Dental Facilities Research Articles

Aviation-Modeled Investigation of Significant Obstetric Events.

In this research, the authors attempted to ascertain whether or not the Root Cause Analysis Event Support and Engagement Team (RESET) investigates the use of U.S. Army aviation-based techniques by staff members or organizations in which serious obstetrical events have occurred. Root cause analysis (RCA), originating in the manufacturing and engineering sectors, attempts to elucidate an underlying cause of a problem. Most recently, this process has been applied to the investigation of medical error. RESET was established in order to perform centralized investigation of significant medical error within U.S. Army medical and dental treatment facilities based on request from a hospital commander or general officer. Significant obstetric events are high profile, discussed in multiple safety forums, and an area of close RESET focus. Yet it is unclear if RESET investigates the use of aviation-based techniques by staff and/or organizations involved in serious obstetrical events. Therefore the present survey study was conducted. A structured, anonymous, voluntary survey was fielded to RESET staff in order to assess whether or not the RESET investigates the use of aviation-based techniques by staff members or organizations in which serious obstetrical events have occurred. Five of six members of this small team completed the survey. Prebriefs, debriefs, and checklist use were consistently investigated. The employment of a sterile cockpit, first-name introductions, annual check ride, and emergency procedure rehearsal were infrequently investigated. Obstetric RESET investigations inconsistently ascertain whether or not some of the aviation-based techniques are utilized by staff members or organizations in which serious obstetrical events have occurred. Standardization of investigative procedures and education directed at under-investigated practices may optimize medical investigation using proven tenets of an aviation-based approach.

Mapping the geographic availability of public dental services in Uganda relative to ruralization and poverty of the population

Objectives: Uganda is a low-income country faced with a number of challenges in health service delivery, including oral health services. Despite reports of an increased prevalence of oral diseases, they are afforded less priority, amidst competing priorities of infectious and other non-communicable diseases. Oral health-care services are offered free-of-charge in public health facilities. The majority of the Ugandan population live in rural areas. This would imply that public dental services should be more widely distributed in rural areas to meet the needs of the majority population. This study, therefore, aimed to determine the geographic distribution of public dental services relative to poverty and ruralization of the Ugandan population. Materials and Methods: All 112 districts in Uganda were to be surveyed for this study using an ecological design that incorporated the Ugandan population with socio-demographics obtained from the latest Uganda National Housing and Population Census and poverty data from the national Poverty Status Report 2014. The data from the districts were on the availability of public dental services and the physical location of these dental facilities. Overall, 182 public facilities were included in the study. The geographic location of public dental clinics was established using open-data sources. The data on ruralization were aggregated at the district level and that on poverty at the subregion level. Spatial analysis was done using geographic information science software, Quantum Geographic Information System. Results: The total Ugandan population was 34 million. Overall, 19.7% of the population was poor with the highest proportion located in the North and East of Uganda. Urban-rural characteristics varied across the country. Information on the 182 public dental clinics was collected from 97 of the 112 Ugandan districts. Among the 97 districts, 15% had no public clinic and were located in the poorest Ugandan regions. Among the 40 districts containing over 90% of the rural population, 20% had none, and 55% only had one dental clinic. In general, service availability reduced as the proportion of the rural and poor population increased. Conclusion: The spatial analysis presents an avenue to inform and guide the decision making and planning process by identifying geographic areas with access gaps relative to population socio-demographic characteristics. This study revealed that public dental services were least available for the poorest and rural populations, and yet they are already vulnerable to other access barriers. It is recommended that efforts should be made by health planners and policymakers to avert the health inequalities presented by inequitable access.

