BackgroundThe lack of procedure-specific, evidence-based dental antibiotic guidelines increases unnecessary and inappropriate antibiotic prescribing. The primary objective was to evaluate changes in antibiotic prescribing before and after antibiotic stewardship (AS) education by infectious diseases (ID) AS experts in addition to implementation of self-monitored antibiotic dashboards. A secondary objective was to link antibiotic prescriptions to standardized Current Dental Terminology (CDT) procedure codes.MethodsWe conducted a retrospective, multi-practice cohort study among 9 private practice periodontists who completed AS education by ID-AS experts. Antibiotic data, CDT codes, and medical histories were extracted from electronic dental records from 1 January 2021 through 30 June 2025. Individualized dashboards displayed longitudinal antibiotic prescribing and linkage to CDT procedure codes. Outcomes were compared across pre-education, post-education year 1, and post-education year 3 periods.ResultsA total of 11 795 antibiotic prescriptions for 7331 unique patients were identified; 85.6% were therapeutic (≥3 days) and 14.4% were prophylactic. Prophylactic antibiotics for patients with prosthetic joint implants decreased by 89% by post-education year 3 (P < .05). Clindamycin and fluoroquinolone use declined by 85% (P < .001) and 31% (P < .15), respectively. Ten-day antibiotic durations decreased by 87% (P < .001) with a corresponding increase in courses of 3–5 days across multiple CDT procedure categories. Improvements were sustained 3 years after education without ongoing external audit and feedback.ConclusionsDentists demonstrated sustained improvements in antibiotic use following ID-AS–led stewardship education and implementation of self-monitored antibiotic dashboards. Linking prescriptions to CDT codes supports future development of evidence-based dental antibiotic guidelines.

ObjectivesThis study investigates clear aligner treatment (CAT) of adult patients in private dental practice and aims to identify: 1) The awareness of and knowledge about CAT among citizens, 2) how citizens who have received CAT experience the treatment and 3) how general dentists and orthodontists assess CAT.Materials and methodsThe study was based on an observational cross-sectional questionnaire investigation. Two separate online questionnaires were sent out to all private dental clinics in Denmark and to a group of 2000 citizens aged ≥18 years.Results217 citizens and 200 practitioners were included in the analysis. The citizens’ awareness of CAT was poor in general, and younger citizens were more aware of CAT. The citizens most often became aware of CAT through their own dentist or through friends and family. The citizens were in general satisfied with their treatments.The practitioners always/often informed about all parameters possible. The most frequent indication for CAT was cosmetics. The orthodontists more often included a lateral cephalogram in the diagnostics before CAT and more often made changes and more comprehensive changes to the digital treatment plan. The orthodontists were less satisfied with CAT compared to the general dentists.ConclusionsThis study has provided valuable knowledge on the awareness and satisfaction of CAT among the citizens and indicated how practitioners assess CAT of adult patients in private dental practice in Denmark.

This study examined population-specific morphological variations in human premolar roots and canals and their clinical implications. Cone-beam computed tomography (CBCT) was used with the Ahmed classification system. A retrospective descriptive cross-sectional study analysed 388 maxillary premolars from CBCT scans of 97 participants obtained from participating private dental practices in Swakopmund and Windhoek and from the University of Namibia dental clinic. The root number and canal configuration were classified by the Ahmed system. Associations were assessed by comparing identical tooth types in the right and left maxilla. First premolars were mostly two-rooted (56.2%), and second premolars were mostly single-rooted (88.1%), with key configurations of 1MP1, 1MP1-2 and 2MP B1P1. Age-related changes showed increased 2MP B1P1 in first premolars and 1MP1-2-1 in second premolars. The dominant configurations in this Namibian sample align with other populations, emphasising the importance of population-specific data for endodontic treatment and supporting the relevance of the Ahmed classification.

