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Journal of the American Dental... Sep 2023Blood-borne pathogens (BBPs) are infectious microorganisms that are found in human blood and can cause diseases in humans. Health care workers such as physicians,... (Review)
Review
BACKGROUND
Blood-borne pathogens (BBPs) are infectious microorganisms that are found in human blood and can cause diseases in humans. Health care workers such as physicians, surgeons, nurses, dentists, dental students, dental assistants, laboratory technicians, personnel handling infectious waste, and other health care employees are at increased risk of exposure to these pathogens. Percutaneous injuries from needles or other sharp objects are the major sources of BBPs in the workplace. Needlestick injuries (NSIs) have the most potential to transmit and have the easiest mode of transmission of BBPs.
TYPES OF STUDIES REVIEWED
The authors searched electronic databases (PubMed, Web of Science, Google Scholar, Scopus, Embase, MEDLINE-Ovid) for studies and articles focused on the various aspects of NSIs, their possible causes, prevention, and management protocols.
RESULTS
There is a lack of literature on the global prevalence of NSIs among dental practitioners and underreporting of NSIs by clinicians. The authors also found that dental students and inexperienced practitioners were the most vulnerable. They found apparent inconsistencies in guidelines and recommendations from various regulatory and statutory agencies in charge of limiting and managing NSIs.
CONCLUSION
The most significant occupational risks for health care workers globally are NSIs. Dentists are recognized as one of the high-risk groups for exposure to NSIs. Although the reporting rate was noticeably low, the frequency of NSIs among dental students was alarmingly high.
PRACTICAL IMPLICATIONS
Appropriate and succinct training of dental health care workers is crucial for prevention and management of NSIs. It is recommended that dentists familiarize themselves with recommendations from such agencies and organizations as the Center for Disease Control and Prevention, Occupational Safety and Health Administration, and American Dental Association.
Topics: Humans; Dentists; Needlestick Injuries; Professional Role; Health Personnel; Dentistry
PubMed: 37530693
DOI: 10.1016/j.adaj.2023.06.004 -
Primary Dental Journal Dec 2023Traumatic dental injuries (TDIs) occur commonly in children and young adults with one in three adults having experience of a TDI to their permanent dentition. Although...
Traumatic dental injuries (TDIs) occur commonly in children and young adults with one in three adults having experience of a TDI to their permanent dentition. Although the management of TDIs have evolved vastly, the consequences of TDIs can still be profound and generally carry a high burden for the patient, family, or carer, as well as the clinician and healthcare services. Hence, prevention of TDIs where possible is key. It is important to ensure that all risk factors for dental trauma are fully explored to allow preventative advice to be tailored to each patient. General Dental Practitioners are well placed to establish a rapport with patients owing to the continuity of care that is commonly seen in dentistry, however, it is imperative that the appropriate questions are asked.This article aims to review dental trauma highlighting the significance of identification of clinical and social risk factors and prevention of TDIs. These risk factors are further divided into modifiable and non-modifiable risk factors which can guide the clinician on what further action is required and when other members of the dental or medical team should be involved. The importance of patient education in prevention of TDIs, including use of mouthguards in sport, and mouthguard design will be discussed.
