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Bagdesar M, Samuel R, Brown TDG, Shetty S, Kaur J, Kong AC, George A, Ajwani S. Integrated oral care for patients with spinal cord injuries: perceptions of non-dental professionals. Disabil Rehabil 2024:1-10. [PMID: 38910433 DOI: 10.1080/09638288.2024.2367599] [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: 10/08/2023] [Accepted: 06/10/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE To understand the oral health attitudes, knowledge, and practices among non-dental professionals caring for patients with spinal cord injuries, as well as the barriers and facilitators to oral care across acute and rehabilitation hospital settings. MATERIALS AND METHODS This study was a descriptive qualitative study. Nine focus groups with spinal cord injury clinicians from two Sydney hospitals were conducted (n = 35). A thematic analysis was undertaken. RESULTS Four themes were constructed: understanding the impact of spinal cord injuries on oral health and wellbeing; limited support in the spinal cord injury unit to promote oral care; strategies that enable oral care promotion; and recommendations to expand scope in oral care and education. Although most clinicians considered oral health to be important there was a lack of guidelines to support standardised oral care practices. Barriers included lack of time, limited oral care resources, low priority and difficulty in accessing treatment. Staff were receptive to an integrated, multidisciplinary approach to oral care. CONCLUSION This Australian first study provides insight into spinal cord injury clinicians' knowledge and practices of oral care. The findings will help guide future research in developing appropriate models of care to promote oral health among patients with spinal cord injuries.
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Affiliation(s)
- Mary Bagdesar
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Surry Hills, Sydney, NSW, Australia
| | - Rebecca Samuel
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Surry Hills, Sydney, NSW, Australia
| | - Travis D G Brown
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Surry Hills, Sydney, NSW, Australia
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Sachin Shetty
- Spinal Injuries Unit, Prince of Wales Hospital, Sydney, NSW, Australia
- Medicine and Health, The University of New South Wales, Sydney, NSW, Australia
| | - Jasbeer Kaur
- Spinal Cord Injury Unit, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Ariana C Kong
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, NSW, Australia
- ACIOH, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Ajesh George
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Surry Hills, Sydney, NSW, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, NSW, Australia
- ACIOH, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Shilpi Ajwani
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Surry Hills, Sydney, NSW, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, NSW, Australia
- Oral Health Services, Sydney Dental Hospital, Surry Hills, NSW, Australia
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Coker J, Sevigny M, Nguyen N, Battaglino R, Morse L. Factors Associated With Regular Dental Care in People With Spinal Cord Injury: A Secondary Analysis of Data From the FRASCI Study. Top Spinal Cord Inj Rehabil 2023; 29:71-79. [PMID: 38076285 PMCID: PMC10644853 DOI: 10.46292/sci22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Oral health and regular dental care are critical to overall health. Research has found associations between oral health and infections, respiratory disease, and poor quality of life in the general population. While risks for all are increased in people with spinal cord injury (SCI), there is limited information on dental care after SCI. Objectives The purpose of this analysis was to examine factors associated with regular dental care in people with SCI. Methods We analyzed data from 348 individuals with traumatic and nontraumatic SCI who were enrolled in the Fracture Risk after SCI (FRASCI) study. The dataset included two variables on dental care, as well as demographics, injury-related characteristics, and secondary conditions. Bivariate relationships were determined using two-sided t tests and chi-square tests. Results Over 60% of the sample received regular dental care twice per year, and 71% reported seeing a dentist within the past year. Those participants receiving regular dental care twice a year were more likely to be female, be working, have more than a high school diploma, have private insurance, and need a caregiver compared to those who do not receive regular dental care. In addition, these participants were more likely to have had pneumonia since their SCI and have had a urinary tract infection in the past year and since injury. Conclusion More data on oral health are needed to make conclusions about the impact of oral health on secondary conditions and quality of life in people with SCI.
