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Journal of the Formosan Medical... Jun 2024Taiwan has implemented a Medical Home Healthcare (MHHC) policy to provide home healthcare services to residents in need. First was the Ordinary Medical Home Healthcare...
Taiwan has implemented a Medical Home Healthcare (MHHC) policy to provide home healthcare services to residents in need. First was the Ordinary Medical Home Healthcare (OMHHC) program in 1997 and then expanded to Integrated Medical Home Healthcare (IMHHC) in 2016. The OMHHC is provided care for residents with tubes at home or in institutions by physicians and nurses, and the IMHHC include additional professions, such as pharmacists and dentists. This study analyzed the longitudinal data from 2013 to 2020 with respect to overall home health services utilizations, and the type of services, and compared the differences between areas with and without healthcare shortages. Our results showed that the IMHHC program enhanced the accessibility of home healthcare to those in needs, especially those in healthcare shortage areas. However, some services in the IMHHC program may still have low utilization rates. It is necessary to investigate the potential barriers for residents to access those services.
PubMed: 38851913
DOI: 10.1016/j.jfma.2024.06.002 -
Journal of Dentistry Jun 2024Dentists' diagnostic accuracy in detecting periapical radiolucency varies considerably. This systematic review and meta-analysis aimed to investigate the accuracy of... (Review)
Review
OBJECTIVES
Dentists' diagnostic accuracy in detecting periapical radiolucency varies considerably. This systematic review and meta-analysis aimed to investigate the accuracy of artificial intelligence (AI) for detecting periapical radiolucency.
DATA
Studies reporting diagnostic accuracy and utilizing AI for periapical radiolucency detection, published until November 2023, were eligible for inclusion. Meta-analysis was conducted using the online MetaDTA Tool to calculate pooled sensitivity and specificity. Risk of bias was evaluated using QUADAS-2.
SOURCES
A comprehensive search was conducted in PubMed/MEDLINE, ScienceDirect, and Institute of Electrical and Electronics Engineers (IEEE) Xplore databases. Studies reporting diagnostic accuracy and utilizing AI tools for periapical radiolucency detection, published until November 2023, were eligible for inclusion.
STUDY SELECTION
We identified 210 articles, of which 24 met the criteria for inclusion in the review. All but one study used one type of convolutional neural network. The body of evidence comes with an overall unclear to high risk of bias and several applicability concerns. Four of the twenty-four studies were included in a meta-analysis. AI showed a pooled sensitivity and specificity of 0.94 (95 % CI = 0.90-0.96) and 0.96 (95 % CI = 0.91-0.98), respectively.
CONCLUSIONS
AI demonstrated high specificity and sensitivity for detecting periapical radiolucencies. However, the current landscape suggests a need for diverse study designs beyond traditional diagnostic accuracy studies. Prospective real-life randomized controlled trials using heterogeneous data are needed to demonstrate the true value of AI.
CLINICAL SIGNIFICANCE
Artificial intelligence tools seem to have the potential to support detecting periapical radiolucencies on imagery. Notably, nearly all studies did not test fully fledged software systems but measured the mere accuracy of AI models in diagnostic accuracy studies. The true value of currently available AI-based software for lesion detection on both 2D and 3D radiographs remains uncertain.
PubMed: 38851523
DOI: 10.1016/j.jdent.2024.105104 -
BMC Oral Health Jun 2024This study adopts a novel approach of using single-item surveys to simplify the assessment of oral health status and behaviors among Japanese private sector employees....
BACKGROUND
This study adopts a novel approach of using single-item surveys to simplify the assessment of oral health status and behaviors among Japanese private sector employees. We aimed to establish the validity of self-reported oral health in relation to clinical dental examinations, and to elucidate the relationship between oral diseases, health behaviors, and self-assessments. A secondary aim was to explore the association of self-rated oral health with oral health behaviors.
MATERIALS AND METHODS
Self-administered questionnaires and dental examinations were obtained from 2262 Japanese private sector employees. Workers self-rated their overall oral health status according to five choices: "very good," "good," "fair," "poor," or "bad." Self-reports were then compared with the results of clinical dental examinations, which included measuring the oral hygiene index (DI-S), the number of decayed teeth, periodontal status (Community Periodontal Index) and number of missing teeth. Convergent validity was also tested by examining the correlations of self-reported oral health status with oral health behaviors.