Topics: Child; Young Adult; Humans; Tooth Injuries; Dentists; Professional Role; Mouth Protectors; Risk Factors
PubMed: 38018671
DOI: 10.1177/20501684231210090 -
Orthodontics & Craniofacial Research Dec 2023Juvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatic disease of childhood. JIA can affect any joint and the temporomandibular joint (TMJ) is one... (Review)
Review
Juvenile idiopathic arthritis (JIA) is the most common inflammatory rheumatic disease of childhood. JIA can affect any joint and the temporomandibular joint (TMJ) is one of the joints most frequently involved. TMJ arthritis impacts mandibular growth and development and can result in skeletal deformity (convex profile and facial asymmetry), and malocclusion. Furthermore, when TMJs are affected, patients may present with pain at joint and masticatory muscles and dysfunction with crepitus and limited jaw movement. This review aims to describe the role of orthodontists in the management of patients with JIA and TMJ involvement. This article is an overview of evidence for the diagnosis and treatment of patients with JIA and TMJ involvement. Screening for the orofacial manifestation of JIA is important for orthodontists to identify TMJ involvement and related dentofacial deformity. The treatment protocol of JIA with TMJ involvement requires an interdisciplinary collaboration including orthopaedic/orthodontic treatment and surgical interventions for the management of growth disturbances. Orthodontists are also involved in the management of orofacial signs and symptoms; behavioural therapy, physiotherapy and occlusal splints are the suggested treatments. Patients with TMJ arthritis require specific expertise from an interdisciplinary team with members knowledgeable in JIA care. Since disorders of mandibular growth often appear during childhood, the orthodontist could be the first clinician to see the patient and can play a crucial role in the diagnosis and management of JIA patients with TMJ involvement.
Topics: Child; Humans; Adolescent; Orthodontists; Temporomandibular Joint; Temporomandibular Joint Disorders; Arthritis, Juvenile; Mandible
PubMed: 37226648
DOI: 10.1111/ocr.12676 -
Journal of Esthetic and Restorative... Oct 2023This article provides an overview of the implications of ChatGPT and other large language models (LLMs) for dental medicine. (Review)
Review
OBJECTIVE
This article provides an overview of the implications of ChatGPT and other large language models (LLMs) for dental medicine.
OVERVIEW
ChatGPT, a LLM trained on massive amounts of textual data, is adept at fulfilling various language-related tasks. Despite its impressive capabilities, ChatGPT has serious limitations, such as occasionally giving incorrect answers, producing nonsensical content, and presenting misinformation as fact. Dental practitioners, assistants, and hygienists are not likely to be significantly impacted by LLMs. However, LLMs could affect the work of administrative personnel and the provision of dental telemedicine. LLMs offer potential for clinical decision support, text summarization, efficient writing, and multilingual communication. As more people seek health information from LLMs, it is crucial to safeguard against inaccurate, outdated, and biased responses to health-related queries. LLMs pose challenges for patient data confidentiality and cybersecurity that must be tackled. In dental education, LLMs present fewer challenges than in other academic fields. LLMs can enhance academic writing fluency, but acceptable usage boundaries in science need to be established.
CONCLUSIONS
While LLMs such as ChatGPT may have various useful applications in dental medicine, they come with risks of malicious use and serious limitations, including the potential for misinformation.
CLINICAL SIGNIFICANCE
Along with the potential benefits of using LLMs as an additional tool in dental medicine, it is crucial to carefully consider the limitations and potential risks inherent in such artificial intelligence technologies.
Topics: Humans; Artificial Intelligence; Dentists; Professional Role; Language; Fenbendazole
PubMed: 37017291
DOI: 10.1111/jerd.13046 -
Primary Dental Journal Dec 2023This paper aims to aid clinicians in the assessment and immediate management of dental trauma displacement injuries to permanent teeth. Long term sequelae, the impact of...
This paper aims to aid clinicians in the assessment and immediate management of dental trauma displacement injuries to permanent teeth. Long term sequelae, the impact of such injuries, and the evidence-base for managing these are discussed.Clinical cases are provided to illustrate management challenges and highlight where further evidence-based guidance is needed. The role of the general dental practitioner in the immediate management and follow-up of traumatic dental injuries is outlined and sequelae, worthy of potential referral, described.
Topics: Humans; Tooth Fractures; Dentists; Professional Role; Dentition, Permanent; Tooth Injuries
PubMed: 38018680
DOI: 10.1177/20501684231213770 -
Journal of Dentistry Oct 2023Dentists in Australia are the second largest prescriber group, and are generally not formally taught how to prescribe. The objective of this review is to describe the... (Review)
Review
OBJECTIVES
Dentists in Australia are the second largest prescriber group, and are generally not formally taught how to prescribe. The objective of this review is to describe the Prescribing Competencies Framework and its relevance to dentistry.
