Dental Team Research Articles

A refresher on sugar and oral health

Maria Morgan and Ruth Fairchild consider why nutrition is an important consideration for dental teams.

‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance

ObjectiveTo investigate which organisational characteristics of primary care dental practices influence the implementation of evidence-based guidance.DesignA multimethod study set within primary care dentistry in Scotland comprising: (1) Semistructured interviews with...

Gluten-free foods: a 'health halo' too far for oral health?

Background Over the past decade, the rise of consumers following a gluten-free diet has increased greatly. The majority of people following a gluten-free diet have not been diagnosed with coeliac disease or gluten or wheat intolerance but believe it to be a health benefit.Aim To assess the differences between gluten-free and gluten-containing products with regards to the implications this might have on oral (and wider) health.Method In total, 50 purposively selected products (25 gluten-free and gluten-containing pairs) available to UK consumers, classified using the UK National Diet and Nutrition Survey food categories, were analysed using content analysis of food packaging. The European Union front-of-pack labelling system revealed the nutritional composition of each product, focusing on carbohydrates, sugars and energy. Cost and use of emotive language to market products was also assessed.Results A nutritional comparison of the 25 product pairings found that, on average, all gluten-free products contained more calories, total carbohydrates and total sugar. The majority of the gluten-free products were classified as 'confectionary' or 'baked goods,' emphasising that products primarily consisted of foods high in sugar. The average sugar per 100 g for each category of food ranged from 2.5-37.0 g/100 g (gluten-free) compared to 2.1-30 g/100 g (gluten-containing). All gluten-free products were considerably more expensive when compared with the conventional version; the average price difference ranged from £0.08 to £4.40.Conclusion This study emphasises the 'health halo' phenomena, where foods for special diets are regarded by consumers as healthy when in fact they are not. This results partly from the products being mainly high-sugar 'treats', which are not a core of the UK Eatwell Guide food-based dietary guidelines. As many people consuming gluten-free products in the UK do not need them from a medical perspective, this could have implications for oral and wider health. It is important that members of the dental team are aware of the possible implications of a gluten-free diet where it is not medically indicated, coupled with reliance on convenience foods.

Different types of medical emergencies in dental practice: A review

Fortunately medical emergencies rarely occurs in daily dental practice. The risk of any serious complications can be reduced by ensuring that the basic life supporting drugs are in the appropriate place and the whole dental team should be well trained in basic life support measures. It is important for a dental practioner to have a thorough knowledge in recognizing and carrying out its initial management.

Treat the dental team as part of the NHS!

Treat the dental team as part of the NHS!

A comprehensive event for the dental team

A comprehensive event for the dental team

Oral Adverse Events Following COVID-19 Vaccination: Analysis of VAERS Reports.

BackgroundOral adverse events (AEs) following COVID-19 vaccination have been sporadically reported during the previous months, warranting further investigation for their prevalence and suspected relationship with vaccine-elicited immune response.MethodsA retrospective analysis using the Vaccine Adverse Event Reporting System (VAERS) data was conducted to evaluate AEs within the oral cavity (mucosa, tongue, lips, palate, dentition, salivary glands) and AEs involving taste and other sensations. Oral AEs reported after receiving COVID-19 vaccination (test group) and seasonal influenza vaccination (control group) were extracted and cross-tabulated to assess their relative prevalence.ResultsAmong the 128 solicited (suspected) oral AEs, oral paresthesia (0.872%) was most reported after receiving COVID-19 vaccines, followed by the swelling of lips (0.844%), ageusia (0.722%), oral hypoesthesia (0.648%), swollen tongue (0.628%), and dysgeusia (0.617%). The reported prevalence of oral AEs was higher in the COVID-19 vaccine group than in the seasonal influenza group. The distribution pattern of the most reported oral AEs was similar for both COVID-19 and seasonal influenza vaccines. Female sex, older age (>39 years old), primer doses, and mRNA-based COVID-19 vaccines exhibited a higher reported prevalence of oral AEs.ConclusionWithin the limitations of this study, COVID-19 vaccines were found to be associated with rare oral AEs that are predominantly similar to those emerging following seasonal influenza vaccines. The most commonly reported oral AEs were oral paraesthesia (mouth-tingling), lip swelling, and ageusia, representing various pathophysiologic pathways that remain unclear. Taste-related AEs should be acknowledged in the context of the COVID-19 pandemic and the public should be adequately informed about a potential taste dysfunction after receiving the COVID-19 vaccination. Dentists and dental teams need to be aware of the prevalence, severity, and prognosis of oral AEs to inform their patients and increase public confidence in vaccines.

Going electronic: an Epic move.

