Basic oral health care package utilisation in the Western Cape

Objective: To determine the utilisation of the basic oral health package in the Eden district. Background: The Eden district in the Western Cape, South Africa has been selected as a pilot site for the initiation phase of National Health Insurance. The prevalence of dental caries in the primary dentition (86%) in the Western Cape is very high when compared to the national mean. The prescribed basic oral health care package (BOHP) includes: an examination, bitewing radiographs, scaling and polishing, simple (1-3 surface) fillings, and emergency relief of pain and sepsis, including dental extractions. Methods: A cross-sectional study design with structured administered interviews of all dentists from the public dental clinics (n=27).  Objectives: To determine (i) the proportion of clinics that can offer the basic oral health package; (ii) the distance dentists have to travel to satellite clinics; (iii) the number of days per month that a dentist visits each clinic; (iv) the type and frequency of dental services over a 10-year; and (v) the dentist: population ratios. Results:  Less than a fifth (18.75%) of all the dental clinics could offer the basic treatment package.  Traveling distance for some dentists were as much as 260km (return journey) on a single day. There was a significant difference in mean number of days per month where a dentist visited a satellite clinic compared to a main clinic (p=0.0004).  The extraction: filling ratio was 23:1 and the population:dentist ratio in Eden is 1:74 571. Almost a quarter of children less than 6 years received treatment under general anaesthesia.  Conclusion: The majority of public dental clinics are only offering emergency relief of pain and sepsis and satellite clinics are visited only 1-4 times per month. Increasing the utilisation of the BOHP should be enforced by facility managers.