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Clinical and Experimental Dental... Jun 2024Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that... (Review)
Review
OBJECTIVES
Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that may benefit oral health. However, the effects of oral irrigation on oral health, its role in oral home care, and its mechanism of action are not fully understood. A comprehensive search of the literature revealed no existing broad scoping reviews on oral irrigators. Therefore, this study aimed to provide a comprehensive systematic review of the literature on oral irrigation devices and identify evidence gaps.
METHODS
The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were utilized to prepare the review. Four databases and eight gray literature sources were searched for English publications across any geographical location or setting.
RESULTS
Two hundred and seventy-five sources were included, predominantly from scientific journals and academic settings. Most studies originated from North America. Research primarily involved adults, with limited studies in children and adolescents. Oral irrigation was safe and well-accepted when used appropriately. It reduced periodontal inflammation, potentially by modulating the oral microbiota, but further research needs to clarify its mechanism of action. Promising results were reported in populations with dental implants and special needs. Patient acceptance appeared high, but standardized patient-reported outcome measures were rarely used. Anti-inflammatory benefits occurred consistently across populations and irrigant solutions. Plaque reduction findings were mixed, potentially reflecting differences in study designs and devices.
CONCLUSIONS
Oral irrigators reduce periodontal inflammation, but their impact on plaque removal remains unclear. Well-designed, sufficiently powered trials of appropriate duration need to assess the clinical, microbiological, and inflammatory responses of the periodontium to oral irrigation, particularly those with periodontitis, dental implants, and special needs. Patient-reported outcome measures, costs, caries prevention, and environmental impact of oral irrigation need to be compared to other oral hygiene aids.
Topics: Humans; Therapeutic Irrigation; Oral Hygiene; Oral Health; Dental Caries; Periodontal Diseases
PubMed: 38881230
DOI: 10.1002/cre2.912 -
Environmental Health and Preventive... Feb 2021Globally, dental caries may be a major public health issue which may be preventable. Many studies have been conducted on dental caries in Ethiopia which present... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Globally, dental caries may be a major public health issue which may be preventable. Many studies have been conducted on dental caries in Ethiopia which present inconsistent results.
OBJECTIVE
This meta-analysis was expected to consolidate the findings conducted in various regions of the country and generate country representative information on the burden and its associated factors of dental caries in Ethiopia.
METHODS
Our systematic review and meta-analysis was carried out to estimate the pooled prevalence of dental caries and its associated factors in the Federal Democratic Republic of Ethiopia. Medical specialty databases like ScienceDirect, HINARI, Embase, PubMed, Google Scholar, and Cochrane Library were consistently and exhaustively searched. To determine the aggregate prevalence, studies delineating the prevalence of dental caries and associated factors were included. Important data were extracted employing a standardized data extraction tool ready in Microsoft Excel and imported to the STATA version-13 statistical software package for analyses. To assess non-uniformity, the Cochrane Q test statistics and I test were performed respectively. A random effects model meta-analysis was accustomed to estimate the pooled burden of dental caries.
RESULTS
The result of thirteen studies disclosed that the overall prevalence of dental caries in the Federal Democratic Republic of Ethiopia was found to be 40.98 (31.62, 50.34). Within the subgroup analysis, the uppermost prevalence was determined in Tigray region (46.59% (24.64, 68.54)) whereas the bottom prevalence was determined in Addis Ababa (34.20% (8.42, 59.97)). Dental caries prevalence was considerably high among study subjects who consumed sweet food (OR= 2.4 (95% CI (1.91, 3.01))). But the presence of dental plaque (OR = 5.14 (95% CI (0.67, 39.39))) and habit of tooth- cleaning (OR = 0.71 (95% CI (0.17, 2.96))) were not statistically significant with the outcome of interest.
CONCLUSION
Our meta-analysis found that the prevalence of dental caries was comparatively high, and sweet food consumption was the most risk issue for dental caries in Ethiopia. The Ethiopian Federal Ministry of Health ought to offer a lot of attention to strengthen the oral health care system and also the implementation of community-level interference programs.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Dental Caries; Ethiopia; Humans; Middle Aged; Prevalence; Risk Factors; Young Adult
PubMed: 33579186
DOI: 10.1186/s12199-021-00943-3 -
Children (Basel, Switzerland) May 2023Investigation into the impact of dental trauma on the results of orthodontic treatment is crucial because it can have a major influence on patient care. However, there... (Review)
Review
BACKGROUND AND OBJECTIVES
Investigation into the impact of dental trauma on the results of orthodontic treatment is crucial because it can have a major influence on patient care. However, there has not yet been a thorough review or meta-analysis of the available data, which is inconsistent and scant. Therefore, the goal of this systematic review and meta-analysis is to investigate the impact of dental trauma on orthodontic parameters. Search methods and criterion of selection: Major online databases were searched (beginning from the year 2011) for relevant articles using a properly defined search strategy. Analysis protocol: Risk of bias (RoB) and the Cochrane risk of bias tool were utilized for the purposes of bias evaluation within the individual studies and within the review, respectively.
