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Evidence-based Dentistry Dec 2022Introduction UK dentists experience high levels of stress, anxiety and burnout. Poor mental health can lead practitioners to exit the profession, contributing to... (Review)
Review
Introduction UK dentists experience high levels of stress, anxiety and burnout. Poor mental health can lead practitioners to exit the profession, contributing to workforce and service loss. Therefore, there is a need to focus on interventions to protect the mental health and wellbeing of dental teams. Three levels of intervention can be deployed in the workplace to support mental health and wellbeing: primary prevention, secondary prevention, and tertiary prevention.Aim The aim of this systematic review was to identify evidence on interventions used to prevent, improve or tackle mental health issues among dental team members and dental profession students in countries of very high development.Methods This systematic review was conducted according to a predefined protocol and reported according to PRISMA guidelines. The MEDLINE, Embase CINAHL, DOSS, Scopus, and PsycINFO databases were searched. Prospective empirical studies were considered for inclusion. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of the included studies. The identified interventions were categorised according to level of prevention.Results The search yielded 12,919 results. Eight studies met the inclusion criteria. All of the studies concerned dentists or dental students. There were no studies for other groups of dental professionals. No primary prevention-level studies were identified. Secondary prevention-level studies (n = 4) included various psychoeducational interventions aiming to raise awareness and improve coping skills and led to significant improvements in stress levels and burnout of dentists and dental students. Tertiary prevention-level studies (n = 4) mainly employed counselling which was shown to be beneficial for dentists and students experiencing psychological ill-health.Conclusions Mental wellbeing awareness should be put at the centre of dental education and the workplace. Leadership and innovation are required to design primary-level interventions which can be implemented in the UK dental sector, with its distinct organisational and service characteristics.
PubMed: 36477677
DOI: 10.1038/s41432-022-0831-0 -
Clinical Oral Investigations Feb 2022We present this systematic review and meta-analyses to evaluate current evidence on the prevalence of depression, anxiety, and stress in patients with oral lichen planus... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
We present this systematic review and meta-analyses to evaluate current evidence on the prevalence of depression, anxiety, and stress in patients with oral lichen planus and their magnitude of association.
MATERIAL AND METHODS
We searched PubMed, Embase, Web of Science, Scopus, PsycInfo, and Google Scholar for studies published before January 2021. We evaluated the quality of studies using a specific method for systematic reviews addressing prevalence questions, designed by the Joanna Briggs Institute. We carried out meta-analyses and performed heterogeneity, subgroups, meta-regression, and small-study effects analyses.
RESULTS
Fifty-one studies (which recruited 6,815 patients) met the inclusion criteria. Our results reveal a high prevalence of depression (31.19%), anxiety (54.76%), and stress (41.10%) in oral lichen planus. Furthermore, OLP patients presented a significantly higher relative frequency than control group without OLP for depression (OR = 6.15, 95% CI = 2.73-13.89, p < 0.001), anxiety (OR = 3.51, 95% CI = 2.10-5.85, p < 0.001), and stress (OR = 3.64, 95% CI = 1.48-8.94, p = 0.005), showing large effect sizes. Subgroups meta-analyses showed the relevance of the participation of psychologists and psychiatrists in the diagnosis of depression, anxiety, and stress in patients with OLP. Multivariable meta-regression analysis showed the importance of the comorbidity of depression-anxiety in patients with OLP.
CONCLUSIONS
Our systematic review and meta-analysis show that patients with OLP suffer a higher prevalence of depression, anxiety, and stress, being more frequent than in general population. Clinical relevance In the dental clinic, especially dentists should be aware of depression, anxiety, and stress in OLP patients to achieve a correct referral.
Topics: Anxiety; Depression; Humans; Lichen Planus, Oral; Prevalence
PubMed: 34460001
DOI: 10.1007/s00784-021-04114-0 -
Archives de Pediatrie : Organe Officiel... Jan 2022Primary sleep bruxism (SB) affects between 6 and 30% of children and adolescents. Its frequency increases with age, reaching a peak at 10-14 years of age, after which it... (Review)
Review
AIM
Primary sleep bruxism (SB) affects between 6 and 30% of children and adolescents. Its frequency increases with age, reaching a peak at 10-14 years of age, after which it drops until adulthood. The treatment of SB has not been extensively documented, resulting in a lack of reference points and legitimate concerns for dentists in their everyday practice. The aim of this literature review was to summarize the available evidence on the management of SB in children and adolescents and the efficacy of the different approaches.
METHOD
A systematic literature search was conducted according to PRISMA guidelines from January 2006 to December 2020 using the PubMed, The Cochrane Library, Science Direct, and Google Scholar databases. All types of SB treatment were accepted. Eight studies were selected for their protocol quality, according to the PICOS tool.
