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Community Dentistry and Oral... Oct 2023With elimination of the financial burden of dental services, one can expect an increase in utilization of dental services. This study aimed to investigate the effective...
OBJECTIVES
With elimination of the financial burden of dental services, one can expect an increase in utilization of dental services. This study aimed to investigate the effective mechanisms of financial barriers to the utilization of dental services in an Australian adult population.
METHODS
South Australian survey data from the Dental Care and Oral Health Study (2015) were analysed. Following the flexible mediation approach, the direct effect of income and indirect effect of income through mediators (insurance, concession card and service sector) on the outcomes (visit avoidance and treatment prevention due to the cost) were calculated.
RESULTS
Findings showed that around half of the low-income people and one-third of the high-income South Australians experienced a financial burden on receiving a dental visit or service. The indirect effect of income on both outcomes of financial burden was negligible, while the direct effect was significant. By changing the potential outcome distribution to their counterfactual exposure distribution and if the mediators are drawn from their counterfactual exposure (lower/higher income) distribution, the odds of visit avoidance and treatment prevention due to the cost were almost twice (Odds Ratio: 2.13, 95% CI 1.72-2.60) and 98% (Odds Ratio: 1.98, 95% CI 1.67-2.35) than in the lower-income individuals, respectively.
CONCLUSIONS
It can be concluded that the level of household income, directly and regardless of insurance status, concession card ownership and whether the service sector was public or private, affected the financial burden on utilization of dental services.
Topics: Adult; Humans; Mediation Analysis; Health Services Accessibility; Australia; Income; Dental Care
PubMed: 35681256
DOI: 10.1111/cdoe.12767 -
Head & Face Medicine Aug 2023The application of artificial intelligence (AI) in orthodontics and orthognathic surgery has gained significant attention in recent years. However, there is a lack of...
BACKGROUND
The application of artificial intelligence (AI) in orthodontics and orthognathic surgery has gained significant attention in recent years. However, there is a lack of bibliometric reports that analyze the academic literature in this field to identify publishing and citation trends. By conducting an analysis of the top 100 most-cited articles on AI in orthodontics and orthognathic surgery, we aim to unveil popular research topics, key authors, institutions, countries, and journals in this area.
METHODS
A comprehensive search was conducted in the Web of Science (WOS) electronic database to identify the top 100 most-cited articles on AI in orthodontics and orthognathic surgery. Publication and citation data were obtained and further analyzed and visualized using R Biblioshiny. The key domains of the 100 articles were also identified.
RESULTS
The top 100 most-cited articles were published between 2005 and 2022, contributed by 458 authors, with an average citation count of 22.09. South Korea emerged as the leading contributor with the highest number of publications (28) and citations (595), followed by China (16, 373), and the United States (7, 248). Notably, six South Korean authors ranked among the top 10 contributors, and three South Korean institutions were listed as the most productive. International collaborations were predominantly observed between the United States, China, and South Korea. The main domains of the articles focused on automated imaging assessment (42%), aiding diagnosis and treatment planning (34%), and the assessment of growth and development (10%). Besides, a positive correlation was observed between the testing sample size and citation counts (P = 0.010), as well as between the time of publication and citation counts (P < 0.001).
CONCLUSIONS
The utilization of AI in orthodontics and orthognathic surgery has shown remarkable progress, particularly in the domains of imaging analysis, diagnosis and treatment planning, and growth and development assessment. This bibliometric analysis provides valuable insights into the top-cited articles and the trends of AI research in this field.
Topics: Humans; Orthognathic Surgery; Orthodontics; Artificial Intelligence; Dental Care; Bibliometrics
PubMed: 37612673
DOI: 10.1186/s13005-023-00383-0 -
PloS One 2023The affordability of dental care continues to receive attention in Canada. Since most dental care is privately financed, the use of dental care is largely influenced by...
BACKGROUND
The affordability of dental care continues to receive attention in Canada. Since most dental care is privately financed, the use of dental care is largely influenced by insurance coverage and the ability to pay-out-of pocket.
OBJECTIVES
i) to explore trends in self-reported cost barriers to dental care in Ontario; ii) to assess trends in the socio-demographic characteristics of Ontarians reporting cost barriers to dental care; and iii) to identify the trend in what attributes predicts reporting cost barriers to dental care in Ontario.
