Hossein Jabbari Beyrami
1,2 
, Salar Mohammaddokht
1 , Mahsa Zohdi
3 , Milad Baseri
1,2* 1 Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3 Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Background. Oral health is a crucial component of general health. However, statistics and indicators have not shown improvements in dental health in Iran in recent years. Enhancing the quality of dental services in the country requires comprehensive knowledge of the current state of dental care provision. Therefore, this study aimed to evaluate dental services for children in Tabriz over the past five years and to propose strategies for improvement.
Methods. This qualitative study employed a phenomenological approach and was conducted in Tabriz in 2021 (1400 Persian Calendar year). Data were collected through focus group discussions with 13 participants and semi-structured individual interviews with six participants. Among the 19 participants, 11 were general dentists, and five were pediatric dentists. Data were analyzed using Diekelmann's seven-stage phenomenological analysis method, and the main and sub-themes were categorized.
Results. Six main themes and 33 sub-themes were identified. The main themes were: stewardship and leadership, service delivery, human resources, facilities and equipment, information recording, and economic issues. Seven sub-themes were found under stewardship and leadership, eight sub-themes emerged under service delivery, seven sub-themes were identified under human resources, one sub-theme was found under facilities and equipment, emphasizing their adequacy and appropriateness, five sub-themes emerged under information recording, highlighting its weaknesses, and finally, five sub-themes were identified under economic issues.
Conclusion. The provision of dental equipment and facilities was identified as a major strength. However, inadequate preventive and educational dental services for children, along with deficiencies in the recording and utilization of health information, were the primary weaknesses in the delivery of dental services to children in Tabriz over the past five years.
Extended Abstract
Background
Oral health is a critical component of public health. Oral and dental diseases, such as dental caries, represent a significant public health problem worldwide. Statistics have not shown improvement in Iranian dental health in recent years. An examination of DMFT/dmft indicators in Tabriz between 2010 and 2016 reveals the ineffectiveness of preventive and therapeutic measures in children's dentistry. Improving the quality of dental services in the country requires a comprehensive understanding of the current state of dental service provision. This study evaluated the provision of dental services to children in Tabriz over the past five years.
Methods
This research employed a qualitative approach and a phenomenological strategy, utilizing semi-structured interviews. The study population comprised pediatric dentists, general dentists employed by the Deputy of Health at Tabriz University of Medical Sciences, and related dental officials and healthcare workers. Data saturation was achieved after conducting a focus group discussion with 13 participants and individual interviews with six participants. The interviews generally encompassed three parts: 1) Strengths of dental service provision to children in Tabriz over the past five years; 2) Weaknesses of dental service provision to children in Tabriz over the past five years; 3) Suggested solutions to address the identified weaknesses. Diekelmann's seven-stage phenomenological analysis method was employed to determine themes and sub-themes.
Results
Nineteen individuals participated in the study, with the majority being male (53%). Most participants were dentists, and the majority held a Doctor of Dental Surgery (D.D.S.) degree. Most participants were employed as dentists in health centers. A total of six themes and 33 sub-themes were extracted. The themes were: stewardship and leadership, service delivery, human resources, facilities and equipment, information recording, and economic issues. Within these themes, seven sub-themes related to stewardship and leadership, eight to service delivery, seven to human resources, one to facilities and equipment, five to information recording, and five to economic issues were identified. The study's findings generally indicated that the strengths of the system included the active involvement of the specialized hospital of the Faculty of Dentistry and the community-oriented department, the support of a charity fund, the quantitative adequacy of specialized human resources, and effective interdepartmental cooperation. Weaknesses included deficiencies in preventive and educational services for children, inappropriate use of services under anesthesia, inadequate human resource management at various levels, challenges in recording and applying health information, a lack of documented analysis, and economic and financial barriers affecting both public access to health services and the provision of services by dentists. Additionally, the study highlighted infrastructural issues within the country's health system and its predominantly treatment-focused nature. Finally, solutions were proposed, including: strengthening the foundations of integrated health education in schools, collaborating with insurance and charity funds to expand access to quality dental services, shifting from a purely therapeutic approach to investing in early childhood prevention, training skilled human resources and deploying them effectively with financial incentives and fair compensation, improving information management, and implementing decision-making based on statistical evidence.
Conclusion
The study found that the provision of dental equipment and facilities for children's dental services in Tabriz over the past five years was satisfactory. However, weaknesses were identified, such as inadequate preventive and educational dental services for children and deficiencies in the recording and utilization of health information. Addressing these weaknesses could be achieved by leveraging World Health Organization programs and implementing the proposed solutions. These include strengthening integrated health education in schools, promoting preventive dentistry from a young age, and enhancing and expanding dental services covered by insurance, all contributing to the improvement of dental service provision for children.