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Park SA, Lim JN, Lee JY. Evaluation of the Effectiveness of Children's Dental Care Programs: A Retrospective Study. Healthcare (Basel) 2024; 12:721. [PMID: 38610144 PMCID: PMC11011933 DOI: 10.3390/healthcare12070721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024] Open
Abstract
This study aimed to evaluate the long-term impact of children's dental care programs on children and adolescents to reduce oral health inequalities. It measured and assessed the improvement effects of children's dental care programs on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and children's dental care program between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. A frequency analysis was conducted for demographic characteristics, and a binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. The data were analyzed using PASW Statistics with the statistical significance level set at α = 0.05. Regarding oral health status based on the frequency of participation in children's dental care program for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health status in children's dental care program between primary and adolescent age groups, individuals under continuous oral health care showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, a binary logistic regression analysis revealed significant influences (p < 0.05) of the developmental stage and frequency of program participation on dental caries prevalence. Children's dental care programs are essential for alleviating oral health inequalities among children and adolescents and preventing oral diseases. Furthermore, the developmental stage of children and the frequency of program participation are crucial factors in preventing oral conditions, such as dental caries.
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Affiliation(s)
- Soo-Auk Park
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan 31116, Republic of Korea;
| | - Ji-Na Lim
- Department of Public Health Science, Graduate School, Dankook University, Cheonan 31116, Republic of Korea;
| | - Jae-Young Lee
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan 31116, Republic of Korea;
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Welti R, Jones B, Moynihan P, Silva M. Evidence pertaining to modifiable risk factors for oral diseases: an umbrella review to Inform oral health messages for Australia. Aust Dent J 2023; 68:222-237. [PMID: 37649239 DOI: 10.1111/adj.12972] [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] [Accepted: 08/09/2023] [Indexed: 09/01/2023]
Abstract
The aim of this umbrella review was to collate and appraise the evidence base regarding modifiable risk factors for the prevention of oral diseases to inform the update of the Oral Health Messages for Australia. Eleven questions related to modifiable risk factors and dental disease were investigated. Electronic databases (Medline, Embase and PubMed) were searched from January 2010 to October 2022. Systematic reviews evaluating interventions/exposures in healthy subjects from high-income countries, where Westernized practices, oral health promotion and healthcare systems are similar to Australia, were included. Quality appraisal of included systematic reviews was guided by the AMSTAR tool. Of the 3637 articles identified, 29 articles met eligibility criteria. High-quality systematic reviews were identified for questions relating to diet, infant feeding, dental check-ups and oral hygiene. Free sugars consumption above 5% of energy intake, infrequent toothbrushing, smoking/vaping and alcohol intake were consistently associated with poorer oral health outcomes. Breastfeeding up to the age of 24 months was not associated with an increased risk of early childhood caries. The use of interdental cleaning devices and mouthguards during contact sports are likely to be effective in preventing dental disease.
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Affiliation(s)
- Rachelle Welti
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Bree Jones
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Paula Moynihan
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mihiri Silva
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Stormon N, Sexton C. Parental recall bias in observational studies: Child dental service use. Int J Paediatr Dent 2023; 33:450-456. [PMID: 36692191 DOI: 10.1111/ipd.13051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/19/2022] [Accepted: 01/19/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Parents are frequently used to recall events of exposure and disease as a proxy for their children in observational health research. AIM To assess the validity of parental recall of children's utilisation of dental services. DESIGN Parents in the Longitudinal Study of Australian Children (LSAC) were asked to recall their children's overall dental service use in the previous year and whether the study child had received fillings or extractions due to decay in the previous 2 years. True positives were identified through parents who correctly recalled child dental service utilisation with actual dental treatment received in a linked dataset. RESULTS Of the 10 090 participants from the LSAC, 1290 study children had linked dental treatment data eligible for inclusion in this study. The absolute true-positive rate for parental recall of dental service use in the previous year was 82% (n = 1263). Overall true-positive percentages were lower for recall of fillings (40%) and extractions (7%) in the previous 2 years. Increasing number of recall days was associated with the rate of true-positive recall adjusted for other factors in all three models. CONCLUSION Accuracy of parental recall for tooth fillings and extractions was low. The use of parental recall for specific dental treatment over a time span of 2 years in further research is not recommended.
