Elaboration d'un outil d'orientation des patients vers l'Unité Fonctionnelle d'Urgence du service d'odontologie de Clermont-Ferrand

CLERMONT FD-BCIU Odontol. (631132226) / SudocCLERMONT FD-BCIU-Santé (631132104) / SudocSudocFranceF

Production d'inégalités de santé par le système de soins (apport de la recherche qualitative)

Les inégalités de santé sont le plus souvent déterminées hors du système de soins car elles dépendent principalement de facteurs sociaux, psycho-sociaux ou environnementaux. Elles peuvent cependant être renforcées par les difficultés d'accés aux soins. L'objectif de ce travail est de déterminer si certaines structures délivrant des soins dentaires en France -dentistes libéraux ou structures hospitalo-universitaires- peuvent générer des difficultés d'accès aux soins. Des méthodologies qualitatives ont été utilisées pour comprendre les expériences des chirurgiens-dentistes libéraux face aux patients économiquement défavorisés et pour identifier les caractéristiques propres à une structure hospitalo-universitaire, susceptibles d'être des facteurs d'exclusion pour les patients. Une dernière étude a utilisée des méthodologies qualitative et quantitative pour élaborer un outil d'information et évaluer son impact sur la continuité des soins au sein d'un service d'odontologie. Les résultats montrent que les structures de soins étudiées peuvent générer des difficultés d'accés aux soins. Les dentistes libéraux peuvent mettre en place des mécanismes d'exclusion face à certains patients démunis qui fréquentent irrégulièrement les cabinets dentaires. La double mission de soins et d'enseignement des structures hospitalo-universitaires est un élément qui peut aussi être à l'origine d'exclusion. La diffusion d'un outil d'information concernant le fonctionnement de ces structures semble avoir un faible impact sur la continuité des soins. L'origine de la production d'inégalités de santé au sein du système de soins semble complexe et multifactorielle. Néanmmois, ce travail montre que l'absence du patient à ses rendez-vous est une des raisons d'exclusion de celui-ci et en même temps une conséquence d'un processus d'exclusion développé par les structures de soins.Many epidemiological studies have revealed important differences in terms of oral status according to the socioeconomic status of the studied populations. Health inequalities are mostly determined outside the care system because they mainly depend on social, psycho-social or environnemental factors. However, they may be reinforced by the difficulties of acces to care. The objective of this work is to show if the main structures delivering dental care in France -private dentist and university dental clinics- can generate difficulties in access to care. Qualitative methods were used on one hand to understand the private dentist' experiences concerning economically disadvantaged patients and on the other hand to identify which characteristics of a university hospital may be factors of exclusion for patients. A final study used qualitative and quantitative methodologies to develop an information brochure and evaluate its impact, in a university hospital, on the continuity of care. The results show that the studied structures can create difficulties in access to care. The dentists can implement exclusion mechanisms against patients with low economic status. The dual mission of care and teading of the university hospital is an element which also can lead to exclude the patient. The spreadind of an information brochure has a little impact on the continuity of care. The origin of the implementation of inequalities within the health care system seems complex and multifactor. Nevertheless, this work shows that the non attendance of the patient to his appointment is one of the reasons for his exclusion and also a consequence of an exclusion process developed by the health care system.CLERMONT FD-BCIU Odontol. (631132226) / SudocCLERMONT FD-BCIU-Santé (631132104) / SudocSudocFranceF

Elaboration et évaluation d'un enseignement en odontologie relatif à la détection, la prise en charge et l'orientation des victimes de violences conjugales

CLERMONT FD-BCIU Odontol. (631132226) / SudocCLERMONT FD-BCIU-Santé (631132104) / SudocSudocFranceF

Reconnaître la santé orale comme un enjeu de santé publique

International audienc

Inégalités en santé orale : déterminants de l’accès à la prévention et aux soins en France

International audienc

Étude de l’accès à un parcours de soins spécifique pour les personnes vulnérables.

National audienc

Influence of an oral health promotion program on the evolution of dental status in New Caledonia: A focus on health inequities

New Caledonia is a sui generis collectivity of overseas France situated in the south Pacific Ocean. Geographical and social inequalities are superimposed on ethnic disparities with high prevalence of chronic diseases such as oral diseases. In 2012, the health agency has evaluated the children’s health status. Then, an oral health promotion program was developed in 2014. Another study was conducted in 2019 in New Caledonia to appreciate the evolution of children’s oral health. A sample of 488 9-years-old children was randomly selected. Dental status was clinically recorded, families and children answered questionnaires about oral health determinants. The methodology (sampling, study variables…) was similar to the one used in the 2012 study. Multivariate mixed-models were conducted to compare 2012 and 2019 dental status and to explore the determinants of caries experience in 2019. Results indicated that caries prevalence and experience decreased between 2012 and 2019, with nonetheless various trends depending on the province or type of indexes. The number of carious lesions (d 3 t + D 3 T) in 2019 was used as an outcome variable in four models. Model 1 integrated social variables; ethnicity was found to be the only significant determinant. Model 2 was related to oral health care; participation in the program & and access to oral health care was found to be significant. For oral health behaviours (model 3), tooth brushing frequency and consumption of sugary snacks were significant risk factors. In a final model with significant variables from the previous models, ethnicity, accessibility of oral health care, number of sealed molars, consumption of sugary snacks remained explanatory factors. Five years after the implementation of the oral health promotion program, positive changes in oral health have been observed. However, health equity is still an issue with varying health status depending on ethnicity, behavioural factors and accessibility to oral health care

Prevalence of oral impacts on daily performances in French children.

International audienc

Évolution de la santé orale et de l’état staturopondéral des enfants de 6 , 9 et 12 ans scolarisés en Nouvelle-Calédonie entre 2012-2019

International audienc

Validation of a French version of the Child‐OIDP index

International audienceThe Child‐OIDP index is an indicator of oral health‐related quality of life, which has been validated among 12‐yr‐old children in Thailand. The aim of this study was to assess the reliability, validity, and applicability of this questionnaire among French children. After translation and cultural adaptation, the Child‐OIDP was tested on 414 10‐yr‐old children in France. The children completed the Child‐OIDP in face‐to‐face interviews, were clinically examined, and answered questions evaluating their global self‐rated oral health. Parents filled in a questionnaire concerning their socio‐demographic background. An oral impact on daily life was reported by 73% of the children. The mean Child‐OIDP score was 6.32 [standard deviation (SD) 8.22] and the median was 3.33. The internal reliability was confirmed with a Cronbach's alpha of 0.57. The retest procedure ( n = 62) showed a satisfactory reproducibility ( r = 0.81, κ = 0.75). The index was shown to be a valid instrument. Construct validity was satisfactory as the Child‐OIDP score increased when the children's perceived oral health decreased. The Child‐OIDP score was able to discriminate between different socio‐demographic groupings and varied according to dental status. This study showed that the Child‐OIDP is applicable for use among children in France. It has promising psychometric properties but further research is required to evaluate its sensitivity to change