RESULTS
Out of the six clinical trials selected, a significant impact of trauma was observed in individuals in all but one paper. Gender predilection varied across studies and could not be conclusively determined. The follow-up period ranged from two months to two years in the trials. The odds ratio (OR) 0.38 [0.19, 0.77] and the risk ratio (RR) 0.52 [0.32, 0.85] indicated that both the odds as well as the relative risk of experiencing dental trauma were lower in the group with negligible impact compared to the group with noticeable impact. Conclusion and further implications: The findings show that dental trauma significantly affects orthodontic parameters, with lower risk and likelihood of suffering dental trauma in the group with negligible impact than in the group with noticeable impact. However, given the substantial heterogeneity among the studies, it is advised to exercise caution when extrapolating the findings to all populations. Registration and protocol: Registration in the PROSPERO database was carried out before initiating the investigation [CRD42023407218].
PubMed: 37238433
DOI: 10.3390/children10050885 -
Journal of Dentistry Nov 2020To review leadership for dentists in patient facing, primary care dental practice. (Review)
Review
OBJECTIVES
To review leadership for dentists in patient facing, primary care dental practice.
METHODS
A three stage systematic review with narrative synthesis included stage 1: a scoping overview of management and leadership policy context; stage 2: systematic review of review of leadership in healthcare; and stage 3: systematic focused review of leadership in patient-facing dental practice.
RESULTS
The healthcare literature mirrors the generic literature in relation to the temporal evolution of leadership theories. Policy papers influence healthcare literature, though these are generally written by independent bodies, link solely to medical publications, and are often commissioned from the grand strategic level thereby grounding them in a politicised system. The healthcare leadership literature offers few studies at the operational (patient care) level of leadership, with none of these focused explicitly on dentistry and dental practice. Numerous aims, definitions, models, conceptualisations, and links to theories of leadership are reported. The stage 1 literature demonstrates more contemporaneous ideas of leadership, while the dental practice literature is too often grounded in outdated concepts and theories.
CONCLUSIONS
The overarching trend is from leaders to leadership; with no unified definition, model, theory, concept nor aim recognised. The fundamental importance of specific context and the reaction of others to leadership is reinforced. Leadership theories aligned to healthcare include Engaging, Authentic, Collective and the Transformational-Transactional continuum. Leadership is a dynamic, socially constructed process, only occurring in a group setting. Consisting of multiple moderating variables that demonstrate reciprocal influence on one another, these influences are neither equal nor stable. (246 words) CLINICAL SIGNIFICANCE: Leadership is embedded in regulatory guidance and standards relating to general dental practice. It is therefore crucial to have an evidenced based understanding of what leadership means in this context, and what further work is necessary to support clinicians in the leadership domain.
Topics: Delivery of Health Care; General Practice, Dental; Humans; Leadership
PubMed: 32961259
DOI: 10.1016/j.jdent.2020.103480 -
Environmental Research Nov 2023Water fluoridation is considered a safe and effective public health strategy to improve oral health. This review aimed to systematically summarize the available evidence... (Review)
Review
Water fluoridation is considered a safe and effective public health strategy to improve oral health. This review aimed to systematically summarize the available evidence of water fluoridation in Australia, focusing on the history, health impacts, cost effectiveness, challenges, and limitations. A systematic search was conducted on the Ovid Medline, Web of Science, Scopus, ProQuest Central, Cinahl, and Informit databases to identify literature on water fluoridation in Australia. A grey literature search and backward snowballing were used to capture additional literature. Primary studies, reviews, letters, and opinion papers were included in the quantitative analysis and summarized based on the year of publication and geographical location. The data were extracted from primary studies and summarized under three subheadings: history, community health impacts and the limitations and challenges. Water fluoridation in Australia was first implemented in 1953 in Tasmania. Most states and territories in Australia embraced water fluoridation by 1977 and currently, 89% of the Australian population has access to fluoridated drinking water. Studies report that water fluoridation has reduced dental caries by 26-44% in children, teenagers, and adults, benefiting everyone regardless of age, income, or access to dental care. It has been recognized as a cost-effective intervention to prevent dental caries, especially in rural and low-income areas. Water fluoridation as a public health measure has faced challenges, including political and public opposition, implementation and maintenance costs, access and equity, communication and education, and ethical concerns. Variations in research activities on water fluoridation across Australian states and territories over the last seven decades can be due to several factors, including the time of implementation, funding, and support. Ongoing monitoring and research to review and update optimal fluoride levels in drinking water in Australia is warranted to ensure sustainable benefits on oral health while preventing any adverse impacts.
