Primary Dentists Research Articles

Improving Healthcare in South Texas Rural Communities: An Interprofessional Initiative for Primary Care Dental and Medical Residents.

To enhance primary care dentistry and medicine residents' didactic knowledge, communication skills to address patient's healthcare needs, and collaboration among healthcare professionals, while increasing confidence in integrating primary care skills into their clinical practice. An Interprofessional Education workshop was organized to enhance didactic knowledge and learning of 42 primary care dentistry (PCD) and family and community medicine (FCM) residents on topics including addressing facial and dental trauma in adults, managing patients with alcohol use and abuse, pain control and prescription opioid use in dentistry, and opioid use disorder and treatment. An online survey was administered before and after the workshop to assess changes in knowledge, confidence, and future intentions to incorporate targeted primary care skills learned during the workshop into clinical practice and to elicit residents' perceptions of workshop quality. Overall scale means were assessed by chi-square tests for knowledge scales and analysis of variance for confidence and career intentions scales, significance levels were set at 0.05. Pre-workshop assessments were completed by all attendees while post assessments received a response rate of 83.3%. Both PCD and FCM residents reported an increase in their knowledge (p<0.05) and confidence (p<0.05) in providing care for patients with facial/dental trauma, identifying signs of opioid abuse, addressing alcohol abuse, and understanding the referral processes following the workshop. While an overall increase was noted regarding intentions to incorporate skills learned during the workshop into practice by the PCD (pre-course=4.33, post-course=4.42) and FCM (pre-course=4.55, post-course=4.73) residents, the differences were not statistically significant differences. The interprofessional education workshop for PCD and FCM residents enhanced their knowledge, confidence, and future intentions to incorporate primary care skills into clinical practice and improve patient outcomes.

Primary Dental Journal: Continuing Professional Development for the Primary Care Dentistry Team.

Primary Dental Journal: Continuing Professional Development for the Primary Care Dentistry Team.

Abstract 998: Pursuing leadership in literacy to ameliorate head and neck cancer disparities

Abstract Overview of Proposed Research. Head and neck cancers are a deadly cancer that ranks among the six most common cancers worldwide. (American Cancer Society, 2021). Studies have shown greater disease burden among minority populations for head and neck cancer, higher mortality rates and lower oral cancer knowledge, but limited evidence has defined the underlying causes of late stage diagnoses and access to the healthcare system (Suzuki et al, 2019). More specifically, in comparison to the national rates, South Carolina is among the top ten for head and neck cancers (Community Outreach, Hollings Cancer Center, MUSC, 2019). Dental and primary care play a critical role delivering quality patient education, prevention, risk reduction and treatment regimes. However, there is a paucity of information published on the value of designing and implementing a health literacy program to prioritize head and neck cancer screening and prevention. Rural communities face unique challenges to achieving optimal oral health, impacted mainly by geographic location and socioeconomic status (IOM&amp;NRC, 2011). More specifically, rural southern states such as SC continues to have a tremendous shortage of primary care providers. SC currently has 44 of 46 counties designated as geographic Primary Care and Dental Health Professional Shortage Areas and approximately 25% of SC citizenry are living in rural areas (HRSA, 2018). Because the vast majority of the state has challenges with availability of primary care and dental providers, this potentially exacerbates access to care inequities for rural and underserved minority populations. To enhance the quality and equity of oral cancer prevention in rural SC, it is critical that we prioritize strategies to elevate the significance of head and neck cancer risks. Therefore, the need to design and deliver innovative strategies to increase opportunities that intersect the healthcare system and community is inevitable. In this regard, we propose PULL A-HEAD, Pursuing Leadership in Literacy to Ameliorate HEAd and neck cancer Disparities. PULL A-HEAD is aimed to develop and implement a community-centered approach design for increasing the health literacy and efficacy of navigating the healthcare system for early detection of head and neck cancers. In this presentation we will share outcome and impact results of a community-centered, health literacy program in collaboration with our Regional Medical Library - Region 2 (RML2), National Library of Medicine partners at the Medical University of South Carolina. The program (i.e. PULL A-HEAD) will emphasize the delivery of health literacy education and health systems navigation tools to improve the early detection of head and neck cancers. Citation Format: Joni D. Nelson, Irene M. Lubker. Pursuing leadership in literacy to ameliorate head and neck cancer disparities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 998.

