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Romanian Journal of Morphology and... 2019Patients with anticoagulant therapy have a high thromboembolic risk. Due to the rich oro-maxillofacial vasculature and the fact that some dental procedures may cause a... (Review)
Review
Patients with anticoagulant therapy have a high thromboembolic risk. Due to the rich oro-maxillofacial vasculature and the fact that some dental procedures may cause a bleeding, the physician should be able to correlate this risk with the hemorrhagic risk. Dental procedures are a trigger for psychic stress. One of the most important changes in acute stress is in cardiovascular system. In healthy patients, these changes are reversible and have no significant consequences, but in patients with cardiovascular diseases, the response to the catecholamine stress can cause organic lesions resulting in an acute myocardial infarction or stroke. This review explores in a concise manner the biochemical changes concerning anticoagulation and thrombolytic treatment in dental procedures.
Topics: Anticoagulants; Dental Care; Humans; Thrombolytic Therapy
PubMed: 31658312
DOI: No ID Found -
Revista Medica de Chile Jul 2018This review examines the evidence about the relationship between dental procedures and the incidence of transient bacteremia. One of the main obstacles was to define... (Review)
Review
This review examines the evidence about the relationship between dental procedures and the incidence of transient bacteremia. One of the main obstacles was to define "invasive dental procedure" as an indication for antimicrobial prophylaxis for patients with high risk of bacteremia. A search in WorldWideScience and ScienceDirect was performed and 20 articles were selected for review. Two contradictions stood out. There is no concrete evidence that a transient bacteremia arising during a dental procedure may be a risk factor for the appearance of bacterial endocarditis. There is no certainty about the effectiveness of antimicrobial prophylaxis, due to the lack of clinical trials of good quality. There is a similitude between bacteremia resulting from invasive and non-invasive dental procedures. The importance of periodontal health as a preventive measure for bacterial endocarditis among high risk patients is highlighted.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Antibiotic Prophylaxis; Bacteremia; Dental Care; Endocarditis, Bacterial; Evidence-Based Medicine; Humans; Oral Surgical Procedures; Risk Factors
PubMed: 30534890
DOI: 10.4067/s0034-98872018000700899 -
The Journal of Rural Health : Official... Jun 2021To assess rural-urban differences in dental service use and procedures and to explore the interaction effects of individual- and county-level factors on having dental...
PURPOSE
To assess rural-urban differences in dental service use and procedures and to explore the interaction effects of individual- and county-level factors on having dental service use and procedures.
METHODS
Data were from the 2016 Medical Expenditure Panel Survey (MEPS). We assessed rural-urban differences in 3 outcome variables: number of dental visits (1, 2, or 3+ visits), preventive care procedures (Yes/No), and treatment procedures (Yes/No). The study sample included 8,199 adults ≥ 18 years of age who reported at least 1 dental visit in the past year. Sampling weights embedded in MEPS were incorporated into all the analyses.
FINDINGS
A significant interaction between residential location and race/ethnicity (P = .030) suggested limited access to dental visits for minority groups, especially for blacks in the more rural areas. Adults from a more rural area were less likely to have received a preventive procedure (AOR = 0.55, 95% CI: 0.35-0.87) than those from an urban area. Adults of racial/ethnic minority groups, with lower SES, and without dental insurance were less likely to have received a preventive procedure (all P < .01) but were more likely to have received a treatment procedure (all P < .05).
CONCLUSIONS
The study showed rural adults were less likely to have received preventive dental procedures than their urban counterparts. Racial/ethnic minority groups living in a more rural area had even more limited access to dental services. Innovative service delivery models that integrate telehealth and community-based case management may contribute to addressing these gaps in rural communities.
Topics: Adult; Dental Care; Ethnicity; Health Expenditures; Health Services Accessibility; Humans; Minority Groups; Rural Population
PubMed: 32697007
DOI: 10.1111/jrh.12500 -
Journal of Occupational Health 2023Dental check-ups at the workplace provide the opportunity for early detection of dental diseases. Dental check-ups during working hours could reduce the number of days...