RESULTS
Overall, 30.8% of workers reported their oral health as "poor" or "bad." "Poor" or "bad" oral health status was significantly correlated with missing teeth, periodontitis, and decayed teeth. However, lower correlations were found for gingivitis and the oral hygiene index. Most self-reported oral health behaviors were correlated with self-rated oral health; exceptions were "tooth brushing instructions received in a dental clinic," "having a primary-care dentist," and "habitual snacking between meals."
CONCLUSIONS
Self-rated oral health provides reasonably valid data, and correlated well with clinically assessed oral health status, including dental caries, periodontal status, and tooth loss. Convergent validity was also found for oral health behaviors.
TRIAL REGISTRATION
Clinical trial registration number: UMIN000023011 (UMIN-CTR). Date of clinical trial registration: 06/07/2016.
Topics: Humans; Oral Health; Male; Female; Adult; Middle Aged; Japan; Self Report; Health Behavior; Surveys and Questionnaires; Health Status
PubMed: 38849799
DOI: 10.1186/s12903-023-03794-2 -
Juntendo Iji Zasshi = Juntendo Medical... 2023To investigate the effects of interventions provided by a multidisciplinary team consisting of anesthesiologists, dentists, pharmacists, and nurses at a Preoperative...
Introduction of a Multidisciplinary Preoperative Clinic at Juntendo University Hospital - A Retrospective Observational Study Focusing on Effects of Preoperative Interventions on Clinical Outcomes.
OBJECTIVES
To investigate the effects of interventions provided by a multidisciplinary team consisting of anesthesiologists, dentists, pharmacists, and nurses at a Preoperative Clinic (POC) on postoperative outcomes.
METHODS
We retrospectively investigated patients who underwent preoperative evaluation at the POC at Juntendo University Hospital between May and July, 2019. Patients were divided into intervention and non-intervention groups according to whether they received intervention(s) at the POC or not. Postoperative outcomes were compared between the groups, before and after propensity score (PS) matching.
RESULTS
We investigated 909 patients who completed POC evaluation and underwent surgery. Patients in the intervention group (n = 455 [50.1%]) received at least one intervention delivered, in the order of higher delivery frequencies, by dentists, pharmacists, nurses, and anesthesiologists. Before PS matching, the intervention group was associated with older age, more frequent cardiovascular comorbidities, and higher ASA-PS grades than the non-intervention group, while neither frequencies nor severities of postoperative complications differed between the groups. These outcomes did not differ between 382 PS-matched pairs with comparable risk factors either.
CONCLUSIONS
Before PS matching, postoperative outcomes did not differ between the groups, although the intervention group was associated with higher risks. These suggested that POC interventions could have improved postoperative outcomes in the higher-risk intervention group to the same level as in the non-intervention group. However, such potential beneficial effects of interventions could not be proven after PS matching. Further studies are required to elucidate effects of POC interventions on postoperative outcomes.
PubMed: 38845727
DOI: 10.14789/jmj.JMJ23-0023-OA -
Neurologia I Neurochirurgia Polska 2024
Topics: Humans; Flushing; Hypohidrosis; Autonomic Nervous System Diseases; Thermography; Male; Adult; Female
PubMed: 38845593
DOI: 10.5603/pjnns.100534 -
BDJ Open Jun 2024Professionalism is a dynamic construct that requires constant revision based on contemporary practices and attitudes.
BACKGROUND
Professionalism is a dynamic construct that requires constant revision based on contemporary practices and attitudes.
OBJECTIVES
The purpose of this study was to cross-culturally adapt an already validated English questionnaire assessing patient perceptions of professionalism among dentists, into the Malay language.
METHODS
An original 24-item questionnaire was cross-cultural adapted in the Malaysian context through two phases. Phase I included content and face validity from experts' evaluation which was followed by translation into the Malay language. Phase II involved psychometric assessment including construct validity and reliability analysis.
RESULTS
Expert evaluation indicated that all items demonstrated excellent content validity for the characteristics of relevance (CVI = 0.75-1.00 Kappa = 0.72-1.00) and clarity (CVI = 0.75-1.00 and Kappa= 0.72-1.00). A total of 300 dental patients completed the questionnaire. EFA was done on the first dataset and the second dataset was subjected to CFA which showed composite reliability (CR) ranging between 0.741 and 0.897 indicating acceptable reliability among items. The final questionnaire had 20 items with 3 domains; Patient expectation of a dental care provider, Ethics and Dentist's professional responsibilities, Patient communication and confidentiality.
