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BMC Oral Health Feb 2024Oral health has an important role in the general health and well-being of individuals. Dental teams are ideally placed to support patients in preventing ill-health.... (Review)
Review
BACKGROUND
Oral health has an important role in the general health and well-being of individuals. Dental teams are ideally placed to support patients in preventing ill-health. Understanding the barriers and facilitators to the adoption, promotion and facilitation of preventive advice and treatment is key to improving oral health services. The Theoretical Domains Framework (TDF) is a useful psychological framework to help identify individual, interpersonal and environmental issues which could be impacting clinicians' ability to provide preventive advice and care. The aim of this review was to identify the perceived barriers and facilitators to preventive oral health care from the perspectives of the oral healthcare team within the general dental practice.
METHODS
A search strategy was developed, piloted, and run in: Medline via Ovid, PsycInfo, Web of Science, SCOPUS, EMBASE, Conference Proceedings Citation Index- Science, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews and followed PRISMA guidelines. Identified records were screened independently by two researchers. Data were coded using the Theoretical Domains Framework (TDF) and analysed using narrative data synthesis.
RESULTS
5610 papers were identified, and 19 included in this review. Thirteen papers focussed on dentists. Of the 106 items mapped onto the TDF, 48 were facilitators. The domains most frequently represented were, environmental context and resources, beliefs about consequences, social professional role and identity, skills, beliefs about capabilities and knowledge. Six studies focussed on dental hygienists. There were 47 items mapped onto the TDF, 18 were facilitators. The domains most frequently represented were environmental context and resources, social influences, beliefs about consequences and knowledge.
CONCLUSIONS
The review identified that the delivery of preventive activities did not focus solely on the patient and dental professional interaction as many previous studies have highlighted. The review found that multiple factors influence whether prevention is delivered to patients. The largest barrier and facilitator for the dental professionals identified in this review was the environmental context and resources. Further research is needed to evaluate the effectiveness of interventions that aim to promote preventive oral health care in primary care settings to understand whether they address the barriers identified in this review.
Topics: Humans; Dentists; Professional Role; Oral Health; Preventive Health Services; Delivery of Health Care
PubMed: 38368349
DOI: 10.1186/s12903-024-04022-1 -
Sleep & Breathing = Schlaf & Atmung Jun 2024The goal of this review is to provide sleep physicians, dentists, and researchers with an evidence-based overview of the literature on smart mandibular advancement... (Review)
Review
PURPOSE
The goal of this review is to provide sleep physicians, dentists, and researchers with an evidence-based overview of the literature on smart mandibular advancement devices (MADs) for the treatment of obstructive sleep apnea.
METHODS
A systematic literature search was conducted by two blinded reviewers and an information specialist. A smart MAD was defined as any MAD with additional functionality besides mandibular protrusion. The bibliographic databases Medline, Embase, and Scopus were used to identify relevant publications. Studies were included if they described any stage of development of smart MADs. A total of 3162 titles and abstracts were screened for their relevance. In total, 58 articles were selected for full-text screening, 26 of which were included in this review.
RESULTS
The overall quality of the available literature was low. Most of the studies were observational, clinical or applied-research articles. The authors classified MADs into two main groups: passive and active. Passive MADs measured patient data, most commonly patient compliance. Active MADs adjusted protrusion of the mandible in response to patient data and were found in various phases of technological readiness (in development, demonstration, or deployment).
CONCLUSION
Innovations in smart mandibular advancement devices most frequently track patient compliance. Devices measuring other health parameters and active, feedback-controlled, devices are increasingly reported on. However, studies demonstrating their added benefit over traditional methods remain sparse. With further study, smart mandibular advancement devices have the potential to improve the efficiency of obstructive sleep apnea treatment and provide new treatment possibilities.
PubMed: 38886278
DOI: 10.1007/s11325-024-03068-3 -
BMC Oral Health Oct 2023Considered the most prevalent noncommunicable disease in childhood, dental caries is both an individual and a collective burden. While international guidelines highlight...
BACKGROUND
Considered the most prevalent noncommunicable disease in childhood, dental caries is both an individual and a collective burden. While international guidelines highlight prevention as a major strategy for caries management in children, health professionals still struggle to implement prevention into their clinical practice. Further research is needed to understand the gap between the theoretical significance of dental prevention and its lack of implementation in the clinical setting. This systematic review aims to identify and classify factors perceived by health professionals to be barriers or facilitators to caries prevention in children.
METHOD
A systematic literature search was conducted in three electronic databases (Medline, Web of Science and Cairn). Two researchers independently screened titles, abstracts and texts. To be selected, studies had to focus on barriers or facilitators to caries prevention in children and include health professionals as study participants. Qualitative and quantitative studies were selected. The factors influencing caries prevention in children were sorted into 3 main categories (clinician-related factors, patient-related factors, and organizational-related factors) and then classified according to the 14 domains of the theoretical domains framework (TDF).
