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The Bulletin of Tokyo Dental College Mar 2022In Japan, domiciliary care fees are only covered by the public health insurance system if the clinic concerned is located within 16 km of the patient's residence. This...
In Japan, domiciliary care fees are only covered by the public health insurance system if the clinic concerned is located within 16 km of the patient's residence. This nationwide rule does not take local conditions into account and therefore may not be appropriate. The goal of the present study was to assess the current state of domiciliary dental care nationwide in view of this restriction to clarify the current situation and any inherent problems. Six dental institutions providing domiciliary dental care were selected by location (urban or mountainous area) and size. Travel time from clinics to the 16 km points and the longest time required for the journey from clinics were investigated. Two of the dental clinics were located in depopulated areas with few dental institutions. These clinics had to provide domiciliary dental care not only in the 16-km area around the clinic, but also in areas over 16 km away. Travel time to the 16-km points was between 52 and 90 min. On the other hand, the longest time for actual visiting was between 30 and 60 min. In some areas, no domiciliary dental care was available within the 16 km limit. This indicates that the 16-km area is too wide to be covered by one dental institution alone and that it poses a problem in areas with few dental institutions. This suggests that it would be preferable to consider time required to visit rather than geographical distance in forming policy. The 16-km limit often spans multiple residential areas, indicating that greater coordination is needed between the Community-based Integrated Care System and dental offices.
Topics: Aged; Dental Care; Dental Care for Aged; Home Care Services; Humans; Japan; Surveys and Questionnaires
PubMed: 35173083
DOI: 10.2209/tdcpublication.2021-0016 -
Community Dentistry and Oral... Aug 2019The aim of this longitudinal study was to investigate causal pathways among as well as interrelationships between changes in dental fear and dental attendance in a...
OBJECTIVES
The aim of this longitudinal study was to investigate causal pathways among as well as interrelationships between changes in dental fear and dental attendance in a nationally representative sample of adult Finns aged 19 years or older in 2000, with 11 years of follow-up.
METHODS
Data from the Health 2000 and 2011 Surveys (BRIF8901) in Finland were used. The Health 2000 survey used a stratified two-stage cluster sampling design (N=9742). Of the participants in 2000, 7964 were eligible and invited to participate in 2011. Of the participants in 2011 (n=5806), 3,631 (63%) responded to both dental fear and attendance questions in both years. Both fear and attendance were assessed using single questions and dichotomized. The background variables included were age, gender and education. Path analysis and logistic regression models were used.
RESULTS
Dental fear led to nonhabitual use of dental services rather than vice versa (-0.07 to 0.04 vs. 0.00). When confounders were considered, in both age groups (29-39 years and 40+ years) an increase in fear predicted nonhabitual dental attendance. This association was stronger among the younger age group (OR = 4.91) than among those aged 40 years and older (OR = 2.88). Among the younger age group, improved dental fear decreased the risk of nonhabitual dental attendance (OR = 0.16), while among older age group, stable fear increased the risk of nonhabitual dental attendance (OR = 2.33).
CONCLUSIONS
Dental fear causes nonhabitual dental attendance, and decreasing dental fear increases habitual attendance. Oral health personnel should adapt measures to prevent and treat dental fear.
Topics: Adult; Aged; Dental Anxiety; Dental Care; Dental Health Services; Female; Finland; Humans; Longitudinal Studies; Male; Middle Aged; Office Visits; Oral Health; Young Adult
PubMed: 30941810
DOI: 10.1111/cdoe.12458 -
Journal of Otolaryngology - Head & Neck... Aug 2020Subcutaneous cervical emphysema is a clinical sign associated with many conditions, including laryngotracheal trauma, pneumothorax and necrotizing deep tissue infections. (Review)
Review
BACKGROUND
Subcutaneous cervical emphysema is a clinical sign associated with many conditions, including laryngotracheal trauma, pneumothorax and necrotizing deep tissue infections.
