Oral Health Care Professionals Research Articles

A scoping review on the use of traditional medicine and oral health in Africa.

This review aimed to chart the landscape of literature concerning the precise applications of traditional medicine in managing specific oral diseases and, in doing so, to pinpoint knowledge gaps surrounding the use of traditional medicine for oral disease management in the African context. A systematic search of the literature was conducted on PubMed, Web of Science, Scopus, and CINAHL. The search was conducted from the inception of the database till September 2023. A search of related citations and references was also carried out. Only English language publications were included. A summary of studies that met the inclusion criteria was conducted. Of the 584 records identified, 11 were duplicates and 12 studies, published between 2006 and 2021, met the inclusion criteria. The studies were published from eight countries located in the five sub-regions on the continent. All the studies were either experimental designs or ethnobotanical surveys and they all utilized plant-based remedies. The five experimental studies aimed to assess the impact of whole plants or plant extracts on the three microorganisms responsible for dental caries and seven responsible for periodontal diseases. The number of plant species identified by the seven ethnobotanical surveys ranged from 29 to 62 while the number of plan families ranged from 15 to 29. The remedies were either topical applied, use as mouth rinses, gargled, or chewed. The systemic routes of administration identified were inhalation and drinking. The remedies were used for the treatment of hard such as dental caries and tooth sensitivity, to soft tissue lesions such as mouth ulcers, gingival bleeding, and mouth thrush. Other oral disorders managed include halitosis, jaw fracture, and oral cancer. Given the increasing prevalence of oral diseases within the region, the shortage of oral healthcare professionals and limited access to financial resources, it becomes imperative to support the generation of empirical evidence to enhance the provision of traditional medicine for oral healthcare in Africa.

Expanding the phenotype in Pitt-Hopkins syndrome; description of new oral finding and dental management considerations

BackgroundPitt-Hopkins syndrome (PTHS) is a rare neurodevelopmental disorder with physical, cognitive, and behavioral characteristics that is caused by heterozygous mutations in the TCF4 gene. Patients with PTHS might present a unique challenge for oral healthcare professionals because of the associated comorbidities.Case reportHere we describe a new case of PTHS in a 13-year-old girl with particular emphasis on oro-dental findings and oral healthcare management. Observed oro-dental findings in our case included shallow palate, absence of lingual frenum, gingival enlargement, thick lips and relative microdontia. The patient was unable to tolerate dental care under local anesthesia. Therefore, comprehensive dental treatment was performed under general anesthesia after a careful pre-anesthetic cardio-respiratory, neurological, and hematological evaluation. The patient was closely monitored intra-operatively for breathing rhythm, O2 saturation, and signs of respiratory distress. The patient was observed for 24 h post-op for respiratory distress and was discharged then uneventfully.ConclusionDental treatment under general anesthesia in these patients might be complicated by the abnormal breathing rhythm, and close monitoring and follow up for signs of respiratory distress after general anesthesia is necessary. Recognition of oral and dental findings might help to expand the phenotype and better characterize rare syndromes.

Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management.

Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.

Oral Rinses: Some Kill and Some Cripple Candida albicans

Introduction: Oral healthcare professionals play a crucial role in guiding patients toward evidence-based choices among the many available oral rinses. In this study, we explored how specific oral rinse formulations affect the viability and modulate critical virulence traits of the opportunistic fungal pathogen Candida albicans. Materials and Methods: We assessed the effects of these oral rinses on the production of germ tube, production of phospholipase and hemolysin, as well as biofilm formation. Results: We found that oral rinses containing cetylpyridinium chloride (CPC) and chlorhexidine (CHX) showed the greatest fungicidal activity with the lowest minimum fungicidal concentrations (0.38% and 0.78%, respectively). Oral rinses based on zinc chloride and sodium fluoride with Miswak bark extract (MIS) or essential oils (EO) had much lower fungicidal activity (8–16 times lower) compared to CHX and CPC. However, they had a significantly greater impact on the virulence traits of C. albicans. They reduced germ tube production by 86–89% (vs. 42% for CHX and 29% for CPC), completely inhibited phospholipase and hemolysin production, and together with the CPC-based oral rinse, exerted the greatest reductions in biofilm formation across all tested concentrations. This was in contrast to both the controls and CHX, which had a minimal effect on biofilm formation. Conclusion: By inhibiting the virulence factors, the oral rinse can have a crippling effect on C. albicans, weakening this opportunistic pathogen and hindering its potential to cause infection.

