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Knowledge and Attitude of Dentists Toward Geriatric Patients: A Systematic Review and Meta-Analysis.Cureus Nov 2023The knowledge and attitude of dentists toward geriatric patients are crucial for providing optimal oral healthcare to this growing population. This systematic review and... (Review)
Review
The knowledge and attitude of dentists toward geriatric patients are crucial for providing optimal oral healthcare to this growing population. This systematic review and meta-analysis aimed to examine the association between dental professionals' experience and their knowledge and attitude scores toward geriatric patients. A comprehensive search was conducted across multiple databases to identify relevant epidemiological and cross-sectional studies. The selected studies underwent a rigorous screening process, and data extraction was performed systematically. The Assessment of the Methodological Quality of Systematic Reviews tool was used to assess the risk of bias in the included studies. Three studies were ultimately selected for further analysis. For dental professionals with less than five years of experience, no significant association was found between knowledge scores and experience (odds ratio (OR) = 1.00, 95% confidence interval (CI) = 0.71 to 1.41). However, dental professionals with 5 to 10 years, greater than 10 years, and greater than 15 years of experience showed a statistically significant association between knowledge scores and experience (OR = 0.61, 95% CI = 0.48 to 0.77; OR = 0.69, 95% CI = 0.54 to 0.89; OR = 0.59, 95% CI = 0.44 to 0.79, respectively). The overall analysis indicated a significantly positive association between knowledge scores and experience among dental professionals (OR = 0.68, 95% CI = 0.59 to 0.78). The findings provide evidence of a positive association between dental professionals' experience and their knowledge and attitude scores toward geriatric patients. The findings highlight the importance of experience in enhancing dental professionals' understanding and approach to geriatric dental care. These results have implications for improving dental education, training, and policy development to better address the oral health needs of older adults.
PubMed: 38060704
DOI: 10.7759/cureus.48339 -
Diagnostics (Basel, Switzerland) Nov 2023This study systematically reviews the literature to evaluate the potential relationships between oral/perioral piercing and consequent oral complications in the... (Review)
Review
Oral Complications Associated with the Piercing of Oral and Perioral Tissues and the Corresponding Degree of Awareness among Public and Professionals: A Systematic Review.
This study systematically reviews the literature to evaluate the potential relationships between oral/perioral piercing and consequent oral complications in the corresponding society. The second objective was determining public/professional sectors' awareness of the subject. This research followed PRISMA and Cochrane guidelines for conducting systematic reviews and searching scientific databases, including PubMed, Scopus, Cochrane, and Google Scholar, until April 2023. Cross-sectional, cohort, and case-control studies in English were deemed eligible. The methodological quality of the included studies was assessed using proper quality assessment guidelines. Of the 965 initial articles retrieved, 34 were considered suitable for qualitative synthesis after screening procedures and removing duplicates and irrelevant records. There appears to be an imbalance between the general public's low and dentists' high awareness. This draws attention to the shortage of professional and societal knowledge-sharing and education initiatives. Women were more than twice as likely as men to have oral piercings. Piercing usage had a low incidence among a cohort of students with a mean age of 16. Merely circumstantial evidence has indicated a plausible correlation between oral and perioral piercings and the emergence of secondary bacterial and fungal colonization, particularly periodontopathogenic bacteria and Candida albicans. Furthermore, several adverse consequences have been observed linked to various piercings-such as lip and tongue piercings. These include caries, gingivitis/periodontitis, dental fractures, enamel chipping/cracks, plaque buildup, bone loss, bleeding, inflammation, and swelling. Given the risks involved and the complications that might impair oral health, the prevalence of oral piercings is alarming. As a result, public health authorities need to firmly support initiatives to raise awareness of the risks associated with oral/perioral piercings. For piercers to enhance their expertise in this field, professional training is necessary because there is a shortage of knowledge on the possible adverse effects of piercings.
PubMed: 37958268
DOI: 10.3390/diagnostics13213371 -
JPMA. the Journal of the Pakistan... Oct 2023To compare disease-free survival rates in oral squamous cell carcinoma patients initially attended and referred by dentists versus other physicians.
OBJECTIVE
To compare disease-free survival rates in oral squamous cell carcinoma patients initially attended and referred by dentists versus other physicians.
METHODS
The systematic review was conducted after registration with the International prospective register of systematic reviews at the University of York, the United Kingdom, and comprised search on Medline, PubMed, Cochrane and CINAHAL Plus databases for studies published up to December 2021. The Population-Intervention-Comparison- Outcomes-Study criteria was used to search for studies involving patients diagnosed with oral squamous cell carcinoma receiving referrals by dentist or by other healthcare providers. Disease-free survival of patients was taken as the main outcome. Customized data collection proforma was used to record data in line with the Preferred Reporting Items in Systematic Reviews and Meta- Analysis guidelines. Data was subjected to systematic, qualitative review.
