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Pouraskari Z, Yazdani R, Khademi M, Hessari H. Patterns and factors associated with dental service utilization among insured people: a data mining approach. BMC Med Inform Decis Mak 2024; 24:180. [PMID: 38915072 PMCID: PMC11197210 DOI: 10.1186/s12911-024-02572-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Insurance databases contain valuable information related to the use of dental services. This data is instrumental in decision-making processes, enhancing risk assessment, and predicting outcomes. The objective of this study was to identify patterns and factors influencing the utilization of dental services among complementary insured individuals, employing a data mining methodology. METHODS A secondary data analysis was conducted using a dental insurance dataset from Iran in 2022. The Cross-Industry Standard Process for Data Mining (CRISP-DM) was employed as a data mining approach for knowledge extraction from the database. The utilization of dental services was the outcome of interest, and independent variables were chosen based on the available information in the insurance dataset. Dental services were categorized into nine groups: diagnostic, preventive, periodontal, restorative, endodontic, prosthetic, implant, extraction/surgical, and orthodontic procedures. The independent variables included age, gender, family size, insurance history, franchise, insurance limit, and policyholder. A multinomial logistic regression model was utilized to investigate the factors associated with dental care utilization. All analyses were conducted using RapidMiner Version 2020. RESULTS The analysis encompassed a total of 654,418 records, corresponding to 118,268 insured individuals. Predominantly, restorative treatments were the most utilized services, accounting for approximately 38% of all services, followed by diagnostic (18.35%) and endodontic (13.3%) care. Individuals aged between 36 and 60 years had the highest rate of utilization for any dental services. Additionally, families comprising three to four members, individuals with a one-year insurance history, people contracted with a 20% franchise, individuals with a high insurance limit, and insured individuals with a small policyholder, exhibited the highest rate of service usage compared to their counterparts. The regression model revealed that all independent variables were significantly associated with the use of dental services. However, the patterns of association varied among different service categories. CONCLUSIONS Restorative treatments emerged as the most frequently used dental services among insured individuals, followed by diagnostic and endodontic procedures. The pattern of service utilization was influenced by the characteristics of the insured individuals and attributes related to their insurance.
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Affiliation(s)
- Zahra Pouraskari
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Yazdani
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khademi
- Department of Applied Mathematics, South Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Hossein Hessari
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
- Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Tuuliainen E, Nihtilä A, Komulainen K, Nykänen I, Hartikainen S, Tiihonen M, Suominen AL. Use of oral health care services among older home care clients in the context of an intervention study. Scand J Caring Sci 2024; 38:426-437. [PMID: 38389124 DOI: 10.1111/scs.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/10/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND An increasing number of care-dependent older people living at home need external support to receive regular dental care. OBJECTIVES To investigate the use of oral health care services among old home care clients who participated in an intervention study focusing on oral self-care and nutrition. MATERIALS AND METHODS This study employed data from the multidisciplinary Nutrition, Oral Health and Medication (NutOrMed) intervention study with a population-based sample of 245 home care clients (74% female) aged 75 or more divided in intervention (n = 140) and two control groups (n = 105). The data were collected through interviews at baseline and 6-month follow-up. RESULTS At baseline, 43% of participants reported visits to oral health care within the previous year. At 6-month follow-up, this proportion was 51%. In the intervention group, the corresponding figures were 46% and 53%, and in the controls 39% and 48%. Adjusted regression analyses showed that this change was statistically significant (p = 0.008). In addition, higher education and toothache or other discomfort related to teeth or dentures at baseline were associated with increased use after the 6-month follow-up (OR = 1.1, 95% CI = 1.0-1.2; OR = 3.4, 95% CI = 1.5-7.9) but being edentulous indicated the opposite (OR = 0.2, 95% CI = 0.1-0.4). Belonging to the intervention group was not associated with increased use. CONCLUSIONS In older adults, any efforts to raise awareness of oral health are of great potential to increase use of services.
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Affiliation(s)
| | - Annamari Nihtilä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Social and Health Services, Espoo, Finland
| | - Kaija Komulainen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Irma Nykänen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Miia Tiihonen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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Nagata K, Okubo M, Saito K, Nakashizu T, Atsumi M, Kawana H. Verification of the accuracy of dynamic navigation for conventional and mouthpiece methods: in vivo study. BMC Oral Health 2024; 24:596. [PMID: 38778269 PMCID: PMC11112779 DOI: 10.1186/s12903-024-04327-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Dynamic navigation for implant placement is becoming popular under the concept of top-down treatment. The purpose of this study is to verify the accuracy of a dynamic navigation system for implant placement. METHODS Implant placement was performed on 38 patients using 50 implant fixtures. Patients in group C were treated using a conventional method, in which thermoplastic clips were fixed to the teeth, and patients in group M were treated using thermoplastic clips fixed to a mouthpiece attached to the teeth. The groups were compared to verify whether an accuracy difference existed. A treatment planning support program for dental implants was used to superimpose the postoperative computed tomography data on the preoperative implant design data to measure the entry point, apex point, and angular deviation. RESULTS The accuracy of group C was 1.36 ± 0.51 mm for entry point, 1.30 ± 0.59 mm for apex point, and 3.20 ± 0.74° for angular deviation. The accuracy of group M was 1.06 ± 0.31 mm for the entry point, 1.02 ± 0.30 mm for the apex point, and 2.91 ± 0.97° for angular deviation. Significant differences were observed in the entry and apex points between the two groups. CONCLUSIONS The results indicate that group M exhibited better accuracy than group C, indicating that the stability of the thermoplastic clip is important for ensuring the accuracy of the dynamic navigation system. No previous studies have verified the accuracy of this system using the mouthpiece method, and additional data is required to confirm its accuracy for dental implant placement. The mouthpiece method improves the accuracy of implant placement and provides a safer implant treatment than the conventional method. TRIAL REGISTRATION University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), Registration Number: UMIN000051949, URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view_his.cgi on August 21, 2023.