RESULTS
A total of 1771 references were found by combining manual and database searches. Among them, 26 studies met the inclusion criteria, of which half were qualitative and half were quantitative studies. Dentists (n = 12), pediatricians (n = 11), nurses (n = 9), and physicians (n = 5) were the most frequently interviewed health professionals in our analysis. Barriers and facilitators to caries prevention in children were categorized into 12 TDF domains. The most frequently reported domains were Environmental Context and Resources, Knowledge and Professional Role and Identity.
CONCLUSION
This systematic review found that a wide range of factors influence caries prevention in children. Our analysis showed that barriers to pediatric oral health promotion affect all stages of the health care system. By highlighting the incompatibility between the health care system's organization and the implementation of caries prevention, this study aims to help researchers and policy-makers design new interventions to improve children's access to caries prevention.
TRIAL REGISTRATION
PROSPERO CRD42022304545.
Topics: Humans; Child; Dental Caries; Dental Caries Susceptibility; Health Personnel; Oral Health; Health Promotion
PubMed: 37853400
DOI: 10.1186/s12903-023-03458-1 -
BMC Oral Health Aug 2023Platelet Concentrate (PC) injection therapy has shown potential as a local therapy for oral lichen planus (OLP). However, its safety and efficacy have not yet been fully...
BACKGROUND
Platelet Concentrate (PC) injection therapy has shown potential as a local therapy for oral lichen planus (OLP). However, its safety and efficacy have not yet been fully established. Our research compared the efficacy of PC with topical steroid treatment in alleviating pain and symptoms related to OLP. We aims to present evidence-based alternatives that dentists can use to improve patient outcomes while reducing potential side effects.
METHODS
We conducted a systematic search of five electronic databases up to April 2023, including Embase, Cochrane Central Register of Controlled Trials, PubMed, OVID Medline, and WanFang, to evaluate PCs' efficacy compared to topical corticosteroid therapy for OLP. The literature quality was assessed using the Cochrane ROB tool. A fixed-effects model was used to determine the Weighted Mean Difference (WMD) and Mean Difference (MD) at a 95% confidence interval (CI) for pain severity and other relevant clinical indicators.
RESULTS
The comparison between topical corticosteroid therapy and PCs showed no significant difference for pain relief (WMD = -0.07, CI = 95% -0.34 to 0.19), symptom improvement (MD = -0.21, CI = 95% -0.55 to 0.13), or the severity of included lesions measured by REU scores (MD = -0.25, CI = 95% -0.32 to 0.82).
CONCLUSIONS
Locally injected PC have been found efficient in managing oral lichen planus, indicating that they are a promising alternative option to steroid therapy for OLP patients, particularly those who have not responded favorably to steroid therapy. However, further research is needed to establish determining the recurrence rate and long-term adverse effects.
TRIAL REGISTRATION
The systematic review protocol has been registered in advance with the PROSPERO database (CRD42023415372).
Topics: Humans; Lichen Planus, Oral; Palliative Care; Pain; Pain Management; Adrenal Cortex Hormones
PubMed: 37626383
DOI: 10.1186/s12903-023-03296-1 -
Diagnostics (Basel, Switzerland) Mar 2024A common application for intraoral scanners is the digitization of the morphology of teeth and palatal rugae. Palatal scans are most commonly required to fabricate... (Review)
Review
A common application for intraoral scanners is the digitization of the morphology of teeth and palatal rugae. Palatal scans are most commonly required to fabricate complete dentures and immediate transitional dentures and serve as a reference point for assessing orthodontic results. However, they are also frequently included by accident, even though the main purpose of intraoral scanning is to reconstruct dentition using computer-aided manufacturing (CAM). The literature shows that the identification of disaster victims has frequently involved palatal rugae impressions. As the skull provides sound insulation, the rugae are resistant to heat, chemicals, and stress. Antemortem data might be difficult to find during a forensic inquiry, particularly in disaster victim identification cases. In contrast with DNA and fingerprints, there is a greater likelihood of having a dental record that contains palatal scans. With specialized software, the scans can be exported as open stereolithography (STL) files. Considering that a full case consumes up to about 100 MB of hard drive space, long-term storage should not be an issue compared to a plaster model. Additionally, dentists widely use online databases to exchange data for smile design, implant registration, and orthodontic purposes. This will produce a digital database that grows quickly and is readily usable for forensic investigations. The uniqueness of forensic features is frequently challenged; however, palatal morphology's unique trait could make it possible as it is characteristic of individuals as well as the most distinguishing factor. This review will highlight how rugae, palatal morphology, mirroring, superimposition, and geometrics can serve in forensic identification.
