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Chatzopoulos GS, Jiang Z, Marka N, Wolff LF. Periodontal Disease, Tooth Loss, and Systemic Conditions: An Exploratory Study. Int Dent J 2024; 74:207-215. [PMID: 37833208 PMCID: PMC10988265 DOI: 10.1016/j.identj.2023.08.002] [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: 03/27/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Although systemic medical conditions are associated with periodontitis and tooth loss, large-scale studies that include less prevalent systemic conditions are needed. The purpose of the study was to investigate the link between periodontal disease and tooth loss with systemic medical conditions in a large and diverse population. METHODS Dental charts of adult patients who had attended the dental clinics seeking dental therapy of the universities contributing data to the BigMouth network and accepted the protocol of the study were included. Dental Procedure Codes and Current Procedural Terminology procedures were utilised to identify patients with and without periodontitis. Data were extracted from patients' electronic health records including demographic characteristics, dental procedural codes, and self-reported medical conditions as well as the number of missing teeth. RESULTS A total of 108,307 records were ultimately included in the analysis; 42,377 of them included a diagnosis of periodontitis. The median age of the included population was 47.0 years, and 55.2% were female. Older and male individuals were significantly more likely to be in the periodontitis group and have higher number of missing teeth. A number of systemic conditions are associated with periodontitis and a higher number of missing teeth. High blood pressure, smoking, drug use, and diabetes were all found to be significant. Other significant conditions were anaemia, lymphoma, glaucoma, dialysis, bronchitis, sinusitis hepatitis, and asthma. CONCLUSIONS Within the limitations of this retrospective study that utilised the BigMouth dental data repository, the association of a number of systemic conditions such as smoking, diabetes, and hypertension with periodontitis and tooth loss has been confirmed. Additional connections have been highlighted for conditions that are not commonly reported in the literature.
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Affiliation(s)
- Georgios S Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA; Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Ziou Jiang
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nicholas Marka
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, USA
| | - Larry F Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
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Büttner M, Leser U, Schneider L, Schwendicke F. Natural Language Processing: Chances and Challenges in Dentistry. J Dent 2024; 141:104796. [PMID: 38072335 DOI: 10.1016/j.jdent.2023.104796] [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: 10/17/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Natural language processing (NLP) is an intersection between Computer Science and Linguistic which aims to enable machines to process and understand human language. We here summarized applications and limitations of NLP in dentistry. DATA AND SOURCES Narrative review. FINDINGS NLP has evolved increasingly fast. For the dental domain, relevant NLP applications are text classification (e.g., symptom classification) and natural language generation and understanding (e.g., clinical chatbots assisting professionals in office work and patient communication). Analyzing large quantities of text will allow understanding diseases and their trajectories and support a more precise and personalized care. Speech recognition systems may serve as virtual assistants and facilitate automated documentation. However, to date, NLP has rarely been applied in dentistry. Existing research focuses mainly on rule-based solutions for narrow tasks. Technologies such as Recurrent Neural Networks and Transformers have been shown to surpass the language processing capabilities of such rule-based solutions in many fields, but are data-hungry (i.e., rely on large amounts of training data), which limits their application in the dental domain at present. Technologies such as federated or transfer learning or data sharing concepts may allow to overcome this limitation, while challenges in terms of explainability, reproducibility, generalizability and evaluation of NLP in dentistry remain to be resolved for enabling approval of such technologies in medical devices and services. CONCLUSIONS NLP will become a cornerstone of a number of applications in dentistry. The community is called to action to improve the current limitations and foster reliable, high-quality dental NLP. CLINICAL SIGNIFICANCE NLP for text classification (e.g., dental symptom classification) and language generation and understanding (e.g., clinical chatbots, speech recognition) will support administrative tasks in dentistry, provide deeper insights for clinicians and support research and education.
