General Dental Clinic Research Articles

A comparison of oral health-related quality of life and satisfaction among patients undergoing root canal treatment or tooth extraction – A prospective controlled cohort study

Objective: This study aimed to evaluate the impact of root canal treatment on Oral Health-Related Quality of Life (OHRQoL) in general dental practice and compare it with tooth extraction. Additionally, patient satisfaction following tooth-preserving treatment was assessed. Material and methods: In all, 65 patients were recruited from 6 general dental clinics in Västra Götaland over 8 weeks, with 37 starting root canal treatment and 28 having extractions. Questionnaires, including Oral Health Impact Profile-14 (OHIP-14) and 9 questions assessing patient satisfaction, were administered at treatment initiation, and at 1, 6, and 12 months. The responses from both modalities were analysed using descriptive and analytical statistical methods. Results: The response rate ranged from 73.8% to 92.3%. Regarding OHRQoL, differences between the groups were few compared to baseline. However, significant improvements were observed in the extraction group at the 6- and 12-month follow-ups, in the ‘total score’, and the dimensions ‘pain’, ‘discomfort’, and ‘handicap’. Patient satisfaction was generally high, with cost being the least satisfactory item. Pain intensity remained consistently low. Conclusions: In this prospective cohort study few differences were found between the two treatment modalities. However, significant improvements were observed in the extraction group in several dimensions. The patient satisfaction regarding root canal treatment was considered high.

Effects of Nitrate and Nitrite on Plaque pH Decrease and Nitrite-Producing and -Degrading Activities of Plaque in vitro.

The purpose of this study was to investigate the effects of nitrate and nitrite on the pH-lowering activity of human plaque, the nitrite-producing and -degrading activities of human plaque, and their correlation. Nitrate and nitrite were added to human plaque suspensions collected from the buccal aspect of maxillary molars of patients visiting a general dental clinic, and changes in pH were measured with and without glucose addition. Nitrite-producing and -degrading activities were evaluated by adding nitrate and nitrite to the plaque suspension and measuring the increase and decrease in nitrite with Griess reagent, respectively. The addition of nitrate inhibited both endogenous and glucose-induced plaque pH-lowering. The addition of glucose enhanced the production of nitrite from nitrate by about 3.3-fold. The addition of nitrite also inhibited endogenous plaque pH-lowering, but the addition of glucose promoted nitrite degradation by only about 1.1-fold. Nitrite-producing activity was positively correlated with age, but not with nitrite-degrading activity. This study revealed that nitrite was produced from nitrate and inhibited the pH-lowering activity of human plaque, which may contribute to caries control. Both nitrite-producing and -degrading activities occurred in human plaque, but no correlation was found between them. Furthermore, nitrite production was enhanced by glucose metabolism, which may function as a self-regulatory mechanism (resilience) to prevent excessive acidification by glucose metabolism.

Relationship between Body Mass Index and Sarcopenia with Oral Function Decline in Older Japanese Patients Who Regularly Attend a General Dental Clinic.

This study examined the relationship between body mass index (BMI) and sarcopenia with oral function decline in older patients as well as whether a combination of underweight BMI and sarcopenia was associated with decreased oral function in individuals with conservative restorative and prosthetic treatment for masticatory disorders. This cross-sectional study included 290 older Japanese patients who regularly attended a general dental clinic. A detailed examination of oral function, sarcopenia, and BMI according to the Asian Working Group for Sarcopenia 2019 criteria was conducted for patients aged 65 years. This study used odds ratios as an epidemiological measure in the cross-sectional survey. Multinomial logistic regression analysis showed that the number of remaining teeth and tongue pressure was associated with both ideal and overweight BMI in individuals with sarcopenia when compared to healthy individuals. The underweight BMI plus sarcopenia group was associated with tongue and lip motor function [ka] sound test, swallowing function, and the presence of oral hypofunction. Our findings indicated that various aspects of oral function were impaired in community-dwelling older adult Japanese patients with sarcopenia and underweight BMI. Notably, among older adults with sarcopenia, both obese and thin patients exist, suggesting that distinct pathophysiological mechanisms influence oral function. The above findings support the hypothesis that the coexistence of sarcopenia and underweight BMI is associated with poor oral function. Regular oral function assessments and weight measurements in general dental practice can aid the prompt identification of sarcopenia and reduced swallowing function and can facilitate early intervention. The presence of sarcopenia and impaired swallowing function should be considered in patients with underweight BMI, reduced [ka] sound, and low tongue pressure following a thorough oral function examination.

