Improving oral health service delivery: the patient perspective

BACKGROUND: Rehabilitation with removable complete dentures (RCDs) involves navigating public dental systems that often present barriers like long wait times and limited access. While clinical outcomes are often known, patient experiences with service delivery remain underexplored. Understanding these experiences is key to improving denture care in public settings. OBJECTIVES: This study aimed to explore and gain a comprehensive understanding of the service delivery experiences of patients rehabilitated with RCDs through the public dental health system in the State of Tasmania in Australia with the goal of informing improvements to the patient journey and overall service quality. METHODS: A qualitative study using a Constructivist Grounded Theory (CGT) approach was undertaken. Twenty-five adult participants who received RCDs between 2017 and 2022 were purposively selected from public dental clinics. Data were collected through in-depth, semi-structured, face-to-face interviews. Analysis followed CGT principles, including iterative coding, constant comparison, memo writing, and the co-construction of meaning with participants. RESULTS: Participants reported emotional distress linked to prolonged waiting times and limited continuity of care. Despite valuing the professionalism and empathy of individual practitioners, many expressed a need for improved communication, more coordinated interdisciplinary care, and greater system responsiveness. Good service was characterised by accessibility, affordability, approachability, friendly staff, and high-quality care. Suggestions for improvement included moving services close to patients, better integration with other health sectors, and the use of visual aids to support understanding and self-management. CONCLUSIONS: Patient narratives reveal a pressing need to address delays, communication gaps, and fragmented care in the public denture service pathway. System-level changes adopting a more holistic approach such as patient-centred approach, improving interprofessional collaboration, decentralising service provision, and enhancing health communication may significantly improve the denture rehabilitation experience and patient outcomes.