Factors influencing the oral health behaviour of Dutch adolescents with mild to borderline intellectual disabilities living in residential care: A qualitative study.

Toothbrushing, limiting intake frequency, and scheduled visits to an oral healthcare professional (OHP) are key for good oral health. We aimed to explore factors influencing these oral health behaviours in Dutch adolescents with mild to borderline intellectual disabilities (MBID) in residential care. Using a qualitative, descriptive approach, we conducted focus groups and interviews with 12 adolescents, 9 counsellors, and 6 OHPs. Thematic analysis mapped factors influencing adolescents' knowledge, attitude, planning, and execution of oral health behaviours to oral care stakeholders. Of nine identified influencing factors, three were pivotal: Structure (influencing toothbrushing and intake frequency), Anxiety (impeding dental visits), and Support (provided by counsellors). Counsellors should provide structured daily guidance on oral hygiene and diet for adolescents with MBID, while respecting the adolescents' autonomy. As intermediaries between adolescents and OHPs, counsellors are key in reducing dental anxiety. Counsellors need clear oral health policies within care facilities to address competing priorities.

Exploring collaboration reasons and leadership styles in Dutch primary oral healthcare practices

AimsTo outline the extent to which practice owners in Dutch oral healthcare practices (OHPs) use a directive and supportive leadership styles, to map out which goals practice owners in Dutch OHPs consider most important when choosing collaboration within the practice and to identify the reasons why oral healthcare professionals choose to engage in collaborative practice.Materials and methodsA survey involving 802 general dental practitioners, dental hygienists, and prevention assistants was conducted. The questionnaire covered, among other subjects, leadership styles and reasons for collaboration. Data analysis included descriptive statistics, chi-square tests, one-way ANOVA, linear regression, and logistic regression.ResultsCompared to employees, practice owners ascribe to themselves more characteristics of both directive and supportive leadership. The most frequently mentioned reasons for choosing a practice form that involves collaboration were the possibilities to provide the best care and the desire to focus on prevention. Healthcare providers chose to work in a collaborative practice for several reasons, which were associated with profession, age and gender.ConclusionsThe degree of directive and supportive leadership among practice owners in dental care practices in the Netherlands showed a strong correlation. The most frequently mentioned reasons for choosing collaboration were related to healthcare content.

Environmental sustainability: the attitudes and experiences of UK students in the oral health care profession.

Objective This study aims to provide insight into the attitudes and perspectives of undergraduate dental students from UK dental schools regarding environmental sustainability in dentistry (ESD) and the manner and extent in which ESD is included in the current undergraduate oral health care curricula.Methods This study is a multi-centre, nationally representive study involving a cross-sectional online survey of undergraduate Bachelor of Dental Surgery and dental hygiene and therapy students in UK-based dental schools. Data analysis was conducted through descriptive statistics and thematic analysis.Results In total, 263 students from 13 UK schools completed the survey, resulting in a national school response rate of 68.4%. Key findings are: 97.3% of students believe that the dental profession should be more actively engaged in environmental sustainability but students currently have very little exposure to ESD at an undergraduate level; and 76.8% of students expressed that they are concerned about the impact that oral health care provision has on the environment, but only 23% of students have independently researched ESD.Conclusions Students identify that oral health care professionals should become more engaged in efforts to mitigate the negative impacts from our activities on the environment, principally via education at all levels. The data from this study provide insight into the current level of awareness and concerns for the environmental impacts of oral health care provision, and are a powerful driver for the inclusion of ESD into the undergraduate curriculum in UK based dental schools.