RESULTS
Several treatment methods were assessed from the eight clinical studies selected, such as occlusal splint, palatal expansion, and pharmacological treatment. Assessment of the treatment methods was difficult because only eight studies were selected, and both the treatment methods and the study protocols used were different. The therapeutic strategies found in the literature were based on the general condition of the case. Treatment approaches were distinguished into treatments for isolated SB and those for SB associated with ventilatory disorders.
CONCLUSION
The current study shows the need to define diagnostic criteria adapted to SB in children in order to improve epidemiological surveys and subsequently clinical practice. To overcome the difficulties related to SB diagnostic criteria, a multidisciplinary approach, involving pediatricians, otorhinolaryngologists, and dental practitioners, is essential for a better management and follow-up of young patients. A case-by-case approach, taking into account the specificities of each young patient, seems the most appropriate management today.
Topics: Adolescent; Child; Dentists; Humans; Occlusal Splints; Palatal Expansion Technique; Professional Role; Sleep Bruxism
PubMed: 34955303
DOI: 10.1016/j.arcped.2021.11.014 -
Dental Traumatology : Official... Apr 2022Treatment after traumatic tooth loss is challenging and is currently guided by expert opinion and the individual patient situation. The aim of this study was to provide... (Review)
Review
BACKGROUND/AIMS
Treatment after traumatic tooth loss is challenging and is currently guided by expert opinion and the individual patient situation. The aim of this study was to provide an overview on the outcome of dental implant treatment in the anterior maxilla after traumatic tooth loss, based on a systematic review of the existing evidence.
MATERIALS AND METHODS
A systematic search of the literature was performed on PubMed, Cochran Library and Web of Science following the PRISMA guidelines based on a structured research question (PICO). All clinical studies of five patients or more with follow-up of at least 1 year after implant loading were included. Patients were at least 18 years of age. Cohen's Kappa-coefficient was calculated. The Newcastle-Ottawa Scale was applied to assess the quality of the included studies. Descriptive statistical methods were applied.
RESULTS
Nine hundred and ninety-nine articles were identified through the systematic search. Finally, six articles were eligible for inclusion. The studies comprised prospective and retrospective cohort studies and case series. From these, 96 patients with 120 implants were included. The age ranged from 18 to 59 years. The survival rates of implants and superstructures were 97% and 95%, respectively, after a mean follow-up of 3.5 years. Mean marginal bone resorption was 0.56 mm (range 0.21-1.30 mm). Complication rates were 7% and 11% on implant and superstructure level, respectively. Patient-reported outcome measures and objective evaluations showed a high level of satisfaction with the aesthetic outcome. Bone augmentation was performed in 60 implant sites. Three patients underwent pre-surgical orthodontic treatment. The maxillary central incisor was the most frequently replaced tooth (70%).
CONCLUSIONS
This systematic review revealed a low level of evidence on the outcome of dental implant treatment after traumatic tooth loss. Systematic reporting of treatment outcomes of tooth replacements after dental trauma is highly encouraged to further guide dentists for the benefit of these challenging patients.
Topics: Adolescent; Adult; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Follow-Up Studies; Humans; Maxilla; Middle Aged; Prospective Studies; Retrospective Studies; Tooth Loss; Treatment Outcome; Young Adult
PubMed: 34997947
DOI: 10.1111/edt.12730 -
Journal of Dentistry May 2023To evaluate the knowledge, attitudes, and practice (KAP) of dentists on Minimal Intervention Dentistry (MID). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the knowledge, attitudes, and practice (KAP) of dentists on Minimal Intervention Dentistry (MID).
DATA
Cross-sectional studies that analyzed KAP outcomes on MID principles were included.
SOURCES
Eight databases (Cochrane, DOSS, Embase, LILACS, PsycINFO, PubMed, Scopus, and Web of Science) and the gray literature were searched on January 2022.
STUDY SELECTION
Two independent reviewers selected the included studies, initially by screening titles and abstracts and, finally, by full-text reading. The methodological quality of studies was assessed by using the Joanna Briggs Institute Critical Assessment Checklist for Prevalence Studies. Proportion meta-analysis was conducted using a random effect model for data analysis. Cochran's Q test was used to assess the heterogeneity and the I² statistic for evaluation of true variation due to heterogeneity.
RESULTS
Of 2079 studies initially identified, twelve were included in the systematic review. Twenty-four statements about MID were included in the meta-analysis, based on data from ten studies (n = 1728 participants). The pooled proportion of knowledge on MID was 75.66% (95%CI: 69.33 - 81.48; p < 0.01; I²: 97%; Tau2: 0.0456) and of attitudes and practice was 47.95% (95%CI: 38.55-57.43; p < 0.01; I²: 98%; Tau2: 0.0743). The higher prevalences rates were in the "knowledge" field, and the lowest was in "attitudes and practice".
