Lessons drawn from research utilization in the maternal iodine supplementation policy development in Thailand

In this paper, the authors share their experience on evidence utilization in the development of Thailand’s maternal iodine supplementation policy in 2009–2010. Observations and reflections on their experience of engaging with research for policymaking are illustrated. The case study indicates that rapid approaches in conducting research, namely a targeted literature review and cross-sectional survey of professionals’ opinions and current practices were efficient in achieving the timeliness of evidence provision. In addition pro-activity, trust and interaction between researchers and policymakers enhanced the research–policy integration. The Thai experience may be useful for other developing countries which pursue evidence-informed policymaking, despite differences in the health system context

Teleconsultation/telediagnosis using teledentistry technology: a pilot feasibility study

Abstract—This study assessed the feasibility of a teledentistry model for teleconsultation and telediagnosis in Residential Aged Care Facilities. Study feasibility was defined by the ability to develop remote treatment plans. Reliability of the remote assessments was assessed by comparing with those performed by traditional face-to-face oral examinations. An intraoral camera was operated by trained teledentistry assistants with the aim of screening residents for oral diseases and pathological conditions. The model was supported by traning and an instructional kit for the introral camera operators. The structure, content and delivery of the program, was evaluated. Residents ’ views about the structure, content and delivery of the program were also evaluated. A total of 50 residents participated in this assessment. Results indicated that the proposed teledentistry approach for oral health screening is feasible and reliable as an alternative to traditional oral health examination. Residents expressed high levels of satisfaction with the teledentistry service. This study provides an innovative solution towards closing the service delivery gap in the provision of sustainable oral health care services to underserviced populations (e.g., nursing homes, rural areas)

Minimally invasive dentistry based on atraumatic restorative treatment to manage early childhood caries in rural and remote Aboriginal communities: protocol for a randomized controlled trial

BACKGROUND: The caries experience of Aboriginal children in Western Australia (WA) and elsewhere in Australia is more than twice that of non-Aboriginal children. Early childhood caries (caries among children &lt;6 years) has a significant impact on the quality of life of children and their caregivers, and its management is demanding and commonly undertaken under general anesthesia. A randomized controlled trial using a minimally invasive dentistry approach based on Atraumatic Restorative Treatment (ART) in metropolitan Perth, WA, has demonstrated a significant reduction in the rate of referral to a dental specialist for dental care among children with early childhood caries, potentially reducing the need for treatment under general anesthesia. The tested approach was clinically successful and was without adverse effects on child dental anxiety. The model of ART-based primary care requires further testing and development if similar outcomes for Aboriginal children in remote and rural settings are to be achieved. OBJECTIVE: The study aims to develop, implement, and evaluate a remote primary care model to deliver effective primary dental services, encompassing treatment and preventive services, to Aboriginal preschool children (based on minimally invasive approaches including ART). METHODS: This is a two-arm parallel cluster randomized controlled study in which a test group will be provided with the intervention treatment at the start of the study and a control group will be provided with the intervention treatment 12 months after study commencement (delayed intervention). Participating communities, stratified by size of community (ie, number of children in the sample frame) and baseline caries experience, will be randomly assigned using a computer-generated block randomized list into immediate (test group) or delayed intervention (control group; provided with standard care). Informed consent will be obtained from all participants. Aboriginal research assistants will explain the study to the parents and assist the parents in completing the questionnaires. Participants in the randomized study will be examined at baseline and at 12 months follow-up by a calibrated examiner. Test group participants will subsequently be contacted and appropriate appointments coordinated for treatment. Control group participants will be provided with standard preventive care by the Aboriginal Health Workers and managed for treatment as per standard procedures. RESULTS: Community consultations have been undertaken and 26 communities have agreed to participate. Fieldwork is in progress to recruit study participants. CONCLUSIONS: The significance of the study lies in its holistic approach to testing the model of care. Clinical evaluations as well as oral health‒related quality of life evaluations will be undertaken. Cost-effectiveness and cost-utility evaluations will assist in the development of policy options for oral health services for rural and remote communities. The elicitation of caregiver perspectives through focus group interviews will supplement the clinical, psychosocial, and cost-utility evaluations and provide a richer evaluation of the intervention.<br /

A Cost Analysis of an Outreach School-Based Dental Program: Teeth on Wheels

Background: This study evaluated an outreach mobile dental service called Teeth on Wheels (TOW). The dental program targeted Australian children from low household income, who are eligible for the Child Dental Benefits Scheme (CDBS) in Victoria, Australia. The program is complemented with a school-based oral health promotion element. Methods: A retrospective cohort study was performed with a convenience sample. Children must have had at least three dental examinations during the 2016–2019 calendar years to be included in the study. Comparisons were made between the 2016–17 and 2018–19 calendar years. It was hypothesised that the program would result in reduced costs and the number of restorations and extractions in the latter period. Results: A total of 414 children were included in the analysis. The total mean costs of the program per child reduced from AU$605.3 in 2016–17 to AU$531.1 in 2018–19. The results showed an overall mean reduction in all restorations and extractions performed, but only statistical significance was noted for reductions of restored deciduous teeth. Conclusions: This outreach program, which is focused on prevention and minimally invasive dentistry, can be a promising alternative model of delivery for dental services in young children

A dental workforce strategy to make Australian public dental services more efficient

BACKGROUND: Dental services can be provided by the oral health therapy (OHT) workforce and dentists. This study aims to quantify the potential cost-savings of increased utilisation of the OHT workforce in providing dental services for children under the Child Dental Benefits Schedule (CDBS). The CDBS is an Australian federal government initiative to increase dental care access for children aged 2-17&thinsp;years. METHODS: Dental services billed under the CDBS for the 2013-2014 financial year were used. Two OHT-to-dentist workforce mix ratios were tested: Model A National Workforce (1:4) and Model B Victorian Workforce (2:3). The 30% average salary difference between the two professions in the public sector was used to adjust the CDBS fee schedule for each type of service. The current 29% utilisation rate of the CDBS and the government target of 80% were modelled. RESULTS: The estimated cost-savings under the current CDBS utilisation rate was AUD 26.5M and AUD 61.7M, for Models A and B, respectively. For the government target CDBS utilisation rate, AUD 73.2M for Model A and AUD 170.2M for Model B could be saved. CONCLUSION: An increased utilisation of the OHT workforce to provide dental services under the CDBS would save costs on public dental service funding. The potential cost-savings can be reinvested in other dental initiatives such as outreach school-based dental check programmes or resource allocation to eliminate adult dental waiting lists in the public sector