Trends in the geographic distribution of dental clinics in Japan.

AIM: In Japan, along with the increase in the number of dentists, the number of dental facilities has continuously increased as well. This study aimed to examine whether the increase in the number of dental clinics in Japan has led to an improvement in their geographic distribution. METHODS: We analysed the number of dental clinics and population in all municipalities in Japan as of 2000, 2005 and 2010. We obtained data on the population from the population census and data on the number of dental clinics from the Survey of Medical Institutions. The number of municipalities was 3,258 in 2000 but had dropped to 1,750 by 2010 due to municipal mergers so population and dental data for other years were recalculated based on 2010 municipal boundaries. Lorenz curves and Gini coefficients were used to assess the distribution of dental clinics per 100,000 persons. RESULTS: The mean number of dental clinics per 100,000 persons among all municipalities was 49.9 in 2000, 52.2 in 2005 and 53.4 in 2010. The Gini coefficient for the clinics in the whole country was 0.172 in 2000, 0.164 in 2005 and 0.153 in 2010. CONCLUSION: The results suggest that the regional inequalities in the availability of dentists have been reduced gradually as the number of dental clinics has increased.

Oral health resources for cancer patients in Texas.

Over 1.4 million new cases of cancer are diagnosed each year, and many of these patients will, by necessity, be treated in private practice, including dental practice. Dental professionals play a key role in helping patients understand that good oral care can prevent or reduce oral complications. Treatment of oral cancers and other malignancies cause oral sequelae that can compromise patients' quality of life and dictate reduction or discontinuation of optimal therapeutic regimens, which in turn reduces the odds of long-term survival. This can be prevented or better managed if dental and medical health care providers work together. The purpose of this article is to identify the cancer centers associated with dental clinics and the dental practitioners in the state of Texas, including maxillofacial prosthodontists, with training and/or a special interest in providing oral care to cancer patients. To be included on the list, which will be available on the Dental Oncology Education Program (DOEP) Web site (doep.org), please contact Grady Basler at the DOEP office (grady@doep.org), or the Department of Public Health Sciences (214-828-8350).

[Assessing the supply and use of secondary care in specialized dental clinics in Bahia State, Brazil]. / Avaliação da oferta e utilização de especialidades odontológicas em serviços públicos de atenção secundária na Bahia, Brasil.

This study aimed to evaluate the utilization of dental services in four specialized dental clinics in Bahia State, Brazil, and to identify associated factors. This was an evaluative study in which the quantitative stage focused on a cross-sectional analysis of secondary data from the Outpatient Information System of the Unified National Health System and the qualitative component was based on 20 semi-structured interviews with coordinators and managers, in addition to on-site observation of health services. The study showed good results in the supply of these services from the health professionals' perspective, but with a low utilization rate. The low utilization rate reveals access barriers in the health services themselves, like the lack of performance standards and goals by specialty, lack of patients (who are not replaced), and different technologies used by each specialist. The results suggest the need for studies that analyze different forms of services organization that would have allowed greater utilization of the available supply, with pay differentials, linkage to primary care, and adjustment of the supply to the population's health needs.

Geographic distribution of postgraduate dental trainees in Japan.

Postgraduate clinical training for dentists in Japan became mandatory in April 2006. Mandatory postgraduate clinical training for physicians has been criticized as having accelerated the imbalance in distribution of physicians. This suggests the danger that the same phenomenon might occur in distribution of dentists. It is also necessary to investigate the geographic distribution of dental trainees and practicing dentists in Japan. In this study, the number of dental trainees enrolled in each clinical training program and number that had actually received clinical training at each facility were compared by prefecture. The results suggest that disparities in the number of dental trainees among prefectures are being compensated for by movement across prefectural borders under the clinical training facilities-group system. Postgraduate dental trainees, however, showed a significantly greater imbalance in geographic distribution than practicing dentists. Continuation of the postgraduate clinical training for dentists under the existing system may accelerate this imbalance in distribution of dentists. To prevent this, practical measures should be taken in accordance with the coming review of the system, based on research regarding changes in geographic distribution of dental trainees.

Puesta el día en iluminación / Update in lighting

A la hora de planificar la iluminación en una clínica dental, es muy importante lograr la funcionalidad de un buen sistema sin olvidar la estética, ni los posibles riesgos derivados de la misma. La iluminación en la clínica depende de varios factores los cuales interaccionan al unísono, es por tanto esencial prestarles una completa atención y cuidado minucioso, para conseguir así la optimización al completo de nuestro trabajo (AU)

When planning the lighting in a dental clinic, it is very important to achieve the functionality of a good system without forgetting aesthetics, or the possible risks that may be derived from it. Lighting in the clinic depends on various factors which interact simultaneously; therefore, it is essential to give it full attention and meticulous care, in order to attain the complete optimization of our work (AU)

Functionally dependent veterans. Issues related to providing and improving their oral health care.

This article discusses issues related to the quality and effectiveness of new, emerging, and existing oral health delivery mechanisms and models for the functionally dependent veteran. It describes the particular needs and unique qualities of functionally dependent veterans and enumerates the clinical dental interventions and delivery systems available to this group. Barriers specific to The Department of Veterans Affairs (VA) regarding this population and suggestions for improved access to care are summarized. Suggestions for further research are proposed with the intent that limited resources be utilized so that maximum benefits are provided to the functionally dependent veterans who need care most. What we know: Among the veteran population and the general population, the oldest cohort of elderly (those age 85 and older) are growing faster than any other age group. The rate of functional dependency increases dramatically with age, from about 10% at age 65 to 69 to about 57% after age 85. Functionally dependent elderly are the most likely group to be home-bound or in nursing homes. Compared with independent elderly, the oral status of functionally dependent elderly tends to be poorer. Functionally dependent elderly have higher rates of tooth loss, greater prevalence of denture-related problems, greater prevalence and severity of dental caries, higher prevalence of gingival and periodontal disease, and typically not seen a dentist in at least 5 years. The Department of Veterans Affairs has several advantages over non-VA settings in delivering dental care to the functionally dependent including the presence and availability of dental clinics at VA medical centers and outpatient facilities, the fact that they are free to eligible VA patients, and the greater knowledge base of the dentists. Although VA is effective in delivering oral care to a small percentage of the total population, it is likely that demand will increase and resources exhausted if certain anticipated changes occur (eg, greater demand for dental care and/or changing dental status, such as more elderly with teeth). Questions that need to be answered: What quality of oral care is VA providing to the functionally dependent veteran? What delivery systems are the most effective in providing care to the functionally dependent elderly? Is there a difference in oral health outcomes when dental personnel serve on patient care teams? What barriers exist for delivering quality oral care for the functionally dependent elderly? How can we eliminate or minimize these barriers?

The reorganization of the city of Toronto dental services: a community development model.

The dental program of the Department of Public Health, City of Toronto, is over 75 years old. Recently, the department engaged in extensive community-based planning, which culminated in the closing of forty-eight school-based clinics and the opening of eight community clinics. A geriatric dental program also was established. This paper will describe the data utilized, the analysis of which enabled the department to focus its efforts on those at high risk for dental disease. These groups included immigrants and institutionalized seniors. This analysis also enabled the department to locate its clinics in those areas of the city with greatest need. The community development model, quite unique to major reorganizations, is also described. It was this wide support that resulted in the unanimous approval by the city council of the reorganization and gave impetus to personnel changes resulting in the ability of staff to communicate in the major languages of a city where over 50 percent speak a language other than English or French.