Special Issue "Health Services Research on Dentistry in Aged Society"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Oral Health".

Deadline for manuscript submissions: 31 January 2022.

Special Issue Editor

Prof. Dr. Hiroko Miura
E-Mail Website
Guest Editor
Department of Oral Growth & Development, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
Interests: community oral health; gerontology; preventive dentistry; health service research regarding dentistry; medical sociology

Special Issue Information

Dear Colleagues,

As the global aging of the population will continue, there is an urgent issue to provide enough oral healthcare services to all generations. Fortunately, the prevalence of dental caries in children is being improved in many countries through the expansion of fluoride applications. However, adequate oral health services are not yet being provided to the elderly.

Because the systems for providing dental services vary from country to country, there has been inadequate knowledge gathering on oral health care delivery. In particular, there is little information regarding the extent to which public services cover oral health for the elderly. Another major challenge for health services research in dentistry is the analysis of the dental professional workforce, which is essential for providing adequate dental health services to all generations.

Health services research requires multidisciplinary approaches that examine the relationship between social factors, financial systems, medical technology, accessibility to health care, and the quality and cost of health care. It has been shown that improvement of oral health plays a major role in improving quality of life. The provision of appropriate oral health services is expected to make a significant contribution to the maintenance and improvement of overall health status. We hope that the keywords listed below provide an outline of this topical collection.

Prof. Dr. Hiroko Miura
Guest Editor

Manuscript Submission Information

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Keywords

  • oral health care service delivery
  • workforce analysis of dental profession
  • health care quality assessment
  • geriatric oral health
  • health insurance system
  • cost of oral health services
  • universal health coverage
  • real world data on dentistry

Published Papers (7 papers)