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Affiliation(s)
- Martha Büttner
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Germany.
| | - Ulf Leser
- Department of Computer Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lisa Schneider
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Germany
| | - Falk Schwendicke
- Clinic for Operative, Preventive and Pediatric Dentistry and Periodontology, Ludwig-Maximilians-University, Munich, Germany
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3
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Walji MF. Informatics approaches to improve the quality of dental care. Orthod Craniofac Res 2023; 26 Suppl 1:98-101. [PMID: 36919982 DOI: 10.1111/ocr.12655] [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: 01/17/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/16/2023]
Abstract
Despite technological advances, challenges exist in US dental care, including variations in quality of care, access and untreated dental needs. The implementation of learning health systems (LHSs) in dentistry can help to address these challenges. LHSs use robust informatics infrastructure including data and technology to continuously measure and improve the quality and safety of care and can help to reduce costs and improve patient outcomes. The use of EHRs and standardized diagnostic terminologies are highlighted, as they allow for the storage and sharing of patient data, providing a comprehensive view of a patient's medical and dental history, and can be used to identify patterns and trends to improve the delivery of care. The BigMouth Dental Data Repository is an example of an informatic platform that aggregates patient data from multiple institutions and is being used to for scientific inquiry to improve oral health.
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Affiliation(s)
- Muhammad F Walji
- Department of Diagnostic and Biomedical Sciences, Texas Center for Oral Healthcare Quality and Safety School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA
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Banava S, Lippman SA, Schenk G, Gansky SA. Intimate partner violence and orofacial injuries in a multi-school dental data repository. J Dent Educ 2023; 87 Suppl 3:1827-1831. [PMID: 35703990 PMCID: PMC9751224 DOI: 10.1002/jdd.13016] [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: 12/09/2021] [Revised: 03/25/2022] [Accepted: 05/28/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Sepideh Banava
- University of California San Francisco, Division of Oral Epidemiology and Dental Public Health, Department of Preventive and Restorative Dental Sciences, School of Dentistry, 707 Parnassus Ave., San Francisco, CA, USA 94143
- Center to Address Disparities in Children’s Oral Health, 3333 California Street, San Francisco, CA, USA 94143
| | - Sheri A. Lippman
- University of California San Francisco, Division of Prevention Science, Department of Medicine, School of Medicine, Box 0886, Floor 03, Room 3168, San Francisco, CA, USA 94143
| | - Gundolf Schenk
- University of California San Francisco, Bakar Computational Health Sciences Institute, Box 2933, San Francisco, CA, USA 94143
| | - Stuart A. Gansky
- University of California San Francisco, Division of Oral Epidemiology and Dental Public Health, Department of Preventive and Restorative Dental Sciences, School of Dentistry, 707 Parnassus Ave., San Francisco, CA, USA 94143
- Center to Address Disparities in Children’s Oral Health, 3333 California Street, San Francisco, CA, USA 94143
- University of California San Francisco, Bakar Computational Health Sciences Institute, Box 2933, San Francisco, CA, USA 94143
- Philip R. Lee Institute for Health Policy Studies, Box 0936, San Francisco, CA, USA 94118
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Saleh MHA, Decker A, Tattan M, Tattan O, Decker J, Alrmali A, Wang HL. Supplement Consumption and Periodontal Health: An Exploratory Survey Using the BigMouth Repository. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:919. [PMID: 37241151 PMCID: PMC10223792 DOI: 10.3390/medicina59050919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/03/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Dietary supplements have been investigated for their impact on the periodontal apparatus (alveolar bone, mucosa, periodontal ligament, and cementum) and their hypothetical protective role against periodontitis. There remains a gap in the field in this area. Thus, the present study aims to examine the correlation between populations who report taking different dietary supplements and their relative periodontal health. METHODS The BigMouth dental data repository derived from the dental Electronic Health Records (EHRs) of the University of Michigan school of dentistry was used to extract data relating to all patients who fulfilled the eligibility criteria. The prevalence of periodontitis compared to periodontal health as related to supplement consumption was assessed. RESULTS A total of 118,426 individuals (55,459 males and 62,967 females) with self-reported consumption of the dietary supplements of interest were identified in the University of Michigan database via the BigMouth repository. Associations with the following vitamins were investigated, Vitamin B, Vitamin C, Vitamin D, Vitamin E, Multivitamins, Fish oil, Calcium, Omega 3, Saw palmetto, Zinc, Sildenafil, Flax seed, Folic acid, Garlic pills, Ginger pills, Ginko, Ginseng, Glucosamine, Iron, and Magnesium. Out of these supplements, only multivitamins and iron were found to significantly favor periodontal health, while folic acid and vitamin E significantly favored periodontitis. CONCLUSIONS This study found a minimal association between the consumption of dietary supplements with periodontal health.