OBJECTIVES
Dental check-ups at the workplace provide the opportunity for early detection of dental diseases. Dental check-ups during working hours could reduce the number of days of absence from work due to visits to dental clinics outside the workplace. Although health check-ups are provided to workers in Japan, dental check-ups is not mandatory. This study aimed to determine the association between the place of dental check-ups and absenteeism due to visits to the dental clinic.
METHODS
This cross-sectional study used data from an online self-reported worker survey conducted for 2 weeks in March 2017. We applied linear regression analysis with robust variance to determine the association between the place of dental check-ups and absenteeism due to dental clinic visits while adjusting for sociodemographic, health, and oral health covariates.
RESULTS
The average age of the 3930 participants was 43.3 ± 11.7 years, and 52.3% were male. The number of days of absenteeism due to dental clinic visits in the past year for those who received check-ups only at the dental clinic and at the workplace were 0.57 ± 2.67 days and 0.21 ± 1.20 days, respectively. After adjusting for covariates, it was found that those who received dental check-ups at the workplace had 0.35 (95% CI, 0.12-0.58) fewer days of absence than those who received dental check-ups at the dental clinic.
CONCLUSION
Workers who received dental check-ups at the workplace were associated with fewer days of absence due to dental visits than those who received at the dental clinic.
Topics: Adult; Female; Humans; Male; Middle Aged; Absenteeism; Cross-Sectional Studies; East Asian People; Surveys and Questionnaires; Workplace; Dental Health Services; Ambulatory Care; Dental Care
PubMed: 37354491
DOI: 10.1002/1348-9585.12415 -
Acta Orthopaedica Oct 2017Background and purpose - To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic... (Review)
Review
Background and purpose - To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question: can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015. Studies were included if they involved patients with joint implants undergoing dental procedures, and either considered HPJI as an outcome measure or described a correlation between HPJI and prophylactic antibiotics. A guideline was formulated using the GRADE method and AGREE II guidelines. Results - 9 studies were included in this systematic review. All were rated "very low quality of evidence". Additional literature was therefore consulted to address clinical questions that provide further insight into pathophysiology and risk factors. The 9 studies did not provide evidence that use of antibiotic prophylaxis reduces the incidence of dental HPJI, and the additional literature supported the conclusion that antibiotic prophylaxis should be discouraged in dental procedures. Interpretation - Prophylactic antibiotics in order to prevent dental HPJI should not be prescribed to patients with a normal or an impaired immune system function. Patients are recommended to maintain good oral hygiene and visit the dentist regularly.
Topics: Antibiotic Prophylaxis; Dental Care; Humans; Joint Prosthesis; Netherlands; Prosthesis-Related Infections; Risk Assessment
PubMed: 28639846
DOI: 10.1080/17453674.2017.1340041 -
PloS One 2019Dental disease is one of the most common health problems in dogs. However, no studies have investigated the attitudes, opinions and practices of dog owners,...
BACKGROUND
Dental disease is one of the most common health problems in dogs. However, no studies have investigated the attitudes, opinions and practices of dog owners, veterinarians and veterinary nurses regarding dental health and preventative dental home care in dogs. The objective of this study was therefore to develop and validate questionnaires for this purpose, in accordance with survey methodology guidelines.
METHODS
Questionnaire items were determined based on the authors' academic knowledge and clinical experience, and modified throughout the validation process. Several measures were taken to reduce sampling, coverage, measurement and non-response errors. Content validity was assessed by Subject-Matter Experts (SME) and cognitive interviews were conducted in accordance with the "think-aloud protocol". Non-response analysis was performed using several methods.
