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Nguyen TM, Tonmukayakul U, Calache H. Evaluation of an intervention to promote minimally invasive dentistry (MID) in an Australian community dental agency-A pilot study. Int J Dent Hyg 2022; 20:627-634. [PMID: 34018672 PMCID: PMC9788196 DOI: 10.1111/idh.12523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 04/27/2021] [Accepted: 05/10/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To evaluate the impact of an intervention consisting of a 1-day continuing professional development (CPD) education programme on the International Caries Classification and Management System (ICCMS™ ), and monthly performance feedback, and to promote minimally invasive dentistry (MID) for children aged under 12 years in an Australian community dental agency. The a priori hypotheses assumed the intervention would increase preventive services, and treatment demand was met. METHODS A quasi non-randomized controlled trial with convenience sampling method was adopted. Fourteen dental practitioners received the intervention. The prevalence of dental caries and gingivitis in Australian children was used to determine the treatment demand and used as the performance benchmark. Ten types of preventive and non-preventive dental services were examined. A Difference-in-Differences (DiD) of 12-month pre- (baseline) and post-intervention analysis was performed. RESULTS The intervention group demonstrated increases in topical fluoride application and dietary analysis and advice services. The standard care group had increases in oral prophylaxis or scale and clean, topical fluoride application and oral hygiene instructions (p-value <0.05). The DiD analysis confirmed the above findings in the intervention group, while other preventive services declined. In the intervention group, the performance benchmark for oral prophylaxis or scale and clean and oral hygiene instructions was met at baseline and post-intervention. CONCLUSIONS Only a few preventive services had already met the performance benchmark. The intervention was associated with varied changes to preventive and non-preventive dental services. More robust study design addressing the study limitations and validating the performance benchmark is required.
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Affiliation(s)
- Tan Minh Nguyen
- Deakin Health EconomicsInstitute for Health TransformationDeakin UniversityWaurn PondsVic.Australia
- Community Dental ProgramPeninsula HealthFrankstonVic.Australia
| | - Utsana Tonmukayakul
- Deakin Health EconomicsInstitute for Health TransformationDeakin UniversityWaurn PondsVic.Australia
| | - Hanny Calache
- Deakin Health EconomicsInstitute for Health TransformationDeakin UniversityWaurn PondsVic.Australia
- Dentistry and Oral HealthLa Trobe Rural Health SchoolLa Trobe UniversityBendigoVic.Australia
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Kaurani P, Batra K, Rathore Hooja H, Chander NG, Bhowmick A, Arora S, Baba SM, Khateeb SU, Abdulla AM, Grover V, Saluja P. Assessing the Compliance of Dental Clinicians towards Regulatory Infection Control Guidelines Using a Newly Developed Survey Tool: A Pilot Cross-Sectional Study in India. Healthcare (Basel) 2022; 10:healthcare10101877. [PMID: 36292324 PMCID: PMC9601445 DOI: 10.3390/healthcare10101877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/27/2022] Open
Abstract
Adherence to the dental practice regulatory guidelines instituted during the COVID-19 pandemic is essential to minimize the transmission of SARS-CoV-2 strains. Given the lack of a valid and reliable survey tool to assess the adherence to dental practice guidelines, this study aims to develop, validate, and test a survey tool on a pilot sample of dental clinicians practicing in India. A survey tool was developed/validated through a sequential phasic approach: Phase I- developing survey using conceptual and literature framework; Phase II: ascertaining its validity and reliability; Phase III: pilot testing; and Phase IV: assessing construct validity by exploratory factor analysis (EFA) on the responses collected in Spring 2021. The EFA was achieved using a traditional unweighted least squares extraction method through a varimax rotation with Kaiser normalization. A six-factor solution with 18 items (with the global reliability of 86%) related to screening, regular infection prevention measures, infection control inside the dental operatory, disinfection of the dental unit, disposal, and other COVID-19-specific preventive measures were extracted. Our sample had higher compliance with regard to providing alcohol-based hand scrubs, providing protective gear to attendees, collecting travel/medical history, and screening patients for COVID-19 symptoms. In contrast, less compliance was observed regarding the use of paperless forms of practice and rubber dams in the operatory. The use of a validated survey tool ensures the collection of reliable and valid data, which can serve as baseline data to measure the uptake and effectiveness of dental practice regulatory guidelines in a clinical setting and community dental health clinics.
