ABSTRACT
BACKGROUND: Dental diseases have detrimental effects on healthcare systems and societies at large. Providing access to dental care can arguably improve health outcomes, reduce healthcare utilization costs, and improve several societal outcomes. OBJECTIVES: Our objective was to review the literature to assess the impacts of dental care programs on healthcare and societal outcomes. Specifically, to identify the nature of such programs, including the type of services delivered, who was targeted, where services were delivered, and how access to dental care was enabled. Also, what kind of societal and healthcare outcomes have been attempted to be addressed through these programs were identified. METHODS: We conducted a scoping review by searching four databases, MEDLINE, EMBASE, CINAHL, and Sociological Abstracts. Relevant articles published in English language from January 2000 to February 2022 were screened by four reviewers to determine eligibility for inclusion. RESULTS: The search resulted in 29,468 original articles, of which 25 were included in the data synthesis. We found minimal evidence that answers our proposed research question. The majority of identified programs have demonstrated effectiveness in reducing medical and dental healthcare utilization (especially for non-preventive services) and avert more invasive treatments, and to a lesser degree, resulting in cost-savings. Moreover, some promising but limited evidence about program impacts on societal outcomes such as reducing homelessness and improving employability was reported. CONCLUSION: Despite the well-known societal and economic consequences of dental problem, there is a paucity of studies that address the impacts of dental care programs from the societal and healthcare system perspectives. MESH TERMS: Delivery of Health Care, Dental Care, Outcome assessment, Patient acceptance of Health Care.
Subject(s)
Delivery of Health Care , Patient Acceptance of Health Care , Humans , Outcome Assessment, Health Care , Dental CareABSTRACT
Periodontal disease is associated with diabetes mellitus and poor overall health. While the biological underpinnings of this relationship have been identified, less is known about the extent to which this relationship is affected by dental and medical care visits. Two studies lead by the primary author (KKP) explored the likelihood of diabetes complications among persons living with diabetes in Ontario, Canada, who were followed prospectively in administrative health data. The results from both studies confirmed that poor to fair self-reported oral health was associated with a greater risk for diabetes complications, and that poor dental and medical care visiting behaviours increased this risk. In general, the findings indicate that a greater number of dental and medical visits had a protective effect on the overall health of persons with diabetes. This discovery has important implications for all health care providers interested in managing oral and systemic health.
La maladie parodontale est associée au diabète sucré et à un mauvais état de santé général. Bien que les causes biologiques de ce lien ont bien été définies, la mesure par laquelle ce lien est influencé par des visites dentaires et médicales est peu connue. Deux études menées par l'auteur principal (KKP) ont exploré la probabilité de complications diabétiques chez les personnes atteintes de diabète en Ontario, au Canada, qui ont été suivies prospectivement dans les données administratives de santé. Les résultats des 2 études ont confirmé qu'un état de santé buccodentaire autodéclaré pauvre à moyen était associé à un risque plus élevé de complications diabétiques, et que de mauvais comportements en matière de visites de soins médicaux et dentaires augmentaient ce risque. Les résultats ont généralement révélé qu'un nombre plus élevé de visites dentaires et médicales ont un effet protecteur sur la santé globale des personnes atteintes de diabète. Cette découverte a d'importantes répercussions pour tous les fournisseurs de soins de santé qui s'intéressent à la gestion de la santé buccodentaire et systémique.