Given the increasing reliance on online health information, this study aimed to systematically assess the quality of German-language eHealth information on head and neck cancer (HNC) related dental care. German-language websites were searched via Google.de, Bing.de/Yahoo.de, and DuckDuckGo.com in February 2025. German-language Youtube-videos were searched in March 2025. Websites were assessed across 4 domains: technical/functional aspects (LIDA-instrument), readability (Flesh-reading-ease-score), comprehensiveness (structured checklist), and quality and risk of bias (DISCERN-instrument). Differences between domains were tested using the Friedman test. Group differences among provider types were examined with one-way ANOVA or Kruskal-Wallis tests. YouTube-videos were assessed for comprehensiveness, viewers' interaction, and viewing rate. The Wilcoxon rank-sum test compared comprehensiveness between Youtube-videos and websites. A total of 134 eligible websites and 26 YouTube-videos were included. 63.4% of the websites were operated by private dental practices. All four domains differed significantly from each other (p < 0.001). Websites from private and corporate dental practices or private hospital groups showed significantly lower scores in technical/functional aspects compared with websites from dental societies, regulatory bodies, public institutions, or insurance companies. Overall readability was poor, with the highest scores observed for institutional websites (median 49.0) and the lowest for private practices (median 38.0). Comprehensiveness of patient-oriented information was low, especially among corporate dental practices and private hospital groups (median 5.0). Quality of consumer health information was highest for commercial or non-profit information services (median 29) and lowest for private and corporate dental practices (median 23.0). Only 19.2% of YouTube-videos originated from private dental practices, and exhibited low viewer interaction (median 0.9). No significant difference in comprehensiveness was observed between websites and YouTube-videos (p = 0.924). German-language eHealth information on dental care in HNC is generally of low quality. This study highlights the need for standardized, reliable, and patient-oriented online resources to support oral health and quality of life in HNC patients.

Background Medical–dental integration (MDI) is increasingly recognized as a promising approach to preventing disease and reducing oral health disparities. Although integrated care delivery is central to community health centres (CHCs), limited knowledge exists on how CHCs in British Columbia integrate medical and dental services. We conducted an environmental scan with the aim of describing the current state of MDI practices and strategies employed by CHCs in British Columbia. Methods A cross-sectional environmental scan approach combining passive conditioned viewing and active searching modes was used. Data were collected through an Internet search of organizational materials, an online survey of CHC representatives and clarifying telephone conversations. We included BC CHCs that addressed oral health through referrals or direct service provision. Descriptive statistical and content analyses were conducted. MDI practices and strategies were categorized as relating to workforce, information sharing, evidence-based care, and measuring and monitoring. Results Among the 23 CHCs included in the study, approximately half provided on-site dental services through co-located clinics (n = 9, 39%) or embedded dental hygienists (n = 3, 13%), whereas others relied on referrals (n = 9, 39%), and a smaller subset (n = 2, 9%) partnered with local private and nonprofit dental practices to provide off-site care. Implementation of integrating processes was limited overall. Less than one-quarter of the CHCs reported processes for information exchange, referral tracking and standardized screening protocols. Few reported using dedicated personnel, training resources or interoperable technology to support integration. Conclusion Our findings established a baseline understanding of MDI in BC CHCs, revealing significant gaps in the implementation of integrating processes. Further research is needed to explore these gaps and to build on lessons learned from other jurisdictions.

Background/Objectives: Dental Practice-Based Research Networks (DPBRNs) bridge the gap between academic research and private dental practice, addressing questions relevant to everyday medical care. Despite their growing scientific output, little research has explored the experiences of practitioners engaged in these networks. Our study therefore aims to investigate these practitioners' perspectives in order to identify strategies for improving investigator recruitment, training and data quality in future DPBRN studies. Methods: The qualitative methodology was chosen, and our study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines. Semi-structured interviews were conducted with dentists who had participated in a DPBRNs study and transcribed before being thematically analysed using Braun and Clarke's framework. MaxQDA 2022 software was used to facilitate coding of the verbatim quotes. Results: Three major themes emerged: (1) obstacles to participation, including time constraints, difficulties in patient recruitment, and a perceived disconnect between academia and private practice; (2) facilitators of engagement, such as strong leadership, logistical support, and a collaborative research environment; and (3) personal benefits, such as skill development, breaking professional routines, and counteracting stereotypes about private practitioners' involvement in research. Conclusions: The findings align with existing literature on medical Practice-Based Research Networks (PBRNs), highlighting logistical and motivational barriers while also emphasizing the importance of social and professional benefits. Notably, although financial compensation or credits for continuing professional development are frequently cited as motivators for research participation, these were not significant concerns for our participants. This study sheds light on the experiences of health practitioners in PBRNs, offering recommendations to overcome challenges through strategies such as accessible training, practical incentives and collaboration opportunities.