Innovations in pre‐doctoral dental education: Influencing attitudes and opinions about patients with substance use disorder

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based model for managing patients with substance use disorders (SUD). Historically, SUD were seen as a criminal issue and access to treatment was limited, but that paradigm is shifting and substance abuse is now being recognized as a disease state and the management of patients with SUD is increasingly within the healthcare system starting with primary healthcare settings including dental facilities. In a new training initiative, first-year dental students (DDS1) attended a 90-minute SBIRT training. An Attitudes and Opinion Survey (AOS) consisting of 8 questions that separately assesses DDS1 attitudes toward alcohol and drug use disorders was utilized to evaluate the training. Assenting DDS1 anonymously completed the AOS before and following the training. Over 3 years, we analyzed changes in the AOS of 230 DDS1 using Chi-squared test for bivariate comparison. We then applied a Bonferroni correction to the P-values. Response rate was 95.5%. The SBIRT training improved DDS1 attitudes and opinions toward patients with SUD with respect to all AOS questions. There was a statistically significant improvement (P < 0.003) in DDS1 attitudes and opinions with respect to whether other patients care suffers because of time and resources spent on patients with SUD and whether the SBIRT training provided adequate education to prepare DDS1 to manage patients with SUD. SBIRT training is relevant to dental education. It fills an important educational gap and is a suitable model for other dental schools.

Process and outcome evaluation of the Oral Health Improvement through Outreach (OHIO) Project.

The purpose of this study was to longitudinally evaluate an ongoing primary objective of the Oral Health Improvement through Outreach (OHIO) Project Program, which is to build strong partnerships between The Ohio State University (OSU) College of Dentistry (CoD) and community-based dental facilities and increase access to dental care for underserved populations. Upon exempt Institutional Review Board approval (2004H0067), a longitudinal evaluation study was conducted of 15 years of the OHIO Project during the 2004-2019 academic years. Descriptive statistics were used to evaluate the OHIO Project using process and outcome evaluation methods. The data from 107,510 patients were analyzed. Process evaluation revealed the OHIO Project has been reaching the target population of communities with dental care needs and limited access, as evidenced by the main methods of patient payment/non-payment and the quantity of completed restorative/oral surgery procedures. Outcome evaluation revealed the OHIO Project has been building strong partnerships between the CoD and communities to address dental care needs and improve access, as evidenced by the increased number and distribution of the community-based facilities throughout Ohio. Process and outcome evaluation revealed the OHIO Project has been meeting its primary goal of building strong partnerships between the CoD and OHIO Project community-based facilities to address the basic dental needs and increase access for Ohio residents. Future research is needed to evaluate the dental student impact of providing community-based care.

Dental Caries assessment of Rural Population of Sindh by DMFT (Decayed missing and filled teeth) Index.

Dental caries is known as an infectious disease of microbiologic origin. Streptococcus mutans is established to be the main causative agent, which leads to localized dissolution and destruction of the calcified tissues. It is the most prevalent oral disease which shows an inevitable geographic dissimilarity, socioeconomic patterns and severity around the globe. The role of Fluoride in Caries prevention is extremely imperative as it is substance which relates strongly in the caries process and favours remineralisation of the affected tooth after the bacterial attack has ceased. Objectives: The objective of this study was to record dental caries experience in rural population of district Matiari Sindh. Study Design: Descriptive Cross Sectional. Setting: Camp of Taluka Hospital Matiari. Period: From the period of one year from Jan-Dec 2018. Material &amp; Methods: A total of 102 visitants of camp were included in the study with caries evaluation of around 2569 teeth. Dental Caries status was checked by using DMFT index as recommended by WHO for oral health surveys. Results: Mean DMFT was found to be 0.07±. 146 (5.75%) teeth were found decayed, 43 (1.7%) were found missing due to caries, No tooth was found restored while 2378 (92.6%) were found to be in sound condition. Conclusion: Access to Oral and Dental healthcare services found to be minimal may be due to inadequate Dental facilities and lack of Dental professionals in rural areas of Sindh province.

Dealing with dental patients during and after coronavirus disease 2019 outbreak

The coronavirus disease 2019 (COVID-19) outbreak was declared a pandemic on March 11, 2020. Several dental care facilities in affected countries have been completely closed or have been only providing minimal treatment for emergency cases. However, several facilities in some affected countries are still providing regular dental treatment. This can, in part, be a result of the lack of universal protocol or guidelines regulating the dental care provision during such a pandemic. This lack of guidelines can, on the one hand, increase the nosocomial COVID-19 spread through dental health care facilities, and on the other hand, deprive patients' in need of the required urgent dental care. Moreover, ceasing dental care provision during such a period will incense the burden on hospital emergency departments already struggle with the pandemic. This review article is aimed to develop guidelines for dental patients' management during and after the COVID-19 pandemic.

