Dental Team Research Articles

Should suicide risk assessment be embedded in undergraduate dental curricula?

Aims and objectives The aim of this Plan-Do-Study-Act cycle was to establish if undergraduate students believe they have a role to play in suicide risk assessment, and to discuss the implementation of suicide risk prevention into the undergraduate dental curriculum. Data gathered informed development of a subsequent suicide risk assessment educational workshop.Methodology An online questionnaire was disseminated to undergraduate students as part of a quality improvement service evaluation within a UK dental hospital and school. This sought to gain information on attitudes to suicide prevention, previous suicide awareness training, and the appetite and potential barriers to future training.Results A response rate of 23% (n = 30) was achieved. In total, 87% of undergraduate students responding reported having no experience or training in the identification of suicidal patients, 97% of respondents expressed a desire for training, and 80% stated not knowing what to do if a patient disclosed suicidal thoughts during an appointment.Conclusion The dental team have a role to play in suicide risk assessment and the signposting of at-risk patients to appropriate services. To embed this within daily practice, awareness and training must be introduced to undergraduate curricula.

The dental workforce recruitment and retention crisis in the UK.

The precarious state of NHS dentistry is widely acknowledged, yet there is limited progress in addressing the underlying issues. Further delays will undoubtedly impact patient care, leading to oral health deterioration and unnecessary suffering. This will predominantly affect the most vulnerable in society, resulting in greater oral health inequalities.The underlying issues contributing to the current NHS dental crisis are many, and they include: prolonged delays in contract reform; long-term underinvestment; private sector growth; and fewer dentists working full-time and/or in the NHS. In England, an NHS dental contract that fails to promote prevention or equality of access continues to have a deep and pernicious impact on the future of NHS dentistry. The devastating impact of the COVID-19 pandemic on access cannot be underestimated and neither should the effect of Brexit on the availability of workforce.The recruitment and retention of dentists, and other members of the dental team, is undoubtedly a major issue in terms of capacity and access to NHS dental care. These problems, seen across the UK, are a particular issue in England, with acute challenges within rural and coastal areas.There is an urgent necessity to develop coherent, multifaceted strategies, aided by the collection of clear and accurate workforce data, to tackle these issues.

Nanometals and Metal Ion Pollution from Dental Materials in Dental Environment

The dental environment is being polluted with metals from dental materials in many ways, mainly due to aerosol-generating procedures; this could affect the long-term well-being of dentists, dental students, and dental personnel. The current dental pollution incorporates metallic nanoparticles, which are highly reactive and quickly become airborne, especially those particles that become unbound in the bulk composition. In addition, liquid mercury or mercury vapors may be released from dental amalgam, causing concerns in the dental community. In our study, we reviewed the behavior of metallic elements present in dental materials, their routes of exposure, and their potentially toxic effects on the dental team. This review found that skin and lung disorders are the most harmful effects of metallic exposure for dentists, dental students, and dental personnel. Therefore, chronic exposure to low concentrations of metals in the dental environment, especially in nanosized forms, should be further investigated to improve the environmental matrix, material choice, and safety protocols.

'The dental nurse played a vital role in helping to manage the patient': a thematic analysis of undergraduate dental students' reflective journals from outreach placements.

Introduction Community-based dental education, or 'outreach', forms a key part of dental courses in some high-income countries. Its educational benefits are well-established and once graduated, participants feel better prepared for their early career. Yet, it is less clear what students actually learn while on placements.Materials and method Qualitative document and thematic analysis of a convenience sample of anonymised dental student reflective journals (n = 51).Results The reflective journals described varied and broadly positive learning experiences. Analysis identified a number of themes of learning. Most related to the process and outcomes of care, but two key themes - dental anxiety and teamworking - were interrelated with both. Within teamworking, dental nurses appeared important in students' learning. Three process interrelated themes of learning were identified in the data. These were: tailoring your approach; communication and time; and evidence-based dentistry and minimising risk. Two broad interrelated themes relating to outcomes for patients and students were also identified: trust and confidence; and professionalism and personal development.Conclusion This research identified important and potentially transformative learning from outreach placements. This included how dental anxiety impacts patients and the dental team, the importance of teamworking, and the role of dental nurses in students' experiential learning.

