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Nilsson A, Young L, Evans R, Jennings E, Lee A. Australian dental school academics' perceptions of gerodontology education in the undergraduate curriculum. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:337-346. [PMID: 37798833 DOI: 10.1111/eje.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/26/2023] [Accepted: 09/10/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Australia's rapidly growing population of dentate, frail, care-dependent older people require graduates skilled in managing the health needs of this patient group. The perceptions of academics teaching gerodontology may inform future dental curricula recommendations. This study explored the perceptions of gerodontology education amongst Australian dental school academics. MATERIALS AND METHODS All nine Australian dental schools providing entry-to-practice dentistry programs were invited to participate in semi-structured interviews. Academics from six dentistry programs took part, and the data were analysed using a thematic approach. RESULTS The three main themes identified from interviews included 'clinical exposure', 'organisational levers', and 'sociological barriers'. The attitudes of students, as well as society and health professionals, were seen as strongly influential in preparing the workforce for managing the oral health of older people. The themes inter-linked with a knock-on effect where societal attitudes and organisational levers impact on the ability to successfully support students' preparation for gerodontology practice. Limited resources were barriers to achieving ideal learning and teaching and continued upon graduation as oral health care for older people was perceived as undervalued and under-resourced. CONCLUSION There has been a continued cycle of failure in healthcare schemes and advocacy for the improvement of oral health for older people which has contributed to the inadequate preparation of dental graduates for managing frail and care-dependent older people. Organisational, societal, and political change is needed to support the education of dental students in this area to ensure graduate dentists are competent to manage the oral care needs of this growing population.
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Affiliation(s)
- Angie Nilsson
- James Cook University, Douglas, Queensland, Australia
| | - Louise Young
- James Cook University, Douglas, Queensland, Australia
| | - Rebecca Evans
- James Cook University, Douglas, Queensland, Australia
| | | | - Andrew Lee
- James Cook University, Douglas, Queensland, Australia
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Davies R, Doshi M. Prevention of oral diseases for the older person (Part 1). Br Dent J 2024; 236:35-41. [PMID: 38225311 DOI: 10.1038/s41415-023-6610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Older adults often experience poorer levels of oral health than younger adults, especially if they have become dependent on a third party to support their daily oral care routine. However, the deterioration of oral health does not need to be a part of the ageing process. Most oral diseases are largely preventable with the daily removal of dental plaque that forms on teeth and dentures, using a fluoride toothpaste, eating a healthy diet and reducing any tobacco consumption. The dental team have a duty of care to ensure that older people receive evidence-based oral health preventative advice tailored to the individual, taking into account individual risk factors that can increase with age. This can include the clinical application of topical fluoride and minimally invasive dentistry. Older people at an increased risk of poor oral health include those with cognitive conditions, physical impairments and certain medical conditions. Care home residents face particular barriers to attaining a satisfactory standard of oral care which are discussed herein. Good oral health preventative routines must be established early after the diagnosis of progressive chronic conditions and will help to prevent the need for dental intervention later in life when treatment can be more difficult to tolerate. Inclusion of oral health prevention within health policy and legislation is necessary to improve the oral health for older people living in all health and care settings.
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Affiliation(s)
| | - Mili Doshi
- Dental and Maxillofacial, Surrey and Sussex Healthcare NHS Trust, Surrey, United Kingdom.
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Marchini L. Educating dental students to provide compassionate age friendly care for older adults. J Dent Educ 2023. [PMID: 37082979 DOI: 10.1002/jdd.13227] [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: 01/13/2023] [Revised: 03/31/2023] [Accepted: 04/08/2023] [Indexed: 04/22/2023]
Abstract
As the world population ages, the need for age friendly care increases. In dentistry, age friendly care requires an appropriate comprehension of multiple factors that can be categorized in socio-economic circumstances, systemic health problems, and oral health conditions. In addition to the understanding of these factors and its relationships among each other, the future dental workforce should also be aware of unconscious and pervasive societal stereotypical perception of older persons, aging, and being old, which results in ageism and ageist attitudes. Dental schools can play an important role on raising ageism awareness and combating ageism in healthcare, thus preparing the future of the dental workforce to provide compassionate age friendly care. This paper will discuss ageism in dental schools and learning strategies used to combat it and increase compassionate care delivery for older adults.
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Affiliation(s)
- Leonardo Marchini
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
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Alsaleh A, Kapila A, Shahriar I, Kapila YL. Dental informed consent challenges and considerations for cognitively impaired patients. Periodontol 2000 2021; 87:43-49. [PMID: 34463995 PMCID: PMC8456831 DOI: 10.1111/prd.12397] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Because the US population is living to an older age, the number of individuals with cognitive impairment and periodontitis is increasing, as both conditions/diseases increase with age. Dental informed consent best practices for dental/periodontal treatment of individuals with cognitive impairment have not been explored, yet warrant consideration, because complex dental treatments to address periodontal needs/edentulism raise challenges for informed consent in the elderly with cognitive impairment. The purpose of this review is to help practitioners better understand this topic and develop best practices in dentistry for informed consent of patients with cognitive impairment that need extensive dental treatment, including surgical and implant therapy.