Dental Risks and Precautions during COVID-19 Pandemic: A Systematic Review.

ABSTRACTObjective:To provide dentists and dental team with insights concerning risk and precautions during COVID-19 outbreak crisis as it would help in decision making among dental community.Materials and Methods:A comprehensive review of all English and non-English articles was carried out using the available CORD-19 dataset with MEDLINE via PubMed, Cochrane library, Google Scholar and ScienceDirect databases. The study included all articles that matched the search terms.Results:A total of 353 were retrieved, of which 13 articles were reviewed comprehensively. Studies included in this systematic review emphasized on reinforcing strict infection control measures and minimizing human-to-human contact during COVID-19 outbreak. All surfaces in operatory room including waiting area need adequate ventilation and disinfection. Dental patients need to be screened using COVID-19 targeted questions as well as measuring their body temperature. Restricting dental treatments to only emergency cases and rescheduling all routine visits is advised with careful attention to minimize aerosol generation and following highest level of personal protection when treating COVID-19 confirmed cases. Dental offices need to establish a standard protocol of case reporting and referral to other well-prepared facilities. Lastly, online platforms are beneficial tools in providing psychological support to distressed dentists, dental team and dental patients and educating public during COVID-19 crisis.Conclusion:Dental team need to follow strict infection control measures and minimize aerosol generation during COVID-19 outbreak. It is the responsibility of dental care workers to keep themselves informed and ensure safety and control transmission within dental facilities. Further research is required.

Teledentistry; Escalating Horizon in COVID-19

Teledentistry has emerged as an efficacious technique of extending oral care services to the patients remotely assisted by the sophisticated technology of telecommunication. Over time, teledentistry has established itself as a convenient, labour saving, time effective and an economical alternative alongside bridging the inequality of the available services between the urban and rural demographics. This review explores the evolution and applications of teledentistry and how it has been instrumental in attending to the needs of patients specifically in times of a roaring pandemic where inpatient examination and treatment in a dental facility was not feasible or stalled as a precautionary measure. Not only does it assists in attending to emergencies and routine consults but also in screening and reporting of any plausible cases with COVID infection.

Dental care access for dystrophic epidermolysis bullosae children in Russian Federation

To assess the quality and access to dental care for children with dystrophic epidermolysis bullosae (DEB) living in RF regions. 181 (55.9%) out of 324 DEB children registered in RF were enrolled in the study. The parents filled the survey assessing primary examination time, annual number of visits, quality of dental care and dental facilities, as well as access to urgent dental care, dental care under general anesthesia and dental caries prevention. 37.6% of children do not have regular dental examinations. Among these only in 13 cases the parents do not understand the importance of regular dental care and caries prevention, while in 55 cases the reasons are the absence of pediatric dentist and the refusal of dentist to perform examination and treatment. Only parents of 72 (40%) from 181 children think then can get proper dental care at the place of residence. Parents of 103 children stated the presence of facilities for dental treatment under general anesthesia at the place of residence but 40 of them could not have the access to it in case of urgent dental care need. In 61 cases (33.7%) the family must move to federal centers to receive urgent dental care and almost one third of children (51 from 181) receive any kind of dental treatment in federal institutions in Moscow. A large part of children with DEB living in distant RF regions have no access even to urgent dental care with cases of dentist's refusal to perform dental examination and treatment because of 'distressing' visual aspect of some DEB patients. This leads to the necessity for the family to move to state federal centers to receive dental treatment which for the financial reasons makes impossible proper frequency of dental examinations and preventive measures resulting in many cases of advanced oral pathology where multiply teeth extractions are needed.

Impact of pandemic COVID-19 on dental services: A review

COVID-19 has emerged as a pandemic outbreak, and it has become a virulent disease. Coronavirus belongs to the family of enveloped, single-stranded, positive-strand RNA viruses classified under Nidovirales order. Dentists are at very high risk to get exposed to the virus due to direct contact with the oral cavity and aerosol produced by the salivary droplets of patients. Hence, several dental care facilities in the affected nations were completely closed or have been presenting minimum remedy for emergency cases. This assessment article aimed to provide a brief knowledge about the origin, mode of transmission, stages of spread of the disease, effect of the outbreak of the disease on dentistry, and patient management and prevention guidelines to be followed by dental practitioners.