Autism and general anesthesia for dental care

Autism is the fastest growing serious developmental disability. Infantile autism is associated with a characteristic cognitive, language and behavioral features. Autism spectrum disorders (ASD) have lifelong effects on areas of individual daily life functioning such as learning, relationships and independence. The future of anesthetic management of ASD will depend on how well we understand the etiology, psycho-social and medical issues with the disease. A wide spectrum of medical and behavioral symptoms is exhibited by children with autism, which makes routine dental care very difficult in them. Autism is a neurobehavioral and cognitive disorder characterized by impaired development of interpersonal and communication skills, limited interests, and repetitive behaviors. American Academy of Paediatric Dentistry's guidelines on Caries Risk Assessment has categorized them under High risk for physicians and other nondental health care providers and Moderate risk for dental providers. Attitude and knowledge of the oral health care professionals are of utmost importance while rendering oral health care to such children. The treatment rendered currently provides a long-term benefit for the patient. More focus had to be given for the long-term maintenance of oral health in special children. A 24-year-old autistic child with a history of seizures came to the operating room where he received general anesthesia for dental work. The awakening was particularly slow, as the patient's condition was characterized as severe autism with the corresponding medication, which interacts with the anesthetic drugs and makes awakening difficult.

Clinical encounters of giant cell fibroma: A comprehensive report on two distinct cases, exploring varied clinical presentations

A giant-cell fibroma (GCF) is a benign, localized mucosal mass composed of fibrous tissue that exhibits clinical similarities to other fibro-epithelial growths. Its differentiation from other lesions relies on its distinctive histopathological characteristics. GCF is a rare oral fibrous lesion, often misdiagnosed as other fibrous growths. The first case involves a 24-year-old female with a GCF located near mandibular buccal gingiva. The second case centers on a 14-year-old boy who developed GCF on the incisive papilla region. These cases shed light on the diverse clinical manifestations and histopathological markers used in the diagnosis of GCF. The report delves into the clinical presentation, histological features, and differential diagnoses, offering valuable insights for oral healthcare professionals. Understanding the occurrence of GCF on different aspects of the gingiva is crucial for accurate diagnosis and effective treatment. This report contributes to the growing body of knowledge regarding this rare oral lesion and emphasizes the importance of considering GCF in the differential diagnosis of gingival growths.

Tooth Wear in Older Adults: A Review of Clinical Studies.

Tooth wear is a prevalent dental condition among older adults, leading to pain and adversely affecting aesthetics, functionality, and their overall quality of life. This review aims to update the information on tooth wear in older adults from the past five years and to provide guidance on the clinical management of tooth wear in older adults. A literature search was conducted in three electronic databases, Scopus, Pubmed, and Embase, for English publications from January 2019 to December 2023 on clinical studies with participants aged 65 or above on tooth wear. A total of 307 articles were retrieved and 14 articles were finally included as references for this study. This review highlights the common causes of tooth wear and various risk factors, such as medical conditions, hyposalivation, dietary habits, oral hygiene practices, parafunctional habits, and occlusal factors, associated with tooth wear. It is crucial for oral health care professionals to diagnose and manage tooth wear at an early stage through a risk assessment and a clinical examination to avoid complex restorative procedures. Tooth wear management should prioritize prevention, aiming to control etiological and risk factors while employing non-restorative treatments. Restorative intervention, if indicated, should be simple, minimally invasive, and cost-effective. Tooth wear progression should be monitored regularly to determine if a further intervention is needed. Since the clinical studies on tooth wear in older adults over the past five years are limited and mainly cross-sectional, more interventional clinical studies are warranted to provide more clinical guidance on tooth wear management in older adults.

Integrating oral health assessment in the care for older people by means of the interRAI oral health section: an implementation and evaluation study. 

