Milestones in oral health services in the Republic of Ireland.

With the many changes occurring in Ireland it would seem an opportune time to review the body of research conducted and policy enacted in the Republic of Ireland on oral health services and oral health. The dental health of the nation prior to water fluoridation, the legislation and policy decisions impacting on oral health up to budgetary changes, and the production of evidence-based guidelines will be discussed. The first national survey of dental health was conducted in Ireland in 1952 - 'Dental Caries in Ireland'. In the intervening 60 years, further surveys of the oral health of people in Ireland have been carried out. Legislation, surveys and policy documents that have shaped dentistry and the oral health of the population are set out in Tables 1 and 2. A more comprehensive description of the policies can be found in the thesis submitted in fulfilment of Masters in Dental Public Health (MDPH) by the lead author.

Why public policy matters in improving access to dental care.

The executive and legislative branches of state government have broad authority that provides the underpinning for the dental health care system. This article describes four principal areas in which policy makers' decisions can improve children's access to dental care: (1) providing and financing health care (ie, providing opportunities for shaping public insurance programs like Medicaid and SCHIP); (2) regulating health providers and facilities (ie, providing levers for policy change in dental practice acts); (3) ensuring the health of the public (ie, states' choices on population-based approaches and providing leadership in oral health); and (4) education and training of the health workforce (ie, state support of dental education that can ensure a dental workforce that meets the needs of the population).

An assessment of the dental public health infrastructure in the United States.

OBJECTIVES: The National Institute of Dental and Craniofacial Research commissioned an assessment of the dental public health infrastructure in the United States as a first step toward ensuring its adequacy. This study examined several elements of the U.S. dental public health infrastructure in government, education, workforce, and regulatory issues, focused primarily at the state level. METHODS: Data were drawn from a wide range of sources, including original surveys, analysis of existing databases, and compilation of publicly available information. RESULTS: In 2002, 72.5% of states had a full-time dental director and 65% of state dental programs had total budgets of 1 million dollars or less. Among U.S. dental schools, 68% had a dental public health academic unit. Twelve and a half percent of dental schools and 64.3% of dental hygiene programs had no faculty member with a public health degree. Among schools of public health, 15% offered a graduate degree in a dental public health concentration area, and 60% had no faculty member with a dental or dental hygiene degree. There were 141 active diplomates of the American Board of Dental Public Health as of February 2001; 15% worked for state, county, or local governments. In May 2003, there were 640 U.S. members of the American Association of Public Health Dentistry with few members in most states. In 2002, 544 American Dental Association members reported their specialty as Dental Public Health, which ranged from 0 in five states to 41 in California. Just two states had a public health dentist on their dental licensing boards. CONCLUSIONS: Findings suggest the U.S. dental public health workforce is small, most state programs have scant funding, the field has minimal presence in academia, and dental public health has little role in the regulation of dentistry and dental hygiene. Successful efforts to enhance the many aspects of the U.S. dental public health infrastructure will require substantial collaboration among many diverse partners.

Smoking cessation services provided by dental professionals in a rural Ontario health unit.

PURPOSE: This study was undertaken to determine what smoking cessation services dental professionals in Ontario's Wellington-Dufferin-Guelph Health Unit (WDGHU) provide before disseminating a smoking cessation information package. METHODS: Data were collected with 540 self-administered questionnaires mailed to 60 local dental offices. Replies were requested from all dentists, dental hygienists, dental assistants and other dental staff working in each dental office. RESULTS: Completed responses were obtained from 126 dental personnel in 28 (47%) of the 60 dental offices surveyed. The proportion of dental offices, dentists and hygienists providing cessation services to most patients was as follows: asking patients about tobacco-use status, 46%, 31% and 32%; advising tobacco users to quit, 46%, 32% and 29%; assessing tobacco users' interest in quitting, 46%, 25% and 19%; and assisting interested patients to quit, 25%, 6% and 13%, respectively. CONCLUSION: This survey indicates that most dental professionals in the WDGHU do not provide proven smoking cessation services. An opportunity exists to increase the proportion of dental professionals providing proven smoking cessation interventions as part of routine patient services.

Dental hygiene public health supervision: changes in Maine law.

The author analyzed data from a set of reports submitted to the Maine Board of Dental Examiners by dental hygienists practicing under a new supervision category entitled "Public Health Supervision" enacted in Maine in 1995. The data set included information on public health dental hygiene applicants and projects reported between May 1995 and November 1998. With mounting interest from dental hygienists seeking to serve the population with limited access to preventive dental care, the regulatory board created a public health dental hygiene supervision category in the Maine regulations. The analysis revealed that dental hygienists are seeking and receiving the public health supervision endorsement. Sixty percent of the public health projects were implemented by dental hygienists in public service agencies. Those who addressed a need in their own communities without the benefit of a public health organization accounted for 40% of the applications. Examples of projects are described. The report serves as a summary of three years of data from which to assess future trends.