RESULTS
Of the 344 studies found, 8(2.3%) were analysed in detail. Patients referred by dentists ranged from 22.6% to 54%. Males comprised 53% to 70.3% of the sample. The highest number of referrals was made by primary physicians, ranging from 27.4% to 71.6%. Upto 67.6% cases were diagnosed with stage 1 and 2 oral cancer. The highest 5-year survival rate was 75% in a study where 59% patients were diagnosed at an early stage of disease.
CONCLUSION
The relative scarcity of studies makes it impossible to draw an association between oral cancer survival rate and type of referral.
Topics: Male; Humans; Female; Carcinoma, Squamous Cell; Mouth Neoplasms; Disease-Free Survival; Squamous Cell Carcinoma of Head and Neck; Systematic Reviews as Topic; Physicians; Head and Neck Neoplasms; Dentists
PubMed: 37876066
DOI: 10.47391/JPMA.7308 -
BMC Oral Health Oct 2023Considered the most prevalent noncommunicable disease in childhood, dental caries is both an individual and a collective burden. While international guidelines highlight...
BACKGROUND
Considered the most prevalent noncommunicable disease in childhood, dental caries is both an individual and a collective burden. While international guidelines highlight prevention as a major strategy for caries management in children, health professionals still struggle to implement prevention into their clinical practice. Further research is needed to understand the gap between the theoretical significance of dental prevention and its lack of implementation in the clinical setting. This systematic review aims to identify and classify factors perceived by health professionals to be barriers or facilitators to caries prevention in children.
METHOD
A systematic literature search was conducted in three electronic databases (Medline, Web of Science and Cairn). Two researchers independently screened titles, abstracts and texts. To be selected, studies had to focus on barriers or facilitators to caries prevention in children and include health professionals as study participants. Qualitative and quantitative studies were selected. The factors influencing caries prevention in children were sorted into 3 main categories (clinician-related factors, patient-related factors, and organizational-related factors) and then classified according to the 14 domains of the theoretical domains framework (TDF).
RESULTS
A total of 1771 references were found by combining manual and database searches. Among them, 26 studies met the inclusion criteria, of which half were qualitative and half were quantitative studies. Dentists (n = 12), pediatricians (n = 11), nurses (n = 9), and physicians (n = 5) were the most frequently interviewed health professionals in our analysis. Barriers and facilitators to caries prevention in children were categorized into 12 TDF domains. The most frequently reported domains were Environmental Context and Resources, Knowledge and Professional Role and Identity.
CONCLUSION
This systematic review found that a wide range of factors influence caries prevention in children. Our analysis showed that barriers to pediatric oral health promotion affect all stages of the health care system. By highlighting the incompatibility between the health care system's organization and the implementation of caries prevention, this study aims to help researchers and policy-makers design new interventions to improve children's access to caries prevention.
TRIAL REGISTRATION
PROSPERO CRD42022304545.
Topics: Humans; Child; Dental Caries; Dental Caries Susceptibility; Health Personnel; Oral Health; Health Promotion
PubMed: 37853400
DOI: 10.1186/s12903-023-03458-1 -
Cureus Sep 2023Artificial intelligence (AI) has been cited as being helpful in the diagnosis of diseases, the prediction of prognoses, and the development of patient-specific... (Review)
Review
Artificial intelligence (AI) has been cited as being helpful in the diagnosis of diseases, the prediction of prognoses, and the development of patient-specific therapeutic strategies. AI can help dentists, in particular, when they need to make important judgments quickly. It can eliminate human mistakes in making decisions, resulting in superior and consistent medical treatment while lowering the workload on dentists. The existing studies relevant to the study and application of AI in the diagnosis of various forms of mouth ulcers are reviewed in this work. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were followed in the preparation of the review. There were no rule violations, with the significant exception of the use of a better search method that led to more accurate findings. Using search terms mainly such as AI, oral health, oral ulcers, oral herpes simplex, oral lichen planus, pemphigus vulgaris, recurrent aphthous ulcer (RAU), oral cancer, premalignant and malignant disorders, etc., a comprehensive search was carried out in the reliable sources of literature, namely PubMed, Scopus, Embase, Web of Science, Ovid, Global Health, and PsycINFO. For all papers, exhaustive searches were done using inclusion criteria as well as exclusion criteria between June 28, 2018, and June 28, 2023. An AI framework for the automatic categorization of oral ulcers from oral clinical photographs was developed by the authors, and it performed satisfactorily. The newly designed AI model works better than the current convolutional neural network image categorization techniques and shows a fair level of precision in the classification of oral ulcers. However, despite being useful for identifying oral ulcers, the suggested technique needs a broader set of data for validation and training purposes before being used in clinical settings. Automated OCSCC identification using a deep learning-based technique is a quick, harmless, affordable, and practical approach to evaluating the effectiveness of cancer treatment. The categorization and identification of RAU lesions through the use of non-intrusive oral pictures using the previously developed ResNet50 and YOLOV algorithms demonstrated better accuracy as well as adequate potential for the future, which could be helpful in clinical practice. Moreover, the most reliable projections for the likelihood of the presence or absence of RAU were made by the optimized neural network. The authors also discovered variables associated with RAU that might be used as input information to build artificial neural networks that anticipate RAU.
