Access to Dental Care

What do we mean by the term access to dental care?

The Inverse Care law

1. Who does it effect most? 2. How does it effect them? 3. What can be done to over come it? 4. Who is responsible for providing adequate dental services?

Access to Dental Care

Is there an inverse care dental care law?

Is there an inverse care dental care law?

Definition
People most in need of healthcare do not gain the most access.
Those with the least need of healthcare use the health services more and more effectively than do those with the greatest need. (Jones et. Al)

Is there an inverse care dental care law?

1. The availability of dental in Newcastle-upon-Tyne was clearly greater in more affluent areas and poorer in officially designated priority areas. (Jones et. al) 2. I have not seen a dentist for more than two years. I cant afford it. Ive not been able to find an NHS dentist in my area. (Response to Which? Research) 3. 16 and 35% of the public are experiencing difficulties in obtaining an NHS dentist. (McGrath et. al)

Is there an inverse care dental care law?

1.29% of higher class were having difficulty in finding an NHS dentist when only 20% of the lower class were. (McGrath)
2.59% of people found no difficulty in finding an NHS dentist (McGrath)

Is there an inverse care dental care law?

YES Under pre-2006 arrangements, dentists were paid per treatment, whereas in the new contract, for example, one restoration is the same as seven.

Sense of goodwill is lost

Forces practices to become private in wealthier areas so treatments are not paid out of the dentists pocket. Therefore availability in poorer areas has declined and inverse care law kicks in.

What group of people in society are most affected by the inverse care law and what affect does this half on their oral health?

What group of people in society are most affected by the inverse care law and what affect does this half on their oral health?
Children are the group people affected by this law (1). Also, adults in lower social classes such as those in manual labour are affected by this law aswell (2). Effect on oral health: An increase in dental decay which remains untreated and can even pass into the dentin (3). An increase in the number of fillings that are being carried out in primary teeth (3)

What group of people in society are most affected by the inverse care law and what affect does this half on their oral health?

Figure 1 (3)

What group of people in society are most affected by the inverse care law and what affect does this half on their oral health? A rise in number of children with gum inflammation (4). Tooth surface loss on the surfaces of primary incisors and permanent molars (5)

Central incisors effected by opacities (5)

What group of people in society are most affected by the inverse care law and what affect does this half on their oral health?

Defects in the enamel (5)

What group of people in society are most affected by the inverse care law and what affect does this half on their oral health?

What group of people in society are most affected by the inverse care law and what affect does this half on their oral health?
Jones CM, Capitation registration and social deprivation in England. An inverse dental care law? , British Dental Journal, 24th February 2001, 190, 205-206 Julian Tudor Hart, The Inverse Care Law, online, Saturday 27th February 1991, (cited 21st October 2011), Available from http://www.sochealth.co.uk/history/inversecare.htm Rachel Harker, John Morris, Children Dental Health in England 2003, March 2005 (cited 21st October 2011), available from http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/di gitalasset/dh_4107311.pdf Deborah White, Deborah Lader, Periodontal condition Hygiene behaviour and attitudes to oral health, online, October 2004 (cited 21st October 2011), available from http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/di gitalasset/dh_4092550.pdf Barbara Chadwick, Liz Pendry, Children dental health in the United Kingdom 2003, October 2004 , (cited 21st October 2011), http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/di gitalasset/dh_4092549.pdf http://www.dh.gov.uk/en/Publicationsandstatistics/PublishedSurvey/ListOfSurveySince19 90/Surveysonhealthissues/index.htm -finish off using this website

Suggest what can be done to overcome the inverse care law?

Suggest what can be done to overcome the inverse care law?

What steps could you take as a dental care professional to set the tone for a trusting relationship with your patients?

-Majority of populationscared of dentist very important to have a trusting relationship with patients Patient less nervous + Dentist less nervous =

Suggest what can be done to overcome the inverse care law?

Whilst in the waiting room

Friendly receptionist Receptionist is the first person patient meets when walks into surgery. Smiles, speaks clearly, willing to help, gives concise instructions i.e. if patient needs to fill in NHS form. Should be trained regularly

Suggest what can be done to overcome the inverse care law?

Whilst in the waiting room

Ensure good time management- if dentist is running late it is polite to inform the patient of this.

Suggest what can be done to overcome the inverse care law?

Whilst in the waiting room

Layout of waiting room calm colour scheme and design i.e. flowers in a vase (see picture) Forms of entertainment variety of magazines for adults, appropriate toys for children i.e. a wendy house or television with cartoons-must abide regulations-no soft toys allowed comfortable chairs.

Suggest what can be done to overcome the inverse care law?

Whist in the Surgery

Atmosphere Play appropriate music, but not too loud so they cant hear you Setting of room: not messy, not too cluttered Good colour scheme, i.e. blue paint not red paint Room doesnt smell i.e. spray air freshener.

Suggest what can be done to overcome the inverse care law?

Dentist Essential Skills Good communication: talk to patient make conversation i.e. weather, more effective-lead on from previous conversation-i.e. so how was your holiday to Turkey. Also explain procedure, let patient know what you are doing, ask the patient, make them feel like they have authority and they are in control. SMILE Also ability to adjust to patient, if child: the magic chair is just going to go down. Ensure it is a good experience, stickers for children.

Suggest what can be done to overcome the inverse care law?

Suggest what can be done to overcome the inverse care law?

Care should be distributed in relation to the areas that need it most. Improve awareness of dental health in more deprived areas in particular. NSFs have been set up to improve specific areas of healthcare. Encourage dentists into deprived areas.