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Research

Article
Japan’s Dental Care Facing Population Aging: How Universal Coverage Responds to the Changing Needs of the Elderly
Int. J. Environ. Res. Public Health 2021, 18(17), 9359; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179359 - 04 Sep 2021
Viewed by 538
Abstract
Although universal health coverage (UHC) is pursued by many countries, not all countries with UHC include dental care in their benefits. Japan, with its long-held tradition of UHC, covers dental care as an essential benefit, and the majority of dental care services are [...] Read more.
Although universal health coverage (UHC) is pursued by many countries, not all countries with UHC include dental care in their benefits. Japan, with its long-held tradition of UHC, covers dental care as an essential benefit, and the majority of dental care services are provided to all patients with minimal copayment. Being under UHC, the scope of services as well as prices are regulated by the uniform fee schedule, and dentists submit claims according to the uniform format and fee schedule. The author analyzed the publicly available dental health insurance claims data as well as a sampling survey on dental hygiene to illustrate how Japan’s dental care is responding to the challenges from population aging. A marked improvement was found in dental health status in the elderly population as measured by improved tooth-specific survival. The improvement may be attributable to the universal coverage of dental care, as evidenced by the steady increase in home visits by dentists/dental hygienists as well as home oral rehabilitation services. Full article
(This article belongs to the Special Issue Health Services Research on Dentistry in Aged Society)
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Article
Multilevel Analysis of the Association of Dental-Hygienist-Related Factors on Regular Dental Check-Up Behavior
Int. J. Environ. Res. Public Health 2021, 18(6), 2816; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18062816 - 10 Mar 2021
Cited by 1 | Viewed by 1070
Abstract
Few studies have examined the factors related to dental clinics during dental check-ups. We examined the association between dental-hygienist-related factors and patients’ regular dental check-ups. This nationwide cross-sectional study was based on a survey conducted in Japan in 2014. The analyzed population included [...] Read more.
Few studies have examined the factors related to dental clinics during dental check-ups. We examined the association between dental-hygienist-related factors and patients’ regular dental check-ups. This nationwide cross-sectional study was based on a survey conducted in Japan in 2014. The analyzed population included 12,139 patients from 1181 dental clinics. We used three-level Poisson regression analysis, considering patient‒clinic‒prefecture, to examine the association of dental-hygienist-related factors with dental check-up behavior. Patients attending treatment and regular check-ups constituted 63.0% and 37.0%, respectively. The adjusted prevalence ratios (PRs) for patients undergoing regular dental check-ups at dental clinics with dedicated dental hygienists’ units, spending ≥20 min in patient education (compared to 0 min), and with three or more dental hygienists (compared to 0 hygienists) available were 1.17 (95% confidence interval [CI]: 1.06–1.30), 1.25 (95%CI: 1.07–1.46), and 2.05 (95%CI: 1.64–2.56), respectively. The median PR indicates that when a patient randomly moves to another dental clinic with more regular dental check-ups, this prevalence increased 1.69 times. These results suggest that dental check-up behavior is determined not only by individual factors but also dental-clinic-level factors. Improving the dental-hygienist-related factors is necessary to encourage people to visit dentists for regular check-ups. Full article
(This article belongs to the Special Issue Health Services Research on Dentistry in Aged Society)
Article
Gender Differences in Work Status during Early Career of Dentists: An Analysis of National Survey Cohort Data of 10 Years in Japan
Int. J. Environ. Res. Public Health 2021, 18(5), 2335; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052335 - 27 Feb 2021
Cited by 1 | Viewed by 776
Abstract
Few studies have evaluated gender differences in young dentists’ career focusing on career breaks and return to work. We created a cohort dataset for dentists registered in 2006 using the national survey between 2006–2016 (men, 1680; women, 984), and examined the work setting [...] Read more.
Few studies have evaluated gender differences in young dentists’ career focusing on career breaks and return to work. We created a cohort dataset for dentists registered in 2006 using the national survey between 2006–2016 (men, 1680; women, 984), and examined the work setting of dentists by gender 10 years after registration. The proportion of dentists on career break increased each survey year, and was more pronounced in women than in men (2006 to 2016, men, 11.2% to 14.2%; women, 7.9% to 31.0%). The proportion of those who had career breaks between 2006–2016 was 44.8% in men and 62.9% in women. In the multiple logistic regression for examining the associations between those who returned to work compared to those working continuously, in women, the odds ratios (OR) were significantly higher in those working in dental clinics (owner, OR: 5.39; employee, OR: 3.10), and those working part-time (OR: 2.07); however, in men, there was no significant association with part-time work. These results suggest during early career phase, female dentists are more likely than males to take career breaks and choose part-time on returning. These gender differences should be considered for ensuring adequate workforce in dentistry in the future. Full article
(This article belongs to the Special Issue Health Services Research on Dentistry in Aged Society)
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Article
Health-Related Social and Ethical Considerations towards the Utilization of Dental Medical Services by Seniors: Influencing and Protective Factors, Vulnerability, Resilience and Sense of Coherence
Int. J. Environ. Res. Public Health 2021, 18(4), 2048; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18042048 - 19 Feb 2021
Cited by 4 | Viewed by 1196
Abstract
The aim is to analyze protective and modifying factors (e.g., vulnerability, resilience, sense of coherence) in relation to the utilization of dental services by seniors at different levels of the healthcare system. Terminological imprecision in the use and transfer of existing terms (sense [...] Read more.
The aim is to analyze protective and modifying factors (e.g., vulnerability, resilience, sense of coherence) in relation to the utilization of dental services by seniors at different levels of the healthcare system. Terminological imprecision in the use and transfer of existing terms (sense of coherence, resilience, salutogenesis) to gerodontology is clarified. Factors influencing a reduced utilization (static/dynamic factors) can occur isolated or in combination and, thus, model the risk of a reduced utilization of dental services (influencing-factor mechanism). Protective factors of utilization include patient-specific factors for self-motivation and factors that promote oral-health-related resilience. Resistance forces that counteract can be identified as oral-health-related resilience factors. Achieving social and individual appreciation and establishing a prevention-oriented approach to utilization will be increasingly challenging, since the population is becoming older and access is not equal in terms of opportunity. Resistance forces need to be strengthened in an ethical context. Studies should increasingly present resilience processes, determinants and modes of action at the various interfaces in the healthcare system, which can ensure sustainable medical care in old age. The concepts conveyed here are generally valid and able to point out inequalities and ageism in access to dental services. Full article
