-
Medicina Oral, Patologia Oral Y Cirugia... Nov 2016One of the main aims of orthodontists is to reduce the treatment time as much as possible, particularly in view of the rise in demand for orthodontic treatment among... (Review)
Review
BACKGROUND
One of the main aims of orthodontists is to reduce the treatment time as much as possible, particularly in view of the rise in demand for orthodontic treatment among adult patients. The objective of this systematic review was to examine the effectiveness of corticotomy as a surgical procedure that accelerates orthodontic tooth movement, together with its possible adverse effects.
MATERIAL AND METHODS
A systematic review of articles in 4 databases, Pubmed, Cochrane, Scopus and Embase, complemented by a manual search, identified 772 articles. The duplicates were eliminated and a critical reading of titles and abstracts led to the rejection of articles that did not meet the objectives of the review, leaving 69. After reading the full text of these articles, 49 were excluded because they did not meet the inclusion criteria. On applying the CONSORT criteria as a quality filter, a further 4 were eliminated due to low quality. Finally, 16 articles (4 systematic reviews and 12 controlled trials) were reviewed.
RESULTS
All the studies agree that corticotomy prior to orthodontic treatment accelerates dental movement, reducing the treatment time. With regard to side-effects, no periodontal damage was found, although this was only studied in the short term.
CONCLUSIONS
The evidence regarding the results of corticotomy is limited, given the small number of quality clinical studies available. Before this procedure is included as a routine practice in dental surgeries, studies of higher methodological quality are required, studying a greater number of individuals and examining the possible long-term adverse effects and the cost/benefit of the procedure.
Topics: Dental Care; Humans; Oral Surgical Procedures; Tooth Movement Techniques
PubMed: 27475698
DOI: 10.4317/medoral.21208 -
Journal of the American Dental... Oct 2016Although some patients experience adverse events (AEs) resulting in harm caused by treatments in dentistry, few published reports have detailed how dental providers...
BACKGROUND
Although some patients experience adverse events (AEs) resulting in harm caused by treatments in dentistry, few published reports have detailed how dental providers describe these events. Understanding how dental treatment professionals view AEs is essential to building a safer environment in dental practice.
METHODS
The authors interviewed dental professionals and domain experts through focus groups and in-depth interviews and asked them to identify the types of AEs that may occur in dental settings.
RESULTS
The initial interview and focus group findings yielded 1,514 items that included both causes and AEs. In total, 632 causes were coded into 1 of the 8 categories of the Eindhoven classification, and 882 AEs were coded into 12 categories of a newly developed dental AE classification. Interrater reliability was moderate among coders. The list was reanalyzed, and duplicate items were removed leaving a total of 747 unique AEs and 540 causes. The most frequently identified AE types were "aspiration and ingestion" at 14% (n = 142), "wrong-site, wrong-procedure, wrong-patient errors" at 13%, "hard-tissue damage" at 13%, and "soft-tissue damage" at 12%.
CONCLUSIONS
Dental providers identified a large and diverse list of AEs. These events ranged from "death due to cardiac arrest" to "jaw fatigue from lengthy procedures."
PRACTICAL IMPLICATIONS
Identifying threats to patient safety is a key element of improving dental patient safety. An inventory of dental AEs underpins efforts to track, prevent, and mitigate these events.
Topics: Dental Care; Dental Staff; Dentists; Focus Groups; Humans; Interviews as Topic; Medical Errors
PubMed: 27269376
DOI: 10.1016/j.adaj.2016.04.015 -
BMC Oral Health Apr 2010"Pay for performance" is an incentive system that has been gaining acceptance in medicine and is currently being considered for implementation in dentistry. However, it... (Review)
Review
BACKGROUND
"Pay for performance" is an incentive system that has been gaining acceptance in medicine and is currently being considered for implementation in dentistry. However, it remains unclear whether pay for performance can effect significant and lasting changes in provider behavior and quality of care. Provider acceptance will likely increase if pay for performance programs reward true quality. Therefore, we adopted a quality-oriented approach in reviewing those factors which could influence whether it will be embraced by the dental profession.
