1
|
Japuntich SJ, Dunbar MS, Predmore Z, Bloom EL, Fang P, Basile S, Rindal DB, Waiwaiole LA, Carpenter MJ, Kopycka-Kedzierawski DT, Dahne J, Lischka TR, Richardson P. Dental staff and patient attitudes about nicotine replacement therapy samples in dental care: A National Dental Practice-Based Research Network study. Community Dent Oral Epidemiol 2024; 52:440-451. [PMID: 38095239 PMCID: PMC11176262 DOI: 10.1111/cdoe.12937] [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: 03/31/2023] [Revised: 09/26/2023] [Accepted: 11/29/2023] [Indexed: 05/24/2024]
Abstract
OBJECTIVES Cigarette smoking negatively affects oral health. Nicotine replacement therapies (NRT; e.g. nicotine patch or lozenge) and brief interventions (e.g. Ask-Advise-Refer; AAR) can improve cessation outcomes but are underutilized. NRT sampling (NRTS) increases NRT utilization by providing patients with samples of NRT as part of routine healthcare. Ask-Advise-Refer is a brief intervention where practitioners: ask patients about tobacco use, advise those using tobacco to quit and refer to the state quit line. The objective of this qualitative study was to explore dental care practitioners' and patients' attitudes and experiences regarding tobacco cessation treatment and perceptions of two brief intervention models, assessed separately: NRTS and AAR. METHODS Twenty-four dental care practitioners and nine patients, recruited through the National Dental Practice-Based Research Network, participated in semi-structured telephone interviews. Interviews assessed experiences with tobacco use intervention and attitudes towards NRTS and AAR. Thematic analysis identified emergent themes related to feasibility and acceptability of NRTS and AAR. RESULTS Practitioners varied on how they address tobacco use, from systematically to idiosyncratically. Some practitioners recommend NRT; few had prescribed it. Practitioners had favourable attitudes towards AAR and NRTS, with most believing that both interventions would be acceptable and feasible to implement. Concerns regarding AAR were time and patient resistance to discussing tobacco use. Concerns regarding NRTS were patient resistance to using NRT, side effects or medication interactions, and capacity to provide follow-up. Patients reported that oral health practitioners generally ask about tobacco use but do not provide interventions. Patients were open to discussing their tobacco use with practitioners and had favourable attitudes about NRTS. CONCLUSIONS This formative work suggests that NRTS and AAR may be feasible to implement in dental care settings. Future studies are needed to assess the effectiveness and implementation potential of NRTS in dental care settings.
Collapse
Affiliation(s)
- Sandra J Japuntich
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA
- Department of Psychiatry, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Michael S Dunbar
- Health Care Division, RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Zachary Predmore
- Health Care Division, RAND Corporation, Boston, Massachusetts, USA
| | | | - Pearl Fang
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA
| | - Sarah Basile
- Health Partners Institute, Bloomington, Minnesota, USA
| | - D Brad Rindal
- Health Partners Institute, Bloomington, Minnesota, USA
| | - Lisa A Waiwaiole
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | - Matthew J Carpenter
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Dorota T Kopycka-Kedzierawski
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Jennifer Dahne
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Tamara R Lischka
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | | |
Collapse
|
2
|
Kakudate N, Yokoyama Y, Tagliaferro EPDS, Sumida F, Matsumoto Y, Gordan VV, Gilbert GH. Comparison of factors associated with the evidence-practice gap as perceived by Japanese and Brazilian dentists. J Dent 2024; 149:105255. [PMID: 39079315 DOI: 10.1016/j.jdent.2024.105255] [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: 05/10/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVES To identify 1) factors of the evidence-practice gap (EPG) in Japan and Brazil as perceived by dentists and compare these factors between two countries, and 2) mechanisms to close this EPG. METHODS The study employed a cross-sectional design by administering a web-based questionnaire to 136 Japanese and 110 Brazilian dentists. The survey queried dentists' reports of which factors possibly cause an EPG, using a newly developed 20-item questionnaire. RESULTS An international comparison of 20 items related to factors of the EPG between Japan and Brazil revealed that "Dentists' own experiences are sometimes given priority over evidence" and "Dentists' own thoughts are sometimes given priority over evidence" were common factors to both countries, with over 80 % agreement. In logistic regression, "Insufficient opportunity to learn about evidence in dental education at universities", "Evidence-based treatments are sometimes not covered by the dental insurance system", and "Insufficient evidence which helps dentists choose an appropriate treatment for a patient after careful consideration of his/her own background" were significantly associated with the EPG in Japan (p < 0.05). In Brazil, "Insufficient case reports in which evidence-based dentistry (EBD) is applied to clinical practice" and "Image-based information and devices used for diagnosis vary depending on individual dentists" were significantly associated with the EPG (p < 0.05). CONCLUSIONS This study suggests that EPG could be improved in Japan: by promoting EBD education at universities, improving the dental insurance system, and accumulating evidence according to patient background; and in Brazil: by promoting EBD case reports and standardizing diagnostic information and devices. CLINICAL SIGNIFICANCE Two factors of EPG common to Japan and Brazil, namely the prioritization of dentists' own "experiences" and "thoughts" over evidence, are urgent issues for improving EPG. In addition, it will be necessary to address the country-specific factors of EPG that were identified in this study.