PubMed: 38473003
DOI: 10.3390/diagnostics14050531 -
Japan Journal of Nursing Science : JJNS Jul 2024This systematic review aimed to assess the effect of non-pharmacologic perioperative oral hygiene care on reduced incidence of postoperative pneumonia (PP), surgical... (Meta-Analysis)
Meta-Analysis Review
AIM
This systematic review aimed to assess the effect of non-pharmacologic perioperative oral hygiene care on reduced incidence of postoperative pneumonia (PP), surgical site infection (SSI), and the length of hospital stay in patients with cancer, and to describe the details of oral hygiene care.
METHODS
We searched seven databases. Eligibility criteria were based on perioperative oral hygiene care provided by healthcare professionals to patients aged ≥18 years who were surgically treated under general anesthesia and were evaluated for the incidence of PP and SSI. We reported risk ratios (RR) for dichotomous outcomes for PP and SSI using a fixed-effects model of meta-analysis.
RESULTS
The search resulted in 850 articles, among which two were randomized controlled trials (RCTs) and 21 were observational studies. Most studies indicated that dentists and medical care providers performed a combination of oral cleaning, and oral hygiene instructions. In RCTs, perioperative oral hygiene care significantly reduced the incidence of PP (RR, 0.86; p = .60), while in observational studies, perioperative oral hygiene care significantly reduced the incidence of PP (RR, 0.55; p < .001) and SSI (RR, 0.47; p < .001). The length of hospital stay was also significantly reduced (p < .05). However, the effectiveness of nursing intervention was not clear.
CONCLUSIONS
Perioperative oral hygiene care implemented by healthcare professionals prevented PP and SSI and reduced length of hospital stays for patients after cancer surgery. As daily perioperative oral hygiene care is performed by nurses, it is necessary to research the effects of oral hygiene by nurses in the future.
Topics: Humans; Oral Hygiene; Neoplasms; Perioperative Care; Postoperative Complications; Surgical Wound Infection; Length of Stay
PubMed: 38757361
DOI: 10.1111/jjns.12600 -
Journal of Clinical Periodontology Jul 2024To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short... (Meta-Analysis)
Meta-Analysis Comparative Study Review
Short (≤6 mm) compared with ≥10-mm dental implants in different clinical scenarios: A systematic review of randomized clinical trials with meta-analysis, trial sequential analysis and quality of evidence grading.
AIM
To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short (≤6 mm) perform as well as long (≥10 mm) implants regarding implant survival, marginal bone loss, and biologic and prosthetic complications in different clinical scenarios.
MATERIALS AND METHODS
Cochrane Collaboration's risk of bias tool and the GRADE approach were applied. Results were synthesized using random-effects meta-analyses assessed by trial sequential analyses.
RESULTS
Forty reports on 19 RCTs comprising 2214 (1097 short; 1117 long) implants were included. Moderate/high certainty/quality evidence demonstrated similar 5-year survival rates for ≤6-mm and ≥10-mm implants in non-augmented bone and full-mouth rehabilitation in either jaw, and for 6-mm implants in the maxilla instead of sinus lift. Nevertheless, the evidence for 5-year survival rates remains inconclusive or insufficient for the remaining combinations of implant lengths and clinical scenarios. They include 4-mm and 5-mm implants as alternatives to sinus lift as well as placing all implant lengths ≤6 mm instead of vertical ridge augmentation with long implants. Marginal bone level and short- and long-term biologic or prosthetic complications were similar.
CONCLUSIONS
Based on moderate/high certainty/quality evidence from 5-year RCTs, implants ≤6 mm may be viable alternatives to ≥10-mm implants in either jaw in native bone and full-arch rehabilitation, and 6-mm implants may be used as an alternative to sinus lift.
TRIAL REGISTRATION
PROSPERO ID: CRD42021254365.
Topics: Humans; Dental Implants; Randomized Controlled Trials as Topic; Dental Prosthesis Design; Dental Restoration Failure; Dental Implantation, Endosseous; Alveolar Bone Loss
PubMed: 38764386
DOI: 10.1111/jcpe.13981 -
JPMA. the Journal of the Pakistan... Oct 2023To compare disease-free survival rates in oral squamous cell carcinoma patients initially attended and referred by dentists versus other physicians.
OBJECTIVE
To compare disease-free survival rates in oral squamous cell carcinoma patients initially attended and referred by dentists versus other physicians.
