GENEVA, Switzerland: FDI World Dental Federation recently released the results of a survey that asked FDI national dental associations and national endodontic societies about the state of endodontics in their countries. The survey included a political, economic, social, technological, environmental and legal (PESTEL) exercise.
A PESTEL exercise is a tool that is used to identify and analyse the key drivers of change in a specific environment. In this case, it was used to identify the main barriers to optimal endodontic care across the different domains in several countries in Europe, Asia Pacific, Africa, and North and South America, of which only 10% collect data through a national oral health or endodontics survey. It was found that endodontics is a registered specialty in just 53% of the countries surveyed. In terms of referral rates of endodontic cases, an estimated third of patients are sent to specialists in the countries where specialists are available.
The most commonly cited barriers to optimal endodontic care in each domain were:
Political: Public clinics offer limited oral health services offered and oral healthdoes not feature onthe political agenda.
Economic: Endodontic procedures are very expensive and patients receive minimal reimbursement or none at all.
Sociological: The level of oral health literacy is low and a low value is placed on oral health by the population. Patients have preconceptions of endodontic procedures as painful and complicated.
Technological: There is limited availability of endodontic technologies, and these are often expensive to purchase.
Environmental: More training in endodontic procedures is needed, especially at the undergraduate level.
Legal: There is limited regulation of endodontic care.
FDI calls for endodontic care to address a broader set of health outcomes as valued by the patient, including tooth retention and impact on overall health. Many patients are likely to prioritise eliminating pain and keeping the affected tooth healthy and strong over the long term. Consideration for the patient’s perspective in the provision of endodontic care has significant implications for existing treatment guidelines.
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