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2.
Trials ; 25(1): 267, 2024 Apr 16.
Article in English | MEDLINE | ID: mdl-38627819

ABSTRACT

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.


Subject(s)
Dental Implants , Jaw, Edentulous , Humans , Aged , Middle Aged , Denture, Overlay , Workflow , Mandible/surgery , Patient Satisfaction , Printing, Three-Dimensional , Dental Prosthesis, Implant-Supported , Randomized Controlled Trials as Topic
3.
Sante Publique ; 35(HS1): 163-171, 2023 12 01.
Article in French | MEDLINE | ID: mdl-38040640

ABSTRACT

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.


Subject(s)
Ecosystem , Oral Health , Humans , Public Health , Global Health
4.
Disabil Rehabil ; : 1-10, 2023 Jul 05.
Article in English | MEDLINE | ID: mdl-37403705

ABSTRACT

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.

5.
Community Dent Oral Epidemiol ; 51(1): 71-74, 2023 02.
Article in English | MEDLINE | ID: mdl-36749665

ABSTRACT

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.


Subject(s)
Oral Health , Research Design , Humans , Qualitative Research
6.
Gerodontology ; 40(2): 231-237, 2023 Jun.
Article in English | MEDLINE | ID: mdl-35833357

ABSTRACT

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.


Subject(s)
Delivery of Health Care , Dentists , Humans , Quebec , Qualitative Research , Dentistry , Attitude of Health Personnel
7.
Pediatr Dent ; 44(3): 192-197, 2022 May 15.
Article in English | MEDLINE | ID: mdl-35799335

ABSTRACT

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.


Subject(s)
Autism Spectrum Disorder , Aged , Anxiety , Autism Spectrum Disorder/complications , Autism Spectrum Disorder/therapy , Child , Hospitals, Pediatric , Humans , Medicare , Parents , United States
8.
Int Dent J ; 72(4): 529-535, 2022 Aug.
Article in English | MEDLINE | ID: mdl-34656309

ABSTRACT

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.


Subject(s)
Leadership , Oral Health , Dentistry , Humans , Workforce
9.
J Can Dent Assoc ; 87: l5, 2021 04.
Article in English | MEDLINE | ID: mdl-34343068

ABSTRACT

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.


Subject(s)
COVID-19 , Pandemics , Attitude of Health Personnel , Dental Care , Dentists , Humans , Nova Scotia/epidemiology , Practice Patterns, Dentists' , SARS-CoV-2 , Surveys and Questionnaires
10.
Br Dent J ; 231(4): 249-253, 2021 08.
Article in English | MEDLINE | ID: mdl-34446900

ABSTRACT

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.


Subject(s)
Motivation , Humans
11.
Gerodontology ; 38(3): 276-288, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33484003

ABSTRACT

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.


Subject(s)
Dental Care , Dentists , Humans
12.
Spec Care Dentist ; 41(3): 329-339, 2021 May.
Article in English | MEDLINE | ID: mdl-33439491

ABSTRACT

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.


Subject(s)
Disabled Persons , Wheelchairs , Dental Clinics , Humans , United Kingdom
13.
Can J Dent Hyg ; 54(1): 7-15, 2020 02 01.
Article in English | MEDLINE | ID: mdl-33240359

ABSTRACT

Objective: People living with HIV/AIDS (PLWHA) have difficulty accessing oral health services primarily due to HIV-related stigma and discrimination. In 2011, the University of British Columbia (UBC) Dental Hygiene Degree Program implemented a preventive oral health services program at the Positive Living Society of British Columbia (PLSBC), a non-profit organization supporting PLWHA. This study aims to assess the perception of how this type of service delivery influenced access to oral health care for members of PLSBC. Methods: Personal interviews with 10 members and one focus group comprising 12 staff were conducted. Audiorecordings were transcribed verbatim and coded thematically. Emerging themes were identified using the interpretative phenomenology approach following Penchansky and Thomas' theory of access. Results: The program helped members maximize their dental coverage to receive other types of dental services. Members who were influenced by past traumatic experiences appreciated that services were delivered in a safe manner and in a stigma-free setting. Members valued the opportunity to educate future dental professionals to reduce HIV-related stigma. However, dental needs that could not be addressed by the program remained untreated for some members who continued to face barriers to care at referral clinics. Conclusion: This community-based preventive dental program provided affordable dental care, a stigma-free setting, care delivered in a safe manner, an educational opportunity, and accessible location, which all seemed to have a positive influence on access to oral health care for members of PLSBC. However, the limited availability of the program prevented many members from accessing comprehensive oral health care and is a factor that should be addressed.