Purpose The scope of practice for dental hygienists continues to expand into diverse roles in clinical practice, education, administration, corporate environments, and public health, underscoring the need for robust leadership training. The purpose of this study was to explore perceptions of leadership education among dental hygienists in administrative roles; describe the leadership skills identified by dentists; and examine the views of dental hygiene faculty on leadership education and skills within the dental hygiene curriculum.Methods Qualitative research methodology was used with semi-structured interviews conducted on an online platform. Purposive and snowball sampling techniques were used to recruit participants across the three stakeholder groups: dental hygienists in administrative roles, dentists, and dental hygiene faculty from baccalaureate programs. Recruitment in each phase continued until thematic saturation was reached. Open, axial and selective coding were used to analyze the data.Results Four main themes emerged: Building Bridges, Collective Growth, Embracing Responsibilities, and Overcoming Obstacles, through the interview sessions with dental hygienists in administrative roles (n=11), dentists in private practice (n=6), and dental hygiene faculty members (n=19).Conclusion This research underscores the strategic value of integrating leadership education into dental hygiene curricula, laying a strong foundation for students' future roles as leaders in health care. Recommendations include thoroughly reevaluating current curricula, adopting a strategic approach to embed leadership education, and creating a leadership training framework for dental hygiene education programs.

BackgroundBioceramic materials have emerged as a significant advancement in endodontics, offering excellent biocompatibility, sealing ability, and bioactivity.Their use has expanded in recent years, particularly for pulp capping, perforation repair, and regenerative procedures.ObjectivesThis study aimed to assess the knowledge of bioceramics among private practice dentists, evaluate the frequency of use of sealing and filling bioceramics, and examine the applied clinical protocols as well as potential shortcomings.Materials and methodsThis cross-sectional study was conducted according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, based on an epidemiological Knowledge, Attitudes, and Practices (KAP) survey. It was carried out among Tunisian private practice dentists. Data were processed and analyzed using Excel 2007 and Statistical Package for the Social Sciences (SPSS) Statistics 21.0. The sample size was calculated using the standard formula for estimating a proportion in a cross-sectional study, and participants were randomly selected. Participation was voluntary, anonymous, and confidential.ResultsA total of 200 dentists participated. Only 54.5% reported using sealing bioceramics, with 35.05% using them in all cases, 19.94% for periapical lesions, and 16.92% for root perforations. Approximately half of the dentists (53.01%) observed faster healing when using these sealers. Regarding filling bioceramics, 67.5% of participants used them, with a preference for MTA. These materials were indicated for various clinical situations, including repair of floor perforations, pulp capping, apexification of immature permanent teeth, and repair of root perforations. However, 45.61% of participants reported treatment failures when using these bioceramics, with failure to adhere to one of the endodontic treatment steps identified as the primary cause.ConclusionThis study concluded that younger dentists tend to use bioceramics more frequently, filling bioceramics are better known than sealing ones, and most participants are familiar with the clinical indications of these materials. It is essential to provide further guidance and recommendations on the clinical application of bioceramics to optimize treatment outcomes.

To establish the monetary costs of supporting the Indigenous community in Australia to receive culturally safe dental care. Financial data was analysed from a follow-up dental intervention study involving 173 Indigenous Australians-164 adults and nine children-who received fully funded dental treatment through private dental clinics. Participants were seen at baseline and 12-month follow-up for an oral health assessment, conducted at a location of their preference. Following the initial assessment, participants were referred to a private dental practice near their residence or of their choosing, with preference given to a practice that employed an Indigenous dentist. The study team provided additional support as required, such as transportation vouchers to attend appointments, assistance with bookings, providing reminders, and checking in regarding treatment experiences. Most participants were employed and primarily resided in metropolitan and inner regional locations of South Australia. The total expenditure for private dental treatment was nearly $300 000 AUD, with a median per capita cost of $1332 AUD (IQR: $727-$2311). The largest proportion of funding (42.3%) was spent on restorative treatments, both overall and within each age group. Participants who reported they would have considerable difficulty paying a $100 dental bill had a higher median cost of treatment ($1384, IQR: $1073-$2691) than those who reported they would have less difficulty ($961, IQR: $633-$2001). Following dental treatment, participants reported that both their general and oral health improved. The dental expenditure and volume of care required by participants in this study demonstrate that unmet dental needs persist in the Indigenous community, which can be addressed by reducing cultural, structural, and financial barriers.