PubMed: 37842407
DOI: 10.7759/cureus.45187 -
Heliyon Sep 2023Recently, clinical trials have assessed the effectiveness of Silver Diamine Fluoride (SDF) as an indirect pulp capping material (IPC) in primary teeth. This systematic...
INTRODUCTION
Recently, clinical trials have assessed the effectiveness of Silver Diamine Fluoride (SDF) as an indirect pulp capping material (IPC) in primary teeth. This systematic review aimed to assess the evidence presented in these trials.
DATA SOURCES
A comprehensive search identified relevant studies through five electronic databases (PubMed, Scopus, ClinicalTrials.gov, ScienceDirect, and Cochrane). Search strategies were designed using the PICO model to identify all studies that investigated SDF as an IPC compared to calcium hydroxide (CaOH) or mineral trioxide aggregate (MTA). Quality assessment and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to assess the level of evidence.
STUDY SELECTION
Four clinical trials were found to be suitable for inclusion in the qualitative synthesis and three studies were included in the quantitative analysis. Three studies compared SDF with CaOH and only one study compared SDF, CaOH, and MTA. Only one randomized controlled trial (RCT) had a low risk of bias, and the non-RCT study had a moderate risk of bias. The level of evidence based on the GRADE was low. Three out of four studies showed higher clinical and radiographic outcomes with SDF than with CaOH. One non-RCT study showed that SDF resulted in the least reparative dentin at the 6-months follow-up. The meta-analysis showed a non-significant difference between the SDF and CaOH groups (P = 0.36).
CONCLUSION
There is little evidence showing a higher clinical and radiographic outcome of SDF compared to CaOH as an IPC material in primary molars.
CLINICAL SIGNIFICANCE
This systematic review updates pediatric dentists regarding the effectiveness of using SDF as indirect pulp caping in primary teeth.
PubMed: 37809634
DOI: 10.1016/j.heliyon.2023.e19462 -
BMC Oral Health Sep 2023Tooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Tooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music, audiovisuals, and virtual reality (VR) technologies has been employed to reduce dental anxiety. This network meta-analysis (NMA) aimed to assess the comparative effectiveness of relaxing music, audiovisuals, and VR in reducing dental anxiety associated with tooth extraction.
METHODS
Four electronic databases were searched up to March 8, 2023, to identify randomized controlled trials (RCTs) evaluating different multimedia interventions, including the application of using relaxing music, audiovisuals, and VR technologies for dental anxiety. Studies utilizing various anxiety scales for tooth extraction were considered eligible. The pooled standard mean difference (SMD) and 95% confidence interval (CI) of anxiety scale scores were analyzed using Bayesian NMA.
RESULTS
A total of 11 RCTs were included in this NMA. The Bayesian NMA results demonstrated that relaxing music (SMD = -0.64, 95% CI: -1.04, -0.25) and VR (SMD = -0.54, 95% CI: -1.08, -0.02) were associated with a reduction in dental anxiety, while audiovisuals (SMD = -0.34, 95% CI: -0.97, 0.33) required further consideration. Ranking probabilities indicated that relaxing music might be the most acceptable method for individuals with dental anxiety. The frequentist NMA yielded consistent rankings in a sensitivity analysis.
CONCLUSIONS
Relaxing music shows the greatest potential for reducing dental anxiety related to tooth extraction when compared to other multimedia interventions.
Topics: Humans; Dental Anxiety; Music; Music Therapy; Network Meta-Analysis; Tooth Extraction
PubMed: 37735362
DOI: 10.1186/s12903-023-03407-y -
Dental Press Journal of Orthodontics 2023With the advent of COVID-19, teledentistry and remote monitoring have become an imminent reality that allows orthodontists to monitor orthodontic treatment through... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
With the advent of COVID-19, teledentistry and remote monitoring have become an imminent reality that allows orthodontists to monitor orthodontic treatment through virtual checkups, which complement in-office appointments.
OBJECTIVE
To evaluate the effectiveness of using teledentistry in monitoring the evolution of orthodontic treatment.