(This article belongs to the Special Issue Health Services Research on Dentistry in Aged Society)
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Article
Analysis of Factors Related to Working Status of Dental Hygienists in Japan
Int. J. Environ. Res. Public Health 2021, 18(3), 1025; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031025 - 24 Jan 2021
Viewed by 1039
Abstract
The super-aged society of Japan is experiencing an increased demand for dental hygienists, of which there is currently a shortage. This study aimed to investigate the factors related to the working status of dental hygienists in Japan. We conducted a survey by mailing [...] Read more.
The super-aged society of Japan is experiencing an increased demand for dental hygienists, of which there is currently a shortage. This study aimed to investigate the factors related to the working status of dental hygienists in Japan. We conducted a survey by mailing a questionnaire on employment to 1444 dental hygienists and obtained 537 valid responses. We conducted a bivariate analysis using either a chi-square test or t-test as well as a multiple logistic regression analysis to determine the factors related to working status. The overall employment rate was 68.2%, with a significant difference between age groups (p < 0.01). Approximately 80% of respondents considered working hours and human relations at the workplace to be important, and more than 70% of respondents considered wages as important. Finally, the following four variables were found to be significantly associated with employment status: training course attendance, a desire to work full-time, consideration of wages as important, and consideration of working hours as important. These findings suggest that it is necessary to improve working conditions and environments, including wages and working hours, as well as provide a more robust system of continued professional development for dental hygienists to increase the workforce. Full article
(This article belongs to the Special Issue Health Services Research on Dentistry in Aged Society)
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Article
The Relationship between the Sense of Coherence of Dental Hygiene Students in Their Graduation Year and Their View of the Profession and Attitude to Work: A Cross-Sectional Survey in Japan
Int. J. Environ. Res. Public Health 2020, 17(24), 9594; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249594 - 21 Dec 2020
Cited by 1 | Viewed by 853
Abstract
Objective: The need to make sense of coherence in placement support for student dental hygienists has been shown. On this basis, this study investigated the relationship between the sense of coherence of student dental hygienists and their view of the profession and attitude [...] Read more.
Objective: The need to make sense of coherence in placement support for student dental hygienists has been shown. On this basis, this study investigated the relationship between the sense of coherence of student dental hygienists and their view of the profession and attitude to work in order to clarify how they perceive their prospects for employment. Methods: The subjects were graduation-year students at all of the dental hygienist training institutions in Japan, and anonymous, self-administered questionnaires were sent to the institutions by post in 2019. The results were analyzed by χ2 tests, as well as one-way analysis of variance and multiple comparisons using Tukey’s test, with the level of significance set at 5%. Results: Of 6270 questionnaires that were returned, 6264 were analyzed. The sense of coherence (SOC) component senses were manageability (F(26,221) = 5306.06, p < 0.01), meaningfulness (F(26,222) = 4373.48, p < 0.01), and comprehensibility (F(26,216) = 3986.12, p < 0.01), with meaningfulness scoring significantly higher than the other two (p < 0.01). Analysis with SOC scores divided into the low, medium, and high groups showed a relationship between the SOC of student dental hygienists and their view of the profession and attitude to work (p < 0.01), such that higher SOC scores were associated with a better view of the profession and a better attitude to work (F(26,225) = 282.18, p < 0.01). Conclusions: The results suggest that education that increases SOC in dental hygienist training programs may positively affect future prospects for student dental hygienists. Full article
(This article belongs to the Special Issue Health Services Research on Dentistry in Aged Society)
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Article
A Nationwide Survey on Working Hours and Working Environment among Hospital Dentists in Japan
Int. J. Environ. Res. Public Health 2020, 17(23), 9048; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17239048 - 04 Dec 2020
Cited by 2 | Viewed by 718
Abstract
Sustainable human resource is one of the main issues in healthcare delivery and the way hospital dentists work has a significant impact on oral and dental healthcare services. This study is the first large-scale nationwide survey aiming to investigate the working hours including [...] Read more.
Sustainable human resource is one of the main issues in healthcare delivery and the way hospital dentists work has a significant impact on oral and dental healthcare services. This study is the first large-scale nationwide survey aiming to investigate the working hours including the working environment among hospital dentists in Japan. A total of 2914 hospital dentists responded to self-administered questionnaires from general hospitals (GHs) and medical educational institutions (MEIs) across the country. Among full-time dentists, the younger generation (i.e., those in their 20s and 30s) of both male and female dentists working in GHs engage in over 40 h of in-hospital clinical practice per week, apart from their self-learning hours. In contrast, the middle-aged dentists (i.e., those in their 40s and 50s) at MEIs work for more than 50 h on average due to the added teaching and research responsibilities. In a multiple logistic regression model using “more than 60 h of work per week” as the dependent variable, higher ORs (Odds Ratios) were found in males (OR = 1.83, 95%CI 1.50–2.22), MEIs (OR = 1.92, 1.52–2.42), and individuals specializing in dental and oral surgery (OR = 1.85, 1.47–2.32). Task-shifting was requested by 22.6% of the respondents for preventive care and dental guidance. Only a few male dentists experienced taking a parental leave and the peak distribution of working hours was shorter for females working in GHs. The support for child-rearing in the work environment is still insufficient and a consensus on the involvement of male dentists in childcare is needed. Full article
(This article belongs to the Special Issue Health Services Research on Dentistry in Aged Society)
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