Isolation and Culture of Primary Human Dental Pulp Cells-A Description of Technical and Methodological Steps to Maximise Predictability and Yield.

The dental pulp has critical functions in tooth development as well as an ongoing role in promoting and maintaining the vitality of teeth. In particular, its regenerative ability allows dental tissues to be restored following damage caused by traumatic injury or caries. Regenerative endodontic procedures aim to utilise these processes to stimulate dental pulp repair in a minimally invasive manner and reduce the need for more invasive procedures such as root canal treatment. Dental pulp is a source of dental pulp cells (DPCs), which has a subpopulation of dental pulp stem cells (DPSCs), which are attractive for use in regenerative medicine due to their high proliferation rate, ability to differentiate into multiple cell types, and their preserved vitality following cryopreservation. The development of next-generation clinical therapeutics that maximise the potential of dental pulp relies on strong empirical evidence arising from in vitro experimentation. Here, we describe a modified method for the efficient isolation of primary human DPCs from sound third molar teeth for culture using an explant outgrowth method on basement membrane-coated flasks, as well as using high-resolution macro-photography to illustrate the methods. Critically, steps are taken to minimise potential physical and mechanical trauma to the cells and maximise yield. Human DPCs cultured using this method can be further expanded in cell culture flasks to facilitate their use in various in vitro experimental procedures.

Barriers to Accessing Primary Dental Care in Adults with Alcohol Dependence: A Qualitative Study.

People with alcohol dependence (AD) frequently experience oral health problems, but their dental attendance is poor, with limited evidence to the reasons why from their perspective. To explore perceived barriers, motivators, and facilitators to accessing primary dental care in people with AD. Qualitative study consisting of remote one-to-one and group semistructured interviews with a convenience sample of adults with lived experience of AD in northern England. Data were audio-recorded, transcribed, and coded. A reflexive thematic analysis method was used; use of COM-B model informed data interpretation. Twenty adults with lived experience of AD participated in 18 one-to-one interviews and 1 group interview (of 3 participants). Barriers to access were fear and physical, social, and environmental factors (physical effects of AD, financial barriers, nonprioritization of oral health). Motivators to access were pain and prioritization of oral health. Facilitators to access were patterns of alcohol use (i.e., sobriety) and dental service provision within recovery services. Fear of "the dentist" is a major barrier to accessing dental care, and pain is the primary motivator, among people with AD, although neither are unique to this population. Fear and physical, social, and environmental barriers to access contribute to problem-oriented attendance, which negatively affect oral health outcomes. Opportunity to facilitate attendance increases when a person is in remission from AD through their physical capabilities improving. Increasing capability and opportunity can influence attendance beyond the automatic motivation of pain. Provision of dental care within recovery services could facilitate access to care. Understanding the "web of causation" is key to developing any intervention to improve dental access in people with AD. Further research is needed from the perspective of other adult populations with lived experience of AD, as well as of dental professionals, to gain deeper insight into barriers, facilitators, and possible solutions. The results of this study can help dental professionals understand factors affecting access to primary care in people with alcohol dependence to provide knowledge that may reduce stigma surrounding the disease. Results also demonstrate areas for intervention development for public policy.

O-HEALTH-EDU: A viewpoint into the current state of Oral Health Professional education in Europe: Part 1: Programme-level data.

