Provision Of Dental Treatment Research Articles

Appropriateness of antimicrobial prescribing for oral and dental conditions in Australian hospitals: 2013 to 2022

ObjectivesDentists manage a variety of oral infections in clinical practice. Inappropriate antimicrobial prescribing by dentists occurs frequently and antimicrobial stewardship strategies should include dentistry. The aim of this retrospective analysis of the Australian Hospital National Antimicrobial Prescribing Survey (Hospital NAPS) dataset, was to describe the types of oral and dental indications where antimicrobials were prescribed, and assess the guideline compliance and appropriateness of the antimicrobials in Australian hospitals. MethodsData from the Hospital NAPS was extracted for oral and dental indications from 2013 to 2022. The types of oral and dental indications presented, and the corresponding antimicrobials prescribed were assessed for compliance according to national prescribing guidelines, and appropriateness according to the NAPS structured algorithm. ResultsA total of 8,001 prescriptions for 7,477 patients were identified, from 433 hospitals. Antifungal, antibiotic and antiviral agents accounted for 84.5 %, 15.4 % and 0.03 % of prescriptions respectively. A greater proportion of antibiotics were prescribed in regional and rural areas compared to antifungals. The prescriptions assessed as compliant were 80.0 % and 44.7 % of antifungals and antibiotics respectively. Prescriptions assessed as appropriate were 84.4 % of antifungals, and 65.3 % of antibiotic prescriptions. ConclusionsA wide variety of antimicrobials were used with moderate levels of compliance and appropriateness. Future interventions should include targeted education, utilisation of prescribing guidelines, and tools to diagnose and manage oral and dental conditions. Consideration can be given to adjustment of the Hospital NAPS tool to cater for oral conditions and include the provision of dental treatment in the management of these infections. Clinical significanceA wide variety of oral and dental conditions are presented in Australian hospital settings, managed by a range of antibiotics and antifungals, with moderate levels of compliance to guidelines and appropriateness. Antimicrobial stewardship strategies should target and support dentistry in hospital settings.

Current practices and attitudes of dental practitioners regarding the provision of dental treatment for patients with solid organ transplants.

Solid organ transplant provides a lifeline for people with end stage organ failure. Each year the number of individuals in receipt of a solid organ transplant is increasing. Prevention of post-transplant sepsis and infection are critical for transplant success. The oral cavity contains more than 700 different species of bacteria and is a potential reservoir for disease causing pathogens. Prior to undergoing solid organ transplant, individuals must receive a certification of dental health from a dental practitioner. There are currently no guidelines or protocols for dental practitioners to follow when certifying a patient as dentally fit. This allows for a wide variation of the term 'dentally fit'. This survey was conducted as part of a larger study assessing the oral health of adults with cystic fibrosis ongoing in Cork University Dental School and Hospital. The aim of the study was to ascertain current practices and attitudes of dental practitioners regarding the provision of dental treatment pre and post solid organ transplantation. An anonymous cross sectional survey of dental practitioners in Ireland was conducted. The data collected showed a wide variation in the provision of treatment for patient undergoing or in receipt of a solid organ transplant. It demonstrates a need for further research to be conducted to ascertain the full impact solid organ transplant has on oral health, so that guidelines can be developed to aid both dental and medical professionals in the treatment of this vulnerable cohort.

Inhalation sedation: The role of the dental team in the provision of dental treatment in children

Inhalation sedation: The role of the dental team in the provision of dental treatment in children

Delivering oral healthcare for people with cystic fibrosis: A survey of dental practitioners in Ireland

AbstractBackgroundCystic fibrosis (CF) is the most common autosomal recessive condition in Caucasian populations globally. To date, there has been very little research conducted into the oral health of adults with CF possibly due to historic premature mortality. The purpose of this survey was to ascertain knowledge, attitude and practices among dental professionals regarding the oral health of people with cystic fibrosis (PWCF) as part of a larger study being conducted in Ireland.MethodsA cross‐sectional survey of dental practitioners in Ireland was conducted via an online questionnaire. The survey contained close‐ended questions, and clinical scenarios which allowed for both close‐ended and free text responses in relation to the provision of dental treatment for PWCF. Data was subject to descriptive data analysis using IBM SPSS 29.ResultsThe results from the survey indicate a wide variety in the knowledge, attitudes and practices of dental practitioners regarding the oral health of PWCF. There is significant variation in the provision of dental treatment and the conditions under which such treatment is provided.ConclusionThere is a paucity of information and guidelines specific to this vulnerable population which can make the provision of dental treatment challenging for practitioners. Dental professionals may benefit from continuing professional development and further education targeting patient‐specific populations.

