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Ferlias N, Michelotti A, Stoustrup P. Patient safety in orthodontic care: a scoping literature review with proposal for terminology and future research agenda. BMC Oral Health 2024; 24:702. [PMID: 38890596 PMCID: PMC11184803 DOI: 10.1186/s12903-024-04375-7] [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: 03/11/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Knowledge about patient safety in orthodontics is scarce. Lack of standardisation and a common terminology hinders research and limits our understanding of the discipline. This study aims to 1) summarise current knowledge about patient safety incidents (PSI) in orthodontic care by conducting a systematic literature search, 2) propose a new standardisation of PSI terminology and 3) propose a future research agenda on patient safety in the field of orthodontics. METHODS A systematic literature search was performed in the main online sources of PubMed, Web of Science, Scopus and OpenGrey from their inception to 1 July 2023. Inclusion criteria were based on the World Health Organization´s (WHO) research cycle on patient safety. Studies providing information about the cycle's steps related to orthodontics were included. Study selection and data extraction were performed by two of the authors. RESULTS A total of 3,923 articles were retrieved. After review of titles and abstracts, 41 articles were selected for full-text review and 25 articles were eligible for inclusion. Seven provided information on the WHO's research cycle step 1 ("measuring harm"), twenty-one on "understanding causes" (step 2) and twelve on "identifying solutions" (step 3). No study provided information on Steps 4 and 5 ("evaluating impact" or "translating evidence into safer care"). CONCLUSION Current evidence on patient safety in orthodontics is scarce due to a lack of standardised reporting and probably also under-reporting of PSIs. Current literature on orthodontic patient safety deals primarily with "measuring harms" and "understanding causes of patient safety", whereas less attention has been devoted to initiatives "identifying solutions", "evaluating impact" and "translating evidence into safer care". The present project holds a proposal for a new categorisation, terminology and future research agenda that may serve as a framework to support future research and clinical initiatives to improve patient safety in orthodontic care. REGISTRATION PROSPERO (CRD42022371982).
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Affiliation(s)
- Nikolaos Ferlias
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
- Private Practice, Brighton, UK.
| | - Ambrosina Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Peter Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Negruțiu BM, Vaida LL, Judea-Pusta C, Romanec C, Moca AE, Costea CP, Staniș CE, Rus M. Orthodontic Pain and Dietary Impact Considering Age Groups: A Comparative Study. J Clin Med 2024; 13:1069. [PMID: 38398382 PMCID: PMC10889229 DOI: 10.3390/jcm13041069] [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: 01/24/2024] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: orthodontic treatment can frequently be associated with discomfort and pain, a significant factor contributing to treatment discontinuation. (2) Methods: This study, conducted on 160 orthodontic patients across different age groups, aimed to explore the influence of age on patients' responses to treatment, particularly regarding changes in dietary patterns and weight loss. The patients were categorized into three age groups and assessed through a questionnaire about pain perception, pain latency, dietary changes, and weight loss associated with orthodontic appliances. (3) Results: Younger patients (6-12 years) reported lower pain levels, shorter pain latency and fewer alterations in dietary habits compared to adults (over 18 years). Females over 18 represented a significant portion of the sample, suggesting a self-driven inclination towards orthodontic treatment for aesthetic reasons. Fixed orthodontic appliances induced more significant pain than removable ones. Adults experienced more changes in dietary habits and weight loss than younger individuals. (4) Conclusions: the results provide valuable insights for orthodontic practitioners aiming to mitigate adverse effects and improve overall patient experience during treatment.