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Affiliation(s)
- Nicole Stormon
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Christopher Sexton
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
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Bin Hayyan FMF, Heidari E, Bernabé E. Ethnic inequalities in child oral health behaviours among five- and eight-year-old children from England, Wales and Northern Ireland. Br Dent J 2023:10.1038/s41415-023-5577-3. [PMID: 36882488 DOI: 10.1038/s41415-023-5577-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/10/2022] [Accepted: 12/07/2022] [Indexed: 03/09/2023]
Abstract
Aim To examine whether there are ethnic inequalities in child oral health behaviours and the role of parental socioeconomic status (SES) in explaining them.Methods Data from 2,186 five- and eight-year-olds of white, Asian, Black and other ethnicity, who participated in the 2013 Children's Dental Health Survey, were analysed. Parents reported their children's toothbrushing and dental attendance. Logistic regression was used to explore ethnic inequalities in child behaviours, adjusting for demographic factors and parental SES.Results Children of Asian ethnicity were less likely to start brushing early in life (odds ratio [OR]: 0.25; 95% confidence interval [CI]: 0.15-0.43), brush regularly (OR: 0.56; 95% CI: 0.32-0.97) and have a check-up last year (OR: 0.28; 95% CI: 0.16-0.49) than those of white ethnicity. Children of Black ethnicity were less likely to have a check-up last year (OR: 0.39; 95% CI 0.17-0.89) than those of white ethnicity. Children of other ethnicity were less likely to start brushing early in life (OR: 0.41; 95% CI: 0.23-0.77) and brush regularly (OR: 0.45; 95% CI: 0.23-0.87) than children of white ethnicity. Inequalities in toothbrushing frequency and regular dental attendance between children of Black and white ethnicity were fully attenuated after adjustment for parental SES.Conclusion There were ethnic inequalities in child toothbrushing and dental visiting, with children of Asian ethnicity being the most affected. Parental SES only explained part of these inequalities.
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Affiliation(s)
- Faisal M F Bin Hayyan
- Dental Public Health Group, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK; Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ellie Heidari
- Centre for Dental Education, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, UK
| | - Eduardo Bernabé
- Institute of Dentistry, Queen Mary University of London, London, UK.
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Haukka A, Kaila M, Haukka J, Heikkinen AM. Adherence to individualized recall intervals for oral health examinations. Clin Exp Dent Res 2023; 9:177-185. [PMID: 36322122 PMCID: PMC9932253 DOI: 10.1002/cre2.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/21/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The aim of this follow-up study was to investigate whether adults attend an oral health examination (OHE) based on their individual recall interval (IRI) without a reminder recall system. METHODS The study population included adults who were attending an OHE recommended by their dentists based on their IRI in public oral healthcare clinics of Helsinki City January 1, 2009-December 31, 2009. The inclusion criteria were as follows: alive until the end of IRI, length of the IRI of 12-60 months, and study participants had not been treated successfully by a dental specialist during the IRI period (n = 41,255). We used a multinomial model to identify the factors associated with the timing of OHE. The following predictors were included: oral health indices such as Decayed Teeth and the Community Periodontal Index, the length of the IRI based on an OHE in 2009, age, gender, socioeconomic status, presence of chronic diseases, and emergency appointment. Results were presented as odds ratios with 95% confidence intervals. RESULTS The OHE based on IRI occurred for 7505 individuals (18.2%) and the OHE was late for 9159 individuals (22.2%). A total of 24,591 (59.6%) adults did not undergo follow-up OHE based on the IRI period of on time or late. Those who came on time for follow-up OHE experienced less caries than those who came later. There was not much difference in periodontal health between the groups. The models indicated that having an emergency appointment was associated with a higher probability of having an OHE. A long IRI (37-60 months) was associated with a higher probability of not participating in OHE even late. CONCLUSIONS It would be beneficial for patients to take appointments based on the recall interval. The results of this study indicated that more needs to be done to increase awareness in the adult population of the benefits and availability of follow-up OHEs based on their IRI in oral healthcare.