Collapse
Affiliation(s)
- Naoki Kakudate
- Division of Clinical Epidemiology, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka 803-8580, Japan.
| | - Yoko Yokoyama
- Graduate School of Media and Governance, Keio University, 5322 Endo Fujisawa, Kanagawa 252-0882, Japan
| | - Elaine Pereira da Silva Tagliaferro
- Department of Community Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Futoshi Sumida
- Daiich Dental Clinic, 5-5-7, Hanazono, Chitose, Hokkaido 066-0028, Japan
| | - Yuki Matsumoto
- Matsumoto Dental Clinic, 24-3, Komanomai, Doimachi, Okazaki, Aichi 444-0204, Japan
| | - Valeria V Gordan
- Department of Restorative Dental Sciences at the University of Florida College of Dentistry, Room D3-39 P.O. Box 100415, Gainesville, FL 32610-0415, USA
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Room SDB 109, 1720 Second Avenue South, Birmingham, AL 35294-0007, USA
| |
Collapse
|
3
|
Greenlee GM, Lewandowski L, Funkhouser E, Dolce C, Jolley C, Kau CH, Shin K, Allareddy V, Vermette M, Huang GJ. Treatment acceptance in adult patients with anterior open bite: A National Dental Practice-Based Research Network study. Am J Orthod Dentofacial Orthop 2024:S0889-5406(24)00233-6. [PMID: 38980241 DOI: 10.1016/j.ajodo.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/29/2024] [Accepted: 06/05/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION Orthodontists have many techniques to treat anterior open bites and must involve patients in making treatment decisions. This study aimed to investigate orthodontic treatment plan acceptance by United States adults with anterior open bites and to identify associations between treatment acceptance and patient demographics and dentofacial characteristics. METHODS A prospective, observational cohort study enrolled the patients of 91 orthodontic providers. A total of 345 adults were included in the sample. Provider personal and practice demographics were captured. Patient demographics, treatment goals, dentofacial characteristics, and reasons for not accepting the recommended plans were recorded. Adjusted regression models were used to identify associations between patient characteristics and the likelihood of accepting the most highly recommended plan. RESULTS Approximately 78% of patients accepted the most highly recommended treatment plan. 60% of the patients who were recommended surgical plans accepted them. Patients with a history of orthodontics and a concave profile were more likely to accept the most highly recommended plan. Insurance coverage for orthognathic surgery was associated with a higher acceptance rate for surgery. Severe crowding was associated with a lower acceptance of surgery. The most common reasons for declining the recommended plan were not wanting jaw surgery and considering the treatment to be too invasive, risky, and/or costly. CONCLUSIONS Patient acceptance is less common at higher levels of invasiveness of treatment. Prior orthodontic treatment, concave profile, and insurance coverage for surgery were associated with accepting treatment. Most patients accepted a surgical plan when it was the most recommended option.
Collapse
Affiliation(s)
| | | | - Ellen Funkhouser
- Division of Preventive Medicine, School of Medicine, University of Alabama, Birmingham, Ala
| | - Calogero Dolce
- Department of Orthodontics, College of Dentistry, University of Florida, Gainesville Fla
| | | | - Chung How Kau
- Department of Orthodontics, University of Alabama, Birmingham, Ala
| | - Kyungsup Shin
- Deptartment of Orthodontics, University of Iowa, Iowa City, Iowa
| | | | | | - Greg J Huang
- Department of Orthodontics, University of Washington, Seattle, Wash
| |
Collapse
|
4
|
Berryhill MB, Culmer N, Smith T, Kopycka-Kedzierawski D, Gurganus R, Curry G. Perceptions of mental health screening and referral to treatment in National Dental-Practice Based Research Network practices: A qualitative study. J Public Health Dent 2024; 84:124-135. [PMID: 38561327 PMCID: PMC11168878 DOI: 10.1111/jphd.12607] [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: 03/27/2023] [Revised: 11/27/2023] [Accepted: 01/05/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Dental practices can have additional positive impacts on public health by implementing mental health screening and referral to treatment in dental care workflows. In this study, we examined how dental practices identify and address adult patient mental health concerns, attitudes about implementing mental health screening and referral, and potential barriers and facilitators to treatment. METHODS We conducted semi-structured focus groups with 17 dentists, 10 dental hygienists, and 5 dental assistants/office staff in the South-Central region of the National Dental Practice-Based Research Network. Transcribed interviews were analyzed using thematic analysis. RESULTS We identified five main themes from dental practitioners and office staff responses. Practitioners and office staff: (1) discover patient mental health concerns through record review, patient/caregiver disclosure, and patient observation; (2) respond to patients' mental health concerns by making the patient more comfortable, documenting the concern in the patient's chart, and directly addressing the mental health concern; (3) want a systematic process for mental health screening and referral to treatment in their dental office; (4) recognize potential barriers in implementing health screening and referral to treatment processes; (5) desire training on mental health matters. An overarching theme emerged: developing a trusting relationship with patients. CONCLUSIONS Participants noted the importance of implementing systematic procedures for mental health screening and referral to services into dental practices, while also recognizing the potential barriers for integrating such processes. They also expressed a desire for quality training and resources that can support better care for patients with mental health concerns.
