{"id":418,"date":"2022-12-16T11:30:44","date_gmt":"2022-12-16T18:30:44","guid":{"rendered":"https:\/\/blogs.ubc.ca\/imhablog\/?p=418"},"modified":"2023-07-10T13:30:27","modified_gmt":"2023-07-10T20:30:27","slug":"addressing-barriers-and-gaps-in-oral-health-care-moving-from-access-limitations-to-health-equity-for-people-living-with-disabilities","status":"publish","type":"post","link":"https:\/\/blogs.ubc.ca\/imhablog\/2022\/12\/16\/addressing-barriers-and-gaps-in-oral-health-care-moving-from-access-limitations-to-health-equity-for-people-living-with-disabilities\/","title":{"rendered":"Addressing barriers and gaps in oral health care &#8211; moving from access limitations to health equity for people living with disabilities"},"content":{"rendered":"<p>By: Dr. Sharat Pani<\/p>\n<p><a href=\"mailto:spani@uwo.ca\">spani@uwo.ca<\/a><\/p>\n<p><em>Le fran\u00e7ais suit \/ French follows<\/em><\/p>\n<p><strong>Background<\/strong><\/p>\n<p>The CIHR recently awarded a 5-year grant to the Network for Canadian Oral Health Research (NCOHR). \u00a0The NCOHR was originally established in 2012 to serve as a platform where researchers and research teams from the 10 dental schools in Canada could come together to advance oral health research.<\/p>\n<p>The lack of access to oral health care among socioeconomically disadvantaged individuals, individuals with disabilities and First Nation populations in Canada have been well-documented. As there is little research on the specific challenges to access of oral health care that each group faces, NCOHR has launched 7 Working Groups (Aging and Well-being, Pediatrics and Growing Healthy, Indigenous Peoples Health, Oral Cancer, Orofacial Pain, Disability and Oral Health, and the CADR-NCOHR Trainee Development). We have opened a grant competition to fund research into the barriers and gaps in oral health care, from access limitations to health equity. \u00a0Here we examine the lack of access to oral health care for people living with disabilities and how solutions may be found through collaborative research.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Researching Access to Oral Health Care for Individuals with Disability<\/strong><\/p>\n<p>The 2017 Canadian Survey on Disability reported that 22.7% of individuals over the age of 15 experienced disability in some form. Previous disability surveys have not looked at access to oral healthcare, levels of oral disease, or oromotor function (ability to speak, chew or swallow) among people living with disability. The current disability survey (2022) is in progress and the report is expected by the end of 2023 and will for the first time include data on accessibility barriers faced by Canadians with disability. However, there is still much work to be done to collect and analyze data on access to oral healthcare for these individuals.<\/p>\n<p>The Disability and Oral Health working group of NCOHR was established in 2022 to promote research on the oral healthcare needs of individuals with special healthcare needs. The group has established collaborations with the Canadian Society of Disability and Oral Health and the International Association for Disability and Oral Health.<\/p>\n<p>There are two components to accessible oral health care the willingness of dental care providers to provide care for persons with disabilities and their ability to do so. Access to oral health care for individuals with disabilities requires oral health professionals who are willing to treat them. However, it also requires individuals who have the required training to provide care within dental offices, and more importantly, effectively triage those cases that need to be seen in the hospital. With this in mind, the group has begun work on research projects that look at how Special Care Dentistry is taught among the dentistry and dental hygiene programs in Canada.<\/p>\n<p>The Canadian Dental Association and the Canadian Society for Disability and Oral Health in 2019 developed a case complexity tool that aimed to provide oral healthcare providers an effective tool to triage patients with disabilities (Fig 1.). It has been estimated that in countries that have established special care dentistry referral pathways, fewer than 10% of patients living with disabilities need to be seen in a hospital setting. A validated tool for the triage of patients with disabilities could help oral health care professionals in Canada see more patients living with disabilities in their offices and effectively triage those individuals that need to be seen in hospitals. Validation of this tool is a priority for the working group, and it is hoped that the use of an effective tool can facilitate access to dental care for individuals with disability.