Oral health and cystic fibrosis in pediatrics: A survey of health professionals.

Children with cystic fibrosis(CF) are usually managed by hospital-based, multidisciplinary teams (MDTs). This study aimed to investigate oral health perspectives, training, and practices of health professionals working with children with CF. Data were collected through an online survey distributed to health professionals caring for children with CF by the CF Director in 12 Australian hospitals. The questions related to perspectives, training, and dental referral/advice relating to oral health for children with CF. The data were analyzed using descriptive statistics. Forty-fourparticipants (26 physicians, 8 nurses, 6 physiotherapists, 2 dieticians, 1 psychologist, and 1 pharmacist) completed the survey. Most (n = 33, 75%) indicated they rarely/never check or discuss dental health. Of those who did, most reported lacking skills to inspect teeth and discuss dental health. Frequently reported barriers were lack of skills, training, knowledge, and time. Most respondents (n = 30, 68%) indicated they rarely/never recommend patients to see the dentist. The most frequently reported barrier to referrals was not considering it part of their role (43%). Closer working relations between CF units and dental teams may remove barriers that prevent non-dental clinicians from supporting patients with CF maintain oral health. Better integration of dental care within the MDT through improved professional training, increased referral practices, and availability of digital resources may help to improve dental care for all children, including children and adolescents with CF.

How can general dental practitioners help in the management of sleep apnoea?

This article discusses the aetiology, prevalence and treatment of obstructive sleep apnoea (OSA) and highlights the important role general dental practitioners can perform in improving the quality of life of patients suffering from OSA. Clinical and laboratory stages of making a mandibular advancement appliance are also highlighted.Members of the dental team have a duty of care to our patients. The earlier undiagnosed cases of OSA are referred for treatment, the less morbidity and potential mortality endured by patients.After reading this article, the reader should have a greater understanding of OSA, how to identify symptoms of the condition in patients and be confident in referring patients to appropriate healthcare professionals.

The implications of a cost-of-living crisis for oral health and dental care.

A cost-of-living crisis is currently affecting the UK. While this has been explored in terms of the effect on dental practice, the dental implications for patients and for population oral health have not received sufficient attention. This opinion piece discusses how: i) financial pressures leading to hygiene poverty may limit the ability to afford the basic products necessary to maintain oral hygiene; ii) food insecurity is associated with a diet high in sugar and lacking in appropriate nutrition; and iii) reduced disposable income may limit the ability to attend and successfully engage with dental care. The impact of the cost-of-living crisis on the lowest paid members of the dental team is also considered.The most common dental diseases are closely correlated with social and economic deprivation and the points discussed here act as a reminder of how the present financial circumstances have significant potential to widen oral health inequalities.

Perspectives on Getting Dental Team Members Involved in DSM

Perspectives on Getting Dental Team Members Involved in DSM

Eating disorders and the role of the dental team.

Although primarily classified as psychiatric disorders, eating disorders have a complex aetiology and presentation, with comorbidities spanning multiple disciplines, including dental complications. In some cases, general dental practitioners may be the first health professional to become aware that someone is struggling with an eating disorder. The dental team is in an ideal position to sensitively explore the presentation and signpost the patient to appropriate services while offering support and/or remedial management for dental complications of the eating disorder. Anyone from any background, gender or ethnicity may develop an eating disorder, of which the main diagnoses are anorexia nervosa, bulimia nervosa and binge eating disorder. Some of the frequently seen oral manifestations of these disorders include generalised dental erosion, caries, self-inflicted palatal or oropharyngeal trauma, atrophic mucosa, bilateral parotid gland enlargement, xerostomia and periodontal disease. The dentist's role is pivotal in recognising the possible implications of some of these findings, approaching the patient sensitively, and communicating empathetically to engage them in treatment, reducing the risk of further erosion and improving oral health and hygiene. The dental team may be able to signpost the patient to their general practitioner for onward referral or to a local eating disorder support network.

