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Journal of Orthodontics Mar 2023Among non-gender conforming populations, there is a subgroup of individuals who experience significant distress associated with their gender incongruity, commonly...
Among non-gender conforming populations, there is a subgroup of individuals who experience significant distress associated with their gender incongruity, commonly referred to as gender dysphoria (GD). In the UK, there is a recognised pathway for individuals experiencing GD. This has traditionally been initiated by a referral to the Gender Identity Development Service (GIDS) for children and adolescents or to a Gender Identity Clinic (GIC) for adults. This pathway can potentially involve several specialties and treatment modalities, including the prescription of various hormones. It is important for orthodontists to have an understanding of this field, as well as the potential treatment modalities, so that they can support this often marginalised patient group. Inherent differences between male and female facial features may also lead patients with GD to present to orthodontists, wishing to change their facial appearance. This article highlights the current national pathway for GD and the orthodontic considerations for these individuals.
Topics: Child; Adult; Adolescent; Humans; Male; Female; Gender Identity; Gender Dysphoria; Orthodontists
PubMed: 36217902
DOI: 10.1177/14653125221131062 -
TheScientificWorldJournal 2014Age-related changes of jaws and soft tissue profile are important both for orthodontists and general dentists. Mouth profile is the area which is manipulated during... (Review)
Review
Age-related changes of jaws and soft tissue profile are important both for orthodontists and general dentists. Mouth profile is the area which is manipulated during dental treatment. These changes should be planned in accordance with other components of facial profile to achieve ultimate aim of structural balance, functional efficacy, and esthetic harmony. Through this paper, the authors wish to discuss age changes of the hard and soft tissues of human face which would help not only the orthodontists but also oral surgeons, prosthodontists, pedodontists, and general dentists.
Topics: Aging; Humans; Jaw; Maxilla; Smiling
PubMed: 25506064
DOI: 10.1155/2014/301501 -
Dental Press Journal of Orthodontics 2018This cross-sectional observational study was designed to assess the biosafety conducts adopted by orthodontists, and possible differences regarding training time. (Observational Study)
Observational Study
OBJECTIVE
This cross-sectional observational study was designed to assess the biosafety conducts adopted by orthodontists, and possible differences regarding training time.
METHODS
Both the application of methods for sterilization/disinfection of instruments and materials, and the use of personal protective equipment (PPE) were collected through questionnaires via e-mail.
RESULTS
The questionnaires were answered by 90 orthodontists with a mean age of 37.19 ± 9.08 years and mean training time of 13.52 ± 6.84 years. Regarding orthodontic pliers, 63.23% use an autoclave, except 1 who does not perform any procedure. All participants use autoclave to sterilize instruments, and 95.6% of respondents perform cleaning with chemicals prior to sterilization. Most of them (65.56%) use an autoclave to sterilize orthodontic bands, with some still associating disinfection methods, while few (18.89%) do nothing at all. There was a high incidence of the answer "nothing" for the methods used for elastic, accessories, bandages, metal springs, and arches. All respondents use mask and gloves in attendance, 78.92% use aprons, 58.92% use protective goggles, and 50.01% use cap. Training time significantly influenced (p = 0.003) only the use of glutaraldehyde for sterilization/disinfection of pliers.
CONCLUSIONS
The sterilization and cleaning of pliers, instruments, and bands, besides the use of PPE, received more uniform and positive responses, while other items suggest disagreements and possible failures. Only orthodontists trained for more than 13 years choose using glutaraldehyde for pliers sterilization/disinfection, the only adopted method with a significant difference in relation to training time.
Topics: Adult; Containment of Biohazards; Cross-Sectional Studies; Dental Instruments; Dental Materials; Disinfection; Humans; Orthodontists; Practice Patterns, Dentists'; Protective Clothing; Surveys and Questionnaires
PubMed: 30088568
DOI: 10.1590/2177-6709.23.3.073-079.oar -
The Angle Orthodontist Jan 2022To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those...
OBJECTIVES
To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those characteristics that are most negatively and positively rated.
MATERIALS AND METHODS
A smiling photograph of a female dental student was selected and digitally manipulated to create changes in different microesthetic parameters. These altered images were rated by the following five groups: 120 orthodontists, 45 periodontists, 49 prosthodontists, 130 general dentists, and 172 laypersons. Smile esthetics scores were calculated, and comparisons between groups were performed using the univariate general linear model.
RESULTS
The presence of black triangles between the upper incisors was the most negatively rated, and the ideal smile was the most positively rated. Significant differences were detected in the rating scores among the different study groups (P < .05). Orthodontists, prosthodontists, and general dentists scored the presence of a black triangle in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.
CONCLUSIONS
The ideal smile and that with black triangles between the upper incisors were rated as the most and the least attractive smiles, respectively. Orthodontists, prosthodontists, and general dentists scored the presence of black triangles in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive smiles, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.
