Patients' willingness to pay for dental services in a population with limited restorative services.

OBJECTIVES: To determine and compare patients' willingness-to-pay (WTP) for tooth extraction and filling services in Tanzania and to assess the socio-demographic factors that are associated with such valuations. METHODS: Contingent valuation survey utilizing an open-ended willingness-to-pay format was administered among 1522 outpatients in four regional hospitals in Tanzania. WTP for extraction and tooth filling services for various tooth categories were determined and compared using Mann-Whitney and Kruskal-Wallis tests. The association of WTP values with socio-demographic background factors was assessed using multiple regression analysis. RESULTS: The mean WTP amounts for tooth filling were Tanzania shillings (Tshs) 7,398 (3.4 US$) and Tshs 7,726 (3.5 US$) for anterior and posterior teeth respectively. The mean WTP for tooth filling services was lower than the average charged fees in dental facilities. The mean WTP amounts for tooth extraction were Tshs 5,448 (2.5 US$) and Tshs 6,188 (2.8 US$) for anterior and posterior teeth respectively. WTP amounts were shown to vary by age, income, outpatient status and previous experience with the dental services. Belonging in youngest age group (18-24 years) and having a high-income level was associated with increased odds for high WTP valuations irrespective of tooth and treatment types. CONCLUSIONS: WTP reveals a preference for tooth filling rather than extraction services in this population. More studies are needed to address the discrepancy between the stated preferences and utilization patterns for dental services.

Intervals for oral health examinations among Finnish children and adolescents: recommendations for the future.

AIM: To review the frequency of routine annual dental examinations for children in Finland and to make recommendations for appropriate examination intervals for children and adolescents. METHOD: The National Research and Development Centre for Welfare and Health in Finland appointed an expert group to prepare a review. RESULTS: According to the literature, examination intervals for individuals with low caries risk can be extended to 1.5-2.0 years without jeopardising their oral health. If implemented, this would lead to a saving of 15% in treatment and examination times for children. Although there is no accurate measure for identifying high-risk individuals, a considerable proportion of low-risk children can be identified fairly accurately. CONCLUSIONS: The expert group recommended prolonging the average examination intervals to 1.5-2.0 years, taking into account the risk of each individual, the local distribution of oral health problems and cost-effective use of resources. Part of the savings could be redirected to children with high levels of dental need and/or at risk of dropping out from the oral health services.

The perceptions of users about barriers to the use of free systematic oral care among Finnish pre-school children--a qualitative study.

With the economic recession in the early 1990s in mind, and the change in the provision of healthcare services, our aim was to explore qualitatively what barriers families of Finnish pre-school children had perceived related to the use of free systematic oral healthcare. Qualitative interviews were carried out with the parents of 12 pre-school children attending an oral health examination to ascertain what barriers those using oral services had overcome, and what they considered to be the reasons for the non-attendance of other families. Content analysis was used by classifying groups of barriers and their reported importance as well as the reasons for non-attendance. The barriers discovered were related to: difficulties in the (i) change of daily routines or (ii) booking time for care, (iii) poor coordination with other healthcare services, (iv) fear and negative image of oral care, and (v) inconsistent content of oral health information. When parents replied to the externalized question about reasons for the non-attendance of some families, they most often mentioned difficulties in changing daily routines, laziness, lack of interest and fear. Barriers to attending oral healthcare could be lowered by emphasizing the positive image of oral health services, by providing more effective coordination with mother and child health services, and by providing appointment times later in the day.

Fluoride and sugar intake among adults and youth in Mauritius: preliminary results.

The potential use of different vehicles for delivering fluoride to prevent dental caries has been discussed recently in Mauritius. Water fluoridation was found not to be feasible, and extending the fluoride tablet program would not be easy. Thus, sugar fluoridation as one possibility was considered. For these purposes, the average fluoride and sugar intake was estimated in Mauritius. The results are based on two studies--a Survey on Diet, Health and Lifestyle of Youth in Mauritius (1990) and the Mauritius Diet and Health Survey. Information was collected by trained interviewers using food-frequency and 24-hour-recall questionnaires. The daily total sugar intake, manufactured and natural, was found to be 62 g per day in young people and 50 g per day in adults. In the younger groups, daily frequencies of raw sugar, sweets, and biscuit (cookie) consumption were 1.5, 0.2, and 0.2 times a day, respectively. For adults, the mean daily frequency of consuming sugar-containing foods was 2.6 (SD = 1.3). The daily sucrose intake was rather high, representing about 10% of the daily energy intake. The fluoride levels of foods were calculated by use of Finnish and other available fluoride tables. The mean fluoride intakes per day were 0.64, 0.72, and 0.62 mg per day for 8-17-year-, 18-24-year-, and 30-64-year-old groups, respectively. The median fluoride intake for the oldest group was 0.62 mg/day. The estimated fluoride intake from food did not correspond with the proposed level for the prevention of caries (Murray, 1986) except for the 18-24-year-olds, where it might have been just above the lower recommended limit. However, further data based on analysis of the fluoride contents of Mauritian food samples, especially of whole daily diet, are needed.