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Affiliation(s)
| | | | - Nguyen Nguyen
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Ricardo Battaglino
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Leslie Morse
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
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Auerbacher M, Kakoschke TK, Hickel R, Kaisarly D. Treatment Plan and Challenges in Full-Mouth Rehabilitation of a Quadriplegic Patient: A Clinical Report. J Prosthodont 2021; 31:183-189. [PMID: 34859932 DOI: 10.1111/jopr.13461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/28/2022] Open
Abstract
Spinal cord injuries lead to physical limitations, and the resulting levels of dependency and emotional distress have devastating consequences on individuals' oral health. A 46-year-old patient with incomplete quadriplegia due to a complicated medical history presented for prosthetic rehabilitation. The patient's ability and tolerance to be treated in the dental chair was assessed. Prosthetic treatment options were discussed considering his dependency on alternating caregivers. The final treatment plan involved restorative treatment, implant-supported crowns, an implant-supported fixed dental prosthesis and, in the upper jaw, an implant-supported overdenture to allow proper oral hygiene. The dental treatment sessions were performed with frequent interruptions in the dental chair, whereas the implants were placed under general anesthesia in the maxillo-facial surgery department. The final treatment plan resulted in a compromise between the prosthetic recommendation and the patient's wish. The decisive factor for choosing an implant-supported overdenture rather than an implant-supported fixed dental prosthesis in the upper jaw was the inability of the patient to maintain adequate hygiene measures by himself and his dependence on the caregivers. This clinical report demonstrates how special care dentistry can improve quality of life, even in people with severe physical and/or mental impairments. We would like to encourage dental professionals to provide high-quality care for patients with disabilities in particular, and this practice is in line with the requirements of the UN convention on the rights of persons with disabilities.
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Affiliation(s)
- Marc Auerbacher
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Tamara Katharina Kakoschke
- Department of Oral & Maxillofacial Surgery & Facial Plastic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Dalia Kaisarly
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany.,Biomaterials Department, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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M M A, Khatri A, Kalra N, Tyagi R, Khandelwal D. Pain perception and efficacy of local analgesia using 2% lignocaine, buffered lignocaine, and 4% articaine in pediatric dental procedures. J Dent Anesth Pain Med 2019; 19:101-109. [PMID: 31065592 PMCID: PMC6502762 DOI: 10.17245/jdapm.2019.19.2.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/04/2019] [Accepted: 04/10/2019] [Indexed: 11/15/2022] Open
Abstract
Background The purpose of this study was to compare the pain perception and anesthetic efficacy of 2% lignocaine with 1:200,000 epinephrine, buffered lignocaine, and 4% articaine with 1:200,000 epinephrine for the inferior alveolar nerve block. Methods This was a double-blind crossover study involving 48 children aged 5–10 years, who received three inferior alveolar nerve block injections in three appointments scheduled one week apart from the next. Pain on injection was assessed using the Wong-Baker Faces pain scale and the sound eye motor scale (SEM). Efficacy of anesthesia was assessed by subjective (tingling or numbness of the lip, tongue, and corner of mouth) and objective signs (pain on probing). Results Pain perception on injection assessed with Wong-Baker scale was significantly different between buffered lignocaine and lignocaine (P < 0.001) and between buffered lignocaine and articaine (P = 0.041). The onset of anesthesia was lowest for buffered lignocaine, with a statistically significant difference between buffered lignocaine and lignocaine (P < 0.001). Moreover, the efficacy of local analgesia assessed using objective signs was significantly different between buffered lignocaine and lignocaine (P < 0.001) and between lignocaine and articaine. Conclusion Buffered lignocaine was the least painful and the most efficacious anesthetic agent during the inferior alveolar nerve block injection in 5–10-year-old patients.
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Affiliation(s)
- Afsal M M
- Department of Pedodontics and Preventive Dentistry, UCMS (University of Delhi) & GTB Hospital, Delhi, India
| | - Amit Khatri
- Department of Pedodontics and Preventive Dentistry, UCMS (University of Delhi) & GTB Hospital, Delhi, India
| | - Namita Kalra
- Department of Pedodontics and Preventive Dentistry, UCMS (University of Delhi) & GTB Hospital, Delhi, India
| | - Rishi Tyagi
- Department of Pedodontics and Preventive Dentistry, UCMS (University of Delhi) & GTB Hospital, Delhi, India
| | - Deepak Khandelwal
- Department of Pedodontics and Preventive Dentistry, UCMS (University of Delhi) & GTB Hospital, Delhi, India
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Orejuela-Zapata JF, Rodriguez S, Ramirez GL. Self-Help Devices for Quadriplegic Population: A Systematic Literature Review. IEEE Trans Neural Syst Rehabil Eng 2019; 27:692-701. [DOI: 10.1109/tnsre.2019.2901399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sermsuti-Anuwat N, Pongpanich S. Perspectives and experiences of Thai adults using wheelchairs regarding barriers of access to dental services: a mixed methods study. Patient Prefer Adherence 2018; 12:1461-1469. [PMID: 30147304 PMCID: PMC6103305 DOI: 10.2147/ppa.s174071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To explore the perspectives and experiences of Thai wheelchair users regarding barriers of access to dental services and report potential solutions in terms of customer satisfaction. PARTICIPANTS AND METHODS We conducted a 2-phase cross-sectional study with quantitative and qualitative components at a community club for individuals with disabilities in Pathum Thani province, Thailand, in February 2018. In quantitative phase, participants were interviewed using a structured questionnaire that consisted of 1) questions on demographic characteristics and 2) adapted questions that were based on the modified Penchansky and Thomas dimensions of access. Enter method of binary logistic regression analysis was used. Regarding qualitative phase, focus group discussions were conducted using the themes of a semi-structured discussion guide. Thematic analysis was used. RESULTS A total of 156 wheelchair users participated in the quantitative phase. Most study participants had not attended dental care services in the previous year (78.2%). Multivariate analysis found a statistically significant association that indicated that participants who had education level ≤primary education were 3.5 times more likely to had not attended a dental appointment in the previous year (P=0.003). In the qualitative phase, 33 participants were included in 3 focus groups (each comprising 11 participants), they were wheelchair users with education >primary, who did not go to see a dentist in the previous 12 months. Findings of the 3 focus groups suggest generally negative views about Thai dental services for all dimensions of access. CONCLUSION This study reflects the unheard voices of wheelchair users and provides rigorous evidence in Thai context that difficulties of access to dental services persist. Policy makers and oral health professionals in oral health system should be alerted to the explicit barriers reported, such that equitable and equal dental services for disabled individuals can be developed.