DISCUSSION
The factors contributing to the adoption of value-based purchasing were categorized according to the Donabedian quality of care framework. We identified the dental insurance market, the dental profession position, the organization of dental practice, and the dental patient involvement as structural factors influencing the way dental care is practiced and paid for. After considering variations in dental care and the early stage of development for evidence-based dentistry, the scarcity of outcome indicators, lack of clinical markers, inconsistent use of diagnostic codes and scarcity of electronic dental records, we concluded that, for pay for performance programs to be successfully implemented in dentistry, the dental profession and health services researchers should: 1) expand the knowledge base; 2) increase considerably evidence-based clinical guidelines; and 3) create evidence-based performance measures tied to existing clinical practice guidelines.
SUMMARY
In this paper, we explored factors that would influence the adoption of value-based purchasing programs in dentistry. Although none of these factors were essential deterrents for the implementation of pay for performance programs in medicine, the aggregate seems to indicate that significant changes are needed before this type of program could be considered a realistic option in dentistry.
Topics: Consumer Organizations; Current Procedural Terminology; Dental Care; Evidence-Based Dentistry; Humans; Insurance, Dental; Practice Management, Dental; Practice Patterns, Dentists'; Quality Indicators, Health Care; Reimbursement, Incentive; United States
PubMed: 20423526
DOI: 10.1186/1472-6831-10-9 -
BMC Oral Health Feb 2020A three-arm parallel group, randomised controlled trial set in general dental practices in England, Scotland, and Wales was undertaken to evaluate three strategies to... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A three-arm parallel group, randomised controlled trial set in general dental practices in England, Scotland, and Wales was undertaken to evaluate three strategies to manage dental caries in primary teeth. Children, with at least one primary molar with caries into dentine, were randomised to receive Conventional with best practice prevention (C + P), Biological with best practice prevention (B + P), or best practice Prevention Alone (PA).
METHODS
Data on costs were collected via case report forms completed by clinical staff at every visit. The co-primary outcomes were incidence of, and number of episodes of, dental pain and/or infection avoided. The three strategies were ranked in order of mean cost and a more costly strategy was compared with a less costly strategy in terms of incremental cost-effectiveness. Costs and outcomes were discounted at 3.5%.
RESULTS
A total of 1144 children were randomised with data on 1058 children (C + P n = 352, B + P n = 352, PA n = 354) used in the analysis. On average, it costs £230 to manage dental caries in primary teeth over a period of up to 36 months. Managing children in PA was, on average, £19 (97.5% CI: -£18 to £55) less costly than managing those in B + P. In terms of effectiveness, on average, there were fewer incidences of, (- 0.06; 97.5% CI: - 0.14 to 0.02) and fewer episodes of dental pain and/or infection (- 0.14; 97.5% CI: - 0.29 to 0.71) in B + P compared to PA. C + P was unlikely to be considered cost-effective, as it was more costly and less effective than B + P.
CONCLUSIONS
The mean cost of a child avoiding any dental pain and/or infection (incidence) was £330 and the mean cost per episode of dental pain and/or infection avoided was £130. At these thresholds B + P has the highest probability of being considered cost-effective. Over the willingness to pay thresholds considered, the probability of B + P being considered cost-effective never exceeded 75%.
TRIAL REGISTRATION
The trial was prospectively registered with the ISRCTN (reference number ISRCTN77044005) on the 26th January 2009 and East of Scotland Research Ethics Committee provided ethical approved (REC reference: 12/ES/0047).
Topics: Child; Cost-Benefit Analysis; Dental Care; Dental Caries; England; Humans; Incidence; Pediatric Dentistry; Prospective Studies; Scotland; Wales
PubMed: 32041605
DOI: 10.1186/s12903-020-1020-1 -
Israel Journal of Health Policy Research May 2019Routine dental examinations are important for early diagnosis and treatment of dental problems among older adults in order to improve their quality of life and avoid...
