Dental Sector Research Articles

The impact of Brexit on oral health.

Introduction The United Kingdom (UK) left the European Union (EU) on 31 January 2020. Brexit will impact many sectors of the economy, including the dental sector.Methods and analysis This policy analysis evaluates UK and EU legislation and planning documents, as well as the published literature, to analyse the impact of two scenarios relating to the UK's exit from the EU on the dental sector: a free trade agreement based on the jointly agreed Political Declaration (the 'FTA') and a 'no-deal' scenario.Conclusion An FTA could cause price increases of medicines and medical devices, and cause some disruption to the ability of regulating authorities in this area, while a no-deal would additionally risk shortages of medicines and medical devices as well as more dramatic price increases. In both an FTA and a 'no-deal scenario', with EU law no longer applicable to the UK, more innovative policy in the area of tobacco control could be developed. An FTA could exacerbate existing workforce shortages and would likely cause a reduction in EU research funding, as well as posing issues with data transfers, with these all likely to be more severe under a no-deal scenario.

Are Special Care Dentistry Services Prepared for a Global Disruption in Healthcare? A Call for a Wider Promotion of Dental Conscious Sedation Training.

Recently, calls for prompt and smart reform of dental education and postgraduate training have been made, reflecting the current global healthcare needs and addressing the most common problems faced by dental care providers. Objectives: Herewith, we propose the enhancement of multilevel dental training in dental conscious sedation (DCS), in order to meet the increasing demands associated with current and post-pandemic times. The temporary suspension of general anaesthesia and hospital-based sedation provision in response to coronavirus disease 2019 (COVID-19) revealed the urgent need for more efficient utilization of a variety of forms of DCS. Whilst the global spread of Severe Acute Respiratory Syndrome novel coronavirus (SARS-CoV-2) has particularly challenged dental sedation teams in community services, the appropriate preparation for similar disruptions in future should be undertaken proactively. In response, dental schools and commissioners are obliged to implement innovations in teaching, with the development of new programs supporting trainer–trainee interactions and focusing on practical sedation skills. Conclusions: The joint efforts of educators, healthcare providers, and commissioners, as well as adequate and robust DCS training utilizing a variety of teaching methods, would allow our profession to face the growing demand for pain and anxiety control measures in light of the current situation, which may increase even further over time. Decision makers are urged to consider making training in DCS more accessible, meeting current healthcare demands, and equally providing essential support for the special dental care sector.

Self-perception of oral health in the elderly associated with health literacy and related factors

Abstract The aim of this study was to evaluate the self-perception of oral health in the elderly and to verify its association with oral health literacy and sociodemographic factors, through a cross-sectional study. Data collection took place in a probabilistic sample consisting of 535 elderly people over 60 years of age, who did not have cognitive problems, and were residents of the areas covered by six Family Health Units of the public health service, as well as users of a Center for Dental Specialties and dental clinics at the Faculty of Dentistry of Piracicaba (FOP), all located in the city of Piracicaba, Sao Paulo. A questionnaire with sociodemographic and health issues was applied, as well as the Health Literacy in Dentistry (HeLD-14) instrument for the assessment of oral health literacy. Poisson regression was used to estimate the associations between self-perceived oral health and literacy in oral health, as well as sociodemographic and general health characteristics. The data were analyzed using the SAS statistical software. The final regression model demonstrated that the elderly who were more likely to report poor oral health self-perception were associated with a low level of oral health literacy, were of the “non-white” ethnic group, had chronic illnesses and had sought the dentist for curative reasons in the last year. It was concluded that the self-perception of oral health in the elderly is influenced by variables that go beyond the dental sector, a fact that demands multiprofessional and intersectoral actions for their care. This fact highlights the importance of integrating aspects of health literacy in health and sociodemographic factors into the process of assessing oral health in the elderly, expanding the perspective of public health assessment for actions focused only on normative needs. Key messages We show the importance of assessing the oral health of the elderly in association with health literacy, expanding the perspective of public health assessment to actions beyond the normative needs. Despite the importance of the topic, there is still a scarcity of studies on health literacy and its impact on oral health behaviors and outcomes, impacting public health.