Collapse
Affiliation(s)
| | | | - Todd Smith
- The University of Alabama, Tuscaloosa, Alabama, USA
| | | | - Ria Gurganus
- The University of Alabama, Tuscaloosa, Alabama, USA
| | | |
Collapse
|
5
|
Mungia R, Funkhouser E, Cochran DL, Cunha-Cruz J, Gordan VV, Rindal DB, Meyerowitz C, Allareddy V, Fellows JL, Gilbert GH. Recruitment strategies and retention rates for five National Dental PBRN studies. J Clin Transl Sci 2024; 8:e56. [PMID: 38617061 PMCID: PMC11010183 DOI: 10.1017/cts.2024.499] [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] [Received: 11/13/2023] [Revised: 02/23/2024] [Accepted: 03/11/2024] [Indexed: 04/16/2024] Open
Abstract
Background We describe a retrospective assessment of practitioner and patient recruitment strategies, patient retention strategies, and rates for five clinical studies conducted in the National Dental Practice-Based Research Network between 2012 and 2019, and practitioner and patient characteristics associated with retention. Methods Similar recruitment strategies were adopted in the studies. The characteristics of the practitioners and patients are described. The proportion of patients who either attended a follow-up (FU) assessment or completed an online assessment was calculated. For studies with multiple FU visits or questionnaire assessments, rates for completing each FU were calculated, as were the rates for completing any and for completing all FU assessments. The associations of practitioner and patient characteristics with all clinic FU visits, and with the completion of all assessments for a study were ascertained. Results Overall, 591 practitioners and 12,159 patients were included. FU rates by patients for any assessment varied from 91% to 96.5%, and rates for participating in all assessments ranged from 68% to 87%. The mean total number of patients each practitioner recruited was 21 (sd = 15); the mean number per study was 13 (sd = 7). For practitioners, practice type and patient enrollment were associated with greater clinic retention, while only race was associated with their patients completing post-visit online assessments. For patients, age was associated with clinic retention, while female gender, age, race, and education were all associated with greater completion of post-visit online assessments. Conclusion The Network efficiently recruited practitioners and patients and achieved high patient retention rates for the five studies.
