The Seychelles Dental Service.

The Seychelles Dental Service dates back to the 1920s, growing from rudimentary dentistry to the evidence-based dentistry of today. Until the 1970s, dental care was provided by a small number of dentists. However, since the establishment of the School Dental Service (SDS) in the 1980s, child oral health has been the responsibility of Dental Therapists (DTs). Today Seychelles has a well organised oral health care system in place with modern infrastructure and equipment and trained personnel. Locally trained DTs constitute 85% of the SDS workforce. A national oral health plan serves as a guide to ensure that programmes are developed in accordance with WHO global oral health goals, guided by periodic reviews. We present a resume of the major strengths and challenges of the Seychelles Dental Service, concluding with recommendations for staff development. Findings and recommendations of reviews and assessments of various dental health issues conducted in the country between 1977 and 1999 are summarised in the appendix.

Use of the Explicit Health Guarantee of Oral Health Care for Pregnant Women at a Family Health Center, Concepción, Chile, 2014-2015.

BACKGROUND: Oral health plays a crucial role in general health, quality of life and well-being of pregnant women and their newborns. In Chile, pregnant women have dental care guaranteed by law. However, due to the lack of previous epidemiological studies on the benefits of this guarantee, it is necessary to describe this situation and evaluate the need to change the methods of providing dental services. OBJECTIVES: The objective of this study was to describe the pattern of providing dental benefits resulting from the Explicit Health Guarantee - Integral Oral Health in Pregnant Women (GES-SOIE) program to pregnant women attending the Juan Soto Fernández Family Health Center, Concepción, Chile, in 2014-2015. MATERIAL AND METHODS: A cross-sectional study of the electronic dental records of patients admitted to GES-SOIE was conducted. The variables studied were sociodemographic data, dental chair hours, non-attendance, treatment completion, and the type of referral to secondary healthcare (SHC). RESULTS: Of 233 pregnant women, 65.2% were registered for non-attendance, 21.2% required referral to SHC and 76.4% completed their treatment. When performing logistic regression, it was found that for each non-attendance the chance of not completing the treatment increased 1.4 times. CONCLUSIONS: The level of non-attendance and opting out of the treatment in pregnant women is high, which hinders the proper functioning and effectiveness of GES-SOIE.

[The analysis of the judicial practice of treating the civil lawsuits concerning the inadequate dental health service appeals launched by the patients in the Russian Federation during the period from 1993 to 2017]. / Analiz sudebnoi praktiki po grazhdanskim delam, sviazannym s defektami okazaniia stomatologicheskoi pomoshchi naseleniiu Rossiiskoi Federatsii za period s 1993 po 2017 g.

The objective of the present study was to elucidate the characteristic features and peculiarities in the dynamic of the civil legal proceedings concerning the quality of the stomatological aid to the population of the Russian Federation during the period from 1993 to 2017. We have undertaken the analysis of the official sources containing the court reports on the statements of claim launched by the patients. The study gave evidence of the currently well apparent sustained tendency toward the increase in the number of such civil lawsuits. The probabilities of legal proceedings in connection with the unfavourable outcomes of the dental treatment are roughly identical in all areas of the stomatological practice. The maximum number of the respective civil lawsuits arise from the claims of the patients against the dental surgeons employed by the healthcare settings designated as the limited liability companies. The majority of the statements of case coming from the patients contain the demanding financial claims for the compensation of the moral damage. It is concluded that the aforementioned tendencies in the strategy of the development of the stomatological aid for the population of the Russian Federation dictate the necessity of the priority development of the quality standards (including the clinical guidelines, protocols, etc.) designed to improve the medical assistance for the patients presenting with dental problems, the modernization of the validated methods for the evaluation of the effectiveness of the stomatological aid for the population, the implementation of the measures needed to introduce the mechanisms of professional liability insurance into the routine stomatological practice. These measures are believed to allow to meet the demand of the population of this country for the high-quality stomatological services.

More Rhode Island Adults Have Dental Coverage After the Medicaid Expansion: Did More Adults Receive Dental Services? Did More Dentists Provide Services?

