Who get access to free oral health assessment at home?

Objectives: When society successively gets an improved oral health, dependent individuals show severe oral problems. In the year of 1999 a dental remuneration was introduced in Sweden that prescribes free oral health assessments for dependent individuals. An evaluation in the beginning of the year 2006 showed that only about half of the expected individuals had got benefit of this remuneration. The worst result was shown for those staying in their own homes. The amount of caring activities is decided when a case manager from the community meets the caretaker or the “client”. In that moment it is also decided whether the individual may have a dental offer or not why it is of greatest importance how this task is handled by the case manager. The aim with the present project was to describe the attitudes case managers have to free oral health care assessments for dependent caretakers. Methods: To describe attitudes to oral health care assessments we used individual interviews with case managers. A strategic sample from three community areas was done to get rich data. The interviews were composed of introducing questions concering background data, followed by open ended questions concering the interviewees working context and the dental remuneration. The interviews were tape recorded, verbatim transcribed by a secretary and qualitatively content analysed. Results: We performed 24 interviews with case managers and found that they did not look upon themselves as the proper professionell group to handle this task. They found the given information as confusing and did not act actively but waited for signals from somebody else concering their clients oral health situation. Conclusions: Case managers work with other goals for dependent individuals than health care workers. This creates a need for special education if oral care responsibility will be handled by this professional group.