A proposed classification for orthodontic practice in India

Aim and Background:Dental practice is blooming in India with many conventional and advanced setups providing orthodontic services. Orthodontics as a specialty has come to the forefront, as awareness of orthodontic therapy has increased. It is important to classify any health practice to understand, compare, and research the implications of various organizational setups in the country. It should possess the ability to chart the similarities and distinctions between different setups for ease of communication and patient awareness. Presently, there is no defined system that classifies the type of orthodontic practice in the country. Lack of any classification of the organizational setups makes it impossible to categorize or compare the various setups for research purpose, recognition of the dental personnel and facilities provided. This article aims to propose a simple 3-stage classification to orthodontic practices in India.Technique:Three-stage classification of orthodontic practice in group, type, and subtype gives a comprehensive coverage to all types of orthodontic setups in India. The group explains the center in three levels based on the armamentarium and services provided. The type explains the center in five levels based on ownership and scope of providing care. Finally, the subtype explains the availability and qualification of the operating personnel.Conclusion and Significance:This classification aims to provide a tool for communication and recording the levels of orthodontic care possible at any given center. It also facilitates continued study of its impact on practice efficacy and patient awareness.

Biological and social aspects of Coronavirus Disease 2019 (COVID-19) related to oral health.

The expansion of coronavirus disease 2019 (COVID-19) throughout the world has alarmed all health professionals. Especially in dentistry, there is a growing concern due to it's high virulence and routes of transmission through saliva aerosols. The virus keeps viable on air for at least 3 hours and on plastic and stainless-steel surfaces up to 72 hours. In this sense, dental offices, both in the public and private sectors, are high-risk settings of cross infection among patients, dentists and health professionals in the clinical environment (including hospital's intensive dental care facilities). This manuscript aims to compile current available evidence on prevention strategies for dental professionals. Besides, we briefly describe promising treatment strategies recognized until this moment. The purpose is to clarify dental practitioners about the virus history and microbiology, besides guiding on how to proceed during emergency consultations based on international documents. Dentists should consider that a substantial number of individuals (including children) who do not show any signs and symptoms of COVID-19 may be infected and can disseminate the virus. Currently, there is no effective treatment and fast diagnosis is still a challenge. All elective dental treatments and non-essential procedures should be postponed, keeping only urgent and emergency visits to the dental office. The use of teledentistry (phone calls, text messages) is a very promising tool to keep contact with the patient without being at risk of infection.

Initial management of dental trauma: musts, shoulds, and cans.

When dental trauma occurs, initial management on the day of injury has a determining influence on healing and thus on the prognosis of the affected teeth. Improper, delayed, and/or inconsistent treatment often has far-reaching consequences that cannot be reversed later, even with great effort, especially in children and adolescents. In most cases, it is unrealistic or impossible for the patient to get to a specialized dental trauma facility in time. Therefore, it is every dental practitioner's duty to provide adequate initial diagnosis and treatment of dental trauma at their dental practice, even if they do not have routine experience in this area. This article serves as a guide to the initial management of dental trauma. It utilizes a three-tiered approach to illustrate which initial management measures are absolutely essential (MUSTS), which should ideally be performed (SHOULDS), and which are not top priorities but can be performed (CANS) if the necessary time, training and experience, and equipment and facilities are available. For further treatment, dental practitioners should realistically assess the limits of their ability to treat complex dental trauma cases and, if necessary, they should refer the patient to a specialist or specialized treatment center. (Quintessence Int 2020;51:763-774; doi: 10.3290/j.qi.a45103; modified from a previously published article (in German) Quintessenz 2019;70(9):990-1002).

