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JDR Clinical and Translational Research Oct 2023Strong evidence supports use of dental sealants to prevent tooth decay, and professional guidelines recommend use in children with elevated caries risk. However, not all...
INTRODUCTION
Strong evidence supports use of dental sealants to prevent tooth decay, and professional guidelines recommend use in children with elevated caries risk. However, not all children indicated for sealants receive this preventive intervention, even when they use routine dental care.
OBJECTIVE
The aim of this study was to explore the extent to which dentists' use of sealants varied in pediatric patients with elevated caries risk.
METHODS
Claims and enrollment data from a private dental program were used to identify a cohort of 6- to 17-y-olds with elevated caries risk ( = 27,677) and general dentists ( = 818) who provided services to the children. Children were identified as having elevated caries risk based on history of restorative treatment over a 5-y period (2010-2014). The 2 outcomes of interest were whether a dentist provided any sealants to children with elevated risk and, if so, the extent to which these were used during a 2-y observation period (2013-2014). A 2-stage hurdle model was used for multivariable analysis to identify dentist characteristics associated with sealant use.
RESULTS
Over the observation period, 13.3% ( = 109) of dentists did not provide any sealants to their elevated risk patients from the study cohort. Logistic regression found that female dentists were significantly more likely to have used sealants (odds ratio = 2.27); dentist age and practice in an isolated small rural town were negatively associated with any sealant use. However, among dentists who did place sealants ( = 709), female dentists, older dentists, dentists in solo practice, and those working full-time were significantly more likely to provide sealants to a child. Overall, substantial variation in practitioners' use of sealants was observed.
CONCLUSION
This is the first study to explore provider-level variation in sealant use, representing a critical step in future efforts to increase routine use of sealants by dentists and eliminate oral health disparities.
KNOWLEDGE TRANSFER STATEMENT
Findings from this study can be used to design targeted policy and behavioral interventions to increase sealant use by general dentists. This study provides foundational evidence for future research that explores motivation and barriers to routine use of preventive dental interventions by clinicians.
Topics: Humans; Child; Female; Dental Caries Susceptibility; Pit and Fissure Sealants; Dental Caries; Logistic Models; Dentists
PubMed: 35708460
DOI: 10.1177/23800844221102836 -
Children (Basel, Switzerland) Oct 2023The enhancement of the clinical management of growing patients has always been a great challenge for orthodontists and pediatric dentists [...].
The enhancement of the clinical management of growing patients has always been a great challenge for orthodontists and pediatric dentists [...].
PubMed: 37892341
DOI: 10.3390/children10101678 -
Cureus Oct 2023Providing effective dental treatment during pregnancy is related to controlling oral diseases and helps maintain a healthy oral cavity. One of the possible treatment...
BACKGROUND
Providing effective dental treatment during pregnancy is related to controlling oral diseases and helps maintain a healthy oral cavity. One of the possible treatment options for endodontic disease is to treat the odontogenic infection, maintain a healthy oral environment, and minimize the expected complications that can occur later in pregnancy or during the postpartum period. Sufficient awareness among obstetricians and dentists is essential to delivering appropriate preventive and curative care to pregnant patients.
OBJECTIVE
The aim of this cross-sectional study is to assess knowledge, attitudes, and behaviors regarding oral health care and providing dental treatment among King Saud University Medical City obstetricians and dentists during pregnancy and the association of dental and periodontal disease with adverse pregnancy outcomes.
METHODS
This study was conducted in Saudi Arabia, Riyadh, from December 2022 to June 2023 (six months). The data were collected from 381 participants in Riyadh, Saudi Arabia, from January 2023 to June 2023. The study targeted male and female general dentists and obstetricians living in Riyadh, Saudi Arabia, and excluded those who are not dentists and obstetricians or not living in Riyadh, Saudi Arabia.
RESULT
Out of a total of 381 completed responses, 281 (73.8%) of the participants were dentists, while 100 (26.2%) were obstetricians. It was observed that the majority of the participants agreed that oral health is a part of prenatal care, while the minority did not agree (0.3%). Of the 281 (73.8%) respondents, most of them reported periodontal disease can cause preterm birth, low birth weight, and gestational diabetes (73.2%), while only 0.5% answered no. Two hundred and seventy-eight of the participants answered that it is essential to consult with an obstetrician before treating pregnant patients.
CONCLUSION
The overall knowledge of dentists and obstetricians was adequate regarding dental disease during pregnancy. However, more education should be assessed and continuously improved regarding the treatment options, as well as future recommendations regarding the medications used in dental clinics and awareness programs promoting dental health care in pregnant patients.