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Affiliation(s)
- Bianca-Maria Negruțiu
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Claudia Judea-Pusta
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Cristian Romanec
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Cristina Paula Costea
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | | | - Marius Rus
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
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Muacevic A, Adler JR, Imani MM, Aghajani R, Khabbaz S, Shafiei Haghshenas E. Evaluation of Pain, Dietary Intake, Body Mass Index, and Periodontal Status in Patients Undergoing Fixed Orthodontic Treatment With Bite Raiser. Cureus 2022; 14:e32800. [PMID: 36694539 PMCID: PMC9859663 DOI: 10.7759/cureus.32800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Background The aim of this study is to evaluate the effect of bite raisers on patients' body mass index (BMI), nutrient intake, periodontal status, and pain experienced during orthodontic treatment. Material and Methods This cohort study included 44 patients aged 18 to 35 years old; undergoing fixed orthodontic treatment. Patients of the intervention group received a composite resin bite raiser (3M Espe, St. Paul, USA) over their first mandibular molars along with fixed orthodontic appliances (slot 0.022 × 0.030", 3M Unitek, Monrovia, Calif), while the control group only received a fixed orthodontic appliance. Pain levels using the visual analog scale (VAS), dietary intake (calories, proteins, carbohydrate, and fat intake), body mass index (BMI), tooth mobility, bleeding on probing (BOP), and pocket depth (PD) were assessed for all patients in the first three months after fixed orthodontic appliance placement. The data were analyzed using SPSS software version 22.0 (IBM Corp, Armonk, NY, USA) at a significance level of 0.05. Results The pain had an increasing and then decreasing significant trend during the study for all patients (P<0.001). Calory intake also had an increasing and then decreasing significant trend for all participants (P=0.007). The consumption of carbohydrates and BMI significantly decreased during the study in both groups of patients (P<0.01) and tooth mobility, BOP, and PD significantly increased for all participants (P<0.001). No significant differences were observed between the intervention and control groups in terms of the above-mentioned variables. Conclusion The application of bite raiser does not influence patients' pain, dietary intake, BMI, and periodontal status. However, fixed orthodontic appliances affect patients' calorie and carbohydrate intake, patients' BMI, and periodontal indexes including tooth mobility, BOP, and PD.
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Albaqami G, Abreu LG, Bernabé E. Is wearing orthodontic appliances associated with eating difficulties and sugar intake among British adolescents? A cross-sectional study. Eur J Orthod 2021; 43:193-199. [PMID: 33184645 DOI: 10.1093/ejo/cjaa071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To determine whether wearing orthodontic appliances was associated with eating difficulty and lower sugars intake among British adolescents. METHODS This study analysed data from 4116 12- and 15-year-olds who participated in the 2013 Children's Dental Health Survey in the UK. Information on eating difficulties in the past 3 months and usual intake of six sugary items was collected through self-administered questionnaires. The presence and type of orthodontic appliances (fixed or removable) were assessed during clinical examinations. Logistic regression was used to evaluate the association between wearing orthodontic appliances and eating difficulty whereas linear regression was used to evaluate the association between wearing orthodontic appliances and sugars intake. Regression models were adjusted for socio-demographic, behavioural, and clinical characteristics of adolescents. RESULTS 12.9 per cent of the 4116 adolescents wore orthodontic appliances (10.1 per cent fixed and 2.8 per cent removable), 21.0 per cent reported eating difficulties and the mean daily intake of sugars was 5.3 times/day (SD: 3.7, range: 0-20). Adolescents with fixed appliances had 4.02 (95% CI: 3.03, 5.33) greater odds of reporting eating difficulty than those with no appliances, but no differences were found between adolescents wearing removable and no appliances. No association was found between wearing orthodontic appliances and daily sugars intake either [coefficients of 0.20 (95% CI: -0.27, 0.66) and -0.30 (95% CI: -0.96 to 0.36) for adolescents wearing fixed and removable appliances, respectively]. CONCLUSION Wearing fixed orthodontic appliances were associated with greater odds of reporting eating difficulty, but not with lower sugars intake among British adolescents.
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Affiliation(s)
- Ghaliah Albaqami
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
| | - Lucas Guimarães Abreu
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK.,Department of Child's and Adolescent's Oral Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
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Ozdemir M, Ilhan A, Gorucu-Coskuner H, Taner T, Bilgic P. Assessment of food consumption changes in adolescents during orthodontic treatment. Am J Orthod Dentofacial Orthop 2021; 159:604-612. [PMID: 33583694 DOI: 10.1016/j.ajodo.2019.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/01/2019] [Accepted: 11/01/2019] [Indexed: 10/22/2022]
Abstract
INTRODUCTION This study aimed to evaluate the changes in food consumption in adolescents during orthodontic treatment. METHODS Twenty-five adolescents aged between 12 and 18 years participated in the study. Before the treatment, the participants were interviewed, and their food consumption frequency and 24-hour retrospective food consumption records were taken. Participants were followed up for 3 months, that is, in the first, fourth, and 12th week of the treatment. In the interviews, questions about food consumption changes and posttreatment pain were asked to the participants, and 24-hour retrospective food consumption records were obtained. RESULTS When the food consumption records of the adolescents before the orthodontic treatment and at the first week, first month, and third month of the active orthodontic treatment were compared, there was no significant difference between total energy, protein, and carbohydrate intake. However, total fat intake decreased in the first week of treatment and increased significantly during the treatment period (P = 0.05). There was a significant decrease in the amount of fiber (P = 0.039), vitamin E (P = 0.043), and vitamin C (P = 0.048) intake of patients during the orthodontic treatment. CONCLUSIONS Nutrition and feeding habits are important for growth and development in adolescence. In adolescents having orthodontic treatment, vitamin C, vitamin E, and fiber intake decreased significantly, especially in the first weeks of treatment. The intake of these nutrients did not return to their initial levels by the 12th week of the orthodontic treatment. It is thought that cooperation with dietitians and orthodontists might minimize the undesired nutritional effects of the orthodontic treatment.
