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Kelly N, Kilgariff JK. Should suicide risk assessment be embedded in undergraduate dental curricula? Br Dent J 2023; 234:601-605. [PMID: 37117368 PMCID: PMC10141816 DOI: 10.1038/s41415-023-5736-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 04/30/2023]
Abstract
Aims and objectives The aim of this Plan-Do-Study-Act cycle was to establish if undergraduate students believe they have a role to play in suicide risk assessment, and to discuss the implementation of suicide risk prevention into the undergraduate dental curriculum. Data gathered informed development of a subsequent suicide risk assessment educational workshop.Methodology An online questionnaire was disseminated to undergraduate students as part of a quality improvement service evaluation within a UK dental hospital and school. This sought to gain information on attitudes to suicide prevention, previous suicide awareness training, and the appetite and potential barriers to future training.Results A response rate of 23% (n = 30) was achieved. In total, 87% of undergraduate students responding reported having no experience or training in the identification of suicidal patients, 97% of respondents expressed a desire for training, and 80% stated not knowing what to do if a patient disclosed suicidal thoughts during an appointment.Conclusion The dental team have a role to play in suicide risk assessment and the signposting of at-risk patients to appropriate services. To embed this within daily practice, awareness and training must be introduced to undergraduate curricula.
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Affiliation(s)
- Niamh Kelly
- Dental Core Trainee in Restorative Dentistry and Quality Improvement, Dundee Dental Hospital and School, Park Place, Dundee, DD1 4HR, United Kingdom
| | - Julie K Kilgariff
- Consultant in Endodontics, Dundee Dental Hospital and School, Park Place, Dundee, DD1 4HR, United Kingdom.
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Anderson S, Gopi-Firth S. Eating disorders and the role of the dental team. Br Dent J 2023; 234:445-449. [PMID: 36964374 DOI: 10.1038/s41415-023-5619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 03/26/2023]
Abstract
Although primarily classified as psychiatric disorders, eating disorders have a complex aetiology and presentation, with comorbidities spanning multiple disciplines, including dental complications. In some cases, general dental practitioners may be the first health professional to become aware that someone is struggling with an eating disorder. The dental team is in an ideal position to sensitively explore the presentation and signpost the patient to appropriate services while offering support and/or remedial management for dental complications of the eating disorder. Anyone from any background, gender or ethnicity may develop an eating disorder, of which the main diagnoses are anorexia nervosa, bulimia nervosa and binge eating disorder. Some of the frequently seen oral manifestations of these disorders include generalised dental erosion, caries, self-inflicted palatal or oropharyngeal trauma, atrophic mucosa, bilateral parotid gland enlargement, xerostomia and periodontal disease. The dentist's role is pivotal in recognising the possible implications of some of these findings, approaching the patient sensitively, and communicating empathetically to engage them in treatment, reducing the risk of further erosion and improving oral health and hygiene. The dental team may be able to signpost the patient to their general practitioner for onward referral or to a local eating disorder support network.
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Affiliation(s)
- Stephen Anderson
- Consultant Psychiatrist in Eating Disorders, NHS Greater Glasgow and Clyde, UK.
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A Systematic Review and Meta-Analysis of the Association Between Periodontal Disease and Severe Mental Illness. Psychosom Med 2022; 84:836-847. [PMID: 35797566 DOI: 10.1097/psy.0000000000001102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Periodontal disease represents a global public health concern, with a disproportionate burden being borne by vulnerable populations. One such group is people with severe mental illness (SMI), and this study examined whether periodontal health is poorer in people with SMI than the general population. METHODS We conducted a systematic search for studies published before March 2021 on the periodontal health of people with SMI using the following databases: PubMed, PsycINFO, EMBASE, China National Knowledge Infrastructure, and Chongqing VIP. Outcomes were periodontitis, periodontal disease, and shallow and deep periodontal pockets. Results were compared with the general population. RESULTS Seventeen studies had sufficient data for a random-effects meta-analysis, consisting of 4404 psychiatric patients and 95,411 controls. SMI was associated with an increased prevalence of periodontitis (odds ratio = 1.97, 95% confidence interval [CI] = 1.15-3.35) compared with the general population. People with SMI had 4.28 the odds of having periodontal disease compared with controls (95% CI = 2.54-7.21). They also had 3.65 the odds of shallow pockets (95% CI = 1.80-7.42) and 2.76 the odds of deep pockets (95% CI = 1.10-6.93). CONCLUSIONS Our findings highlight the increased prevalence and severity of periodontal disease in people with SMI. Oral health is often considered the gateway to overall health and should be a public health priority for this population.
