335

RESUMEN

Purpose: Desensitization is a behavior guidance technique that has been used to help improve behavior and capacity to receive dental care in patients with autism spectrum disorder (ASD). The purpose of this study was to elicit parents' perspectives regarding the effectiveness, benefits, and barriers associated with desensitization. Methods: A qualitative descriptive approach was used. Participants included parents of children with ASD who received regular dental care in a pediatric hospital. Data were collected through individual in-depth semi-structured interviews. All interviews were audio-recorded to be transcribed verbatim and analyzed using a thematic approach. Results: Thirteen parents were interviewed. The findings indicate that desensitization improved children's dental care experience, as the repetition of appointments allowed them to develop familiarity in the clinical setting, reduced their stress and anxiety, and consequently treatment acceptance. However, parents described certain barriers to desensitization, including the organization and burden of frequent appointments and structural and financial issues, as the cost associated with desensitization visits was not covered by Medicare/Medicaid. Conclusion: Desensitization is seen by parents as an important avenue for improving dental encounters for children with autism spectrum disorder.


Asunto(s)
Trastorno del Espectro Autista , Anciano , Ansiedad , Trastorno del Espectro Autista/complicaciones , Trastorno del Espectro Autista/terapia , Niño , Hospitales Pediátricos , Humanos , Medicare , Padres , Estados Unidos
15.
Int Dent J ; 72(4): 529-535, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34656309

RESUMEN

BACKGROUND: Dental leadership in different models of care is not well documented, and therefore the objectives of this study were to explore how dental leaders develop their own leadership and how they engage others to increase access to oral health services as well as to describe perceived challenges in developing coalitions for promoting oral health care. METHODS: We adopted a qualitative descriptive research methodology. We recruited dental leaders using a purposeful sampling approach and a snowball technique. Data were collected using a remote digital platform; we organised semi-structured interviews based on the LEADS conceptual framework. Saturation was reached after 11 interviews. Data analysis included the following iterative steps: decontextualisation, recontextualisation, categorisation, and data compilation. The analysis was performed manually, assisted by the use of QDA Miner software. RESULTS: Fourteen dental leaders participated in the study. Our analysis revealed 3 overarching themes: (I) lead self, with 3 subthemes: leadership insights; leadership traits; opportunity-role model dyad; (II) leadership strategies; and (III) challenges in leadership development, with 3 subthemes: limited engaged practice and workforce, valorise the image of dentistry, and lack of leadership training. CONCLUSIONS: Our research findings showed that, despite a limited scope of leadership in dentistry, the dental leaders recognise its importance and acknowledge the need for formal training and mentorship at different levels. This study identified challenges in dental leadership development that could further orient dental education programmes and support the implementation of evidence-based, high-quality, and efficient oral health services.


Asunto(s)
Liderazgo , Salud Bucal , Odontología , Humanos , Recursos Humanos
16.
J Can Dent Assoc ; 77: b131, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22014877

RESUMEN

OBJECTIVE: To better understand the dental health care pathways of Montreal-based Chinese immigrants. METHODS: An ethnographic study based on 12 in-depth semi-structured qualitative interviews was conducted among low-income Chinese immigrants in Montreal, Canada, from January to June 2005. Data about their dental health care-seeking pathways, barriers to the use of professional dental health care services and attitudes to dental health care were collected and coded, and resulting themes analyzed. RESULTS: Dental health care pathways include self-treatment and consulting a dentist in Canada or during a return visit to China. The pathways vary, depending on the circumstances. For dental caries and other acute dental diseases such as toothache, Chinese immigrants preferred to consult a dentist. For chronic diseases, some of them relied on self-treatment. Financial problems, and language and cultural barriers were the main factors that affected Chinese immigrants' access to dental care services in Canada. CONCLUSION: Understanding immigrants' dental health care pathways can help dental health care providers supply culturally competent services and help policy makers devise preventive dental health care programs to suit community needs and cultural contexts.


Asunto(s)
Pueblo Asiatico/psicología , Actitud Frente a la Salud , Atención Odontológica/psicología , Emigrantes e Inmigrantes/psicología , Accesibilidad a los Servicios de Salud , Adulto , Anciano , China/etnología , Cultura , Caries Dental/diagnóstico , Autoevaluación Diagnóstica , Escolaridad , Empleo , Femenino , Financiación Personal , Humanos , Seguro Odontológico , Entrevistas como Asunto , Lenguaje , Masculino , Estado Civil , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Pobreza/psicología , Quebec , Autocuidado , Odontalgia/diagnóstico , Adulto Joven
17.
Gerodontology ; 28(1): 62-8, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20545777

