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International Dental Journal Jun 2018In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their... (Review)
Review
BACKGROUND
In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their use. As a consequence, dentists are encountering larger numbers of patients who are undergoing anti-thrombotic treatment and who have increased risk for bleeding. The current paper aims to review the literature regarding up-to-date anti-thrombotic treatment and provide information regarding their implications on dentistry.
METHODS
An online search was performed of the literature published between 2000 and 2016. Articles dealing with evidence-based clinical guidelines for anti-thrombotic treatments, as well as literature reporting the use of anti-thrombotic medications were included. The manuscripts were screened according to their relevance to dentistry as well as their treatment protocol guidelines.
RESULTS
In total, 5,539 publications were identified: 56 of 554 evidence-based clinical guidelines were found that dealt with treatment protocols with anti-thrombotic agents; and 132 of 5,539 articles describe direct anti-thrombotic medications.
CLINICAL IMPLICATIONS
Dental treatment includes a risk for bleeding. As a result of the increasing number of patients taking new-generation anti-thrombotic drugs, dentists must be up to date regarding the implications of such drugs on dental treatment as well as the practical means to achieve haemostasis.
Topics: Clinical Protocols; Dental Care; Fibrinolytic Agents; Hemostatic Techniques; Humans; Oral Hemorrhage; Pharmaceutical Research; Practice Guidelines as Topic
PubMed: 28921533
DOI: 10.1111/idj.12322 -
Deutsches Arzteblatt International Nov 2013
Topics: Dental Anxiety; Dental Care; Female; Humans; Male; Mental Disorders; Patient Compliance
PubMed: 24280432
DOI: 10.3238/arztebl.2013.0751b -
Community Dental Health Sep 2006Examine and compare differences in oral health attitudes and behaviour among Jordanian dental students.
OBJECTIVE
Examine and compare differences in oral health attitudes and behaviour among Jordanian dental students.
BASIC RESEARCH DESIGN AND PARTICIPANTS
Cross-sectional study of 314 dental students was conducted to compare differences in oral health behaviour and attitudes among these students in different levels of academic education.
SETTING
Jordan University of Science and Technology.
METHODS
Subjects were surveyed using a modified version of the Hiroshima University Dental Behavior Inventory (HU-DBI) questionnaire (20 Items). Multivariate binary and polytomous logistic regression analyses were performed in order to study change of patterns of statements during preclinical and clinical, and year of study, respectively.
RESULTS
The percentage of students claiming to brush their teeth twice daily or more often was four times higher amongst clinical students than amongst pre-clinical students.. The odds of visiting a dentist only in case of toothache was reduced by a factor of more than three among clinical year students (OR 0.30, 95% CI 0.15-0.61). Clinical year students rarely complained of bleeding gums after toothbrushing (OR 0.10, 95% CI 0.03-0.27). On the other hand, a number of items regarding use of dental floss and tooth paste, bad breath, colour and appearance of teeth, and cigarette smoking was similar between preclinical and clinical students. Evaluation of trends during dental studies employing polytomous multivariate logistic regression analysis revealed an abrupt change at the end of preclinical studies for items characterizing professional attitude.
CONCLUSIONS
With advancement in dental school, dental student's oral health awareness and attitudes improved in some aspects. Preventive dentistry courses should be taught early in the dental curriculum of the pre-clinical years.
Topics: Attitude of Health Personnel; Cross-Sectional Studies; Dental Care; Health Knowledge, Attitudes, Practice; Humans; Jordan; Likelihood Functions; Logistic Models; Odds Ratio; Oral Hygiene; Students, Dental; Surveys and Questionnaires
PubMed: 16995562
DOI: No ID Found -
International Journal For Equity in... Jun 2021Maintaining oral health is one of the global public health challenges. Income and out-of-pocket payments for dental care services are predictors of dental care...
BACKGROUND
Maintaining oral health is one of the global public health challenges. Income and out-of-pocket payments for dental care services are predictors of dental care utilisation. Although public assistance programmes guarantee income security for impoverished people, access barriers other than financial costs may cause unmet dental care needs. We aimed to explore the potential sociodemographic factors determining dental care utilisation among recipients of public assistance in Japan using linkage data of public assistance database and medical assistance claim data administered by municipalities.
