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Implementation of statutory oral health examinations among Finnish preschool children: a register-based pilot study
Anna-Maria Pelkonen1, Päivi Rajavaara2, Hannu Vähänikkilä3
1Research Unit of Population Health, University of Oulu, Oulu, Finland; The Wellbeing Services County of North Ostrobothnia, Pohde, Finland. anna.pelkonen@oulu.fi.
Insights
Finnish preschool children experienced significant absenteeism from statutory oral health care, with limited dentist involvement and poor multiprofessional cooperation. These findings highlight gaps in implementing the Health Care Act and Decree for child dental services.
Area of Science:
- Public Health
- Pediatric Dentistry
- Health Services Research
Background:
- The Finnish Health Care Act and Decree aim for equitable nationwide child oral health services.
- Understanding the implementation and content of these services is crucial for child well-being.
Purpose of the Study:
- To explore the implementation and content of statutory oral health examinations and screenings for Finnish preschool children.
- To assess multiprofessional cooperation, absenteeism, and the need for family support within these services.
Main Methods:
- A register-based pilot study analyzed medical records of preschool children in Oulu, Finland (n=206).
- Data collected included dental examinations, missed appointments, referral patterns, and reasons for non-attendance.
- Statistical analysis (Chi-squared/Fisher's Exact Test) compared differences between age groups.
Main Results:
- Absenteeism from statutory oral health care ranged from 8.7% to 21.4%.
- Dentists conducted only 3.1% of examinations for preschool children, indicating low professional involvement.
- Multiprofessional cooperation was scarce, and reasons for missed appointments were rarely addressed (5.1%).
Conclusions:
- The implementation of the Health Care Act and Decree for preschool oral health services was only partially achieved.
- High absenteeism, lack of multiprofessional collaboration, and failure to identify needs for child protection services are significant concerns.
- Further research and targeted interventions are necessary to improve statutory oral health care delivery for children.
Objective:
The purpose of statutory oral health care services based on the Health Care Act (implemented 01 May 2011) and Decree (implemented 06 April 2011) is to provide equal services nationwide for all children. The aim of this register-based study was to explore the implementation and content (multiprofessional co-operation, absenteeism and the need for family's special support) of statutory oral health examinations and screenings among a group of Finnish preschool children.
Materials And Methods:
The study group consisted of the medical records of Finnish children in the City of Oulu from three different age groups (born in 2014-2018, n = 2,023-2,456). In this pilot study, data on dental examinations/screenings and missed appointments and their reasons of 206 randomly selected preschool-aged were collected from patient records in oral and public child health clinics during March 2022 to July 2022. Referrals within oral health care, along with the occupations of those referred to, were registered. Chi-squared or Fisher's Exact Test was used to evaluate differences between three age groups. Results: Across different age groups, 8.7% - 21.4% of children dropped out of statutory oral health care services. Dentists performed only a small proportion of oral health examinations for preschool-aged children (3.1%). Co-operation between oral health professionals was scarce. They rarely solved the reasons for missed appointments of dental care visits (5.1%). No referrals to Child Protection Services were made from oral health care. Conclusion: In this group of preschool children, implementation of Health Care Act and Decree was only partially completed. Absenteeism from statutory oral health care, addressing the need for Child Protection Services, and lack of multiprofessional co-operation seem to be causes for concern. Further research and attention to this topic is necessary.
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