Management strategies and determinants of clinical decision-makingin oroantral communication among dental practitioners.

Valuing oral health: Accomplishments and challenges

Comprehensive Analysis of Orthodontic Treatment Effects on the Oral Microbiome, Metabolome, and Associated Health Indicators

The development of appropriate communication skills by healthcare providers is central to providing quality patient-centred care. Patients can provide valuable feedback to practitioners about their clinical communication. However, in oral health care, their involvement is uncommon and instruments specific for communication in oral health care have not been available. Recently, two complementary instruments have been developed by the Faculty of Dentistry, University of Manitoba for evaluating student-clinicians' clinical communication: one for patient evaluation and one for student self-evaluation. The aim of the current study was to provide validity evidence for the scores related to the internal structure of the revised 2007 versions of these instruments in two dental clinical/education contexts, namely the Universities of Manitoba, Canada (UM) and Adelaide, Australia (UA). The proposed factor structure and loadings, and their stability across contexts were assessed using confirmatory factor analysis, and the adequacy of the internal consistency reliability of the scores was analysed using Cronbach's alpha. The factor structure of the current 2007 versions of the patient and student instruments, derived from the previously developed longer versions of these instruments, was confirmed and was consistent across the two clinical/educational contexts. A model of partial invariance provided the best fit for these data due to variations in the magnitude of the factor loadings between sites. The internal consistency reliability of scores was high with a range of 0.88-0.97. In conclusion, the current study provides preliminary evidence regarding the validity of the scores of the current 2007 instruments, in terms of the internal structure, as measuring the five factors well. Replication of the factor structure of these instrument scores with more participants at both UA and other institutions is required.

Oral health of people with dementia

This paper describes the principles of economics and their application to the promotion, protection and restoration of oral health in populations and the planning, management and delivery of oral health care. After illustrating the economic determinants of oral health, the demand for oral health care is discussed with particular reference to asymmetric information between patient and provider. The reasons for the market failure in (oral) health care and their implications for efficiency and equity are explained. We go on to describe how economic evaluation contributes to policies aimed at maximising oral health gains where resources are constrained. The behavioural aspects of patients´ demand for and dental professionals´ provision of oral health services are discussed. Finally, we outline methods for planning the dental workforce in ways that reflect system goals.

Periodontal disease is a major cause for tooth loss and adversely affects individuals' oral health and quality of life. Research shows its potential association with systemic diseases like diabetes and cardiovascular disease, and social habits such as smoking. This study explores mining potential risk factors from dental electronic health records to predict and display patients' contextualized risk for periodontal disease. We retrieved relevant risk factors from structured and unstructured data on 2,370 patients who underwent comprehensive oral examinations at the Indiana University School of Dentistry, Indianapolis, IN, USA. Predicting overall risk and displaying relationships between risk factors and their influence on the patient's oral and general health can be a powerful educational and disease management tool for patients and clinicians at the point of care.

Objective To explore the effect of the clinical scenario-based simulation communication education based on Calgary -Cambridge Guide for undergraduate nursing students. Methods Totally 87 undergraduate nursing students were enrolled and divided into the experimental group (n=44) and the control group (n=43). The experimental group received clinical scenario-based simulation communication education based on Calgary -Cambridge Guide for communication. The control group received traditional class-based education for communication. The clinical communication skills questionnaire and Communication Observing Questionnaire were administered before and after the training. The testing results of both groups were compared. Results After participating in the education project, six dimensions of clinical communication competence and the total score were significantly improved after training compared with those before training in the experimental group. After training, the experimental group was better than the control group in establishment of harmonious relationship, confirming patients' problems, efficient information transfer, validation experience and communication competence,t values were 2.64, 2.32, 2.19, 2.20 and 4.36,P< 0.05. In testing of integrated cases, scores of six aspects such as case design, information collection, explaining behavior, relationship development, conflict coordination and service behavior in the experimental group were significantly higher than those of the control group,t values were 2.15, 2.10, 3.26, 2.84, 2.14 and 2.61,P<0.05. Conclusions The clinical scenario -based simulation education based on the Calgary-Cambridge Guide can improve communication competence of nursing students. Key words: Teaching; Students, nursing; Communication; Scenario-based simulation

In this research, a comparative analysis of results of investigations involving different human populations, in terms of a relation between the oral cavity health and the species composition of mouth microbiota is reported. The purpose of this analysis was to identify and assess microorganisms that could cause health complications in patients with neoplasm requiring dental problem-related surgical management. The patients with the oral cancer surgically treated and those without neoplasm were assessed for their oral health: status of teeth, gingiva, periodontium, and occurrence of inflammatory processes. From each patient, microorganisms isolated of periodontium, dental plaque, and dental pocket swabs were identified in wet and stained microscopic preparations; standard microbiology in vitro techniques were also applied to determine the fungal and bacterial strains. The comparative analysis of results of direct microscopic examinations and in vitro cultures assessment indicated significant differences in prevalences of fungi, parasitic oral protozoans and bacteriae in particular patient’s groups. Yeast-like fungi belonging to Candida genus, mostly of C. albicans group, were identified in 93.75% patients with the oral cancer, while in 25% of individuals assessed without neoplasm. E. gingivalis amoebae were only found in 12.5% patients with the serious disease; no trichomonads were detected in all patients analyzed. Among bacteria species, potentially pathogenic Enterobacteriaceae were found in the patients with oral cancer. The pronounced shift in the microbiota species composition in the patients who needed prolonged treatment due to oral cavity cancer, compared to other generally healthy persons has been showed in this analysis.