PubMed: 38022243
DOI: 10.7759/cureus.47098 -
Advances in Clinical and Experimental... Nov 2023Halitosis (fetor ex ore, malodor, bad breath) is defined as an unpleasant odor coming from the oral cavity, regardless of the cause: local or systemic. It affects 22-50%...
BACKGROUND
Halitosis (fetor ex ore, malodor, bad breath) is defined as an unpleasant odor coming from the oral cavity, regardless of the cause: local or systemic. It affects 22-50% of the population worldwide, leading to a significant decrease in the overall quality of life, and can have oral and extra-oral etiologies. There is an increased interest in the management of halitosis.
OBJECTIVES
This study aims to evaluate the patient-dentist communication on halitosis, the dentists' knowledge about the management and etiology of halitosis, and the treatment options used by dentists who practice in Poland and Lebanon.
MATERIAL AND METHODS
An online questionnaire was sent to both Lebanese and Polish dentists using Google Forms (Google LLC, Mountain View, USA). In total, 205 dentists completed the questionnaire, of which 100 practiced in Poland (group P) and 105 practiced in Lebanon (group L). A multivariate analysis was conducted to determine differences between both groups and to identify parameters that could influence a dentist's management of halitosis.
RESULTS
According to the questionnaire, 86% of group P members and 65.7% of group L members reported communicating with patients about halitosis. Regarding the knowledge of halitosis, 78% of dentists in group P and 85.7% of dentists in group L reported that there is a classification for halitosis. A significant majority of dentists in both groups revealed not having any tool to measure halitosis (67.6% and 68% from group P and group L, respectively).
CONCLUSIONS
This study confirms the need for improved communication skills in Polish and Lebanese dentists, as well as for education on the subject among dentists in both countries, and for standardization in diagnosis, treatment modalities and management of halitosis.
Topics: Humans; Halitosis; Poland; Quality of Life; Surveys and Questionnaires; Dentists
PubMed: 37326577
DOI: 10.17219/acem/161813 -
Frontiers in Oral Health 2023The present study investigated the clinical potential of managing anxiety during dental procedures to reduce acute attacks in patients with hereditary angioedema (HAE).... (Review)
Review
OBJECTIVE
The present study investigated the clinical potential of managing anxiety during dental procedures to reduce acute attacks in patients with hereditary angioedema (HAE). HAE is a rare disease, little known to physicians and dentists, but with an increased hospitalization rate over the years. HAE is due to a deficiency/dysfunction of the C1 esterase inhibitor, leading to increased vascular permeability. Recommendations for HAE management include long-term and short-term prophylaxis and treatment of acute attacks, but the importance of anxiety control is underestimated.
MATERIALS AND METHODS
The authors reviewed the literature to provide the scientific community with an overview of possible protocols for managing anxiety in dental practice and their effectiveness. Management can be used in prosthetics, periodontal and implant surgery, endodontics, and oral surgery.
DISCUSSIONS
Our analysis shows that although there are few articles in the indexed literature, protocols for managing anxiety in HAE patients in dentistry will become increasingly prevalent in the daily clinical practice of dentists due to its benefits.
CONCLUSIONS
The benefits and better control of intraoperative complications and risks may lead clinicians to use sedation, assessment, or anxiety control techniques in daily clinical practice to reduce such attacks. Clinical relevance: This study suggests that controlling and managing anxiety can help prevent and reduce acute angioedema attacks.
PubMed: 37927822
DOI: 10.3389/froh.2023.1257703 -
Cureus Jan 2024In recent years, dental technology has experienced remarkable advancements, mirroring the evolution of communication and information technologies. The advent of... (Review)
Review
In recent years, dental technology has experienced remarkable advancements, mirroring the evolution of communication and information technologies. The advent of information technology has paved the way for a new frontier in healthcare known as teledentistry. This innovative approach has revolutionized the delivery of dental care across geographical distances, enhancing accessibility and communication in the realm of oral health. This article aims to highlight the various methodologies of teledentistry, discuss its benefits for both patients and dentists, and emphasize its potential to overcome geographical barriers, enhance access to dental care, and promote oral health equity, especially among children. There are three primary teledentistry methods: real-time consultation, the store-and-forward method, and the remote monitoring method. Real-time consultation facilitates immediate interaction between dentists and patients through video conferencing, enabling the sharing of data and medical history. The store-and-forward method involves the collection and transmission of essential diagnostic materials, enhancing diagnostic accuracy. Remote monitoring allows continuous patient evaluation from a distance, improving healthcare delivery and patient safety. Teledentistry's impact on pediatric and preventive dentistry is substantial. It offers remote counseling, diagnosis, and monitoring for children, especially in areas with limited access to dental care. Additionally, mobile gaming apps play a role in behavioral management and reducing dental anxiety among children. Both patients and dentists benefit from teledentistry. Patients gain access to timely consultations, reducing the need for immediate in-person visits. Dentists can efficiently evaluate and monitor patients, collaborate with specialists, and provide expert advice, leading to improved healthcare delivery. Teledentistry is transforming dental care by overcoming geographical barriers, improving access, and enhancing communication. While facing challenges, its potential to revolutionize healthcare delivery and promote oral health equity is undeniable. With ongoing advancements and strategic measures, teledentistry is poised for a promising future in healthcare.