CASE PRESENTATION
We discuss a case of a 76-year-old man presenting with extensive cervical emphysema a few hours after a minor dental filling procedure. The CT-scan revealed a significant amount of air within the cervical and mediastinal spaces, reaching lobar bronchi. Vitals were within normal values Bloodwork demonstrated an elevation of creatinine kinase (3718; normal < 150) and mild leukocytosis (WBC = 11.6). We decided to proceed to an urgent cervical exploration to exclude necrotizing fasciitis. This revealed air but no tissue necrosis nor abnormal fluid. The patient improved clinically and was discharged two days later with oral antibiotics. Although cervicofacial subcutaneous emphysema following dental procedures has been reported, it is usually less extensive and involving more invasive procedures using air-driven handpieces.
CONCLUSION
As an otolaryngologist confronted with extensive subcutaneous emphysema following a potential entry route for an aggressive infection, given the seriousness of this diagnosis, the decision of whether or not to perform a diagnostic surgical exploration should remain.
Topics: Aged; Dental Care; Dental Instruments; Dental Restoration, Permanent; Diagnosis, Differential; Fasciitis, Necrotizing; Humans; Male; Mediastinal Emphysema; Subcutaneous Emphysema; Tomography, X-Ray Computed
PubMed: 32811562
DOI: 10.1186/s40463-020-00455-0 -
Australian Dental Journal Jun 2013
Topics: Dental Care; Dental Caries; Dentistry; Humans; Organ Sparing Treatments
PubMed: 23721331
DOI: 10.1111/adj.12043 -
Clinical Oral Investigations Sep 2022This study evaluated particle spread associated with various common periodontal aerosol-generating procedures (AGPs) in simulated and clinical settings.
OBJECTIVES
This study evaluated particle spread associated with various common periodontal aerosol-generating procedures (AGPs) in simulated and clinical settings.
MATERIALS AND METHODS
A simulation study visualized the aerosols, droplets, and splatter spread with and without high-volume suction (HVS, 325 L/min) during common dental AGPs, namely ultrasonic scaling, air flow prophylaxis, and implant drilling after fluorescein dye was added to the water irrigant as a tracer. Each procedure was repeated 10 times. A complementary clinical study measured the spread of contaminated particles within the dental operatory and quantified airborne protein dispersion following 10 min of ultrasonic supragingival scaling of 19 participants during routine periodontal treatment.
RESULTS
The simulation study data showed that air flow produced the highest amount of splatters and the ultrasonic scaler generated the most aerosol and droplet particles at 1.2 m away from the source. The use of HVS effectively reduced 37.5-96% of splatter generation for all three dental AGPs, as well as 82-93% of aerosol and droplet particles at 1.2 m for the ultrasonic scaler and air polisher. In the clinical study, higher protein levels above background levels following ultrasonic supragingival scaling were detected in fewer than 20% of patients, indicating minimal particle spread.
CONCLUSIONS
While three common periodontal AGPs produce aerosols and droplet particles up to at least 1.2 m from the source, the use of HVS is of significant benefit. Routine ultrasonic supragingival scaling produced few detectable traces of salivary protein at various sites throughout the 10-min dental operatory.
CLINICAL RELEVANCE
The likelihood of aerosol spread to distant sites during common periodontal AGPs is greatly reduced by high-volume suction. Clinically, limited evidence of protein contaminants was found following routine ultrasonic scaling, suggesting that the the majority of the contamination consisits of the irrigant rather than organic matter from the oral cavity.
Topics: Aerosols; Dental Care; Dental Scaling; Fluorescein; Humans; Suction
PubMed: 35581347
DOI: 10.1007/s00784-022-04532-8 -
Supportive Care in Cancer : Official... Jul 2014Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of... (Review)
Review
PURPOSE
Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children's Oncology Group.
METHODS
An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network "Categories of Consensus" system.
RESULTS
The Children's Oncology Group oral-dental panel selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Additionally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent malignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment.
CONCLUSIONS
Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life.