METHODS
This was a retrospective cohort study involving a sample of public assistance recipients. We extracted the recipients' sociodemographic data (age, sex, household number, employment status, nationality, disability certificates, and long-term care status) in January 2016 and observed them until December 2016 to identify incidences of dental care utilisation as outcomes. We performed a multivariable modified Poisson regression analysis with a robust standard error estimator to calculate the incidence ratio (IR) of dental care utilisation in each variable.
RESULTS
We identified a total of 4497 recipients at risk. Among them, 839 recipients used dental care services. Younger age was associated with a higher incidence of dental care utilisation. The female recipients had a higher incidence of dental care utilisation when compared to the male ones (adjusted IR, 1.22; 95% confidence interval [CI], 1.08-1.38). Immigrant recipients had a higher incidence of dental care utilisation than the Japanese ones (IR, 1.53; 95% CI, 1.16-2.01). Recipients with mental disabilities had higher incidences than those without disability certificates (IR, 1.30; 95% CI, 1.08-1.56).
CONCLUSIONS
Non-financial sociodemographic inequities in dental care utilisation stemming from age, sex, nationality, and presence of mental disability were found despite minimum income protection and equitable financial dental service access amongst public assistance recipients in Japan. Providing targeted preventive care and treatments for dental care among underserved populations is required to tackle oral health inequities.
Topics: Aged; Dental Care; Female; Humans; Japan; Male; Middle Aged; Patient Acceptance of Health Care; Retrospective Studies; Social Welfare; Socioeconomic Factors
PubMed: 34134717
DOI: 10.1186/s12939-021-01473-8 -
Preventing Chronic Disease Jan 2018Poor oral health is associated with lost hours at work or school, which may affect a person's productivity. The objective of our study was to estimate work or school...
INTRODUCTION
Poor oral health is associated with lost hours at work or school, which may affect a person's productivity. The objective of our study was to estimate work or school hours lost to dental visits among adults aged 18 and older by the types of visits (emergency or unplanned; routine, planned, or orthodontic; or cosmetic) and to determine the factors associated with hours lost.
METHODS
We used the most recent Oral Health Supplement data, from the 2008 National Health Interview Survey (NHIS), to estimate the total hours lost at work or school for dental visits among adults in the United States. The associations of the hours lost in unplanned and planned dental visits with socioeconomic characteristics, oral health status, and affordability were calculated. We used χ tests and logistic regression to determine associations at P < .05.
RESULTS
An average of 320.8 million work or school hours were lost annually for dental care in the United States, of which 92.4 million hours were for emergency (unplanned) care (0.99 h/adult), 159.8 million for routine (planned) care or orthodontic care (1.71 h/adult), and 68.6 million for cosmetic care (0.73 h/adult). Adults with poor oral health were more likely to lose one or more hours in unplanned dental visits (OR = 5.60; 95% confidence interval [CI], 3.25-9.63) than those who reported very good oral health. Not being able to afford dental care was positively associated with more work hours lost in unplanned care (odds ratio [OR] = 2.56; 95% CI, 1.76-3.73). Compared with Hispanic adults, non-Hispanic white adults (OR = 2.09; 95% CI, 1.40-3.11) and non-Hispanic Asian adults and adults of other races/ethnicities (OR =1.91; 95% CI, 1.06-3.47) were more likely to lose any hours for planned care. Consistently, those with more than a high school education were more likely to lose any hours in planned care (OR = 1.39; 95% CI, 1.06-1.83) than those with a high school education or less.
CONCLUSIONS
Dental problems result in hours lost from work and may adversely affect a person's productivity. There is disparity in lost hours at work by race/ethnicity and dental care affordability.
Topics: Absenteeism; Adult; Aged; Attitude to Health; Dental Care; Female; Health Surveys; Humans; Logistic Models; Male; Middle Aged; Oral Health; Time Factors; United States
PubMed: 29324218
DOI: 10.5888/pcd15.170225 -
Australian Dental Journal Dec 2013While dental service use in Australia has been extensively reported, little is known about associated costs. The aim of this article was to describe the annual...