Trends of number of patient visits, demographic, and patient diagnosis at a dental hospital during the COVID-19 pandemic: a descriptive study

ABSTRACTIntroduction: The long-standing COVID-19 pandemic had resulted in the implementation of service restrictions and the emergence of patients' fear of coming to health facilities, which could have caused changes in patient visit trends. The aim was to determine trends in the number of visits, demographic characteristics and patient diagnoses during the COVID-19 pandemic. Method: the descriptive and population research used secondary data from medical records of new visiting patients and existing patients at the general dental clinic, pavilion clinic, and emergency ward at the Universitas Padjadjaran Dental Hospital (RSGM UNPAD) from April 2019 to March 2021. Sample for number of patient visits before and during the pandemic, the total sampling was 12,714 and the characteristics and diagnosis of patients during the pandemic were 3,625 medical records, while non-probability sampling technique with purposive sampling was used. Univariate analysis used frequency distribution, line charts, bar charts. Result: The number of patient visits at RSGM UNPAD during the pandemic decreased by around 60% (from 9,089 to 3,625 visits) compared to before the pandemic. The patient demographics during the pandemic at RSGM and at its three polyclinics were relatively the same: adults (26-45 years), female, domiciled in the city of Bandung, private employees, Moslem, Sundanese, unmarried, and past patient status.The most common diagnosis at RSGM was pulpitis 914 (61%); in general dental polyclinic was pulpitis 751 (33%); in the pavilion clinic was malocclusion 428 (32%) and in the emergency ward was pulpitis, necrosis of pulp and impacted each 4 (16%). Conclusion: During the COVID-19 pandemic, patient visits to the dental hospital decreased more than half, the demographic characteristics of the three polyclinics were relatively the same and the most common patient diagnosis was pulpitis.KEYWORDS : Demographics; dental hospital; oral diagnosis; the COVID-19 pandemic; trend of patient visits

Isfahan general dentist's awareness, attitude, and performance regarding prescription of new caries prevention materials containing calcium and fluoride components.

Fluoride Ion can cause remineralization of primary caries lesions in the presence of calcium and phosphate. New compounds of calcium-containing casein phosphopeptides-amorphous calcium phosphate (CPP-ACP), make the remineralization more effective. This research has been done to evaluate the awareness, attitude, and performance of Isfahan general dentists regarding the prescription of new caries prevention materials containing calcium and fluoride components. This cross-sectional-descriptive-analytic study has been conducted on 152 general dentists in Isfahan ensuring confidentiality of information and obtaining informed consent. Isfahan general dental offices and clinics were selected using a simple random method. Data of this research were collected using a questionnaire from previous studies. The questions were divided into four sections, including demographic information, awareness, attitude, and performance towards products containing calcium and fluoride prescription. The significance level of P was considered 0.05. Data were analyzed using SPSS version 22, T statistical test, Pearson correlation coefficient, and one-way analysis of variance. The mean score for dentists awareness was 46.3 (standard deviation [SD] = 15.4), the mean score of attitude was 91.4 (SD = 26.1) and the Mean Score of performance was 54.3 (SD = 27.3) (the scores range from 0 to 100). According to the Pearson correlation coefficient, there was no significant relationship between dentists' awareness, attitude besides performance, and their ages together with dentistry work experiences (P > 0.05). According to the study results, dentists' awareness of compounds containing CPP-ACP is overall average. However, attending to their positive attitudes toward this context, providing appropriate training programs seem to stimulate them for optimum cooperation as well as using these products for patients.

