Dentistry In General Practice Research Articles

The ADEPT study: a comparative study of dentists' ability to detect enamel-only proximal caries in bitewing radiographs with and without the use of AssistDent artificial intelligence software

Introduction Reversal of enamel-only proximal caries by non-invasive treatments is important in preventive dentistry. However, detecting such caries using bitewing radiography is difficult and the subtle patterns are often missed by dental practitioners.Aims To investigate whether the ability of dentists to detect enamel-only proximal caries is enhanced by the use of AssistDent artificial intelligence (AI) software.Materials and methods In the ADEPT (AssistDent Enamel-only Proximal caries assessmenT) study, 23 dentists were randomly divided into a control arm, without AI assistance, and an experimental arm, in which AI assistance provided on-screen prompts indicating potential enamel-only proximal caries. All participants analysed a set of 24 bitewings in which an expert panel had previously identified 65 enamel-only carious lesions and 241 healthy proximal surfaces.Results The control group found 44.3% of the caries, whereas the experimental group found 75.8%. The experimental group incorrectly identified caries in 14.6% of the healthy surfaces compared to 3.7% in the control group. The increase in sensitivity of 71% and decrease in specificity of 11% are statistically significant (p <0.01).Conclusions AssistDent AI software significantly improves dentists' ability to detect enamel-only proximal caries and could be considered as a tool to support preventive dentistry in general practice.

Controversial and unresolved issues of modern therapeutic dentistry from the point of view of practical dentists (according to the survey-questionnaire)

Aim. Using the method of questionnaire survey of dentists to assess their awareness of the current problems of modern practical therapeutic dentistry.Materials and methods. The analysis of the results of a survey- questionnaire of 376 practical dentists, who is practicing a therapeutic dentistry (dentists with legal certificates in fields: ’’therapeutic dentistry” or "general practice dentistry"). Questioning of 238 dentists (63.3%) was carried out in person, questioning of 138 dentists (36.7%) was carried out remotely using the stomweb.com network resource.Results. Significant differences and contradictions in approaches to the implementation of key dental procedures were revealed: aesthetic restoration of anterior teeth, restoration of the contact surfaces of posterior teeth, adhesive preparation, therapeutic tactics for deep caries and reversible forms of pulpitis, approaches to the diagnosis and treatment of cervical non-carious dental defects, preparation tactics cavities, the use of intracanal pins in the restoration of endodontically treated teeth, attitudes towards teeth whitening, fluoride-containing toothpastes and electric toothbrushes, etc.Conclusions. The data obtained indicate the need for targeted scientific research, further trainings on a hans-on courses, addressing several studied issues, based on the principles of evidence-based medicine, as well as the expediency of reforming the education system for dental professionals in order to limit the dissemination of information that does not have scientific justification and/or evidence base.

631 Designing an Oral and Maxillofacial Trauma Assessment Proforma for Dental Core Trainees in Northern Ireland

Abstract Aim The dental core training (DCT) scheme is an optional postgraduate training pathway for dental graduates who have completed their foundation training and wish to undergo further specialist training. The majority of posts available in Northern Ireland (NI) are within oral and maxillofacial surgery (OMFS) units and include on-call commitment. Dental core trainees (DCTs) are expected to examine and assess OMFS trauma patients and often have limited experience of this prior to post commencement. This project outlines the development of an OMFS trauma assessment proforma designed for DCTs working in NI. Method An initial OMFS trauma proforma was designed alongside senior staff. This was introduced to 6 DCTs and 2 trust SHOs within a tertiary OMFS unit. 34 proformas were recorded within month 1, following which a feedback survey was completed by the 8 trainees. A revised proforma was redistributed and 33 recorded over month 2, followed by a repeat feedback survey. Results The revised proforma was found to be successful amongst trainees within the unit to act as an aid memoir and provide systematic structure to trauma examination. 100% of trainees recorded the revised proforma as useful. As a result, the proforma was introduced as part of the national induction programme for new DCTs commencing training posts in NI. Conclusions Progressing from general practice dentistry to the role of an OMFS DCT can be a challenging transition for many trainees. The proforma aids to guide junior clinicians in how to structure and record oral and maxillofacial trauma whilst ensuring thorough and comprehensive examination.