PubMed: 37598841
DOI: 10.1016/j.envres.2023.116915 -
Clinical Oral Investigations Nov 2023This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic and clinical parameters, as well as biological and mechanical complications, were considered.
MATERIALS AND METHODS
A systematic search was performed up to March 2022 to identify CCTs/RCTs comparing zirconia and titanium implants with a minimum of 12 months of follow-up. Meta-analysis was performed when ≥ 2 articles with similar characteristics were retrieved.
RESULTS
Four published articles with two RCTs (2 different patient populations) with 100 zirconia and 99 titanium implants that were followed up over 12-80 months were selected out of the 6040 articles. A non-statistically significant difference between zirconia and titanium implant survival at 12 months was suggested (P = 0.0938). The success rates were 57.5-93.3% and 57.1-100% for zirconia and titanium implants, respectively. The pink aesthetic score (PES) was higher for zirconia (10.33 ± 2.06 to 11.38 ± 0.92) compared to titanium implants (8.14 ± 3.58 to 11.56 ± 1.0).
CONCLUSION
Based on the 2 RCTs retrieved in the literature, similar survival rates were reported for zirconia and titanium implants in the short term (12 months of follow-up). Future RCTs are warranted to evaluate the long-term outcomes of zirconia implants.
CLINICAL RELEVANCE
Zirconia implants may be the procedure of choice, particularly in the aesthetic zone, since they show a similar survival and success rate as titanium implants on a short-term follow-up.
TRIAL REGISTRATION
Systematic review registration number-CRD42021288704 (PROSPERO).
Topics: Humans; Dental Implants; Titanium; Dental Restoration Failure; Esthetics, Dental; Zirconium; Dental Prosthesis Design
PubMed: 37740825
DOI: 10.1007/s00784-023-05242-5 -
Primary Dental Journal Jun 2022There has been much research relating to stressors in the dental environment and concerns over dentists' health and wellbeing. The determinants of dentists' health and...
BACKGROUND
There has been much research relating to stressors in the dental environment and concerns over dentists' health and wellbeing. The determinants of dentists' health and wellbeing within the UK include factors, such as healthcare systems and regulation; factors, such as job specification and workplace characteristics; and factors, such as personal aspects, professional career level, and personal and professional relationships. Given the challenges in dentistry, research is needed to investigate the key determinants relating to the health and wellbeing of clinical dental care professionals (DCPs) nationally.
AIM
To review the literature on the key determinants of health and wellbeing among dental hygienists, dental therapists, clinical dental technicians, and orthodontic therapists in the UK.
MATERIALS AND METHODS
A systematic review of the literature was conducted across seven databases. The records were screened by title, abstract and full text based on the study inclusion criteria. Extraction of data and a qualitative synthesis of the included studies was performed. A mixed methods appraisal tool was used to quality assess for risk of bias.
RESULTS
Twelve studies were included in this review, eleven of which were medium to high quality (5*, 4*) and one low quality (2*). Ten studies focused on dental therapists, and/or hygienists, with only one each on orthodontic therapists and clinical dental technicians. Job satisfaction and professional careers were the primary factors explored in the included studies and clearly identified as determinants of health and wellbeing. However, there was evidence of these being associated and linked with a range of determinants at macro-, meso-, and micro-levels, with a general lack of evidence on the overall health and wellbeing.
CONCLUSION
There is currently very limited evidence on the key determinants of health and wellbeing of clinical DCPs within the UK, but the available evidence maps to the same domains as dentists. Further well conducted research examining the overall health and wellbeing is required, with consideration of the full matrix of possible factors.
Topics: Dental Care; Humans; Job Satisfaction; Workplace
PubMed: 35658664
DOI: 10.1177/20501684221101663 -
Frontiers in Oral Health 2022The purpose of this systematic review was to evaluate current evidence to prevent and manage dental caries in patients with type 2 diabetes mellitus (T2DM). (Review)
Review
PURPOSE
The purpose of this systematic review was to evaluate current evidence to prevent and manage dental caries in patients with type 2 diabetes mellitus (T2DM).