Analysis of Hospital-Based Dental Procedures Under General Anesthesia in Uncooperative Patients: a Retrospective Study.

General anesthesia is a well-documented therapeutic option for the provision of dental treatment, particularly in patients with special healthcare needs and uncooperative pediatric patients. This retrospective study aimed to analyze the characteristics of dental general anesthesia (DGA) procedures for uncooperative patients of all ages in a tertiary healthcare facility, Clinical Hospital Dubrava, in Zagreb, Croatia. The hospital records for the patients treated for various dental reasons under GA were obtained at the Clinical Hospital Dubrava in Zagreb, Croatia. Between 2014 and 2019, a total of 810 DGA procedures were performed including 607 patients. The median age was 18 years. Almost half of the patients referred to undergo DGA procedures were from the City of Zagreb and Zagreb County, 27.8% (N=225) and 21.0% (N=170), respectively. More than 90% of patients undergoing DGA procedures were referred with 1 to 3 medical conditions. 47.9% of patients had 1 to 3 dental conditions, of which caries was the most common condition (95.7%). The mean waiting time (±SD) was 113.06 (±62.62) days. 90 patients (14.8%) were referred for dental procedures under GA more than once, accounting for 203 procedures (25.1%). DGA remains a single dental treatment option for specific individuals. There is an institutional and, also, an organizational need to address the long waiting times and high repeated DGA rates.

A comparative analysis of outcomes of root canal therapy for pediatric medicaid beneficiaries from New York State.

This study investigated differences in the provision of root canal therapy and outcomes in a publicly insured cohort of children and adolescents. New York State Medicaid administrative claims from 2006 to 2018 were analyzed. Enrollees aged 6-18 were included in the study if they had initial non-surgical root canal therapy (NSRCT), in the permanent dentition, that allowed for at least 1 year of post-treatment follow-up. Descriptive analyses, multivariable logistic regression, and multivariable Cox proportional hazard models were used to examine the association between demographic variables (gender, age, race/ethnicity, and area-based factors) and dental treatment provision and outcomes. Male gender was associated with having more than one initial NSRCT (adjusted odds ratio (aOR) = 1.06; 95% confidence interval (CI) = 1.02-1.10), as was rurality (aOR = 1.15; 95% CI = 1.06-1.24). Black/African American (AA) and Hispanic children were less likely than non-Hispanic white children to have multiple NSRCTs (aOR = 0.88; 95% CI = 0.83-0.93 and aOR = 0.78; 95% CI = 0.74-0.83). Being older or female conferred a lower hazard of an untoward event (aHR = 0.93; 95% CI = 0.92-0.94 and aHR = 0.86; 95% CI = 0.81-0.91). Compared to non-Hispanic white children, Hispanic and Black/AA children had a higher risk of untoward event (aHR = 1.31; 95% CI = 1.21-1.41 and aHR = 1.55; 95% CI = 1.43-1.67) while children of Asian descent had a lower incidence after initial NSRCT (aHR = 0.79; 95% CI = 0.71-0.88). Race/ethnicity was the strongest demographic predictor of provision of initial non-surgical root canal therapy, subsequent placement of a permanent restoration and the occurrence of an untoward event after NSRCT in this cohort.