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Nagarajappa R, Sanadhya S, Batra M, Daryani H, Ramesh G, Aapaliya P. Perceived barriers to the provision of preventive care among dentists of Udaipur, India. J Clin Exp Dent 2015; 7:e74-9. [PMID: 25810847 PMCID: PMC4368023 DOI: 10.4317/jced.51770] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 11/04/2014] [Indexed: 11/05/2022] Open
Abstract
AIM To investigate the practice-, patient- and dentist related barriers to the provision of preventive dental care as perceived by dentists of Udaipur city, Rajasthan, India. SETTINGS AND DESIGN - A cross sectional descriptive survey was conducted among 120 dentists of Udaipur city, Rajasthan. MATERIAL AND METHODS Mean Content Validity Ratio (CVR) was calculated as 0.87 based on the opinions expressed by a panel of total six academicians. Cronbach's coefficient was found to be 0.88, which showed a high internal reliability of the questionnaire. The questionnaire consisted of demographic questions and 12 specific research questions. STATISTICAL ANALYSIS USED - Student's t-test and ANOVA test were applied for the statistical evaluation of means. Level of significance was set at 0.05. RESULTS The barriers correlated strongly with each other (0.60 to 0.85). A significant gender difference was observed in mean sums of scores of practice and patient related barriers. Practice, dentist and patient related barriers for very much hindrance were reported by 8 to 13%, 5 to19% and 0 to 29% of the dentists respectively. A significant difference was observed among mean of sum scores of practice and patient related barriers with age and experience. Qualification was significantly related to practice related barriers. CONCLUSIONS Perception of dentists showed that patient related barriers were found to be the foremost to the provision of preventive care. Also, dentist's attitude towards health promotion and disease prevention needs a radical transformation. Key words:Dental care, dentists, patients, perception.
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Affiliation(s)
- Ramesh Nagarajappa
- Professor and Head, Department of Public Health Dentisty, Rama Dental College and Hospital, A-1/8, Lakhanpur, Kanpur - 208024, Uttar Pradesh
| | - Sudhanshu Sanadhya
- Assistant Professor, Department of Public Health Dentisty, Government Dental College, Jaipur, Rajasthan
| | - Mehak Batra
- Senior Lecturer, Department of Public Health Dentistry, Pacific Dental College and Hospital, Airport Road, Debari, Udaipur - 313024, Rajasthan
| | - Hemasha Daryani
- Senior Lecturer, Department of Public Health Dentistry, Hitkarni Dental College, Jabalpur, Madhya Pradesh
| | - Gayathri Ramesh
- Associate Professor, Department of Oral and Maxillofacial Pathology, Rama Dental College and Hospital, A-1/8, Lakhanpur, Kanpur - 208024, Uttar Pradesh
| | - Pankaj Aapaliya
- Senior Lecturer, Department of Public Health Dentistry, Vaidik Dental College and Research Centre, Nani, Daman
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Huang RY, Lin YF, Kao SY, Shieh YS, Chen JS. A retrospective case-control analysis of the outpatient expenditures for western medicine and dental treatment modalities in CKD patients in Taiwan. PLoS One 2014; 9:e88418. [PMID: 24533085 PMCID: PMC3922810 DOI: 10.1371/journal.pone.0088418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 01/07/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To determine if expenditures for dentistry (DENT) correlate with severity of chronic kidney disease (CKD). METHODS A total of 10,457 subjects were enrolled from January 2008 to December 2010, divided into three groups: healthy control (HC) group (n = 1,438), high risk (HR) group (n = 3,392), and CKD group (n = 5,627). Five stages were further categorized for the CKD group. OPD utilization and expenditures for western medicine (WM), DENT, and TCM (traditional Chinese medicine) were analyzed retrospectively (2000-2008) using Taiwan's National Health Insurance Research Database. Three major areas were analyzed among groups CKD, HR and HC in this study: 1) demographic data and medical history; 2) utilization (visits/person/year) and expenditures (9-year cumulative expenditure, expenditure/person/year) for OPD services in WM, DENT, and TCM; and 3) utilization and expenditures for dental OPD services, particularly in dental filling, root canal and periodontal therapy. RESULTS OPD utilization and expenditures of WM increased significantly for the CKD group compared with the HR and HC groups, and increased steadily along with the severity of CKD stages. However, overall DENT and TCM utilization and expenditures did not increase for the CKD group. In comparison among different CKD stages, the average expenditures and utilization for DENT including restorative filling and periodontal therapy, but not root canal therapy, showed significant decreases according to severity of CKD stage, indicating less DENT OPD utilization with progression of CKD. CONCLUSIONS Patients with advanced CKD used DENT OPD service less frequently. However, the connection between CKD and DENT service utilization requires further study.
