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International Journal of Environmental... Jun 2023Antibiotics have undoubtedly revolutionized medicine and the health and survival of patients with life-threatening infections, being nonetheless free from potential... (Review)
Review
Antibiotics have undoubtedly revolutionized medicine and the health and survival of patients with life-threatening infections, being nonetheless free from potential adverse effects, and the risk of intestinal dysbiosis, antimicrobial resistance, and the resulting consequences for the patient's health and the public purse. The present study narratively reviewed the epidemiological data on worldwide antibiotic consumption and administration in dental practice, patients' adherence to prescriptions, the antimicrobial resistance phenomenon in dentistry, and the evidence supporting and recommending appropriate antibiotic use in dental care. Eligible systematic reviews and original studies in humans published in the English language from January 2000 to 26 January 2023 were considered. A total of 78 studies, 47 on the epidemiology of antibiotic use and prescription in dentistry, 6 on antibiotic therapy in dentistry, 12 on antibiotic prophylaxis in dentistry, 0 on adherence of dental patients to antibiotic prescription, and 13 on antimicrobial resistance in dentistry, were presently considered. Retrieved evidence revealed that antibiotics are frequently overused and misused in dental practice, dental patients frequently do not adhere to prescriptions, and antimicrobial resistance in dentistry is a still rising phenomenon also secondary to improper oral antiseptics use. The present findings highlighted the need to establish more evidence-based and accurate antibiotic prescriptions to sensitize dentists and dental patients to minimize and rationalize the use of antibiotics only when it is indicated and necessary, improve patients' adherence, and enhance knowledge and awareness of the antimicrobial resistance in dentistry.
Topics: Humans; Anti-Bacterial Agents; Dentists; Antibiotic Prophylaxis; Prescriptions; Dentistry
PubMed: 37297629
DOI: 10.3390/ijerph20116025 -
Medicina (Kaunas, Lithuania) May 2022The accurate diagnosis of pulpal pathology in pediatric dentistry is essential for the success of vital pulp therapy. Pulp testing is often a challenging task due to... (Review)
Review
The accurate diagnosis of pulpal pathology in pediatric dentistry is essential for the success of vital pulp therapy. Pulp testing is often a challenging task due to understanding and cooperation issues of pediatric patients, as well as the particularities of pulpal physiology encountered in primary and immature permanent teeth. Sensibility tests, although still widely used by dental practitioners, are no longer recommended by pediatric specialists mainly due to their subjective nature. Vitality pulp tests have gained popularity in the last decade in light of some encouraging results of clinical studies. However, their use is not a routine practice yet. This paper is a literature review aimed to guide dental practitioners towards selecting the appropriate pulp testing method for their pediatric cases. It provides an overview on a multitude of pulp testing methods and an update in recommendations for primary and immature permanent teeth.
Topics: Child; Dental Pulp; Dentists; Humans; Pediatric Dentistry; Professional Role
PubMed: 35630082
DOI: 10.3390/medicina58050665 -
BMC Geriatrics Jun 2021Tooth loss, systemic diseases and medications add to the complexity of the oral conditions in geriatric popuation, making this age group a special group in need of...
BACKGROUND
Tooth loss, systemic diseases and medications add to the complexity of the oral conditions in geriatric popuation, making this age group a special group in need of specific preventive and curative oral health care. Therefore, the dental teams need to be equipped with specific knowledge and skills to provide the appropriate dental care. This study was iaimed to assess the knowledge, attitude, practice and willingness of general dentists to provide dental care to geriatric patients.
METHODS
This cross-sectional study was conducted on 231 dentists using a questionnaire including demographic characteristics, knowledge, attitude and practice sections. The availability of the facilities for providing services to the older people in the office was also evaluated. Data were fed into SPSS-22 and analysed using descriptive statistics, t-test, Chi-squared, ANOVA and correlation coefficient tests (α = 0.05).
