-
Evidence-based Dentistry Mar 2024The search strategy involved three sequential stages. Initially, MEDLINE/PubMed was explored for relevant articles, identifying pertinent terms for formal searching.... (Meta-Analysis)
Meta-Analysis Review
DATA SOURCES
The search strategy involved three sequential stages. Initially, MEDLINE/PubMed was explored for relevant articles, identifying pertinent terms for formal searching. Using the terms ethnic, race, minoritised and dental caries, a strategy was formed and nine databases searched. Finally, hand-searching of reference lists of included articles and sourcing grey literature from relevant government reports, national oral health surveys, and registries which had comparative data for dental caries between racial groups, completed the search.
STUDY SELECTION
Studies included were original primary research which reported dental caries and compared racially minoritised children, aged 5-11 years, to similarly aged from national, majority, or privileged populations. Dental caries had to be recorded from a clinical examination which assessed decayed, missing, and filled teeth (dmft) in primary dentitions. Studies were excluded if they used immigration status as a basis of racial status, or they were a case report, case series, in vitro study, or literature review.
DATA EXTRACTION AND SYNTHESIS
After removing duplicates, two independent researchers screened abstracts, prior to extracting critical data following full-text reviews of included articles. Information collected included study and participant characteristics, definitions of race, and dental caries measurement. The authors of studies which had missing data were contacted, whilst those not written in the English language were translated. Methodological quality of each study was independently assessed by two reviewers using a modified version of the Newcastle-Ottawa scale. All studies were included in the review regardless of quality. A narrative overview of all included studies was conducted. Meta-analyses were completed using studies that reported the mean and standard deviation of the caries outcomes in both groups. Caries outcomes included severity (defined as mean dmft) or prevalence (percentage of teeth with untreated dental caries > 0%). Due to anticipated heterogeneity, statistical analyses approaches such as I statistics were used to estimate between-study variability. Additional sub-group analyses were conducted based on country of study and world income index. Contour-enhanced funnel plots and trim-and-fill analysis were completed to explore potential publication bias. Sensitivity analyses were performed to ensure robustness of the findings.
RESULTS
Seventy-five studies were included from a variety of countries. A higher mean dmft score of 2.30 (0.45, 4.15) and prevalence of decayed teeth (d > 0) was 23% (95% CI: 16, 31) was noted amongst racially minoritised children compared to privileged children's populations. Notable disparities were reported in high-income countries, with minoritised children burdening the greatest distribution of caries incidence. The study faced challenges in consistent racial classification and encountered high heterogeneity in its findings, leading to varied GRADE assessment scores.
CONCLUSIONS
The study calls for global, social, and political changes to tackle the substantial disparities in dental caries among minoritised children to achieve oral health equity.
Topics: Child; Humans; Data Collection; Data Management; Dental Care; Dental Caries; Dental Health Surveys; Child, Preschool
PubMed: 38279035
DOI: 10.1038/s41432-024-00977-w -
Journal of the American Veterinary... Dec 2023Geriatric horses have a high prevalence of dental disease, which is a culmination of age-related dental changes and dental disease throughout the life of the horse that...
Geriatric horses have a high prevalence of dental disease, which is a culmination of age-related dental changes and dental disease throughout the life of the horse that may have long-term consequences. Wear abnormalities, diastemata with periodontal disease, pulpitis and endodontic disease, infundibular caries, and equine odontoclastic tooth resorption and hypercementosis become more prevalent with age. Recognition of age-related dental disease at an early stage can help to treat and possibly preserve teeth for longer. With a natural decrease in masticatory efficiency, it is even more important to preserve teeth where possible and prevent any painful dental disease. Regular routine dental examination and maintenance will help to prevent many dental conditions such as wear disorders and possibly secondary diastemata. Successful treatment and management of most dental diseases are possible even in older patients and will ensure that we are able to maintain a high standard of welfare as horses age.
Topics: Animals; Dental Care; Horse Diseases; Horses; Tooth Diseases; Animal Welfare
PubMed: 37669744
DOI: 10.2460/javma.23.06.0350 -
Journal of the World Federation of... Aug 2023This article describes the importance of biomechanics in orthodontics through the development of the segmented arch technique and the research performed in this field.... (Review)
Review
This article describes the importance of biomechanics in orthodontics through the development of the segmented arch technique and the research performed in this field. Clinicians are encouraged to develop specific goals of treatment based on a precise diagnosis and to design appliances that will deliver the desired force system. In this article we emphasize the importance of a thorough analysis of the force system needed to achieve the desired orthodontic tooth movement and avoid any of the undesired side effects of treatment mechanics. We show that a well-thought out and planned treatment will lead to better clinical outcomes that will benefit our patients.
Topics: Humans; Orthodontics; Biomechanical Phenomena; Tooth Movement Techniques; Dental Care
PubMed: 37330323
DOI: 10.1016/j.ejwf.2023.04.004 -
Clinical Oral Investigations Dec 2023To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in... (Meta-Analysis)
Meta-Analysis Review
Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of non-surgical periodontal treatment in patients with concurrent systemic conditions.