Tooth loss and predictors of tooth extractions due to dental caries among adults: A multi-center study in North-eastern Nigeria

Background: Tooth loss and the level of edentulism may be an indication of a populations' oral health. The aim of this study was to evaluate the contribution of dental caries to tooth loss, as well as its predictors among adults in North-eastern Nigeria. Methods: A cross-sectional survey over a 2-month period of all adult patients who had tooth extractions in three dental centers across North-eastern Nigeria. Data on sociodemographics (age, gender, and level of education), history, and examination findings were collected with a preformed questionnaire to include the frequency and reasons for the use of dental facilities, previous tooth extractions and reason for extractions, missing teeth, and present diagnosis for the teeth to be extracted. Bivariate and multivariate analyses were used to determine the association and relationships between missing teeth, extractions due to caries and population variables. Results: The prevalence of preextraction tooth loss was 37.98% with a mean tooth loss of 3.05 ± 3.15 per participant, 2.24 ± 1.46 among the 35–44 years old and highest (10.08 ± 8.02) among the 65–74 years old participants. Age was the single significant predictor of tooth loss (β = 0.428, P

Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China

Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the associated factors for Chinese dentists experiencing medical emergencies.Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December 2018. Demographic information of the dentists and the characteristics of medical emergencies they encountered were collected and analyzed. The associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression model.Results A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental clinics. Among them, 85.0% reported that they had encountered medical emergencies, and 35.5% had encountered at least twice. Syncope (35.9%) and hypoglycemia (30.3%) were the most common reported medical emergencies. Medical emergencies were most likely to occur during local anesthesia (49.9%), out-patient oral surgery (25.9%), and root canal treatment (11.3%). There were 6 patients (0.2%) died in emergencies. 84.0% dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life Support. Longer practicing time (10-15 years) (OR=0.59, 95% CI: 0.41-0.85, P=0.004), working in private dental facilities (OR=1.69, 95% CI: 1.20-2.38, P=0.003) were associated with an increased risk of experiencing medical emergencies.Conclusion More efforts are needed in prevention, early identification, and timely management of medical emergencies in dental clinics in order to prevent fatal outcomes. The results of this survey are useful information for re-designing emergency training courses for Chinese dentists.

Assessment of the oral health seeking behavior of patients with premalignant lesions.

Background:Before choosing/visiting any dental facility for their treatment, patients consider several factors. These factors may be related to the patient or service provider. The health-seeking behavior of a society defines how health services are used.Aims:To assess the health seeking behavior of patients with premalignant lesions.Material and Method:A cross sectional study using questionnaire was done among the patients who consulted in the Department of Oral Medicine and Radiology, of age 18 and above suffering from precancerous lesions. The questionnaire included 25 close-ended questions which collected information about the demographic details, oral hygiene habits, oral health issues, deleterious habits. The responses were either on dichotomous scale (yes and no) or on the frequency habits. A total of 218 subjects were included in the study. The data were analyzed using the Chi-square test. The acceptable level of significance was reduced to P < 0.05.Result:Slightly over 50% of study participants visited the dentist for their dental problems. Most of the participants visited dental clinic whenever needed. Maximum positive health seeking behavior is seen in fourth and fifth decade and minimum seen in second and third decade.Conclusion:The oral premalignant lesions have high chances of transformation into malignancies. The progression of these lesions can be prevented by stopping the progression at an early stage and thus instilling positive health seeking behavior serves as an important key to it.

Assessment of knowledge and awareness about biomedical waste management among health care personnel in a tertiary care dental facility in Delhi.

The study was conducted to assess knowledge and awareness of biomedical waste management (BMWM) among undergraduate students, residents, and nursing staff in a tertiary care dental facility in Delhi. A questionnaire survey (using ten close ended questions) was conducted regarding various aspects of BMWM among undergraduate students, residents, and nursing staff in a tertiary care dental facility. In each group, scores were determined depending upon the correct responses, the participants marked. The data were compiled and subjected to statistical analysis. Only 33.3% undergraduate students gave over 70% correct answers as compared to nursing staff (100%) and residents (62.2%). Undergraduate students showed various lacunae in terms of knowledge regarding BMWM. The difference between the knowledge of the 3 groups i.e., nursing staff, residents, and undergraduate students was statistically significant (P = 0.001). Residents exhibited better awareness regarding BMWM as compared to undergraduate students (P = 0.003). The pertinence of the issue of BMWM and lack of adequate preparation of the trainee dentists at undergraduate level reflects the urgent need to fill the lacunae in the dental undergraduate curriculum.