The Challenge of Early Detection of Oral Cancer in General Dental Clinic: Analysis of Oral Cancer Screening Cases Using Liquid-based Cytology

The Challenge of Early Detection of Oral Cancer in General Dental Clinic: Analysis of Oral Cancer Screening Cases Using Liquid-based Cytology

Validation of a Simplified Digital Periodontal Health Screening Module for General Dental Practitioners.

As a silent disease, individuals at risk of periodontitis are not easily identified until the disease has become severe. Early detection at the community level is essential, especially for general dental practitioners. The aim of this study was to design a comprehensive, user-friendly tool to screen patients’ periodontal health at community level and to evaluate users’ acceptance of its use. The periodontal health screening module was first developed by an expert panel of periodontists, public health specialists and general dentists. The developed module was tested for content acceptance on 156 graduating dental students from three public schools and later validated by 12 private general dental practitioners (GDPs) for reliability. Most of the students (64.1%) found the new module an easy assessment tool for periodontal health compared to the Basic Periodontal Examination (BPE). Most claimed that they understand the contents (80.8%) and accepted the designs (86.6%) and agreed (82.7%) that the new assessment module would allow them to screen patients anytime in the clinic. The interrater reliability as assessed between the GDPs and the investigators revealed acceptable agreement ranging from 62.5–100.0% (mean 89.6 ± 10.2%). The simplified digital periodontal health screening module showed promising acceptance for application in private general dental clinics.

Leadership, work environment and caries prevention – what is good for the staff, is also good for the patients

Objectives Dental caries is a health problem that can be prevented. The aim of this study is to analyse if the quality of leadership, in Swedish Public Dental Health clinics, influences the extent to which patients with caries receive preventive care, and if any such effect is mediated through a collaborative work climate, clear role expectations and a low average level of burnout among staff. Methods The multilevel cross-sectional design includes work environment data from surveys of 75 general public dental clinics, register-based data on preventive measures provided to 5398 patients who received a dental filling due to a caries diagnosis, and patient demographics. Using a multilevel path analysis with logistic regression, we tested a model with one direct and three indirect pathways, controlling for the potential confounding effect of patient demographic factors. Results Leadership quality, as assessed by the staff at the clinic, was associated with increased odds of patients with caries receiving prevention, controlling for patient demographic factors. Leadership quality was also positively related to a collaborative work climate, clear role expectations and a low average level of burnout among staff. Against expectations, however, no indirect effect from leadership quality on prevention through the other work environment factors was found. Conclusions In conclusion, the quality of leadership in Swedish Public Dental Health clinics was positively related to a good work environment for staff and to delivery of preventive care to patients experiencing caries.

The influence of intolerance of uncertainty on the correlation between the severity of symptoms and satisfaction with oral state in patients with burning mouth syndrome

Intolerance of uncertainty (IU) is thought to be involved with the psychological factors that influence the symptoms in patients with burning mouth syndrome (BMS) and affect their limited satisfaction with the treatments provided. However, the influence of IU on satisfaction has not been explored in detail. Therefore, the purpose of this study was to investigate whether IU can affect the satisfaction of patients with BMS. A total of 34 patients with BMS and 100 patients without the disease who visited the general dental clinic were included in the study. They were required to complete a questionnaire measuring the subjective severity of their symptoms and satisfaction with their oral state, and a short IU scale. The BMS patients were separated from the control patients based on the IU score. The coefficients between the severity of symptoms and satisfaction were calculated to examine the influence of IU on the relationship between the two variables. The relationship between satisfaction and severity of symptoms was significant in BMS patients with high IU, but not in control patients with low IU. This study demonstrated that IU in BMS patients influences the relationship between the severity of symptoms and the satisfaction, thus indicating that the dissatisfaction in BMS patients with high IU might be prevented by decreasing the IU. Limited satisfaction experienced by BMS patients can influence the patient-doctor relationship. This study provides suggestions for building a good patient-doctor relationship.