Quach, S. S., N. Johnson, R. Dudhia, A. Puljich, S. Ivanovski, and R. S. B. Lee. 2025. "The Periodontal Benefits of Alveolar Ridge Augmentation With Xenograft Following Third Molar Extraction: A Randomised Controlled Trial." Journal of Clinical Periodontology 52, no. 10:1419-29. https://doi-org.plymouth.idm.oclc.org/10.1111/jcpe.14205 . A 6-month randomised controlled trial was conducted to determine whether xenograft grafting using deproteinised bovine bone mineral with collagen (DBBM-C) affects periodontal healing at the distal aspect of the second molar (D2M) following third molar extraction. The study included 28 participants and a total of 42 extraction sites, which were allocated to either the test group (socket grafting with DBBM-C following extraction) or the control group (extraction without grafting). The surgical procedures in this study were carried out by two experienced specialist oral and maxillofacial surgeons. Participants in this study were initially assessed in a private dental practice, whilst all surgical procedures were performed at the Wesley Hospital in Brisbane. Adult patients aged 18-45 years with an ASA 1 status and one or two unerupted mandibular third molars with horizontal or mesio-angular impactions were included. These had either class I or II and position B or C impactions and demonstrated radiographic bone loss ≥5 mm on the distal aspect of the second molar on the CBCT. The study excluded patients with a history of periodontal disease, a full mouth plaque score ≥40%, and those who were not willing to return for review. Additionally, disto-angular impactions, extractions that required extensive surgery or pathology that required more than just extraction and primary wound closure were also excluded. Outcomes were assessed radiographically and clinically. CBCT scans were obtained at baseline and 6 months post-surgery where the D2M and extraction sockets were evaluated by linear and volumetric CBCT measurements by a single blinded examiner. Linear CBCT measurements assessed bone height adjacent to the mandibular second molar (CEJ-C) from the CEJ to the most coronal aspect of the alveolar crest at distobuccal, distal and distolingual sites. Volumetric CBCT measurements recorded included the socket healing volume (SHV) and the periodontal healing volume (PHV) around the D2M. Clinically, a full mouth plaque index, gingival index and probing pocket depths of distobuccal, distal and distolingual sites around the D2M were measured, 6 months post-operatively. Sample size determination was calculated from previous bone height data, with a total of 18 extraction sites per group included. Intra-group differences were evaluated using paired t-tests, while inter-group differences were assessed via linear regression with robust standard errors to account for repeated measures. Data normality was assessed through skewness and kurtosis analyses. Measurement reliability was confirmed using intraclass correlation coefficients (ICC). Of the 28 participants initially recruited, only 17 completed the six-month follow-up and were included in the final analysis after accounting for dropouts and exclusions. Most teeth were Class II, position B and all of them were either mesio-angular or horizontal with mean impaction angle of 63.4° ± 17.79° in the control group and 57.54° ± 21.59° in the test group. At 6 months, SHV showed 86.2% ± 12.6% and 88.8% ± 7.1% bony infill in the control and test groups, respectively, while PHV improved to 73.6% ± 21.0% and 75.1% ± 13.9% in the control and test groups. Overall both linear and volumetric measures showed significant bony healing at the D2M 6 months post-operatively. However, there were no significant differences between the test and control groups.

ABSTRACT Background Molecular identification of dental caries microbes is advancing rapidly, yet sampling methods remain outdated and imprecise. Objective To refine microbe sample harvesting and preserve taxa pre-harvest spatial positions relative to lesion pulpal depth. Methods Refinements included a sterile zone surrounding the dissection site and emphasize asepsis, surgical microscope magnification and lighting, and micro-surgical techniques. Retention of taxa pre-harvest spatial positions relative to lesion pulpal depth used shallow-layered dissection (mean 6 mg/layer, SD 2.65 mg), where each layer became a separate sample for molecular identification before sequential reassembly in a layered lesion diagram. To evaluate the method’s robustness, 14 lesions varying in severity and type from private dental practices were dissected using the method (7 pit and fissure and 7 facial lesions; 4 untreated, 3 treated). Results Pre-harvest taxa detail, not possible previously, showed taxa location, abundance and diversity relative to lesion pulpal depth, as well as absolute abundance per milligram and taxa transitions and fluctuations from superficial through the deepest dissected layers. The method provides these data regardless of lesion type, stage, or complexity, whether untreated or treated. Conclusions This method provides new details and perspectives on dental caries taxa that could help develop diagnostic instruments and treatments to halt dental caries progression.