How dental teams can help patients with temporomandibular disorders receive general dental care: an international Delphi process.

Many patients with temporomandibular disorders (TMD) find it difficult to undergo dental care due to challenges caused by their condition, previous temporomandibular joint surgery or invasive dental procedures, and the impact of comorbid conditions. Managing routine dental care for some patients with TMD can be seen as challenging by some dental practitioners. The objective of this study was to work with patients experiencing TMD and clinicians to co-produce recommendations aimed at helping general dentists to provide routine dental care for patients with TMD. A modified Delphi process was used to co-produce recommendations. Six patients experiencing TMD, patient advocates and seven clinicians took part, including international TMD clinicians. Two meetings were held with patient participants, mediated by a trained facilitator. Recommendations suggested by patient participants were distributed to clinicians who were asked to add additional suggestions, but not to modify patients' recommendations unless to aid clarity. Additional themes were identified from the existing literature, and the recommendations were then reviewed by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) consortium. Recommendations were given to support patients before, during, and after dental treatment. Participants identified specific and practical recommendations to help patients with TMD receive routine dental care, but also emphasised the need for professionals to listen sensitively to patients' concerns and work with patients in an empathetic and non-judgmental way. These recommendations, co-developed with patients experiencing TMD, should help dental professionals to provide supportive general dental care for patients with TMD.

Looked after children: an overview for the dental team

Looked after children (LAC) are children and young people (CYP) who have been under the continuous care of the local authority for more than 24 hours. Reasons for becoming looked after include concerns about abuse or neglect, breakdown in family functioning, or absence of a suitable caregiver (for example bereavement, parental illness, or separation, such as for unaccompanied asylum-seeking children). Many LAC live with foster families, extended family, or in residential care homes, but a CYP can be legally 'looked after' and still be living with their original or birth family, or living independently with support. Regardless of the circumstances, the local authority has responsibility for meeting the needs of the CYP, including dental care, usually via a named social worker. The evidence available suggests that LAC are at higher risk of dental caries and pain. In 2021, Public Health England reported on inequalities in oral health in England and although evidence was limited, found LAC to have poorer oral health and access to care. It is important that LAC are considered for enhanced prevention and reviewed regularly to enable appropriate provision of dental care. Understanding who can consent for dental treatment is essential.

Dental Caries Experience in Children in Public Kindergartens of Sarajevo, Bosnia and Herzegovina.

Dental caries first occurs within primary dentition in toddlers and preschool children, in a form of early childhood caries (ECC). In every day's busy and employment burdened parenting, caretakers and institutions have become important even more nowadays, not only for forming child general behavior and character, but also for maintenance of their general and oral health as well. To evaluate the presence and severity of ECC in children who attended public kindergartens in Sarajevo, and to offer basic information for the maintenance and improvement of child oral health to their parents and kindergarten teachers. The study included 1722 preschool children aged 3-6 years who attended kindergartens within Sarajevo public kindergarten institution, together with their parents and kindergarten teachers. Dental team members gradually visited all kindergartens situated in four Sarajevo city municipalities and examined kindergarten children according to the WHO Oral Health Survey Manual. Oral health promotion material for parents and kindergarten teachers was also distributed simultaneously during sequential visits. ECC was present in preschool kindergarten children in Sarajevo, with its high prevalence (67.71%); dmft-value (3.97) and severity (SiC index 8.79). There was also a significant lack of dental healthcare to examined children mostly related to lack of visiting dental offices by children's parents (CI=10.55%, RI=10.80%, TI=12.98%). Parental role in preserving and improving of their children oral health should be systematically and profoundly improved. Kindergarten officials and staff should recognize the importance of anticariogenic diet menus and oral hygiene maintenance within their institutions.