Association between Oral Function and Oral Health-related Quality of Life in Older Adult Patients Visiting a General Dental Clinic who Needed Prosthetic Dentistry

Association between Oral Function and Oral Health-related Quality of Life in Older Adult Patients Visiting a General Dental Clinic who Needed Prosthetic Dentistry

Opioids and older adults: Increasing trends in opioid usage in a dental population compared to a National Database (NHANES).

AimTo examine self‐reported opioid prevalence at a dental school clinic for patients ≥65 years old as compared to national data, comparing gender, ethnicity/race and older adult age groupings.Methods and resultsSelf‐reported prescription opioid medication use was extracted from the medical record for dental patients ≥65 years old who visited the school's general dental clinic (GDC) in 2012 or 2017. This data was compared to the National Health and Nutrition Examination Survey (NHANES) data for 2011–2012 and 2017–18. There was a significant increase in prevalence of opioid use in adults ≥65 between 2012 (4.5%) and 2017 (6.5%) and for ages 65–79 (from 4.7% to 6.3%) and ≥80 (3.4% to 7.9%), women (4.8% to 7.0%), and African Americans (4.7% to 8.4%) in the GDC. Older adults at the GDC reported less opioid use than the NHANES national average for both periods no matter the gender or the age with variable results for race/ethnicity.ConclusionThe prevalence of older adults taking opioids in our general dental school clinic population increased significantly in 2017 as compared to 2012 but was lower than the national average for the respective periods. Awareness of existing opioid usage in older adult patients and its higher adverse risk potential is critical when prescribing analgesics for dental pain for this age group.

Process maturity and patient orientation in times of a health system reform

PurposeThis study investigates the impact of the degree of process maturity on the degree of patient orientation in the context of radical process changes. The study is based on a sample of healthcare providers in Ukraine which experiences a fundamental transformation of its healthcare system.Design/methodology/approachThe investigation was conducted among the full population of the chief physicians from 53 medical institutions (hospitals, general practitioners centers, dental clinics, and maternity clinics) in one of the largest cities in Ukraine. We investigated the maturity of the process of interaction with patients as perceived by these top managers. We applied variance-based structural equation modeling (SmartPLS3).FindingsThe study shows that each stage of process maturity predetermines the following one. With regard to the impact of each stage of process maturity on patient orientation, all stages show a positive and significant relationship toward patient orientation, i.e. even the lowest stage of maturity is critical for patient orientation. A further contradictory finding to extant literature is, that based on the set of indicators, the process appears to be in different stages at the same time. This speaks against the regular sequence-based approach toward process maturity.Originality/valueAlthough it has been assumed that higher degrees of process maturity are associated with higher customer (patient) orientation, this work shows that the relationship holds also for each stage of process maturity separately. This research is based on a very unique sample – the almost complete set of chief physicians and their deputies of practically all medical institutions of a large city.

Incidental Finding of Unilateral Parotid Gland Agenesis: A Case Report

A 34-year-old male active duty soldier presented to the Dwight David Eisenhower Army Medical Center (DDEAMC) Oral and Maxillofacial Surgery Clinic on referral from a local General Dental Clinic for a reported history of temporomandibular joint painful popping and clicking, favoring the right side. As a component of the patient’s outpatient clinical workup, an MRI of the bilateral temporomandibular joints was ordered with an incidental finding noted of partial-to-complete absence of the left parotid gland. The patient completed a conservative therapy regimen and subsequently underwent a non-arthroscopic lysis and lavage of the right temporomandibular joint with resolution of the index symptoms.

Preventing Wrong Tooth Extraction.