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Affiliation(s)
- Ahmed Alsaleh
- Department of Orofacial Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Anjuli Kapila
- College of Letters and Science, University of California, Davis, Davis, California, USA
| | - Iftee Shahriar
- College of Letters and Science, University of California, Davis, Davis, California, USA
| | - Yvonne L Kapila
- Department of Orofacial Sciences, University of California, San Francisco, San Francisco, California, USA
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Patel J, Wallace J, Doshi M, Gadanya M, Ben Yahya I, Roseman J, Srisilapanan P. Oral health for healthy ageing. THE LANCET HEALTHY LONGEVITY 2021; 2:e521-e527. [DOI: 10.1016/s2666-7568(21)00142-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022]
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Bastos RS, Lauris JRP, Bastos JRM, Velasco SRM, Foger-Teixera D, Sá LM. The impacts of oral health-related quality of life of elderly people living at home: a cross-sectional study. CIENCIA & SAUDE COLETIVA 2021; 26:1899-1910. [PMID: 34076130 DOI: 10.1590/1413-81232021265.11962019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/10/2019] [Indexed: 11/21/2022] Open
Abstract
The scope was to verify the impact of oral and sociodemographic conditions, the dental treatment needs and dental pain, on the quality of life of the elderly. This cross-sectional study was conducted in 15 primary health care areas. A backward multivariate linear regression model was used (p<0.05) with oral health related-quality of life as dependent variable. There were 335 elderly people with predominance of women (56.72%) and aged up to 74 years (59.40%). Those who had up to 8 years of education predominated (87.46%), and those who were still working were the minority (13.43%). Multivariate linear regression (p<0.05) showed association with missing teeth (β=0,12; IC 0,00:0,04; p<0,04) and dental prosthesis needs (β=0,14; IC 0,13:0,81; p<0,01), women (β=0,18; IC 0,23:0,85; p<0,01), less aged (β=-0,12; IC -0,05:0,00; p<0,02), not working (β=-0,15; IC -1,09:-0,20; p<0,01), with dental care need (β=0,24; IC 0,25:0,63; p<0,01) and dental pain (β=0,14; IC 0,10:0,64; p<0,01). Missing teeth, sociodemographic conditions, dental treatment needs and dental pain might impact oral health-related quality of life of elders.
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Affiliation(s)
- Roosevelt Silva Bastos
- Faculdade de Odontologia de Bauru, Universidade de São Paulo. Alameda Otavio Pinheiro Brisola 9/75, Vila Universitária. 17012-901 Bauru SP Brasil
| | - José Roberto Pereira Lauris
- Faculdade de Odontologia de Bauru, Universidade de São Paulo. Alameda Otavio Pinheiro Brisola 9/75, Vila Universitária. 17012-901 Bauru SP Brasil
| | - José Roberto Magalhães Bastos
- Faculdade de Odontologia de Bauru, Universidade de São Paulo. Alameda Otavio Pinheiro Brisola 9/75, Vila Universitária. 17012-901 Bauru SP Brasil
| | - Sofia Rafaela Maito Velasco
- Faculdade de Odontologia de Bauru, Universidade de São Paulo. Alameda Otavio Pinheiro Brisola 9/75, Vila Universitária. 17012-901 Bauru SP Brasil
| | - Debora Foger-Teixera
- Faculdade de Odontologia de Bauru, Universidade de São Paulo. Alameda Otavio Pinheiro Brisola 9/75, Vila Universitária. 17012-901 Bauru SP Brasil
| | - Leticia Marques Sá
- Faculdade de Odontologia de Bauru, Universidade de São Paulo. Alameda Otavio Pinheiro Brisola 9/75, Vila Universitária. 17012-901 Bauru SP Brasil
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Moore D, Allen T, Birch S, Tickle M, Walsh T, Pretty IA. How effective and cost-effective is water fluoridation for adults? Protocol for a 10-year retrospective cohort study. BDJ Open 2021; 7:3. [PMID: 33479223 PMCID: PMC7820470 DOI: 10.1038/s41405-021-00062-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Tooth decay can cause pain, sleepless nights and loss of productive workdays. Fluoridation of drinking water was identified in the 1940s as a cost-effective method of prevention. In the mid-1970s, fluoride toothpastes became widely available. Since then, in high-income countries the prevalence of tooth decay in children has reduced whilst natural tooth retention in older age groups has increased. Most water fluoridation research was carried out before these dramatic changes in fluoride availability and oral health. Furthermore, there is a paucity of evidence in adults. The aim of this study is to assess the clinical and cost-effectiveness of water fluoridation in preventing invasive dental treatment in adults and adolescents aged over 12. METHODS/DESIGN Retrospective cohort study using 10 years of routinely available dental treatment data. Individuals exposed to water fluoridation will be identified by sampled water fluoride concentration linked to place of residence. Outcomes will be based on the number of invasive dental treatments received per participant (fillings, extractions, root canal treatments). A generalised linear model with clustering by local authority area will be used for analysis. The model will include area level propensity scores and individual-level covariates. The economic evaluation will focus on (1) cost-effectiveness as assessed by the water fluoridation mean cost per invasive treatment avoided and (2) a return on investment from the public sector perspective, capturing the change in cost of dental service utilisation resulting from investment in water fluoridation. DISCUSSIONS There is a well-recognised need for contemporary evidence regarding the effectiveness and cost-effectiveness of water fluoridation, particularly for adults. The absence of such evidence for all age groups may lead to an underestimation of the potential benefits of a population-wide, rather than targeted, fluoride delivery programme. This study will utilise a pragmatic design to address the information needs of policy makers in a timely manner.