OBJECTIVE
To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up.
MATERIALS AND METHODS
A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities.
RESULTS
The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: -0.69; -0.41) after 3 months compared to the control group.
CONCLUSION
Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions.
TRIAL REGISTRATION
This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.
Topics: Male; Female; Pregnancy; Humans; Randomized Controlled Trials as Topic; Dental Care; Patients; Arthritis, Rheumatoid; Periodontitis
PubMed: 38147183
DOI: 10.1007/s00784-023-05392-6 -
British Dental Journal Nov 2023Introduction Dental professionals have an ethical and legal obligation to diagnose and manage medical emergencies which may occur in primary dental care.Aims and...
Introduction Dental professionals have an ethical and legal obligation to diagnose and manage medical emergencies which may occur in primary dental care.Aims and objectives To investigate the prevalence of medical emergencies in UK primary dental care and explore the medical emergency training needs of UK primary dental care professionals.Design and setting Cross-sectional survey, targeting dentists, dental hygienists and dental therapists across the UK working within primary dental care.Materials and methods An online survey was distributed via dental society mailing lists, social media groups and a dental conference. The questionnaire consisted of participants demographics and training in, prevalence of and confidence surrounding medical emergencies.Results Respondents (n = 400) were dentists (55.8%), dental hygienists/therapists (38.8%) and specialists (5.5%). Most participants received basic life support training (62%) in 2019, before COVID-19. The most common medical emergencies were syncope, non-specific collapse and hypoglycaemia, being encountered every 1.59, 1.64 and 8.26 years, respectively. The preferred method for medical emergency training was practical based, with more training in administering emergency drugs and equipment identified as a training need.Conclusion Dental professionals will encounter medical emergencies in primary dental care every 1-2 years and are therefore not uncommon.
Topics: Humans; Emergencies; Prevalence; Cross-Sectional Studies; United Kingdom; Dental Care; Dentists
PubMed: 37945869
DOI: 10.1038/s41415-023-6444-y -
European Journal of Paediatric Dentistry Dec 2023The aim of the present study is to evaluate the relationship between sequential visits in dental caries treatments and dental anxiety levels of paediatric patients...
AIM
The aim of the present study is to evaluate the relationship between sequential visits in dental caries treatments and dental anxiety levels of paediatric patients through the use of anxiety scales and physiological measurements.
METHODS
A total of 224 children aged 5-8 years who needed at least two bilateral restorative dental caries treatments of the mandibular first primary molar was included in the study. The treatment duration was approximately 20 minutes and time span between the two appointments was a maximum of two weeks. The Wong-Baker FACES Pain Rating Scale (WBFPS) and The Modified Dental Anxiety Scale (MDAS) were used for subjective measurements and the objective measurement of dental anxiety was performed by measuring the heart rate using a portable pulse oximeter. Statistical analysis was carried out using the Statistical Package for the Social Sciences version 22 (IBM corp. Armonk, NY, USA).
RESULTS
Out of the 224 children, 117 were girls (mean age 6.4 ± 1.1 years) and 107 were boys (mean age 6.1 ± 1.2 years). The mean age of the patients was 6.26 ± 1.147 years, ranging from 5 to 8. There were no statistical significant differences between children’s age and genders with dental anxiety. However, there were statistical significant differences for the variables regarding the sequential visits. When comparing the MDAS scores statistically significant differences were observed between the first and second visits (p<0.001). Both preoperative and postoperative WBFPS scores were significantly higher at the first visit than at the second visit. Statistically significant differences were observed in the heart rate scores between the treatment sessions (p<0.001).
CONCLUSION
The results of this study show a significant reduction in dental anxiety after sequental dental visits in children aged 5-8 years, which highlights the importance of the sequental visits in paediatric dentistry.
Topics: Child; Humans; Dental Anxiety; Dental Caries; Pediatric Dentistry; Dental Care; Molar
PubMed: 37337965
DOI: 10.23804/ejpd.2023.1848 -
Bulletin Du Cancer May 2024Osteoradionecrosis (ORN) is a late secondary iatrogenic complication of external radiotherapy for cancers of the upper aero-digestive tract. Despite the systematization... (Review)
Review
Osteoradionecrosis (ORN) is a late secondary iatrogenic complication of external radiotherapy for cancers of the upper aero-digestive tract. Despite the systematization of intensity-modulated radiotherapy and its potential for preserving salivary secretion and limiting the dose delivered to the supporting bone, ORN remains a feared and frequent complication. The objective of this literature review was to provide an overview of the management of ORN and to determine the key points that would make it possible to improve patient care. The diagnosis of ORN requires to eliminate tumor recurrence then is based on clinical arguments and imaging by CT or Cone Beam evolving in a chronic mode (more than 3-6 months). The harmonization of its classifications aims to offer comprehensive and multidisciplinary care as early as possible. Primary prevention is based on pre-therapeutic oral and dental preparation, then associated with fluoroprophylaxis if salivary recovery is insufficient and requires supervision of invasive dental care and prosthetic rehabilitation. Semi-automatic contouring tools make it possible to identify doses delivered to dental sectors and guide dental care with personalized dosimetric mapping. Conservative medical treatment is offered at an early stage where innovative medical treatments, highlighted by early studies, could be of interest in the future. In the event of advanced ORN, a non-conservative treatment is then proposed and frequently consists of interruptive mandibulectomy associated with reconstruction by bony free flap, the conditions of implantation remaining to be defined with the support of prospective clinical trials.