Background: Oral health of care-dependent older people is generally poor which can affect their general health and well-being. In nursing homes, caregivers such as nurses and nurse aids are important actors for delivering oral care and detecting oral health problems. Performing regular oral health assessments is a key element to improve oral health in older people. The interRAI instrument used in the long-term care facilities (LTCF) includes an oral health section (OHS) and holds the potential to integrate oral care in the general care planning. Since the standard OHS fails to adequately detect oral health problems, an optimized section was developed. The study evaluates the optimized OHS of the interRAI suite of instruments in order to integrate oral health assessment in the daily practice. 
 Setting and participants: Care-dependent older people living in 11 nursing homes in Flanders, Belgium, who are 65 years or older. Their professional caregivers are also included in the study.
 Methods: This 2-year longitudinal cluster randomized controlled trial is set up in three parallel groups (2 test groups and 1 control group) to evaluate the effectiveness and the usability of the optimized and validated OHS for use in the interRAI-LTCF. In the intervention groups T1 and T2, trained caregivers use the interRAI-LTCF with the optimized OHS. Additionally, caregivers in T2 receive support to use new guidelines for oral care. In the control group, caregivers assess oral health using the standard OHS. The study has a longitudinal design with a mixed methods approach.
 The data collected about oral health and general health will be coupled with a national registry database on dental care consumption to analyze the outcome of the OHS regarding dental referral and actual dental care utilization. At the caregiver level, changes in knowledge and attitude regarding oral health will be evaluated using questionnaires. Interviews with older people and focus group discussions with caregivers will help to understand the usability of the optimized OHS and associated training.
 Results: The quantitative results will show whether the use of the optimized OHS enables improved oral health in care-dependent older people in residential care and improves the knowledge, attitude and perception of caregivers towards oral health and oral care. The qualitative data will show how older people and their caregivers experience the use of this OHS and to what extent daily and professional oral health care changes for the older people, being more intensively integrated in general care planning.
 Discussion: In residential care settings, prioritizing care tasks often brings neglect regarding oral care for care-dependent older people. Professional dental care is also difficult to deliver, due to mobility or lack of resources. This study evaluates whether regular oral health assessments performed by caregivers in residential care improve oral health in older people and to what extent these oral health assessments lead to better integration of oral care in general care. The results will shed light on the ongoing situation and will provide evidence to support the use of the optimized OHS and accompanying oral care guidelines in daily practice.

Awareness of Oral and Medical Healthcare Professionals in the Prevention, Diagnosis, and Management of Bisphosphonate-related Osteonecrosis of the Jaw

Awareness of Oral and Medical Healthcare Professionals in the Prevention, Diagnosis, and Management of Bisphosphonate-related Osteonecrosis of the Jaw

A survey on toothbrushing practices and dosing of fluoridated toothpaste among preschool children in the cantons of Basel-Stadt and Berne, Switzerland.

This study aimed to evaluate toothbrushing practices and toothpaste dosing among preschool children aged 0-6 years in Switzerland recruited from the Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, and in daycare centers or in private practices located in the canton of Berne. Three hundred parents of children were surveyed about socioeconomic characteristics, their children's toothbrushing behavior, the use of age-appropriate toothpaste, and whether they were instructed by an oral healthcare professional about appropriate toothbrushing practices and the amount of toothpaste to use. Additionally, the parents were asked to apply toothpaste to two different toothbrushes, one with a narrow and one with a wide brush head, as they usually would at home. The amount of toothpaste was weighed using a portable scale. Over 50% of the parents were not instructed by an oral health care professional on toothbrushing practices and toothpaste dosing. However, nearly all participants used age-appropriate toothpaste. Approximately 50% of the parents of 0- to 2-year-old children applied more than the recommended 0.25 g of fluoridated toothpaste (both brushes, mean ± SD: 0.25 g ± 0.14 g), while two-thirds of the parents of 2- to 3-year-olds (both brushes, mean ± SD: 0.36 g ± 0.23 g) and nearly 90% of the parents of 3- to 6-year-olds applied more than 0.25 g (both brushes, mean ± SD: 0.43 g ± 0.20 g). Overall, parents dispensed more toothpaste on the toothbrush with the wide brush head. The present study suggested that assuming toothpaste as the sole source of fluoride, the amounts generally used are not of concern. However, considering the substantial variation in the amounts of toothpaste applied, oral healthcare professionals should routinely provide instructions on toothbrushing practices and toothpaste dosing during children's dental examinations.

Oral Lesions Associated with Immune Checkpoint Inhibitors in Cancer Therapy: An Emerging Entity Oral Healthcare Professionals Should Comprehend

Immune checkpoint inhibitors (ICIs) are a new group of drugs that have been recently used as part of antineoplastic therapy targeting the immune system to activate the anti-tumor effect. However, as a result of this immune activity adverse events usually occur that can affect different body parts known as immune related adverse events (irAEs). In the oral and maxillofacial area, irAEs mimic many immune-mediated conditions, including oral lichen planus, mucous membrane pemphigoid, and Sjögren syndrome, among others. The aim of this review is to summarize the irAEs in oral and maxillofacial areas and to enlighten oral healthcare professionals on how to recognize these events and to be a part of the care team for patients treated with ICIs.

Predictors of patients' satisfaction after temporomandibular disorder treatment in a referral clinic.

