Resource Allocation in a National Dental Service Using Program Budgeting Marginal Analysis

Introduction: In any health system, choices must be made about the allocation of resources (budget), which are often scarce. Economics has defined frameworks to aid resource allocation, and program budgeting marginal analysis (PBMA) is one such framework. In principle, patient and public values can be incorporated into these frameworks, using techniques such as willingness to pay (WTP). However, this has not been done before, and few formal resource allocation processes have been undertaken in dentistry. This study aimed to undertake a PBMA with embedded WTP values in a national dental setting. Methods: The PBMA process was undertaken by a panel of participant-researchers representing commissioners, dentists, dental public health staff, and academics. The panel reviewed current allocations and generated a set of weighted criteria to evaluate services against. Services to be considered for removal and investment were determined by the panel and wider discussion and then scored against the criteria. Values from a nationally representative WTP survey of the public contributed to the scores for interventions. Final decisions on removal and investment were taken after panel discussion using individual anonymous electronic voting. Results: The PBMA process resulted in recommendations to invest in new program components to improve access to general dentists, care home dentistry, and extra support for dental public health input into local government decisions. Disinvestments were recommended in orthodontics and to remove routine scaling and polishing of teeth. Discussion: The PBMA process was successful in raising awareness of resource allocation issues. Implementation of findings will depend on the ability of decision makers to find ways of operationalizing the decisions. The process illustrates practical aspects of the process that future dental PBMAs could learn from. Knowledge Transfer Statement: This study illustrates a framework for resource allocation in dental health services and will aid decision makers in implementing their own resource allocation systems.

New Understanding of Dental Public Health: A Review

Oral disorders are a most important public health issue in most of the developing countries, and their prevalence is on the rise. To enhance the population's oral wellbeing by providing preventive and therapeutic services is the main aim of dental public health (DPH). However, due to low requirement of capability and ability among DPH personnel, its accomplishment in India is being probed [1]. For many people, dental care has grown expensive, and a huge number of patients around the world are delaying or ignoring important dental procedures. in addition, the ageing of the worldwide populace, as well as the resulting growth in common and dental concern needs, raises worries about the long-term viability of healthcare organization. These changes underscore the critical requirement for a new dental care representation that is both sustainable and efficient [2]. In this regard, the favorable approach for transforming the scene of oral healthcare is the adoption of scientific advancements in dentistry, commonly known as "digital dentistry" by many. In addition, the World Health Organization (WHO) campaigns revolutionize on a regular basis, encouraging the creation and spread of community wellbeing practices that are holded up by both documentation and conveyance technology (e-Health) and mobile phones (m-Health) [3]. We can see how scientific developments could facilitate to accomplish these aims by offering constructive apparatus if we focus on the concept of Dental Public Health (DPH) as “the knowledge and art of arresting and scheming dental disorders and understanding dental wellbeing through efficient group hard work” [4].

Assessment of Educational Status of Periodontics and Oral Health and Community Dentistry Departments in Yazd Dental School Using CIPP Model in 2018

Introduction: Considering the changes, which implemented in the dental education program in recent years and also the importance of reviewing their feedback in educational affairs, the purpose of this study was to evaluate the periodontics and dental public health departments of Dental School based on the CIPP evaluation model in 2018. Methods: The present study was performed in a descriptive cross-sectional format on the target population of dental students of 10-12 semesters and professors of the mentioned groups. Context, input, process and product were assessed using a questionnaire consistent with the CIPP pattern checklist. Data were analyzed by ANOVA and T-test via SPSS 16 software. Results: The average scores of professors and students in different areas of the Periodontology Department were as followed: the context (75, 58.6); input (18.9, 1.37); process (68.7, 8.37) and product (56.2, 1.37) fields, respectively. In the Dental Public Health Department, the average scores also included context (50, 3.64); input (25, 5.63); process (100, 58) and product (75, 3.58) areas, respectively. Conclusion: In the Department of Periodontics, the input as well as process and output were undesirable for the students and the input was undesirable for the professors. In the Dental Public Health Department, just input was unfavorable for professors and relatively desirable for students in all four areas.

Dental public health

Dental public health is concerned with preventing oral disease, promoting oral health, and improving the quality of life through the organized efforts of society. Oral diseases including dental caries, periodontal disease, oral neoplasms, and dentofacial trauma are common, have a significant impact on individuals and wider society, and are largely preventable. While the prevalence and severity of these most common and costly dental diseases have fallen in most developed countries, oral health inequalities exist in relation to socioeconomic status, ethnicity, or region. The links between oral and general health indicate that strategies to improve both sets of problems and reduce inequalities should be integrated within the framework advocated by the Commission for the Social Determinants of Health. Of particular relevance to oral health are increasing the availability of fluoride and ensuring universal access to quality dental services. Factors influencing oral health in the future include tighter financial pressures, changes in disease prevalence, the deprofessionalization of dentistry, the role of consumerism in oral health, and the need for a better evidence base.

COVID-19 lockdown and recovery: a dental public health perspective from Lancashire and South Cumbria

The COVID-19 pandemic has created novel barriers in providing and accessing all forms of healthcare, including dentistry. The national dental response during the first peak of the pandemic resulted in rapid changes in the provision of service, to safeguard providers and users of dental care. Such rapidly leveraged changes resulted in several issues in service delivery, requiring careful input from managers and commissioners within NHS England and Improvement, trainees and consultants in dental public health within Public Health England, and frontline dental teams working across the health and social care system. The local response from Lancashire and South Cumbria is outlined within this article. Teamwork, communication and reflexive, iterative learning from these groups ensured the delivery of an Urgent Dental Care service during the first lockdown of the pandemic. The impact of COVID-19 has enabled considerable learning which will inform future pandemic planning, alongside providing the opportunity to deliver meaningful change within NHS dentistry as the service continues to recover.

Is Pediatric Dentistry a Topic of Interest for Pediatric Journals? A Scoping Review

Background: Pediatric dentistry shares many skills with pediatrics. This review evaluates the amount of literature on pediatric dentistry in the first 30 pediatric journals classified by the Web of Science in 2019. The aim was to perform a quantitative analysis of the main dental topics addressed. Methods: A scoping review with the PRISMA-ScR criteria was performed. The Clarivate Analytics Journal Citation Report was consulted for journals ranked in the category “Pediatrics” in 2019. Papers were searched in PubMed using an ad hoc prepared string. Results: A total of 504 papers were included. Papers on dental hard tissues were the most prevalent (45.6%), followed by dental public health (23.2%), orofacial development (15.3%), soft tissues related conditions (12.3%), and orofacial trauma (3.6%). Increasing trends have been observed for total papers published (R2 = 0.9822) and total dental papers (R2 = 0.8862), with no statistically significant differences (χ2(6) = 0.051 p > 0.05). The majority of papers (n = 292, 57.9%) were cited between 1 and 10 times, whilst less than 7% of papers received more than 40 citations. Discussion: It is desirable that papers on pediatric dentistry increase in the pediatric scenario, allowing the two related disciplines to intertwine more in the future.