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Affiliation(s)
- Pragati Kaurani
- Department of Prosthodontics, Mahatma Gandhi Dental College and Hospital, Sitapura Industrial Area, Jaipur 302004, India
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
- Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89102, USA
- Correspondence:
| | - Himangini Rathore Hooja
- Department of Psychology, IIS (deemed to be University), Gurukul Marg, Mansarovar, Jaipur 302020, Rajasthan, India
| | - N. Gopi Chander
- Department of Prosthodontics, SRM Dental College, Ramapuram Chennai 600089, India
| | - Anamitra Bhowmick
- Indegene Lifesystems Private Limited, Bengaluru, Karnataka 560045, India
| | - Suraj Arora
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Suheel Manzoor Baba
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Shafait Ullah Khateeb
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Anshad M. Abdulla
- Department of Pediatric Dentistry & Orthodontics, College of Dentistry, King Khalid University, Abha 61321, Saudi Arabia
| | - Vishakha Grover
- Department of Periodontology & Oral Implantology, Dr. H. S. J. Institute of Dental Sciences & Hospital, Panjab University, Chandigarh 160015, India
| | - Priyanka Saluja
- Department of Conservative Dentistry and Endodontics, JCD Dental College, Vidyapeeth Sirsa 125055, Haryana, India
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Feres MFN, Ruiz-Rodrigues L, Prado VDO, Vicioni-Marques F, Feres M, Nelson-Filho P, Flores-Mir C. Dentists' attitudes and practices toward evidence-based dentistry: a systematic review. JBI Evid Implement 2022; 22:02205615-990000000-00019. [PMID: 36378117 DOI: 10.1097/xeb.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND AIMS Considering that attitudes toward evidence-based dentistry (EBD) may predict implementation behaviors, the objective of this systematic review was to synthesize and evaluate the existing evidence related to dentists' attitudes and practices toward EBD. METHODS We included primary studies that collected information from interviews, questionnaires, or conversation sessions with dentists. The following sources were searched: Cochrane Central Register of Controlled Trials, Embase, PubMed, Scopus, and Web of Science, in addition to gray literature. The included studies were appraised according to the assessment tools recommended by the Joanna Briggs Institute for qualitative and quantitative observational studies. Descriptive data were collected in standardized tables and descriptively synthesized. RESULTS The selection process resulted in 36 included studies. Dentists share positive opinions about EBD and predominantly report willingness to learn or adopt these practices. Despite high methodological risks and significant heterogeneity, the results collected in this review indicated that scientific journals, clinical practice guidelines, and trusted colleagues are generally perceived as influential and useful by dentists, who highly consulted these information sources. CONCLUSION Despite supportive reported attitudes toward EBD, very low certainty exists about actual EBD-related practices.
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Affiliation(s)
| | - Larissa Ruiz-Rodrigues
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Viviane de Oliveira Prado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Fernanda Vicioni-Marques
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
- The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Carlos Flores-Mir
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Johnson KS, Schmidt AM, Bader JD, Spallek H, Rindal DB, Enstad CJ, Fricton JR, Asche SE, Kane SM, Thirumalai V, Godlevsky OV, Johnson NJ, Acharya A, Rush WA. Dental Decision Simulation (DDSim): Development of a virtual training environment. J Dent Educ 2020; 84:1284-1293. [PMID: 32702778 DOI: 10.1002/jdd.12303] [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: 11/11/2019] [Revised: 06/11/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022]
Abstract
PURPOSE Case-based simulations are powerful training tools that can enhance learning and drive behavior change. This is an overview of the design/development of Dental Decision Simulation (DDSim), a web-based simulation of an electronic dental record (EDR). The purpose was to use DDSim to train dentists to make evidence-based treatment planning decisions consistent with current evidence. This simulated EDR provides case-based information in support of a set of defined evidence-based learning objectives. METHODS The development of this complex simulation model required coordinated efforts to create several components: identify behavior changes, case authoring mechanism, create virtual patient visits, require users to make treatment plan decisions related to learning objectives, and a feedback mechanism to help users recognize departures from those learning objectives. This simulation was evaluated in a 2-arm, clinic-randomized, controlled pilot study examining the extent to which DDSim changed dentists' planned treatment to conform to evidence-based treatment guidelines relative to change in dentists not exposed to DDSim. Outcomes were measured by comparing preintervention and postintervention patient EDR treatment data. RESULTS Changes in behavior over time did not favor intervention or control clinics. CONCLUSION DDSim provides a standardized learning platform that cannot be achieved through the use of live patients. Both live patients and case-based simulations can be used to transfer knowledge and skill development. DDSim offers the advantage of providing a platform for developing treatment planning skills in a low-risk environment. However, further research examining behavior change is needed.