BACKGROUND
While dental service use in Australia has been extensively reported, little is known about associated costs. The aim of this article was to describe the annual individual dental expenditure of Australian adults.
METHODS
Self-reported service use and expenditure data were sourced from a sample of 3000 adults aged 30 to 61 years who were randomly selected from the electoral roll. Bivariate associations between total individual dental expenditure and out-of-pocket expenditure (fees less insurance rebate) and a range of participant characteristics were explored.
RESULTS
Response rate for the baseline questionnaire was 39.4% and of these, 53.1% responded at 12-month follow-up. The mean total dental expenditure was $702 and mean out-of-pocket expenditure was $489. Toothache was associated with total dental expenditure; adults experiencing toothache had higher median expenditure ($445) than adults who hardly ever/never had toothache ($308) (p < 0.05). Dental insurance status was not associated with total expenditure, but insured had lower median out-of-pocket expenditure ($146) than uninsured adults ($320) (p < 0.01).
CONCLUSIONS
Affordability variables typically associated with access to dental care, such as insurance status, were not associated with total expenditure, while poorer oral health was associated with higher total expenditures.
Topics: Adult; Australia; Dental Care; Female; Financing, Personal; Humans; Insurance Coverage; Insurance, Dental; Male; Middle Aged; Oral Health; Self Report; Toothache
PubMed: 24320908
DOI: 10.1111/adj.12108 -
Journal of the American Dental... Dec 2021Demand for dental services has been known to be linked closely to dental insurance and disposable income. Widespread economic uncertainty and health systems changes due...
BACKGROUND
Demand for dental services has been known to be linked closely to dental insurance and disposable income. Widespread economic uncertainty and health systems changes due to COVID-19 thus may have a significant impact on dental care use.
METHODS
Using deidentified dental practice management data from 2019 and 2020, the authors observed variations in dental care use among insured patients since the COVID-19 outbreak (during the period of practice closure and after the reopening) by patient age, procedure type, insurance type, practice size, geographic area, and reopening status. The authors examined whether the rebound in procedure volumes at dental practices can be explained by county-level characteristics using hierarchical regression models.
RESULTS
Although dental care use among privately insured patients fully rebounded by August 2020, use still remained lower than the prepandemic level by 7.54% among the publicly insured population. Demand for teledentistry increased 60-fold during practice closure. Geographic characteristics-such as median household income, percentages of rural or Black populations, and dental care professional shortage designations-were associated significantly with the number of procedures performed at dental practices.
CONCLUSIONS
As a result of COVID-19, dental practices experienced substantial decreases in procedure volume, particularly among patients covered by public insurance or residing in underserved areas.
PRACTICAL IMPLICATIONS
During economic downturns, state health officials should be encouraged to adopt policies to expand access to oral health care for vulnerable populations via oral health promotion strategies and increasing the supply of dentists or midlevel dental care providers in underserved areas.
Topics: COVID-19; Dental Care; Health Services Accessibility; Humans; SARS-CoV-2; United States
PubMed: 34656295
DOI: 10.1016/j.adaj.2021.07.002 -
PloS One 2016This study explored catastrophic health expenditure in China, due to out-of-pocket payments for dental care, and its associated individual- and contextual-level factors....
This study explored catastrophic health expenditure in China, due to out-of-pocket payments for dental care, and its associated individual- and contextual-level factors. We pooled data from 31,566 adults who participated in the third National Oral Health Survey with province-level data from different sources. We defined catastrophic dental health expenditure (CDHE) as payments for dental services and/or medication for dental problems during the last year that exceeded the 10% and 20% of the household income. The association of individual and contextual factors with catastrophic dental health expenditure was evaluated using two-level logistic regression models with individuals nested within provinces. Socioeconomic position (education and household income), household size and dental status (pain in teeth or mouth and number of teeth) were the individual-level factors associated with CDHE among the full sample of participants; and, also, among those who used dental services in the past year. Greater gross domestic product per capita was the only contextual factor associated with CDHE, and only at the lower income threshold. This study shows that out-of-pocket expenses for dental services may put a considerable, and unnecessary, burden on households' finances. Our findings also help characterise those households more likely to face catastrophic expenditure on health if they have to pay for dental services.