Medicine and dentistry have historically existed as separate entities, resulting in the creation of separate patient health records, which may limit patient care and safety. The General Dental Council emphasise the need to 'make and keep contemporaneous, complete and accurate patient records' as part of the expected standards of the dental team, with no suggested preference on paper or electronic notes. Despite offering clear advantages in primary care dental practice for efficiency, patient accessibility and financial benefit, the comparatively limited uptake of electronic records in dentistry in the secondary care setting has created barriers for patients and clinicians in delivery of evidence-based oral care. In this paper, we report on the challenges and benefits presented by the national drive to integrate technology into the NHS, including the enhancement this can provide to patient care. In primary care dentistry, electronic record keeping is well established in the UK. There is sparse literature or reported outcomes on the use of electronic record keeping in dental departments in secondary care. The Royal National Ear, Nose and Throat and Eastman Dental Hospitals is now a fully digitised hospital through the introduction of Epic, a fully integrated electronic health record. We explore the role of electronic record keeping in primary and secondary care dental practice, the benefits to patient care and the challenges presented when implementing an electronic health record. We consider the benefits and challenges in digitising a centrally-based specialist teaching dental hospital, including specific features of Epic, which provide enhanced user accessibility and applications for general use and specialised services, including research and public health surveillance.

Are you (and your patients) hooked on the sweet stuff?

We are a nation addicted to sugar – so how can dental teams help break those habits of a lifetime? Timothy Ives shares his insight on the power of the ‘tribe’.

Pregnancy and dentistry: a guide for the general dental practitioner. Part 1

Pregnancy is a unique time in a woman's life when many physiological, physical, emotional and hormonal changes occur. It can also be quite an anxious time for women, particularly in the first trimester, when the risk of miscarriage is at its highest. Uncertainty still exists around the topic of dental treatment and care during pregnancy, which may create challenges for both the patient and the dental team. CPD/Clinical Relevance: The common health and oral health conditions that occur in pregnancy are relevant to all clinicians.

Huntington's disease: the role of dentistry in the multidisciplinary team

Huntington's disease is a progressive, genetic disorder, leading to changes to cognition, movement and behaviour. The oral health of these patients can rapidly deteriorate if they are not assessed and managed early. This article explores the role of the dental team, as part of the multidisciplinary team, in caring for Huntington's disease patients. It highlights some of the challenges in providing oral care for this complex group, along with a pathway of care, used by one Special Care Dental Team, in helping to reduce oral complications. CPD/Clinical Relevance: It is important for GDPs to understand the oral health needs of patients with Huntington's disease and their role in supporting the oral health of these patients.

Knowledge, Attitude, and Practices (Kap) Survey on the Management of Traumatic Dental Injuries (Tdis) among Dental Students in Prince Sattam Bin Abdulaziz University (Psau), Alkharj.

Background:Traumatic dental injury (TDI) is described as a lesion of variable extension, intensity, and severity caused by forces acting on teeth due to falls, fights, traffic accidents, collisions against objects or people, and para-function and/or as a result of an assault. Appropriate treatments of TDIs can improve the outcome chance and reduce stress and anxiety for both patients and the dental team. Despite the importance of this topic, there remains a paucity of evidence on the current situation of TDI management among dental students in Prince Sattam bin Abdulaziz University.Objectives:To assess the knowledge, attitude, and practice (KAP) of dental students about the management of TDIs and compare the knowledge according to the year of study.Methodology:A KAP survey was conducted on undergraduate dental students at Prince Sattam bin Abdulaziz University dentistry college. All clinical dental students (4th–5th year) and interns enrolled during the 2019–2020 academic year were invited to participate in the study (n = 92). Participants filled out a questionnaire containing 16 items related to KAPs toward the management of TDIs.Results:The majority of fifth-year students (78.8%) and interns (70.8%) perceived that TDIs have the priority to be seen as an urgent case, compared to only 45.7% of fourth-year students (P = 0.013). Also, more than half of study participants reported not following any protocol for TDIs with no significant differences between study years. Furthermore, 69.7% of fifth-year students and 66.7% of interns considered the Hanks-balanced solution as the best medium for storing an avulsed permanent tooth.Conclusion:The current results demonstrated a significant shortage in the KAP toward TDI management among dental students in Prince Sattam bin Abdulaziz University. Almost half of the students (45.7%) did not know any guidelines for the treatment of TDIs. The majority of study participants had no exposure to any previous workshops, symposiums, or conferences about managing TDIs, which makes it more difficult for them to understand and manage dental traumatic injuries. Hence, there is a need to assess the reasons behind this issue and develop solutions to improve the current situation.

