Oral Health Care Professionals Research Articles

Predictors of oral healthcare utilization and satisfaction among Indian migrants and the host population in the Netherlands

BackgroundThe aim of this study was to explore predictors associated with reasons for visiting an oral healthcare professional (OHP) and satisfaction with OHPs in the Netherlands among the Indian migrants and the host population.MethodsA random sample was obtained for this cross-sectional questionnaire study. Variables were classified according to the Andersen Behavioural Model of Health Services Utilization. Multivariable binary logistic regression analysis was conducted to identify significant predictors for reasons for visiting an oral healthcare professional (OHP) (routine checkups and preventive care or visiting only for pain and/or treatment) and satisfaction with OHPs (satisfied or dissatisfied).ResultsThe sample consisted of 391 participants (Indian migrants = 147 and host population = 244). Indian migrants with higher internal locus of control (LoC) [OR = 7.73 (95% CI: 2.13;27.99)], more trust in OHPs [OR = 4.12 (95% CI:1.68;10.14)] and higher integration level [OR = 1.09 (95% CI:1.03;1.17)] had higher odds of visiting an OHP for routine checkups and preventive care. In the host population, having dental insurance [OR = 2.64 (95% CI:1.00;6.95)] was significantly associated with increased odds of visiting an OHP for routine checkups and preventive care. For satisfaction, Indians with low paid jobs [OR = 16.26 (95% CI:2.83;93.36)] and those with higher integration levels [OR = 1.29 (95% CI:1.16;1.42)] had higher odds of being satisfied with the Dutch OHPs. Among the host population, those with more trust in OHPs [OR = 2.86 (95% CI:1.19;6.88)] had higher odds of being satisfied.ConclusionOur study emphasize that integration levels and trust emerged as two crucial factors, policy makers can leverage upon to improve access to care for Indian migrants.Clinical trialN.A as this is a survey based cross sectional study.

Dental and dental hygiene students' perceptions on intraprofessional education.

Interprofessional education and intraprofessional learning experiences are fundamental to becoming an efficient member of the healthcare team for dental and dental hygiene students. The purpose of this study is to determine the attitudes and perceptions of The Ohio State University's dental and dental hygiene students on intraprofessional education and collaboration. Dental and dental hygiene students at The Ohio State College of Dentistry were surveyed in this cross-sectional study about their readiness for intraprofessional learning. The questionnaire was modeled after a study conducted by Brame etal. which focused on assessing students' readiness for intraprofessional education and determining their perceptions towards the use of intraprofessional education. Two hundred and seventy students completed the questionnaire for a 61.3% response rate. Dental hygiene students agreed more to how incorporating shared learning would help to think more positively about other oral health care professionals (p=0.025) and would help students to become better oral health care team members (p=0.002). Dental students agreed more than dental hygiene students that the function of a dental hygienist is to provide support for dentists (p ≤ 0.001) and that they must acquire more knowledge than other oral health care students (p ≤ 0.001). Most students (93%) agreed that intraprofessional learning would help in becoming a more effective oral health care team member. Dental hygiene students feel more strongly than dental students about including intraprofessional education in their learning. However, all students were receptive to the idea of incorporating intraprofessional practices.

Content quality and reliablity of YouTube™ videos as a source of information about good oral hygiene practices in adults.

Good oral hygiene is crucial for preventing dental caries and periodontal diseases. However, proper and regular application of oral hygiene practices requires adequate knowledge. In recent years, the internet has become one of the most popular places to find health-related information, necessitating studies that analyze the quality of the content available online. The purpose of the present study was to analyze the content quality and reliability of YouTube™ videos on the topic of adult oral hygiene practices and to guide oral health care professionals who use this platform for patient education. A YouTube™ search was performed of the most frequent search term, 'dental hygiene'. A total of 150 videos were screened, and 51 were included in the final study. The characteristics, sources, and content of the videos were analyzed using the Global Quality Score (GQS) and DISCERN reliability indices. The IBM SPSS 25 program was used for statistical analyses. Most of the included videos were uploaded by oral health care professionals (63%). GQS revealed only 17.6% of the videos were excellent quality whereas 23.5% of them were poor quality. In the content analysis, 62.7% of the videos were deemed moderately useful. Video duration, total content score, and interaction indices were all significantly higher in the useful and very useful groups compared to the slightly useful group (p = 0.020, p < 0.001, p = 0.040). GQS had a positive, low-medium statistically significant correlation with both video duration and total content scores (r = 0.235, r = 0.517; p < 0.05). DISCERN score also had a positive, low-medium statistically significant correlation with total content score (r = 0.500; p < 0.05). The study concluded that most YouTube™ videos on oral hygiene practices for adults are moderately useful. When using YouTube™ for patient education, oral health care professionals and organizations should be aware of low-quality videos and seek out accurate, useful videos. There is also a need for quality videos with expanded oral health content.