PubMed: 38384649
DOI: 10.7759/cureus.52685 -
Journal of the American Dental... Dec 2023Dental pain is common yet understudied and often undertreated in youth. To improve pain management in pediatric dentistry, it is necessary to understand practices and...
BACKGROUND
Dental pain is common yet understudied and often undertreated in youth. To improve pain management in pediatric dentistry, it is necessary to understand practices and perceptions among providers. The authors assessed pediatric dentists' use of and attitudes toward evidence-based pain management (EBPM) strategies.
METHODS
The authors used a 27-item online survey to assess attitudes about EBPM, pain management and assessment practices, tools for disseminating knowledge about EBPM, and opinions regarding priority areas for improving pain management. Descriptive statistics were used to summarize findings; open-ended items were analyzed thematically.
RESULTS
Participants (N = 625) were pediatric dentists (89.2%) and pediatric dentistry residents (10.8%). Most respondents agreed that pain management is an important aspect of clinical care and thought that improvements in pain management practices are needed. Providers reported spending the most time facilitating pain management during the procedure (compared with before or after), and 73.2% said they feel this is an adequate amount of time. Distraction, tell-show-do techniques, and supportive language were the most used nonpharmacologic pain management strategies, and providers' observational approaches were used most frequently for pain assessment. Top priority areas for improving pain management were reported as developing tools for caregivers and provider resources on nonpharmacologic pain management (ie, continuing education courses).
CONCLUSIONS
Providers reported high use of EBPM strategies, low use of validated pain assessment tools, and a particular interest for professional development opportunities and patient resources focused on nonpharmacologic pain management.
PRACTICAL IMPLICATIONS
Findings from this survey can inform dissemination and implementation of science efforts to improve pain management in pediatric dentistry.
Topics: Adolescent; Humans; Child; Pediatric Dentistry; Pain Management; Attitude of Health Personnel; Surveys and Questionnaires; Dentists
PubMed: 37877929
DOI: 10.1016/j.adaj.2023.09.003 -
Israel Journal of Health Policy Research Sep 2023In 2010, Israel reformed its hitherto dominantly privately financed dental services and included preventative and restorative dental care for children in the...
BACKGROUND
In 2010, Israel reformed its hitherto dominantly privately financed dental services and included preventative and restorative dental care for children in the publicly-funded basket of healthcare services. A survey conducted by Brookdale Institute, found that only 67% of low-income Israeli-Arab children were using the new service (compared to 85% of Jewish children) while the majority of others continue using privately funded services. The aim of this study is to explore and explain Israeli-Arab children's low utilization of publicly-funded preventive and restorative dental care.
METHODS
A qualitative study designed to describe and understand the parents' motivations and choices. As a preliminary stage, eight semi-structured interviews were conducted with directors of HMO dental departments and Israeli-Arab dentists. In the second stage, ten one-on-one interviews with parents, and five focus group discussions with 55 parents held on February-March 2017. All discussions in the focus groups were conducted in Arabic and each group was moderated by one of the research team accompanied by another person who documented and recorded the discussion. All interviews and discussions were recorded, transcribed in full and translated into Hebrew.
RESULTS
The prevalent attitude is that one goes to the dentist only when there is a serious problem. The importance of preventive care is not appreciated. A childhood fear of the drill is very remembered and passed onto the children. Social and cultural factors such as kinship with service providers (GPs and dentists) influence the choice and utilization of health services. Economic barriers are still existing since even the small co-payment is daunting to low-income parents of large families. Provision of the public service is inadequate in some Arab villages.