Effective and practical recommendations to dental team when providing dental services in the era of COVID-19


 
 
 Severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) is the coronavirus that causes COVID-19 (coronavirus disease 2019). It is an airborne virus and can spread through small droplets of saliva.Dental professionals work very close to the patient’s mouth, putting them at high risk of contracting SARS-CoV-2. This is because aerosols and splatter are generated when performing some dental procedures, which are known to be the possible potential sources of some other serious diseases to the dental team and patients in the dental settings. During the COVID-19 pandemic, dental professionals continued to provide dental services to patients; however, dental professionals are more likely to become contaminated due to the nature of their work. Hence a cautious emergency implementation of extra-protective measures is paramount to limit viral contamination between patients and the dental team. This research review was performed to summarize essential practical recommendations to be adopted by the dental team when providing dental services to the patient during the COVID-19 period, to minimize the risks of COVID-19.
 
 

COVID-19 VACCINATION AND DENTISTRY: ARE WE FACING NEW CHALLENGES OR WORKING WITHIN OUR POSSIBILITIES? ANALYTICAL REVIEW

Objective. To systematize available data regarding COVID-19 vaccination aspects among dental specialists and highlight relevant occupationally-related features of vaccination challenges.
 Materials and Methods. Search of pertinent literature sources associated with above-formulated objective was provided via PubMed Central database (https://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com/). Criteria of publication date included 2020-2021 years period. Publications in English or at least with English abstract/summary were collected within primary sample for further preliminary content-analysis. All articles collected for in-depth content-analysis were evaluated due to the text-mining, text-identification and text-extraction principles with further clusterization and systematization of outcomes at the Microsoft Excel 2019 software (Microsoft Office, 2019). 
 Results. After full reading of articles’ texts 24 of them were interpreted as those containing new and/or unique information, interpretations or facts, out of which 9 were cross-sectional online surveys, 4 were editorials, 6 were literature/clinical reviews, 1 was brief report, 1 was opinion article, 1 was ethical moment, 1 was advice article, and 1 was web-source. New challenges related with COVID-19 vaccination within dental filed are represented by personal hesitancy of dental professionals and students, which in turn associated with provided information support, previous COVID-19 experience, fear of getting infected or transmit disease to the patients or family members, fear of potential development for post-vaccination side-effects, changes of occupational status, and interaction within dental team. 
 Conclusions. Further improvement of dental care field possible only after vaccination of dental professionals. Vaccination of dentists widening window of their possibilities regarding potential role of dental specialist as members of COVID-19 vaccine’s delivery team, improvement of quality of life among dental patients (after its decreasing changes during pandemic), and providing dentists with important role in so-called “behaviorally informed strategies” and public motivational programs aimed at amplification of positive willingness for COVID-19 vaccination among general public.

Dental teams can be 'vital link' in caring for patients with eating disorders

Dental teams can be 'vital link' in caring for patients with eating disorders

Dental teams can be 'vital link' in caring for patients with eating disorders

Dental teams can be 'vital link' in caring for patients with eating disorders

Necrotizing fasciitis: a severe complication of odontogenic infection

Necrotizing fasciitis is a rare complication of dental infection and is associated with a significant mortality rate. Prompt recognition and urgent referral are therefore essential. Surgical debridement and broad-spectrum intravenous antibiotic therapy are the mainstay of management. This report outlines a case of necrotizing fasciitis of odontogenic origin in an otherwise healthy 32-year-old patient. CPD/Clinical Relevance: This article highlights odontogenic necrotizing fasciitis to the dental team, discusses its management and serves as a reminder of the potential severe complications of unmanaged dental infection.