CONCLUSION
This study has successfully validated the questionnaire for patient perception of professionalism in the Malaysian context.
PubMed: 38844761
DOI: 10.1038/s41405-024-00234-3 -
Cureus May 2024Antibiotics are commonly prescribed as a preventive measure, particularly post-tooth extraction, aiming to minimize the risk of infection. Preemptive analgesia functions... (Review)
Review
Antibiotics are commonly prescribed as a preventive measure, particularly post-tooth extraction, aiming to minimize the risk of infection. Preemptive analgesia functions by disrupting the nervous system's ability to encode pain stimuli, thus preventing the formation of pain memory. Dentists often recommend analgesics and antibiotics either as adjuncts or sole treatments for various dental conditions, offering both efficacy and cost-effectiveness. A comprehensive literature search was conducted across multiple databases, including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, and Lilac, using MeSH terms relevant to the role of antibiotics and analgesics in systemically ill patients undergoing tooth extraction. Out of 178 articles screened, 83 underwent full-text assessment for eligibility, and six were selected for qualitative analysis. The review process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, ensuring methodological rigor and transparent reporting. Across diverse study populations, the role of antibiotics and analgesics consistently demonstrated a statistically significant impact. Hence, the utilization of analgesics and antibiotics plays a pivotal role in preventing infection following tooth extraction in systemically ill patients, thereby promoting optimal oral hygiene and overall health.
PubMed: 38840997
DOI: 10.7759/cureus.59711 -
Clinical and Experimental Dental... Jun 2024Mouthguards (MGs) have the potential to prevent contact sport-related dental injuries. However, varying perceptions of their effectiveness persist, influencing...
Un "boxing" the reality: Knowledge, attitude, and perception of orthodontists, dental practitioners, and orthodontic patients toward mouthguards' wear during contact sports-A cross-sectional study.
INTRODUCTION
Mouthguards (MGs) have the potential to prevent contact sport-related dental injuries. However, varying perceptions of their effectiveness persist, influencing recommendations by dental professionals.
AIM
To assess the attitudes, knowledge, and perceptions of orthodontists, other dental practitioners (general dentists and other dental specialists), and orthodontic patients involved in contact sports regarding the use of MGs.
METHODOLOGY
A cross-sectional survey was designed to collect information from dental clinicians (orthodontists and other dental practitioners) and their orthodontic patients about using MGs during sports participation. A convenience sampling technique was used to recruit the participants for an online survey. A total of 107 (32 males/75 females) dental clinicians and 147 (75 males/72 females) orthodontic patients (mean age 17.5 ± 5.84 years) participated in the study. Pre-validated questionnaires, specifically designed for dental clinicians and orthodontic patients, were used. Data were analyzed using SPSS software (version 28.0; SPSS).
RESULTS
Nearly 50% of dental clinicians have recently recommended MGs to their patients in their clinical practice out of which 59% preferred the stock type; 33% of dental clinicians enquired their patients about involvement in contact sports during initial visits. The majority of orthodontic patients acquired knowledge about MGs through the Internet. More than half of orthodontic patients expressed unwillingness to pay for MGs, and 89% of orthodontic patients found using MGs during contact sports uncomfortable.
CONCLUSION
The findings provide valuable insights into the practices and attitudes of dental clinicians and orthodontic patients regarding MGs, their recommendations, and the comfort levels associated with using them during contact sports.
Topics: Humans; Cross-Sectional Studies; Female; Male; Mouth Protectors; Health Knowledge, Attitudes, Practice; Orthodontists; Athletic Injuries; Dentists; Surveys and Questionnaires; Adolescent; Young Adult; Adult; Tooth Injuries; Attitude of Health Personnel; Orthodontics; Boxing; Sports
PubMed: 38837625
DOI: 10.1002/cre2.904 -
BMC Oral Health Jun 2024The primary purpose of this study was to assess the prevalence and socio-behavioral determinants of ever-use of dental care services among adolescents aged 10-18 years,...