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Affiliation(s)
| | | | - James D Bader
- Department of Operative Dentistry, University of North Carolina School of Dentistry, Chapel Hill, North Carolina, USA
| | - Heiko Spallek
- Dean, University of Sydney School of Dentistry, Sydney, Australia
| | - D Brad Rindal
- HealthPartners Institute, Minneapolis, Minnesota, USA
| | | | | | | | - Sheryl M Kane
- HealthPartners Institute, Minneapolis, Minnesota, USA
| | | | | | - Neil J Johnson
- HealthPartners Institute, Minneapolis, Minnesota, USA.,Centennial Lakes Dental Group, Minneapolis, Minnesota, USA
| | - Amit Acharya
- Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
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Sitnikova K, Pret-Oskam R, Dijkstra-Kersten SMA, Leone SS, van Marwijk HWJ, van der Horst HE, van der Wouden JC. Management of patients with persistent medically unexplained symptoms: a descriptive study. BMC FAMILY PRACTICE 2018; 19:88. [PMID: 29914406 PMCID: PMC6006667 DOI: 10.1186/s12875-018-0791-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/08/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND In 2013 the Dutch guideline for management of medically unexplained symptoms (MUS) was published. The aim of this study is to assess medical care for patients with persistent MUS as recorded in their electronic medical records, to investigate if this is in line with the national guideline for persistent MUS and whether there are changes in care over time. METHODS We conducted an observational study of adult primary care patients with MUS. Routinely recorded health care data were extracted from electronic medical records of patients participating in an ongoing randomised controlled trial in 30 general practices in the Netherlands. Data on general practitioners' (GPs') management strategies during MUS consultations were collected in a 5-year period for each patient prior. Management strategies were categorised according to the options offered in the Dutch guideline. Changes in management over time were analysed. RESULTS Data were collected from 1035 MUS consultations (77 patients). Beside history-taking, the most frequently used diagnostic strategies were physical examination (24.5%) and additional investigations by the GP (11.1%). Frequently used therapeutic strategies were prescribing medication (24.6%) and providing explanations (11.2%). As MUS symptoms persisted, GPs adjusted medication, discussed progress and scheduled follow-up appointments more frequently. The least frequently used strategies were exploration of all complaint dimensions (i.e. somatic, cognitive, emotional, behavioural and social) (3.5%) and referral to a psychologist (0.5%) or psychiatrist (0.1%). CONCLUSIONS Management of Dutch GPs is partly in line with the Dutch guideline. Medication was possibly prescribed more frequently than recommended, whereas exploration of all complaint dimensions, shared problem definition and referral to mental health care were used less.
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Affiliation(s)
- Kate Sitnikova
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands.
| | - Rinske Pret-Oskam
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Sandra M A Dijkstra-Kersten
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Stephanie S Leone
- Department of Public Mental Health, Trimbos Institute: Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521, VS, Utrecht, the Netherlands
| | - Harm W J van Marwijk
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, University of Brighton, Falmer, Brighton, BN1 9PH, UK
| | - Henriëtte E van der Horst
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Johannes C van der Wouden
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
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