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Affiliation(s)
- Muhammad H. A. Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Ann Decker
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Mustafa Tattan
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA 52242, USA
| | - Omar Tattan
- RAK College of Dental Sciences, RAK Medical & Health Sciences University, Ras Al-Khaimah 11172, United Arab Emirates
| | - Joseph Decker
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Abdusalam Alrmali
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
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Rodriguez JL, Thakkar-Samtani M, Heaton LJ, Tranby EP, Tiwari T. Caries risk and social determinants of health: A big data report. J Am Dent Assoc 2023; 154:113-121. [PMID: 36503669 DOI: 10.1016/j.adaj.2022.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/30/2022] [Accepted: 10/10/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Oral health is influenced by social determinants of health (SDH), predisposing people and communities to greater risk of developing caries. This study evaluated the association between caries risk in adults and SDH such as ZIP Codes, systemic diseases, payment methods, and race or ethnicity. METHODS The BigMouth Dental Data Repository (n = 57,211) was used to extract clinical and SDH data from patients' dental electronic health records for 2019. Caries risk categories were used as ZIP Code data was merged with the Social Deprivation Index, a composite measure of area-level deprivation based on 7 demographic characteristics collected in the American Community Survey. RESULTS The results showed that the odds of being in the high caries risk group were higher for people in the 49- to 64-year age group (adjusted odds ratio [aOR], 2.24; 95% CI, 2.08 to 2.40; P ≤ .001), men (aOR, 1.19; 95% CI, 1.13 to 1.25; P ≤ .001), people who had comorbidities (diabetes: aOR, 1.16; 95% CI, 1.08 to 1.24; P ≤ .001; cardiovascular disease: aOR, 1.40; 95% CI, 1.32 to 1.50), and people with an Social Deprivation Index score above the 75th percentile (aOR, 2.39; 95% CI, 2.21 to 2.58; P ≤ .001). In addition, Hispanic and Black people had higher odds of being at high caries risk than other races or ethnicities (Hispanic: aOR, 3.05; 95% CI, 2.32 to 4.00; Black: aOR, 2.05; 95% CI, 1.02 to 4.01). CONCLUSIONS This study shows the association of caries risk with higher social deprivation, reinforcing the role of structural and upstream factors in oral health. This study is unique in using recorded ZIP Code information and assessing caries risk levels for those regions. PRACTICAL IMPLICATIONS The physical and structural environment should be considered contributors to caries risk in people.
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Pethani F, Dunn AG. Natural language processing for clinical notes in dentistry: A systematic review. J Biomed Inform 2023; 138:104282. [PMID: 36623780 DOI: 10.1016/j.jbi.2023.104282] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/01/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To identify and synthesise research on applications of natural language processing (NLP) for information extraction and retrieval from clinical notes in dentistry. MATERIALS AND METHODS A predefined search strategy was applied in EMBASE, CINAHL and Medline. Studies eligible for inclusion were those that that described, evaluated, or applied NLP to clinical notes containing either human or simulated patient information. Quality of the study design and reporting was independently assessed based on a set of questions derived from relevant tools including CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS). A narrative synthesis was conducted to present the results. RESULTS Of the 17 included studies, 10 developed and evaluated NLP methods and 7 described applications of NLP-based information retrieval methods in dental records. Studies were published between 2015 and 2021, most were missing key details needed for reproducibility, and there was no consistency in design or reporting. The 10 studies developing or evaluating NLP methods used document classification or entity extraction, and 4 compared NLP methods to non-NLP methods. The quality of reporting on NLP studies in dentistry has modestly improved over time. CONCLUSIONS Study design heterogeneity and incomplete reporting of studies currently limits our ability to synthesise NLP applications in dental records. Standardisation of reporting and improved connections between NLP methods and applied NLP in dentistry may improve how we can make use of clinical notes from dentistry in population health or decision support systems. PROTOCOL REGISTRATION PROSPERO CRD42021227823.