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Elliott E, Sharma S, Omar A, Hurst D, Marshall C, Blair A, McCullagh A, Chopra A, Claudia A, Patel G, Beaty H, Busnaina S, Lal V. A multi-centre early evaluation of the effectiveness of workshop teaching to improve the confidence of UK and Irish dental students when addressing patient mental health. Br Dent J 2021:10.1038/s41415-021-3613-8. [PMID: 34815478 PMCID: PMC8609992 DOI: 10.1038/s41415-021-3613-8] [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: 12/04/2020] [Accepted: 02/08/2021] [Indexed: 11/08/2022]
Abstract
Background Dental practitioners can have low confidence when addressing patient mental health as part of wider patient management. This is increasingly relevant due to the rising prevalence of mental health conditions and the relationship that can exist between mental and oral health. Interactive workshop teaching on patient mental health may enhance the confidence of dental students when addressing mental health conditions in patients. This study trialled workshop teaching as an educational intervention in five UK and Irish dental schools.Methods A quantitative, scenario-based confidence survey to further establish the need for intervention, followed by delivery of a workshop intervention to volunteer participants. Pre- and post-workshop surveys were used to assess the effectiveness of the workshop.Results Survey data showed low confidence among dental students when addressing patient mental health. Workshop intervention improved dental student confidence on average from 2.3-3.7 on a five-point scale, with less than 0.5% likelihood that reported changes in confidence were due to chance.Discussion Low confidence of dental students addressing patient mental health scenarios echoed wider literature findings surrounding dental clinicians' ability to address patient mental health. This further demonstrated the need for educational intervention, with workshop effectiveness demonstrated within this paper.Conclusion Workshop teaching is an effective way to enhance dental student confidence when addressing patient mental health and should be considered for implementation in the Bachelor of Dental Surgery curriculum.
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Affiliation(s)
- Emma Elliott
- Undergraduate Student, Institute of Dentistry, Barts and The London School of Medicine and Dentistry Dental Hospital, Turner Street, London, E1 2AD, UK.
| | - Sathyam Sharma
- Undergraduate Student, Institute of Dentistry, Barts and The London School of Medicine and Dentistry Dental Hospital, Turner Street, London, E1 2AD, UK
| | - Alya Omar
- Former Undergraduate Student, Institute of Dentistry, Barts and The London School of Medicine and Dentistry Dental Hospital, Turner Street, London, E1 2AD, UK
| | - Dominic Hurst
- Queen Mary University of London, Institute of Dentistry, Barts and The London School of Medicine and Dentistry Dental Hospital, Turner Street, London, E1 2AD, UK
| | - Catherine Marshall
- Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Alex Blair
- Undergraduate Student, Dundee Dental Hospital and School, 2 Park Place, Dundee, DD1 4HR, UK
| | - Alison McCullagh
- Undergraduate Student, Dublin Dental University Hospital, Lincoln Place, Dublin, D02 F859, Ireland
| | - Anusha Chopra
- Undergraduate Student, King´s College Dental Institute, Guy´s Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Aurelia Claudia
- Undergraduate Student, Newcastle School of Dental Sciences, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK
| | - Gopi Patel
- Undergraduate Student, King´s College Dental Institute, Guy´s Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Harriet Beaty
- Undergraduate Student, Newcastle School of Dental Sciences, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK
| | - Shahd Busnaina
- Undergraduate Student, Dublin Dental University Hospital, Lincoln Place, Dublin, D02 F859, Ireland
| | - Varsha Lal
- Undergraduate Student, Dublin Dental University Hospital, Lincoln Place, Dublin, D02 F859, Ireland
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