<\/p>\n<p>(Source: Canadian Dental Association: accessible online at: http:\/\/www.cda-adc.ca\/en\/oral_health\/cfyt\/special_needs\/)<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>The path forward<\/strong><\/p>\n<p>The 2022 WHO, Global Oral Health Report recognizes persons living with disabilities as a significant cause of oral health care inequality. The renewal of the NCOHR grant and the recognition of \u201cAddressing barriers and gaps in oral health care\u201d as an area of priority for collaborative research provides a much-needed launch pad for research into the oral healthcare needs of persons living with disability in Canada. It is hoped that collaborative research into the oral healthcare needs of persons living with disabilities can help address the causes, and provide potential solutions to the oral health care inequalities experiences faced by these individuals.<\/p>\n<hr \/>\n<h1><strong>Surmonter les obstacles et les lacunes en mati\u00e8re de soins buccodentaires \u2013 passer des limites d\u2019acc\u00e8s \u00e0 l\u2019\u00e9quit\u00e9 en sant\u00e9 pour les personnes vivant avec un handicap<\/strong><\/h1>\n<p><strong>Contexte<\/strong><\/p>\n<p>Les Instituts de recherche en sant\u00e9 du Canada (IRSC) ont r\u00e9cemment accord\u00e9 une subvention de cinq ans au R\u00e9seau canadien de recherche en sant\u00e9 buccodentaire (RCRSB). Le RCRSB a \u00e9t\u00e9 mis sur pied en 2012 pour offrir aux chercheurs et aux \u00e9quipes de recherche des dix \u00e9coles de m\u00e9decine dentaire du Canada une plateforme pour faire progresser la recherche en sant\u00e9 buccodentaire.<\/p>\n<p>Le manque d\u2019acc\u00e8s aux soins buccodentaires chez les personnes d\u00e9favoris\u00e9es sur le plan socio\u00e9conomique, les personnes handicap\u00e9es et les membres des Premi\u00e8res Nations au Canada est bien document\u00e9. Comme peu de recherches ont \u00e9t\u00e9 men\u00e9es sur les d\u00e9fis particuliers qui se posent relativement \u00e0 l\u2019acc\u00e8s aux soins buccodentaires auxquels chaque groupe est confront\u00e9, le RCRSB a constitu\u00e9 sept groupes de travail portant sur le vieillissement et le bien-\u00eatre, la p\u00e9diatrie et la croissance saine, la sant\u00e9 des Autochtones, le cancer buccal, la douleur buccofaciale, l\u2019incapacit\u00e9 et la sant\u00e9 buccodentaire, ainsi qu\u2019un programme de stages \u00e9labor\u00e9 conjointement par l\u2019Association canadienne de recherches dentaires (ACRD) et le RCRSB. Nous avons ouvert un concours de subventions pour financer la recherche sur les obstacles et les lacunes en mati\u00e8re de soins buccodentaires, des limites d\u2019acc\u00e8s jusqu\u2019\u00e0 l\u2019\u00e9quit\u00e9 en mati\u00e8re de sant\u00e9. Nous examinerons ci\u2011dessous le manque d\u2019acc\u00e8s aux soins buccodentaires pour les personnes vivant avec un handicap et comment des solutions peuvent \u00eatre trouv\u00e9es gr\u00e2ce \u00e0 la recherche en collaboration.<\/p>\n<p><strong>Recherches sur l\u2019acc\u00e8s aux soins buccodentaires pour les personnes vivant avec un handicap<\/strong><\/p>\n<p>L\u2019Enqu\u00eate canadienne de 2017 sur l\u2019incapacit\u00e9 a r\u00e9v\u00e9l\u00e9 que 22,7\u00a0% des personnes \u00e2g\u00e9es de plus de 15\u00a0ans pr\u00e9sentaient un handicap sous une forme ou une autre. Les sondages pr\u00e9c\u00e9dents sur l\u2019incapacit\u00e9 n\u2019ont toutefois pas permis d\u2019examiner l\u2019acc\u00e8s aux soins buccodentaires, les niveaux de maladies buccodentaires ni la fonction oromotrice (capacit\u00e9 \u00e0 parler, \u00e0 m\u00e2cher ou \u00e0 avaler) chez les personnes vivant avec un handicap. L\u2019Enqu\u00eate canadienne de 2022 sur l\u2019incapacit\u00e9 se poursuit, et un rapport est attendu d\u2019ici la fin de l\u2019ann\u00e9e 2023; il comprendra, pour la premi\u00e8re fois, des donn\u00e9es sur les obstacles \u00e0 l\u2019accessibilit\u00e9 rencontr\u00e9s par les Canadiennes et Canadiens vivant avec un handicap. Il reste cependant encore beaucoup \u00e0 faire pour recueillir et analyser les donn\u00e9es sur l\u2019acc\u00e8s aux soins buccodentaires pour ces personnes.<\/p>\n<p>Le groupe de travail sur l\u2019incapacit\u00e9 et la sant\u00e9 buccodentaire du RCRSB a \u00e9t\u00e9 cr\u00e9\u00e9 en 2022 pour promouvoir la recherche sur les besoins en soins buccodentaires des personnes ayant des besoins de sant\u00e9 particuliers. Le groupe collabore avec la Canadian Society of Disability and Oral Health et l\u2019International Association for Disability and Oral Health.