Pilot Study Evaluating the Use of Typodonts (Dental Models) for Teaching Veterinary Dentistry as Part of the Core Veterinary Curriculum.

Periodontal disease is one the most common disease pathologies in small animal medicine, yet new graduates report they feel unprepared to perform dentistry in general practice. Novel methodologies to close the knowledge gap in veterinary dentistry need to be identified. Typodonts (dental models) are commonly used in human dental schools to teach basic principles prior to practice on clinical patients and have been shown to be an effective teaching tool. The study aimed to determine if independent study and self-guided practice on a veterinary typodont prior to a structured, in-person cadaver laboratory with feedback increases students' perceived dentistry clinical skills in performing periodontal techniques. We calculated the knowledge gap before and after the cadaver laboratory by comparing the students' perceived and desired skill levels in performing periodontal charting, ultrasonic cleaning, hand scaling, and root planing. Ninety-six percent of students reported that practice with the dental typodont prior to the cadaver laboratory increased their comfort level in performing periodontal skills. However, practice did not result in a significant decrease in knowledge gap compared with participation in the cadaver laboratory alone. Although students perceived a benefit to practicing with the typodont, self-guided practice was not effective in decreasing the knowledge gap, most likely due to a lack of structured feedback with typodont use. Further investigation into the use of typodonts with direct feedback prior to structured laboratory or, alternatively, as an additional practice tool following a structured laboratory would further define if there is a benefit to typodont practice in veterinary dentistry.

Dentists’ restorative treatment decisions: A south african study

Aim: To focus on clinical decision-making by dentists for defective restorations in the context of an overburdened healthcare system and a high caries rate. Materials and Methods: A cross-sectional study was conducted using mixed-methods. An online survey was administered to all members of the South African Dental Association followed by in-depth interviews of 15 purposefully selected dentists in the Western Cape. The online data included demographic data, education level, knowledge, attitudes, and practises related to dental amalgam use. The interviews consisted of two patient cases where dentist were asked to explain their treatment decisions. Quantitative data was analysed using statistical software SAS (SAS Institute Inc., Cary, NC, USA) and a Chi-square test and Spearman’s correlation was used with P < 0.05. The interviews were coded, transcribed, and analysed using the Atlas.ti ® software. Responses were analysed using the framework method. Results: A significant relationship was found between dentists with more than 21 years of experience and the repair of defective restorations (P = 0.0027*). Remaining tooth structure and the presence of pain were the most important clinical factors influencing treatment decisions. Non-clinical factors such as fear, ethical conscience, cost to patient and dental school had an influence on their decisions. Conclusion: Clinical factors and non-clinical factors influence dentists’ treatment decisions. There was a lack of translation of evidence-based information to everyday general practice dentistry in South Africa. These results have implications in changing current continuing professional education activities and motivating policy makers to incentivize preventive and minimally invasive dentistry.

Complex Dentistry in General Practice - What Would You Do?

In 2019, in a world of instant gratification, what are the expectations of patients and dentists? Is training sufficient to meet these expectations? Decision-making in dentistry impacts the treatment choices patients are given, and may influence the outcomes of such treatment. It is therefore important to ensure as much standardisation as possible. In order to achieve this, it is important to know the current standard and the views of dentist as this will influence dental treatment planning. Clinical Relevance: This paper captures the treatment planning dilemmas of dentists, specifically of those in their Foundation training year, in order to aid targeting of training and development. Objective Statement: To understand treatment decisions of general dental practitioners and specialists.

The implementation of a decision-tree did not increase decision-making in patients with temporomandibular disorders in the public dental health service

Objective: Many patients with temporomandibular disorders (TMD) seem to go undetected within primary dental health care. Primarily we evaluated if the implemented intervention increased the clinical decision-making for TMD patients; secondarily we evaluated if other factors could be identified that predicted performed or recommended TMD treatment.Material and Methods: This case–control study was carried out within the Public Dental Health service in Västerbotten County, Sweden. An intervention based on a decision-tree with three screening questions for TMD (3Q/TMD) was implemented during 2015 in four clinics and compared with the remaining county. A total of 400 individuals were selected—200 3Q-positives and 200 3Q-negatives. The 3Q/TMD consists of Q1—frequent jaw pain, Q2—frequent pain on function, and Q3—frequent catching and/or locking of jaw. The 3Q/TMD answers were analyzed in relation to TMD treatment and any TMD related decision that was collected from the digital dental records.Results: The intervention did not increase the frequencies of traceable clinical decisions among patients with TMD.Conclusions: Despite the implemented intervention aimed, the indicated undertreatment of patients with TMD remains. Future studies are still needed to gain a deeper understanding of the clinical decision-making process for TMD patients in general practice dentistry.