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Affiliation(s)
- Merve Ozdemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Azad Ilhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Hande Gorucu-Coskuner
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Tülin Taner
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Pelin Bilgic
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
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Aljohani SR, Alsaggaf DH. Adherence to Dietary Advice and Oral Hygiene Practices Among Orthodontic Patients. Patient Prefer Adherence 2020; 14:1991-2000. [PMID: 33116442 PMCID: PMC7586054 DOI: 10.2147/ppa.s277034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/06/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Adherence to dietary advice and proper oral hygiene practices during orthodontic treatment are critical to maintaining good oral health and achieving successful treatment results. Thus, understanding patients' habits and practices before, during, and after orthodontic treatment is needed to ensure better oral health-related behavior among these patients. PURPOSE To investigate sugar-related dietary habits, visits to dental hygienists and dentists, and oral hygiene practices among patients during orthodontic treatment and after treatment compared to patients before treatment. METHODS A cross-sectional self-administered survey collected data from 375 patients (aged 10 years and older) from the Orthodontic Department at King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia. Patients were grouped according to their history of receiving orthodontic treatment into: patients before orthodontic treatment, patients during treatment, and patients after treatment. The survey assessed sugar-related dietary habits, frequency of visits to hygienists and dentists, and oral hygiene practices. RESULTS Patients during orthodontic treatment and those after treatment were less likely to eat sticky food compared to patients before treatment (OR=0.4, 95% CI=0.2-0.9 and OR=0.5, 95% CI=0.3-0.9, respectively). No significant differences were found in the odds of dental visits among the groups. Compared to patients before orthodontic treatment, patients during treatment and patients after treatment had higher odds of tooth brushing twice or more per day (OR=4.8, 95% CI=1.7-14.3, and OR=4.0, 95% CI=1.2-13.6, respectively) and were more likely to brush for an adequate time (OR=2.6, 95% CI=1.6-4.4 and OR=1.9, 95% CI=1.0-3.5, respectively). Moreover, the likelihood of flossing once daily was higher in patients during treatment and in patients after treatment relative to those before treatment. However, only patients during orthodontic treatment used interdental brushes more than patients before treatment. CONCLUSION Patients' oral health-related behavior seems to improve during and after orthodontic treatment. The findings of this study suggest that orthodontists can play a role in improving oral hygiene practices among their patients. More reinforcement of dietary instructions and periodic dental and hygiene visits is needed during orthodontic follow-up appointments.