Topics: Attitude of Health Personnel; Attitude to Health; Dentists; Esthetics, Dental; Female; Gingiva; Humans; Smiling
PubMed: 34520516
DOI: 10.2319/020521-108.1 -
Journal of the American Dental... Aug 2020The rise of direct-to-consumer (DTC) orthodontics has caused significant controversy among dentists and orthodontists. However, little is known about the actual harms or...
BACKGROUND
The rise of direct-to-consumer (DTC) orthodontics has caused significant controversy among dentists and orthodontists. However, little is known about the actual harms or benefits experienced by users of at-home teeth aligners.
METHODS
The authors designed a 24-item online survey to assess users' experiences with at-home aligners. The authors recruited users for 6 months (March-August 2019) on social media platforms (Instagram, Twitter) and online forums related to DTC orthodontics. A total of 470 responses were analyzed.
RESULTS
The typical respondent was a white, female millennial (23-38 years old in 2019) who purchased aligners to correct crowding. More than one-half of respondents consulted with a dentist before purchasing aligners. In those interactions, the dentist most often recommended an in-office treatment. Although most respondents (87.5%) were satisfied with DTC treatment, 6.6% had to visit their dentist due to the severity of adverse effects.
CONCLUSIONS
Although many respondents would have preferred traditional treatment from a dentist or orthodontist, they opted for DTC aligners because of cost and convenience.
PRACTICAL IMPLICATIONS
Rather than warning patients wholesale against at-home aligners, it might be more productive for dentists to have frank discussions with them about the risks and benefits. In parallel to pushing for increased accountability, it might be prudent to consider new ways of coexisting in this altered landscape, such as offering professional oversight of DTC treatments.
Topics: Adult; Dental Care; Female; Humans; Malocclusion; Orthodontics; Surveys and Questionnaires; Young Adult
PubMed: 32718492
DOI: 10.1016/j.adaj.2020.02.025 -
Children (Basel, Switzerland) Nov 2022The present study aims to define through questionnaires the frequency and the variety of accidental incidents occurring in orthodontic clinical practice among Greek...
BACKGROUND
The present study aims to define through questionnaires the frequency and the variety of accidental incidents occurring in orthodontic clinical practice among Greek practicing orthodontists.
METHODS
A questionnaire survey was conducted among orthodontists from the registry of orthodontists in Greece. The questionnaire was divided into two parts. The first part involved three questions relating to the socio-demographic status and the background of the orthodontist, and the second part concerned exclusively the frequency of accidental incidents that have occurred during clinical practice with three possible answers: never, once, more than once.
RESULTS
From the 200 initially distributed questionnaires, 124 were finally completed and sent back (response rate: 62%). The results showed that orthodontists with more years of clinical practice had faced more accidental incidents. Among the ingestion incidents caused by foreign objects, the most frequently occurring was the ingestion of elastic separators, followed by the ingestion of elastic ligatures and ingestion of hooks. The most commonly reported traumatic incidents were the trauma-lesion of the mucosa by the orthodontic wire or part of it, followed by trauma-lesion by hooks and wire ligatures. The reported number of incidents with further complications and with patients referred to an emergency room was very low.
CONCLUSIONS
The results of the present study determined a high frequency of accidental incidents among Greek orthodontists. The longer clinical experience was accompanied by more accidental incidents. Orthodontists, like other health professionals, must learn and continuously update their knowledge regarding the management protocols of medical emergencies.
PubMed: 36553243
DOI: 10.3390/children9121801 -
Progress in Orthodontics Aug 2020The aims of this study were to survey the occurrence of acute medical situations in Dutch orthodontic practice and to examine the self-perceived competence of...
BACKGROUND
The aims of this study were to survey the occurrence of acute medical situations in Dutch orthodontic practice and to examine the self-perceived competence of orthodontists in managing acute medical emergencies.
METHODS
A self-designed questionnaire was distributed among all 149 Dutch orthodontists attending the spring meeting of the Dutch Society for Orthodontists. The questionnaire was divided into three parts, addressing background information of the orthodontist, precautions against and experiences in acute medical situations, and self-perceived competence of nine common medical emergencies. The statistical analysis was performed using the chi-square test and a multiple logistic regression analysis.
RESULTS
The response rate was 74.5% (105 out of 149). The male to female ratio in this population was 55:50. Mean age of all participants was 46.9 years (SD 10.4 years) with on average 16.7 years of working experience (SD 10.6 years). The most common medical emergency reported by Dutch orthodontists was vasovagal collapse (n = 219), followed by acute allergic reaction (n = 163) and hyperventilation (n = 83). On average, 75% (n = 79) of the orthodontists felt competent to handle any acute medical situation with an average occurrence of 0.36 acute medical emergencies per orthodontist per year. Male participants were more likely to send patients towards the emergency department (p = 0.049). Moreover, a statistically significant negative correlation was observed between self-perceived competence handling hypoglycemia and years of clinical experience. The longer orthodontists were clinically active, the less competent they felt when encountered with a hypoglycemia (p = 0.031).