“Drilling Down”: psychiatry and dentistry in collaborative action

AimsPeople with severe mental health illnesses experience multiple adverse physical health outcomes, in part caused by difficulties accessing, engaging with health promoting behaviour, treatment and recovery strategies. As oral health is a major contributor to physical and mental wellbeing, obstacles to care, prevention, and therapy play an important role in the oral health of individuals with mental illnesses. Psychiatric medications are known to predispose to oral health pathologies, including sialorrhea and dental caries, electroconvulsive therapy (ECT) may rarely result in dental fractures, and substance misuse may contribute to poor dental health. Unsurprisingly, COVID-19 has been more acutely noticed by those already at risk of worse oral health outcomes, including people with mental health conditions.MethodsWe address the interplay between mental health and dental care, outline evidence behind the vital importance of collaborative working, and advocate for a joint approach between mental health and dental teams utilising harm reviews adapted to assessing the impact of delay dental care upon patients and families’ quality of life. As COVID-19 persists and winter pressures are experienced every year, these raise the question of what needs to be done to demonstrate the effects of poor oral health on patients with learning difficulties and mental illness.ResultsWith annual winter pressures in healthcare, many elective operations are postponed to allow capacity for increased demand. Dental general anaesthetics are amongst the first lists to be suspended, particularly since the arrival of COVID-19. During the first peak of the pandemic, limited access to personal protective equipment and concerns over viral transmission risked by aerosol generating procedures restricted the provision of community dental care to urgent cases, and dental general anaesthetics to life-threatening infections alone.These impacts were particularly acute for those with learning difficulties and mental illness, further exacerbated by social, geographical and financial inequalities. Waiting for patients to deteriorate to access dental care treatment seems in direct opposition to the mental health movement towards community and early management of mental illnesses.ConclusionAdapted harm reviews are a powerful tool for mental health and dental teams to demonstrate to hospital managers the multidimensional impact that poor oral health has and causing physical, behavioural and emotional deterioration on patients, families and supporting staff. Wider understanding of the dental needs of those with mental health conditions may foster research on the interplay between oral and psychological health, and remains vital to multidisciplinary, compassionate and holistic care.

First complex maxillofacial reconstruction with free flaps in the Gaza Strip, occupied Palestinian territory: case series from an area under conflict

BackgroundLarge mandibular and maxillary defects are repaired by maxillofacial reconstructive microsurgery (MRM) using free flaps, which is challenging to perform in austere settings owing to its demanding nature in terms of time, equipment, and trained personnel. Humanitarian missions refrain from performing MRM procedures in the host country and instead transfer patients to their home country to perform surgery. We report on the first nine MRM procedures in Gaza. MethodsA French medical mission performed the surgical operations at Al Shifa Hospital, Gaza, occupied Palestinian territory. Fibula free flap, radial forearm free flap, scapular free flap, and thoracodorsal perforator free flap were performed. We recorded the patients’ demographics, diagnoses, and immediate postoperative and follow-up status. We also report the special considerations required to perform the surgery in Gaza's austere and resource-poor environment. FindingsNine patients (five female, four male; mean age 22 years) underwent ablative head and neck surgery from January, 2017, to March, 2019. Before arrival, the missions closely coordinated with local surgeons, who assisted in performing the surgeries and followed the patients postoperatively. Essential surgical equipment needed for the surgery (such as loupes, microvascular sutures, and titanium plates) were donated by the foreign missions. Patients were followed up by local surgeons for a period ranging from 5 to 12 months. No complications occurred at the donor or recipient sites. There was no extrusion of hardware or breakage of the titanium mini plates or reconstructive plates. Patients remained in the intensive care unit postoperatively for at least 48 h. Owing to financial restraints, removable prostheses were used. Rehabilitation was provided by a local dental team despite the lack of professional dental rehabilitation services. Patients had stable bony union and acceptable facial contour. Patients regained satisfactory masticatory function, resumed their normal diets after 6 months without weight loss, and maintained intelligible speech. InterpretationMRM can be successfully performed in conflict settings such as Gaza. Although the study population was small, the study suggests that further investigation into the conditions and elements needed to perform complex surgeries in conflict settings is warranted. Selection of health-care professionals in the surgical and postoperative care teams, effective coordination with local doctors, availability of essential equipment, and postoperative follow-up protocols could all be carefully considered to optimise the results of surgery. In addition, starting rehabilitation as soon as possible following surgery may restore and improve functional and aesthetic outcomes. FundingThe Palestine Children's Relief Fund (PCRF).

Characteristics of Hospitals Employing Dentists, and Utilization of Dental Care Services for Hospitalized Patients in Japan: A Nationwide Cross-Sectional Study.

Dental care for hospitalized patients can improve nutritional status and feeding function while reducing complications. However, such care in Japan is not uniformly provided. This investigation examined the presence and characteristics of hospitals where dentists work and the collaboration between medical and dental teams. This cross-sectional study involves 7205 hospitals using the administrative reports on the Hospital Bed Function of 2018. Indicators described were the proportion of hospitals employing dentists, those providing perioperative oral care, and those with a nutrition support team (NST) that included dentists. A two-level logistic regression model was performed using hospital-based and secondary medical area-based factors to identify factors associated with hospitals employing dentists and dental care services. Some hospitals had poor medical and dental collaboration, even those with dentists, and no-dentist hospitals had rare medical and dental collaboration. Factors positively associated with hospitals that employed dentists were diagnosis-procedure-combination-hospital types, the Japanese government-established hospitals compared with hospitals established by public organizations, among others. In conclusion, the present study found poor medical and dental collaboration was observed in some hospitals and that hospital type, region, and hospital founders were associated with the performance of collaborative medical and dental care.