Biopsy: The benchmark for diagnostic excellence amidst advanced technological advancements – A review

Biopsy remains a critical diagnostic tool for identifying oral lesions, vital for establishing a definitive diagnosis through the examination of both physical and microscopic tissue abnormalities. Despite technological advancements, biopsy is still the most trusted method among oral healthcare professionals, particularly when clinical, radiographic, and histopathological findings do not align. However, challenges can arise, such as inadequate tissue sampling or the need for deeper analysis. This article explores the skills and potential pitfalls in biopsy procedures, emphasizing the importance of integrating clinical and radiological information to uphold biopsy as the gold standard in diagnosis, even in today's advanced technological landscape.

The impact of parental dental anxiety and oral health literacy on child oral health and dental-visit patterns: a cross-sectional study

BackgroundIdentifying the risk indicators of parental dental anxiety (PDA) and oral health literacy (OHL) can help oral healthcare professionals recognise challenges in this field. Armed with the appropriate information, they can effectively engage with parents to build trust and promote early and regular child dental visits.ObjectivesThis study aimed to investigate the association between PDA and OHL with the sociobehavioural characteristics of families, self-reported child oral health (presence of ≥ 1 untreated decayed teeth) and the dental visit patterns amongst children living in Al Jouf Province, Kingdom of Saudi Arabia.Subjects and methodsA total of 430 parents with children aged ≥ 14 years were invited using a systematic random sampling method. PDA was assessed using the Dental Anxiety Scale-Revised (DAS-R) scale, and parents’ OHL was measured using the Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30). The relationships amongst participant characteristics, PDA and OHL were evaluated through the Chi-square and ANOVA. Additionally, binary regression analysis was conducted to identify predictor variables associated with PDA and OHL. A P value of < 0.05 was considered statistically significant.ResultsChildren with ≥ 1 untreated decayed tooth were 2.5 times more likely to have PDA (95% confidence interval [CI] = 1.37, 4.37). Children who visited the dentist in < 6 months had 93% lower likelihood to have PDA (adjusted odds ratio (AOR) = 0.07; 95% CI = 0.03, 0.18). Parents aged 20–25 years were 81% less likely to have OHL than those above 30 years (AOR = 0.19; P = 0.038). Similarly, parents with medium family income were 52% less likely to have OHL than the high-income group (AOR = 0.48; P = 0.013). Finally, parents of children who visited the dentist within < 6 months were 34 times more likely to have OHL than those whose children visited the dentist > 12 months ago (AOR = 34.94; P < 0.001).ConclusionPDA and OHL were significantly affected by parental age, family income, the presence of ≥ 1 untreated decaying tooth and the child dental visit patterns. During a child’s first dental visit, paediatric dentists should always assess the PDA, OHL and sociobehavioural characteristics of a family by using appropriate scales and semistructured interviews.

Cross-Sectional Analysis of Australian Dental Practitioners’ Perceptions of Teledentistry

INTRODUCTION: There has been an increased use of teledentistry by dental practitioners in Australia as a response to the COVID-19 pandemic. Previous studies conducted analysing the opinions of dental practitioners were performed prior to the pandemic, and therefore it is important to determine if perceptions regarding teledentistry have changed following the outbreak. OBJECTIVES: The aim of this study was to determine the perceptions of oral healthcare professionals regarding teledentistry in a clinical setting. METHODS: The cross-sectional study involved an anonymous electronic questionnaire with a sample of 152 dental practitioners. The questionnaire contained 28 questions utilizing a 5-point Likert-scale to assess the perceptions of general dentists on teledentistry regarding diagnosis, accessibility, patient care, technology and finances. Chi-squared test and analysis of variance (ANOVA) were used to analyse the results and percentages of agreement and disagreement were calculated. RESULTS: The participants of the questionnaire believed that teledentistry was effective for consultations and in the diagnosis of simple cases. They indicated large benefits of teledentistry in improving access, delivering post-operative care, and triaging patients, and found it particularly useful during the COVID-19 pandemic. However, the participants felt that teledentistry was ineffective in diagnosing complex cases such as pathology. Concerns were also raised regarding the interventional capacity of teledentistry, the quality of the technology, data security and medicolegal issues. In general, participants preferred in-person care in comparison with teledentistry. They were neutral regarding finance. CONCLUSION: The study provided an insight into the perceptions of Australian dental practitioners regarding teledentistry post-COVID-19. Opinions have changed slightly, but there are large hurdles still to overcome before teledentistry is more widely accepted. Research should be continued to further improve teledentistry in the future.

Eating disorders and their impacts in dentistry: an examination of case management evidence

Eating disorders are severe psychiatric illnesses associated with physical and psychological morbidity and mortality, and their incidence has increased, suggesting these conditions and their comorbidities as an issue of emerging importance in public health. Oral healthcare professionals may be among the first to observe the signs and symptoms of an eating disorder because of the recognizable and consistent links with oral pathology and it is important that they are sufficiently informed, and feel confident to diagnose and treat oral comorbidities The purpose of this review is to describe the oral impacts of Anorexia nervosa (AN) and Bulimia nervosa (BN) in the oral cavity, and to present a case related to one of this conditions.