METHODS
A secondary data analysis of five cycles (2003, 2005, 2009-10, 2013-14 and 2017-18) of the Canadian Community Health Survey (CCHS) was undertaken. The CCHS is a cross-sectional survey that collects information related to health status, health care utilization, and health determinants for the Canadian population. Univariate and bivariate analyses were conducted to determine the characteristics of Ontarians who reported cost barriers to dental care. Poisson regression was used to calculate unadjusted and adjusted prevalence ratios to determine the predictors of reporting a cost barrier to dental care.
RESULTS
In 2014, 34% of Ontarians avoided visiting a dental professional in the past three years due to cost, up from 22% in 2003. Having no insurance was the strongest predictor for reporting cost barriers to dental care, followed by being 20-39 years of age and having a lower income.
CONCLUSION
Self-reported cost barriers to dental care have generally increased in Ontario but more so for those with no insurance, low income, and aged 20-39 years.
Topics: Humans; Young Adult; Adult; Ontario; Self Report; Cross-Sectional Studies; Oral Health; Insurance Coverage; Dental Care
PubMed: 37418457
DOI: 10.1371/journal.pone.0280370 -
BMC Health Services Research Nov 2023COVID-19 was declared a major public health crisis and a challenge to healthcare systems especially dental services where dentists working close to patients face a...
BACKGROUND
COVID-19 was declared a major public health crisis and a challenge to healthcare systems especially dental services where dentists working close to patients face a greater risk of infection. This cross-sectional study aimed to assess the risk perception and practice modifications of undergraduate dental students at Tanta University to ensure safe dental practice during the COVID-19 pandemic.
METHODS
A convenience sample of 450 dental students from practical academic years at Tanta University, Egypt responded to a self-administered pre-designed validated and pretested questionnaire from the 11 of February 2022 to the end of April 2022 to assess some sociodemographic data, risk perception, and their practice during the COVID-19 pandemic.
RESULTS
Females reported significantly higher levels of fear than males concerning; contracting COVID-19 infection from patients (97.3% vs. 93%) (P = 0.028, 95% CI = 95.6(93.2-97.3), anxiety while treating symptomatic patients (95.1% vs. 90.3%) (P = 0.050, 95% CI = 93.1(90.4-95.3), and fear of infecting their families (94.7% vs. 89.8%) (P = 0.049, 95% CI = 92.7(89.9-94.9). More than half of the students (53.7%) had good practice scores, followed by 44% with average practice and 2.2% with poor practice. A good practice score was significantly associated with the age and academic year (P = 0.044, P = 0.044). Significant predictors of a good practice score in the logistic regression analysis were; updating knowledge with current guidelines for cross-infection regarding COVID-19 (P = 0.001, 95% CI = 53.20, 2.733), asking every patient's travel history before performing treatment (P = 0.021, 95% CI = 21.149, 1.286), deferring patients showing suspicious symptoms (P = 0.042, 95% CI = 20.688, 1.054), following routine universal precautions of infection for every patient (P = 0.016, 95% CI = 36.469, 1.438), using high-volume suction for every patient (P = 0.025, 95% CI = 20.826, 1.226) and using safety glasses or visor (P = 0.036, 95% CI = 21.673, 1.106).
CONCLUSION
The dental students exhibited anxiety and fear while caring for patients during the COVID-19 pandemic. Additionally, considerable changes in dental practices based on the standard guidelines were observed among the students. It is strongly advised that all dental schools have student counselors who are accessible for in-person and online counseling sessions. Peer support is a great approach to spot problems with stress and anxiety in pupils and start solving them.
Topics: Male; Female; Humans; COVID-19; Egypt; Students, Dental; Cross-Sectional Studies; Pandemics; Perception; Dental Care
PubMed: 37957726
DOI: 10.1186/s12913-023-10196-1 -
International Dental Journal Dec 2023The Belt and Road Initiative (BRI) aims to strengthen China's connectivity with the world and, in doing so, improve health and well-being. There is a dearth of...
BACKGROUND
The Belt and Road Initiative (BRI) aims to strengthen China's connectivity with the world and, in doing so, improve health and well-being. There is a dearth of information relating to schoolchildren's oral health to inform oral health-related BRI initiatives. The aim of this research was to report on the oral health status of 12-year-old children across BRI countries and determine variations in oral health regarding geographic regions (BRI routes) and country-income levels.
METHOD
Dental caries experience of 12-year-old children was obtained from the World Health Organization's (WHO) database. BRI countries were classified into BRI routes and country income level. Data were assessed for completeness and contemporariness. Variations in dental caries experiences were examined across BRI routes and with respect to country income levels.
