Children's Oral Health Initiative: workers' perspectives on its impact in First Nations communities. / Initiative en santé buccodentaire des enfants : le point de vue des intervenants quant à ses effets dans les communautés des Premières Nations.

INTRODUCTION: Since 2004, the Children's Oral Health Initiative (COHI) has been working in many First Nations and Inuit communities in Canada to address oral health disparities, specifically early childhood caries (ECC). The COHI community-based approach improves early childhood oral health (ECOH) by balancing prevention with minimally invasive dentistry. The goal is to reduce the burden of oral disease, mainly by minimizing the need for surgery. We investigated program success in First Nations communities in the province of Manitoba, from the perspective of COHI staff. METHODS: First Nations community-based dental therapists and dental worker aides participated in three focus groups and an in-depth semistructured interview. The collected data were thematically analyzed. RESULTS: Data from 22 participants yielded converging and practitioner-specific themes. Participants reported that dental therapists and dental worker aides provide access to basic oral care in their communities including oral health assessments, teeth cleaning, fluoride varnish applications and sealants. The participants agreed that education, information sharing and culturally appropriate parental engagement are crucial for continuous support and capacity building in the community programs. Low enrolment, difficulty accessing homes and getting consent, limited human resources as well as lack of educational opportunities for dental worker aides were identified challenges. CONCLUSION: Overall, the participants reported that the COHI program positively contributes to ECOH in First Nations communities. However, increased community-based training for dental workers, community awareness about the program, and engagement of parents to facilitate culturally appropriate programming and consent processes are critical to improving program outcomes.

Comparative Analysis of Geographic Accessibility of Dentists, Physiotherapists and Family Physicians in an Urban Centre: A Case Study of Saskatoon, Canada.

BACKGROUND: The spatial arrangement of primary health care (PHC) services is influenced by many factors and varies across provider types. In Canada, unlike physician services, certain PHC services (i.e., dentistry, physiotherapy) are not fully funded under the health care system. As a result, one might expect the arrangement of these services to differ by neighbourhood, even in dense metropolitan areas. OBJECTIVE: This study examines the intra-urban variability of geographic access to dental (DS) and physiotherapy (PT) services in relation to family physician (FP) services in an urban area and identifies underserviced neighbourhoods. METHODS: Practice location information was gathered from publicly available and routinely updated provincial sources (physician, physiotherapy and dentistry regulatory colleges). A neighbourhood accessibility score for all 3 PHC services was calculated using a GIS-based, 3-step floating catchment area method. A set of parameters, such as catchment type (road network buffer), size (3 km radius) and census centroids (dissemination areas), was used. RESULTS: The overall access scores for FP, PT and DS services (based on the 281 FPs, 226 PTs, and 152 DSs) were 1.45 (SD 0.94), 1.18 (SD 0.81) and 0.79 (SD 0.53) providers/1000 population, respectively. Spatial comparison of the accessibility scores indicated a greater proportion of the Saskatoon population has lower access scores (< 0.5/1000 population) for both physiotherapy (n = 79 450) and dental (n = 101 270) services compared with family physician services (n = 64 420). Exploration of the relation between PHC service arrangement and key sociodemographic variables (e.g. low income, education levels) showed that a considerable proportion of those in each sociodemographic group has poor PT and DS access. CONCLUSION: This research has identified accessibility gaps and serves to inform the development of health policies focused on equitable distribution and funding of PHC services based on population health needs.

Perceived causes of stress among a group of western Canadian dental students.

OBJECTIVE: The demanding nature of dental education, both academically and clinically, results in higher levels of perceived stress among its students. The aim of this study was to determine how dental students at the College of Dentistry, University of Saskatchewan perceived stress. During the 2013-2014 academic year, all students were asked to complete a modified dental environmental survey (DES). RESULTS: Of the 111 students enrolled at the College that year 92 completed the survey (response rate = 83%). In general, female students reported higher stress levels than males. Higher stress levels were associated with living away from home, concerns about manual dexterity and the transition from pre-clinical to clinical studies. Additionally, students who enter dental school with higher debt loads (> 100,000) report high stress levels relating to finances. This study found that financial and clinical workloads result in high stress levels among dental students.

Time loss due to dental problems and treatment in the Canadian population: analysis of a nationwide cross-sectional survey.

BACKGROUND: The purpose of this study was to quantify time loss due to dental problems and treatment in the Canadian population, to identify factors associated with this time loss, and to provide information regarding the economic impacts of these issues. METHODS: Data from the 2007/09 Canadian Health Measures Survey were used. Descriptive analysis determined the proportion of those surveyed who reported time loss and the mean hours lost. Linear and logistic regressions were employed to determine what factors predicted hours lost and reporting time loss respectively. Productivity losses were estimated using the lost wages approach. RESULTS: Over 40 million hours per year were lost due to dental problems and treatment, with a mean of 3.5 hours being lost per person. Time loss was more likely among privately insured and higher income earners. The amount of time loss was greater for higher income earners, and those who reported experiencing oral pain. Experiencing oral pain was the strongest predictor of reporting time loss and the amount of time lost. CONCLUSIONS: This study has shown that, potentially, over 40 million hours are lost annually due to dental problems and treatment in Canada, with subsequent potential productivity losses of over $1 billion dollars. These losses are comparable to those experienced for other illnesses (e.g., musculoskeletal sprains). Further investigation into the underlying reasons for time loss, and which aspects of daily living are impacted by this time loss, are necessary for a fuller understanding of the policy implications associated with the economic impacts of dental problems and treatment in Canadian society.