Attendance and Distribution Patterns of Patients in a Private Dental Clinic During the COVID-19 Pandemic

Background: To investigate the effects of the COVID-19 pandemic on the patients’ attendance/distribution patterns within different departments and the perception of the dental team providing dental services during the COVID-19 outbreak in a private dental clinic. Moreover, the impact of SARS-CoV-2 on dental professionals next to the role of personal protective equipment in the prevention of infection in the corresponding teams was simultaneously investigated.
 Methods: A clinic located in the northern part of Tehran was selected. Forty-four dentists with 48 staff members were involved in treatment teams. Preventive strategies, i.e., personnel/operator/patient management comprising full Personal Protective Equipment (PPE), high–volume evacuation suctions, primary screening questions, pulse oximetry, the patient’s body temperature measurement as well as administrative controls, e.g. disinfection of surfaces and using stairs instead of lifts, were implemented to manage the prevalence of disease and analyze the impact of COVID-19 on the distribution/attendance patterns of patients.
 Results: During 6 months, a 26% reduction in the number of patients was observed after the pandemic; however, men’s and women’s distributions were not affected. The department of orthodontics reported a 6% increase in new cases whereas the department of pediatric dentistry revealed the least changes in the number of patients. In the departments of operative dentistry, prosthodontics, oral/maxillofacial surgery, and periodontics, the number of patients was reduced by 10- 30%. In addition, three dentists and four staff members were affected by COVID-19 during the mentioned period.
 Conclusion: It seems that the potential for COVID-19 transmission in dental clinics is relatively low.

Patient Gratification and their Expectation from Dental Professionals- A Cross-Sectional Survey

Introduction: Dentist attire has been molded by tradition and fashion over centuries. There have been many changes in thedental field and patient expectations and with increased proportion of female doctors entering the profession has led to changes in dentist dress code. White coats were worn by dentist for professionalism, identification and hygiene, yet white coats may be a source of, rather than a barrier to cross infection. Aim: The aim of this study is to assess the patients opinion toward dentist appearance, clinical attire, cross infection control, years of experience, and their expectations from their dentist.
 Materials and Methods: Patients attending a dental hospital for a consultation appointment were asked to complete a close-ended questionnaire comprising 12 questions. A representative sample of patients completed 100 questionnaires over a period of 4 weeks. Their responses were tabulated and analyzed statistically.
 Results: The study found that majority of patient preferred their own gender dentist and they preferred young dentist with 1–5 years of experience. Some patients preferred dentist wearing white coat while some patients were comfortable with whatever the dentist was wearing. The majority of patients preferred dentist wearing name badge and personal protective equipment. The majority of patients also preferred treatment from colleges and hospitals and preferred dentist who has done MDS/specialization. The majority of patients were more comfortable with dentist who is smiling, welcoming, and being friendly. Some patients preferred their dentist to talk more while some preferred their dentist to talk appropriately and few patients preferred their dentist to talk less. Dentist having long nails and malaligned or fractured teeth bothered some patient while it did not bother some patients and some patients did not notice it.
 Conclusion: A considerable amount of research dealing with the professional image of health-care providers has been produced, but very little of this has been specific to the practice of dentistry. Hence, it is hoped that this study will be informative for dental team and the results should be taken into consideration.

Are the standards of professionalism expected in dentistry justified? Views of dental professionals and the public

Introduction In the UK, the General Dental Council specifies nine principles of professional standards that dental registrants must follow. There are views that such standards are high, patients' expectations are rising, and the professionalism of dental professionals is increasingly scrutinised. This paper explores whether the high standards expected in dentistry are justified.Methods We applied thematic analysis to 772 free-text responses from dental team members and the public to a modified Delphi survey. Respondents described their views of professional and unprofessional behaviours in dentistry. Data were obtained as part of a larger review of professionalism in dentistry.Results Two lines of argument were identified: professionalism standards are high, but justifiably so; and professionalism standards are too high. Within these, four broad themes emerged: patient trust; comparison with other professions; a culture of fear; and perfection.Conclusion High professionalism standards are justified in a profession where patient trust is paramount. However, a problem lies in the culture that surrounds professionalism in terms of litigation and dental professionals feel pressure to possess an unattainable, infallible nature. These negative impacts need minimising. We suggest that undergraduates and continuing professional development approach professionalism with care, to foster a supportive, positive and reflective culture of professionalism.