In November 2022, the World Health Organization (WHO) launched the first Global Oral Health Status Report (GOHSR) that describes the status of oral health care in the 195 member states. In the present editorial, we summarize the key findings of the GOHSR report and discuss the successes and pitfalls of the suggested remedy strategies. The WHO GOHSR report that is available online was used to summarize and discuss in the present editorial. The report highlights that globally close to 3.5 billion people suffer from oral diseases, with South-East Asian and Western Pacific countries having the highest caseloads. Key issues that have led to the unproportionally high-rise in the caseloads include political, socio-economic, familial, and historical experiences of the communities, ever-growing power, and sophistication of targeted commercial advertisements, negligent attitude of the policy planners and insurance companies, and lack of funding in oral health research and instrumentalization of proper surveillance tools. Global strategies for improving dental health needs to be tailored for each country given the logistical and financial challenges with self-care and regular dental hygiene proving to be the most effective factors in preventing dental diseases.

Purpose: Atraumatic restorative treatment (ART) is a treatment technique that emphasizes maximum healthy tooth structure preservation and enamel remineralization. It has been a widely accepted technique worldwide in the management of dental caries. However, there is limited evidence data available on familiarity with ART technique amongst general dental practitioners (GDPs) of Riyadh, KSA. This study was conducted to assess the knowledge and attitude toward ART amongst GDPs of this region. Materials and Methods: A cross-sectional survey-based study was conducted between March 2020 to May 2020 among GDPs of Riyadh, KSA using a self-administered validated questionnaire. The structure of the questionnaire was based on literary research. Two-hundred and seventy-four GDPs were approached to participate in this study. Data were analyzed using SPSS version 21. A Chi-square test was performed to analyze a correlation between the level of knowledge about ART and gender and time since graduation (years) with a significance level set at p ≤ 0.05. Results: A total of 199 questionnaires were observed to be legible with an overall response rate of 72.6%. More than 90% of study participants were aware of ART and the majority of them (74.9%) claimed that their knowledge regarding ART was achieved during graduation. The variables ART reduces dental anxiety, ART is not used in teeth with exposed pulp, and ART is a definitive restorative treatment that was observed as statistically different (p ≤ 0.05) concerning working experience. Whereas, Composite resins or temporary fillings can be used in ART was also found statistically different among gender (p ≤ 0.05). Conclusion: GDPs have sufficient knowledge and a positive attitude towards ART. However, GDPs lack knowledge of ART related to practicing this treatment approach in a clinical setting.

Aim: The aim of this study was to assess the knowledge and attitude of general dental practitioners (GDPs) toward performing the proper standards of care while managing patients undergoing endodontic treatment in Saudi Arabia. Materials and Methods: An e-questionnaire was distributed among GDPs in Saudi Arabia (n = 650). The e-questionnaire questions covered the assessment of knowledge, attitude, and performance of GDPs toward practicing the proper standards of endodontic treatment in their clinic. Data were analyzed using SPSS version 22, and the relationships between categorical variables were established using Chi-square test. Results: Most of the participants reported obtaining full medical history before root canal treatment (RCT, 82.3%; P Conclusions: Our data show a clear deficiency in the standards of care provided by GDPs when performing RCT in Saudi Arabia. We hope that this publication will help highlight key areas where lack of knowledge and poor attitude exist while performing RCT by the GDPs in Saudi, thereby helping to raise treatment standards and improve treatment outcomes.