BACKGROUND
Routine dental examinations are important for early diagnosis and treatment of dental problems among older adults in order to improve their quality of life and avoid costly future treatments. In Israel, a significant percentage of adults do not seek dental care.
METHODS
The study is based on a 2017 telephone survey conducted among people aged 50-75 from different population groups in Israel to examine their health beliefs and attitudes toward dental treatments.
RESULTS
The results show that among older adults the decision to undergo routine dental checkups is affected by socio-demographic status and health beliefs regarding dental health. Lower age, higher income levels, and Jewish religion predicted higher chances of frequent checkups. In addition, those who saw the benefits of routine checkups, believed that dentists were readily available, and had higher levels of health motivation were more likely to seek out routine dental care.
CONCLUSIONS
According to the recent dental reform in Israel, people aged 75 and over are eligible for subsidized dental treatments. To enhance the frequency of dental checkups among older adults, it is recommended to provide this subsidized coverage for adults under age 75. In addition, planning dental health services for individuals in this age group should be based upon their accepted beliefs and values. Moreover, systematic health education through the media and health maintenance organizations should specifically target this population group to encourage them to undergo dental checkups more frequently.
Topics: Aged; Analysis of Variance; Dental Care; Diagnosis, Oral; Female; Humans; Israel; Male; Middle Aged; Oral Health; Surveys and Questionnaires
PubMed: 31077257
DOI: 10.1186/s13584-019-0312-x -
BMC Oral Health Mar 2011So far, there are few studies considering the development of dental anxiety and dental attendance patterns across time in the general population of Norwegian adults....
BACKGROUND
So far, there are few studies considering the development of dental anxiety and dental attendance patterns across time in the general population of Norwegian adults. This study aimed to 1) determine the frequency of dental anxiety and regular dental attendance among 25-year-olds in Norway in 1997 and 2007, 2) to study the development (time trend) of dental anxiety and the socio-behavioral distribution of dental anxiety from 1997 to 2007.
METHOD
Random samples of 1,190 and 8,000 25-yr-olds were drawn from the populations of three counties in Western Norway in 1997 and 2007, respectively. The eligible participants received questionnaires by mail including questions on socio-demographics, dental anxiety (DAS) and dental attendance.
RESULTS
In 1997, 11.5% males versus 23% females reported high dental anxiety (DAS ≥ 13). Corresponding figures in 2007 were 11.3% and 19.8%. The proportions who had attended yearly for a dental check-up during the past 5 years fell from 62% in 1997 (men 56.9% and women 66.4%) to 44.6% (men 38.1% and women 48.6%) in 2007. After controlling for potential confounding factors, the 25-year-olds were 1.4 times more likely to report dental anxiety in 1997 compared to 2007. The decrease was largely attributable to a lower mean DAS score among higher educated females in 2007 than in 1997. The discrepancy in dental anxiety between regular and non-regular dental attendees had decreased, largely attributable to a decline in dental anxiety among irregular dental attendees.
CONCLUSION
The study showed reduced dental anxiety and dental attendance among 25 year-olds in Norway from 1997 to 2007. This study points to the importance of controlling for possible changes in socio-demographic distributions when different cohorts are compared.
Topics: Adult; Dental Anxiety; Dental Care; Educational Status; Female; Health Behavior; Humans; Income; Logistic Models; Male; Manifest Anxiety Scale; Norway; Odds Ratio; Sampling Studies; Social Class; Surveys and Questionnaires
PubMed: 21426538
DOI: 10.1186/1472-6831-11-10 -
Revista de Saude Publica 2020To evaluate if factors related to the mother's previous guidance on her children's dental health and the school attendance of children influence the regular dental care...
OBJECTIVE
To evaluate if factors related to the mother's previous guidance on her children's dental health and the school attendance of children influence the regular dental care of preschoolers living in the rural area of a municipality in Southern Brazil.