Evaluating patients' satisfaction after received care for temporomandibular disorders (TMD) pain provides oral health care professionals with knowledge and tools to improve their clinical procedures. However, knowledge on patient characteristics that determine satisfaction with the received care for TMD pain is lacking. To identify potential baseline predictors for patients' satisfaction regarding the management of TMD pain upon treatment completion in a referral clinic. Eligible patients, viz., individuals of ≥16 years of age, with a TMD-pain diagnosis according the diagnostic criteria for TMD (DC/TMD), and who were treated in a referral clinic, were included. As part of their standard care, a set of diagnostic questionnaires was filled in (e.g. TMD-pain screener, graded chronic pain scale (GCPS), etc.). After completion of the received care, patients filled in a custom-made questionnaire based on patient reported experience measures (PREMs) to quantify their satisfaction with their treatment results and received care. To identify potential predictors associated with patients' satisfaction, univariate and multivariate linear regression analyses were used. Twenty-seven patients (mean 39.6, SD 15.0) were included in this study. Overall, the patients were satisfied with the treatment results and the received care. Depressive feelings were negatively associated with satisfaction of treatment results (p = .01) and positively associated with satisfaction of received care (p = .01), while pain intensity was negatively associated with satisfaction of the received care. Depressive feelings are a significant negative predictor of patients' satisfaction with the treatment result for TMD pain, while average pain intensity is a significant negative predictor of patients' satisfaction with the received care.

Dutch dental hygiene students' knowledge of HPV-related oropharyngeal squamous cell carcinoma and HPV vaccination.

The incidence of human papillomavirus (HPV)-related oropharyngeal cancer is rising, thus the understanding of HPV infection and vaccination among oral healthcare professionals is becoming increasingly important. This study aimed to investigate the knowledge of Dutch dental hygiene students on HPV infection and vaccination and assessed various aspects of HPV-related oropharyngeal cancer. This descriptive cross-sectional study invited the entire Dutch dental hygiene student population registered in September 2016 to complete an online questionnaire concerning the knowledge of HPV infection and vaccination, including the aspects of HPV-related Oro-Pharyngeal Squamous Cell Carcinoma (OPSCC). Data were analysed using t-tests, Mann-Whitney U tests and Chi-square tests. Invited were all 1248 Dutch dental hygiene students and 232 (18.6%) students completed the questionnaire. More than 95% of the students indicated HPV infection as a risk factor for OPSCC and 48.7% was aware of the availability of HPV vaccination. Additionally, students considered it important to discuss HPV as a risk factor for oropharyngeal cancer with their patients. In general, the students scored highest on the questions about risk factors for OPSCC and poorest on the questions about general HPV knowledge and HPV vaccination. Although the mean overall knowledge score was significantly higher in senior compared with junior students, knowledge scores of senior students remained insufficient. This study identified deficits in knowledge of HPV and HPV vaccination among Dutch dental hygiene students. Future research should focus on improving the content of dental hygiene curricula and development of ongoing educational tools for dental hygienists.

One year of COVID-19 in dental health services in Norway: psychological impact, risk perceptions and vaccination status

BackgroundIncreased psychological pressure on oral healthcare professionals (OHP) due to COVID-19 has been shown, yet little is known about the long-term psychological impacts. We aimed to study the psychological impact of COVID-19 and associated factors including perceived risk and preparedness and vaccination status among OHP in the first year after the lockdown period in Norway.MethodsA structured questionnaire sent electronically to dentists, dental hygienists and dental assistants inquired experiences and perceptions during the second year following the outbreak in Norway. The questionnaire comprised a COVID-19 fear scale and questions about risk perception, preparedness and vaccination status. Exploratory factor analysis (EFA) and Structural Equation Modeling (SEM) were used to assess psychological impact, perception of risk and preparedness according to vaccination status of the respondents.ResultsThe majority of the 708 respondents were female (92.8%), had ten or more years of work experience (67.1%), and worked in public dental clinics (95.9%). Fears and concerns related to COVID-19 were common, 72.6% feared getting infected and 85.4% feared infecting others. Of the 642 respondents who agreed that their workplaces handled the situation well, 55.6% were fully vaccinated. Three factors were retrieved from EFA: Insecurity, Instability and Infection. SEM showed that females were more concerned with Infection, and respondents with long clinical experience were less likely to express fear about Instability. Fully vaccinated individuals felt more insecure about becoming infected, and those agreeing that their workplaces handled the current situation well were concerned with Insecurity.ConclusionsDespite widespread perception of adequate preparedness and high vaccine coverage, a considerable psychological impact and high levels of fear of COVID-19 were observed among the majority of OHP. Fully vaccinated individuals had a larger psychological burden than not fully vaccinated and those with unknown vaccination status. These findings can inform means and interventions to reduce negative impacts of fear in populations with a high psychological burden.