OBJECTIVE
The primary purpose of this study was to assess the prevalence and socio-behavioral determinants of ever-use of dental care services among adolescents aged 10-18 years, living with HIV, on Antiretroviral treatment (ART), and attending selected HIV clinics in Kampala, Uganda.
METHODS
A cross-sectional study was carried out between March and September 2020. The study conveniently recruited 154 adolescents between 10 and 18 years old from 4 specific HIV clinics in Kampala. Andersen's behavioral model guided the selection of variables, with the ever-use of dental care services as the outcome and predisposing, enabling, need-related factors and personal dental health practices as exposure variables. Data were analyzed using Fischer's exact test for cross-tabulation and modified Poisson regression for multivariate analysis.
RESULTS
The prevalence of ever-use of dental care services was 12.3%. The adolescents aged 14-18 had higher odds of using dental care services (Prevalence ratio (PR) of 3.35 than those aged 10-13 years. Fear of the spread of HIV was negatively associated with ever-use of dental care services (PR of 0.06). Participants who were afraid of going to the dentist had higher odds of using dental care services (PR of 2.98) than those not afraid. Failure to receive dental treatment because it was not part of the medical appointment had a positive association with the ever-use of dental care services (PR of 4.50). Those who were satisfied with their dental condition had lower odds of using dental care services. The bad oral odor was positively associated with the ever-use of dental care services (PR of 2.80). The use of soap for toothbrushing was positively associated with the ever-use of dental care services (PR of 2.51).
CONCLUSION
The study found a low frequency of dental care use among HIV-infected adolescents in Kampala, Uganda, with age being a predisposing factor. Enabling factors included fear of HIV spread, medical-dental appointment incoordination, and satisfaction with the dental condition and bad oral odor while under personal dental health practices. The use of soap for toothbrushing was an important association with dental care. Nevertheless, these study results cannot be generalized to the entire HIV adolescent population in Uganda.
Topics: Humans; Adolescent; Uganda; Cross-Sectional Studies; HIV Infections; Male; Female; Child; Dental Care; Anti-Retroviral Agents
PubMed: 38835044
DOI: 10.1186/s12903-024-04426-z -
Human Resources For Health Jun 2024The resource needs of health services are served by the recognition of qualifications across borders which allows professionals to migrate between countries. The... (Comparative Study)
Comparative Study
BACKGROUND
The resource needs of health services are served by the recognition of qualifications across borders which allows professionals to migrate between countries. The movement of dentists across the European Union (EU), especially into the United Kingdom (UK), has provided a valuable boost to workforce supply. Recent changes to policy recognising overseas qualifications have brought attention to the equivalence of qualifications awarded in EU countries. Professional regulators need to be confident that dentists who qualified elsewhere have the appropriate knowledge, skills and experience to practise safely and effectively. The aim of this study was to compare UK and EU dental curricula, identify any differences, and compare the extent of pre-qualification clinical experience.
METHODS
This was a mixed methods study comprising a questionnaire and website searches to identify information about curricula, competences, and quality assurance arrangements in each country. The questionnaire was sent to organisations responsible for regulating dental education or dental practice in EU member states. This was supplemented with information obtained from website searches of stakeholder organisations for each country including regulators, professional associations, ministries, and providers of dental education. A map of dental training across the EU was created.
RESULTS
National learning outcomes for dental education were identified for seven countries. No national outcomes were identified 13 countries; therefore, learning outcomes were mapped at institution level only. No information about learning outcomes was available for six countries. In one country, there is no basic dental training. Clinical skills and communication were generally well represented. Management and leadership were less represented. Only eight countries referenced a need for graduates to be aware of their own limitations. In most countries, quality assurance of dental education is not undertaken by dental organisations, but by national quality assurance agencies for higher education. In many cases, it was not possible to ascertain the extent of graduates' direct clinical experience with patients.
CONCLUSIONS
The findings demonstrate considerable variation in learning outcomes for dental education between countries and institutions in Europe. This presents a challenge to decision-makers responsible for national recognition and accreditation of diverse qualifications across Europe to maintain a safe, capable, international workforce; but one that this comparison of programmes helps to address.
Topics: Humans; Education, Dental; Curriculum; Clinical Competence; Surveys and Questionnaires; Dentists; European Union; Europe; United Kingdom; Foreign Professional Personnel; Emigration and Immigration; Health Workforce
PubMed: 38835022
DOI: 10.1186/s12960-024-00918-9