CONCLUSIONS
The extension of Israel's National Health Insurance Law's basket of services to include dental care for children, while important, is not sufficiently embraced by Israeli Arab children. The remaining barriers include poor living conditions, low educational level that requires very clear sharing of information about the new service, and the resistance of cultural and social traditions. Public dental services providers should focus on conveying relevant oral health messages to the parents too, either through their children or directly.
Topics: Child; Humans; Arabs; Israel; Qualitative Research; Focus Groups; Dental Care
PubMed: 37667386
DOI: 10.1186/s13584-023-00579-4 -
Clinical, Cosmetic and Investigational... 2023Studies show that Teledentistry helps enhance communication between dental peers and patients and improves time management and education. The knowledge and awareness of...
PURPOSE
Studies show that Teledentistry helps enhance communication between dental peers and patients and improves time management and education. The knowledge and awareness of Teledentistry levels need to be measured for a wider adaption. This study aimed to explore the knowledge and awareness of Teledentistry among dental practitioners and patients who live in Jeddah City, Saudi Arabia.
PATIENTS AND METHODS
This study is a descriptive cross-sectional study with two participant groups. It uses five-point Likert-type quantitative, valid, and reliable questionnaires, one for dental providers and one for patients. The providers' questionnaire covers four domains: (1) Teledentistry system effectiveness to improve practice, (2) Teledentistry system usefulness for the dental practice, (3) Teledentistry system usefulness for patients, and (4) Concerns about confidentiality and security of Teledentistry. The patients' questionnaire covers two domains: (1) Patients who have previous experience in Teledentistry and (2) Patients who did not have previous experience in Teledentistry. The Institutional Review Board (IRB) approved this study and distributed it at teaching, governmental hospitals, and private dental clinics. Convenience and snowball sampling were used to collect responses. All consent forms have been collected from the participants.
RESULTS
A total of 512 responses were collected using Google Forms, 203 from the dental healthcare provider and 309 from the patients. The collected data were coded and analyzed using Microsoft Excel and SPSS. More than 60% of dentists believe in the worth of Teledentistry, which helps patient education, monitors patients' conditions, and improves the services provided to patients in remote areas. Also, more than 70% of patients believe that Teledentistry can significantly save time and money, and more than half wish that Teledentistry be applied to all hospitals.
CONCLUSION
Dentists and patients generally showed optimism and support for the Teledentistry concept, in addition to how Teledentistry can be beneficial for both dentists and patients.
PubMed: 38050576
DOI: 10.2147/CCIDE.S427142 -
BMC Oral Health Nov 2023To assess the impact of coronavirus disease-2019 (COVID-19) in its outbreak stage (Spring Festival in 2020) on oral emergency services.
BACKGROUND
To assess the impact of coronavirus disease-2019 (COVID-19) in its outbreak stage (Spring Festival in 2020) on oral emergency services.
METHODS
Oral emergency cases in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, during the Spring Festival after the outbreak of the COVID-19 epidemic in 2020 were collected and compared with those in 2018 and 2019. Electronic medical records including the visited department, age, sex, time, date, region, and diagnosis were collected and analyzed. The results were statistically analyzed using Pearson's Chi-square test and one-way analysis of variance (ANOVA).
RESULTS
Compared with that in 2018 and 2019, the total number of patients decreased during the Spring Festival in 2020 (p < 0.001), but the proportions of patients visiting Oral Surgery and Oral, Head, and Neck Oncology Emergency departments increased. The average age of patients increased, and the number of night visits decreased. Toothache diseases involving endodontic and periodontal diseases increased, while the proportion of maxillofacial trauma decreased. The wasn't a linear association between diagnosis or genders (P > 0.001) across years. However, a linear-by-linear association between age groups and years, visited departments and years were observed (P < 0.001).
CONCLUSIONS
The study revealed that the transmission of COVID-19 affected the patient population and structure of disease types and oral services in 2020 during the Spring Festival, compared with those in the previous two years. The visits to oral emergency departments and the proportions of patients who were children and adolescents reduced; meanwhile, the percentage of the elderly people increased during the outbreak of COVID-19. The clear trend of age groups and visiting divisions could be used as a marker to reflect the severity of the COVID-19 pandemic. These results may serve as a reference for dental practitioners involved in oral emergency services and to allocate the limited emergency health resources.
Topics: Child; Adolescent; Humans; Male; Female; Aged; COVID-19; Retrospective Studies; Pandemics; Dentists; China; Professional Role
PubMed: 37932699
DOI: 10.1186/s12903-023-03563-1