The provision of portable dental care in Malta

Abstract

Introduction: Portable Dental Care is a dental service provided in a patient’s residence, typically residential and nursing homes. Its goal is to provide patients with dental care when their situation makes receiving dental care at a fixed clinic, hospital or mobile dental clinic difficult, unreasonable or otherwise impractical. The provision of this service is often left to each dentist’s discretion, often leading to unmet dental needs of the patient. Aim of study: To investigate the provision of portable dental care provided in Malta, and to explore barriers to the increased provision of portable dentistry. Methods: An online questionnaire was distributed among various dental groups and associations to reach as many dental surgeons in Malta and Gozo as possible. Results: Of the 94 participants, 59 were male (62.77%) and 35 (37.23%) were female, with males having more years of experience (Mann Whitney U Test score; P = <0.001). Males were more likely to provide more PDC to community-dwelling elderly (Pearson Chi-Squared; P = 0.037) but no significant difference exists for PDC in care homes. A lack of time was the most reported barrier to PDC by both genders but more so by males (Pearson Chi-Squared; P = 0.014). Furthermore, 13 (14.94%) participants had training in PDC and these were more likely to provide PDC in the community (Pearson Chi-Square; P = <0.001), but 31.08% of those without training reported a lack of training as a barrier to PDC (Pearson Chi-Square; P = 0.047). Simple examinations (>90%) and the fabrication of complete dentures (>70%) were the most provided treatments in a portable setting irrespective if in the community or care homes. Irrespective of the setting of PDC, females were more likely to have positive views towards the treatment of the elderly as they were more likely to view a lack of dental care in residential and care homes (Mann Whitney U Test; P = <0.001) and felt a sense of duty towards older patients who cannot attend the dental clinic (Mann Whitney U Test; P = 0.004). Conclusions: There is a higher provision of PDC in Malta and Gozo by male dentists and dentists without training in PDC. The treatments offered the most are the simplest to perform in a portable setting such as examinations, denture fabrication and temporary restorations. Commitments to in-clinic patients, a lack of affordable portable equipment and poor ergonomics are the most common factors preventing the uptake or increased provision of portable dental care in Malta, among other reasons.