Objective of WorkWrong-site tooth extraction (WSTE) is the most common serious patient safety incident in dentistry. Safety checklists have significantly reduced wrong-site surgery, although their benefit is unproven in primary care dentistry. Our quality improvement project developed and implemented a checklist optimised for oral surgery procedures in primary care to reduce WSTE risk.Material and MethodsLocal best practice for tooth extraction record-keeping (LBP), using national guidelines and standards was devised. We then retrospectively audited tooth extraction record-keeping against LBP. Deficiencies in current record-keeping practice were identified and used to design a checklist aimed at improving compliance. We provided a computerised safety checklist compliant with LBP to eleven clinicians at three general dental clinics within our region. The checklist included a pre-operative safety check, a pause to re-confirm the surgical site and a post-operative record-keeping proforma. The checklist was linked to our record-keeping software for use during tooth extraction. We audited checklist completion and compliance with LBP fortnightly for ten weeks.ResultsThe introduction of a safety checklist resulted in increased compliance with LBP for tooth extraction record keeping. At week ten, 67% of records contained the computerised safety checklist. This resulted in a 50% increase in overall compliance with LBP for tooth extraction compared to baseline.ConclusionsA computerised safety checklist for tooth extraction in primary care has potential to improve patient safety by adopting measures to prevent WSTE and standardising communication between clinicians. Checklists in general practice should be encouraged.

Does workplace social capital predict care quality through job satisfaction and stress at the clinic? A prospective study

BackgroundWelfare societies like Sweden face challenges in balancing the budget while meeting the demand for good quality healthcare. The aim of this study was to analyse whether care quality, operationalized as survival of dental fillings, is predicted by workplace social capital and if this effect is direct or indirect (through stress and/or job satisfaction among staff at the clinic), controlling for patient demographics.MethodsThe prospective design includes A) work environment data from surveys of 75 general public dental clinics (aggregated data based on 872 individual ratings), and B) register-based survival of 9381dental fillings performed during a 3-month period around the time of the survey, and C) patient demographics (age, gender, income level and birth place). Using a multi-level discrete-time proportional hazard model, we tested whether clinic-level social capital, stress, and job satisfaction could predict tooth-level filling failure, controlling for patient demographics. One direct and two indirect pathways, moderated by filling tooth, location, and filling type, were tested.ResultsHigh workplace social capital reduced the risk of early failure of fillings in molar teeth, mediated by group-perceived job satisfaction (indirect path: OR = 0.93, p < .05, direct path from job satisfaction: OR = 0.89, p < .05). Contrary to expectations, we found no support for a direct effect from social capital on care quality or for the indirect pathway via stress at the clinic level.ConclusionsWorkplace social capital boosted the quality of dental fillings through increased levels of job satisfaction. In addition, staff at clinics with higher social capital reported less stress and higher levels of job satisfaction. These results indicate that promotion of social capital may improve both occupational health and care quality.

Implementasi Data Mining untuk mengelompokkan Pasien Rawat Jalan dan Rawat Inap Asuransi Kesehatan

Patient Visits Outpatient and inpatient insurance at Class C Hospitals is increasing from year to year. Increased visits to insurance patients will have an impact on the inpatient and outpatient health services provided. From the increase in patient visits, the data owned by the hospital is increasingly abundant. The data can be used to explore knowledge, find certain patterns.&#x0D; To explore knowledge about Inpatient and Outpatient Insurance patients, data mining clustering techniques are used with the Self Organizing Map (SOM) algorithm using R Studio tools. Clustering technique with the implementation of the Self Organizing Map (SOM) algorithm is a technique for grouping data based on certain characteristics which are then mapped into areas that resemble map shapes. The CRISP-DM method is used in this study to perform the stages of the data mining process.&#x0D; The results obtained from the implementation of clustering with the Self Organizing Map (SOM) algorithm are obtained 2 clusters representing dense areas and non-congested areas. Dense areas are represented by Internal Medicine Clinic, Surgery Clinic, Eye Clinic, Hemodialysis, Melati Room, Orchid Room, Bougenville Room, Flamboyan Room. Non-crowded areas are represented by General Clinics, Dental Clinics, Obstetrics and Gynecology Clinics, Children's Clinics, Mawar Room and Soka Room