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Affiliation(s)
- Ren-Yeong Huang
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yuh-Feng Lin
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Division of Nephrology, Department of Medicine, Shuang Ho Hospital, New Taipei City, Taiwan
- Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sen-Yeong Kao
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Shing Shieh
- Department of Oral Diagnosis, School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jin-Shuen Chen
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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Abstract
Study design one group pre- and post-test design Objective The primary aim was to examine both the short- and long-term effects of an oral home telecare program on improving gingival health among adults with tetraplegia. Methods Eight adults with tetraplegia participated. The oral home telecare program consisted of individualized oral hygiene training in the use of assistive devices (powered toothbrush and adapted flosser and/or oral irrigator) using PC-based videoconferencing between each participant and an occupational therapist. Training was conducted on an average of five 15 to 30 min sessions across three months. During these training sessions, supervised practice of oral hygiene, and provision of immediate corrective feedback and positive reinforcement in the use of adaptive oral hygiene devices was emphasized. Gingival health assessment using the Löe-Silness gingival index (LSGI) was conducted at baseline, six months and 12 months. Results From baseline to six months, participants showed statistically significant differences (i.e., improvement with less gingival inflammation) in their LSGI scores (z=2.18, P=.03). From baseline to 12 months, participants also showed a statistically significant difference (i.e., improvement, z=2.03; P=.04) in their LSGI scores. Conclusion This study indicates that preventive oral home telecare with repeated oral hygiene training in the use of adaptive devices improved gingival health at six and 12 months among adults with tetraplegia.
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Yuen HK, Azuero A, London S. Association between seeking oral health information online and knowledge in adults with spinal cord injury: a pilot study. J Spinal Cord Med 2011; 34:423-31. [PMID: 21903017 PMCID: PMC3152815 DOI: 10.1179/2045772311y.0000000020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To characterize adults with spinal cord injury (SCI) who seek oral health information online, and investigate whether seeking oral health information online is associated with oral health knowledge and behaviors. METHODS An online oral health survey was posted on the South Carolina Spinal Cord Injury Association website. Respondents were 192 adult residents of the US ages 19-83 years who identified themselves as having SCI occurring at least 1 year before the survey date. RESULTS About 12% (n=23) of the respondents searched oral health information online in the past 12 months. Significant associations between the proportion of respondents who searched for oral health information online and socio-demographic and the proportion of respondents who engaged in various oral health behaviors were not detected. However, multivariable logistic regression indicated that respondents who searched oral health information online in the past 12 months have 3.4 times the odds of possessing adequate oral health knowledge compared to respondents who did not search oral health information online (adjusted odds ratio=3.41, 95% confidence interval = 1.35, 8.62, P=0.01). CONCLUSIONS Given the significant association between seeking oral health information online and adequate oral health knowledge, this study suggests that online oral health information may be a potential avenue for dental health professionals to supplement oral health education in adults with SCI.
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Affiliation(s)
- Hon K. Yuen
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, AL, USA,Correspondence to: Hon K. Yuen, University of Alabama at Birmingham, Birmingham, AL 35294-1212, USA.
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, AL, USA
| | - Steven London
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, NY, USA
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