RESULTS
Constructs were identified using exploratory factor analysis and two predefined constructs from the dog owner questionnaire were confirmed "Dog owners' attitudes towards brushing their dog's teeth" (Cronbach's α = 0.86) and "Dog owners' assessment of their dog's dental health" (α = 0.76). Additionally, exploratory factor analysis identified three potential constructs. In the veterinary health practitioner questionnaire, two constructs were identified: "Veterinary health practitioners' attitudes towards dental chews and dental feed" (α = 0.78) and "Veterinary health practitioners' attitudes and opinions on dental problems and dental cleaning" (α = 0.73). Non-response analysis showed a higher proportion of women in the sample of dog owners and veterinarians compared to the target populations. Veterinarians in the sample were also younger. In contrast, gender and age distributions in veterinary nurses did not differ between sample and target.
CONCLUSION
The validation presented in this work showed that the developed questionnaires could be used as accurate and reliable tools for measuring attitudes and practices regarding dental home care in dogs among Swedish dog owners, veterinarians and veterinary nurses.
Topics: Animal Technicians; Animals; Dental Care; Dog Diseases; Dogs; Health Knowledge, Attitudes, Practice; Humans; Oral Health; Ownership; Pets; Surveys and Questionnaires; Sweden; Tooth Diseases; Veterinarians
PubMed: 30682017
DOI: 10.1371/journal.pone.0204581 -
BMJ Open Oct 2016Integrated care has been introduced as a means of improving health outcomes and access to care, and reducing the cost of healthcare. Despite its importance, the... (Review)
Review
INTRODUCTION
Integrated care has been introduced as a means of improving health outcomes and access to care, and reducing the cost of healthcare. Despite its importance, the integration of oral health into primary care is still an emerging healthcare pathway. This scoping review protocol has been developed and funded by the Canadian Institutes of Health Research to provide an evidence-based synthesis on a primary oral healthcare approach and its effectiveness in improving oral health outcomes.
METHODS AND ANALYSIS
The 6-stage framework developed by Levac et al underpins this scoping review. We will identify relevant existing theories, programmes and original research through a comprehensive and systematic search of electronic databases such as OVID (MEDLINE, EMBASE, Cochrane databases), NCBI (PubMed), EBSCOhost (CINAHL), ProQuest, Databases in Public Health, Databases of the National Institutes of Health (health management and health technology) and relevant organisational websites and other sources of grey literature. All types of studies from 1978 to May 2016 in the French and English languages will be included. Using the Rainbow conceptual model of integrative primary care, a qualitative descriptive approach and thematic analysis will be used to synthesise the literature. Implementing novel healthcare models necessitates identifying barriers, sharing knowledge and delivering information. The integration of oral healthcare into primary care is an approach that promotes breaking the boundaries separating oral healthcare professionals and primary care. It creates opportunities for the dental workforce to become more involved in community-based practice and to assume shared responsibility with healthcare professionals to address the unmet oral health needs of those experiencing vulnerability and marginalisation.
ETHICS AND DISSEMINATION
The scoping study has received approval from the Université de Montréal's Institutional Review Board (#14-097-CERES-D). The findings will be disseminated through publications and presentations in provincial, national and international research symposiums and professional meetings.
Topics: Canada; Cost-Benefit Analysis; Delivery of Health Care, Integrated; Dental Care; Evidence-Based Practice; Health Services Accessibility; Health Services Needs and Demand; Humans; Oral Health; Primary Health Care
PubMed: 27798039
DOI: 10.1136/bmjopen-2016-013807 -
Special Care in Dentistry : Official... Jan 2023To investigate the frequency of preventive dental care among adults with autism and explore factors associated with receiving regular preventive care.
PURPOSE/AIM
To investigate the frequency of preventive dental care among adults with autism and explore factors associated with receiving regular preventive care.
MATERIALS AND METHODS
De-identified data was collected from electronic health records of 18-year-old or older patients with autism that had at least one preventive dental procedure recorded. The data was then analyzed to describe the frequency of preventive dental procedures provided for this population and investigate what variables are associated with regular care.