DATA
The four-model stage of prescribing by Coombes and colleagues, and the seven competencies within the Prescribing Competencies Framework devised by the Australian National Prescribing Service MedicineWise, are discussed and applied to dentistry.
SOURCES AND STUDY SELECTION
Each of the seven competencies are analysed and detailed in the context of clinical dental practice. Competencies 1-5 describe the skillset and tasks required by dentists to safely prescribe, whereas Competencies 6 and 7 describe the clinical environment and recommended resources to support dentists to prescribe safely and effectively.
CONCLUSIONS
The Prescribing Competencies Framework provides an overview of safe and effective prescribing. Prescribing is a process, and a separate skillset to clinical dentistry. The process involves information gathering, clinical assessment, effective communication and review of the patient. Access to timely and appropriate resources and relevant electronic sources of health information for clinicians are important to provide the support required for better informed prescribing decisions. The framework describes a patient-centered prescribing process, and ultimately prescribing should be a shared decision between the dentist and the patient.
CLINICAL SIGNIFICANCE
Safe and effective prescribing is an integral part of dentistry and dentists are the second largest prescriber group. However, dentists display high rates of inappropriate and unnecessary prescribing, and to minimise errors, the Prescribing Competencies Framework has been established. This article details how the Framework applies to clinical practice dentistry.
Topics: Humans; Australia; Dentistry; Dentists
PubMed: 37574106
DOI: 10.1016/j.jdent.2023.104654 -
Journal of Dentistry Jun 2024Primary care dentistry is the first point of contact that someone has with the dental system and is predominantly focused on the treatment and prevention of dental... (Review)
Review
INTRODUCTION
Primary care dentistry is the first point of contact that someone has with the dental system and is predominantly focused on the treatment and prevention of dental caries and periodontal disease. The aim of this paper was to review the Australian primary dental care system.
METHODS
This paper reviews the primary dental care system in Australia, drawing on data reporting on the dental workforce, funding sources for dental care, oral health outcome measures and dental visiting patterns.
RESULTS
Primary dental health care in Australia is predominantly provided by dentists working in private practice, with the number of dentists per 100,000 people in Australia increasing from 46.9 in 2000 to 65.1 in 2022. However, there has been a gradual shift over the past twenty years towards greater service provision by other members of the dental team who now represent one quarter of the dental workforce, and some expansion of publicly funded dental care. Despite this dentistry remains isolated from the rest of primary health care, and the lack of government funding means that many people continue to miss out of necessary dental care, particularly those living in regional and rural Australia and from low-income groups.
CONCLUSIONS
Australians should be able to access primary dental care services when and where they need it with adequate financial protection, from services that are well integrated into the broader primary health care system to ensure they are able to achieve optimal oral and general health. For many Australians, this is not currently the case.
CLINICAL SIGNIFICANCE
Australia is at a crossroads with respect to access to dental care, and there is a need for stronger advocacy from stakeholders to improve oral health outcomes and reduce inequalities.
Topics: Humans; Australia; Primary Health Care; Health Services Accessibility; Dental Care; Oral Health; Dentists; Dental Caries; Private Practice; Workforce
PubMed: 38621524
DOI: 10.1016/j.jdent.2024.104996 -
Indian Journal of Dental Research :... 2023Noncooperative behaviour faced by a paediatric dentist is the most common attribution towards behavioural manifestations of anxiety in children, and it had been observed... (Review)
Review
Noncooperative behaviour faced by a paediatric dentist is the most common attribution towards behavioural manifestations of anxiety in children, and it had been observed that these relationships are long-deterministic and form part of the aforementioned belief system of the child. Forehead and Long in their study found that most uncooperative behaviour of the child is due to their strong will and these children are generally confident, persistent and independent. A fruitful method to deal with strong willed children is to violate the causal relationship by some magic tricks from preventive via curative to his/her follow ups visits. Tricks can be applied at three levels of their visit. Level 1 is preoperative tricks, which includes the preventive measures that teach and educate children for good oral health. Level 2 is operative tricks, which involves child preparedness for successful dental procedures. Level 3 is postoperative tricks, which involve positive reinforcement for regular follow ups. The purpose of this review is to make paediatric dentists think like magicians by using the science behind the magic and applying it in their practice for creating a positive attitude of a child toward dentistry and better procedural experience.