Collapse
Affiliation(s)
- Rahma Mungia
- Department of Periodontics, School of Dentistry, The
University of Texas Health San Antonio, San Antonio,
TX, USA
| | - Ellen Funkhouser
- Division of Preventive Medicine, School of Medicine,
University of Alabama at Birmingham, Birmingham,
AL, USA
| | - David L. Cochran
- Department of Periodontics, School of Dentistry, The
University of Texas Health San Antonio, San Antonio,
TX, USA
| | - Joana Cunha-Cruz
- Department of Clinical and Community Sciences, School of Dentistry,
University of Alabama at Birmingham, Birmingham,
AL, USA
| | - Valeria V. Gordan
- Director of Practice-based Research and Associate Dean for Research,
University of Florida, College of Dentistry,
Gainesville, FL, USA
| | - Donald B. Rindal
- Associate Dental Director for Research, HealthPartners Dental Group,
HealthPartners Institute, Minneapolis,
MN, USA
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester School of Medicine
and Dentistry, Rochester, NY,
USA
| | - Veerasathpurush Allareddy
- Brodie Craniofacial Endowed Chair, and Head of Department of Orthodontics,
University of Illinois Chicago College of Dentistry,
Chicago, IL, USA
| | | | - Gregg H. Gilbert
- Department of Clinical & Community Sciences, Distinguished Professor
and the James R. Rosen Chair of Dental Research Chair, School of Dentistry,
University of Alabama at Birmingham, Birmingham,
AL, USA
| | | |
Collapse
|
6
|
Kakudate N, Yokoyama Y, da Silva Tagliaferro EP, Sumida F, Matsumoto Y, Gordan VV, Gilbert GH. The Evidence-practice Gap in Minimal Intervention Dentistry: An International Comparison Between Dentists in Japan and Brazil. Oper Dent 2024; 49:127-135. [PMID: 38196080 PMCID: PMC10984213 DOI: 10.2341/23-074-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES This study was designed to: 1) evaluate and compare the evidence-practice gap (EPG) in minimal intervention dentistry (MID) in Japan and Brazil by measuring concordance between dentists' clinical practice and published evidence; and 2) identify dentists' factors associated with the EPG in both countries. METHODS We performed a cross-sectional study using a web-delivered questionnaire among 136 Japanese and 110 Brazilian dentists. The questionnaire consisted of three questions concerning "restoration diagnosis and treatment," "deep caries diagnosis and treatment," and "caries risk assessment" regarding MID. A chi-square test was used to analyze differences in concordance among clinical practice and evidence from the literature between Japanese and Brazilian dentists. Logistic regression analyses were performed to analyze dentists' factors associated with overall concordance for all three questions. RESULTS Overall concordance was significantly higher in Brazil (55%) than in Japan (38%) (p<0.01). Concerning how evidence was obtained, textbooks, nonacademic journals, and seminars and workshops were used as information sources more frequently by Japanese than Brazilian dentists (p<0.001), whereas scientific journal articles in English were used more frequently by Brazilian dentists (p<0.001). On logistic regression analysis, overall concordance was higher for Japanese dentists who frequently obtained evidence from scientific journal articles in English (p<0.05), whereas Brazilian dentists who frequently obtained evidence from the Internet were associated with lower overall concordance (p<0.05). CONCLUSIONS Because overall concordance was significantly higher in Brazil than in Japan, Japan may have a greater EPG in MID practice. Specific characteristics of Japanese and Brazilian dentists showed significant associations with overall concordance.
Collapse
Affiliation(s)
- Naoki Kakudate
- Professor & Division Director, Division of Clinical Epidemiology, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan
| | - Yoko Yokoyama
- Project Senior Assistant Professor, Graduate School of Media and Governance, Keio University, 5322 Endo Fujisawa, Kanagawa, 252-0882, Japan
| | - Elaine Pereira da Silva Tagliaferro
- Professor, Department of Community Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Rua Humaitá, 1680, Centro - 14801-903 - Araraquara, SP, Brazil
| | - Futoshi Sumida
- Dentist, Daiich Dental Clinic, 5-5-7, Hanazono, Chitose, Hokkaido, 066-0028, Japan
| | - Yuki Matsumoto
- Director, Matsumoto Dental Clinic, 24-3, Komanomai, Doimachi, Okazaki, Aichi, 444-0204, Japan
| | - Valeria V Gordan
- Professor and Interim Associate Dean for Research, Department of Restorative Dental Sciences at the University of Florida College of Dentistry, Room D3-39 P.O. Box 100415 Gainesville, FL 32610-0415, USA
| | - Gregg H Gilbert
- Distinguished Professor, James R. Rosen Endowed Chair of Dental Research, & Chair, Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Room SDB 109, 1720 Second Avenue South, Birmingham, AL 35294-0007, USA
| |
Collapse
|
7
|
Kalenderian E, Tungare S, Mehta U, Hamid S, Mungia R, Yansane AI, Holmes D, Funkhouser K, Ibarra-Noriega AM, Urata J, Rindal DB, Spallek H, White J, Walji MF. Patient and dentist perspectives on collecting patient reported outcomes after painful dental procedures in the National Dental PBRN. BMC Oral Health 2024; 24:201. [PMID: 38326805 PMCID: PMC10848340 DOI: 10.1186/s12903-024-03931-5] [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: 08/29/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Dental Patient Reported Outcomes (PROs) relate to a dental patient's subjective experience of their oral health. How practitioners and patients value PROs influences their successful use in practice. METHODS Semi-structured interviews were conducted with 22 practitioners and 32 patients who provided feedback on using a mobile health (mHealth) platform to collect the pain experience after dental procedures. A themes analysis was conducted to identify implementation barriers and facilitators. RESULTS Five themes were uncovered: (1) Sense of Better Care. (2) Tailored Follow-up based on the dental procedure and patient's pain experience. (3) Effective Messaging and Alerts. (4) Usable Digital Platform. (5) Routine mHealth Integration. CONCLUSION Frequent automated and preferably tailored follow-up messages using an mHealth platform provided a positive care experience for patients, while providers felt it saved them time and effort. Patients thought that the mHealth questionnaires were well-developed and of appropriate length. The mHealth platform itself was perceived as user-friendly by users, and most would like to continue using it. PRACTICAL IMPLICATIONS Patients are prepared to use mobile phones to report their pain experience after dental procedures. Practitioners will be able to close the post-operative communication gap with their patients, with little interruption of their workflow.