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Affiliation(s)
- Anna Haukka
- Dental Care, Health Services, Social Services and Health CareCity of HelsinkiFinland
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Minna Kaila
- Public Health Medicine, Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Jari Haukka
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
| | - Anna M. Heikkinen
- Department of Oral and Maxillofacial Diseases, Head and Neck CenterUniversity of Helsinki, Helsinki University HospitalHelsinkiFinland
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
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Kotsanos N, Sulyanto R, Ng MW. Dental Caries Prevention in Children and Adolescents. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Almehmadi AH. Evidence-based Decisioning on the Management of a High Caries Risk Patient-A Case Report. J Multidiscip Healthc 2021; 14:1893-1900. [PMID: 34321886 PMCID: PMC8309663 DOI: 10.2147/jmdh.s319722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/08/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The evidence-based approach to treatment planning has been at the forefront of clinical dentistry and the use of scientific evidence for clinical decisions has an impact on this case report, where the treatment planning of a high caries risk patient was performed with this approach. Background In this case report, management of a 30-year-old female patient with multiple carious lesions in her oral cavity has been discussed, and microbiological tests for caries risk assessment were performed that categorized her in the high caries risk group. Methods The management of this patient was formulated by carrying out a systematic search of the literature according to the clinical question. It is the evidence-based dentistry protocol, and the search was carried out in the following databases: PubMed, Embase, Medline, and Google Scholar. The CAMBRA protocol was employed for the management of high caries risk patients. Results A total of seven articles that included two randomized clinical trials, one case report, and four retrospective studies were identified for the evidence-based approach of the treatment planning. Conclusion The caries management by risk assessment has been advocated in this case report, where the patient was identified in the high caries risk group according to the caries assessment tests (microbiological), and the management was carried out inculcating the CAMBRA protocol.
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Affiliation(s)
- Ahmad H Almehmadi
- King Abdulaziz University, Faculty of Dentistry, Department of Oral Biology, Jeddah, Saudi Arabia
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Oral Health Behaviour of Nine-Year-Old Children and Their Parents in Sarajevo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063235. [PMID: 33800979 PMCID: PMC8003837 DOI: 10.3390/ijerph18063235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/17/2022]
Abstract
The oral health situation in Bosnia and Herzegovina is among the worst in Europe. We investigated the oral health behaviour of primary schoolchildren and their parents in Sarajevo. This was an anonymous cross-sectional survey among third-grade schoolchildren and their parents’ oral health habits in Canton Sarajevo. Cluster random sampling yielded a representative sample from all the public schools in Canton Sarajevo in 2019. The survey targeted a total of 441 children and 365 parents. Two thirds (66.5%) of the children reported brushing their teeth twice daily, and almost half of them failed to use fluoride toothpaste daily. Girls brushed their teeth significantly more often than did the boys (74% vs. 58%, p = 0.004). Children living in residential areas of middle and high socioeconomic status (SES) reported better oral health habits than did those living in areas of low SES. Our study showed that Sarajevo children’s oral health habits were poor. One-third of the nine-year-olds failed to brush their teeth according to recommendations, and almost half of them failed to use fluoride toothpaste daily. Improving the children’s oral health in the future will urgently require national oral health promotion and prevention programmes.