Secondary bruxism: A valid diagnosis or just a coincidental finding of additional masticatory muscle activity? A narrative review of literature.

Bruxism is defined as a repetitive masticatory muscle activity that can manifest it upon awakening (awake bruxism-AB) or during sleep (sleep bruxism-SB). Some forms of both, AB and SB can be associated to many other coexistent factors, considered of risk for the initiation and maintenance of the bruxism. Although controversial, the term 'secondary bruxism' has frequently been used to label these cases. The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques, however, are important factors to be considered when judging the literature findings. The use (and abuse) of drugs, caffeine, nicotine, alcohol and psychoactive substances, the presence of respiratory disorders during sleep, gastroesophageal reflux disorders and movement, neurological and psychiatric disorders are among these factors. The scarcity of controlled studies and the complexity and interactions among all aforementioned factors, unfortunately, does not allow to establish any causality or temporal association with SB and AB. The supposition that variables are related depends on different parameters, not clearly demonstrated in the available studies. This narrative review aims at providing oral health care professionals with an update on the co-risk factors and disorders possibly associated with bruxism. In addition, the authors discuss the appropriateness of the term 'secondary bruxism' as a valid diagnostic category based on the available evidence. The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques found in many studies preclude any solid and convincing conclusion on the existence of the 'secondary' bruxism.

Short and Long Term Impact on Oral Health Related Quality of Life After Maxillofacial Trauma.

Maxillofacial fracture cases require detailed diagnosis, planning and timely restoration of the proper function and aesthetics of the traumatized tissues, as well as appropriate physical, psychological and social rehabilitation to achieve the best possible treatment outcome. Oral health related quality of life allows oral healthcare professionals to evaluate the efficacy of treatment protocols from patients' perspectives and allows clinician to address and measure the clinically meaningful changes. The study was carried out in 86 patients with fracture of any one facial bone from September 2020 to March 2022 in Department of Dental Surgery, Nepalgunj Medical College Teaching Hospital, Kohalpur, Nepal. The quality of life was assessed by using Nepali version of Oral Health Impact Profile (OHIP-14) questionnaire, modified to address maxillofacial injury/treatment. A total of 86 patients (male: Female ratio=40:3) were included in the study with mean age of 30.69±11.88 years. Patient with fracture of mandible and midface showed complete recovery on OHIP-14 Scale after 6 months whereas, in patient with panfacial fracture some residual effect in quality of life (0.13±0.50) was seen in two domains psychological discomfort (0.06±0.25) and social disability (0.06±0.25) even after 6 months. Impact of maxillofacial fracture on quality of life is long lasting and huge on patients. Referral to a psychiatrist or psychologist might be beneficial in addition to open reduction and internal fixation of maxillofacial fractures as early as possible to achieve better quality of life in maxillofacial fracture cases.

Implementation of oral hygiene practices in nursing homes – a qualitative approach among supervisor nurses

Objectives This study describes daily oral health care in private enhanced service housing units and nursing homes in Finland using a qualitative method. Methods Nineteen supervisor nurses were interviewed in the six largest cities in Finland. The interviews consisted of semi-structured questions. The interviews were then transcribed and analyzed using inductive content analysis. Results The qualitative content analysis revealed five main categories: diet, education in the oral health of older people, oral care equipment and taking care of them, caring for the mouths of residents, and professional oral health care. The results revealed that sugary snacks were given daily in the units and there was a need for oral health care education. The dental equipment of residents was taken care of well and the oral health of the residents was taken care of moderately well. Furthermore, there was a need for co-operation between dental professionals and only half of the residents had an individual oral care plan. Conclusions It can be concluded that based on this qualitative study, the implementation of daily oral health care in most nursing homes and enhanced housing units seems to be at a sufficient level and more oral health-related practical and theoretical education is needed.