METHODS
A population-based study was conducted with 264 children under five years of age and their mothers. Socioeconomic and behavioral data were collected using a questionnaire, and the children were subjected to dental health tests. The outcome was the regular use of dental services. The main exposure variables were children's care in daycare centers or schools and maternal guidance on the child's dental health. Poisson regression analysis with robust variance adjustment was used to estimate prevalence ratios, considering a 95% confidence interval.
RESULTS
The prevalence of regular use was 11.4% (95%CI 7.5-15.2). In the adjusted analysis, the regular use of services was associated with the child attending day care center/school (PR = 2.44; 95%CI 1.38-4.34), and the mother received dental health guidance (PR = 4.13; 95%CI 1.77-9.61), even with control for socioeconomic, maternal and child variables.
CONCLUSION
When mothers receive previous information on child dental health care and children attend schools or daycare centers, the likelihood of regular dental appointments in preschoolers living in rural locations increases.
Topics: Adolescent; Adult; Brazil; Child, Preschool; Cross-Sectional Studies; Delivery of Health Care; Dental Care; Health Education, Dental; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Mother-Child Relations; Oral Health; Prevalence; Rural Health; Rural Population; Schools; Socioeconomic Factors; Surveys and Questionnaires; Young Adult
PubMed: 32267371
DOI: 10.11606/s1518-8787.2020054001686 -
PloS One 2021Scientific evidence highlights the importance of E-Readiness in the adoption and implementation of E-Oral Health technologies. However, to our knowledge, there is no... (Observational Study)
Observational Study
INTRODUCTION
Scientific evidence highlights the importance of E-Readiness in the adoption and implementation of E-Oral Health technologies. However, to our knowledge, there is no study investigating the perspective of patients in this regard. Therefore, the objective of this study was to explore patients' E-Readiness in the field of dentistry.
MATERIALS AND METHODS
A qualitative study was conducted using interpretive descriptive methodology. Purposeful sampling with maximum variation and snowball techniques were used to recruit the study participants via McGill University dental clinics and affiliated hospitals, as well as private or public dental care organizations. A total of 15 face-to-face, semi-structured and 60 to 90-minute audio recorded interviews were conducted. Data collection and analyses were performed concurrently, and interviews were continued until saturation was reached. Activity theory was used as the conceptual framework, and thematic analysis was used to analyze data. Data analysis was conducted both manually and with the use of "ATLAS-ti" software.
RESULTS
Four major themes emerged from the study; unlocking barriers, E-Oral Health awareness, inquisitiveness for E-Oral Health technology and enduring oral health benefits. These themes correspond with all three types of readiness (core, engagement and structural).
CONCLUSION
The study results suggest that dental patients consider E-Oral Health as a facilitator to access to care, and they are ready to learn and use E-Oral Health technology. There is a need to implement and support E-Oral Health technologies to improve patient care.
Topics: Adult; Aged; Aged, 80 and over; Dental Care; Female; Health Knowledge, Attitudes, Practice; Health Services Needs and Demand; Humans; Male; Middle Aged; Oral Health; Patient Preference; Qualitative Research; Quality Improvement; Telemedicine; Young Adult
PubMed: 34252096
DOI: 10.1371/journal.pone.0253922 -
PloS One 2021The aim of this study was to evaluate the content of periradicular surgery-related YouTube videos available for patients' education. YouTube search was made for videos...