MATERIAL AND METHODS
Searches were performed in on-line databases. PECO strategy focused on comparing orthodontic patients exposed and not exposed to teledentistry. Searches and data extraction followed PRISMA guidelines. The assessment of the risk of bias and the certainty of the evidence was performed using the ROBINS-I and GRADE tools, respectively. A meta-analysis was also performed.
RESULTS
Out of 1,178 records found, 4 met the criteria and were included in the qualitative analysis. The risk of bias for follow-up assesment in aligner treatment was low to moderate; while for interceptive treatment, it was high. Studies are favorable to the use of teledentistry. The meta-analysis was performed with aligners studies only, due to heterogeneity. The certainty of the evidence was considered very low.
CONCLUSION
With very low certainty of evidence, teledentistry using Dental Monitoring® software is effective as an aid in monitoring the evolution of interceptive orthodontic treatment (high risk of bias) and, especially, treatment performed with aligners (low to moderate risk of bias). The meta-analysis evidenced a reduction in the number of face-to-face appointments (mean difference = -2.75[-3.95, -1.55]; I2=41%; p<0.00001) and the time for starting refinement (mean difference = -1.21[-2.35, -0.08]; I2=49%; p=0.04). Additional randomized studies evaluating corrective orthodontic treatment with brackets and wires are welcome.
Topics: Humans; COVID-19; Databases, Factual; Orthodontics, Corrective; Orthodontists; Software
PubMed: 37729285
DOI: 10.1590/2177-6709.28.4.e2322195.oar -
Medicine Sep 2023Antibiotics are a type of medication routinely prescribed by dental professionals; however, it is very common that the administration is not justified. Around 15% of...
BACKGROUD
Antibiotics are a type of medication routinely prescribed by dental professionals; however, it is very common that the administration is not justified. Around 15% of dentists admit that they have administered antibiotics unnecessarily more than once a week. The objective of this project is to identify the effectiveness of the use of antibiotics as prophylactic therapy in oral surgery, and to carry out an analysis of the alternatives to pharmacological therapy.
METHODS
The search strategy was carried out in the PubMed, Scopus, and ScienceDirect databases. For study selection, a first filter was carried out by title and abstract, which mentioned the use of prophylactic antibiotics in some type of oral surgery. To establish the risk of bias, the JBI Critical Appraisal Checklist for Randomized Controlled Trials was utilized.
RESULTS
The type of antibiotics most prescribed as prophylactic therapy were beta-lactams, which were indicated in 100% of the studies. Penicillins predominated, observing amoxicillin as the most indicated drug in 54.1% of the studies (n = 13) followed by the use of amoxicillin in conjunction with clavulanic acid in 33.3% of the studies (n = 8). Of the 21 studies included, 17 mention that there is insufficient evidence to support the use of antibiotics as prophylactic therapy in patients who will undergo some type of oral surgery.
CONCLUSIONS
Without a doubt, the biggest challenge is to develop academic update strategies aimed at dentists with active clinical practice and dental students from educational and government institutions to provide updated information about the correct use of prescription drugs.
Topics: Humans; Anti-Bacterial Agents; Oral Surgical Procedures; Amoxicillin; Penicillins; Clavulanic Acid
PubMed: 37713865
DOI: 10.1097/MD.0000000000035011 -
Occupational Medicine (Oxford, England) Oct 2023Hearing loss leads to increased irritability and disengagement in social activities and conversations, which may impact quality of life. Dental professionals are at risk...
BACKGROUND
Hearing loss leads to increased irritability and disengagement in social activities and conversations, which may impact quality of life. Dental professionals are at risk of developing hearing loss through daily exposure to noise from a wide range of equipment that produces significantly high decibels and noise frequencies.
AIMS
The aim of this systematic review was to investigate the risk of hearing loss in dental professionals, including dentists, dental specialists, dental hygienists and dental assistants.
METHODS
This review was conducted following the Cochrane Handbook for Systematic Reviews. PubMed, Scopus, Embase, Cochrane, Science Direct, Google Scholar and ProQuest were searched up to March 2023. Seventeen of 416 studies met the inclusion criteria. Quality assessment was performed according to the Newcastle-Ottawa Scale for cohort and case-control studies, and a modified version of this tool for cross-sectional studies.
RESULTS
The majority of included studies (82%) found a positive association with hearing loss for dentists and dental specialists, with years of clinical experience identified as a prominent risk factor. Dental hygienists and dental assistants were less commonly reported in the literature. Difference between the left and right ears was found in 71% of studies, with the left ear more affected in both dentists and dental assistants due to proximity to the noise-inducing equipment.
CONCLUSIONS
Dental professionals are at risk of hearing loss in their workplace, especially linked to years of clinical experience, which highlights the need for prevention and appropriate ear-protective devices.
PubMed: 37682842
DOI: 10.1093/occmed/kqad084