Implementing the Child Oral Health Initiative (COHI): improving access to preventive dental care to achieve Saudi Vision 2030 healthcare goals.

Abstract

Background: Dental caries is one of the most important health concerns in Saudi Arabia. It poses a substantial burden considering the clinical outcomes and treatment costs. Oral health is an integral part of general health, and primary healthcare providers may contribute to the primary prevention of caries by initiating early referrals, dental screening and early diagnosis of caries with regular medical visits.

Objectives: This project aimed to integrate the Child Oral Health Initiative (COHI) into regular paediatric healthcare services to effectively promote oral health and improve access to preventive dental care services. However, referrals to the dental department were primarily paper-based targeting dental clearance, emergencies and treatments. This referral system impaired the accessibility and manageability of medical records, necessitating the need for a traceable robust referral system to successfully screen children.

Methods: The first phase of the project was to develop an electronic referral system for the COHI (ECOHI-referrals) to improve communication between the COHI dental team and other hospital teams, increase dental preventive screening rates and to track referrals. Four Plan-Do-Study-Act (PDSA) cycles were used to initiate and track the new referral system and improve the screening rate of referred children.

Results: After implementation, the number of ECOHI-referrals for caries prevention in the paediatric ward increased from 0 to 351 during the project period. The dental team received 351 ECOHI-referrals out of 420 (83.5%) eligible children in the paediatric ward. Of the referred 351 children, 317 (90.3%) underwent dental screening. Of the screened children, 263 (82.9%) established an ongoing dental home, and 98 (30.9%) children received fluoride applications.

Conclusion: Quality improvement methods facilitated the successful integration of COHI into hospital inpatient settings, increasing dental prevention visits to the paediatric ward, improving tracking of e-referrals, establishing dental homes for children and enhancing communication between teams.