CONCLUSIONS
The findings suggest that the knowledge of dentists on MID topics is acceptable, and the attitudes and practices need improvements. The studies lacked uniformity in methods and there is still a need for more studies to elucidate the KAP of dentists worldwide.
CLINICAL SIGNIFICANCE
Understanding the cognizance and the way oral healthcare professionals are treating dental caries is the first step to expanding the minimal intervention evidence into a dental practice. The final goal is to change the practice and make Minimal Intervention Dentistry the standard of care for dental caries worldwide.
REGISTRATION
PROSPERO CRD42021257518.
Topics: Humans; Dental Caries; Health Knowledge, Attitudes, Practice; Cross-Sectional Studies; Dentists; Dentistry
PubMed: 36958696
DOI: 10.1016/j.jdent.2023.104484 -
Evidence-based Dentistry Sep 2022Introduction As an attempt to provide supporting evidence for the formulation of future educational strategies on knowledge translation, this systematic review assessed... (Review)
Review
Introduction As an attempt to provide supporting evidence for the formulation of future educational strategies on knowledge translation, this systematic review assessed and synthesised the available evidence related to the dentists' awareness, perceived and actual knowledge of evidence-based dentistry (EBD) principles, methods and practices.Methods Primary studies that considered dentists' reports collected from interviews, questionnaires, or conversation sessions were selected. Studies enrolling students, dental hygienists, or other health professionals were not included. Reviews, editorials, letters, study protocols, articles presenting knowledge translation strategies and initiatives, examples of EBD approaches to specific clinical questions, and guidelines focused on EBD implementation were also excluded. Cochrane, Embase, PubMed, Scopus and Web of Science databases were searched. Grey literature was partially covered by the Google Scholar search and the reference lists of the pre-selected studies. The study search was concluded in February 2021. Descriptive data of the selected studies were synthesised, and the risk of bias was assessed according to the National Institutes of Health Quality Assessment Tool for observational cohort and cross-sectional studies.Results Twenty-one articles were included. High percentages of dentists were aware of EBD. Variable proportions of professionals declared to have some understanding of EBD, although few presented actual knowledge of principles, methods and practices.Discussion Methodologically, most studies presented limitations regarding sample representativity, participation rates, detailing of the outcome measures, and validation of the assessment tools. Additionally, extensive overall ranges of responses were often observed across the studies, possibly as a result of heterogeneity across samples and assessment tools. The authors thus suggest developing valid questionnaires including all dimensions (awareness, perceived knowledge and actual knowledge) within an assessment tool. This would contribute to establishing knowledge translation strategies to overcome specific gaps in EBD knowledge.
PubMed: 36138157
DOI: 10.1038/s41432-022-0821-2 -
Community Dentistry and Oral... Oct 2023This systematic review aimed to answer the following question 'What are the worldwide prevalence of SARS-CoV-2 infection and associated factors among oral health-care... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review aimed to answer the following question 'What are the worldwide prevalence of SARS-CoV-2 infection and associated factors among oral health-care workers (OHCWs) before vaccination?'
METHODS
Seven databases and registers as well as three grey databases were searched for observational studies in the field. Paired reviewers independently screened studies, extracted data and assessed the methodological quality. Overall seroprevalence for SARS-CoV-2 infection was analysed using a random-effect model subgrouped by professional category. Meta-regression was used to explore whether the Human Development Index (HDI) influenced the heterogeneity of results. The associated factors were narratively evaluated, and the certainty of the evidence was assessed using the GRADE approach.
RESULTS
Seventeen studies were included (five cohorts and twelve cross-sectional studies), summing 73 935 participants (54 585 dentists and 19 350 dental assistants/technicians) from 14 countries. The overall estimated pooled prevalence of SARS-CoV-2 infection among OHCWs was 9.3% (95% CI, 5.0%-14.7%; I = 100%, p < .01), being 9.5% for dentists (95% CI, 5.1%-15.0%; I = 100%, p < .01) and 11.6% for dental assistants/technicians (95% CI, 1.6%-27.4%; I = 99.0%, p < .01). In the meta-regression, countries with lower HDI showed higher prevalence of SARS-CoV-2 infection (p = .002). Age, comorbidities, gender, ethnicity, occupation, smoking, living in areas of greater deprivation, job role and location/municipalities, income and protective measures in dental settings were associated with positive serological SARS-CoV-2 test, with very low certainty of evidence.
CONCLUSIONS
The SARS-CoV-2 virus infected 9.3% of the OHCWs evaluated worldwide before vaccination. OHCWs should be included in policy considerations, continued research, monitoring and surveillance (PROSPERO CRD42021246520).
