Management of traumatic dental injuries: a survey of paediatric emergency department health professionals

OBJECTIVE

To assess paediatric emergency department (PED) health professionals' confidence, experience and awareness in managing traumatic dental injuries (TDIs).

DESIGN

A cross-sectional online survey.

SETTING

PED at Alder Hey Children's Hospital and Birmingham Children's Hospital.

RESULTS

94 ED health professionals responded. One-third of responders (n=26) encounter children with dental trauma daily or weekly. TDI teaching during undergraduate training was received by 13% (n=12) of responders, and 32% (n=30) had never received training. Responders thought they would benefit from online resources and regular teaching on paediatric TDIs, in addition to an easy-to-use decision-making tool to signpost families.ED health professionals' confidence in giving advice to families following a TDI, and in recognising types of TDIs, was notably low; -79 and -76 Net Promotor Score, respectively.Responders' awareness of how to recognise and manage TDIs was varied. Majority were aware of the need to attempt to reimplant an avulsed permanent tooth, and the need to refer a child presenting with a complex permanent tooth injury to the oncall dentist. However, very few responders commented on the importance of follow-up. Responders also raised concerns about the lack of dental services to treat TDIs in children.

CONCLUSIONS

There is a need to enhance dental trauma teaching for all ED health professionals who encounter TDIs to increase their confidence and enable them to triage and advise patients appropriately. Additionally, increased signposting for families to the appropriate service could in turn improve outcomes and experience for children who experience a TDI.

Exploring oral care practices, barriers, and facilitators in an inpatient stroke unit: a thematic analysis

PURPOSE

Oral care is essential to support the health and rehabilitation of stroke survivors but is often performed poorly in the inpatient setting. This article examines the current practices, barriers and facilitators to oral care on an Australian stroke unit to inform future knowledge translation interventions within this setting.

METHODS

Qualitative semi-structured interviews were conducted with nursing staff members and speech-language pathologists with experience delivering oral care to stroke survivors. Reflexive thematic analysis was used to analyse the data.

RESULTS

Three themes were developed from the data. In the first theme, participants described current oral care practices within their stroke unit and acknowledged that there is room for improvement. In the second theme, participants identified the multiple overlapping barriers to oral care delivery on the ward. Finally, the third theme explored participants' suggestions for improving oral care, including both local and organisational change.

CONCLUSIONS

This study illustrates the complexities of oral care in the inpatient stroke setting and gives voice to the perspectives of nursing and speech-language pathology staff. It is clear that future oral health interventions in this setting require a comprehensive approach to addressing barriers and should prioritise the concerns of staff delivering the care.IMPLICATIONS FOR REHABILITATIONThe delivery of good oral care post-stroke is essential, but in practice is difficult due to limited time and supplies, inadequate education, fear of harm to patient and self, and perceived low priority of the care.Speech-language pathologists are often involved in oral care, but their role is not clearly delineated, and they are not provided with formal training in oral care provision.Oral care interventions should be comprehensive, including organisational policies, clear practice guidelines, structured multi-disciplinary education, and appropriate supplies.

Knowledge of Oral Cancer Risk Factors among International Medical and Dental Students at the Lithuanian University of Health Sciences: A Cross-Sectional Study

The aim of this study was to evaluate knowledge of oral cancer risk factors among international dental and medical students at the Lithuanian University of Health Sciences (LSMU). A cross-sectional study was conducted among international medical and dental students at the LSMU in 2018−2019. In total, 253 students participated, for a response rate of 76.2%. An anonymous self-administered English questionnaire, consisting of 18 items, covered background information (gender, faculty and academic study year), and statements about risk factors for oral cancer and attitudes towards the prevention and treatment of oral cancer. The fifteen statements had the following answer options: yes, no and I don’t know. The statistical data analysis was performed using SPSS version 22. Overall, a good, fair and poor knowledge of oral risk factors was reported by 15.02%, 56.92% and 28.06% of the participants, respectively. The mean score for knowledge of oral cancer risk factors was 10.01 (SD = 2.56), which was defined as fair knowledge. Cronbach’s alpha was found to be 0.78 (a good value). Bartlett’s sphericity test and the KMO index were adequate (χ2 = 677.563, p < 0.001; KMO = 0.788). This study demonstrates a lack of knowledge of oral cancer risk factors among international medical and dental students.