<\/p>\n<p>L\u2019accessibilit\u00e9 des soins buccodentaires repose sur deux \u00e9l\u00e9ments\u00a0:\u00a0la volont\u00e9 des fournisseurs de services dentaires \u00e0 offrir des soins aux personnes vivant avec un handicap et leur capacit\u00e9 \u00e0 le faire. L\u2019acc\u00e8s aux soins buccodentaires pour les personnes ayant une incapacit\u00e9 n\u00e9cessite des professionnels de la sant\u00e9 buccodentaire dispos\u00e9s \u00e0 les traiter. Cependant, il faut aussi des personnes qui ont la formation requise pour fournir des soins en cabinet dentaire et, plus important encore, pour trier efficacement les cas qui doivent \u00eatre examin\u00e9s \u00e0 l\u2019h\u00f4pital. Dans cette optique, le groupe a commenc\u00e9 \u00e0 travailler \u00e0 des projets de recherche portant sur la mani\u00e8re dont la m\u00e9decine dentaire pour les personnes ayant des besoins sp\u00e9ciaux est enseign\u00e9e dans les programmes de dentisterie et d\u2019hygi\u00e8ne dentaire au Canada.<\/p>\n<p>L\u2019Association dentaire canadienne et la Canadian Society of Disability and Oral Health ont mis au point, en 2019, un outil d\u2019\u00e9valuation de la complexit\u00e9 des cas visant \u00e0 offrir aux fournisseurs de soins buccodentaires un moyen efficace de trier les patients ayant un handicap (Figure\u00a01). On estime que dans les pays qui ont mis en place des voies d\u2019orientation pour les soins dentaires sp\u00e9ciaux, moins de 10\u00a0% des patients qui vivent avec un handicap doivent \u00eatre examin\u00e9s en milieu hospitalier. Un outil valid\u00e9 pour le triage des patients ayant un handicap pourrait aider les professionnels de la sant\u00e9 buccodentaire au Canada \u00e0 voir davantage de patients en cabinet et \u00e0 trier efficacement les personnes qui doivent \u00eatre examin\u00e9es \u00e0 l\u2019h\u00f4pital. La validation de cet outil est une priorit\u00e9 pour le groupe de travail, et nous esp\u00e9rons que l\u2019utilisation d\u2019un outil efficace facilitera l\u2019acc\u00e8s aux soins dentaires pour les personnes qui vivent avec une incapacit\u00e9.<\/p>\n<p>(Source\u00a0:\u00a0Association dentaire canadienne\u00a0\u2013 accessible en ligne \u00e0 l\u2019adresse <a href=\"http:\/\/www.cda-adc.ca\/fr\/oral_health\/cfyt\/special_needs\/\">http:\/\/www.cda-adc.ca\/fr\/oral_health\/cfyt\/special_needs\/<\/a>)<\/p>\n<p><strong>La voie de l\u2019avenir<\/strong><\/p>\n<p>Le rapport 2022 de l\u2019Organisation mondiale de la Sant\u00e9 (OMS) sur la sant\u00e9 buccodentaire dans le monde reconna\u00eet que les personnes vivant avec un handicap sont en butte \u00e0 d\u2019importantes in\u00e9galit\u00e9s en mati\u00e8re de soins buccodentaires. Le renouvellement de la subvention du RCRSB et la reconnaissance de \u00ab\u00a0l\u2019\u00e9limination des obstacles et des lacunes dans les soins de sant\u00e9 buccodentaire\u00a0\u00bb \u00e0 titre de domaine prioritaire pour la recherche en collaboration constituent une rampe de lancement indispensable pour la recherche sur les besoins en soins buccodentaires des personnes vivant avec un handicap au Canada. Nous esp\u00e9rons que la recherche coop\u00e9rative dans ce domaine permettra de r\u00e9ellement s\u2019attaquer aux causes des in\u00e9galit\u00e9s en mati\u00e8re de soins buccodentaires auxquelles ces personnes sont confront\u00e9es.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By: Dr. Sharat Pani spani@uwo.ca Le fran\u00e7ais suit \/ French follows Background The CIHR recently awarded a 5-year grant to the Network for Canadian Oral Health Research (NCOHR). \u00a0The NCOHR was originally established in 2012 to serve as a platform &hellip; <a href=\"https:\/\/blogs.ubc.ca\/imhablog\/2022\/12\/16\/addressing-barriers-and-gaps-in-oral-health-care-moving-from-access-limitations-to-health-equity-for-people-living-with-disabilities\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":91514,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-418","post","type-post","status-publish","format-standard","hentry","category-oral-health"],"_links":{"self":[{"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/posts\/418","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/users\/91514"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/comments?post=418"}],"version-history":[{"count":2,"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/posts\/418\/revisions"}],"predecessor-version":[{"id":525,"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/posts\/418\/revisions\/525"}],"wp:attachment":[{"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/media?parent=418"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/categories?post=418"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.ubc.ca\/imhablog\/wp-json\/wp\/v2\/tags?post=418"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}