Collapse
Affiliation(s)
- Elsbeth Kalenderian
- Marquette University, School of Dentistry, Milwaukee, WI, USA
- University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA, USA
- University of Pretoria, School of Dentistry, Pretoria, South Africa
| | - Sayali Tungare
- UTHealth School of Dentistry, 7500 Cambridge St. room 4160, Houston, TX, TX 77054, USA
| | - Urvi Mehta
- UTHealth School of Dentistry, 7500 Cambridge St. room 4160, Houston, TX, TX 77054, USA
| | - Sharmeen Hamid
- UTHealth School of Dentistry, 7500 Cambridge St. room 4160, Houston, TX, TX 77054, USA
| | - Rahma Mungia
- UTHealth School of Dentistry, San Antonio, TX, USA
| | - Alfa-Ibrahim Yansane
- University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA, USA
| | | | - Kim Funkhouser
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227-1098, USA
| | - Ana M Ibarra-Noriega
- UTHealth School of Dentistry, 7500 Cambridge St. room 4160, Houston, TX, TX 77054, USA
| | - Janelle Urata
- University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA, USA
| | | | - Heiko Spallek
- University of Sydney, School of Dentistry, Sydney, Australia
| | - Joel White
- University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA, USA
| | - Muhammad F Walji
- UTHealth School of Dentistry, 7500 Cambridge St. room 4160, Houston, TX, TX 77054, USA.
| |
Collapse
|
8
|
Thyvalikakath T, Siddiqui ZA, Eckert G, LaPradd M, Duncan WD, Gordan VV, Rindal DB, Jurkovich M, Gilbert GH. Survival analysis of posterior composite restorations in National Dental PBRN general dentistry practices. J Dent 2024; 141:104831. [PMID: 38190879 PMCID: PMC10866618 DOI: 10.1016/j.jdent.2024.104831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/01/2024] [Accepted: 01/02/2024] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE Quantify the survival of posterior composite restorations (PCR) placed during the study period in permanent teeth in United States (US) general dental community practices and factors predictive of that survival. METHODS A retrospective cohort study was conducted utilizing de-identified electronic dental record (EDR) data of patients who received a PCR in 99 general dentistry practices in the National Dental Practice-Based Research Network (Network). The final analyzed data set included 700,885 PCRs from 200,988 patients. Descriptive statistics and Kaplan Meier (product limit) estimator were performed to estimate the survival rate (defined as the PCR not receiving any subsequent treatment) after the first PCR was observed in the EDR during the study time. The Cox proportional hazards model was done to account for patient- and tooth-specific covariates. RESULTS The overall median survival time was 13.3 years. The annual failure rates were 4.5-5.8 % for years 1-5; 5.3-5.7 %, 4.9-5.5 %, and 3.3-5.2 % for years 6-10, 11-15, and 16-20, respectively. The failure descriptions recorded for < 7 % failures were mostly caries (54 %) and broken or fractured tooth/restorations (23 %). The following variables significantly predicted PCR survival: number of surfaces that comprised the PCR; having at least one interproximal surface; tooth type; type of prior treatment received on the tooth; Network region; patient age and sex. Based on the magnitude of the multivariable estimates, no single factor predominated. CONCLUSIONS This study of Network practices geographically distributed across the US observed PCR survival rates and predictive factors comparable to studies done in academic settings and outside the US. CLINICAL SIGNIFICANCE Specific baseline factors significantly predict the survival of PCRs done in US community dental practices.
Collapse
Affiliation(s)
- Thankam Thyvalikakath
- Office of Dental Informatics & Digital Health, Indiana University School of Dentistry, IUPUI, Research Scientist & Director, Dental Informatics, Center for Biomedical Informatics, Regenstrief Institute, Inc., OH 144A, 415 Lansing Street, Indianapolis, IN 46202, USA.