RESULTS
62.8% of the participants were women and their mean age was 34. 4±8. 1 years. The knowledge mean score was 13.3± 2.9 (out of 30). 86. 5% of the participants had moderate knowledge, and 2.6% displayed good knowledge. The mean score related to the attitudes toward geriatric was 55.8 ± 6. 1 (out of 85), which was not significantly different based on gender. The mean score of practice was 21. 4± 4.3. There was a significantly positive correlation between knowledge and attitude. Dentists with a higher knowledge score had moderately a more positive attitude towards the older people (R = 0.33, p_ value < 0.001). However, over 60% preferred to provide care to the young patients. Significant correlation was observed between their practice and attitude (R = 0. 2, P-value = 0.006). Nearly 30% of the dentists found their knowledge and experience insufficient in treating the older people with complex medical problems. 40% believed that the current dental education in dental schools did not provide adequate training in geriatric dental care.
CONCLUSION
Although the dentists in this study had average knowledge and capacity, they mostly displayed a positive attitude towards the old. A high percentage of them were unsatisfied with the sufficiency of geriatric dental education in dental schools.
Topics: Aged; Attitude of Health Personnel; Cross-Sectional Studies; Dentists; Female; Health Knowledge, Attitudes, Practice; Humans; Knowledge; Surveys and Questionnaires
PubMed: 34193078
DOI: 10.1186/s12877-021-02343-2 -
The Cochrane Database of Systematic... May 2021Intimate partner violence (IPV) includes any violence (physical, sexual or psychological/emotional) by a current or former partner. This review reflects the current... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intimate partner violence (IPV) includes any violence (physical, sexual or psychological/emotional) by a current or former partner. This review reflects the current understanding of IPV as a profoundly gendered issue, perpetrated most often by men against women. IPV may result in substantial physical and mental health impacts for survivors. Women affected by IPV are more likely to have contact with healthcare providers (HCPs) (e.g. nurses, doctors, midwives), even though women often do not disclose the violence. Training HCPs on IPV, including how to respond to survivors of IPV, is an important intervention to improve HCPs' knowledge, attitudes and practice, and subsequently the care and health outcomes for IPV survivors.
OBJECTIVES
To assess the effectiveness of training programmes that seek to improve HCPs' identification of and response to IPV against women, compared to no intervention, wait-list, placebo or training as usual.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase and seven other databases up to June 2020. We also searched two clinical trials registries and relevant websites. In addition, we contacted primary authors of included studies to ask if they knew of any relevant studies not identified in the search. We evaluated the reference lists of all included studies and systematic reviews for inclusion. We applied no restrictions by search dates or language.
SELECTION CRITERIA
All randomised and quasi-randomised controlled trials comparing IPV training or educational programmes for HCPs compared with no training, wait-list, training as usual, placebo, or a sub-component of the intervention.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures outlined by Cochrane. Two review authors independently assessed studies for eligibility, undertook data extraction and assessed risks of bias. Where possible, we synthesised the effects of IPV training in a meta-analysis. Other analyses were synthesised in a narrative manner. We assessed evidence certainty using the GRADE approach.
MAIN RESULTS
We included 19 trials involving 1662 participants. Three-quarters of all studies were conducted in the USA, with single studies from Australia, Iran, Mexico, Turkey and the Netherlands. Twelve trials compared IPV training versus no training, and seven trials compared the effects of IPV training to training as usual or a sub-component of the intervention in the comparison group, or both. Study participants included 618 medical staff/students, 460 nurses/students, 348 dentists/students, 161 counsellors or psychologists/students, 70 midwives and 5 social workers. Studies were heterogeneous and varied across training content delivered, pedagogy and time to follow-up (immediately post training to 24 months). The risk of bias assessment highlighted unclear reporting across many areas of bias. The GRADE assessment of the studies found that the certainty of the evidence for the primary outcomes was low to very low, with studies often reporting on perceived or self-reported