OBJECTIVE: Under the Affordable Care Act (ACA) Medicaid expansion since 2014, 68,000 more adults under age 65 years were enrolled in Rhode Island Medicaid as of December 2015, a 78% increase from 2013 enrollment. This report assesses changes in dental utilization associated with this expansion. METHODS: Medicaid enrollment and dental claims for calendar years 2012-2015 were extracted from the RI Medicaid Management Information System. Among adults aged 18-64 years, annual numbers and percentages of Medicaid enrollees who received any dental service were summarized. Additionally, dental service claims were assessed by provider type (private practice or health center). RESULTS: Although 15,000 more adults utilized dental services by the end of 2015, the annual percentage of Medicaid enrollees who received any dental services decreased over the reporting periods, compared to pre-ACA years (2012-13: 39%, 2014: 35%, 2015: 32%). From 2012 to 2015, dental patient increases in community health centers were larger than in private dental offices (78% vs. 34%). Contrary to the Medicaid population increase, the number of dentists that submitted Medicaid claims decreased, particularly among dentists in private dental offices; the percentage of RI private dentists who provided any dental service to adult Medicaid enrollees decreased from 29% in 2012 to 21% in 2015. CONCLUSION: Implementation of Medicaid expansion has played a critical role in increasing the number of Rhode Islanders with dental coverage, particularly among low-income adults under age 65. However, policymakers must address the persistent and worsening shortage of dental providers that accept Medicaid to provide a more accessible source of oral healthcare for all Rhode Islanders. [Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].

VA Dental Insurance Program. Final rule.

This document revises Department of Veterans Affairs (VA) medical regulations to reflect the codification of the authority for the VA Dental Insurance Program (VADIP), a program through which VA contracts with private dental insurers to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. The VA Dental Insurance Reauthorization Act of 2016 codified the authority of the VADIP, and this final rulemaking accordingly revises the authority citation in the VA medical regulations that implement VADIP.

TRICARE; Revision of Nonparticipating Providers Reimbursement Rate; Removal of Cost Share for Dental Sealants; TRICARE Dental Program. Final rule.

This final rule revises the benefit payment provision for nonparticipating providers to more closely mirror industry practices by requiring TDP nonparticipating providers to be reimbursed (minus the appropriate cost-share) at the lesser of billed charges or the network maximum allowable charge for similar services in that same locality (region) or state. This rule also updates the regulatory provisions regarding dental sealants to clearly categorize them as a preventive service and, consequently, eliminate the current 20 percent cost-share applicable to sealants to conform with the language in the regulation to the statute.

'We are all scared for the baby': promoting access to dental services for refugee background women during pregnancy.

BACKGROUND: Vulnerable populations such as people with refugee backgrounds are at increased risk of poor oral health. Given that maternal characteristics play a significant role in the development of dental caries in children, antenatal care offers an opportunity to both provide information to women about the importance of maternal oral health and accessing dental care. Although pregnant women are recognised for 'priority' care under Victorian state-government policy, rarely do they attend. This study aims to describe Afghan and Sri Lankan women's knowledge and beliefs surrounding maternal oral health, barriers to accessing dental care during pregnancy, and to present the perspectives of maternity and dental service providers in relation to dental care for pregnant women. METHODS: One agency comprising both dental and maternity services formed the setting for the study. Using participatory methods that included working with bicultural community workers, focus groups were conducted with Afghan and Sri Lankan refugee background participants. Focus groups were also completed with midwives and dental service staff. Thematic analysis was applied to analyse the qualitative data. RESULTS: Four community focus groups were conducted with a total of 14 Afghan women, eight Sri Lankan women, and three Sri Lankan men. Focus groups were also conducted with 19 dental staff including clinicians and administrative staff, and with ten midwives. Four main themes were identified: perceptions of dental care during pregnancy, navigating dental services, maternal oral health literacy and potential solutions. Key findings included women and men's perception that dental treatment is unsafe during pregnancy, the lack of awareness amongst both the midwives and community members of the potential impact of poor maternal oral health and the overall lack of awareness and understanding of the 'priority of access' policy that entitles pregnant women to receive dental care cost-free. CONCLUSION: This study highlights a significant policy-to-practice gap which if not addressed has the potential to widen oral health inequalities across the life-course. Stakeholders were keen to collaborate and support action to improve the oral health of mothers and their infants with the over-riding priority being to develop inter-service relationships to promote seamless access to oral health care.

