(1) Background: The process of managing children at the emergency dental clinic (ER-C) is a difficult challenge. This matched case-control study assessed risk factors associated with children visiting the ER-C compared to visits at the regular dental clinic (RD-C). (2) Methods: The participants included 421 children aged three to 12 years who were recruited at the ER-C (cases) and RD-C (controls) at King Abdulaziz University Dental Hospital, with each group matched for gender and age. A data-collection form was developed and validated in both Arabic and English, containing the following four sections: DMFT/dmft index, Frankl’s behaviour rating scale, Dental Neglect Scale, and Dental Care Barriers questionnaire. (3) Results: The ER-C (vs RD-C) group showed significantly more uncooperative behaviour (p = 0.002), a higher total mean dental neglect score (p = 0.003), and a higher dental barrier score (p < 0.001). Binary regression analysis showed that those making their first visit (AOR: 2.65, p < 0.001) and with higher dental barriers (AOR: 1.121, p < 0.001) were statistically significantly more associated with ER-C visitation. (4) Conclusion: These findings suggest that children who visit the ER-C are more prone to dental care barriers, uncooperative behaviour, and dental neglect, thus highlighting the importance of encouraging and planning their attendance to ensure optimal dental care.

OBJECTIVE: This study aimed to compare the cost-effectiveness estimates of a brief counselling of smoking cessation in dentistry by using two different health economic models.
METHODS: Intervention effectiveness was estimated in a cluster randomised controlled trial. The number of quitters was estimated based on 7-day abstinence and on smoking reduction at follow-up. Health economic evaluation was performed using two models: (1) a population-based model employing potential impact fractions and (2) a Markov model estimating the cost-effectiveness of the intervention for the actual participants. The evaluation was performed from healthcare and societal perspectives, and health gains were expressed in quality-adjusted life-years (QALYs).
METHODS: Dental clinics in Sweden.
METHODS: 205 Swedish smokers aged 20-75 years.
METHODS: A brief, structured behavioural intervention was compared with \'usual care\'.
RESULTS: The cost per quitter was US$552 in the intervention and US$522 in the \'usual care\' condition. The net saving estimated with the population-based model was US$17.3 million for intervention and US$49.9 million for \'usual care\', with health gains of 1428 QALYs and 2369 QALYs, respectively, for the whole Swedish population during 10 years. The intervention was thus dominated by \'usual care\'. The reverse was true when using the Markov model, showing net societal savings of US$71 000 for the intervention and US$57000 for \'usual care\', with gains of 5.42 QALYs and 4.74 QALYs, respectively, for lifelong quitters.
CONCLUSIONS: The comparison of intervention and \'usual care\' derived from small-scale studies may be highly sensitive to the choice of the model used to calculate cost-effectiveness.
BACKGROUND: The cluster randomised trial is registered in the ISRCTN register of controlled trials with identification number ISRCTN50627997.

To compare the outcomes of routine provider-initiated HIV testing and counselling (PITC) and oral rapid HIV testing for dental clinic outpatients in a hospital.
We employed a case-control study design and recruited dental outpatients into routine serum-based and oral rapid testing groups. We compared the acceptance, completion and result notification rate between groups.
A dental outpatient clinic in the Yuxi People\'s Hospital, Yunnan.
A total of 758 and 816 dental outpatients were enrolled for routine and oral rapid testing, respectively.
The percentage of participants willing to receive routine HIV testing was 28.1% (95% CI 24.9% to 31.3%) and 96.1% (95% CI 94.8% to 97.4%, χ2=186.4, p<0.001) for the rapid testing. Among accepted participants, the percentage of participants who received HIV testing was 26.8% (95% CI 20.9% to 32.7%) in the routine testing group and 100.0% in the oral rapid HIV testing group (χ2=77.5, p<0.001). About 93.0% of routine testers returned for the test results on the next day, whereas all rapid testers received their test results on the same day (χ2=34.6, p<0.001). These correspond to an overall completion rate of 7.0% (95% CI 5.2% to 8.8%) and 96.1% (95% CI 94.8% to 97.4%, p<0.001), respectively. Among the 545 patients who declined routine serum-based HIV testing, the main reasons included, an unnecessary hassle (254/545, 46.6%), having been previously tested (124/545, 22.8%) and self-perceived low risk of HIV infection (103/545, 18.9%). In contrast, only 32 individuals declined oral rapid testing, and having received a previous test was the primary reason. Three patients in the rapid testing group were later confirmed HIV-positive, yielding an HIV prevalence of 0.38%.
Oral rapid HIV testing is a feasible and efficient approach in a clinical setting.