The aim of this study was to evaluate the content of periradicular surgery-related YouTube videos available for patients' education. YouTube search was made for videos related to periradicular surgery using specific terms. After exclusions, 42 videos were selected, viewed and assessed by two independent observers. The videos were assessed in terms of duration, days since upload, country of upload, number of views, likes and dislikes, authorship source, viewing rate and interaction index. To grade the content of videos about periradicular surgery, a usefulness score was created with 10 elements based mainly on the American Association of Endodontists guidelines. Each element was given a score of 0 or 1. SPSS software (SPSS Inc, Chicago, IL, USA) was used to analyze data at a 95% confidence level. An inter-evaluator reliability analysis for the scoring system was performed using the Kappa statistic. The videos received an average of 35103.9 views (range: 9-652378) with an average duration of 338.71 seconds (range: 42-2081), respectively. Most videos were provided by individuals (57%). Half of the videos were posted by authors from the United States. The inter-evaluator reliability for usefulness scoring was 94.5%. No video covered the 10 scoring elements completely, presenting very low usefulness scores (mean: 3.2; range: 1-7). The most discussed elements were supporting media (100%) and steps of the procedure (90.5%) followed by indications and contraindications (45.2%) and symptoms (31%). None of the included videos discussed the procedure's cost or prognosis. In terms of usefulness score, no significant difference was detected between different sources of upload (chi-square test, P > 0.05). Information on periradicular surgery in YouTube videos is not comprehensive and patients should not rely on YouTube as the only source of information. Dental professionals should enrich the content of YouTube with good quality videos by providing full and evidence-based information that will positively affect patients' attitudes and satisfaction.
Topics: Dental Care; Humans; Information Dissemination; Patient Education as Topic; Periapical Diseases; Social Media; Video Recording
PubMed: 34890439
DOI: 10.1371/journal.pone.0261309 -
Rural and Remote Health Jul 2023Improving the oral health of Aboriginal and Torres Strait Islander people has been prioritised by both of the Australian National Oral Health Plans (2004-2013 and...
CONTEXT
Improving the oral health of Aboriginal and Torres Strait Islander people has been prioritised by both of the Australian National Oral Health Plans (2004-2013 and 2015-2024). However, providing adequate access to timely dental care to remote Aboriginal communities remains a challenge. The Kimberley region of Western Australia in particular experiences a significantly higher prevalence of dental disease compared to other regional centres. The region covers an area of over 400 000 km2, with 97% of this being classified as very remote and 42% of the population identifying as Aboriginal and/or Torres Strait Islander. The provision of dental care to remote Aboriginal communities in the Kimberley is complex and involves careful consideration of the unique environmental, cultural, organisational and clinical factors at play.
ISSUE
The low population densities combined with the high running costs of a fixed dental practice mean that establishing a permanent dental workforce is generally not viable in remote communities in the Kimberley. Thus there is a pressing need to explore alternative strategies to extend care to these communities. In this context, the Kimberley Dental Team (KDT), a non-government, volunteer-led organisation, was established to 'fill the gaps' and extend dental care to areas of unmet need. There is currently a lack of literature around the structure, logistics and delivery of volunteer dental services to remote communities. This paper describes the KDT, its development, resources, operational factors and organisational characteristics of the model of care, including mapping the reach of the program.
LESSONS LEARNED
This article underlines the challenges around dental service provision to remote Aboriginal communities and the evolution of a volunteer service model over the course of a decade. The structural components integral to the KDT model were identified and described. Community-based oral health promotion through initiatives such as supervised school toothbrushing programs enabled access to primary prevention for all school children. This was combined with school-based screening and triage to identify children in need of urgent care. Collaboration with community-controlled health services and cooperative use of infrastructure enabled holistic management of patients, continuity of care and increased efficiency of existing equipment. Integration with university curricula and supervised outreach placements were used to support training of dental students and attract new graduates into remote area dental practice. Supporting volunteer travel and accommodation and creating a sense of family were central to volunteer recruitment and sustained engagement. Service delivery approaches were adapted to meet community needs; a multifaceted hub-and-spoke model with mobile dental units was used to increase the reach of services. Strategic leadership through an overarching governance framework built from community consultation and steered by an external reference committee informed the model of care and its future direction.
Topics: Child; Humans; Australia; Australian Aboriginal and Torres Strait Islander Peoples; Health Services, Indigenous; Population Groups; Volunteers; Western Australia; Dental Care
PubMed: 37410938
DOI: 10.22605/RRH7366