CONCLUSIONS
Medical emergencies may be rare but challenging occurrences in the orthodontic practice. It is strongly recommended for all orthodontists and supporting staff to be trained regularly in the management of medical emergencies and to possess up-to-date evidence-based knowledge. Familiarity with and availability of appropriate drugs and equipment are deemed essential to the management of acute medical emergencies that may arise in the orthodontic practice.
Topics: Emergencies; Female; Humans; Male; Middle Aged; Orthodontists; Surveys and Questionnaires
PubMed: 32776156
DOI: 10.1186/s40510-020-00327-3 -
International Journal of Environmental... Apr 2023The advent of new technology has caused significant changes in the field of dentistry, enabling dentists and orthodontists to provide more efficient and effective...
The advent of new technology has caused significant changes in the field of dentistry, enabling dentists and orthodontists to provide more efficient and effective treatments to their patients [...].
Topics: Humans; Dentists; Public Health; Orthodontists; Dental Care; Technology
PubMed: 37047978
DOI: 10.3390/ijerph20075364 -
Dental Press Journal of Orthodontics 2022The relationship between temporomandibular disorders (TMDs) and orthodontic treatment/malocclusion has changed from a cause-and-effect association to an idea without...
INTRODUCTION
The relationship between temporomandibular disorders (TMDs) and orthodontic treatment/malocclusion has changed from a cause-and-effect association to an idea without sufficient evidence.
OBJECTIVE
This survey was designed to assess the beliefs of different disciplines - orthodontists, oral surgeons, and oral medicine specialists - on the relationship between TMDs and orthodontic treatment, with regard to treatment, prevention and etiology of TMDs.
METHOD
A survey in the form of questionnaire was designed and distributed to 180 orthodontists, 193 oral surgeons and 125 oral medicine specialists actively involved in treating TMDs. The questionnaire aimed to collect basic information about each participant and their beliefs, and clinical management of patients with TMDs.
RESULTS
Halve of the responding orthodontists and most of the oral surgeons (69.9%) were male participants, whereas the majority of oral medicine specialists (83.3%) were female respondents. The participants' age ranged from 29 to 58 years. The majority of orthodontists believes that there is no relationship between orthodontic treatment and TMDs, and that orthodontic treatment does not provoke TMDs or prevent the onset of the disorder. However, oral surgeons and oral medicine specialists have different and conflicting opinions. Most surgeons tended to treat those patients, while most of the other two disciplines tended to seek an interdisciplinary approach. Chi-square test was done to find an association between the referral status and specialists' experience, and to compare between the different disciplines' belief.
CONCLUSIONS
Orthodontist's beliefs were in accordance with the scientific evidence, whereas most oral surgeons and oral medicine specialist believed that orthodontic treatment may provoke TMDs. Therefore, continuing program series development is important to embrace the concept of the multidisciplinary team approach and improve the health care and quality of life for those patients.
Topics: Adult; Female; Humans; Male; Malocclusion; Middle Aged; Orthodontics; Orthodontists; Quality of Life; Surveys and Questionnaires; Temporomandibular Joint Disorders
PubMed: 35416864
DOI: 10.1590/2177-6709.27.1.e2220406.oar -
Pituitary Feb 2022Oro-facial manifestations of acromegaly are among the earliest signs of the disease and are reported by a significant number of patients at diagnosis. Despite this high...
PURPOSE
Oro-facial manifestations of acromegaly are among the earliest signs of the disease and are reported by a significant number of patients at diagnosis. Despite this high prevalence of acromegaly oral manifestation, dentists do not play a pivotal role in acromegaly identification and diagnosis. The aim of our study was to evaluate the ability of dentists and orthodontists in the early recognition of the oro-facial manifestations of acromegaly.
METHODS
A telematic questionnaire was administered to dentists and orthodontists. The questionnaire included photos with facial and oral-dental details and lateral teleradiography of acromegaly patients (ACRO).
RESULTS
The study included 426 participants: 220 dentists and 206 orthodontists. Upon reviewing the photos, dentists most often observed mandibular prognathism and lips projection, while orthodontists also reported the impairment of relative soft tissue. Orthodontists, who usually use photos to document patients' oral-facial characteristics, paid more attention to oral-facial impairment than dentists. During dental assessment, 90% of the participants usually evaluated tongue size and appearance, diastemas presence, and signs of sleep impairment (mainly orthodontists). Orthodontists were also more able to identify sella turcica enlargement at teleradiography. A total of 10.8% of the participants had ACRO as patients and 11.3% referred at least one patient for acromegaly suspicion.
CONCLUSION
The study highlighted dentists' strategic role in identifying ACRO. Increasing dentists' awareness about acromegaly clinical issues may improve early diagnosis, potentially resulting in an increased quality of life and decreased mortality among ACRO.
Topics: Acromegaly; Humans; Orthodontists; Quality of Life; Referral and Consultation; Surveys and Questionnaires
PubMed: 34518997
DOI: 10.1007/s11102-021-01183-y