The expansion of Indonesia’s National Health Insurance program (Jaminan Kesehatan Nasional, JKN) has improved access to primary dental care services. However, factors influencing participants’ selection of dental care facilities, whether community health centers (pusat kesehatan masyarakat or puskesmas), private clinics, or private dental practices, remain underexplored. This study aimed to identify the determinants of facility preference among JKN participants seeking primary oral health services. The study employed a retrospective cross-sectional design, utilizing secondary data from the 1% Sample Data of Indonesia National Health Insurance (2017–2023). The population consisted of 140,395 adult JKN participants (aged 18 years or older) who received dental care and were alive as of December 31, 2023. Multinomial logistic regression was used to examine the associations between facility choice and sociodemographic variables, including age, sex, premium class, membership segmentation, and residential area. Community health centers were the most accessed (41.1%), followed by private clinics (37.2%). Participants in the government-subsidized segmentation were far more likely to use community health centers (RRR = 16.38; 95% CI: 15.54–17.27). Those in the highest premium class favored private clinics (RRR = 1.29; 95% CI: 1.23–1.35). Residents of Regency had lower odds of visiting community health centers than city residents (RRR = 0.46; 95% CI: 0.44–0.47). These findings indicate that administrative and demographic characteristics have a significant impact on dental care utilization under JKN. Healthcare providers, particularly private clinics and dental practices, should develop value-based strategies centered on service quality and long-term patient relationships. Policymakers may consider capitation adjustments to support quality improvements.

ABSTRACTAimTo determine (i) the parameters used by dental professionals to evaluate patients with periodontitis, (ii) the prevalence of periodontitis using different case definitions and (iii) associations between periodontitis and diabetes mellitus, cardiovascular disease and rheumatoid arthritis among adult patients in private practices in Denmark.Materials and MethodsThis nationwide descriptive study used data collected from private practices using the DentalSuite electronic dental record system between 2000 and 2022. Patients 18 years or older with a Danish social security number were included in the study. Prevalences of periodontitis were calculated using periodontal registrations and different case definitions for periodontitis. Registrations of selected comorbidities along with periodontitis, namely diabetes mellitus, cardiovascular diseases and rheumatoid arthritis, were also collected.ResultsA total of 1,473,428 individuals were included in the study, of whom 782,464 (53%) were females. About 302,604 (20.5%) patients complied with the periodontal probing depth ≥ 5 mm PD case definition. Furthermore, 130,688 (8.9%) patients had periodontal parameters that fulfilled the more specific 2018 AAP/EFP classification. Periodontal probing depth registrations were available for 24% of the patients. Patients identified with periodontitis had higher prevalences of the selected comorbidities compared to the population as a whole.ConclusionsIn private practices in Denmark, probing pocket depth was the most frequently registered periodontal parameter used for screening and monitoring periodontitis. The selected comorbidities appeared to be more prevalent in patients with periodontitis.

BackgroundThis study assessed job satisfaction and dissatisfaction among Pennsylvania dental hygienists using the validated Job Satisfaction Survey (JSS) to identify key workplace factors associated with job satisfaction, dissatisfaction, and workforce instability.MethodsA cross-sectional quantitative survey was distributed in 2024 to licensed dental hygienists in Pennsylvania using convenience sampling at two professional events. Participants completed the JSS, a 36-item instrument covering nine workplace domains, via an anonymous Qualtrics survey. Descriptive statistics were used to summarize overall satisfaction levels, and chi-squared tests to assess relationships between JSS responses and demographic variables such as years of experience and work setting.ResultsOf 342 responses, 328 met the inclusion criteria. Respondents were predominantly female (98.5%) and aged 55 and older (52.7%) and worked primarily in private dental practices (71.6%). Although the respondents reported high satisfaction with intrinsic motivators, such as pride in work (mean score = 5.31) and relationships with coworkers (mean = 5.06), they reported significant dissatisfaction with income (60.4% disagreed that they were fairly paid), promotional opportunities (87.1% agreed there was little chance for promotion), and organizational support. Frequency of raises and perceived inequity in benefits varied significantly among work settings, as did supervisory support and workplace conflict.ConclusionDespite high professional pride and collegiality, dissatisfaction with income, limited advancement, and administrative barriers may contribute to instability in the broader workforce. Addressing systemic dissatisfaction while reinforcing drivers of satisfaction may help sustain a resilient dental hygiene workforce and support access to care.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-025-13269-5.