A retrospective, single-center cohort study on complications after dental extractions in patients taking biologic agents

Although biologic agents represent a growing class of therapeutics, little is known about how these agents affect the provision of dental treatment. This retrospective case-control study analyzed patients undergoing dental extraction treated with biologic agents from 2017 through 2020. Complications within 30 days postextraction were recorded. One-hundred twenty-one patients were treated during 147 encounters. Fifteen patients experienced complications during 16 encounters. Notable or excessive pain was most common (14/16; 88%). Patients who experienced complications were treated with 7 biologic agents: dulaglutide, belimumab, adalimumab, aflibercept, tofacitinib, ranibizumab, and ixekizumab. Complication after extraction-specifically, pain-was elevated for patients receiving aflibercept and ranibizumab. When grouped by class, complications were more common with vascular endothelial growth factor antagonism. The impact of biologics on the provision of and recovery after dental treatment remains unknown. Pain was most commonly reported. Patients treated with vascular endothelial growth factor antagonists experienced an elevated rate of complications. This study provides preliminary data on how patients taking biologic agents heal after dental extraction. It is limited by small sample sizes. Further work will build on this data to determine appropriate management of patients taking biologics in the dental setting.

Patient Satisfaction with the Provision of Dental Treatment

Objectives: This study's goal is to learn how satisfied patients are with the dental department's services at a tertiary care hospital in Islamabad, Pakistan. Study design: A cross-sectional study Place and duration of study: The study was carried out in Islamic international dental hospital, Islamabad in six months duration. Materials and methods: In a dental hospital, a descriptive cross-sectional study was conducted. The sample size was 153, the confidence level was 95%, and the margin of error was 5%. Through the use of convenience sampling, data were gathered. To gauge patients' impressions of their satisfaction with the hospital's availability, accessibility, and convenience of services as well as staff behaviour, a survey was undertaken. Results: The results gathered indicated that the patients were satisfied with the dentistry department's services. Participants expressed high levels of satisfaction with the hospital's cleanliness, doctor's demeanour, and appointment scheduling. It was noted that several aspects, such as waiting times, were their top priorities. Conclusion: This survey demonstrates how satisfied patients are with the periodontology department at Islamic International Dental College & Hospital in terms of accessibility, availability, and convenience. A few procedures for shortening wait times and scheduling appointments still require improvement. Keywords: patient satisfaction, dental hospital, services.

Dental sedation—Airing a concept

AbstractAimTo establish current practices and experiences of dental practitioners, who are carrying out procedures under sedation in primary care, relating to assessment and management of the airway. We also review current recommendations and consider a need for further clinical guidance to standardise practice.MaterialsThe survey was created using Survey Monkey and distributed through social media channels such as WhatsApp, Facebook and via emailing a local sedation group.MethodsA service evaluation was carried out in the form of an online survey. This was distributed via social media and by emailing previous and current attendees of Dental Sedation Courses. This link remained active for 3 months with a minimum target of 50 completed responses. During this period, a total of 64 responses were received.Results51 of 64 respondents stated they complete airway assessments, of which, less than half used a pro‐forma for this purpose. Within this cohort, 21.9% of respondents acknowledged a compromised airway incident requiring initial management, with the most favoured adjunct/manoeuvre being a head tilt chin lift of the patient.ConclusionAs sedation operators, dentists carry the responsibility for the provision of dental treatment alongside the management of the airway. Conscious intravenous sedation is usually carried out using midazolam, a short acting and amnesic benzodiazepine. Whilst this is widely used, risks such as respiratory depression or loss of the airway remain. To prevent this, it is vital for an airway assessment to be carried out pre‐operatively as echoed by the Intercollegiate Advisory Committee for Sedation in Dentistry (IACSD) and Scottish Dental Clinical Effectiveness Programme (SDCEP). This article highlights the need for guidance to support general dental practitioners in the pre‐operative assessment of airways to further streamline and improve patient care.

The Impact of COVID-19 Pandemic on Patients Receiving Orthodontic Treatment.