| | - Zasim Azhar Siddiqui
- West Virginia University School of Pharmacy, Morgantown, WV, USA; Department of Public Health and Dental Informatics, Indiana University School of Dentistry, IUPUI, Indianapolis, IN 46202, USA
| | - George Eckert
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, 340W 10th St, Indianapolis, IN 46202, USA
| | - Michelle LaPradd
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, 340W 10th St, Indianapolis, IN 46202, USA; Syneos Health, 1030 Sync St, Morrisville, NC 27560, USA
| | - William D Duncan
- Department of Community Dentistry, University of Florida, College of Dentistry, Gainesville, FL, USA; Biomedical Data Science and Shared Resource, Roswell Park Cancer Center, Buffalo, NY, USA
| | - Valeria V Gordan
- University of Florida, College of Dentistry, Gainesville, FL, USA
| | - D Brad Rindal
- 8170 33rd Avenue South | P.O. Box 1524, MS 23301A Minneapolis MN 55440, USA
| | - Mark Jurkovich
- HealthPartners Institute, Minneapolis MN, USA; 8170 33rd Ave S, Bloomington, MN 55440, USA
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, SDB Room 109, University of Alabama at Birmingham, Birmingham, AL, USA; National Dental PBRN Collaborative Group, 1720 University Blvd, Birmingham, AL 35294, USA; University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
9
|
Riley JLI, Rindal DB, Velly AM, Anderson GC, Johnson KS, Gilbert GH, Schiffman EL. Practitioner/Practice- and Patient-Based Factors Contributing to Dental Practitioner Treatment Recommendations for Patients with Pain-Related TMDs: Findings from the National Dental PBRN. J Oral Facial Pain Headache 2023; 37:195-206. [PMID: 37975783 PMCID: PMC10664701 DOI: 10.11607/ofph.3263] [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: 05/23/2022] [Accepted: 04/16/2023] [Indexed: 11/19/2023]
Abstract
AIMS To document National Dental Practice-Based Research Network (PBRN) practitioner treatment recommendations for patients with painful temporomandibular disorders (TMDs) and to identify practitioner/practice- and patient-related factors contributing to treatment recommendations made at the initial clinical visit. METHODS This prospective single-sample cohort study formed groups based on treatment recommendations made by 185 dental practitioners who treated 1,901 patients with painful TMDs. At the baseline visit, which this article describes, practitioners provided patients with their diagnoses and a treatment plan and then completed a comprehensive questionnaire. RESULTS Self-care, an intraoral appliance, medication, and practitioner-recommended jaw exercises were the most frequently recommended treatments. Practitioners recommended multiple treatments to most patients. TMD signs, symptoms, and diagnoses were primary considerations in treatment planning, but the practitioner's expectations for improvement were only significant for intraoral appliances and self-care. Female practitioners and those with expertise in TMDs more frequently recommended patient-directed and multidisciplinary treatments compared to their counterparts. CONCLUSIONS Practitioners used a wide range of treatments for patients with few consistent patterns. The propensity to use TMD signs, symptoms, and diagnoses when making treatment recommendations suggests a tendency to conceptualize patients using the biomedical model. Infrequent referral to nondental providers suggests a lack of availability of these providers, a misunderstanding of the complexity of TMDs, and/or discomfort with assessment of psychosocial factors. Implications include the need for comprehensive training in the assessment and management of TMD patients during dental school and participation in TMD continuing education courses following evidence-based guidelines.
Collapse
|
10
|
Feldman CA, Fredericks-Younger J, Fine D, Markowitz K, Sabato E. Advancing oral health through practice-based research. J Am Dent Assoc 2023; 154:959-962.e2. [PMID: 37115141 PMCID: PMC10792412 DOI: 10.1016/j.adaj.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/17/2023] [Accepted: 03/05/2023] [Indexed: 04/29/2023]
Affiliation(s)
- Cecile A. Feldman
- Rutgers University, School of Dental Medicine
- Rutgers University, School of Public Health
| | | | - Daniel Fine
- Rutgers University, School of Dental Medicine
| | | | | |
Collapse
|
11
|
Cunha-Cruz J, Gilbert GH, Allareddy V, Cochran DL, Fellows J, Kopycka-Kedzierawski DT, McBurnie M, Meyerowitz C, Mungia R, Rindal DB, Gordan VV. Characteristics of dentists in the National Dental Practice-Based Research Network. J Dent 2023; 137:104653. [PMID: 37572986 PMCID: PMC10528504 DOI: 10.1016/j.jdent.2023.104653] [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: 07/18/2023] [Accepted: 08/08/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVES Our aims are to describe the characteristics of dentists, members of the US National Dental practice-based research network (PBRN) in the United States, and determine how often these dentists provide specific dental procedures. METHODS Dentists completed a questionnaire when they enrolled in the Network about their demographic and training characteristics and characteristics of their practices and patients. Dentists also reported the frequency of providing specific dental procedures. Data were analyzed using descriptive statistics. RESULTS Of 4,483 dentists in active clinical practice, 34% identified as females, 70% as white, and 73% as general dentists. Most dentists practiced in large metropolitan areas (87%) and in solo or small practices (72%). On average, they reported about one-half of their patients were children or older adults, a third were from historically underrepresented racial and ethnic groups, and one-quarter were covered by public insurance. Most dentists routinely performed restorations and fixed prosthetics (78%), extractions (59%), removable (44%) and implant (40%) prosthetics, and endodontics on incisor and premolar teeth (44%). CONCLUSIONS Dentists participating in the National Dental PBRN have much in common with dentists at large. The network has a broad representation of dentists, practice types, patient populations, and treatments offered, including diversity regarding race/ethnicity, gender, insurance, and geography of its practitioners and patients. CLINICAL SIGNIFICANCE Characteristics of National Dental PBRN dentists suggest that a broad range of dentists is interested in participating in national-level research studies, thereby enabling an array of clinical study settings and topics that can optimize the generalizability of study findings.