outcomes rather than actual HCPs' practices or outcomes for women. Eleven of the 19 included studies received some form of research grant funding to complete the research. Within 12 months post-intervention, the evidence suggests that compared to no intervention, wait-list or placebo, IPV training: · may improve HCPs' attitudes towards IPV survivors (standardised mean difference (SMD) 0.71, 95% CI 0.39 to 1.03; 8 studies, 641 participants; low-certainty evidence); · may have a large effect on HCPs' self-perceived readiness to respond to IPV survivors, although the evidence was uncertain (SMD 2.44, 95% CI 1.51 to 3.37; 6 studies, 487 participants; very low-certainty evidence); · may have a large effect on HCPs' knowledge of IPV, although the evidence was uncertain (SMD 6.56, 95% CI 2.49 to 10.63; 3 studies, 239 participants; very low-certainty evidence); · may make little to no difference to HCPs' referral practices of women to support agencies, although this is based on only one study (with 49 clinics) assessed to be very low certainty; · has an uncertain effect on HCPs' response behaviours (based on two studies of very low certainty), with one trial (with 27 participants) reporting that trained HCPs were more likely to successfully provide advice on safety planning during their interactions with standardised patients, and the other study (with 49 clinics) reporting no clear impact on safety planning practices; · may improve identification of IPV at six months post-training (RR 4.54, 95% CI 2.5 to 8.09) as in one study (with 54 participants), although three studies (with 48 participants) reported little to no effects of training on identification or documentation of IPV, or both. No studies assessed the impact of training HCPs on the mental health of women survivors of IPV compared to no intervention, wait-list or placebo. When IPV training was compared to training as usual or a sub-component of the intervention, or both, no clear effects were seen on HCPs' attitudes/beliefs, safety planning, and referral to services or mental health outcomes for women. Inconsistent results were seen for HCPs' readiness to respond (improvements in two out of three studies) and HCPs' IPV knowledge (improved in two out of four studies). One study found that IPV training improved HCPs' validation responses. No adverse IPV-related events were reported in any of the studies identified in this review.
AUTHORS' CONCLUSIONS
Overall, IPV training for HCPs may be effective for outcomes that are precursors to behaviour change. There is some, albeit weak evidence that IPV training may improve HCPs' attitudes towards IPV. Training may also improve IPV knowledge and HCPs' self-perceived readiness to respond to those affected by IPV, although we are not certain about this evidence. Although supportive evidence is weak and inconsistent, training may improve HCPs' actual responses, including the use of safety planning, identification and documentation of IPV in women's case histories. The sustained effect of training on these outcomes beyond 12 months is undetermined. Our confidence in these findings is reduced by the substantial level of heterogeneity across studies and the unclear risk of bias around randomisation and blinding of participants, as well as high risk of bias from attrition in many studies. Further research is needed that overcomes these limitations, as well as assesses the impacts of IPV training on HCPs' behavioral outcomes and the well-being of women survivors of IPV.
Topics: Adult; Bias; Dentists; Female; Health Personnel; Humans; Intimate Partner Violence; Medical Staff; Midwifery; Nursing Staff; Psychology; Randomized Controlled Trials as Topic; Social Workers; Students, Health Occupations
PubMed: 34057734
DOI: 10.1002/14651858.CD012423.pub2 -
The Journal of Clinical Pediatric... Sep 2023Stainless steel crowns (SSCs) are the preferred restoration of pediatric dentists for children requiring a pediatric dental rehabilitation due to their low cost and...
Stainless steel crowns (SSCs) are the preferred restoration of pediatric dentists for children requiring a pediatric dental rehabilitation due to their low cost and durability. Despite low technique sensitivity SSC placement can be challenging in some clinical situations including when placed on primary canines. Primary canines restored with SSCs often result in premature contacts and posterior open bite making acquiring an "as the patient presented" (ATPP) occlusion difficult when providing a pediatric dental rehabilitation. Opening of the posterior occlusion due to premature canine contact in a dental rehabilitation is often viewed as unavoidable. This technique article describes a simple method to address this clinical situation and reviews basic principles and techniques for placing SSCs.