Encounters and management of oral conditions at general medical practices in Australia

Background

Poor oral health has been widely recognised as an ongoing public health issue. Patients with oral conditions may visit either a general practitioner (GP) or a dental practitioner for management. The aims of this study are to report (i) the GP management rate of oral health conditions by patient and GP demographics, (ii) what specific oral conditions were managed, and (iii) how GPs managed oral conditions.

Methods

Data from the Bettering the Evaluation and Care of Health study (2006 to 2016 inclusive) were analysed. Descriptive statistics with 95% confidence intervals around point estimates were used to summarise data. Multivariate logistic regression was performed to determine the independent effect of patient and GP characteristics.

Results

A total of 972,100 GP encounters were included in the dataset, with oral condition-related encounters managed at a rate of 1.19 oral conditions per 100 GP encounters. Patients who were aged 54 years or younger, resided in a socioeconomically disadvantaged area, came from a non-English speaking background or Indigenous background were more likely to have oral conditions managed by GPs. The most commonly reported oral conditions were dental and oral mucosa-related. Over 60% of oral conditions were managed by GPs through prescribed medications.

Conclusions

This study provided an overview of management of oral conditions by GPs in Australia. Patients from certain vulnerable demographic groups were more likely to attend a GP for management of oral conditions. Common oral conditions and management approaches were identified. The findings of this study contribute to public health and health policy discussions around optimising primary care provision in oral health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08299-2.

Knowledge and attitudes towards periodontal health among Australians diagnosed with diabetes

Diabetes and periodontitis are two major diseases affecting the Australian population. Despite the established interrelationship between the diseases, the knowledge of people with diabetes about this interrelationship is limited. This study investigated the knowledge of individuals with diabetes towards periodontal health in Australia. Adults diagnosed with diabetes participated in a survey asking about demographics, medical history, symptoms in the oral cavity, oral hygiene, attendance at the dentist and their knowledge of the interactions between periodontal disease and diabetes. The survey was completed by 113 participants, most of whom thought their diabetes was well controlled. Over half reported bleeding on brushing and one-third reported swollen gums. More than half (53.6%) the respondents were unaware of any complications of diabetes associated with the oral cavity, especially periodontal disease. Most respondents did not talk to their dentist about diabetes (53.6%), yet most wanted to know more about the effects of diabetes on gum health (75.3%). These findings demonstrate that, in this survey, adult Australians diagnosed with diabetes have limited knowledge about how periodontal disease affects them. These individuals, who are at a higher risk of periodontal disease, need to be better informed of the established bidirectional relationship between diabetes and oral health by all health professionals.

Oral health care: The experience of Australian paediatricians

AIM

Many Australian children have dental decay in their deciduous teeth. Poor oral health can negatively impact a child's ability to eat, speak, sleep and socialise, with adverse impacts later in life. Paediatricians are well placed to examine children's teeth and to provide advice and education about oral health. Using a sample of Australian paediatricians, we aimed to determine: (i) self-reported oral health knowledge and skills, (ii) frequency of office-based oral health-related discussions, (iii) perceived role of paediatricians and (iv) barriers to oral health-related discussions.

METHODS

Members of a national network of paediatricians - the Australian Paediatric Research Network - completed a multi-topic survey, which included questions designed to assess oral health knowledge, current practice and barriers to oral health-related discussions.

RESULTS

Of 430 active members, 178 (41%) completed the survey. Few paediatricians reported very good/excellent ability to assess plaque build-up (8%) and dental caries (17%). Only 10% reported broaching the issue of oral health with all patients. Significant barriers included lack of professional training (52%) and other more pressing issues needing to be addressed (67%).

CONCLUSIONS

The increasing (and inequitable) rates of dental decay in Australian children mean that paediatricians should play a key role in the management of children's oral health. Many paediatricians reported a lack of specific training in oral health and limited ability to assess children and educate families. Despite the traditional divide between medicine and oral health, this study highlights the opportunity for Australian paediatricians to improve oral health through early intervention in the consultation room and beyond.