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Affiliation(s)
- Deborah Moore
- Dental Public Health, Division of Dentistry, Dental Health Unit, The University of Manchester, Lloyd Street North Manchester Science Park, Manchester, M15 6SE, UK.
| | - Thomas Allen
- Director, Centre for the Business and Economics of Health, University of Queensland, St Lucia, Queensland, 4072, UK
| | - Stephen Birch
- Director, Centre for the Business and Economics of Health, University of Queensland, St Lucia, Queensland, 4072, UK
- Health Economics, Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building Oxford Road, Manchester, M13 9PL, UK
| | - Martin Tickle
- Dental Public Health & Primary Care, Division of Dentistry, The University of Manchester, Coupland 3, Manchester, M13 9PL, UK
| | - Tanya Walsh
- Healthcare Evaluation, Division of Dentistry, The University of Manchester, Coupland 3, Manchester, M139PL, UK
| | - Iain A Pretty
- Public Health Dentistry, Division of Dentistry, Dental Health Unit, The University of Manchester, Lloyd Street North Manchester Science Park, Manchester, M15 6SE, UK
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Uchinuma S, Shimada Y, Matin K, Hosaka K, Yoshiyama M, Sumi Y, Tagami J. Effects of UVB and UVC irradiation on cariogenic bacteria in vitro. Lasers Med Sci 2018; 34:981-989. [DOI: 10.1007/s10103-018-2685-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/07/2018] [Indexed: 12/21/2022]
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Zhou Y, Shimada Y, Matin K, Sadr A, Yoshiyama M, Sumi Y, Tagami J. Assessment of root caries under wet and dry conditions using swept-source optical coherence tomography (SS-OCT). Dent Mater J 2018; 37:880-888. [PMID: 29962412 DOI: 10.4012/dmj.2017-273] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to compare optical properties of root caries under two observing conditions using swept-source optical coherence tomography (SS-OCT). In vitro and natural root caries were observed by SS-OCT under wet and dry conditions, followed by confocal laser scanning microscope (CLSM) and transverse microradiography (TMR). Signal intensity (SI), distance between SI peaks (SI-distance) and optical lesion depth were obtained from OCT. Lesion depth was measured from CLSM; lesion depth (LDTMR) and mineral loss (ML) were obtained from TMR. In vitro root caries under wet and dry conditions showed different OCT images and SI patterns. Lesion depth of OCT and that of CLSM, SI-distance and LDTMR, LDTMR and ML significantly correlated. Under dry conditions, half natural root caries showed similar OCT images and SI patterns as in vitro root caries. The base of demineralized dentin could be detected more clearly under dry conditions than under wet conditions.
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Affiliation(s)
- Yuan Zhou
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yasushi Shimada
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Department of Operative Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Khairul Matin
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Endowed Department of International Oral Health Science (affiliated with Department of Translational Research), School of Dental Medicine, Tsurumi University
| | - Alireza Sadr
- Biomimetics Biomaterials Biophotonics Biomechanics & Technology Laboratory, Department of Restorative Dentistry, University of Washington
| | - Masahiro Yoshiyama
- Department of Operative Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Yasunori Sumi
- Division of Oral and Dental Surgery, Department of Advanced Medicine, National Hospital for Geriatric Medicine, National Center for Geriatrics and Gerontology
| | - Junji Tagami
- Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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ZHOU Y, MATIN K, SHIMADA Y, SUMI Y, TAGAMI J. Evaluation of resin infiltration on demineralized root surface: An in vitro study. Dent Mater J 2017; 36:195-204. [PMID: 28111390 DOI: 10.4012/dmj.2016-229] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yuan ZHOU
- Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Khairul MATIN
- Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
- Endowed Department of International Oral Health Science (affiliated with Department of Translational Research), School of Dental Medicine, Tsurumi University
| | - Yasushi SHIMADA
- Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yasunori SUMI
- Division of Oral and Dental Surgery, Department of Advanced Medicine, National Hospital for Geriatric Medicine, National Center for Geriatrics and Gerontology
| | - Junji TAGAMI
- Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Epasinghe DJ, Yiu CKY, Burrow MF. Effect of flavonoids on remineralization of artificial root caries. Aust Dent J 2016; 61:196-202. [DOI: 10.1111/adj.12367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 12/21/2022]
Affiliation(s)
- DJ Epasinghe
- Oral Biosciences; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - CKY Yiu
- Paediatric Dentistry and Orthodontics; Faculty of Dentistry; The University of Hong Kong; Hong Kong SAR China
| | - MF Burrow
- Biomaterials; Melbourne Dental School; The University of Melbourne; Victoria Australia
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