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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 -
Clinical Oral Investigations Dec 2023To evaluate the prevalence of awake bruxism (AB) in the adult population. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the prevalence of awake bruxism (AB) in the adult population.
MATERIALS AND METHODS
Six main electronic databases and three sources of grey literature were searched to identify cross-sectional studies in which AB was assessed. The studies were independently selected by two reviewers in two phases, based on their eligibility criteria. The first one consisted of reading titles and abstracts, and the second one involved reading the full articles. The study quality assessment was obtained by using the "Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data", and the "R Statistics" software was used to perform meta-analyses.
RESULTS
Seventeen out of 3086 identified studies were included. None of the studies scored high in methodological quality across all 9 items of the JBI checklist. However, "the use of valid methods to identify pathology" and "appropriate statistical analysis" were considered to have high methodological quality in all the studies. The overall pooled prevalence of the meta-analysis was 15.44% (99% confidence interval: 10.81 to 20.72%) and there was no difference for sex, sampling method and according to consensus-based classification.
CONCLUSIONS
The prevalence of AB in adults was low. There was substantial methodological variability, which highlights the need for standardized guidelines.
CLINICAL RELEVANCE
Prevalence data are useful for raising patients' and clinicians' awareness of the AB. Moreover, since AB can lead to possible pain and overload of the stomatognathic system, this knowledge can also guide dentists to achieve an early diagnosis of AB and to provide appropriate care management.
Topics: Adult; Humans; Prevalence; Bruxism; Cross-Sectional Studies; Wakefulness; Software
PubMed: 37853263
DOI: 10.1007/s00784-023-05302-w -
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 -
International Journal of Paediatric... May 2024School-based oral health education has emerged as one of the most effective methods to instill a positive attitude toward oral health in children. (Review)
Review
BACKGROUND
School-based oral health education has emerged as one of the most effective methods to instill a positive attitude toward oral health in children.
AIM
This systematic review (SR) aimed to assess the effectiveness of different methods of oral health education in children and adolescents.
DESIGN
Systematic search was conducted in PubMed, Cochrane, Web of Science, LILACS, Scopus, and EMBASE on January 29, 2023. Review included only randomized controlled trials (RCTs), and their risk of bias (ROB) was assessed by Cochrane RoB-2. Data were extracted and analyzed by expert group. The GRADE approach was used to assess the quality of evidence for each outcome. Every step was conducted in duplicate, and disagreements were resolved by consulting the third reviewer.
RESULTS
The SR included 10 RCTs with majority showing a high ROB. They included 12 methods with the commonest being the use of leaflets/flash cards. Most interventions were effective in improving oral hygiene, gingival health, and knowledge except conventional teaching methods, lecture by using PowerPoint by dentists, and e-learning interventions. The grade of evidence in the majority of outcomes was found to be low or very low.
CONCLUSION
Interventions using the interactive methods such as games, motivational-experiential learning, and audiovisual methods were found to be more effective than controls and other interventions. Variabilities in study methods and outcome variables must be addressed in the future.
Topics: Child; Humans; Adolescent; Oral Health; Randomized Controlled Trials as Topic; Oral Hygiene; Schools; Health Education, Dental
PubMed: 37840214
DOI: 10.1111/ipd.13125 -
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 -
Journal of Dentistry Nov 2023To identify the prevalence of Awake Bruxism (AB). (Review)
Review
OBJECTIVES
To identify the prevalence of Awake Bruxism (AB).
SOURCES
The electronic search was done in Embase, PubMed/MEDLINE, LILACS, Livivo, Scopus, and Web of Science databases up to January 2nd, 2023. The search strategies combined terms such as "bruxism," "awake," and related terms when conducting searches in databases. Grey literature was consulted through Google Scholar, ProQuest, and OpenGrey.
STUDY SELECTION
Two independent reviewers participated in the study selection stages and included observational studies assessing the prevalence of AB, detected using reporting feedback (self or family report), clinical examination, and/or instrumental methods, regardless of the sex and age of the population.
DATA
Methodological quality was assessed using the Joanna Briggs Institute's checklist for prevalence studies. Ratio meta-analyses were performed using R Statistics software.
RESULTS
From a total of 3,083 studies identified by the searches on databases, 322 articles were reviewed the full-text and a total of 81 (quantitative synthesis) and 83 (narrative synthesis) studies were included. Only fifteen studies reached complete methodological quality. Two overall meta-analyses were performed, grouped based on convenience and population-based samples. The overall prevalence for possible AB was 32.08 % and 16.16 %, respectively. For the subgroup analyses, the prevalence rate showed a wide variation in different studied populations, approximately 14 %-32 % for women and 19 %-30 % for men, for population-based and convenience studies, respectively.
CONCLUSION
Possible AB prevalence was set from 16 % to 32 %. Studies with probable AB and definitive AB are still necessary.
CLINICAL SIGNIFICANCE
Studying the prevalence of waking bruxism is of interest to both dentists and patients. Knowing the probability of patients having awake bruxism allows the dentist to offer comprehensive preventive approaches to patients, avoiding deleterious consequences resulting from this condition. The present study reveals that the condition of bruxism during wakefulness is present in one out of every six adult patients studied. In pediatric patients, although this condition seems to be equally present, not enough studies were found to support this information for probable and definitive bruxism.
Topics: Male; Adult; Humans; Female; Child; Bruxism; Wakefulness; Prevalence
PubMed: 37739056
DOI: 10.1016/j.jdent.2023.104715 -
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 -
Journal of Paediatrics and Child Health Oct 2023Apart from various typical gastrointestinal symptoms, coeliac disease may have its clinical manifestations in the oral cavity which is the entrance of the... (Review)
Review
AIM
Apart from various typical gastrointestinal symptoms, coeliac disease may have its clinical manifestations in the oral cavity which is the entrance of the gastrointestinal tract.
METHODS
A systematic review of literature was performed using the following databases: Medline, Scopus, EBSCOhost and Cochrane Library for Systematic Review.
INCLUSION CRITERIA
observational or experimental original studies published in English with full text available between January 2000 and December 2022, regarding children and adolescents under the age of 20. Risk of bias was determined with the use of Risk Of Bias In Non-randomised Studies of Exposure.
RESULTS
Thirty-four studies were included in the review. The analysis confirmed a higher prevalence of numerous oral manifestations in coeliac disease concerning both hard and soft tissues. Our study found the prevalence of dental enamel defects to be at the level of 17.9%-83.5% (P value <0.047) and recurrent aphthous stomatitis of 8.3%-69% (P value <0.039).
CONCLUSION
Oral manifestations may precede gastrointestinal symptoms. Patients presenting such manifestations should be screened for coeliac disease. The cooperation of gastroenterologists and dentists could lead to an increased detectability of coeliac disease.
Topics: Adolescent; Humans; Child; Celiac Disease; Oral Health; Stomatitis, Aphthous; Prevalence
PubMed: 37712495
DOI: 10.1111/jpc.16494