Strategies to Manage Dental Anxiety

Dental anxiety is a psychological and physiological response to an extreme fear of dental treatments, the use of clinical instruments, and even the general dental clinic atmosphere. It affects the oral health of patients as they miss or delay dental appointments, which can exacerbate diseases (Yildirim 2016; Mihaela, Lyndsay 2016). Hmud &amp; Walsh, 2007 demonstrates the same fact through statistical evidence, reporting a prevalence of between 5 and 20%, with a recent estimate of 6-15% globally, of patients who avoid dental care because of high levels of dental anxiety and dental phobia. It evokes physical, cognitive, emotional, and behavioral responses in an individual (Deva Priya, 2016). Moreover, patients with elevated anxiety have negative feelings and thoughts, sleep disturbance, increased use of medication, a greater tendency towards socialization, impaired social and occupational functioning relative to patients without dental anxiety (Gordona, Heimberga, Tellezb, &amp; Ismail, 2013).

Porphyromonas gingivalis, the most influential pathogen in red‐complex bacteria: A cross‐sectional study on the relationship between bacterial count and clinical periodontal status in Japan

Porphyromonas gingivalis is a key pathogen in microbiota associated with periodontitis. The purpose of the present study was to assess the association between salivary counts of red-complex bacteria and clinical periodontal status in a Japanese population. A total of 977 subjects who visited a general dental clinic in Japan from 2003 to 2006 were enrolled in the study. Stimulated saliva was obtained, and the amounts of major periodontal bacteria were measured using real-time polymerase chain reaction. Probing pocket depth (PPD), bleeding on probing (BOP), and each subject's average proximal bone crest level (BCL) on dental radiographs were measured. The number of P. gingivalis strongly associated with percentage of 4mm or more PPD sites, BOP positive percentage, and 1.5mm or more BCL sites. The detection of P. gingivalis with Treponema denticola and/or Tannerella forsythia showed a high rate of three positive clinical parameters, whereas the only P. gingivalis detected group and those without P. gingivalis had a low rate of three positive clinical parameters. Among red-complex bacteria, the amount of P. gingivalis showed the strongest association with the severity of periodontal condition, and co-occurrence of P. gingivalis with T. denticola and/or T. forsythia showed heightened progression of periodontitis.

Current number of teeth and rate of severe periodontal disease among elderly patients at first visit to general dental clinics

Current number of teeth and rate of severe periodontal disease among elderly patients at first visit to general dental clinics

Survival rate after endodontic treatment in general dentistry for cracked teeth with different coronal restorations

Objective The aim of this study was to analyse the survival rate of cracked teeth after endodontic treatment. The secondary aim was to compare the survival rate of cracked teeth restored with composite filling/crown and those restored with a full crown. Materials and methods The study was conducted retrospectively from three general dental clinics in Stockholm, which are all part of the national dental service organisation. Two-hundred patients with teeth receiving endodontic treatment due to symptomatic cracks were included. The patient data range from year 2001 to 2016. Results The mean age of the patients was 48 years (range 29–69). Fifty-five per cent had cracks located above the pulpal cavity, 11% within the pulpal cavity and 3% located in the root canal. The cracks were located most commonly on the proximal surfaces. The survival rate for teeth with cracks was 68% and 54% after 5 and 10 years, respectively. The survival rate was significantly higher (97%) for cracked teeth receiving a full crown after endodontic treatment compared to teeth restored with either a composite filling or composite crown. Conclusion The overall survival rate for cracked teeth was 68% after 5 years, while it was significantly higher for cracked teeth restored with a full crown. The results suggest within the limitations of this study that cracked teeth should be restored with a full crown after endodontic treatment.