RESUMEN

OBJECTIVE: The aim of this study was to gain greater in-depth understanding of why elderly patients who are currently dissatisfied with conventional dentures decline implant treatment. BACKGROUND: There is strong evidence from high-quality randomised controlled trials to support the use of implant-supported overdentures for the restoration of the edentulous mandible. However, whilst recruiting for randomised clinical trials, researchers have found that a high proportion of potential subjects decline participation, despite the removal of financial constraints. MATERIALS AND METHODS: The study adopted a qualitative approach to provide a rich and deep understanding of people's reasons for refusal. Data were collected through focus group interviews in a two-centre study based in Montreal, Canada and Newcastle, UK. A semi-structured interview schedule was used and iteratively developed as analysis identified themes from previous focus groups. Transcripts of focus groups were coded and emergent themes determined. RESULTS: Two main themes emerged; patients' fear and anxiety (relating to the pain of surgery, complications of the procedure and immediate post-surgical denture use), and the appropriateness of the procedure in an elderly person. CONCLUSIONS: Fears of pain, complications and social embarrassment, exacerbated by age, are important factors that help explain refusal of implants by elderly patients.


Asunto(s)
Prótesis Dental de Soporte Implantado , Dentadura Completa Inferior , Prótesis de Recubrimiento , Negativa del Paciente al Tratamiento , Factores de Edad , Anciano , Anciano de 80 o más Años , Actitud Frente a la Salud , Ansiedad al Tratamiento Odontológico/psicología , Implantación Dental Endoósea/efectos adversos , Implantación Dental Endoósea/psicología , Miedo/psicología , Femenino , Grupos Focales , Humanos , Relaciones Interpersonales , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/psicología , Autoimagen
18.
Br Dent J ; 231(4): 249-253, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34446900

RESUMEN

There is a dearth of tools designed to inform people about what to expect from person-centred dental encounters and to guide them during the care process. This is why we propose the Montreal-Toulouse Wheel of patients' expectations for dental visits, which describes what people could expect during person-centred clinical encounters. The Wheel comprises four core expectations: 1) be understood; 2) be respected; 3) have power; and 4) be given enough time. It also includes three expectations that are more specific to the process of care: 5) be informed and understand; 6) share decisions with the dentist and even co-construct the treatment plan; and 7) be comfortable during clinical procedures and the whole care process. We also propose a Q-List to help patients reflect on their relationship with dental professionals and engage them in person-centred dental care. This Q-List describes the seven expectations of the Wheel and provides open-ended questions that we invite patients to reflect upon. We also hope that dental professionals and educators will find the Wheel and the Q-List useful to develop person-centredness and promote inclusive and equitable dentistry.


Asunto(s)
Motivación , Humanos
19.
Spec Care Dentist ; 41(3): 329-339, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33439491

RESUMEN

AIMS: We aimed to explore the scientific literature on accessible dental clinics for wheelchair users. More specifically, we sought out literature addressing how the human environment and physical space shape the dental services of accessible dental clinics. METHODS: We conducted a scoping review (May 2019) in Embase, PubMed, Web of Science, and the Avery index of architectural Periodicals (3994 articles). We followed Arksey and O'Malley's recommended procedures; after screening, we retained 17 articles. We performed a critical appraisal, followed by thematic content analyses of extracted data. RESULTS: The articles originated mainly from the United States and United Kingdom. Only three reported original research. We illustrated the results within a three-step dental care pathway cycle. In each step, the interaction between accessibility of the physical and human environments (ie, the layout/design of the clinic and the attitudes and skills of the dental professional, respectively) contributed to the overall accessibility. We also found that empirical evidence on clinics' accessibility was lacking: many articles resorted to broad "one size fits all" recommendations and fragmented information on accessibility. Finally, the voice of wheelchair users was missing. CONCLUSION: There are knowledge gaps in terms of dental clinics' accessibility. We thus invite researchers to conduct original studies with dental professionals, wheelchair users, and their caregivers.


Asunto(s)
Personas con Discapacidad , Silla de Ruedas , Clínicas Odontológicas , Humanos , Reino Unido
20.
Dent J (Basel) ; 8(3)2020 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-32756307

RESUMEN

Dentistry has seen a slow trend toward person-centred care (PCC), with most approaches developed by scholars who have tried to progress away from disease-centred care. Unfortunately, the perspectives and experiences of underprivileged people have not been considered in the development of these approaches. Our objective was thus to understand underprivileged people's experiences and expectations about dental care and contribute to the development of person-centred dentistry. We conducted a qualitative descriptive study with a sample of 13 people living in poverty. We used a maximum variation sampling strategy and selected them among the users of a free dental clinic in Montreal, Canada. We conducted semi-structured interviews that we audio recorded, transcribed verbatim, and thematically analysed. Our main finding is that participants wanted to feel human and respected by dentists. More specifically, they wanted to be more involved in the dental care process through quality time and empathetic conversations with the dentist. They also wished for an exchange of information free of technical terms and built on mutual trust. In conclusion, person-centred dental care models should emphasize empathy, trust, and quality care beyond technical skills. Clinicians should provide comprehensive information in dental encounters and treat their patients as whole persons.

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