Topics: Humans; COVID-19; SARS-CoV-2; Prevalence; Seroepidemiologic Studies; Cross-Sectional Studies; Health Personnel
PubMed: 36576013
DOI: 10.1111/cdoe.12827 -
The Saudi Dental Journal Sep 2021Effective management of Missing lateral incisor has remained a challenge for the clinicians. A multi-disciplinary approach involving orthodontist, restorative dental... (Review)
Review
BACKGROUND
Effective management of Missing lateral incisor has remained a challenge for the clinicians. A multi-disciplinary approach involving orthodontist, restorative dental specialist, pediatric dental specialist, periodontist, oral surgeon and general dentist has proved ideal. Our aim is to review the ultimate esthetic success, and long term survival results between the orthodontic and restorative management of missing lateral incisor.
MATERIALS AND METHODS
Following the PRISMA guidelines, a systematic review of the published articles pertaining to the topic of interest was done. Searches were carried out in four different databases since February 2021 to April 2021.
RESULTS
A total of 580 references were found from searches conducted in PubMed, Scopus, Cochrane and Web of Science, and 19 articles were selected and analyzed fully, after screening the title and abstract, 6 articles were included for the study.
CONCLUSION
An essential orthodontic space closure in combination with modern aesthetic prosthetic tooth replacement techniques has been reported to achieve greater success.
PubMed: 34434032
DOI: 10.1016/j.sdentj.2021.07.002 -
International Journal of Environmental... Apr 2021OSCC remain a global health problem. Lack of awareness leads to inadequate watchfulness regarding early signs/symptoms despite the ease of visual oral inspection. What... (Meta-Analysis)
Meta-Analysis Review
OSCC remain a global health problem. Lack of awareness leads to inadequate watchfulness regarding early signs/symptoms despite the ease of visual oral inspection. What clinicians know and feel, and how they behave on OSCC is crucial to understand the feasibility and effectiveness of screening programs. The aim of this systematic review was to assess knowledge, attitudes, and practice (KAP) regarding OSCC among health care providers (HCPs). Therefore, a systematic review was conducted with SPIDER and PICO as major tools. A meta-analysis was structured through common items in two comparison groups of medical and dental practitioners. Descriptive statistics and a Mantel-Haenszel test were used to validate data. Sixty-six studies were selected for systematic review, eight of which are useful for meta-analysis. A statistically significant difference was recorded between dentists and medical practitioners for questions regarding: Alcohol ( < 0.001); ( < 0.012); ( < 0.0001); ( < 0.019); ( < 0.010); ( < 0.020); ( < 0.0001); ( < 0.0001) and ( < 0.002). Overall, the incidence of OSCC screening is low. Most HCPs feel the need to increase KAP. Data confirmed gaps in KAP, highlighting the need for a more efficient pre- and post-graduation training, necessary to increase competence worldwide.
Topics: Aged; Attitude of Health Personnel; Cross-Sectional Studies; Dentists; Health Knowledge, Attitudes, Practice; Health Personnel; Humans; Professional Role; Surveys and Questionnaires
PubMed: 33922752
DOI: 10.3390/ijerph18094506 -
Journal of International Society of... 2020To provide dentists and dental team with insights concerning risk and precautions during COVID-19 outbreak crisis as it would help in decision making among dental... (Review)
Review
OBJECTIVE
To provide dentists and dental team with insights concerning risk and precautions during COVID-19 outbreak crisis as it would help in decision making among dental community.
MATERIALS AND METHODS
A comprehensive review of all English and non-English articles was carried out using the available CORD-19 dataset with MEDLINE via PubMed, Cochrane library, Google Scholar and ScienceDirect databases. The study included all articles that matched the search terms.
RESULTS
A total of 353 were retrieved, of which 13 articles were reviewed comprehensively. Studies included in this systematic review emphasized on reinforcing strict infection control measures and minimizing human-to-human contact during COVID-19 outbreak. All surfaces in operatory room including waiting area need adequate ventilation and disinfection. Dental patients need to be screened using COVID-19 targeted questions as well as measuring their body temperature. Restricting dental treatments to only emergency cases and rescheduling all routine visits is advised with careful attention to minimize aerosol generation and following highest level of personal protection when treating COVID-19 confirmed cases. Dental offices need to establish a standard protocol of case reporting and referral to other well-prepared facilities. Lastly, online platforms are beneficial tools in providing psychological support to distressed dentists, dental team and dental patients and educating public during COVID-19 crisis.
CONCLUSION
Dental team need to follow strict infection control measures and minimize aerosol generation during COVID-19 outbreak. It is the responsibility of dental care workers to keep themselves informed and ensure safety and control transmission within dental facilities. Further research is required.
PubMed: 33282761
DOI: 10.4103/jispcd.JISPCD_295_20