[The new law concerning public health services in North Rhine- Westphalia--essentials and perspectives in dentistry]. / Zum Gesetz über den Offentlichen Gesundheitsdienst NW: Essentials und Perspektiven für den Zahnärztlichen Dienst.

A new regulation affecting the public health services (OGDG) in North Rhine Westphalia has been in effect since 1st January 1998. The present authors--members of a ministerial workgroup responsible for guidelines and recommendations for the implementation of the new regulation--have made an attempt to formulate the substantial and formal essentials of section 13 ODGD (dental health in children and the young) and its future perspectives in light of the reorientation of the national health service and, in particular, of dental services.

Quality evaluation of oral health record-keeping for Finnish young adults.

The objective of this study was to assess the quality of oral health record-keeping in public oral health care in relation to dentists' characteristics. A random computerized selection of 239 subjects, born in 1966-71 and clinically examined during 1994 in an administrative unit of the public oral health service in southern Finland, included 4-5 cases per dentist, the number of dentists being 50. Data concerning actual clinical examinations and treatment courses carried out in public dental clinics came from original oral health records. Criteria for assessment of oral health record entries were based on Finnish health legislation and detailed instructions of health authorities. The results showed that each patient's identity was available in 90% of documents. Recordings concerning continuity of comprehensive care were infrequent; a questionnaire concerning each patient's up-to-date health history was in only 26% of the oral health records. Notes concerning each patient's bite and function of the temporomandibular joint were in 37% of the records, notes about oral soft tissues were in 11%, and the check-up interval was recorded in 21%. Recording of indices on periodontal and dental status varied greatly; the community periodontal index of treatment need was found in 93% and the index of incipient lesions in 16% of the records. Female dentists and dentists younger than 37 years tended to record more information. Dentists should be encouraged to better utilize the options offered by oral health records for individual treatment schemes.

Integración docente-asistencial: su validación en el proceso de cambio de la práctica odontológica / Integration educational-assistance: its validation in the process of the change of odontologic practice

El presente trabajo realiza el diseño y comprobación de un modelo para la evaluación del proceso de integración docente-asistencial en el área odontológica, a traves del análisis de los programas desarrollados en el área odontológica. El estudio fue conducido en el Municipio Maracaibo-Venezuela, en los programas entre la Facultad de Odontología de la Universidad del Zulia y el Ministerio de Sanidad y Asistencia Social durante el período 1991-1994. El modelo utilizado aborda el funcionamiento de los programas con base en la metodología CIPP (contexto-insumo-proceso-producto) recomendada para la evaluación de programas de carácter social. Los resultados corroboran la hipótesis planteada según la cual la estructura organizacional de las instituciones involucradas explica la tendencia del proceso a perseguir los fines que cada una toma como preferentes: la universidad, un espacio para la formación de recursos humanos, y la institución asistencial, la prestación de servicios de amplia cobertura a bajo costo. Las características encontradas denotan la persistencia de una actividad docente que refuerza el aprendizaje praxiológico de la profesión, aislada de la producción de conocimientos científico y apoyada en un modelo de atención individualizado, curativo mutilador y de baja productividad, lo cual permite deducir que tal como se desarrolla en la actualidad, la integración docente-asistencial no esta contribuyendo realmente a la transformación cuali-cuantitativa de la práctica en salud oral de la región zuliana

Saúde bucal: um desafio à democratizaçäo do setor / Oral health: one challange to democratization of section

Neste artigo, o autor toma como objetivo de discussäo o padräo de formulaçäo das políticas federais de Saúde Bucal, o perfil da açäo das elites técnicas da burocracia governamental e os limites da Esfera Pública subsetorial, ao longo da segunda metade da década de 80, no período das primeiras iniciativas de constituiçäo do Sistema Nacional de Saúde Tardio brasileiro

15 years of CPITN--a Japanese perspective.

In Japan CPITN has been widely applied in dentistry over the past 10 years. CPITN has been introduced for screening purposes into basic dental epidemiology, dental public health and dental clinical practice. From many surveys the periodontal needs of young, mature and elderly populations have been documented. For the purpose of promoting improved periodontal awareness and care, CPITN has been implemented in dental public health and community based activities in schools, in industry, and in health centres. This has involved periodontal screenings and appropriate health guidance. The Japanese Health Laws are being modified to include a need for periodic oral examinations which will incorporate a CPITN screening. National goals for periodontal health at different age levels, based on CPITN, have been proposed and included in the national '8020' goal for oral health.