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Affiliation(s)
- Salha R Aljohani
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Correspondence: Salha R AljohaniDepartment of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Alsulemaneya, PO Box 80209, Jeddah21589, Saudi ArabiaTel +966 504684941Fax +966 12 692 1262 Email
| | - Doaa H Alsaggaf
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Enerbäck H, Möller M, Nylén C, Ödman Bresin C, Östman Ros I, Westerlund A. Effects of orthodontic treatment and different fluoride regimens on numbers of cariogenic bacteria and caries risk: a randomized controlled trial. Eur J Orthod 2019; 41:59-66. [PMID: 29722800 DOI: 10.1093/ejo/cjy025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Background Caries is an undesirable side-effect of treatment with fixed orthodontic appliances. Therefore, it is crucial to understand how orthodontic treatment and different fluoride regimens affect caries risk and individual risk factors. Objective To evaluate the effects of orthodontic treatment and different fluoride regimens on caries risk and caries risk factors, including cariogenic bacteria. Trial design Three-armed, parallel group, randomized, controlled trial. Methods Patients referred to the Specialist Clinic of Orthodontics, Mölndal Hospital, Sweden, were distributed randomly into the following groups: group I (Control group), 1450 ppm fluoride (F) toothpaste; group II, 1450 ppm F toothpaste plus 0.2 per cent sodium fluoride (NaF) mouth rinse; and group III, 5000 ppm F toothpaste. The inclusion criteria were: age 12-20 years; and bimaxillary treatment with fixed appliances. The primary outcome variables were: caries risk; and the numbers of cariogenic bacteria. Radiographs were taken before treatment to determine the caries status. Data were collected before treatment and after 1 year with a fixed appliance. The variables were compiled into a Cariogram to assess the caries risk. Comparisons were made over time within and between the groups. The generation of randomization sequence was performed in blocks of 30. Blinding was employed during the data analysis and the caries registration. Recruitment The clinical study duration was from October 2010 to December 2012. Results Overall, 270 patients were randomized, of which 15 were excluded from the study. Therefore, 255 patients were included in the analyses. The caries risk increased significantly during orthodontic treatment in group I (P < 0.0001), whereas groups II and III had unchanged caries risks. All the groups showed statistically significant increases in the numbers of cariogenic bacteria. Harms No harms were reported during the trial. Conclusions To avoid an increased risk of caries during orthodontic treatment, everyday use of high-fluoride toothpaste (5000 ppm F) or mouth rinse (0.2% NaF) in combination with ordinary toothpaste is recommended. Registration The trial was not registered.
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Affiliation(s)
- Hanna Enerbäck
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Marie Möller
- Department of Orthodontics, Specialist Clinic for Orthodontics, Public Dental Service, Mölndal Hospital, Mölndal, Sweden
| | - Cathrine Nylén
- Department of Orthodontics, Specialist Clinic for Orthodontics, Public Dental Service, Mölndal Hospital, Mölndal, Sweden
| | - Cecilia Ödman Bresin
- Department of Orthodontics, Specialist Clinic for Orthodontics, Public Dental Service, Mölndal Hospital, Mölndal, Sweden
| | - Ingrid Östman Ros
- Department of Orthodontics, Specialist Clinic for Orthodontics, Public Dental Service, Mölndal Hospital, Mölndal, Sweden
| | - Anna Westerlund
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Brazilian adolescents' perception of the orthodontic appliance: A qualitative study. Am J Orthod Dentofacial Orthop 2019; 155:490-497. [DOI: 10.1016/j.ajodo.2018.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 11/20/2022]
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Carter LA, Geldenhuys M, Moynihan PJ, Slater DR, Exley CE, Rolland SL. The impact of orthodontic appliances on eating — young people’s views and experiences. J Orthod 2015; 42:114-22. [DOI: 10.1179/1465313314y.0000000128] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Mensink G, Gooris P, Mulder F, Gooris-Kuipers C, van Merkesteyn R. Experiencing your own orthognathic surgery: a personal case report. Angle Orthod 2014; 85:890-6. [PMID: 25369107 DOI: 10.2319/062414-453.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
There has been much research on minimizing the side effects of orthognathic surgery. However, there are very few doctors and researchers who themselves have undergone this surgery. This case report describes the findings of a maxillofacial surgeon who underwent combined orthodontic and orthognathic treatment for correction of Class II malocclusion. In March 2012, the surgeon was referred to an orthodontist, and an orthodontic examination revealed a Class II, division 2, malocclusion with a traumatic palatal bite and attrition of the lower front teeth. The patient underwent alignment of the upper and lower arches, followed by a bilateral sagittal split osteotomy. During this treatment, he made many interesting observations and learned much as a patient, which can have implications in improving the outcomes and quality of care for patients receiving such treatment. Thus, this case report aims to provide a critical perspective of the surgical procedure and treatment from the viewpoint of a maxillofacial surgeon who himself experienced the surgery as a patient.
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Affiliation(s)
- Gertjan Mensink
- a Consultant in Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands, and Senior Researcher, Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Peter Gooris
- b Consultant in Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, The Netherlands; Consultant in Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Amsterdam Medical Centre, Amsterdam, The Netherlands; and Affiliate Professor, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, Wash
| | - Florine Mulder
- c Private practice, Tandheelkundig Centrum Dudok, Breda, The Netherlands
| | | | - Richard van Merkesteyn
- e Professor, Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands
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