Topographical and histological analysis of keratinized mucosal grafts removal techniques an ex-vivo study in porcine mandibles

The aim of this study was to assess the surface and tissue quality of keratinized mucosa grafts (KMG) obtained using the conventional scalpel and mucotome techniques. This was an experimental in vitro/ex vivo study involving six porcine hemi-mandibles. Specimens were harvested using both the mucotome and conventional scalpel techniques, with randomization determining the choice of technique for tissue removal. The specimens were prepared following predefined laboratory protocols and subsequently subjected to optical microscopy for evaluating epithelial and connective tissue and scanning electron microscopy for topographical and 3D profilometry analysis. Tissues harvested using the mucotome exhibited a linear base and uniform thickness, along with the presence of submucosa and fibrous connective tissue, all of which are ideal for graft success. Differences in the surface characteristics of specimens obtained through the two techniques were observed during a comparative analysis of images obtained through both microscopy types. KMG obtained using the mucotome technique displayed greater uniformity and reduced undesirable cell presence compared to the scalpel technique, thereby enhancing the likelihood of success in soft tissue graft surgical procedures. This study provides valuable insights to oral healthcare professionals and may contribute to future research aimed at achieving more successful surgeries, shorter postoperative recovery times, reduced discomfort, and an overall more positive patient experience.

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.

Association between oral health conditions and the risk of major noncommunicable diseases: A protocol for systematic review and meta-analysis.

Although epidemiological studies suggest that oral health conditions may be associated with an increased risk of noncommunicable diseases, the findings have yet to be comprehensively synthesized, particularly for a major noncommunicable diseases-related health and economic burden. Therefore, we will perform a systematic review and meta-analysis of all available observational studies investigating the association between oral health conditions and subsequent risk of major noncommunicable diseases. With limited English publications, we will search electronic databases, including MEDLINE, Embase, PubMed, Cochrane Library, Scopus, and CINAHL. Based on the temporal properties and natural course of disease progression, we will seek cohort or case-control studies that investigate the association between oral disease conditions and the risk of noncommunicable diseases. Regarding the World Health Organization agenda, oral health conditions will include dental caries, periodontal disease, oral cancer, edentulism, other oral conditions (i.e., oro-dental trauma, cleft lip and palate, and noma), and endodontic lesions. Based on the global disease burden, primary outcomes of interest will include the four major systemic noncommunicable diseases: cardiovascular diseases, cancers, chronic respiratory diseases, and type 2 diabetes mellitus. Random-effects meta-analysis will be used to estimate pooled effects estimate and 95% confidence intervals. Statistical heterogeneity will be investigated using the I 2 index and τ 2 statistics. Preplanned subgroup and sensitivity analyses and random-effects meta-regression analyses will be performed to address possible heterogeneity and establish the robustness of the meta-analytic estimates. The prediction intervals, expected (E)-value, and evidence certainty will be appraised to synthesize the findings and draw evidence-based conclusions. This systematic review will summarize all available evidence regarding the association between oral health conditions and the risk of major noncommunicable diseases. The findings will encourage collaboration between oral health and primary care professionals for early detection and management of noncommunicable diseases and promote oral health well-being. PROSPERO: CRD42021274184.

Evaluation of oral health services and challenges faced by oral health practitioners working in Nyarugenge, Rwanda.

Oral healthcare professionals encounter considerable challenges while providing services to curb the oral disease burden. The aim of this study was to explore the challenges faced by oral health practitioners providing oral health services in Nyarugenge, Rwanda and to appraise the availability and adequacy of oral hygiene equipment, instruments, and materials. This was a cross-sectional concurrent mixed methods study. The quantitative and qualitative parts were independent during data collection and analyses and merged during the interpretation phase. All seven public health facilities and 14 dental professionals working in Nyarugenge were included in the study. Data were collected using an audit checklist and an in-depth interview guide. Descriptive statistics were used to analyze the quantitative data. The interviews were analyzed using thematic content analysis. Most of the dental health professionals were dental therapists (n = 11), women (n = 9), aged 31-40 years (n = 7), and with 11-20 years' experience as oral health practitioners (n = 6). There were five health centers and two hospitals that were audited for equipment, instruments, and materials. The audit of the facilities revealed that most facilities have dental equipment and instruments, but none have adequate preventive dental instruments and materials. Four broad themes emerged from the interviews with the oral health practitioners, namely human resources, supply chain management, patients' oral health awareness and service rendering, and strategic management and administration. The most significant challenges oral health practitioners faced included high dental practitioner/patient ratios, lack of adequate and appropriate equipment and materials, patients' lack of oral health awareness, and a lack of administrative support. Well-established community preventive interventions, such as a mobile oral health App, could reduce the patient/provider ratio by increasing population awareness of oral health and encouraging healthy behaviours. The management of the health facilities should address the human resource challenges and equipment supply chain issues.