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Affiliation(s)
- Farhana Pethani
- Biomedical Informatics and Digital Health, Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Adam G Dunn
- Biomedical Informatics and Digital Health, Faculty of Medicine and Health, the University of Sydney, Sydney, Australia.
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8
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Uribe SE, Sofi-Mahmudi A, Raittio E, Maldupa I, Vilne B. Dental Research Data Availability and Quality According to the FAIR Principles. J Dent Res 2022; 101:1307-1313. [PMID: 35656591 PMCID: PMC9516597 DOI: 10.1177/00220345221101321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
According to the FAIR principles, data produced by scientific research should be findable, accessible, interoperable, and reusable-for instance, to be used in machine learning algorithms. However, to date, there is no estimate of the quantity or quality of dental research data evaluated via the FAIR principles. We aimed to determine the availability of open data in dental research and to assess compliance with the FAIR principles (or FAIRness) of shared dental research data. We downloaded all available articles published in PubMed-indexed dental journals from 2016 to 2021 as open access from Europe PubMed Central. In addition, we took a random sample of 500 dental articles that were not open access through Europe PubMed Central. We assessed data sharing in the articles and compliance of shared data to the FAIR principles programmatically. Results showed that of 7,509 investigated articles, 112 (1.5%) shared data. The average (SD) level of compliance with the FAIR metrics was 32.6% (31.9%). The average for each metric was as follows: findability, 3.4 (2.7) of 7; accessibility, 1.0 (1.0) of 3; interoperability, 1.1 (1.2) of 4; and reusability, 2.4 (2.6) of 10. No considerable changes in data sharing or quality of shared data occurred over the years. Our findings indicated that dental researchers rarely shared data, and when they did share, the FAIR quality was suboptimal. Machine learning algorithms could understand 1% of available dental research data. These undermine the reproducibility of dental research and hinder gaining the knowledge that can be gleaned from machine learning algorithms and applications.
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Affiliation(s)
- S E Uribe
- Bioinformatics Lab, Riga Stradins University, Riga, Latvia.,Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia.,School of Dentistry, Universidad Austral de Chile, Valdivia, Chile.,Baltic Biomaterials Centre of Excellence, Riga Technical University, Riga, Latvia
| | - A Sofi-Mahmudi
- Seqiz Health Network, Kurdistan University of Medical Sciences, Seqiz, Kurdistan.,Cochrane Iran Associate Centre, National Institute for Medical Research Development, Tehran, Iran
| | - E Raittio
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - I Maldupa
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
| | - B Vilne
- Bioinformatics Lab, Riga Stradins University, Riga, Latvia
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Murphy SN, Visweswaran S, Becich MJ, Campion TR, Knosp BM, Melton-Meaux GB, Lenert LA. Research data warehouse best practices: catalyzing national data sharing through informatics innovation. J Am Med Inform Assoc 2022; 29:581-584. [PMID: 35289371 PMCID: PMC8922176 DOI: 10.1093/jamia/ocac024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/14/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shawn N Murphy
- Research Information Science and Computing, Mass General Brigham, Somerville, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Shyam Visweswaran
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Michael J Becich
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Thomas R Campion
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
- Clinical and Translational Science Center, Weill Cornell Medicine, New York, New York, USA
| | - Boyd M Knosp
- Roy J. and Lucille A. Carver College of Medicine and the Institute for Clinical & Translational Science, University of Iowa, Iowa City, Iowa, USA
| | - Genevieve B Melton-Meaux
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
- Institute for Health Informatics (IHI), University of Minnesota, Minneapolis, Minnesota, USA
| | - Leslie A Lenert
- Biomedical Informatics Center (BMIC), Medical University of South Carolina, Charleston, South Carolina, USA
- Health Sciences South Carolina, Columbia, South Carolina, USA
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