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Clarkson JE, Pitts NB, Fee PA, Goulao B, Boyers D, Ramsay CR, Floate R, Braid HJ, Ord FS, Worthington HV, van der Pol M, Young L, Freeman R, Gouick J, Humphris GM, Mitchell FE, McDonald AM, Norrie JDT, Sim K, Douglas G, Ricketts D. Examining the effectiveness of different dental recall strategies on maintenance of optimum oral health: the INTERVAL dental recalls randomised controlled trial. Br Dent J 2021; 230:236-243. [PMID: 33637927 PMCID: PMC7908962 DOI: 10.1038/s41415-021-2612-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/17/2020] [Indexed: 01/15/2023]
Abstract
Objective To compare the clinical effectiveness of different frequencies of dental recall over a four-year period.Design A multi-centre, parallel-group, randomised controlled trial with blinded clinical outcome assessment. Participants were randomised to receive a dental check-up at six-monthly, 24-monthly or risk-based recall intervals. A two-strata trial design was used, with participants randomised within the 24-month stratum if the recruiting dentist considered them clinically suitable. Participants ineligible for 24-month recall were randomised to a risk-based or six-month recall interval.Setting UK primary dental care.Participants Practices providing NHS care and adults who had received regular dental check-ups.Main outcome measures The percentage of sites with gingival bleeding on probing, oral health-related quality of life (OHRQoL), cost-effectiveness.Results In total, 2,372 participants were recruited from 51 dental practices. Of those, 648 were eligible for the 24-month recall stratum and 1,724 participants were ineligible. There was no evidence of a significant difference in the mean percentage of sites with gingival bleeding on probing between intervention arms in any comparison. For those eligible for 24-month recall stratum: the 24-month versus six-month group had an adjusted mean difference of -0.91%, 95% CI (-5.02%, 3.20%); the 24-month group versus risk-based group had an adjusted mean difference of 0.07%, 95% CI (-3.99%, 4.12%). For the overall sample, the risk-based versus six-month adjusted mean difference was 0.78%, 95% CI (-1.17%, 2.72%). There was no evidence of a difference in OHRQoL (0-56 scale, higher score for poorer OHRQoL) between intervention arms in any comparison. For the overall sample, the risk-based versus six-month effect size was -0.35, 95% CI (-1.02, 0.32). There was no evidence of a clinically meaningful difference between the groups in any comparison in either eligibility stratum for any of the secondary clinical or patient-reported outcomes.Conclusion Over a four-year period, we found no evidence of a difference in oral health for participants allocated to a six-month or a risk-based recall interval, nor between a 24-month, six-month or risk-based recall interval for participants eligible for a 24-month recall. However, patients greatly value and are willing to pay for frequent dental check-ups.
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Affiliation(s)
- Jan E Clarkson
- Professor, Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Nigel B Pitts
- Professor, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Patrick A Fee
- Clinical Research Fellow, Dundee Dental Hospital & School, University of Dundee, Dundee, UK.
| | - Beatriz Goulao
- Statistician, Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Dwayne Boyers
- Research Fellow, Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Craig R Ramsay
- Professor, Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Ruth Floate
- Trial Manager, Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Hazel J Braid
- Trial Administrator, Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Fiona S Ord
- Research Hygienist, Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Helen V Worthington
- Professor, The School of Dentistry, University of Manchester, Manchester, UK
| | - Marjon van der Pol
- Professor, Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Linda Young
- Programme Lead, Dental Directorate, NHS Education for Scotland, Edinburgh, UK
| | - Ruth Freeman
- Professor, Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Jill Gouick
- Research Dental Nurse, Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Gerry M Humphris
- Professor, Health Psychology, Bute Medical School, University of St Andrews, St Andrews, UK
| | - Fiona E Mitchell
- Research Dental Nurse, Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Alison M McDonald
- Senior Trials Manager, Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - John D T Norrie
- Professor, Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Kirsty Sim
- Research Hygienist, Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Gail Douglas
- Professor, School of Dentistry, University of Leeds, Leeds, UK
| | - David Ricketts
- Professor, Dundee Dental Hospital & School, University of Dundee, Dundee, UK