Topics: Adolescent; Adult; Aged; Catastrophic Illness; Child; Child, Preschool; China; Cost of Illness; Dental Care; Dental Health Surveys; Epidemiologic Factors; Female; Financing, Personal; Health Expenditures; Humans; Male; Middle Aged; Oral Health; Socioeconomic Factors; Young Adult
PubMed: 27977756
DOI: 10.1371/journal.pone.0168341 -
International Journal of Environmental... May 2022Dental care for hospitalized patients can improve nutritional status and feeding function while reducing complications. However, such care in Japan is not uniformly...
Dental care for hospitalized patients can improve nutritional status and feeding function while reducing complications. However, such care in Japan is not uniformly provided. This investigation examined the presence and characteristics of hospitals where dentists work and the collaboration between medical and dental teams. This cross-sectional study involves 7205 hospitals using the administrative reports on the Hospital Bed Function of 2018. Indicators described were the proportion of hospitals employing dentists, those providing perioperative oral care, and those with a nutrition support team (NST) that included dentists. A two-level logistic regression model was performed using hospital-based and secondary medical area-based factors to identify factors associated with hospitals employing dentists and dental care services. Some hospitals had poor medical and dental collaboration, even those with dentists, and no-dentist hospitals had rare medical and dental collaboration. Factors positively associated with hospitals that employed dentists were diagnosis-procedure-combination-hospital types, the Japanese government-established hospitals compared with hospitals established by public organizations, among others. In conclusion, the present study found poor medical and dental collaboration was observed in some hospitals and that hospital type, region, and hospital founders were associated with the performance of collaborative medical and dental care.
Topics: Cross-Sectional Studies; Dental Care; Dentists; Hospitals; Humans; Japan
PubMed: 35682033
DOI: 10.3390/ijerph19116448 -
BMC Oral Health May 2018General anesthesia has been widely used in pediatric dentistry in recent years. However, there remain concerns about potential postoperative dental morbidity. The goal... (Observational Study)
Observational Study
BACKGROUND
General anesthesia has been widely used in pediatric dentistry in recent years. However, there remain concerns about potential postoperative dental morbidity. The goal of this study was to identify the frequency of postoperative dental morbidity and factors associated with such morbidity in children.
METHODS
From March 2012 to February 2013, physically and mentally healthy children receiving dental treatment under general anesthesia at the Department of Pediatric Dentistry of the Chang Gung Memorial Hospital in Taiwan were recruited. This was a prospective and observational study with different time evaluations based on structured questionnaires and interviews. Information on the patient demographics, anesthesia and dental treatment performed, and postoperative dental morbidity was collected and analyzed. Correlations between the study variables and postoperative morbidity were analyzed based on the Pearson's chi-square test. Correlations between the study variables and the scale of postoperative dental pain were analyzed using the Mann-Whitney U test.
RESULTS
Fifty-six pediatric patients participated in this study, with an average age of 3.34 ± 1.66 years (ranging from 1 to 8 years). Eighty-two percent of study participants reported postoperative dental pain, and 23% experienced postoperative dental bleeding. Both dental pain and bleeding subsided 3 days after the surgery. Dental pain was significantly associated with the total number of teeth treated, while dental bleeding, with the presence of teeth extracted. Patients' gender, age, preoperative dental pain, ASA classification, anesthesia time, and duration of the operation were not associated with postoperative dental morbidity.
CONCLUSION
Dental pain was a more common postoperative dental morbidity than bleeding. The periods when parents reported more pain in their children were the day of the operation (immediately after the procedure) followed by 1 day and 3 days after the treatment.
Topics: Anesthesia, General; Child; Child, Preschool; Dental Care for Children; Female; Humans; Infant; Male; Pain, Postoperative; Postoperative Hemorrhage; Prospective Studies
PubMed: 29747622
DOI: 10.1186/s12903-018-0545-z