The coronavirus disease 2019 (COVID-19) pandemic impacted the provision of dental treatment in a timely manner including orthodontic treatment. The objective of this study was to assess challenges encountered by patients undergoing orthodontic treatment during the pandemic and their attitude toward managing these challenges. A cross-sectional sample of orthodontic patients at Prince Rashid Hospital in the north of Jordan was recruited to participate in a self-administered questionnaire that included questions related to orthodontic problems encountered during the lockdown, ways to overcome these problems, and concerns about their treatment. A total of 120 patients participated, 40 males and 80 females. Most participants (n = 86) had a fixed orthodontic appliance, who reported various orthodontic problems (82%), but the most common problems reported were exposed wire endings and loosening of brackets. Likewise, the most commonly reported problem among those with removable appliances (n = 34) was a broken or loose appliance (60%). However, patients of both types of appliances ignored the problem and waited until the re-opening of dental offices. Further, most patients missed at least one appointment for different reasons and three-quarters of them (76.6%) did not communicate with their orthodontists during the lockdown. Patients expressed their disagreement with the closure of dental offices during the pandemic because of their concern of a prolonged waiting to receive another appointment. The COVID-19 pandemic had a significant impact on orthodontic care and the maintenance of appointments during the lockdown periods. Patients varied in ways they managed their orthodontic problems, including their commitment to communicate with the dentists or maintain their appointments. Hence, patients should be trained on how to manage the appliance problems when they need and encourage them to accept distant communication during the emergencies.

Self-assessed Confidence of Dentists in Pediatric Dentistry: A cross-sectional study

Aim: To assess the confidence of dentists in provision of dental treatment for children and to explore the status of the current pediatric dental services offered by the dental practitioners. Methodology: A self-structured questionnaire was administered. Data was collected from both academic and non-academic dental practitioners and specialists. Pediatric dentists were excluded from the study. Results: The results show that there is lack of undergraduate training in the subject of pediatric dentistry. Dentists reported low confidence in various pediatric dental procedures. The provision of dental services to the pediatric patients was also observed to be inadequate. Conclusion: The undergraduate education of pediatric dentistry is of paramount importance. The curriculum should be structured in such a way so that it translates into provision of best dental services to the children. There is need for continuing education courses for dentists in pediatric dentistry in order to ensure adequate dental care for children. MeSH Keywords: Dentist's Practice Pattern, Pediatric Dentistry, Pedodontics

Tinnitus – a manifestation of neurodegenerative diseases

Background Tinnitus is a widespread hearing impairment that can be characterized by the perception of sound, such as tone or noise, in the absence of an appropriate external sound source. The cause of tinnitus and mechanism are unclear. The prevalence of tinnitus is higher in people over 60 years of age. Tinnitus is usually a manifestation of а hearing impairment. Symptoms can be acute or chronic. In most cases, tinnitus manifests as an idiopathic condition. In the clinical practice, common factors that affect the psychological and emotional well-being of people with tinnitus are: fear, stress, anxiety and depression, which in turn can cause insomnia, impaired concentration and cognitive dysfunction. Tinnitus is a heterogeneous disorder in terms of its etiology and clinic. Tinnitus is associated with hearing loss, as both symptoms often occur together, though in many clinical cases, people with hearing loss do not develop tinnitus. Methods We present а clinical case of a patient diagnosed with a posturographic system, along with a full otoneurological and hearing examinations. Methods of videonystagmography, video head impulse test, subjective visual vertical, audiometry, tympanometry, otoacoustic emissions test, automated auditory brainstem response were used. We provided a dental check-up and an occlusion analysis. Patient filled out questionnaires and signed a written informed consent. The aim of the team was to analyze the manifestation of tinnitus as a precursor of a neurodegenerative disease. Results and discussion From the literature review done chronic tinnitus is associated with anatomical brain abnormalities, including decreased cortical gray matter and decreased white matter integrity. There is also a high prevalence of cognitive impairment reported among patients with tinnitus from a clinical point of view. Tinnitus is an independent risk factor for subsequent neurodegenerative disease. There are a number of neurological conditions that can be encountered in the otorhinolaryngological and dental practice. It is important for the dentist to enrich own knowledge of the underlying neurological conditions, as they may affect the provision of dental treatment. Our findings from the examinations executed are consistent with previous studies, which show that diabetes and head injuries can be risk factors for AD and neurodegeneration. Conclusions Further research is needed to re-confirm the conclusions of our research and to investigate the pathophysiology of the relationship between tinnitus and the Alzheimer’s disease and tinnitus and the Parkinson’s disease in more depth.