High total volatile organic compounds pollution in a hospital dental department

Bioaerosols produced by dental procedures may affect indoor air quality and cause infections in dental healthcare workers. To provide air quality data that can be used to protect dental healthcare workers, this study evaluated the air quality and its influencing factors in the dental department of the Chang Gung Memorial Hospital in Taiwan. The study was a cross-sectional study design. Indoor air quality (IAQ) evaluations were conducted in six locations: pediatric dentistry, craniofacial orthodontic dentistry, periodontal dentistry, and general practice dentistry, instrument washing room, and patient waiting area. The measured air quality parameters included temperature, relative humidity, and concentrations of CO2, total volatile organic compounds (TVOCs), suspended particulate matter (PM), and bacteria. TVOCs concentrations at all six sampling stations were found to exceed the indoor air quality standards prescribed by the Taiwan Environmental Protection Agency. The highest concentrations of atmospheric PM10, PM2.5, and PM1 were found in the periodontal dentistry department, while the lowest concentrations occurred in the patient waiting area. The detection rate for Gram-positive bacteria was highest in the pediatric department (25%) and lowest in the instrument washing room (9%). Micrococcus luteus and Bacillus cereus were the primary pathogens detected. The dental departments of the hospital had a serious TVOCs pollution. The air quality of dental departments deserves long-term surveillance and attention.

Purchaser/provider: what does it mean and how might it affect GDPs?

Purchaser/provider in dentistry has been talked about so much of late, but while the hospital and community dental services have on many occasions felt the full thrust of the NHS changes, GDPs currently remain largely unaffected. This is likely to change, however, and so it seems appropriate to look back into the short history of this particular management tool and describe what it is, how it relates to health care in general and how it might work in general practice dentistry.

Fundamentals of prosthetic practice. Part I--The laboratory.

Prosthetic dentistry in general practice produces many challenges for both the newly qualified trainee and the long-standing practitioner. If these challenges are not appreciated, met and dealt with effectively, the dentist may be left disillusioned with his skills and expertise, and stressed at the thought of treating patients requiring dentures. The economic need for rapid treatment while maintaining good standards of work, can result in pressure, and the temptation to 'cut corners' can prove costly. These articles, far from being a definitive text, seek to illuminate some potential problems and to lead the clinician to establish his own solutions in the areas of the laboratory, the prescription, communication and some alternative clinical techniques.

Preventive dentistry in general practice. A study of current use.

Preventive dentistry in general practice. A study of current use.

Children's dentistry in general practice. 12. Dental care of medically handicapped children.

Children's dentistry in general practice. 12. Dental care of medically handicapped children

Children's dentistry in general practice. 11. Dental care of physically and mentally handicapped children.

Children's dentistry in general practice. 11. Dental care of physically and mentally handicapped children

Children's dentistry in general practice. 10. Interceptive orthodontics.

Children's dentistry in general practice. 10. Interceptive orthodontics.

Children's dentistry in general practice. 9. Periodontal conditions in children.

Children's dentistry in general practice. 9. Periodontal conditions in children.

Children's dentistry in general practice. 8. Injuries to anterior teeth of children.

Children's dentistry in general practice. 8. Injuries to anterior teeth of children.

Children's dentistry in general practice. 7. Treatment for young permanent teeth.

Children's dentistry in general practice. 7. Treatment for young permanent teeth.

Children's dentistry in general practice. 5. Treatment of caries in the deciduous dentition.

Children's dentistry in general practice. 5. Treatment of caries in the deciduous dentition

Children's dentistry in general practice.

Children's dentistry in general practice.

Children's dentistry in general practice. 4. Practical prevention dentistry methods

Children's dentistry in general practice. 4. Practical prevention dentistry methods