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Clarkson JE, Pitts NB, Goulao B, Boyers D, Ramsay CR, Floate R, Braid HJ, Fee PA, Ord FS, Worthington HV, van der Pol M, Young L, Freeman R, Gouick J, Humphris GM, Mitchell FE, McDonald AM, Norrie JD, Sim K, Douglas G, Ricketts D. Risk-based, 6-monthly and 24-monthly dental check-ups for adults: the INTERVAL three-arm RCT. Health Technol Assess 2020; 24:1-138. [PMID: 33215986 PMCID: PMC7701991 DOI: 10.3310/hta24600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Traditionally, patients are encouraged to attend dental recall appointments at regular 6-month intervals, irrespective of their risk of developing dental disease. Stakeholders lack evidence of the relative effectiveness and cost-effectiveness of different recall strategies and the optimal recall interval for maintenance of oral health. OBJECTIVES To test effectiveness and assess the cost-benefit of different dental recall intervals over a 4-year period. DESIGN Multicentre, parallel-group, randomised controlled trial with blinded clinical outcome assessment at 4 years and a within-trial cost-benefit analysis. NHS and participant perspective costs were combined with benefits estimated from a general population discrete choice experiment. A two-stratum trial design was used, with participants randomised to the 24-month interval if the recruiting dentist considered them clinically suitable. Participants ineligible for 24-month recall were randomised to a risk-based or 6-month recall interval. SETTING UK primary care dental practices. PARTICIPANTS Adult, dentate, NHS patients who had visited their dentist in the previous 2 years. INTERVENTIONS Participants were randomised to attend for a dental check-up at one of three dental recall intervals: 6-month, risk-based or 24-month recall. MAIN OUTCOMES Clinical - gingival bleeding on probing; patient - oral health-related quality of life; economic - three analysis frameworks: (1) incremental cost per quality-adjusted life-year gained, (2) incremental net (societal) benefit and (3) incremental net (dental health) benefit. RESULTS A total of 2372 participants were recruited from 51 dental practices; 648 participants were eligible for the 24-month recall stratum and 1724 participants were ineligible. There was no evidence of a significant difference in the mean percentage of sites with gingival bleeding between intervention arms in any comparison. For the eligible for 24-month recall stratum: the 24-month (n = 138) versus 6-month group (n = 135) had an adjusted mean difference of -0.91 (95% confidence interval -5.02 to 3.20); the risk-based (n = 143) versus 6-month group had an adjusted mean difference of -0.98 (95% confidence interval -5.05 to 3.09); the 24-month versus risk-based group had an adjusted mean difference of 0.07 (95% confidence interval -3.99 to 4.12). For the overall sample, the risk-based (n = 749) versus 6-month (n = 737) adjusted mean difference was 0.78 (95% confidence interval -1.17 to 2.72). There was no evidence of a difference in oral health-related quality of life between intervention arms in any comparison. For the economic evaluation, under framework 1 (cost per quality-adjusted life-year) the results were highly uncertain, and it was not possible to identify the optimal recall strategy. Under framework 2 (net societal benefit), 6-month recalls were the most efficient strategy with a probability of positive net benefit ranging from 78% to 100% across the eligible and combined strata, with findings driven by the high value placed on more frequent recall services in the discrete choice experiment. Under framework 3 (net dental health benefit), 24-month recalls were the most likely strategy to deliver positive net (dental health) benefit among those eligible for 24-month recall, with a probability of positive net benefit ranging from 65% to 99%. For the combined group, the optimal strategy was less clear. Risk-based recalls were more likely to be the most efficient recall strategy in scenarios where the costing perspective was widened to include participant-incurred costs, and in the Scottish subgroup. LIMITATIONS Information regarding factors considered by dentists to inform the risk-based interval and the interaction with patients to determine risk and agree the interval were not collected. CONCLUSIONS Over a 4-year period, we found no evidence of a difference in oral health for participants allocated to a 6-month or a risk-based recall interval, nor between a 24-month, 6-month or risk-based recall interval for participants eligible for a 24-month recall. However, people greatly value and are willing to pay for frequent dental check-ups; therefore, the most efficient recall strategy depends on the scope of the cost and benefit valuation that decision-makers wish to consider. FUTURE WORK Assessment of the impact of risk assessment tools in informing risk-based interval decision-making and techniques for communicating a variable recall interval to patients. TRIAL REGISTRATION Current Controlled Trials ISRCTN95933794. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme [project numbers 06/35/05 (Phase I) and 06/35/99 (Phase II)] and will be published in full in Health Technology Assessment; Vol. 24, No. 60. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Jan E Clarkson