Objectif: Les gens qui vivent avec le VIH/SIDA (GVAVS) ont de la difficulté à accéder à des services de santé buccodentaire, principalement en raison de la stigmatisation et de la discrimination associées au VIH. En 2011, le Programme de baccalauréat en hygiène dentaire de l'Université de la Colombie-Britannique (UBC) a mis en place un programme de services de santé buccodentaire préventifs à la Positive Living Society of British Columbia (PLSBC), un organisme sans but lucratif soutenant les GVAVS. La présente étude vise à évaluer la perception de la façon dont ce type de prestation de service a influencé l'accès aux soins de santé buccodentaire pour les membres de la PLSBC. Méthodologie: Des entrevues personnelles ont été menées avec 10 membres et un groupe de discussion comprenant 12 membres du personnel. Les enregistrements sonores ont été transcrits mot à mot et codés par thème. Des thèmes émergents ont été ciblés au moyen de l'approche phénoménologique et interprétative, fondée sur la théorie sur l'accès de Penchansky et Thomas. Résultats: Le programme a aidé les membres à maximiser leur couverture dentaire afin de pouvoir recevoir d'autres types de services dentaires. Les membres qui ont été influencés par des expériences traumatiques précédentes ont été reconnaissants que les services aient été fournis de façon sécuritaire et dans un milieu exempt de stigmatisation. Les membres ont aimé avoir l'occasion d'éduquer les futurs professionnels dentaires en vue de réduire la stigmatisation liée au VIH. Cependant, les besoins dentaires qui ne pouvaient pas être satisfaits par le programme sont demeurés non traités pour certains membres qui ont continué à faire face à des obstacles en matière de soins aux cliniques de renvois. Conclusion: Ce programme dentaire préventif offert en milieu communautaire fournit des soins dentaires à prix abordables, un milieu libre de stigmatisation, des soins offerts de manière sécuritaire, une occasion de formation et un emplacement accessible, qui semblent tous avoir une influence positive sur l'accès aux soins de santé buccodentaire des membres de la PLSBC. Cependant, l'accessibilité limitée du programme a empêché plusieurs membres d'avoir accès à des soins de santé buccodentaire complets et cela est un élément qui doit être abordé.


Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , HIV Infections/therapy , Health Services Accessibility , Humans , Oral Health , Social Stigma
14.
Dent J (Basel) ; 8(3)2020 Aug 03.
Article in English | MEDLINE | ID: mdl-32756307

ABSTRACT

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.

15.
Br Dent J ; 229(2): 133-137, 2020 07.
Article in English | MEDLINE | ID: mdl-32710065

ABSTRACT

Introduction In the last decades, health professions have progressively moved towards person-centredness. Dentistry, however, lags behind the other health professions and remains deeply anchored in a biomedical vision.Aims Our objective was thus to better understand how dentists perceived person-centred care (PCC) and identify the challenges they may face in implementing it.Methods We conducted qualitative descriptive research in the province of Quebec, Canada; it was based on in-depth interviews with 11 general dental practitioners working in private clinics.Results Thematic analyses reveal that dentists had little interest in understanding the life and stories of their patients. Furthermore, their openness to share decision-making was limited to procedures that they considered of relatively low value and less for procedures they considered of higher value, such as indirect restorations.Discussion We argue that dentists' reluctance to understanding and shared decision-making is rooted in the old-established identity of dentistry as an art. Dentists indeed considered the dental craft as sacred - an art form with unbreakable axioms that defined quality of care.Conclusion It is time for the dental profession to reflect on its ideological foundations and reconsider its identity. This reflection is crucial to respond to the needs of a changing society that is losing its confidence in the profession.


Subject(s)
Dentists , Professional Role , Attitude of Health Personnel , Canada , Dental Care , Goals , Humans , Qualitative Research
16.
BMJ Open ; 10(6): e038164, 2020 06 28.
Article in English | MEDLINE | ID: mdl-32595166

ABSTRACT

OBJECTIVE: The Strategic Regional Plan of the Cree Board of Health and Social Services of James Bay (CBHSSJB), serving the Quebec Cree communities, mandates the objective of integrating oral health within primary healthcare. Emerging evidence suggests that the integration of oral health into primary healthcare can decrease oral health disparities. This research study aimed to answer the following research question: how and to what extent does the integration of oral health into primary healthcare address the oral health needs of the Cree communities? DESIGN: We used a multiple-case study design within a qualitative approach and developmental evaluation methodology. The Discovery, Dream, Design and Destiny model of appreciative inquiry was selected as a study framework among existing frameworks of the developmental evaluation. SETTING: Four purposefully selected Cree communities. PARTICIPANTS: Healthcare providers, administrators and patients at the community wellness centres and hospital. OUTCOME MEASURES: Integration of oral health into primary healthcare. RESULTS: A total of 36 interviews and 6 focus group discussions were conducted. We identified ten themes in discovery and dream phases. The Discovery phase identified the strengths of the organisation in facilitating enablers of integration including strategic planning, organisational structure, cultural integration, coordinated networks and colocation. In the Dream phase, participants' oral healthcare stories expressed various dimensions of integration and their wish for strengthening integration via extending public oral healthcare programmes, increasing resources and improving organisational management. In the Design phase, recommendations were formulated for a future action plan within the CBHSSJB. CONCLUSION: This study results suggested that the CBHSSJB has been successful in implementing oral health integration into primary care following its strategic planning. At present, the organisation could extend the level of integration into full integration by following study recommendations derived from the perspective of local stakeholders.