Oropharyngeal cancer and osteoradionecrosis in a novel radiation era: a single institution analysis

AbstractAimThis study investigates the incidence of osteoradionecrosis (ORN) in patients with oropharyngeal cancer (OPC) since the use of intensity‐modulating radiation therapy (IMRT).Materials and methodsThe multi‐disciplinary log for head and neck cancer (HNC) at Guys & St Thomas’ NHS Foundation Trust was used to identify and collect data on all patients with OPC and treated with a curative intent. Basic and oncology‐related demographic data were collected retrospectively. The presence and absence of ORN along with the causative factor was recorded.ResultsA total of 361 patients were available for analysis 1‐year post‐IMRT with the number decreasing to 129 patients at ≥5 years post‐IMRT. Thirty‐eight cases of ORN were identified from which 29 patients had necrotic areas in the region of pre‐RT dental extractions. The occurrence of spontaneous ORN was most evident within the first 2 years following RT while induced causes appear a steady lifelong threat particularly in the human papilloma virus (HPV)‐positive OPC group.ConclusionsThe introduction of novel targeted IMRT has not seen a significant reduction in the incidence of ORN with the condition of concern particularly evident in the HPV‐positive OPC group. These patients present with a relatively intact dentition receiving RT doses above the threshold for development of ORN. Additionally, the favourable long‐term survival of the HPV‐positve OPC population is likely to be contributory to the rise of cases seen which provides a clinical challenge the dental sector will have to proactively manage.

A educação permanente na reorganização da emergência odontológica hospitalar: pesquisa convergente assistencial

O objetivo deste estudo é reorganizar o processo de trabalho em emergência a partir da educação permanente, trazendo implicações práticas à equipe multiprofissional responsável pelo encaminhamento de pacientes a emergência/urgência odontológica. Materiais e método: pesquisa convergente assistencial, aprovada pelo comitê de ética, parecer número 1.210.223. Instrumentos de coleta de dados: observação participante, questionário semi-estruturado e grupos educativos. Referenciais teóricos foram a Política Nacional de Educação Permanente em Saúde e Agostinho de Hipona. Análise baseada na análise de conteúdo de Bardin. Resultados: Emergiram quatro categorias, utilizadas como reflexão na confecção de um instrumento para facilitar o encaminhamento ao setor odontológico e esclarecer o papel do odontólogo no serviço de emergência. Conclusão: Os níveis de atenção à saúde podem ser organizados a partir do grau de gravidade das queixas que comparecem na emergência, a fim de atender com maior eficácia as queixas odontológicas dos pacientes, bem como oferecer um atendimento de qualidade. Reconhecer a necessidade e as deficiências do processo de trabalho também permitiu agregar conhecimento e proporcionando avanços para a equipe multidisciplinar acerca do papel do profissional dentista no serviço de emergência e suas atribuições.

PPE: at the heart of dentistry

The past four months have been a tumultuous time for the dental sector. But as practices prepare to go back to work, what is the PPE supply situation?

3D‐printing of highly translucent ORMOCER®‐based resin using light absorber for high dimensional accuracy

AbstractAdditive manufacturing, more specifically digital light processing as a form of vat photopolymerization, has attracted great interest and plays an important role in many different applications. However, it becomes complicated when complex parts with overhangs and/or pores are printed, especially if the part has to be transparent. The aim of this study is to improve the dimensional accuracy in z‐direction of highly translucent 3D‐printed parts. Therefore, ORMOCER® resin‐based materials containing different light absorbers are developed to control the penetration depth of incident light and thereby increase the resolution in z‐direction. Penetration tests are conducted and show that, in the presence of light absorbers, the curing depth can be adjusted while maintaining a high translucency of the printed part. Furthermore, a model part is developed to quantify the overpolymerization in z‐direction and the influence of the absorber. Additionally, properties that are important for future applications, for example in the dental sector, such as mechanical properties and biocompatibility, are investigated yielding promising results. Finally, a complex filigree 3D‐grid structure is fabricated applying the resin‐based absorber material.

The Attitudes and Professional Approaches of Dental Practitioners during the COVID-19 Outbreak in Poland: A Cross-Sectional Survey.