BACKGROUND: The Government of India is increasingly emphasizing the provisioning of dental services in public hospitals, but the rural and deprived sections are struggling to get basic dental procedures done in public hospitals.
OBJECTIVE: To study variations within and across public hospitals for provisioning of dental health settings in Jalandhar district of Punjab.
METHODS: The study area consisted of four Community Health Centers (CHCs) and District Hospital situated in Jalandhar, Punjab, India.
METHODS: The dental infrastructure and dental procedures performed in the public hospital were checked with the help of a checklist as listed in the Indian Public Health Standards 2012 for CHCs and district hospital, and then, the variations within and across these public hospitals were compared.
METHODS: Percentages were used to make comparisons within and across the public health institutions.
CONCLUSIONS: The results showed that out of total outpatient department (OPD) of the public hospitals, dental OPD formed 5%-10% in public hospitals and extraction was the most frequently performed procedure. There is no availability of prosthodontic and orthodontic procedures in the public hospitals. There were no dental auxiliaries in the CHCs, and there was lack of proper dental materials needed in the dental clinics.

To compare two methods of allocating general dentists to Canadian Armed Forces (CAF) dental detachments: a dentist-to-population ratio model and a needs-based model.
Data obtained from CAF sources were analysed to compare models. Times assigned to treatment plan procedures were used as a proxy for treatment needs. Full-time equivalents (FTEs) were used as an indicator for the number of dentists allocated to each detachment. FTE values were adjusted for military dentists to account for time spent on compulsory nonclinical duties. The paired-samples t test was used to assess differences between the models for all clinics (dental detachments) and by clinic size.
The dentist-to-population ratio model for the CAF population (n=68 183) estimated an allocation of 83.25 FTE general dentists to CAF dental detachments. Based on a systematic sample of the CAF population (n=2226), the needs-based model estimated the requirement for 64.71 FTE general dentists. The average difference between models was 0.71 FTE (SE=0.273), which was statistically significant (P=0.015). In terms of differences by clinic size, differences were more pronounced in clinics serving more than 4000 CAF personnel (2.63 FTEs, SE=0.613, P=0.008).
The findings reveal differences between estimation models of <1 FTE, with higher estimates produced from the dentist-to-population ratio model. A larger difference was found in clinics with larger populations. The perceived overestimation of dental human resource requirements suggests that changing to a needs-based model may result in cost savings.

Primary care practitioners are frequently unprepared to take into account the effects of social determinants on underprivileged patients\' health and health management. To address this issue among dental professionals, an original onsite continuing education (CE) course on poverty was co-developed by researchers, dental professionals, and community organizations. Integrating patient narratives and a short film, course material aims to elicit critical reflection and provide coaching for practice improvements. A qualitative case study conducted with a large Montreal Canada dental team reveals CE course participants\' newfound understandings and increased sensitivity to the causes of poverty and the nature of life on welfare. Participants also describe revised interpretations of certain patient behaviors, subtle changes in communication with patients and improved equity in appointment-giving policy. Unintended outcomes include reinforced judgment and a tendency to moralize certain patient categories. Implications for health professional educators, researchers, and dental regulatory authorities are discussed.