Health Coaching-Based Interventions for Oral Health Promotion: A Scoping Review.

Health coaching-based interventions can support behaviour change to improve oral health. This scoping review aims to identify key characteristics of health coaching-based interventions for oral health promotion. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute manual for evidence synthesis were used in this review. A search strategy using medical subject heading terms and keywords was developed and applied to search the following databases: CINAHL, Ovid, PubMed, Cochrane Library and Scopus. Thematic analysis was used to synthesise the data. Twenty-three studies met the inclusion criteria and were included in this review. These studies were predominantly based on health coaching and motivational interviewing interventions applied to oral health promotion. The following are the characteristics of health coaching-based interventions extracted from themes of the included studies: (a) Health professionals should be trained on the usage of motivational interviewing/health coaching interventions; (b) oral health professionals should acquire motivational techniques in their practice to engage patients and avoid criticisms during the behaviour change process; (c) routine brief motivational interviewing/health coaching intervention sessions should be introduced in dental clinics; (d) traditional oral health education methods should be supplemented with individually tailored communication; and (e) for cost-effectiveness purposes, motivational interviewing/health coaching strategies should be considered. This scoping review reveals that health coaching-based techniques of health coaching and motivational interviewing can significantly impact oral health outcomes and behaviour change and can improve oral health professional-patient communication. This calls for the use of health coaching-based techniques by dental teams in community and clinical settings. This review highlights gaps in the literature, suggesting the need for more research on health coaching-based intervention strategies for oral health promotion.

Your Heart in Your Mouth: Cardiac Surgery and the Dental Team

British Journal of Cardiac NursingVol. 18, No. 3 CommentYour Heart in Your Mouth: Cardiac Surgery and the Dental TeamRobyn Clark, Shazia KakaRobyn ClarkCorrespondence to: Robyn Clark; E-mail Address: [email protected]Guy’s and St Thomas’ NHS Foundation Trust, London, UKSearch for more papers by this author, Shazia KakaGuy’s and St Thomas’ NHS Foundation Trust, London, UKSearch for more papers by this authorRobyn Clark; Shazia KakaPublished Online:6 Apr 2023https://doi.org/10.12968/bjca.2023.0008AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Drayton AL, O’Sullivan JJ, Walton G. Dental surveillance in the adult congenital heart disease population. Heart. 2013;99(21):1624. https://doi.org/10.1136/heartjnl-2013-304509 Crossref, Google ScholarEuropean Society of Cardiology. 2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European society of cardiology (ESC) endorsed by: European association for cardio-thoracic surgery (EACTS), the European A. Eur Heart J. 2015;36(44):3075–3128. https://doi.org/10.1093/eurheartj/ehv319 Crossref, Google ScholarHolland TL, Baddour LM, Bayer AS et al.. Infective endocarditis. Nat Rev Dis Prim. 2016;1(2):16059. https://doi.org/10.1038/nrdp.2016.59 Crossref, Google ScholarJowett N, Cabot L. Patients with cardiac disease: considerations for the dental practitioner. Br Dent J. 2000;189(6):297–302. https://doi.org/10.1038/sj.bdj.4800750 Crossref, Google ScholarLockhart PB, DeLong HR, Lipman RD et al.. Effect of dental treatment before cardiac valve surgery. J Am Dent Assoc. 2019;150(9):739–747. https://doi.org/10.1016/j.adaj.2019.04.024 Crossref, Google ScholarSilvestre FJ, Gil-Raga I, Martinez-Herrera M et al.. Prior oral conditions in patients undergoing heart valve surgery. J Clin Exp Dent. 2017;9(11):e1287–e1291. https://doi.org/10.4317/jced.53902 Google ScholarThornhill MH, Dayer MJ, Nicholl J et al.. An alarming rise in incidence of infective endocarditis sinec 2009: why? Lancet. 2020;395(10233):1325–1327. https://doi.org/10.1016/S0140-6736(20)30530-4 Crossref, Google ScholarWilson W, Taubert KA, Gewitz M et al.. Prevention of infective endocarditis. Circulation. 2007;116(5):1736–1754. https://doi.org/10.1161/CIRCULATIONAHA.106.183095 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 March 2023Volume 18Issue 3ISSN (online): 2052-2207 Metrics History Published online 6 April 2023 Published in print 2 March 2023 Information© MA Healthcare LimitedPDF download