RESULTS
Sample size was 119, 67% were males, average age was 30.8 years, and 58% had Medicaid. Average BMI was 42.8, the prevalence of diabetes and heart disease were 16% and 34%, respectively, and 86% reported mental health problems. Recreational drug use was 6.8%, alcohol use was 19%, and tobacco use 16%. Xerostomia was reported by 32%, and the average number of medications was 7.2 ± 5.5. The average number of preventive dental visits was 7.9 ± 10.6, and 35% of the patients had at least one preventive dental visit per year. Only number of medications had a statistically significant association with number of preventive dental visits.
CONCLUSIONS
Only one in every three adults with autism had at least one preventive dental visit per year.
Topics: Adolescent; Adult; Female; Humans; Male; Autistic Disorder; Dental Care; Medicaid; United States; Dental Care for Disabled; Preventive Dentistry
PubMed: 35636432
DOI: 10.1111/scd.12738 -
BMC Oral Health Dec 2020Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers...
BACKGROUND
Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs.
METHODS
Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States.
RESULT
Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days.
CONCLUSIONS
The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.
Topics: Adolescent; Adult; Child; Child, Preschool; Dental Care; Emergencies; Emergency Service, Hospital; Female; Humans; Infant; Infant, Newborn; Male; Medicaid; Middle Aged; United States; Young Adult
PubMed: 33276770
DOI: 10.1186/s12903-020-01345-7 -
American Journal of Orthodontics and... Feb 2018Identification and appraisal of the outcome measures that have been used to evaluate hypodontia treatment and deliver services are essential for improving care. A lack... (Review)
Review
INTRODUCTION
Identification and appraisal of the outcome measures that have been used to evaluate hypodontia treatment and deliver services are essential for improving care. A lack of alignment between outcomes and patient values can limit the scope for patient-centered care. Our objectives were to identify and appraise the outcomes selected to evaluate hypodontia care.
METHODS
Data sources included 10 electronic databases and grey literature, searched using terms for hypodontia and its treatment methods. Study eligibility included mixed study designs to ensure comprehensive identification of outcomes, excluding case reports and case series with fewer than 10 participants and nonsystematic reviews. Participants and interventions involved people with hypodontia receiving any dental treatment to manage their hypodontia. Simulated treatment, purely laboratory-based interventions, and future treatments still in development were excluded. Research outcomes were identified and synthesised into 4 categories: clinical indicators, and patient-reported, clinician-reported, and lay-reported outcomes. No synthesis of efficacy data was planned, and consequently no methodologic quality appraisal of the studies was undertaken.
RESULTS
The search identified 497 abstracts, from which 106 eligible articles were retrieved in full. Fifty-six studies and 8 quality-improvement reports were included. Clinical indicators were reported in 49 studies (88%) including appearance, function, dental health, treatment longevity, treatment success and service delivery. Patient-reported outcomes were given in 22 studies (39%) including oral health-related quality of life, appearance, function, symptoms of temporomandibular dysfunction, and patient experience. Clinician-reported outcomes were limited to appearance. Variability was seen in the tools used for measuring outcomes.
CONCLUSIONS
There is a lack of rationale and consistency in the selection of outcome measures used to evaluate hypodontia care. Outcomes are largely clinician and researcher-driven with little evidence of their relevance to patients. There was a paucity of outcomes measuring access to care, quality of care, and cost. Evidence from hypodontia research is clinician-focused and likely to have limited value to support patients during decision making. Attempts to synthesise the evidence base for translation into practice will be challenging. There is a need for a core outcomes set with a patient-centric approach to drive improvements in health services.
Topics: Anodontia; Dental Care; Humans; Quality Assurance, Health Care; Treatment Outcome
PubMed: 29407495
DOI: 10.1016/j.ajodo.2017.10.010