The coronavirus infectious disease 2019 (COVID-19) pandemic has put enormous pressure on health care systems around the world. Dentistry has had to adjust to the new epidemic situation to not only bring relief to suffering patients but also to avoid becoming a source of SARS-CoV-2 transmission. Methods: A comprehensive, cross-sectional survey was conducted between April 6 and 16, 2020 among 875 Polish dental practitioners. The aim of the research was to assess dentists’ attitudes and professional approaches resulting from the COVID-19 pandemic. Results: 71.2% of dentists who responded to the questionnaire decided to suspend their clinical practice during that particular time. The main factors for this fact were the shortage of personal protective equipment (PPE), the respondents’ subjective perceptions of the risk of COVID-19 contraction and a general feeling of anxiety and uncertainty regarding the COVID-19 situation. The authors observed a significant decrease in the number of patients admitted weekly in April 2020 (12.06; SD, 11.55) in comparison to that in the time before the state of pandemic was declared on March 11, 2020 (49.21; SD, 24.97). Conclusions: Due to the unpreparedness of the dental sector, both in national health and private settings, most of the Polish dentists decided to voluntarily suspend their clinical practice in order to mitigate the spread of the disease. The COVID-19 outbreak has revealed numerous shortcomings in the dental care system, especially regarding the insufficient coordination of health services related to the pandemic and lack of advanced PPE. This has led to an overwhelming feeling of fear, confusion and anxiety among dental professionals in Poland and a sudden decrease in the number of performed dental procedures. Hopefully enriched with the recent experience and due to the implementation of proper strategic and long-term measures, dental practitioners will be better prepared and adapted to global health care disruptions in the future.

Utilização de fitoterápicos na Odontologia: revisão integrativa

O objetivo do presente estudo foi analisar a literatura acerca do uso de fitoterápicos na odontologia. Trata-se de uma revisão integrativa da literatura que utilizou os descritores: cirurgião-dentista, etnofarmacologia, medicamentos fitoterápicos, separadamente e posteriormente cruzando-os através do operador boleano AND. As bases de dados consultadas foram o Scientific Electronic Library Online (SciELO) e Medical Literature Analysis and Retrievel System online (MEDLINE). Foram analisados 13 artigos indexados na íntegra. Os resultados apontam que os fitoterápicos têm ganhado espaço no setor odontológico, principalmente após a aprovação da Política Nacional de Práticas Integrativas e Complementares (PNPIC) no SUS e do Conselho Federal de Odontologia, e mesmo com comprovação científica da eficácia farmacológica dessa terapêutica, existe uma resistência quanto à indicação e prescrição de fitoterápicos por alguns cirurgiões-dentistas, justificado na maioria das vezes por falta de conhecimento técnico dessa terapêutica. O uso dessa prática pelo cirurgião-dentista tem sido realizada principalmente em metrópoles, com ênfase na região sul do Brasil e mesmo que alguns profissionais afirmem não praticar a fitoterapia por desconhecimento técnico, percebe-se que esta vem sendo bastante utilizada por profissionais que atuam na Estratégia de Saúde da Família.

Digitization in the German Health Care System - An Analysis of the Status Quo Using the Example of the Dental Sector

According to the Federal Ministry of Economics and Energy, the German healthcare industry is growing faster than the economy as a whole but is regularly far behind compared to the rate of digitalization. Nonetheless, the healthcare industry offers great potential for digital applications. The brief overview at hand uses the example of treatment and cost plans in the dental field to illustrate the state of digitalization in the German health care system.
 The primary goal is to examine whether it is possible to transfer the principle of electronic data medium exchange for hospital settlements and the associated electronic data processing to the transmission of treatment and cost plans in the dental field. Anselstetter's (1984) expertise is fundamentally used to evaluate the benefits of electronic data processing and to a treatment and cost plan under critical evaluation. In order to determine relevant benefit effects for health insurance funds and dentists, a transfer and processing form of the treatment and cost plan is used based on a generated model.
 Applying this model can assist health insurance funds to identify effects regarding time, personnel reduction, and more efficient use of existing personnel structures. It also provides health insurance companies and dentists with an overview of the possible benefits of electronic data transmission and processing. Nonetheless, one of the problems is that it is not possible to calculate the expected costs due to the lack of empirical examinations. Consequently, a detailed cost- benefit evaluation of an electronic transmission and processing of the treatment and cost plans is unfeasible.