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Affiliation(s)
- Koudai Nagata
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Manabu Okubo
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kurumi Saito
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Toshifumi Nakashizu
- Division of the Dental Practice Support, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Mihoko Atsumi
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hiromasa Kawana
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan.
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Parisius KGH, Verhoeff MC, Lobbezoo F, Avivi-Arber L, Duyck J, Hirano H, Iijima K, Janssens B, Kossioni A, Lin CS, McKenna G, Müller F, Schimmel M, Visser A, Watanabe Y, Gobbens RJJ. Towards an operational definition of oral frailty: A e-Delphi study. Arch Gerontol Geriatr 2024; 117:105181. [PMID: 37713933 DOI: 10.1016/j.archger.2023.105181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES Building upon our recently developed conceptual definition of oral frailty (the age-related functional decline of orofacial structures), this e-Delphi study aims to develop an operational definition of oral frailty by identifying its components. METHODS We used a modified e-Delphi study to reach a consensus among international experts on the components of oral frailty. Twelve out of fifteen invited experts in the field of gerodontology participated. Experts responded to three rounds of an online 5-point scale questionnaire of components to be included or excluded from the operational definition of oral frailty. After each round, scores and rationales were shared with all experts, after which they could revise their position. A consensus was reached when at least 70% of the experts agreed on whether or not a component should be included in the operational definition of oral frailty. RESULTS The experts achieved a high level of agreement (80 - 100%) on including eight components of oral frailty and excluding nineteen. The operational definition of oral frailty should include the following components: 1) difficulty eating hard or tough foods, 2) inability to chew all types of foods, 3) decreased ability to swallow solid foods, 4) decreased ability to swallow liquids, 5) overall poor swallowing function, 6) impaired tongue movement, 7) speech or phonatory disorders, and 8) hyposalivation or xerostomia. CONCLUSION This e-Delphi study provided eight components that make up the operational definition of oral frailty. These components are the foundation for the next stage, which involves developing an oral frailty assessment tool.
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Affiliation(s)
- Karl G H Parisius
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands; Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, The Netherlands.
| | - Merel C Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands
| | | | - Joke Duyck
- Department of Oral Health Sciences, KU Leuven, Belgium
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Japan
| | - Katsuya Iijima
- Institute for Future Initiatives, Institute of Gerontology, The University of Tokyo, Japan
| | - Barbara Janssens
- Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Belgium
| | - Anastassia Kossioni
- Division of Gerodontology, Department of Prosthodontics, Dental School, National and Kapodistrian University of Athens, Greece
| | - Chia-Shu Lin
- Department of Dentistry, National Yang Ming Chiao Tung University, Taiwan
| | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Northern Ireland United Kingdom
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthdontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthdontics, University Clinics of Dental Medicine, University of Geneva, Switzerland; Department of Reconstructive Dentistry and Gerodontology, school of Dental Medicine, University of Bern, Switzerland
| | - Anita Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University of Groningen, The Netherlands; University Medical Center Groningen, The Netherlands; Department for Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, The Netherlands; Zonnehuisgroep Amstelland, The Netherlands; Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Tranzo Academic Centre for Transformation in Care and Welfare, Faculty of Behavioural and Social Sciences, Tilburg University, The Netherlands
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Hiltunen K, Vehkalahti MM. Why and when older people lose their teeth: A study of public healthcare patients aged 60 years and over in 2007-2015. Gerodontology 2023; 40:326-333. [PMID: 36151752 DOI: 10.1111/ger.12657] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This register-based study on public sector patients aged 60 years and over assessed annual age-specific volume of and reasons for tooth extractions as well as changes in these across the period 2007-2015. BACKGROUND Alongside the rapidly ageing population, the demand for public oral healthcare services is growing. Damaged teeth may induce a long-lasting inflammation burden in old age. MATERIALS AND METHODS Data used the electronic documentation of oral healthcare procedures recorded according to healthcare regulation. The study population consisted of all patients over 60 years of age (n = 216 059) who were treated 2007-2015 in public oral health care available to all citizens of Helsinki, Finland. Data for the 9-year time series included reasons for tooth extractions and were aggregated by patient age into 5-year groups. Statistical analyses included rates and proportions, mean values, correlation coefficients and linear regression modelling. RESULTS Extraction patients (n = 48 623) were more likely in the older age groups: 21.8% in the age group 60-64 and 27.5% in the age group 90+. Mean number of tooth extractions among all patients was 0.4 per patient and 1.7 per extraction patient. Among all tooth extractions (n = 82 677), main reasons were caries 29.5%, apical periodontitis 19.4%, tooth remnant 19.4% and periodontitis 18.0%. Tooth remnant predominated as extraction reason in the oldest age groups, while apical periodontitis displayed an upward trend by calendar year. CONCLUSION Tooth extractions attributable to caries were common in all old-age groups, tooth remnant extractions were most common in older age groups, and apical periodontitis abounded as extraction reason during 2007-2015.