RESULTS
Dental caries experience data were available in the WHO database for most BRI countries (95.7%, 135/141). Most dental caries data were collected pre-2010 (74.1%, 74/135). The mean number of decayed, missing, and filled teeth (DMFT) was approximately 2 (weighted mean, 1.7; SD, 1.2). Variations in DMFT existed with respect to BRI routes-WHO regions (P < .001) and World Bank regions (P < .001)-and with respect to country income levels (P < .01).
CONCLUSIONS
Dental caries data for 12-year-old schoolchildren are readily available (in the WHO database) for most BRI countries, although the data are not very current. In addition, dental caries experience varies with respect to BRI routes (geographic locations) and country income levels. These findings have implications by way of situation analyses to inform oral health-related BRI initiatives.
Topics: Child; Humans; Oral Health; Dental Caries; Dental Care; DMF Index; Prevalence
PubMed: 37117095
DOI: 10.1016/j.identj.2023.03.014 -
International Journal of Molecular... Jan 2024Stroke is a major cause of death and disability worldwide. Endovascular thrombectomy has been impactful in decreasing mortality. However, many clinical results continue... (Review)
Review
Stroke is a major cause of death and disability worldwide. Endovascular thrombectomy has been impactful in decreasing mortality. However, many clinical results continue to show suboptimal functional outcomes despite high recanalization rates. This gap in recanalization and symptomatic improvement suggests a need for adjunctive therapies in post-thrombectomy care. With greater insight into ischemia-reperfusion injury, recent preclinical testing of neuroprotective agents has shifted towards preventing oxidative stress through upregulation of antioxidants and downstream effectors, with positive results. Advances in multiple neuroprotective therapies, including uric acid, activated protein C, nerinetide, otaplimastat, imatinib, verapamil, butylphthalide, edaravone, nelonemdaz, ApTOLL, regional hypothermia, remote ischemic conditioning, normobaric oxygen, and especially nuclear factor erythroid 2-related factor 2, have promising evidence for improving stroke care. Sedation and blood pressure management in endovascular thrombectomy also play crucial roles in improved stroke outcomes. A hand-in-hand approach with both endovascular therapy and neuroprotection may be the key to targeting disability due to stroke.
Topics: Humans; Ischemic Stroke; Neuroprotection; Stroke; Neuroprotective Agents; Dental Care
PubMed: 38255965
DOI: 10.3390/ijms25020891 -
International Journal of Geriatric... Dec 2023People living with dementia are at risk of mouth and dental problems. Many receive help with this aspect of personal care from family carers or homecare workers. We...
OBJECTIVE
People living with dementia are at risk of mouth and dental problems. Many receive help with this aspect of personal care from family carers or homecare workers. We explored the views of homecare providers and carers on how this aspect of personal care is addressed and implemented.
MATERIALS AND METHODS
In this qualitative study we conducted semi-structured interviews with carers (all family members), homecare workers and managers providing support to people living with dementia in their own homes. Interview questions focused on daily care practices, exploring barriers and facilitators to oral care. Interviews were recorded online or over the telephone, transcribed, and thematically analysed.
RESULTS
Carers (n = 8), homecare workers (n = 9) and homecare managers (n = 15) were recruited from across England in 2021-2022. Across interviews, two main themes were identified: (i) Missed opportunities to address oral care, which is not always seen as a priority despite the importance and potential risk of neglect. (ii) Challenges in delivering oral care, including factors related to the person living with dementia (such as cognitive and physical decline) and factors related to the care infrastructure and policies such as training, perception of roles, allocated time, and consistency of care.
DISCUSSION
More emphasis could be given to the training and skills of homecare providers to identify and prevent dental problems and to assist carers. Several strategies and tools (oral care checklists, greater detail around oral care in care assessments and care plans) could be used to enhance this aspect of personal care for people living with dementia.
Topics: Humans; Caregivers; Dementia; England; Qualitative Research; Dental Care
PubMed: 38102870
DOI: 10.1002/gps.6039 -
Journal of Endodontics Jan 2024Nonsurgical endodontic teeth treatment with severe pulp canal obliteration poses challenges, primarily locating canals. By combining 3-dimensional reconstruction and...