METHODS
The systematic review was conducted after registration with the International prospective register of systematic reviews at the University of York, the United Kingdom, and comprised search on Medline, PubMed, Cochrane and CINAHAL Plus databases for studies published up to December 2021. The Population-Intervention-Comparison- Outcomes-Study criteria was used to search for studies involving patients diagnosed with oral squamous cell carcinoma receiving referrals by dentist or by other healthcare providers. Disease-free survival of patients was taken as the main outcome. Customized data collection proforma was used to record data in line with the Preferred Reporting Items in Systematic Reviews and Meta- Analysis guidelines. Data was subjected to systematic, qualitative review.
RESULTS
Of the 344 studies found, 8(2.3%) were analysed in detail. Patients referred by dentists ranged from 22.6% to 54%. Males comprised 53% to 70.3% of the sample. The highest number of referrals was made by primary physicians, ranging from 27.4% to 71.6%. Upto 67.6% cases were diagnosed with stage 1 and 2 oral cancer. The highest 5-year survival rate was 75% in a study where 59% patients were diagnosed at an early stage of disease.
CONCLUSION
The relative scarcity of studies makes it impossible to draw an association between oral cancer survival rate and type of referral.
Topics: Male; Humans; Female; Carcinoma, Squamous Cell; Mouth Neoplasms; Disease-Free Survival; Squamous Cell Carcinoma of Head and Neck; Systematic Reviews as Topic; Physicians; Head and Neck Neoplasms; Dentists
PubMed: 37876066
DOI: 10.47391/JPMA.7308 -
Medicina Oral, Patologia Oral Y Cirugia... Nov 2023The scientific validity of the European Society of Cardiology's (ESC) infective endocarditis (IE) guidelines limiting provision of prophylactic antibiotics (AP) only to...
BACKGROUND
The scientific validity of the European Society of Cardiology's (ESC) infective endocarditis (IE) guidelines limiting provision of prophylactic antibiotics (AP) only to patients having cardiac anomalies (e.g., prosthetic valves) believed to place them at "high risk" of adverse events when undergoing high risk dental procedures (HRDP) is unclear.
MATERIAL AND METHODS
A systematic review of studies conducted between 2017 and 2022 and catalogued in the PubMed database was undertaken to ascertain if this edict was associated with changes in IE incidence, development of infection in unprotected cardiac anomalies, developing infection and resultant adverse clinical outcomes.
RESULTS
Retrieved were 19 published manuscripts, however of these, 16 were excluded because they did not bare upon the issues of concern. Among the three studies eligible for review were those in the Netherlands, Spain, and England. The results of the Dutch study denoted a significant increase in the incidence of IE cases over the projected historical trend (rate ratio: 1327, 95% CI 1.205-1.462; p<0.001) after the introduction of the ESC guidelines. The findings from the Spanish study evidenced the uniquely high in-hospital IE associated fatality rates suffered by patients having bicuspid aortic valves (BAV); 5.6% or mitral valve prolapse (MVP); 10%. The British study provided evidence that the incidence of fatal IE infection was significantly greater among an "intermediate risk" cohort of patients, (a group likely including those with BAC and MVP for which the ESC guidelines don't recommend AP), than among "high risk" patients (P = 0.002).
CONCLUSIONS
Patients having either a BAV or MVP are at significant risk of developing IE and suffering serious sequelae including death. The ESC guidelines must reclassify these specific cardiac anomalies into the "high risk" category so that AP are recognized as being needed prior to provision of HRDP.
Topics: Humans; Mitral Valve Prolapse; Bicuspid Aortic Valve Disease; Endocarditis; Anti-Bacterial Agents; Dentists; Endocarditis, Bacterial
PubMed: 37330961
DOI: 10.4317/medoral.25984 -
Evidence-based Dentistry Jun 2024This systematic review was conducted to explore the factors influencing access to oral health services and to identify and examine the strategies to improve the access.
OBJECTIVE
This systematic review was conducted to explore the factors influencing access to oral health services and to identify and examine the strategies to improve the access.
MATERIALS AND METHODS
PubMed, Scopus and Embase databases were searched. Studies except editorials reported in English regardless of the study design were included. Risk of Bias assessment was carried out using Agency for Healthcare Research and Quality, Newcastle Ottawa Scale and The Joanna Briggs Institute tool for cross-sectional, case-control and cohort and qualitative studies, respectively.
RESULTS
In total, 11,372 records were initially identified, eventually leading to 12 relevant publications to be included in the review. Individuals valued oral health but found it difficult to access oral health services. Dental care was mainly accessed during emergencies and participants felt apprehensive in visiting dentists. Caregiver's and dentist's perspective was also reported.
CONCLUSION
There is a need for provision of education, training and increasing awareness on dental hygiene and annual dental checkups to improve access.
Topics: Humans; Health Services Accessibility; Disabled Persons; Dental Care; Dental Care for Disabled; Oral Health
PubMed: 38225370
DOI: 10.1038/s41432-024-00970-3