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Affiliation(s)
- Kaija Hiltunen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Miira M Vehkalahti
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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Uhlen-Strand MM, Hovden EAS, Schwendicke F, Ansteinsson VE, Mdala I, Skudutyte-Rysstad R. Dental care for older adults in home health care services - practices, perceived knowledge and challenges among Norwegian dentists and dental hygienists. BMC Oral Health 2023; 23:222. [PMID: 37069568 PMCID: PMC10111733 DOI: 10.1186/s12903-023-02951-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 04/06/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Providing dental services to dependent older adults might be challenging because of physical and cognitive decline. The present study aimed to explore current practices, knowledge, and experienced challenges related to the treatment of older adults in home health care services (HHCS) among dentists and dental hygienists in Norway. METHODS An electronic questionnaire survey was distributed to Norwegian dentists and dental hygienists, inquiring about background characteristics, current practices, self-perceived knowledge, and challenges when providing oral health care for older HHCS patients. RESULTS Four hundred and sixty-six dentists and 244 dental hygienists treating older HHCS patients responded to the survey. The majority were female (n=620; 87.3%) and worked in the public dental service (PDS) (n=639; 90%). When older HHCS adults attended the dental practice, the treatments provided were most frequently aimed at relieving acute oral problems, although dental hygienists reported to focus on improving oral health more often than dentists. Dentists reported to have more self-perceived knowledge than dental hygienists regarding patients with complex treatment needs, cognitive or physical impairment. Exploratory Factor Analysis (EFA) was carried out on the 16 items related to challenges, three factors were extracted and Structural Equation Models (SEMs) were performed. Challenges related to dental care for older HHCS adults were related to time, practical organization and communication. Variation within these categories was associated with sex, graduation year and country, as well as time used per patient and work sector, but not with professional status. CONCLUSIONS The results indicate that dental care for older HHCS patients is time-demanding and more often aimed at relieving symptoms than improving oral health. A substantial proportion of dentists and dental hygienists in Norway lack confidence when providing dental care for frail elderly.
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Affiliation(s)
| | | | | | - Vibeke Elise Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
- Department of Public Health Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
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Bots-VantSpijker PC, van der Maarel-Wierink CD, Schols JMGA, Bruers JJM. Assessed and perceived oral health of older people who visit the dental practice, an exploratory cross-sectional study. PLoS One 2021; 16:e0257561. [PMID: 34559825 PMCID: PMC8462729 DOI: 10.1371/journal.pone.0257561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/05/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To assess the oral health of older people who visit the community dental practice from both the dentists' and the patients' perspective. MATERIALS AND METHODS In this exploratory cross-sectional study the oral health of Dutch community dwelling older people was assessed. A representative sample of general dental practitioners was asked to randomly and prospectively select one older patient and describe this patient using a specially-developed registration form; in addition the patient was requested to complete a questionnaire. The oral health of older people was described from the perspective of the dentists and the perspective of the older people themselves based on the definition of oral health from the World Dental Federation (FDI]. Relations between oral health of older people and dentist and older patient characteristics were analysed using Spearman's rank correlation coefficient (rho) and an ordinal regression model. RESULTS In total, 923 dentists were asked to participate in the study; data was available for 39.4% dentist-patient pairs. Dentists assessed the oral health of older patients as good or acceptable in 51.4% of the cases while this was the case in 76.2% of older patients themselves. The assessment of the dentist gets more negative with high treatment intensity and with older patients having certain diseases and more medication, while the assessment is more positive for older patients who visit the dentist on a regular basis. Older people's assessment of their oral health gets more negative by being female and with high treatment intensity, having certain diseases and higher use of medication. CONCLUSIONS AND CLINICAL RELEVANCE Chronically illness as expressed by the number of diseases and the use of medication, seems to be a risk factor for poor oral health. Older patients themselves assess their oral health differently, mostly more positive, than their dentist.
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Affiliation(s)
- Pieternella C. Bots-VantSpijker
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Claar D. van der Maarel-Wierink
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Jos M. G. A. Schols
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Caphri/Department of Family Medicine and Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Josef J. M. Bruers
- Flemish-Netherlands Geriatric Oral Research Group (BENECOMO), Dutch Association for Gerodontology, Bunnik, The Netherlands
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
- Royal Dutch Dental Association (KNMT), Utrecht, The Netherlands
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