Journal of International Oral Health 2015; 7(5):i-ii

Editorial

Dental Outreach Program – How Effective it is in Reaching Out to the Community Rushabh Dagli1, Amarpreet Singh2

Contributors: 1 Reader, Department of Public Health Dentistry, Vyas Dental College & Hospital, Jodhpur, Rajasthan, India; 2Post-graduate Student, Department of Public Health Dentistry, Vyas Dental College & Hospital, Jodhpur, Rajasthan, India. Correspondence: Dr. Rushabh J. Dagli, Reader, Department of Public Health Dentistry, Vyas Dental College & Hospital, Jodhpur, Rajasthan, India. Email: [email protected] How to cite the article: Dagli R, Singh A. Dental outreach program – How effective it is in reaching out to the community. J Int Oral Health 2015;7(5):i-ii

Good oral health helps to ensure overall health and well-being. There has been an indicative social and economic ramification due to poor oral health. In the US alone, illnesses related to oral health result in 6.1 million days of bed disability, 12.7 million days of restricted activity, and 20.5 million workdays lost each year.1 There has been a significant improvement in health for the past few years, but this is not distributed equally across the population as it is utilized higher among the better off. India being a developing country and records second highest population in the world unmatching of the population and oral health professionals serving them has been observed. It has been witnessed that about 80% of dentists are practicing in major cities in India which is very less compared to the 70% of the population residing in rural areas. The ratio of dentist and population in urban areas is 1:10,000 as compared to rural areas which are 1:150,000. The number of qualified dentists in our country is found to be 118,000 still there is lack of availability of basic oral health education and simple intercession to a larger sector of population, resulting in poor oral health also affecting the quality and standard of life, individuality, narcissism and has been linked to demeanor and ontogenic problems.2 The disintegration in the oral diseases can be prevented by making an early identification, investigation and providing the desired treatment which is possible by introducing dental outreach programs. The community-based dental outreach programs play a very crucial role in declining discovery-delivery disconnect by introducing awareness through health education and dental adumbrating services to the community members. These programs are found to be very effective for diminishing health unevenness.3 An outreach program is complete entanglement between the community and the health institution or organizations. It is an attempt by the organizing members to impart its objectives, opinions, skills and practices to the target population or general population thereby generating awareness and improving oral health. Dental outreach programs are generally non-profitable organizations, which may be non-government or government and are directed towards the cost effectiveness and benefit of the community using the community itself as a resource.4 The systematic review was searched in MEDLINE, PSYCINFO, ECONLIT, EMBASE and CINAHL to identify cost effectiveness evaluations of outreach programs in indigenous populations around the world. There were inclusions of 19 studies reporting on 27 interventions in the review. Among them, 23 were interventions that specifically targeted indigenous populations and outreach programs were shown to be consistently cost-effective.5 Peer-reviewed national publications have demonstrated that early prevention can substantially reduce future dental care costs and one such dental outreach program (ABCD) in washinton has proved to be cost-effective method of improving oral health status of young children.6 Several studies examining oral health outcomes have been conducted and are currently in progress to assess the efficacy of the outreach model. Henry Schein Cares Global in 2010 conducted a survey at Grenada a tri-island nation in the Caribbean and found results which were astonishing: More than 83% of Grenada’s children suffer from untreated tooth decay. After performing dental outreach programs in these areas. In May 2013, the national oral health survey was repeated, and it showed 90% decrease in new tooth decay. A mixed-methods impact evaluation was performed to capture the knowledge, attitudes, and practices of parents and teachers relating to oral health and the Smile Grenada program.7 A 3-year study conducted by Pawar et al. showed dental outreach program to be very effective in improving oral status of school childrens during a 3-year follow-up period in Lucknow city.8 i