Background: The implementation of Electronic Medical Records (EMR) is part of the digital transformation of the healthcare system in Indonesia. However, the readiness of primary healthcare facilities, such as private medical and dental practices, varies. The purpose of this study is to analyze the readiness for Electronic Medical Records (EMR) implementation in terms of human resources, work culture, governance and leadership, and infrastructure in private medical and dental practices in Pasuruan City. Method : The research design used a qualitative approach with a case study approach. Informants were selected through observation and interviews with 20 general practitioners and doctors practicing independently at private medical practices and private dental practices located in the city of Pasuruan. This study used purposive sampling techniques. The research instrument used an interview guide. Data collection was conducted in June 2025. Results: The research findings revealed that most respondents understood the basic concepts of Electronic Medical Records (EMR) and had adequate equipment to support its use. Work culture exhibits adaptive characteristics, although there are still barriers in the form of limited training and manual work habits, particularly among senior medical staff. Decision-making regarding Electronic Medical Records (EMR) implementation tends to be top-down, with the practice owner playing a central role. Basic infrastructure such as hardware is available, but internet connectivity and application interoperability remain the primary challenges. Conclusion: In general, the readiness for Electronic Medical Records (EMR) implementation in private medical and dental practices in Pasuruan City is already at a positive early stage. However, full success requires strengthening human resource capacity through continuous training, improving the stability of digital infrastructure, and policy synergy between the government and professional organizations so that EMR implementation runs optimally and sustainably

Two-piece zirconia implants offer a metal-free alternative to titanium implants, but only limited long-term data are available. The aim of this retrospective study was to evaluate the clinical outcomes of two different, identically designed two-piece zirconia implants (NobelPearl™ and Zeramex XT) in a private dental practice. Between 2017 and 2024, 167 implants were placed in 106 patients and followed up to 88 months (Ø 39.1 months). In addition to the implant survival rate, marginal bone loss (MBL), clinical parameters and surface properties were examined using 3D profilometry. The statistical analysis included descriptive evaluations and a survival analysis using the life table method. Three implants were lost (two fractures, one failed osseointegration), corresponding to an effective survival rate of 98.2%. The mean marginal bone loss varied between -0.14 mm and -0.58 mm. The surface roughness was minimal (Sa ~0.5 µm). No risk factor showed a significant association with implant loss in the univariate analysis. Two-piece, screw-retained zirconia implants showed a high survival rate and stable peri-implant tissue conditions over a period of up to seven years. They represent a promising metal-free alternative to titanium implants. Further prospective long-term studies are needed to validate these results and to better understand potential risk factors.

Dental care plays a vital role in overall health, as poor oral health is linked to systemic diseases such as diabetes, cardiovascular issues, and malnutrition. In Indonesia, around 70% of the population experiences oral diseases, yet only 12% seek professional treatment, a figure significantly lower than the global average. This highlights the urgency of examining patient satisfaction in dental care. This study investigates patient satisfaction at DSC Dental Clinic in Surabaya, Indonesia, using a qualitative case study approach. Nine participants who received various dental treatments were interviewed through semi-structured methods and observed directly. The findings reveal that high clinical skills, clear communication, stringent infection control protocols, and a fair price-to-value perception contribute positively to patient satisfaction. However, inefficient administrative services negatively affect the patient experience. These insights can guide better collaboration between clinical and administrative staff to enhance the quality of dental care services. Furthermore, this research supports clinic management and policymakers in regulating private dental practices by ensuring strict hygiene standards, transparent pricing, and effective administrative procedures.