Current legislation leaves Oral Health Professional (OHP) education open to wide interpretation and may result in significant variation in educational practice and resultant professional attributes across Europe. Data regarding the current state of OHP education across Europe is limited. The aim of Part 1 of this series is to provide programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education. A 91-item questionnaire was developed following the Delphi method. The questionnaire and the Articulate glossary of OHP education terms were developed concurrently to facilitate a common understanding of language. Piloting was performed in multiple stages and included institutions internal and external to the research group. The questionnaire was uploaded online and converted to a data hub, allowing dental schools to control their own data and update the data provided whenever they wish. All ADEE member schools (n = 144) were invited to provide data. Forty questions relating to school details, Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education were included in this part of the series. Seventy-one institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education is presented including programme length, funding, languages and fees, student numbers and demographics, student admission and selection processes and permission to practice after graduation. This series of papers, as far as the authors are aware, are the first attempts to build a comprehensive picture of the current state of OHP education in Europe. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe.

Sequelae of Primary Dental Trauma: A Case Series

Trauma to the primary dentition is a common occurrence affecting approximately 1 in 5 young children globally. Damage to the successor tooth may present as a localized enamel defect, dilaceration and disturbed eruption, with subsequent functional and social impact. Appropriate management of acute primary dental trauma, regular review and timely specialist referral upon detection of eruption sequence abnormalities is, therefore, imperative for long-term outcome to be optimal. This article presents a series of four case reports of paediatric patients with a history of severe primary dental trauma that resulted in significant dental anomalies requiring multidisciplinary treatment. CPD/Clinical Relevance: Information on the consequences of primary dental trauma and the advice to give to affected families is of value.

Impact of Non-surgical Periodontal Therapy on Oral Health-related Quality of Life amongst Primary Dental Care Patients: A Prospective Cohort Study

Abstract Aim: The aim of this study was to determine the impact of non-surgical periodontal therapy (NSPT) on oral health-related quality of life (OHRQoL) of a selected group of the Malaysian population at the primary dental care setting. Participants and Methods: This study was conducted from year 2021 to 2022. Patients attending four government dental clinics in Kinta district were included in the study after basic periodontal examination was conducted. The sample size was calculated using the NCSS PASS 11 power analysis and sample size, and a final sample size of 94 was used. A short version of the Malaysian Oral Health Impact Profile (S-OHIP[M]) questionnaire was given as a baseline before the intervention. NSPT was provided in a single session or by a quadrant approach. Patients were then called for review after 6 weeks during when they were required to complete the S-OHIP(M) questionnaire again. All data were then entered and analysed using SPSS version 26.0. Results: The prevalence of impact decreased significantly post-treatment (n [%] pre vs. post: 91 [96.8%] vs. 70 [74.5%]; P &lt; 0.001). A significant decrease was observed in the severity of impact (additive score) (median [interquartile range (IQR)] pre vs. post: 8.5 [5.0–15.0] vs. 2.0 [0.0–6.0]; P &lt; 0.001) and extend of impact (simple count score) (median [IQR] pre vs. post: 0.5 [0.0–2.0] vs. 0.0 [0.0–0.0]; P &lt; 0.001) post-treatment compared to pre-treatment too. Conclusion: The OHRQoL status amongst gingivitis and mild-to-moderate periodontitis patients in primary care has improved after treatment.

Measuring the binary thickness of buccal bone of anterior maxilla in low-resolution cone-beam computed tomography via a bilinear convolutional neural network.