Level of Patient Satisfaction in the Dental Polyclinic of Puskesmas Merdeka Palembang

Rapid economic growth makes competition and competition in the business world even tighter, as well as businesses in health services, which are required to be able to meet the needs and desires of patients who are not only limited to their services. Puskesmas that want to develop must be able to maintain patient loyalty by providing satisfaction to their patients by providing quality services. This study aims to determine the level of patient satisfaction on services at the Dental Polyclinic of the Puskesmas Merdeka. This research is a qualitative research conducted in March 2019 on 62 patients in the dental polyclinic during the period of March 2019 which was taken by accidental sampling. Data obtained using a questionnaire consisting of three variables, the professionalism of dental health workers, service systems, and facilities in the dental polyclinic. The level of patient satisfaction is the percentage of the total score against the total score and categorized as very satisfied, satisfied, quite satisfied, dissatisfied, and very dissatisfied. The results showed that the level of patient satisfaction on the professionalism of dental health workers, service systems, and facilities in the dental polyclinic was 87.01%, 84.71%, and 84.55%, and all in very satisfied category. It can be concluded that the services at the Dental Polyclinic of the Puskesmas Merdeka is a quality service.

Prevalence of damaged and missing teeth among women in the southern plains of Nepal: Findings of a simplified assessment tool.

ObjectiveTo assess the prevalence of missing and damaged teeth among women in the rural southern plains of Nepal using an interviewer-administered tooth assessment module.Setting21wards in seven Village Development Committees across the Tarai of Nepal in 2015.ParticipantsResident, married women of children less than 5 years of age or those married in the 2 years prior to the survey, 14 to 49 years of age participating in a mid-year nutrition and health survey in the Tarai region of Nepal.Outcome measuresPrevalence of missing and damaged teeth, history of dental problems, oral hygiene practices, access to dental treatment and risk factors for missing and damaged teeth.ResultsOf 3007 assessed women, aged 14 to 49 years of age, 22.8% (95% CI: 21.4–24.4) reported ≥ 1 missing or damaged teeth; 81.5% (95% CI 80.1–82.9) reported regularly practicing oral hygiene, typically with standard local dentifrices. Pain or discomfort in the oral cavity in the previous 6 months affected 17.6% of women. Among these, 43.8% had sought treatment from a dental facility, pharmacy or village doctor. Home remedies were commonly applied to relieve pain.ConclusionBroken and missing teeth are common, affecting nearly one-quarter of adult women of reproductive age in rural Southern Nepal, as assessed by an interviewer-administered questionnaire.

Prevalence and policy of occupational violence against oral healthcare workers: systematic review and meta-analysis

BackgroundOccupational violence is considered unlawful in professional environments worldwide. In the healthcare industry, including dentistry, the safety of workers is essential, and it is of the utmost importance to ensure patient and employee safety and provide quality care. This study aimed to evaluate the prevalence of violence and associated workplace policies among oral healthcare professionals. Additionally, it aimed to identify the factors associated with violence and their impact on oral healthcare workers.MethodsA systematic review and analysis of the literature was conducted using PubMed, ScienceDirect, Scopus, Web of Science, Cochrane Library and ProQuest. Original articles written in English and published between January 1992 and August 2019 were included in the analysis.ResultsA total of 980 articles were found, and eight were selected for analysis. The violence experienced by healthcare workers included both physical and non-physical forms, such as shouting, bullying, and threatening; it also included sexual harassment. The impact of violence on workers manifested as impaired quality of work, psychological problems, and, although rare, quitting the job. With regard to dental healthcare, awareness of occupational violence policies among dental professionals has not been previously reported in the literature.ConclusionsThe increasing incidence of occupational violence against oral healthcare workers indicates the need for the implementation of better protective measures to create a safe working environment for dental professionals. There is a current need for increasing awareness of workplace violence policies and for the detection and reporting of aggression and violence at dental facilities.