Previous research regarding dental students has found modest predictive value in preclinical didactic course grades in predicting clinical performance, but systematic assessment of students\' feedback on their perceived preparedness has received little attention as a preclinical assessment methodology. The aim of this study was to assess the perceptions of the dental students at one U.S. academic dental institution regarding their preparedness for clinical performance following the preclinical fixed prosthodontics course. Third- and fourth-year dental students participated in a survey about their perceived preparedness to diagnose and treat patients with fixed prosthodontics needs in the school\'s dental clinics. The respondents (79 out of 161 students, for a response rate of 49%) rated each item on a five-point Likert scale. Responses about which preclinical procedures of the course prepared students the least and the best were consistent for the third- and fourth-year students. Less than 60% of all responding students felt prepared for planning complex cases and performing laboratory-related procedures. The findings of this study indicate that improvement is required in teaching students about laboratory procedures and problem-solving to adequately prepare them for clinical treatment of patients with fixed prosthodontics needs.

This qualitative case study was conducted in a Canadian dental school using a participatory approach and was based on Paulo Freire\'s theoretical concept of conscientização, a form of critical consciousness that involves awareness of social reality and fosters action towards social justice. The aim of the study was to understand dental students\' perceptions of and attitudes about poverty and dental care provided to people living in poverty. It also examined how these perceptions shape students\' plans for their professional careers, as well as their opinions on educational strategies to prepare them to work with poor patients. The sources of data generation were semistructured interviews, participant observations, and document analysis. A deductive-inductive thematic strategy was used to analyze the data. Out of a class of thirty-five senior dental students, the authors interviewed a convenience sample of twelve: five male and seven female. The findings suggest that the students had incipient conscientização about poverty-related themes. They perceived poverty as a distant issue and as the responsibility of the government or of the poor individuals themselves. The students did not have plans to work with patients living in poverty in the future and struggled to envision ways to address these patients\' needs other than volunteer work. This research supports the need for academic dental institutions to adopt strategies to increase students\' critical consciousness about oral health inequities. Reducing oral health inequities is a matter of social justice, and dental care providers are key actors in this endeavor.

OBJECTIVE: We analyzed the operation of one Connecticut federally qualified health center (FOHC) dental program with seven delivery sites. We assessed the financial operation of the different delivery sites and contrasted the overall performance of the FOHC with private practices.
METHODS: We obtained data from a pretested financial survey instrument, electronic patient visit records, and site visits. To assess clinic productivity, we used two output measures: patient visits and market value of services. For the latter, we estimated the implicit fee of each service provided in patient visits.
RESULTS: On average, these clinics were running a modest deficit, mainly due to startup costs of two new clinics. The primary factor that impacted net revenues was low reimbursement rates, including privately insured patients. When FOHC dental revenues were adjusted to market rates, revenues were close to expenses.
CONCLUSIONS: FOHC dental clinics are major components of the dental safety net system. This case study suggests that the established clinics use resources as effectively as private practices.

The purpose of this study was to increase our understanding of the impact of Health Information Technology Systems (HITS) on dental school users when the systems are integrated into chair-side patient care. We used qualitative research methods, including interviews, focus groups, and observations, to capture the experiences of HITS users at a single institution. Users included administrators, clinical faculty members, predoctoral students, support staff, and residents. The data were analyzed using a grounded theory approach, and nine themes emerged: 1) HITS benefits were disproportionate among users; 2) communicating about the HITS was challenging; 3) users experienced a range of strong emotions; 4) the instructor persona diminished; 5) there were shifts in the school\'s power structure; 6) allocation of end-users\' time shifted; 7) the training and support needs of end-users were significant; 8) perceived lack of HITS usability made documentation cumbersome for clinicians; and 9) clinicians\' workflow was disrupted. HITS integration into patient care impacts the work of all system users, especially end-users. The themes highlight areas of potential concern for implementers and users in integrating a HITS into patient care.