Nonsurgical endodontic teeth treatment with severe pulp canal obliteration poses challenges, primarily locating canals. By combining 3-dimensional reconstruction and spatial location registration, the dynamic navigation technique uses an optical tracking system to guide the clinician to drill in real time according to the predesigned path until access to the canal is established. Several in vitro studies and case reports have shown that calcified canal location with dynamic navigation system (DNS) is more accurate and efficient, yet the technique has limitations. In 4 cases with 7 teeth, this work presents manipulation process and clinical outcomes of DNS helping in calcified canal location. We performed handpiece adaptation and elucidated the failure to locate the canals with DNS in 2 teeth, resulting in canal geometry alteration and canal path deviation. Subsequently, the more experienced endodontist located the canals by combining cone-beam computed tomographic imaging and dental operating microscopy. All patients were completely asymptomatic after treatment. At the 1-year follow-up visit, the bone healing of periapical lesions progressed well according to the periapical radiography or cone-beam computed tomographic imaging. These findings indicate that DNS is a promising technique for locating calcified canals; however, it needs to be refined before clinical use.
Topics: Humans; Dental Pulp Cavity; Cone-Beam Computed Tomography; Molar; Dental Care; Root Canal Therapy
PubMed: 37890613
DOI: 10.1016/j.joen.2023.10.010 -
British Dental Journal Apr 2024Gagging during dental work is a common concern for both dentists and patients and can prevent patients from seeking or completing essential and routine dental work,... (Review)
Review
Gagging during dental work is a common concern for both dentists and patients and can prevent patients from seeking or completing essential and routine dental work, often leading to further problems in the future. This paper aims to describe and review the literature on an accessible alternative to other management options to treat a patient with an exaggerated gag reflex. The author compares the effectiveness of current available treatments from published, peer-reviewed sources. The effectiveness of the MAGIC (main amelioration of gagging indoctrination by communication) technique has not yet been clinically reviewed but the experiential success by the author is near 100%. Patients were explained the technique and talked through it during treatment, leading to almost all patients who have not been able to undergo any dental treatment coping with and completing treatment. As this technique has not been assessed under clinical research conditions, we only have experiential evidence of many patients continuing and completing dental treatment following use of the MAGIC technique. This has been used with patients who both have and have not self-reported that they have a hypersensitive gag reflex. This paper reviews a novel technique for the amelioration of a hypersensitive gag reflex that can easily be incorporated in the general dental practice to the benefit of both patient and dental professional.
Topics: Humans; Gagging; Communication; Dentist-Patient Relations; Dental Care
PubMed: 38671112
DOI: 10.1038/s41415-024-7285-z -
Community Dentistry and Oral... Aug 2023The Universal Coverage Health Scheme (UCS) was implemented in Thailand in 2002 to increase access to health services among the Thai population. This study aimed to...
OBJECTIVES
The Universal Coverage Health Scheme (UCS) was implemented in Thailand in 2002 to increase access to health services among the Thai population. This study aimed to evaluate socioeconomic inequalities in dental service utilization (DU) before and after UCS implementation and to assess factors associated with DU among Thai adults.
METHODS
This study is based on secondary data from four Thai national oral health surveys in 2000-2001, 2006-2007, 2012 and 2017. Whether an individual from a nationally representative sample of Thai adults aged 35-44 went to see the dentist during the past year was used to define DU. The slope index of inequality (SII) and relative index of inequality (RII) were used to assess and compare education and income-related inequalities in DU. Poisson regression was used to assess factors associated with DU. Income inequalities were not reported for the year 2001 (Income data not available).
RESULTS
Although DU increased after UCS implementation, socioeconomic inequalities persisted. DU was concentrated among high-education and income groups. Absolute educational inequalities were 0.16 (95% CI: 0.09-0.22), 0.21 (95% CI: 0.10-0.32), 0.26 (95% CI: 0.14-0.38) and 0.25 (95% CI: 0.18-0.32) in 2001, 2007, 2012 and 2017, respectively. Absolute income inequalities were 0.15 (95% CI: 0.04-0.26), 0.07 (95% CI: -0.04-0.18) and 0.12 (95% CI: 0.05-0.19) in 2007, 2012 and 2017, respectively. Occupation, type of health insurance scheme, sex and oral health-related behaviour were associated with DU.
CONCLUSION
UCS has improved accessibility to dental services, but UCS alone might not narrow the inequalities gap for Thai adults.
Topics: Humans; Adult; Socioeconomic Factors; Thailand; Southeast Asian People; Income; Dental Care; Health Status Disparities
PubMed: 37350457
DOI: 10.1111/cdoe.12884