Topics: Humans; Osteoradionecrosis; Radiotherapy, Intensity-Modulated; Head and Neck Neoplasms; Primary Prevention; Dental Care; Neoplasm Recurrence, Local
PubMed: 38480057
DOI: 10.1016/j.bulcan.2024.01.008 -
Journal of Dentistry Oct 2023Our aims are to describe the characteristics of dentists, members of the US National Dental practice-based research network (PBRN) in the United States, and determine...
OBJECTIVES
Our aims are to describe the characteristics of dentists, members of the US National Dental practice-based research network (PBRN) in the United States, and determine how often these dentists provide specific dental procedures.
METHODS
Dentists completed a questionnaire when they enrolled in the Network about their demographic and training characteristics and characteristics of their practices and patients. Dentists also reported the frequency of providing specific dental procedures. Data were analyzed using descriptive statistics.
RESULTS
Of 4,483 dentists in active clinical practice, 34% identified as females, 70% as white, and 73% as general dentists. Most dentists practiced in large metropolitan areas (87%) and in solo or small practices (72%). On average, they reported about one-half of their patients were children or older adults, a third were from historically underrepresented racial and ethnic groups, and one-quarter were covered by public insurance. Most dentists routinely performed restorations and fixed prosthetics (78%), extractions (59%), removable (44%) and implant (40%) prosthetics, and endodontics on incisor and premolar teeth (44%).
CONCLUSIONS
Dentists participating in the National Dental PBRN have much in common with dentists at large. The network has a broad representation of dentists, practice types, patient populations, and treatments offered, including diversity regarding race/ethnicity, gender, insurance, and geography of its practitioners and patients.
CLINICAL SIGNIFICANCE
Characteristics of National Dental PBRN dentists suggest that a broad range of dentists is interested in participating in national-level research studies, thereby enabling an array of clinical study settings and topics that can optimize the generalizability of study findings.
Topics: Female; Child; Humans; United States; Aged; Surveys and Questionnaires; Dental Care; Dentists; Practice Patterns, Dentists'; Dental Research
PubMed: 37572986
DOI: 10.1016/j.jdent.2023.104653 -
International Journal of Dental Hygiene Nov 2023Increased awareness of oral health disparities in the United States has highlighted the need to expand the workforce and access to both primary and preventive dental...
AIMS
Increased awareness of oral health disparities in the United States has highlighted the need to expand the workforce and access to both primary and preventive dental care. Achieving the goal of oral health equity will require dental team members with appropriate clinical skills dedicated to reaching historically marginalized populations through intra- and interprofessional practice.
MATERIALS AND METHODS
Collective efforts by healthcare advocates in Minnesota led to legislation that created a dental hygiene-based workforce model inspired by the vision and foresight of the American Dental Hygienists' Association's 'Advanced Dental Hygiene Practitioner'.
RESULTS
In July 2023, there were 141 licensed dental therapists and 99 certified advanced dental therapists, the majority dually licensed as dental hygienists/dental therapists, providing primary care services in a variety of settings throughout the state. Current data confirm the contributions of this workforce model to increasing access to primary oral health care for Minnesotans across the lifespan.
CONCLUSIONS
While challenges remain, new opportunities are emerging for dual-licensed dental hygienists/dental therapists to reach intended populations. Minnesota's challenges and successes with the authorization and implementation of a dental hygiene-based workforce model can serve to assist others in developing their own intra- and interprofessional oral health care practitioners.
Topics: United States; Humans; Health Services Accessibility; Minnesota; Dental Care; Clinical Competence; Workforce; Dental Hygienists
PubMed: 37831541
DOI: 10.1111/idh.12777 -
Compendium of Continuing Education in... Feb 2024Besides meticulous application of proper bonding protocols and clinical technique, the clinical success of direct resin-based restorations is dependent on the selection...
Besides meticulous application of proper bonding protocols and clinical technique, the clinical success of direct resin-based restorations is dependent on the selection of the appropriate restorative material, curing light, and, whenever certain contours of the tooth need to be rebuilt, matrix band system. All of these aspects have seen significant developments and improvements over the years, all geared toward increased clinical success and longevity. Highlighting some of these key developments, this article provides an update on resin-based composites, curing lights, and matrix bands.
Topics: Humans; Dental Care; Dental Materials
PubMed: 38289628
DOI: No ID Found