The thickness of the buccal bone of the anterior maxilla is an important aesthetic-determining factor for dental implant, which is divided into the thick (≥1 mm) and thin type (<1 mm). However, as a micro-scale structure that is evaluated through low-resolution cone-beam computed tomography (CBCT), its thickness measurement is error-prone under the circumstance of enormous patients and relatively inexperienced primary dentists. Further, the challenges of deep learning-based analysis of the binary thickness of buccal bone include the substantial real-world variance caused by pixel error, the extraction of fine-grained features, and burdensome annotations. This study built bilinear convolutional neural network (BCNN) with 2 convolutional neural network (CNN) backbones and a bilinear pooling module to predict the binary thickness of buccal bone (thick or thin) of the anterior maxilla in an end-to-end manner. The methods of 5-fold cross-validation and model ensemble were adopted at the training and testing stages. The visualization methods of Gradient Weighted Class Activation Mapping (Grad-CAM), Guided Grad-CAM, and layer-wise relevance propagation (LRP) were used for revealing the important features on which the model focused. The performance metrics and efficacy were compared between BCNN, dentists of different clinical experience (i.e., dental student, junior dentist, and senior dentist), and the fusion of BCNN and dentists to investigate the clinical feasibility of BCNN. Based on the dataset of 4,000 CBCT images from 1,000 patients (aged 36.15±13.09 years), the BCNN with visual geometry group (VGG)16 backbone achieved an accuracy of 0.870 [95% confidence interval (CI): 0.838-0.902] and an area under the receiver operating characteristic (ROC) curve (AUC) of 0.924 (95% CI: 0.896-0.948). Compared with the conventional CNNs, BCNN precisely located the buccal bone wall over irrelevant regions. The BCNN generally outperformed the expert-level dentists. The clinical diagnostic performance of the dentists was improved with the assistance of BCNN. The application of BCNN to the quantitative analysis of binary buccal bone thickness validated the model's excellent ability of subtle feature extraction and achieved expert-level performance. This work signals the potential of fine-grained image recognition networks to the precise quantitative analysis of micro-scale structures.

The Health System Services and Insurance Affects Welfare and Socio-Economic Growth of a Country

This paper focuses on the Health System Services, and how affects welfare and socio-economic growth, as an important sector to improve the socio-economic well-being of a developing country such as Kosovo. This study also provides key recommendations of some important policies to be undertaken by the government to improve the Health System Services with the aim for increasing social welfare and socio-economic growth of the country. Some of the different types of government policies and programs have been put in place reducing the Burden of Injury, to improve the health of the population. (Ganguli, I; Grawford, M L; Usadi, B; Mulligan, K L; O'Malley, A J; Yang, C W; Fisher, E S; Morden, N E;, 2023). In our paper we focused on secondary quantitative data collection. The data were provided by the annual health services report for 2022, Pristina Municipality related to the Family Medical Centers “FMC", for 2022. In our study we’ve used the descriptive method, and through tables and charts we’ve provided a comparative analysis, based on some statistics which are expressed in percentage (%) (Sejdiu, Rexha , &amp; Deda, 2023). However, the main purpose is to show the employment structure of the Family Medical Centers "FMC", in Kosovo for 2022, according to the sectors: Primary Health Care and Dental Polyclinic.&#x0D; &#x0D; Received: 29 July 2023 / Accepted: 19 October 2023 / Published: 5 November 2023

Oral and Dental Nursing Care Knowledge and Practice Among Nurses Working at Primary Dental Clinic, at Rohtak District, Harayana

Oral and Dental Nursing Care Knowledge and Practice Among Nurses Working at Primary Dental Clinic, at Rohtak District, Harayana

Uses of Mouthwashes in Primary Dental Care

There are a large number of mouthwashes available, with the majority available to buy without prescription. Different active ingredients in mouthwashes serve different functions, and it can be confusing for patients who may seek guidance from their general dental practitioner on which formulation best suits their oral healthcare needs. It is important that patients are given direction by their dentist on the duration they should use a mouthwash for, side effects they may encounter, and where the mouthwash fits in their daily oral hygiene routine. CPD/Clinical Relevance: Mouthwashes are typically well tolerated, easy to use, and can be a useful addition to a patient's oral healthcare routine.

Biological Performance of Primary Dental Pulp Stem Cells Treated with Gold Nanoparticles.