Topics: Child; Humans; Dentists; Open Bite
PubMed: 37732429
DOI: 10.22514/jocpd.2023.047 -
Anesthesia Progress Jun 2022
Topics: Dental Technicians; Dentists; Humans; Oral Health
PubMed: 35849807
DOI: 10.2344/anpr-69-02-15 -
Missouri Medicine 2019
Topics: Analgesics, Opioid; Dentistry; Dentists; Humans; Practice Patterns, Physicians'
PubMed: 31911725
DOI: No ID Found -
Primary Dental Journal Mar 2020As part of the holistic approach to their patients, General Dental Practitioners are well placed to identify common skin lesions. Awareness and recognition of worrying... (Review)
Review
As part of the holistic approach to their patients, General Dental Practitioners are well placed to identify common skin lesions. Awareness and recognition of worrying lesions allow timely and appropriate referrals for further investigation and treatment. In this paper, we review benign, premalignant and malignant skin lesions, as well as genetic skin conditions. Past medical, family and social history (including sun exposure and previous cutaneous malignancy) is important. Examination includes the lesion, the skin type and the regional lymph nodes. The different common lesions are described, and the epidemiology, clinical features and treatment are discussed. Screening for skin lesions on the head and neck may be undertaken as part of overall dental care as part of the holistic examination of patients. Particularly with precancerous lesions and skin cancer, an early detection and referral from a dentist can expedite treatment and improve prognosis.
Topics: Dentists; Dermatology; Humans; Precancerous Conditions; Professional Role; Skin Neoplasms
PubMed: 32519610
DOI: 10.1177/2050168420911028 -
British Dental Journal Feb 2022Introduction Mentoring plays a key role in supporting individuals and organisations. It is a journey in which the mentor aids the development of their clients by setting... (Review)
Review
Introduction Mentoring plays a key role in supporting individuals and organisations. It is a journey in which the mentor aids the development of their clients by setting achievable goals and realistic plans, monitoring progress and providing feedback or assisting reflection. The mentor assists the learner in solving problems and providing personal support and motivation. As the relationship develops over time, the mentor will need to utilise various skills, knowledge and behaviours in order to facilitate successful outcomes. Effective mentoring relies on a process known as the 'mentor life cycle.' This involves the matching process, contracting, use of mentor models or diagnostic tools, appraisal, peer and group supervision.Methods A literature review was performed (keywords were 'coaching' or 'coach', 'mentoring' or 'mentor' and 'dentistry'). Guidance, institutional publications and original research were considered. Limits were applied (2013 onwards, English only). The evidence was appraised to inform a best practice guide for use in mentoring, applicable to dentistry.Conclusion Mentoring can create a positive culture that can help team members share knowledge, cultivate new ideas and improve team working. This paper explores the role of mentoring in a dental healthcare setting and the use of the 'mentor's toolkit' to promote professional development of the individuals involved. It also highlights the stages of the mentoring process, use of the GROW model and the role of supervision to support mentors in mutual growth and learning. When used effectively, the mentoring process positively impacts on both the organisation and the individuals within it, ultimately resulting in better patient care.
Topics: Dentistry; Dentists; Humans; Mentoring; Mentors; Motivation
PubMed: 35217747
DOI: 10.1038/s41415-022-3979-2 -
British Dental Journal May 2022Background Fictional portrayals of dentists in feature films have remained largely unexamined to date. The aim of this review is consequently to catalogue and analyse... (Review)
Review
Background Fictional portrayals of dentists in feature films have remained largely unexamined to date. The aim of this review is consequently to catalogue and analyse available films produced by US entertainment industry that present 'dentists in action'.Methods Relevant motion pictures were identified by means of keyword-based inquiries in search engines, online databases, websites and by handsearch.Results Between 1913-2013, almost 60 American films with dental treatment as a motif were released. Dentists on-screen appeared mainly in comedies and mostly as supporting actors. Surgical treatments dominated in earlier films and tooth-preserving therapy in later films; other fields of dentistry were marginalised. The time lag between a dental innovation and its screen debut varied between 50 years (x-rays) and 10 years (turbine). For a long time, filmmakers refused to allow female dentists to appear on screen. Although there is no consistent stereotype of a dentist, the figure of 'Dr Awkward' can be attributed to the silent film era, 'Dr Prosperous' to the 1960s/1970s and 'Dr Evil' to the 1980s/1990s.Discussion Popular media does not only reflect aspects of reality; they also create reality and establish a professional image. Thus, filmic representations of dentists have an immediate effect on an audience of millions of movie-goers and television viewers. Greater attention should be devoted to the interplay of cinematic and dental art by both dental professionals and film historians.
Topics: Dentists, Women; Female; Humans; Motion Pictures; Stereotyping; Television; United States
PubMed: 35624265
DOI: 10.1038/s41415-022-4145-6