Dental Public Health in Action: Delivering a domestic violence and abuse screening and identification training programme in North Staffordshire-based dental practices.

Domestic violence and abuse (DVA) is a significant public health problem both globally and in the UK. Dental professionals are aptly place to detect the signs of DVA and support patients to disclose DVA. However, dental professionals may lack confidence to identify and refer patients experiencing DVA; training needs in these areas were identified in Staffordshire. Glow DVA charity and the local Dental Public Health teams worked collaboratively to develop DVA training and resources specific to the needs to the dental team; these were provided to participating dental practices in the North-Staffordshire region. Feedback from the training was positive and the training was refined to better meet the needs of the dental team.mKey challenges included obtaining dental team buy in, securing funding for the continuation of the initiative and minimising the disruption to the dental team when attending training sessions or when managing a DVA disclosure. The implementation of the training highlighted the importance of DVA champions within the third sector organisations to develop and evolve the project, within dental practices to support implementation, and within the local Dental Public Health team to facilitate dental team buy-in and sustained engagement. Future plans include developing the patient-facing resources, finding ways to formally accredit dental teams for taking part in the DVA programme, and evaluating the impact of the training programme on DVA screening, identification and referral.

Preparedness Plan Ensures Dental Service Sustainability During a Public Health State of Emergency

Background In early 2020, the COVID-19 pandemic emerged bringing risk of disease, disability and death to all Americans. As public health officials scrambled to respond, dental offices were shuttered leaving little access to dental care.Methods Collaborating with medical colleagues and partnering with the local public health department, the Asian Health Services (AHS) dental team developed a preparedness plan to ensure the safe and effective ongoing delivery of oral health care services, respond to the national public health state of emergency and support local public health efforts to contain the pandemic.Results AHS dental services remained operational throughout the COVID-19 pandemic due to the swift and strategic response of the dental team. COVID-19 contact tracing, testing and vaccination became new services rendered by dental personnel, which are now integrated into policies, programs and services. Professional education and training were also updated to ensure sustained preparedness.Conclusions By having a comprehensive and coordinated preparedness plan in place, AHS was able to effectively support public health efforts and serve the oral health care needs of the community.Practical Implications Preparedness efforts implemented by a coordinated effort between AHS’s medical and dental leadership in cooperation with local public health officials during the recent COVID-19 pandemic may serve as a future model for all health care professionals.

Sexual harassment of staff members in the dental office: The dentist’s ethical obligations

Q: One of our patients is friendly and likes to hug when he leaves. On his recent visit, he went in for a hug with our hygienist and instead groped her breasts. The staff member was understandably upset by the interaction and asked to no longer see the patient or interact with him. On a separate occasion, one of our associates was followed by a senior dentist into the laboratory where he shut the door, startling the younger dentist. Several crude and offensive comments were made as she stood motionless under his towering stature. She was able to maneuver around him and quickly escape the room. How should we handle instances like these with our team? What are our ethical obligations to our dental team members? Dr. Depp is a part-time lecturer, School of Dentistry, University of Louisville, Louisville, KY. Dr. Jonke is a partner and oral surgeon, Suffolk Oral Sugery, Stony Brook, NY.