Gold nanoparticles (AuNPs) are one of the most stable nanoparticles that have been prevalently used as examples for biological and biomedical applications. Herein, we evaluate the effect of AuNPs on the biological processes of dental pulp stem cells derived from exfoliated deciduous teeth (SHED). Two different shapes of PEGylated AuNPs, rods (AuNR-PEG) and spheres (AuNS-PEG), were prepared and characterized. SHED cells were treated with different concentrations of AuNR-PEG and AuNS-PEG to determine their effect on the stemness profile of stem cells (SCs), proliferation, cytotoxicity, cellular uptake, and reactive oxygen species (ROS), for cells cultured in media containing-fetal bovine serum (FBS) and serum-free media (SFM). Our results showed that both nanoparticle shapes maintained the expression profile of MSC surface markers. Moreover, AuNS-PEG showed a stimulatory effect on the proliferation rate and lower toxicity on SHED, compared to AuNR-PEG. Higher concentrations of 0.5-0.125 nM of AuNR-PEG have been demonstrated to cause more toxicity in cells. Additionally, cells treated with AuNPs and cultured in FBS showed a higher proliferative rate and lower toxicity when compared to the SFM. For cellular uptake, both AuNS-PEG and AuNR-PEG were uptaken by treated cells efficiently. However, cells cultured in SFM media showed a higher percentage of cellular uptake. For ROS, AuNR-PEG showed a significant reduction in ROS at lower concentrations (<0.03 nM), while AuNS-PEG did not show any significant difference compared to the control untreated cells. Thus, our results give evidence about the optimum concentration and shape of AuNPs that can be used for the differentiation of stem cells into specific cell lineages in tissue engineering and regenerative medicine.

Development of a Health Information System for Primary Care Dental Practice

The health information systems (HIS) have become increasingly important in dental practice as they offer benefits such as improved quality of care, increased efficiency, and reduced medical errors. The development of an HIS for primary care dental practice involves several steps, including requirements gathering, system design, implementation, and testing. Dental professionals and staff members must be consulted to identify their needs and preferences for HIS implementation. The system must be designed to be user-friendly and intuitive to ensure ease of use and efficiency. Successful implementation requires the proper consideration of data privacy and security measures. This literature review highlights the benefits of HIS in dental practice and provides real references to studies that have investigated the effectiveness of HIS implementation. The development of an HIS for primary care dental practice can improve patient care and outcomes and enhance the overall efficiency of dental practices.

HL7/FHIR Adaptability in Primary Care Dental Practices in Developing Countries

Limited resources, inadequate infrastructure, and limited technical expertise often hinder healthcare delivery in developing countries. Implementing electronic health records (EHRs) and health information exchange (HIE) has the potential to improve healthcare delivery in these settings. The Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) standard has gained popularity to facilitate interoperability between different EHR systems. This paper reviews the adaptability of HL7/FHIR in developing countries, focusing on the challenges and opportunities for implementation. A systematic literature review was conducted, which identified 15 studies that evaluated the use of FHIR in developing countries. The studies identified several challenges to implementing FHIR, including limited resources, inadequate infrastructure, and limited technical expertise. However, the studies also identified several opportunities for the implementation of FHIR, including the potential to improve healthcare delivery, reduce costs, and improve data quality. The paper suggests potential solutions to address these challenges and promote the adoption of FHIR in developing countries, including capacity building and knowledge transfer, the use of open-source software, and stakeholder engagement.

Using Digital Methods in Primary Dentistry

Using Digital Methods in Primary Dentistry

The Effect of Leadership on Employee Performance Through Employee Motivation in Primary and Private Dental Clinics in Jakarta

In the midst of today's new normal era, the world economy has become very competitive. Many companies are competing to create innovations and make modifications to produce the best service to be provided, especially in the health sector. Health services in the new normal era like today need adaptation in providing services to the community, especially at dental clinics. This study aims to test and analyze "The Influence of Leadership and Employee Motivation on Employee Performance" The sample used in this study was 150 respondents who worked at the Main and Private Dental Clinic Companies. Testing was carried out using SEM analysis. The results of this study support the hypothesis that Leadership has a positive influence on Employee Motivation, Employee Motivation has a positive effect on Employee Performance, Leadership has a positive influence on Employee Performance with Employee Motivation as a mediating variable. This research has implications for the owner and management of the Main Dental Clinic and Personal to improve Employee Performance by paying attention to and increasing Employee Motivation and Leadership, so that in the end it can affect Employee Performance.