Collapse
Affiliation(s)
- Joana Cunha-Cruz
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Medical Towers Suite 402, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Medical Towers Suite 402, 1717 11th Avenue South, Birmingham, AL 35205, United States
| | - Veerasathpurush Allareddy
- University of Illinois Chicago College of Dentistry, 801 S. Paulina Street, Chicago, Illinois 60612, United States
| | - David L Cochran
- Department of Periodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Jeffrey Fellows
- Center for Health Research, Kaiser Permanente, 3800N. Interstate Avenue, Portland, OR 97227-1098, United States
| | - Dorota T Kopycka-Kedzierawski
- Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, PO Box 683, Rochester, NY 14620, United States
| | - MaryAnn McBurnie
- Kaiser Permanente Center for Health Research, 3800N. Interstate Avenue, Portland, OR 97114, United States
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester. 601 Elmwood Avenue, Box 686, Rochester, NY 14642, United States.
| | - Rahma Mungia
- Department of Periodontics, The University of Texas Health San Antonio, 8403 Floyd Curl Drive; MC 8258; Suite 300.29, San Antonio, TX 78229, United States
| | - D Brad Rindal
- HealthPartners Institute, HealthPartners Dental Group, 8170 33rd Avenue South | P.O. Box 1524, MS 21112R, Minneapolis MN 55440-1524, United States
| | - Valeria V Gordan
- University of Florida College of Dentistry, Restorative Dental Sciences Department, PO Box 100415, Gainesville FL 32610-0415, United States
| |
Collapse
|
12
|
Mungia R, Lobbezoo F, Funkhouser E, Glaros A, Manfredini D, Ahlberg J, Taverna M, Galang-Boquiren MT, Rugh J, Truong C, Boone H, Cheney C, Verhoeff MC, Gilbert GH. Dental practitioner approaches to bruxism: Preliminary findings from the national dental practice-based research network. Cranio 2023:1-9. [PMID: 37016587 PMCID: PMC11011247 DOI: 10.1080/08869634.2023.2192173] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
OBJECTIVE Bruxism is a repetitive masticatory muscle activity. This study investigates dental practitioners' approaches to bruxism assessment and treatment in practices. METHODS A brief 5 question questionnaire ("Quick Poll") on bruxism was conducted. RESULTS A total of 397 practitioners responded. More than half (55%) initiated treatment for bruxism on one to three patients per month. The majority believed that stress (97%) and sleep patterns (82%) affected bruxism in their patients. Interestingly, 96% offered an occlusal guard/appliance and 46% made occlusal adjustments. CONCLUSION This study highlights inconsistencies in practitioner approaches to bruxism assessment and management in clinical settings, suggesting gaps in practitioner knowledge evidenced by the varied responses. ABBREVIATIONS PBRN - Practice-Based Research NetworkMMA - Masticatory muscle activitySB - Sleep bruxismAB - Awake bruxismTMJ - Temporomandibular jointOSA - Obstructive sleep apnea.