The subjects of memoir literature expand the range of sources used to study the history of medicine. The article, based on the memoirs of V. Kataev, analyzes dental treatment as a social phenomenon and a special cultural phenomenon, and also focuses on the medical and social problems of receiving this type of medical care. The author believes that at the beginning of the 20th century dentists received exclusive rights to dental care and the image of dentistry began to change to the authority of a profession that plays an important role in the preservation and treatment of teeth. Stable beliefs about regular visits to a specialist, the need for preventive fillings, and the restoration of lost teeth began to be embedded in the consciousness of the average person. However, the system of private dental practice, being at the intersection of craft and medical science, was based on individual sales of medical services, the dependence of the treatment process on the financial condition of the patient and could not dispel the established beliefs and stereotypes of people about the inevitability of dental damage with age, the low effectiveness of treatment and the inevitable physical pain.

Statement of problemAs the global population ages, tooth loss among older adults has become increasingly prevalent, impacting oral function and overall health. Although removable dentures have been used to improve masticatory function, the long-term effects of denture conditions on mortality are unclear. PurposeThe purpose of this clinical study was to clarify the association between removable denture condition and the mortality rate in older adults with reduced occlusal support. Material and methodsThis longitudinal study analyzed survival data (up to 2022) for 186893 individuals aged ≥75 years who underwent dental examinations through public healthcare services between 2018 and 2020. The participants were categorized into 10 groups (A1 to A3, B1 to B4, and C1 to C3) based on their occlusal support status using the Eichner index. Denture conditions were assessed by private practice dentists and classified into 3 categories: well-fitting, poorly fitting, and not used. Cox proportional hazards regression analyses were conducted to examine the association between denture conditions and mortality by considering the following control variables: age, sex, history of chronic diseases (hypertension, diabetes, hyperlipidemia, and dementia), smoking habits, and body mass index for the entire study population and within each of the B1 to B4 and C1 to C3 groups. ResultsSignificantly higher hazard ratios (HRs) for mortality were observed with occlusal support deterioration, poorly fitting dentures, and nonusage, with the peak observed in the C3 group with no dentures. The HRs (with 95% confidence intervals) of well-fitting dentures were consistently the lowest across all groups as follows: 0.98 (0.90 to 1.06) in B1, 1.02 (0.95 to 1.10) in B2, 1.11 (1.03 to 1.19) in B3, 1.14 (1.07 to 1.22) in B4, 1.15 (1.05 to 1.26) in C1, 1.28 (1.21 to 1.37) in C2, and 1.58 (1.46 to 1.72) in C3, with the A1 to A3 group as the reference. Poorly fitting or no dentures were associated with increased HRs in the Eichner groups B3 to C3, compared with well-fitting dentures. ConclusionsThis large population-based cohort study found that well-fitting dentures were associated with lower mortality risk in older adults with reduced posterior occlusal support. Nonusage or poorly fitting dentures were associated with an increased risk of mortality as occlusal support deteriorated.

Over fifteen percent of the global population experiences dental fear, and although evidence-based treatments exist, adoption of these treatments is almost non-existent. Informed by our prior research examining barriers to adopting face-to-face behavioral treatments in dental operatories, this study examined dentists’ responses to three stepped-care Cognitive Behavioral Therapy for Dental Fear (CBT-DF) formats that use technology. All approaches offer an automated component as the first step (a mobile app) and either an in-person, virtual reality (VR), or video telehealth session as the second step. This study aims to understand which of these approaches would most likely be adopted by private practice dentists and why. Eight focus groups/solo interviews with a total of 13 private practice dentists were conducted with the aim to assess barriers and facilitators to implementing three stepped-care approaches of CBT-DF. The qualitative data obtained from these interviews was coded and analyzed according to Rogers’ framework of innovation (relative advantage, compatibility, complexity, trialability, and observability). The results indicated that participants acknowledged the value of interventions to address dental fear, as they had personal experiences with fearful patients that impacted their practices. Participants responded positively to the automated component of treatment (the app) and were more wary of treatment options requiring office space and staff time (in-person VR and in-person mental health provider). The telehealth option received the most favorable response, although some doubts were expressed regarding relative efficacy and patient accountability. Thus, dissemination of an app-telehealth treatment model that allows dentists to serve as referral partners is promising, given dentists’ incentives to decrease patient fear while avoiding opportunity cost (e.g., occupied chairs and staff time).