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Abbasi F, Tabesh A, Yavari A, Makaremi R, Bizhani O, Mahmood M. Evaluation and relation of oral health-related quality of life and oral health status in Thalassemia Major patients, a cross-sectional study. BMC Oral Health 2023; 23:493. [PMID: 37454066 PMCID: PMC10350253 DOI: 10.1186/s12903-023-03202-9] [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: 10/31/2022] [Accepted: 07/05/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Beta-Thalassemia is the most common human inherited disease, directly impacting patients' physical and psychosocial aspects. The present study evaluated oral health status, oral health-related quality of life (OHRQoL), and their correlation in Thalassemia Major patients. METHODS Two hundred Thalassemia Major patients aged 12-49 participated in this cross-sectional study. Subjects were selected among the patients referred to the Faculty of Dentistry of Isfahan University of Medical Sciences using simple sampling. Oral Health Impact Profile 14 (OHIP 14) was used to assess OHRQoL. The decayed, Missing, and Filled Teeth (DMFT) index was used as an oral health index. SPSS 22 was used for analysis, using T and Pearson Correlation tests. RESULTS 53% of participants were female, and 47% were male. The mean OHIP-14 score (± SD) was 13.20 (± 7.01). The mean DMFT score was 9.54 (± 5.72). DMFT and total OHIP 14 scores correlated significantly (p < 0.001, r = 0.78). All domains of the OHIP-14 score were also significantly correlated with DMFT (p < 0.05). CONCLUSIONS Poor oral health conditions might adversely affect OHRQoL in TM patients. It seems necessary to provide oral treatment needs in order to improve OHRQoL in patients suffering from this particular disease.
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Affiliation(s)
- Fatemeh Abbasi
- Dental Research Center, Department of Oral Medicine, Dental research institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Adel Tabesh
- Dental Research Center, Department of Oral Medicine, Dental research institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirmohammad Yavari
- Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasoul Makaremi
- Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Bizhani
- Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Mahmood
- Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Improving care for thalassemia patients in line with best practice standards at a tertiary referral cancer care center. JBI Evid Implement 2021; 20:128-133. [PMID: 33852496 DOI: 10.1097/xeb.0000000000000283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Beta-thalassemia major is a chronic hematological disorder that requires life-long management. This project aimed to improve thalassemia patients' care through the implementation of best practice standards at a tertiary referral cancer care center. METHODS The current project utilized a clinical audit design. A pre and post-implementation audit was carried out following best practice standards for patients with thalassemia. Chart review of nine thalassemia patients was undertaken pre and post-implementation of staff education, local clinical guidelines, and an annual care plan to manage thalassemia to determine adherence to best practice standards. Data were collected between June 2019 and June 2020 at a specialist outpatient and day treatment unit located in inner Brisbane, Australia. RESULTS The pre-implementation audit results showed low compliance to the audit criteria, with the exception of nursing staff education. Following the implementation of strategies to align current care with evidence-based recommendations, the post-implementation audit showed improvement across all areas. Overall, implementation strategies were successful in improving patient care for thalassemia patients by 100%. Staff thalassemia education increased from 45 to 92%. CONCLUSION Implementing an individualized treatment plan and thalassemia-specific nursing documentation as well as developing local clinical guidelines and providing targeted nurse education were effective strategies to improve care for thalassemia patients in line with best practice standards.
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Gusmini MADS, De Sa AC, Feng C, Arany S. Predictors of dental complications post-dental treatment in patients with sickle cell disease. Clin Exp Dent Res 2020; 7:11-19. [PMID: 33225591 PMCID: PMC7853884 DOI: 10.1002/cre2.335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/16/2020] [Accepted: 09/27/2020] [Indexed: 11/30/2022] Open
Abstract
Objective Our aim was to explore potential medical or dental indicators associated with dental complications and the utilization of emergency services in sickle cell disease (SCD), especially that clinical reports on adverse outcomes post‐dental treatment are scarce. Materials and methods A retrospective analysis of dental treatments of 47 eligible adults with confirmed SCD between May 2016 and October 2019. Logistic regression analysis was used whether clinical outcomes, course of dental treatment, and regularity of dental care are associated with dental complications after dental procedures and/or resulted in emergency care or hospital admissions. Results We identified a new, statistically significant association (p‐value = .01) between the number of prescription medications taken and complications (10%) after dental procedures. The most frequent dental procedures were tooth extractions (36%) and pain management (28%) during a non‐scheduled dental encounter (68%). The majority of cases did not participate in regular recall exams and periodical oral hygiene maintenance. Conclusions A higher number of prescription medications was associated with an increased risk of post‐dental complications in SCD patients. A thorough medical history, including a list of prescribed medications, and collaboration with the patient medical team are important to assess the risk of complications post‐dental procedures and the need for antibiotic prophylaxis according to the case complexity.