Topics: Child; Dental Care; Humans; Neoplasms; Survivors
PubMed: 24781353
DOI: 10.1007/s00520-014-2260-x -
Indian Journal of Dental Research :... 2017
Topics: Dental Care; Humans; Practice Management, Dental; Quality of Health Care
PubMed: 29256452
DOI: 10.4103/ijdr.IJDR_237_17 -
Journal of the American Dental... Dec 2020
Topics: Aged; COVID-19; Dental Care; Dental Care for Aged; Health Services Accessibility; Humans; Pandemics; SARS-CoV-2
PubMed: 33066871
DOI: 10.1016/j.adaj.2020.08.004 -
Journal of Public Health Management and...To describe the patterns of specific dental service utilization among the various sociodemographic groups in North Carolina served by the East Carolina University School...
OBJECTIVE
To describe the patterns of specific dental service utilization among the various sociodemographic groups in North Carolina served by the East Carolina University School of Dental Medicine (ECU SoDM).
DESIGN
This was a descriptive study utilizing self-reported patients' sociodemographic information, payment method history, and CDT codes of procedures performed. Deidentified clinical data recorded for 26 710 patients and 534 983 procedures from 2011 to 2020 were extracted from a centralized axiUm database. Data were analyzed using IBM SPSS Statistics, version 25.0. Cross-tabulations between dental service utilizations, patients' demographics, and payment method were performed using chi-square analysis.
SETTING
Nine dental clinic sites across the state of North Carolina.
PARTICIPANTS
In total, 26 710 adults 23 years to older than 65 years were included in the sample for this study.
MAIN OUTCOME MEASURES
In total, 534 983 procedure codes completed for the eligible patients were cross-tabulated with payment method.
RESULTS
Payment method was significantly related to individual characteristics including location of service, age, race, ethnicity, and untreated decay ( P < .001). Payment method is associated with the dental service type utilized by an individual ( P < .001). Patients who received Medicaid benefits were more likely to receive restorative procedures, removable prosthetics, or oral surgery. Despite NC Medicaid covering preventive procedures, patients who received Medicaid benefits showed lower utilization of preventive procedures than expected. Privately insured or self-paying individuals demonstrated a greater variety of service option utilization, as well as more frequent usage of more specialized procedure options such as endodontics, periodontics, fixed prosthodontics, and implants.
CONCLUSIONS
Payment method was found to be related to patients' demographics and type of dental service utilized. Adults older than 65 years demonstrated a higher proportion of self-payment for dental care, indicating a lack of payment options for this population. In the interest of providing care for underserved populations in North Carolina, policy makers should consider expanding dental coverage for adults older than 65 years.
Topics: Adult; United States; Humans; North Carolina; Self Report; Universities; Dental Care; Medicaid; Demography
PubMed: 37290126
DOI: 10.1097/PHH.0000000000001774 -
Revista Medica de Chile Sep 2020We analyze the transmission routes, possible viral reservoirs in the oral cavity and considerations about dental care of SARS-CoV-2 virus infection. We also analyze the...
We analyze the transmission routes, possible viral reservoirs in the oral cavity and considerations about dental care of SARS-CoV-2 virus infection. We also analyze the protocols required before and after a dental procedure, aiming to increase the awareness of dentists about the importance of virus spread prevention among health care workers and patients. The evaluation of symptoms associated with SARS- CoV-2 such as fever, fatigue, dry cough, myalgia, dyspnea, and the inquiry about possible contacts with infected people is of utmost importance. The tongue and oral mucosa are important viral reservoirs and the transmission of the virus occurs primarily by saliva droplets. Therefore, elective dental care should be postponed, attending only dental emergencies during this period, incorporating the use of protective personal equipment (PPE) and using manual instruments to prevent the production of aerosols.
Topics: Aerosols; COVID-19; Dental Care; Humans; Infection Control; Pandemics; Personal Protective Equipment
PubMed: 33399706
DOI: 10.4067/S0034-98872020000901302