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Nigel B Pitts
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Beatriz Goulao
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Dwayne Boyers
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Craig R Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Ruth Floate
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Hazel J Braid
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Patrick A Fee
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Fiona S Ord
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | | | | | - Linda Young
- Dental Directorate, NHS Education for Scotland, Edinburgh, UK
| | - Ruth Freeman
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Jill Gouick
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | | | - Fiona E Mitchell
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | | | - John Dt Norrie
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Kirsty Sim
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Gail Douglas
- School of Dentistry, University of Leeds, Leeds, UK
| | - David Ricketts
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
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Fee PA, Riley P, Worthington HV, Clarkson JE, Boyers D, Beirne PV. Recall intervals for oral health in primary care patients. Cochrane Database Syst Rev 2020; 10:CD004346. [PMID: 33053198 PMCID: PMC8256238 DOI: 10.1002/14651858.cd004346.pub5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is ongoing debate about the frequency with which patients should attend for a dental check-up and the effects on oral health of the interval between check-ups. Recommendations regarding optimal recall intervals vary between countries and dental healthcare systems, but 6-month dental check-ups have traditionally been advocated by general dental practitioners in many high-income countries. This review updates a version first published in 2005, and updated in 2007 and 2013. OBJECTIVES To determine the optimal recall interval of dental check-up for oral health in a primary care setting. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 17 January 2020), the Cochrane Central Register of Controlled Trials (CENTRAL; in the Cochrane Library, 2019, Issue 12), MEDLINE Ovid (1946 to 17 January 2020), and Embase Ovid (1980 to 17 January 2020). We also searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication when searching. SELECTION CRITERIA We included randomised controlled trials (RCTs) assessing the effects of different dental recall intervals in a primary care setting. DATA COLLECTION AND ANALYSIS Two review authors screened search results against inclusion criteria, extracted data and assessed risk of bias, independently and in duplicate. We contacted study authors for clarification or further information where necessary and feasible. We expressed the estimate of effect as mean difference (MD) with 95% confidence intervals (CIs) for continuous outcomes and risk ratios (RR) with 95% CIs for dichotomous outcomes. We assessed the certainty of the evidence using GRADE. MAIN RESULTS We included two studies with data from 1736 participants. One study was conducted in a public dental service clinic in Norway and involved participants under 20 years of age who were regular attenders at dental appointments. It compared 12-month with 24-month recall intervals and measured outcomes at two years. The other study was conducted in UK general dental practices and involved adults who were regular attenders, which was defined as having attended the dentist at least once in the previous two years. It compared the effects of 6-month, 24-month and risk-based recall intervals, and measured outcomes at four years. The main outcomes we considered were dental caries, gingival bleeding and oral-health-related quality of life. Neither study measured other potential adverse effects. 24-month versus 12-month recall at 2 years' follow-up Due to the very low certainty of evidence from one trial, it is unclear if there is an important difference in caries experience between assignment to a 24-month or a 12-month recall. For 3- to 5-year-olds with primary teeth, the mean difference (MD) in dmfs (decayed, missing, and filled tooth surfaces) increment was 0.90 (95% CI -0.16 to 1.96; 58 participants). For 16- to 20-year-olds with permanent teeth, the MD in DMFS increment was 0.86 (95% CI -0.03 to 1.75; 127 participants). The trial did not assess other clinical outcomes of relevance to this review. Risk-based recall versus 6-month recall at 4 years' follow-up We found high-certainty evidence from one trial of adults that there is little to no difference between risk-based and 6-month recall intervals for the outcomes: number of tooth surfaces with any caries (ICDAS 1 to 6; MD 0.15, 95% CI -0.77 to 1.08; 1478 participants); proportion of sites with gingival bleeding (MD 0.78%, 95% CI -1.17% to 2.73%; 1472 participants); oral-health-related quality of life (MD in OHIP-14 scores -0.35, 95% CI -1.02 to 0.32; 1551 participants). There is probably little to no difference in the prevalence of moderate to extensive caries (ICDAS 3 to 6) between the groups (RR 1.04, 95% CI 0.99 to 1.09; 1478 participants; moderate-certainty evidence). 