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Affiliation(s)
| | - Anny Clementino De Sa
- Department of General Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Szilvia Arany
- Department of General Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
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Evidence-based dental management in the new era of sickle cell disease: A scoping review. J Am Dent Assoc 2020; 151:668-677.e9. [PMID: 32854869 DOI: 10.1016/j.adaj.2020.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is an emerging global health issue with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on dental treatment of SCD. TYPES OF STUDIES REVIEWED Using a scoping review approach, the authors examined citations from 13 national SCD guidelines and 10 books spanning 4 decades. The authors also searched the following databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, Scientific Electronic Library Online, and GoogleScholar. Eligibility criteria included SCD, oral health care and dental treatment, related to oral and systemic health, original data, or observations. RESULTS Systemic treatment of SCD might have opposing effects on caries, perhaps explaining the conflicting results published. Malocclusion correlates with marrow expansion. Other unusual orofacial findings reflect ischemia. Of 86 full-text articles examined, only 1, a Brazilian esthetic dentistry study, was a randomized clinical trial. No disease-specific data were found on risk of developing bacterial endocarditis, safety of inhaled nitrous oxide, safety of epinephrine with local anesthetic, or the benefit of comprehensive oral health care. PRACTICAL IMPLICATIONS In SCD, oral health and systemic health could be strongly linked. Penicillin, vaccines, and hydroxyurea might impact caries and bone. The interaction of SCD treatments and oral health merit study.
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Yue H, Xu X, Liu Q, Li X, Jiang W, Hu B. Association between sickle cell disease and dental caries: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2020; 25:309-319. [PMID: 32783601 DOI: 10.1080/16078454.2020.1748927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objectives: Although dental caries has been widely reported in individuals with sickle cell disease (SCD), there is still controversial in the literature regarding the association between SCD and dental caries. The aim of this systematic review was to investigate whether individuals with SCD have more dental caries than individuals with non-SCD. Methods: PubMed and Embase databases were searched for eligible studies. The parameters of the permanent decayed, missing and filled teeth (DMFT) index and the permanent decayed, missing and filled surface (DMFS) index were considered as outcome measures. The overall meta-analyses of the DMFT and DMFS index and various subgroup analyses (caries components, age, and genotypes) of DMFT index were performed to calculate the weighted mean differences (WMD) between patients with SCD and non-SCD individuals. Results: A total of 9 studies covering 1478 individuals were included in this meta-analysis. The results of overall meta-analyses indicated that the scores of the DMFT and DMFS index were not significantly different between patients with SCD and non-SCD participants. The results of subgroup analyses by caries components, age, and genotypes showed no significant difference in most items. The result of the missing teeth was significantly lower in patients with SCD than in non-SCD individuals (WMD, -0.14; 95% confidence interval [CI], -0.25 to -0.03; P = 0.01). Discussion and Conclusions: The results revealed that compared with non-SCD individuals, patients with SCD did not suffer from worse dental caries. Considering the limitations, further well-designed studies are necessary to reveal the association between SCD and dental caries.
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Affiliation(s)
- Hui Yue
- Department of Stomatology, The people' s Hospital of LinShui, Sichuang, People's Republic of China
| | - Xinxin Xu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, People's Republic of China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, People's Republic of China.,College of Stomatology, Chongqing Medical University, Chongqing, People's Republic of China
| | - Qin Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiaozhi Li
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, People's Republic of China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, People's Republic of China.,Department of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Wei Jiang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, People's Republic of China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, People's Republic of China.,Department of Stomatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Bo Hu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, People's Republic of China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, People's Republic of China.,College of Stomatology, Chongqing Medical University, Chongqing, People's Republic of China
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Al Asmari D, Khan MK. Effect of photodynamic therapy on gingival inflammation in patients with thalassemia. Photodiagnosis Photodyn Ther 2020; 29:101595. [DOI: 10.1016/j.pdpdt.2019.101595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022]
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Akcalı A, Yıldız MS, Akcalı Z, Huck O, Friedmann A. Periodontal condition of patients with Thalassemia Major: A systematic review and meta-analysis. Arch Oral Biol 2019; 102:113-121. [PMID: 30999065 DOI: 10.1016/j.archoralbio.2019.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this systematic review was to evaluate the existing evidence on the association between Thalassemia major (TM) and periodontal condition. MATERIALS & METHODS MEDLINE via OVID, EMBASE, and The Cochrane Database (including the Central Register of Controlled Trials (CENTER)), were searched up to September 2018 to identify observational studies eligible for systematic review and meta-analyses. Newcastle-Ottawa Scale (NOS) was used for quality assessment. RESULTS The initial search resulted in 172 articles, and of these, 16 articles were included and a qualitative synthesis was carried out. Based on the quantitative data from 14 studies, significant differences were found in gingival index (GI) (p < 0.001), bleeding on probing (p = 0.02) as well as plaque index (PI) (p < 0.01) measures between TM and systemically healthy controls. Additional analyses (young vs. adult) for GI and PI revealed that such significant differences were only observed in adults, even though overall analysis showed no subgroup effect. The majority of the studies qualified as "intermediate quality". CONCLUSION Patients with TM had significantly higher gingival inflammation scores compared to controls. Therefore, routine comprehensive periodontal screening in TM is recommended in order to prevent occurrence of periodontal diseases and eventually reduce the complexity of the oral health care. Also, conduction of further well-designed observational studies is recommended to contribute to this topic.
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Affiliation(s)
- Aliye Akcalı
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany; Centre for Oral Clinical Research, Institute of Dentistry, Barts &The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, United Kingdom.
| | - Mehmet Selim Yıldız
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Zeynep Akcalı
- Department of Internal Medicine, Havran Government Hospital, Balıkesir, Turkey
| | - Olivier Huck
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France; INSERM 1260 « Regenerative Nanomedicine », Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
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