Xylitol solubility in DMF + ethylene glycol or 1,2-propylene glycol: Measurement and modeling with PC-SAFT and CPA equations of state and UNIFAC activity coefficient model

Xylitol is a sugar alcohol that can be produced from biomass. It has applications in the food, pharmaceutical and dental sectors. As a building block of the chemical industry, it can be used in the production of fuels and solvents. The development of productive processes based on this material requires studies related to reactional media and separation systems. Solid-liquid equilibrium experiments associated with the application of mathematical models assist in the search for solutions to these demands. Based on the importance of the subject, a study is presented on xylitol solubility in binary liquid solutions formed by N,N-dimethylformamide, ethylene glycol and 1,2-propylene glycol at different temperatures. The experimental results were treated by two equations of state, PC-SAFT and CPA, and by the UNIFAC activity coefficient model. A dependence of the solubility on temperature and on the composition of the binary liquid solution, was observed. The efficient application of the models generated binary interaction parameters for the equations of state and revealed the predictive capacity of the UNIFAC model.

Oral health professionals: An exploration of the physical and psychosocial working environment.

Musculoskeletal disorders (MSD) are a significant problem in the oral health profession. This study explores oral health professionals' physical and psychosocial working environments in Australian workplaces. Twelve oral health professionals from the public and private dental sectors participated in semi-structured interviews. Interviews were recorded and transcribed. Themes were identified and a coding framework developed which was refined and clarified during analysis. Participants reported a range of physical and psychosocial experiences in their work environment. Three major categories of themes were identified: Job Characteristics - particularly equipment unsuited for task and time constraints; Job Satisfaction - support from management and colleagues was valued, as was the significance of providing oral health care, particularly to children and minority groups; and Individual Factors - MSD and fatigue were reported by most participants. Oral health professionals are exposed to a range of workplace physical and psychosocial hazards associated with the development of MSDs. Risk management programs for the prevention of MSDs should take into account the range of physical and psychosocial hazards that oral health professionals are exposed to.

Dental and Medical Sector Communication during Public Health Crisis in Saudi Arabia

Dental and Medical Sector Communication during Public Health Crisis in Saudi Arabia

ANALYSIS OF REGULAR DENTAL CHECKUPS OF KYIVITES IN STOMATOLOGICAL ESTABLISHMENTS OF VARIOUS PROPERTY FORMS

The aim: carry out analysis of regular dental checkups in Kyiv in state and private dental establishments. Materials and methods: The analysis was conducted using the statistical reports (approved standard №20) which have been obtained in Kyiv and Ukraine from 2008 till 2017. The method of copying data with using statistical estimation methods was applied. Results: The authors have established significant dental preventive measures decline in Kyiv state dental establishments from 2008 till 2017. A tendency toward increased private dental sector within the dental prevention has been noted. Conclusions: The obtained results will be used to substantiate concepts of municipal stomatological dental care improvement as well as to introduce the university clinic model.

Marketing odontológico del futuro

Recibido: 23 de mayo de 2019Aprobado: 02 de junio de 2019En los últimos dos años, ha habido una explosión en el panorama del marketing digital. Es justo decir que tendrías que haber estado viviendo en una cueva para no ver los desarrollos que se han hecho en esta área. Estos desarrollos han impactado masivamente en el sector dental, más de lo que puede pensar al principio. El siguiente artículo de revisión se plantea hacer una reseña de la forma en que los posibles nuevos pacientes pueden encontrarlo ha avanzado con los cambios en la forma en que la optimización de motores de búsqueda (SEO) clasifica su sitio web. Los avances en la publicidad en línea, particularmente en Facebook en los últimos doce meses, significan que ahora es más fácil interactuar con audiencias más grandes. Junto con eso, el uso de un sofisticado software de gestión de relaciones con el cliente (CRM) significa que ahora es más fácil comunicarse con sus pacientes, ya sean sus pacientes existentes, pacientes inactivos o aquellos posibles pacientes a los que desea ingresar.

Laser-Based Hybrid Manufacturing of Endosseous Implants: Optimized Titanium Surfaces for Enhancing Osteogenic Differentiation of Human Mesenchymal Stem Cells