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Reserve Select; TRICARE Dental Program; Early Eligibility for TRICARE for Certain Reserve Component Members. Final rule.

TRICARE Reserve Select (TRS) is a premium-based TRICARE health plan available for purchase worldwide by qualified members of the Ready Reserve and by qualified survivors of TRS members. TRICARE Dental Program (TDP) is a premium-based TRICARE dental plan available for purchase worldwide by qualified Service members. This final rule revises requirements and procedures for the TRS program to specify the appropriate actuarial basis for calculating premiums in addition to making other minor clarifying administrative changes. For a member who is involuntarily separated from the Selected Reserve under other than adverse conditions this final rule provides a time-limited exception that allows TRS coverage in effect to continue for up to 180 days after the date on which the member is separated from the Selected Reserve and TDP coverage in effect to continue for no less than 180 days after the separation date. It also expands early TRICARE eligibility for certain Reserve Component members from a maximum of 90 days to a maximum of 180 days prior to activation in support of a contingency operation for more than 30 days.

A Novel Approach for the Reimbursement of Permanent Partial Dental Disability Following Dental Injury.

Reimbursement of long-term permanent disability following a dental injury can lead to claims and legal involvement by the injured person. This will delay the treatment the patient's quality of life and the court system. A new formula has been hypothesized to address the problem. This might help the stakeholders including patients, insurance companies. The details of calculating the index and its significance are discussed. Implication studies are mandatory to refine the proposed hypothesis.

Evlynne Gilvarry: GDC view on the 2014 ARF consultation.

Evlynne Gilvarry took over as chief executive and registrar of the GDC on 20 October 2010. She joined the GDC from the General Osteopathic Council (GOsC), the statutory regulator of osteopathy in the UK, where she'd worked as chief executive and registrar since November 2007. Previously she worked in various senior policy and management roles at the Law Society, the regulator and professional body for solicitors in England and Wales. She is a qualified lawyer and mediator. In this interview, Ms Gilvarry discusses the 2014 ARF Consultation with the BDJ.

Changes in state policies related to oral health in the United States, 2002-2009.

OBJECTIVES: Examining state policies in oral health, including changes over time, helps inform the degree to which states fulfill public health dentistry functions and deliver essential services. This study examines changes in state policies affecting oral health in the United States between 2002 and 2009. METHODS: We reviewed 43 oral health policies in three domains (public dental insurance; workforce capacity; and infrastructure, programs, and surveillance). Data sources included federal, state, and private foundation reports and databases. Fifteen of 43 policies had data available for both time points and were analyzed. We examined national and regional changes over time using McNemar's test and Wilcoxon matched pairs signed ranks test. RESULTS: Between 2002 and 2009, the number of states offering Medicaid reimbursement to nondental professionals increased, more states had 12-month continuous coverage in CHIP, income eligibility for children on Medicaid expanded, and the number of licensed dentists per 10,000 population per state increased. However, the percent of public and private state health expenditures going toward dental services declined. Though nationally no other state policies significantly changed, the proportion of population on public water system with fluoridated water increased in Western states, and administration of needs assessments or oral health surveys decreased in the Northeast. CONCLUSION: Efforts are needed to systematically track the status of state policies to promote the public's oral health. Further research can determine if changes in state policies have led to improvements in the provision of oral health services and oral health status and reductions in disparities.

2014 Edition Electronic Health Record certification criteria: revision to the definition of "common Meaningful Use (MU) Data Set." Interim final rule with comment period.

This interim final rule with comment period revises one paragraph in the Common Meaningful Use (MU) Data Set definition at 45 CFR 170.102 to allow more flexibility with respect to the representation of dental procedures data for electronic health record (EHR) technology testing and certification.