Abstract
Background: The French welfare system covers basic oral care except for prosthetic rehabilitation. As a result, underserved people can’t access such care. To limit oral health inequalities, in France, the Ministry of Health has established general and dental consultations in some public hospitals, in a program called PASS (health-care access points). Aims The aim of this poster is to explain how a dental-care access point in a Parisian hospital, which opened in 2013 for adults operates and to list its clinical activity for 2015.
Methods: A patient who wishes to be treated at a PASS is interviewed by a social worker, who then refers the patient to the dental service if they can benefit from this program. During the first appointment, a clinical and radiological examination is performed. A committee, which meets once a month, accepts or not the recommendations of the dental team and authorises payment. The dental care provided is evidence-based and ethical.
Results: In 2015, 190 patients were treated, of whom 153 were seen for the first time: 111 men (58%) and 72 women (42%) (mean age 39 years). The type of housing where they lived was: in their own homes 70 (37%) accommodation in the family or with friends 68 (36%), in voluntary homes (government /charity funded accommodation) 29 (15%). Twenty three (12%) were homeless. Their financial situation was: 90 (52%) had no resources, 38 (20%) received basic welfare benefits, 27 (14%) were employed, and 26 (14%) were retired. The dental care which they received was: complete oral rehabilitation for 95 patients, of whom 90 patients are still receiving ongoing care and 5 gave up at the prosthetic stage. The dental procedures conducted were: 590 radiographic evaluations, 50 periodontal treatments, 38 endodontic treatments and 109 restorative treatments, 93 extractions and 77 fixed or removable prostheses.
Conclusion: This program improves the quality of health care and social services and ensures better integration of underserved people into their communities. Nevertheless, there are still obstacles to treatment for these persons, other than financial ones. They include: language, cultural habits, homelessness, length and difficulty of treatment. The social network helps to support underserved people in their medical and dental care. The positive assessment of this program encourages the hospital to develop the same initiative for children who need care as well as orthodontic treatments.
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