Teamwork or Working as a Team? Exploring the Dimensions of Team Reflexivity and Its Impact within the Primary Care Dental Services: A Case Study

Teamwork or Working as a Team? Exploring the Dimensions of Team Reflexivity and Its Impact within the Primary Care Dental Services: A Case Study

A Case-Finding Protocol for High Cardiovascular Risk in a Primary Care Dental School—Model with Integrated Care

National Health Service (NHS) strategies in the United Kingdom (UK) have highlighted the need to maximise case-finding opportunities by improving coverage in non-traditional settings with the aim of reducing delayed diagnosis of non-communicable diseases. Primary care dental settings may also help to identify patients. Case-finding appointments took place in a primary care dental school. Measurements of blood pressure, body mass index (BMI), cholesterol, glucose and QRisk were taken along with a social/medical history. Participants with high cardiometabolic risk were referred to their primary care medical general practitioner (GP) and/or to local community health self-referral services, and followed up afterwards to record diagnosis outcome. A total of 182 patients agreed to participate in the study over a 14-month period. Of these, 123 (67.5%) attended their appointment and two participants were excluded for age. High blood pressure (hypertension) was detected in 33 participants, 22 of whom had not been previous diagnosed, and 11 of whom had uncontrolled hypertension. Of the hypertensive individuals with no previous history, four were confirmed by their GP. Regarding cholesterol, 16 participants were referred to their GP for hypercholesterolaemia: 15 for untreated hypercholesterolaemia and one for uncontrolled hypercholesterolaemia. Case-finding for hypertension and identifying cardiovascular risk factors has high acceptability in a primary dental care setting and supported by confirmational diagnoses by the GP.

Behavioral Health Within Primary Care Postgraduate Dental Curricula: A Mixed Methods Study.

This study evaluated the integration of behavioral health topics (anxiety disorder, depressive disorder, eating disorders, opioid use disorder, and intimate partner violence) into primary care postgraduate dental curricula. We used a sequential mixed methods approach. We sent a 46-item online questionnaire to directors of 265 Advanced Education in Graduate Dentistry programs and General Practice Residency programs asking about inclusion of behavioral health content in their curriculum. Multivariate logistic regression analysis was used to identify factors associated with inclusion of this content. We also interviewed 13 of the program directors, conducted content analysis, and identified themes pertaining to inclusion. A total of 111 program directors completed the survey (42% response rate). Less than 50% of programs taught their residents to identify anxiety disorder, depressive disorder, eating disorders, and intimate partner violence (86% taught identification of opioid use disorder). From the interviews, we identified 8 main themes: influences on the inclusion of behavioral health in the curriculum; training strategies; reasons for incorporating the training strategies; training outcomes (ie, ways in which residents were evaluated); training outputs (ie, ways in which a program's success was quantified); barriers to inclusion; solutions to barriers; and reflections on how the current program can be made better. Programs housed in settings with no to minimal integration were 91% less likely (odds ratio = 0.09; 95% CI, 0.02-0.47) to include identifying depressive disorder in their curriculum compared with programs in settings with close to full integration. Other influences for including behavioral health content were organizational/government standards and patient populations. Barriers to including behavioral health training included organizational culture and lack of time. Advanced Education in General Dentistry and General Practice Residency programs need to make greater efforts to include in their curricula training on behavioral health conditions, particularly anxiety disorder, depressive disorder, eating disorders, and intimate partner violence.