Additive manufacturing (AM) is becoming increasingly important in the orthopedic and dental sectors thanks to two major advantages: the possibility of custom manufacturing and the integration of complex structures. However, at smaller scales, surface conditions of AM products are not mastered. Numerous non-fused powder particles give rise to roughness values (Sa) greater than 10 μm, thus limiting biomedical applications since the surface roughness of, e.g., metal implants plays a major role in the quality and rate of osseointegration. In this study, an innovative hybrid machine combining AM and a femtosecond laser (FS) was used to obtain Ti6Al4V parts with biofunctional surfaces. During the manufacturing process, the FS laser beam "neatly" ablates the surface, leaving in its path nanostructures created by the laser/matter interaction. This step decreases the Sa from 11 to 4 μm and increases the surface wettability. The behavior of human mesenchymal stem cells was evaluated on these new AM+FS surfaces and compared with that on AM surfaces and also on polished surfaces. The number of cells attached 24 h after plating is equivalent on all surfaces, but cell spreading is higher on AM+FS surfaces compared with their AM counterparts. In the longer term (days 7 and 14), fibronectin and collagen synthesis increase on AM+FS surfaces as opposed to AM alone. Alkaline phosphatase activity, osteocalcin production, and mineralization, markers of osteogenic differentiation, are significantly lower on raw AM surfaces, whereas on the AM+FS specimens they display a level equivalent to that on the polished surface. Overall, these results indicate that using an FS laser beam during the fabrication of AM parts optimizes surface morphology to favor osteoblastic differentiation. This new hybrid machine could make it possible to produce AM implants with functional surfaces directly at the end of AM, thereby limiting their post-treatments.

Minimally invasive rehabilitation with porcelain veneers: case report

The present document exposes the aesthetic dental rehabilitation in the anterior dental sector, recovering the characteristics of natural teeth as color and shape, through ceramic veneers and crowns, getting improve the smile in the face of patient. The intervention by minimally invasive procedures as veneers, recover quickly and with minimum error margin the patient's aesthetics, however, an adequate diagnosis, planning processes, listen the patient's needs and prioritize them, constitute the key to success achieved.

Specific features of deployment of medical staff in the private dental sector

The features of deployment of dentists of different specialties in the private dental sector of the city of Moscow are studied. On the material of 296 dentists, the main reasons for the employment, motivation to change from state, municipal, departmental to private medical organizations are considered for dentists of different specialties.

Associates and their working environment: a comparison of corporate and non-corporate associates.

Introduction The share of the dental market held by corporate bodies continues to increase. With the profession currently facing many challenges it is important to understand their place in the profession and their effect.Aim This exploratory study aims to provide an insight into dental associates in relation to their working environment. Specifically, the differences between working in corporate and non-corporate environments in England.Materials and methods Secondary analysis of a self-report questionnaire examining demographics, pay, working conditions, job satisfaction and morale using a combination of closed and open-ended responses sent to randomly selected associate dentists who are BDA members. Responses from associates working in England solely in either the corporate or non-corporate sector were analysed.Results Significant differences were seen between associates working in corporate practice when compared to those in non-corporates practice, for example, significantly less corporate associates were female and corporate associates reported relatively lower levels of autonomy and control.Discussion The differences seen between sectors could be related to rationalisation and should this be the reality it could have far reaching effects on the profession and its ability to manage itself.Conclusion This study highlights some differences between the corporate and non-corporate dental sectors. Further work is needed to build a deeper understanding of the sector.

Factors Affecting Fee-Setting for Dental Services in Iran’s Private Sector: Dentists’ Perspective

Background and Objectives: In Iran, the private dental sector is the main provider of dental services, however, the price of services that are charged by them is unclear. This study aimed at evaluating the factors affecting fee-setting for dental services delivered by dentists in the private sector and the relative value of services. Methods: In this cross-sectional study, the census sampling method was used among dentists working in the private sector of Kerman city, Iran. The data were collected through a researcher-made questionnaire, the validity and reliability of which were established. Descriptive statistics and Pearson’s correlation coefficient were used to analyze the data. Results: Of the 252 qualified dentists, 147 (58%) participated in this study, of whom 61.5% stated they had reduced their prices to attract more patients and 67.4% mentioned that there is a competition between dentists in attracting more patients. The tariffs applied by the dentists were within the range of government approved tariffs. After the dentist’s wage (42.3%), the most important factors that affected tariff setting included office rent (18.6%), raw materials (15.2%) and staff’s salary (12.6%). Disease severity, dentistry error, dentist’s skill and visit time length should be considered in determining the relative value of services and setting a justified and fair tariff. Conclusions: It is necessary to take appropriate measures by dental health authorities to increase the competition between private dentists in order to decrease prices in favor of patients. Also, due to differences in performance, experience and materials used by dentists and other factors, it is necessary to set maximum and minimum values for tariffs.