ABSTRACTBackground: Oral health affects quality of life and is linked to overall health. Enhanced oral health research is needed in low- and middle-income countries to develop strategies that reduce the burden of oral disease, improve oral health and inform oral health workforce and infrastructure development decisions.Objective: To implement the first National Oral Health Survey of Rwanda to assess the oral disease burden and inform oral health promotion strategies.Methods: In this cross-sectional study, sample size and site selection were based on the World Health Organization (WHO) Oral Health Surveys Pathfinder stratified cluster methodologies. Randomly selected 15 sites included 2 in the capital city, 2 other urban centers and 11 rural locations representing all provinces and rural/urban population distribution. A minimum of 125 individuals from each of 5 age groups were included at each site. A Computer Assisted Personal Instrument (CAPI) was developed to administer the study instrument.Results: Nearly two-thirds (64.9%) of the 2097 participants had caries experience and 54.3% had untreated caries. Among adults 20 years of age and older, 32.4% had substantial oral debris and 60.0% had calculus. A majority (70.6%) had never visited an oral health provider. Quality-of-life challenges due to oral diseases/conditions including pain, difficulty chewing, self-consciousness, and difficulty participating in usual activities was reported at 63.9%, 42.2% 36.2%, 35.4% respectively.Conclusion: The first National Oral Health Survey of Rwanda was a collaboration of the Ministry of Health of Rwanda, the University of Rwanda Schools of Dentistry and Public Health, the Rwanda Dental Surgeons and Dental (Therapists) Associations, and Tufts University and Harvard University Schools of Dental Medicine. The international effort contributed to building oral health research capacity and resulted in a national oral health database of oral disease burden. This information is essential for developing oral disease prevention and management strategies as well as oral health workforce and infrastructure.

Aim : In addition to clinical knowledge, communication skills and sovereign decision making, a good doctor is also expected to posses Aim: In addition to clinical knowledge, communication skills and sovereign decision making, a good doctor is also expected to posses professional values, including the ability to establish empathic relationships with patients. The purpose of the study was to identify the reasons that lead students to choose the study of dental medicine/medicine, and determine the level of emphaty in relation to the choice of study in the first year students of the Faculty of Medicine in Ljubljana. Methods : For the needs of the research we developed a questionnaire, which included basic data on students, their reasons for choosing the study of medicine or dental medicine and the Jefferson scale of empathy–version for students (JSE-S version with a modified scale with 16 arguments). The questionnaire was forwarded to all 227 first-year students in the academic year 2014/15 at the completion of the Communication course. Results : The study involved a total of 216 (response 95.2 %) students; 158 medical students and 58 students of dental medicine. Among the reasons for enrollment to the Medical Faculty, the highest proportion of medical students indicated a desire to help people (85.3 %), a desire to improve human health (78.8 %) and a desire to work with people (64.7 %); 28.8 % of the medical students chose the argument „because employment is guarantee”, while 14.1 % of medical students believed the argument „because it is well paid“ was the reason to choose the study of medicine. The students of dental medicine most often choose the following answers: a desire to help people (87.9 %), a desire to improve human health (74.1 %), followed by a desire to work with people (65.5 %). The argument “because employment is guaranteed” convinced 50 % of the students, and the argument “because the pay is good” convinced 46.6 %. Three claims were significantly associated with self-assessment of empathic stance: the arguments “because I want to help people” (91.08 ± 10.65 vs. 86.61 ± 12.56; p = 0.037) and »because I want to work with people” (91.82 ± 10.18 vs. 87.90 ± 12.11; p = 0.012) were associated with a greater self-assessmentwhile the argument “because the pay is good” (91.36 ± 11.41 vs. 87.29 ± 9.01; p = 0.023) was associated with a lower self-assessment of empathic stance. Conclusion : Students who want to help people have higher level of self-assessment of empathic stance. The task of a medical faculty is to ensure that students whose choice of study is based on their humanist values are encouraged to have those values further developed and put into practice during their study.

The purpose of this paper is to guide the understanding of preventive oral health measures to improve overall health in older adults. Oral health is a key indicator of overall health, well-being, and quality of life, yet, oral health status among older adults has remained alarmingly poor. Common oral conditions include dental decay, periodontal disease, tooth loss, dry mouth, and malodor. The connection between oral and systemic health has been established and this relationship is affected by various interrelated factors which pose many threats to older adults’ health. Documented factors may range from chronic diseases, use of medications, individual lifestyle, decline in cognitive and physical functioning, access to care, to several social indicators of oral health. Dental disease and poor oral health are largely preventable through healthy lifestyle behaviors and effective management of chronic systemic diseases. A collaborative team approach is necessary to ensure that older adults receive comprehensive care appropriate for their complex medical and dental needs.

ABSTRACTIntroduction:Oral health is a critical concern for elderly patients, especially those with cognitive impairment residing in long-term care facilities. Cognitive decline often leads to difficulties in maintaining oral hygiene, resulting in poor oral health outcomes. This study aims to evaluate the oral health challenges faced by these individuals and propose management strategies to address these issues.Methods:The study employed a systematic literature review method, focusing on articles from PubMed and related databases. Three key parameters were assessed: (1) oral health status of elderly patients with cognitive impairment, (2) the role of caregivers in oral hygiene maintenance, and (3) strategies for improving oral health outcomes.Results:The findings revealed a significant correlation between cognitive impairment and deteriorating oral health. The use of caregiver-assisted interventions and regular dental check-ups improved oral health outcomes. Two statistical tables are included to highlight the impact of interventions.Conclusion:Effective management of oral health in cognitively impaired elderly patients requires collaborative efforts between healthcare providers, caregivers, and dental professionals. Timely interventions can significantly enhance oral health outcomes.