Topics: Child; Humans; Dentists; Oral Health; Pediatric Dentistry; Dental Anxiety
PubMed: 38197355
DOI: 10.4103/ijdr.ijdr_986_22 -
Primary Dental Journal Dec 2023Traumatic dental injuries (TDIs) in the paediatric population are common and frequently seen in general dental practice. The management of TDIs can be challenging and,...
Traumatic dental injuries (TDIs) in the paediatric population are common and frequently seen in general dental practice. The management of TDIs can be challenging and, in most cases, the General Dental Practitioner is tasked with the initial assessment and emergency treatment. Patients and their families typically attend with elevated levels of distress, which is complicated by the limited dental experience of some children. Behaviour management is essential and helps prepare patients for dental care at both their emergency and follow-up appointments. Early and accurate diagnosis in combination with appropriate treatment contributes to favourable outcomes for traumatised teeth. Early discussions with or referral to paediatric dental teams for management of complex TDIs is encouraged, however shared follow-up care is beneficial over the long-term. In specific cases, initial dental treatment can be delayed by a few days to a subsequent appointment, allowing the dental team to book sufficient time for the treatment and for the patient and their families to prepare. Education of the patients and adults with parental responsibility is essential to manage expectations, explain likely complications and encourage attendance for long-term follow-up visits. This paper discusses the management of paediatric patients to aid the primary care practitioner in providing effective immediate and long-term care.
Topics: Adult; Child; Humans; Dentists; Professional Role; Tooth Injuries; Tooth Avulsion; Emergency Treatment
PubMed: 38018674
DOI: 10.1177/20501684231211413 -
Journal of Public Health Dentistry Sep 2023The aim of this study was to investigate factors associated with burnout in Australian dental practitioners.
BACKGROUND
The aim of this study was to investigate factors associated with burnout in Australian dental practitioners.
METHODS
A cross-sectional survey of 1483 Australian dental practitioners was conducted from Oct to Dec 2021. Participants reported burnout using the Sydney Burnout Measure, and aspects of mental health including psychological distress, depression, and anxiety disorders. Predictors of burnout were explored using a generalized linear model with a stepped approach including demographic, health and risk factor variables.
RESULTS
One in four participants were classified as likely to be experiencing burnout. Burnout was associated with working in a regional/rural location (β = 2.82, p < 0.001), an academic/non-clinical role (β = 5.01, p = 0.037), more years of experience as a dental practitioner (β = 0.08, p = 0.022), a current diagnosis of depression (β = 2.38, p = 0.049), moderate/severe psychological distress (β = 7.16, p < 0.001), poor self-rated physical health (β = 5.84, p < 0.001) and increasing alcohol consumption (β = 0.17, p = 0.020). Participants who scored high on resilience (β = -0.23, p = 0.002) or perfectionism (β = -0.24, p < 0.001) had lower burnout scores.
CONCLUSION
Australian dental practitioners appear to be at high risk of burnout which may impact on their health and wellbeing and ability to deliver patient care. There is a need for support services to manage burnout and education to address workplace and environmental factors that may contribute to burnout.
Topics: Humans; Dentists; Cross-Sectional Studies; Australia; Professional Role; Burnout, Professional; Surveys and Questionnaires
PubMed: 38018025
DOI: 10.1111/jphd.12594