Collapse
Affiliation(s)
- Rahma Mungia
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ellen Funkhouser
- Department of Medicine, School of Medicine, University of Alabama at Birmingham
| | - Alan Glaros
- School of Dentistry, The University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Daniele Manfredini
- Department of Medical Biotechnologies, Università degli Studi di Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Melanie Taverna
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | | | - John Rugh
- Department of Developmental Dentistry, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | - Clarisse Truong
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | - Honesty Boone
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | | | - Merel C. Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gregg H. Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham
| | | |
Collapse
|
13
|
Kalenderian E, White J, Yansane AI, Urata J, Holmes D, Funkhouser K, Mungia R, Xiao J, Rauschenberger C, Ibarra-Noriega A, Tran D, Rindal DB, Spallek H, Walji M. Study protocol: understanding pain after dental procedures, an observational study within the National Dental PBRN. BMC Oral Health 2022; 22:581. [PMID: 36494795 PMCID: PMC9733211 DOI: 10.1186/s12903-022-02573-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/08/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Patient-reported outcome measures provide an essential perspective on the quality of health care provided. However, how data are collected, how providers value and make sense of the data, and, ultimately, use the data to create meaningful impact all influence the success of using patient-reported outcomes. OBJECTIVES The primary objective is to assess post-operative pain experiences by dental procedure type through 21 days post-procedure as reported by patients following dental procedures and assess patients' satisfaction with pain management following dental surgical procedures. Secondary objectives are to: 1) assess post-operative pain management strategies 1 week following dental surgical procedures, as recommended by practitioners and reported by patients, and 2) evaluate practitioner and patient acceptance of the FollowApp.Care post visit patient monitoring technology (FollowApp.Care). We will evaluate FollowApp.Care usage, perceived usefulness, ease of use, and impact on clinical workload. DESIGN AND METHODS We describe the protocol for an observational study involving the use of the FollowApp.Care platform, an innovative mobile application that collects dental patients' assessments of their post-operative symptoms (e.g., pain). The study will be conducted in collaboration with the National Dental Practice-based Research Network, a collective Network of dental practices that include private and group practices, public health clinics, community health centers and Federal Qualified Health Centers, academic institutional settings, and special patient populations. We will recruit a minimum of 150 and up to 215 dental providers and up to 3147 patients who will receive push notifications through text messages FollowApp.Care on their mobile phones at designated time intervals following dental procedures. This innovative approach of implementing an existing and tested mobile health system technology into the real-world dental office setting will actively track pain and other complications following dental procedures. Through patients' use of their mobile phones, we expect to promptly and precisely identify specific pain levels and other issues after surgical dental procedures. The study's primary outcome will be the patients' reported pain experiences. Secondary outcomes include pain management strategies and medications implemented by the patient and provider and perceptions of usefulness and ease of use by patients and providers.
Collapse
Affiliation(s)
- Elisabeth Kalenderian
- grid.424087.d0000 0001 0295 4797Academic Center for Dentistry at Amsterdam (ACTA), Gustav Mahlerlaan 3004, Room 6N-09, 1081 Amsterdam, LA The Netherlands ,grid.266102.10000 0001 2297 6811University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA USA ,grid.38142.3c000000041936754XHarvard School of Dental Medicine, Boston, MA USA ,grid.49697.350000 0001 2107 2298University of Pretoria, School of Dentistry, Pretoria, South Africa
| | - Joel White
- grid.266102.10000 0001 2297 6811University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA USA
| | - Alfa-Ibrahim Yansane
- grid.266102.10000 0001 2297 6811University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA USA
| | - Janelle Urata
- grid.266102.10000 0001 2297 6811University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA USA
| | - David Holmes
- FollowApp.Care, London, England ,Private Dental Practice, Periodontics and Implant Dentistry, 19 Wimpole St, W1G 8GE London, London UK
| | - Kimberly Funkhouser
- grid.414876.80000 0004 0455 9821Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR 97227-1098 USA
| | - Rahma Mungia
- UTHealth San Antonio, School of Dentistry, San Antonio, TX USA
| | - Jin Xiao
- Department of Dentsitry, Eastman Institute for Oral Health, National Dental PBRN, 625 Elmwood Ave, Box 683, Rochester, NY 14620 USA
| | - Cindy Rauschenberger
- Department of Dentsitry, Eastman Institute for Oral Health, National Dental PBRN, 625 Elmwood Ave, Box 683, Rochester, NY 14620 USA
| | - Ana Ibarra-Noriega
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston, School of Dentistry, Diagnostic and Biomedical Sciences, Research Office, 7500 Cambridge Street, room 4334, Houston, TX 77054 USA
| | - Duong Tran
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston, School of Dentistry, Diagnostic and Biomedical Sciences, Research Office, 7500 Cambridge Street, room 4334, Houston, TX 77054 USA
| | - D. Brad Rindal
- grid.280625.b0000 0004 0461 4886HealthPartners Institute for Education and Research, 8170 33rd Avenue South, P.O. Box 1524, MS 23301A, Bloomington, MN 55440-1524 USA
| | - Heiko Spallek
- grid.1013.30000 0004 1936 834XUniversity of Sydney, School of Dentistry, 2 Chalmers St., Surry Hills, Sydney, NSW 2010 Australia
| | - Muhammad Walji
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston, School of Dentistry, Diagnostic and Biomedical Sciences, Research Office, 7500 Cambridge Street, room 4334, Houston, TX 77054 USA
| |
Collapse
|