Subject(s)
Delivery of Health Care, Integrated/organization & administration , Dental Health Services , Primary Health Care , Focus Groups , Health Services Needs and Demand , Health Services Research , Humans , Indians, North American , Interviews as Topic , Qualitative Research , Quebec , Research Design
17.
Br Dent J ; 228(6): 465-468, 2020 03.
Article in English | MEDLINE | ID: mdl-32221451

ABSTRACT

The biomedical model has been severely criticised in the last decades and its dominance challenged. This is why the concept of person-centred dentistry has penetrated the professional discourse and become a growing concern for our profession. Furthermore, dentists have been urged to take patients' environment more into account and to tackle the social determinants of their health, illness and access to care. Unfortunately, dentists still poorly comprehend person-centredness and social dentistry, and face difficulties to implement biopsychosocial approaches. To respond to these issues, we propose the Montreal-Toulouse Biopsychosocial Model for dentistry, which encompasses patient-centredness and social dentistry. Our model presents three types of tasks (understanding, decision-making and intervening) that dentists should take in each of three overlapping levels (individual, community and society). We also propose a 'Q-List', an original tool designed to help dental professionals adopting this model and reflecting upon their actions. This Q-List includes key questions to elicit dentists' reflexiveness and to support their biopsychosocial practice of dentistry. We invite dental professionals to adopt biopsychosocial approaches and use the Montreal-Toulouse Model as a guide. We also encourage them to use our Q-List and adapt it to their context of practice.


Subject(s)
Dentistry , Dentists , Humans
18.
BMJ Open ; 9(7): e030005, 2019 07 30.
Article in English | MEDLINE | ID: mdl-31366663

ABSTRACT

OBJECTIVE: Patient-centred care is considered to be an important element in the evaluation of integrated healthcare and has been effective in addressing oral health disparities. This study explored the patients' perspectives of patient-centred integrated care in oral health services integrated into a primary healthcare organisation serving a northern Quebec Cree population. DESIGN: This study used a multiple case study design within a qualitative approach and developmental evaluation methodology. Two theoretical models, Picker's Principles of Patient-Centred Care and Valentijn's Rainbow Model of Integrated Care, guided data collection and data analysis. The thematic analysis included transcription, debriefing, codification, data display and interpretation. SETTING: This study was conducted in purposefully selected four Cree communities of Northern Quebec. PARTICIPANTS: Adult patients in need of oral healthcare and who attended the local dental clinic were identified and recruited by maximum variation sampling and snowball techniques. OUTCOME MEASURES: Patients' perspectives of patient-centred integrated oral healthcare. RESULTS: Data analysis generated six major themes: enhanced accessibility, creating supportive environment, building trust through shared decision making, appreciation of public health programmes, raising oral health awareness and growing cultural humility among healthcare providers. Patients identified the integration of dental care into primary healthcare with respect to co-location, provision of free oral healthcare services, care coordination and continuity of care, referral services, developing supportive environment, shared decision making, oral health promotion and culturally competent care. CONCLUSION: These results confirmed that patient-centred care is an important element of integrated care. Patients valued the use of this concept in all domains and levels of integration. They recommended to further strengthen the clinical integration by involving parents in oral health promotion as well as optimising care coordination and empowering a supportive environment in organisational integration.


Subject(s)
Dental Care/methods , Health Services Accessibility , Health Services, Indigenous , Patient-Centered Care/organization & administration , Primary Health Care/organization & administration , Adult , Cultural Competency , Decision Making, Shared , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Quebec
20.
East Mediterr Health J ; 24(7): 653-663, 2018 Sep 06.
Article in English | MEDLINE | ID: mdl-30215475

ABSTRACT

BACKGROUND: Interventions to promote healthy eating in adolescents are needed in the United Arab Emirates. To design effective interventions, adolescent eating behaviours need to be understood. AIMS: This study aimed to describe eating behaviours of adolescents in Dubai and the factors associated with fruit and vegetable intake. METHODS: This was a sequential explanatory study using a mixed methods approach. Ten of the 34 Arabic high schools in Dubai were randomly selected and students in grades 10-12 were included. Data were collected on self-reported fruit and vegetables intake, eating behaviours, food availability and sociodemographic variables. In the qualitative phase, 14 students were interviewed about their eating behaviour. RESULTS: A total of 620 students were included: 57% were boys and most reported medium/high family affluence. Only 28% of the participants met the recommended daily fruit and vegetable intake, with significantly more males than females meeting it (P < 0.01). Lunch was the most frequently eaten meal, breakfast was frequently skipped, and there were high levels of fast food and soft drink consumption. Adequate fruit and vegetable intake was positively associated with increased lunch frequency, being male, parental support for healthy eating, and positive perception of family meals. CONCLUSIONS: There are significant differences in eating habits between Emirati male and female adolescents. Lunch, as the main family meal, faces threats because of modern working hours. The gender-specific social context may require targeted interventions to achieve optimal outcomes in each group.


Subject(s)
Diet/statistics & numerical data , Fruit , Vegetables , Adolescent , Feeding Behavior , Female , Humans , Male , Psychology, Adolescent/statistics & numerical data , Sex Factors , Socioeconomic Factors , Surveys and Questionnaires , United Arab Emirates , Young Adult
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