METHODS
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the Participants, Intervention, Comparison, Outcomes and Study Design (PICOS) strategy was used to formulate a structured search: systematic search of PubMed, Cochrane Library, MEDLINE Ovid, EMBASE, Scopus, Web of Science, and Lilacs without any date limit and/or language restrictions. Two independent reviewers performed data extraction and risk of bias assessments in the included studies. Data homogeneity was assessed according to interventions for treating dental caries in T2DM. Statistical analyses were performed with JMP.
RESULTS
Two studies out of 909 were included in the systematic review. Only quantitative studies involving topical applications for management of dental caries in patients with T2DM were included. One study assessed the effect of intensive oral hygiene care program including toothbrushing and interdental cleaning using interproximal brushes and/or dental floss and supragingival debridement by dental hygienist with educational brochures in T2DM, while another investigated the immunologically active salivary substitutes with using Oral Hygiene Instructions (OHI), mouthwash, and moisturizing gel for 6 months. Intensive oral hygiene care program or immunologically active salivary substitutes with using OHI, mouthwash, and moisturizing gel for 6 months were reported to reverse/arrest dental caries in patients with T2DM.
CONCLUSION
The current randomized controlled clinical trials demonstrated that regular extensive oral health education using interdental cleaning aids, mouthwash, moistening gel, and saliva substitutes including lactoperoxidase, lysozyme, glucose oxidase, and lactoferrin could control oral inflammation and contribute to the management of dental caries in patients with T2DM.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020197507, identifier: CRD42020197507.
PubMed: 36466592
DOI: 10.3389/froh.2022.998171 -
Journal of Oral Rehabilitation Oct 2021Problem-orientated dental attenders account for around one-third of the UK population, these being patients who do not seek regular dental care, instead only attending... (Review)
Review
BACKGROUND
Problem-orientated dental attenders account for around one-third of the UK population, these being patients who do not seek regular dental care, instead only attending with dental pain. In order to develop intervention(s) to encourage regular dental attendance in these patients, any previous intervention development should be identified to aid idea generation or retrofitting of interventions.
OBJECTIVE
To identify previous interventions which have been developed targeted at problem-orientated dental attenders to facilitate the development and co-design of a new intervention.
METHODS
Eight electronic databases were searched for studies which included an intervention targeted at adult problem-orientated or irregular dental attenders to encourage regular dental attendance. Data on the intervention design mapped to the theoretical domains framework were extracted, alongside effectiveness and patient views where available.
RESULTS
Three studies fitted the inclusion criteria for the review. Interventions identified were attendance at a dental anxiety clinic, and a large advertising campaign promoting a free dental update where members of the public could visit local dental practices to look around and meet the dentists. One study looked at the effect of policy change by introducing free dental check-ups in Scotland. Interventions were poorly reported, with significant omissions in their description and a lack of clear identification of what composed the intervention.
CONCLUSION
There are very few interventions developed targeted at problem-orientated dental attendance, but important areas to consider in future intervention development include the following: dentist communication; dentist-patient relationship; increasing the awareness of need; the effect of free dental check-ups.
Topics: Adult; Anxiety; Humans
PubMed: 34398460
DOI: 10.1111/joor.13244 -
Caries Research 2021The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by... (Meta-Analysis)
Meta-Analysis
The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by measuring dental caries prevalence and severity. An electronic database (MEDLINE) was initially searched using relevant keywords. This was followed by use of the search string in the following electronic databases: Scopus, EBSCOhost, Cochrane, and Open Grey. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction, which was facilitated using JBI SUMARI software. The primary outcome was the decayed missing filled teeth (DMFT) score and dental caries prevalence. Subgroup analysis was done by country of publication to identify causes of heterogeneity. Forest plots were used with the standardized mean difference (SMD) and publication bias was assessed using the Egger test with funnel plot construction. For the final review, 43 articles were selected and 34 were meta-analyzed. The pooled mean DMFT for both the permanent dentition (SMD = 0.26; 95% CI 0.13-0.39) and deciduous dentition (SMD = 0.67; 95% CI 0.47-0.87) was higher for the Indigenous population than for the general population. Indigenous populations experienced more decayed teeth (SMD = 0.44; 95% CI 0.25-0.62), a slightly higher number of missing teeth (SMD = 0.11< 95% CI -0.05 to 0.26), and lesser filled teeth (SMD = -0.04; 95% CI -0.20 to 0.13) than their nonindigenous counterparts. The prevalence of dental caries (SMD = 0.27; 95% CI 0.13-0.41) was higher among indigenous people. Globally, indigenous populations have a higher caries prevalence and severity than nonindigenous populations. The factors which have led to such inequities need to be examined.
Topics: Dental Care; Dental Caries; Dentition, Permanent; Health Status Disparities; Humans; Prevalence
PubMed: 34107490
DOI: 10.1159/000516137