Leggett, H, Csikar, J orcid.org/0000-0002-6943-9762, Vinall-Collier, K orcid.org/0000-0001-6362-9824 et al. (1 more author) (2021) Whose Responsibility Is It Anyway? Exploring Barriers to Prevention of Oral Diseases across Europe. JDR Clinical & Translational Research, 6 (1). pp. 96-108. ISSN 2380-0844
Abstract
Introduction:
Dental caries, gum disease, and tooth loss are all preventable conditions. However, many dental care systems remain treatment oriented rather than prevention oriented. This promotes the treatment of oral diseases over preventive treatments and advice. Exploring barriers to prevention and understanding the requirements of a paradigm shift are the first steps toward delivering quality prevention-focused health care.
Objectives:
To qualitatively explore perceived barriers and facilitators to oral disease prevention from a multistakeholder perspective across 6 European countries.
Methods:
A total of 58 interviews and 13 focus groups were undertaken involving 149 participants from the United Kingdom, Denmark, Germany, the Netherlands, Ireland, and Hungary. Interviews and focus groups were conducted in each country in its native language between March 2016 and September 2017. Participants were patients (n = 50), dental team members (n = 39), dental policy makers(n = 33), and dental insurers (n = 27). The audio was transcribed, translated, and analyzed via deductive thematic analysis.
Results:
Five broad themes emerged that were both barriers and facilitators: dental regulation, who provides prevention, knowledge and motivation, trust, and person-level factors. Each theme was touched on in all countries; however, cross-country differences were evident surrounding the magnitude of each theme.
Conclusion:
Despite the different strengths and weaknesses among the systems, those who deliver, organize, and utilize each system experience similar barriers to prevention. The findings suggest that across all 6 countries, prevention in oral health care is hindered by a complex interplay of factors, with no particular dental health system offering overall greater user satisfaction. Underlying the themes were sentiments of blame, whereby each group appeared to shift responsibility for prevention to other groups. To bring about change, greater teamwork is needed in the commissioning of prevention to engender its increased value by all stakeholders within the dental system.
Knowledge Transfer Statement:
The results from this study provide an initial first step for those interested in exploring and working toward the paradigm shift to preventive focused dentistry. We also hope that these findings will encourage more research exploring the complex relationship among dental stakeholders, with a view to overcoming the barriers. In particular, these findings may be of use to dental public health researchers, dentists, and policy makers concerned with the prevention of oral diseases.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © International & American Associations for Dental Research 2020. This is an author produced version of a journal article published in JDR Clinical & Translational Research. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | oral health, dental public health, qualitative, preventive dentistry, health services research, European Union |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Dentistry (Leeds) > Applied Health and Clinical Translation (Leeds) |
Funding Information: | Funder Grant number EU - European Union 635183 |
Depositing User: | Symplectic Publications |
Date Deposited: | 25 Jun 2020 14:48 |
Last Modified: | 27 Jul 2022 13:15 |
Status: | Published |
Publisher: | SAGE Publications |
Identification Number: | 10.1177/2380084420926972 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:162334 |