Oral care for patients with cystic fibrosis

##Aim To outline the systemic manifestations and pharmacological management of cystic fibrosis. Oral manifestations and considerations for the provision of dental care are also addressed. ##Methods A literature search was conducted to identify medical and dental manifestations of cystic fibrosis. These findings were then used to provide recommendations regarding the provision of dental care for people with cystic fibrosis. ##Results Cystic fibrosis is a multiorgan condition. There are no known disease-specific contraindications for the provision of dental treatment. However, dentists can implement protocols to facilitate and encourage regular dental attendance. ##Conclusion Further research should be conducted to assess the oral health of people with cystic fibrosis, notably caries and periodontal status, so that, if necessary, appropriate care strategies and guidelines can be developed.

Dental care during COVID-19 pandemic: Survey of experts' opinion.

ObjectivesThe current COVID‐19 outbreak in conjunction with the need to provide safe dental treatments and the limited knowledge on the efficacy of protective measures has posed dentists into a challenging situation. Therefore, the present article aimed at collecting experiences and recommendations of frontline clinical experts on critical aspects of dental treatment provision during pandemic.Material & MethodsFrom a total of 32 European countries, one leading academic expert in Oral and Maxillofacial Surgery or Oral Surgery per country was asked to participate in an anonymous online 10‐item survey on COVID‐19 covering the topics of safety of dental settings, personal protective equipment (PPE), and patient‐related measures to reduce transmission risk. Data collection took place from April 12th to May 22nd, 2020.ResultsA total of 27 experts from different European countries completed the survey. The transmission risk of SARS‐CoV‐2 in dental settings for aerosol‐generating procedures was considered high by all experts except two. For aerosol‐free and aerosol‐generating procedures, more than 80% of the experts recommended face protection and caps for every single treatment. For aerosol‐generating procedures, additional measures (FFP2/FFP3 masks and gowns) were suggested by the vast majority of the experts. To reduce transmission risk, all experts recommended limiting aerosol‐generating procedures and reducing the number of patients in waiting areas as well as hand hygiene for the patients.ConclusionThe limitation of aerosol‐generating procedures along with the usage of adequate personal protection equipment was considered to be crucial to protect dental healthcare providers and patients, thus reducing the transmission risk of COVID‐19.

Medical status of patients presenting for treatment at an Australian dental institute: a cross-sectional study

BackgroundIndividuals seeking dental treatment often present with medical conditions which may affect dental treatment provision. The purpose of this study was to determine the prevalence of medical conditions and medication use among individuals attending dental clinics at a Western Australian tertiary institution.MethodsThis observational study examined the general demographics, medical and social histories of 873 subjects presenting for a general dental examination at a Western Australian Tertiary Institution between March 2018 and February 2019. Individual recruited were those presenting to the clinics either as new patients to the Centre or returning patients after an extended period of absence.ResultsPresence of a medical condition was reported by 86% of the participants, with males more commonly affected (p = 0.0448). Medication use was noted by 80% of the participants. Cardiovascular disease (37.9%), allergy (32.3%), mental health disorders (29.4%), musculoskeletal (23.0%), endocrine (22.4%) and respiratory disease (17.8%) were the most common conditions identified. Women were significantly more likely to report allergy (p = 0.0002) or a mental health condition (p = 0.0368).ConclusionMedical comorbidities are common among individuals presenting for student dental treatment in Western Australia, highlighting the importance of knowledge and teaching of internal medicine and its application to the dental setting.

Some aspects of the forensic medical evaluation of defects in medical care in the provision of dental treatment using orthopedic structures on dental implants and the occurrence of Galvanism

23 forensic medical examinations were analyzed for patients who received dental care using dental implants in Moscow and the Moscow region. In two cases, patients complained about the phenomena of galvanism. As a result of the analysis, it was revealed that appeals for poorly rendered treatment are not sufficiently justified.

Prevalence and factors associated with traumatic dental injuries among schoolchildren in war-torn Libya.