Journal of International Oral Health 2015; 7(5):i-ii

On the basis of utilization of outreach programs, the results from the study conducted by Kadaluru et al. show that utilization of the dental service among adults attending outreach program was very low (28%),9 it was in concordant with reports from China (20%) and Spain (34.3%).4,10 In some other studies utilization is high in developed countries, with figures of 75% in the US, 61% in the Danish adult population,11 47% in the UK,12 56% in Finland,13 and 43% in Singapore.14 Basic awareness, literacy, and health insurance which cover dental services in these countries can be speculated for the high utilization, which is non-existent in India. Insurance schemes either at the micro level or at the macro level for oral health services for our population should be considered. In a study conducted by Vashisth et al. the disease pattern showed dental caries was found to be in maximum proportion followed by gingivitis. The commonly utilized services in the dental outreach programs were oral prophylaxis, restoration, and extractions.15 Similar findings were reported by national oral health survey (2002-2003).16 The data from Western studies suggests the main reasons for oral care were dental examination (44.4%), tooth restoration (35.0%), and dental cleaning (32.1%).17 The outreach health programs organized by Trinity Care Foundation a Public Health organization has been very successful in identifying and providing Holistic Treatment for Children with Facial Deformities and organizing School Health Programs in Karnataka State, India.3 The utilization of dental services can be improved by identifying the barriers and by providing appropriate education and intervention. The conclusion from various studies showed a positive impact on the oral hygiene status and has been estimated to be on the more positive aspect in future. These outreach programs intends to create replicable models that will improve oral health around the world. By changing the way individuals perceive their own and their children’s oral health, and by transforming the role of dentists in society, sustainability can truly be achieved. References 1. DHHS. Oral Health in America: A Report of the Surgeon General. NIH Publication no. 004713, 2000. Available from: http:// www.surgeongeneral.gov/library/oralhealth/. 2. Tandon S. Challenges to the oral health workforce in India. J Dent Educ 2004;68 7 Suppl:28-33. 3. Trinity Care Foundation Report 2015. Bangalore, India. 4. Pizarro V, Ferrer M, Domingo-Salvany A, Benach J, Borrell C, Pont A, et al. The utilization of dental care services according to health insurance coverage in Catalonia (Spain). Community Dent Oral Epidemiol 2009;37(1):78-84. 5. Angell BJ, Muhunthan J, Irving M, Eades S, Jan S. Global systematic review of the cost-effectiveness of indigenous health interventions. PLoS One 2014 Nov 5;9(11):e111249. 6. Kobayashi M, Chi D, Coldwell SE, Domoto P, Milgrom P. The effectiveness and estimated costs of the access to baby and child dentistry program in Washington State. J Am Dent Assoc 2005;136(9):1257-63. 7. Henry Schein Cares Global Student Outreach Program, NYU College of Dentistry Department of Global Outreach Report, 2013. 8. Pawar H, Saha S, Jagannath G, Kumari M, Narang R, Singh E. Effectiveness of outreach program: a three year follow-up study among 12 years school students in Lucknow. J Clin Diagn Res 2015;9(1):ZC35-8. 9. Kadaluru UG, Kempraj VM, Muddaiah P. Utilization of oral health care services among adults attending community outreach programs. Indian J Dent Res 2012;23(6):841-2. 10. Brown LJ, Lazar V. Dental care utilization: how saturated is the patient market? J Am Dent Assoc 1999;130(4):573-80. 11. Petersen PE. Dental visits and self-assessment of dental health status in the adult Danish population. Scand J Prim Health Care 1984;2(4):167-73. 12. McGrath C, Bedi R, Dhawan N. Factors influencing older people’s self reported use of dental services in the UK. Gerodontology 1999;16(2):97-102. 13. Murtomaa H. Utilization of dental services by Finnish adults in 1971 and 1980. Acta Odontol Scand 1983;41(2):65-70. 14. Lo GL. The use of dental services by adult Singaporeans. Singapore Dent J 1993;18(1):22-5. 15. Vashisth S, Gupta N, Bansal M, Rao NC. Utilization of services rendered in dental outreach programs in rural areas of Haryana. Contemp Clin Dent 2012;3 Suppl 2:S164-6. 16. National Oral Health Survey and Fluoride Mapping 2002-2003. New Delhi, India: Dental Council of India; 2004. 17. Sánchez-García S, de la Fuente-Hernández J, Juárez-Cedillo T, Mendoza JM, Reyes-Morales H, Solórzano-Santos F, et al. Oral health service utilization by elderly beneficiaries of the Mexican Institute of Social Security in México city. BMC Health Serv Res 2007;7:211. ii