No previous epidemiological study has investigated the prevalence and associated factors of traumatic dental injuries (TDIs) among Libyan children. Such information is required for the planning and evaluation of health services. The aim of this study was to assess the prevalence of TDIs and associated factors among 12-year-old schoolchildren in Benghazi, Libya. Data for this study were collected as part of a comprehensive, cross-sectional survey investigating oral health status and treatment needs of 12-year-old schoolchildren in Benghazi, Libya, between December 2016 and May 2017. Sociodemographic information was collected through a dental health questionnaire. The children were assessed for oral health status, including TDIs according to modified World Health Organization (WHO) classification criteria, in their classroom by trained and calibrated examiners. Anthropometric measures, lip competence and overjet were all assessed and reported. History of TDIs was sought among those affected. Logistic regression models were applied for TDIs as an outcome variable. The statistical significance for all tests was ≤0.05. Data from 1134 participants were included in this study. TDIs were observed in 10.3% of the sample. Most of these TDIs were enamel fractures only (55.6%) and enamel and dentine fractures (35.9%). "Falling" was the most common cause of TDIs, accounting for 51% of cases. While increased overjet appeared to be associated with higher risk of TDIs (OR: 1.92; 95% CI: 1.29-2.86), being female (OR: 0.34; 95% CI: 0.22-0.53) and overweight (OR: 0.33; 95% CI: 0.13-0.83) were also associated with lower risk of having TDIs. This survey showed that a considerable proportion (10.3%) of 12-year-old Libyan children had TDIs, with relatively high unmet treatment needs. More efforts are required to develop effective prevention programmes and to enhance the provision of dental treatment of TDIs for Libyan children.

Sedation versus general anaesthesia for provision of dental treatment to patients younger than 18 years.

Sedation versus general anaesthesia for provision of dental treatment to patients younger than 18 years.

The need for further oral health research surrounding the provision of dental treatment for people with drug dependency.

The aim of this article is to highlight the need for further research in providing dental care for people with drug dependency. The association between people who misuse substances and dental disease is widely known occurrence, yet there have been few studies conducted in the UK surrounding this issue due to the nature of the cohort. Further to this, there are a multitude of barriers to accessing/seeking dental care that exist for those with drug dependency. Going forward, there is a need for the development of a new service model where dental care is part of a multidisciplinary team working towards treating people with drug dependency in a holistic way.

Barriers and facilitators for provision of oral health care in dependent older people: a systematic review.

Provision of oral health care (OHC), including oral hygiene (OH) or oral/dental treatment, to dependent older people (DOP) is frequently insufficient. We aimed to assess barriers and facilitators perceived by different healthcare professionals towards providing OHC to DOP. A systematic review was performed. Studies reporting on knowledge, attitudes, and beliefs acting as barriers and facilitators for provision of OHC were included. One database (PubMed) was searched and data extraction independently performed by two reviewers. Thematic analysis was used and identified themes translated to the domains and constructs of the theoretical domains framework (TDF) and aligned with the domains of the behavior change wheel (BCW). Analyses were stratified for the two target behaviors (providing oral hygiene and providing oral/dental treatment) and according to different stakeholders' perspective. For quantitative analysis, frequency effect sizes (FES) were calculated. In total, 1621 articles were identified and 41 (32 quantitative, 7 qualitative, 2 mixed method) studies included. Within these 41 studies, there were 7333 participants (4367 formal caregivers, 67 informal caregivers, 1100 managers of care, 1322 dentists, 340 DOP). Main barriers for providing OH were "lack of knowledge" (FES 65%, COM-B domain: capability, TDF domain: knowledge) and "patients refusing care" (62%, opportunity, environmental context and resources). Main facilitators were "OHC training/education" (41%, capability, skills) and "presence of a dental professional" (21%, opportunity, environmental context and resources). Main barriers for provision of dental treatment were "lack of suitable facilities for treatment/transportation of patients" (76%) and "patients refusing care" (53%) (both: opportunity, environmental context and resources). Main facilitators were "regular visiting dentist" (35%) and "routine assessment/increased awareness by staff" (35%) (both: opportunity, environmental context and resources). A number of barriers and facilitators for providing different aspects of OHC were identified for different stakeholders. Our findings help provide the evidence to develop implementation strategies for providing high-quality systematic OHC to DOP. This review was registered at Prospero (CRD42017056078).