24-month recall versus 6-month recall at 4 years' follow-up We found moderate-certainty evidence from one trial of adults that there is probably little to no difference between 24-month and 6-month recall intervals for the outcomes: number of tooth surfaces with any caries (MD -0.60, 95% CI -2.54 to 1.34; 271 participants); percentage of sites with gingival bleeding (MD -0.91%, 95% CI -5.02% to 3.20%; 271 participants). There may be little to no difference between the groups in the prevalence of moderate to extensive caries (RR 1.05, 95% CI 0.92 to 1.20; 271 participants; low-certainty evidence). We found high-certainty evidence that there is little to no difference in oral-health-related quality of life between the groups (MD in OHIP-14 scores -0.24, 95% CI -1.55 to 1.07; 305 participants). Risk-based recall versus 24-month recall at 4 years' follow-up We found moderate-certainty evidence from one trial of adults that there is probably little to no difference between risk-based and 24-month recall intervals for the outcomes: prevalence of moderate to extensive caries (RR 1.06, 95% CI 0.95 to 1.19; 279 participants); number of tooth surfaces with any caries (MD 1.40, 95% CI -0.69 to 3.49; 279 participants). We found high-certainty evidence that there is no important difference between the groups in the percentage of sites with gingival bleeding (MD -0.07%, 95% CI -4.10% to 3.96%; 279 participants); or in oral-health-related quality of life (MD in OHIP-14 scores -0.37, 95% CI -1.69 to 0.95; 298 participants). AUTHORS' CONCLUSIONS For adults attending dental check-ups in primary care settings, there is little to no difference between risk-based and 6-month recall intervals in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period (high-certainty evidence). There is probably little to no difference between the recall strategies in the prevalence of moderate to extensive caries (moderate-certainty evidence). When comparing 24-month with either 6-month or risk-based recall intervals for adults, there is moderate- to high-certainty evidence that there is little to no difference in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period. The available evidence on recall intervals between dental check-ups for children and adolescents is uncertain. The two trials we included in the review did not assess adverse effects of different recall strategies.
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Affiliation(s)
- Patrick A Fee
- Dundee Dental School, University of Dundee, Dundee, UK
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Janet E Clarkson
- Division of Oral Health Sciences, Dundee Dental School, University of Dundee, Dundee, UK
| | - Dwayne Boyers
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Paul V Beirne
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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12
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Haukka A, Heikkinen AM, Haukka J, Kaila M. Oral health indices predict individualised recall interval. Clin Exp Dent Res 2020; 6:585-595. [PMID: 32776480 PMCID: PMC7745075 DOI: 10.1002/cre2.319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 01/22/2023] Open
Abstract
Objectives The individualised recall interval (IRI) is part of the oral health examination. This observational, register‐based study aimed to explore how oral health indices DMFT (decayed, missing, filled teeth), DT (decayed teeth), CPI (Community Periodontal Index, maximum value of individual was used) and number of teeth are associated with IRI for adults. Methods Oral health examination includes an assessment of all oral tissues, diagnosis, a treatment plan and assessment and a determination of the interval before the next assessment. It is called the IRI. This cross‐sectional study population included 42,533 adults (age range 18–89 years), who had visited for an oral health examination during 2009, provided by the Helsinki City Social Services and Health Care. The recall interval was categorised into an ordinal scale (0–12, 13–24, 25–36 and 37–60 months) and was modelled using a proportional odds model. ORs less than one indicated a shorter recall interval. Results Recall interval categories in the study population were 0–12 months (n = 4,569; 11%), 13–24 months (n = 23,732; 56%), 25–36 months (n = 12,049; 28%), and 37–60 months (n = 2,183; 5%). The results of statistical models clearly showed an association between the length of recall intervals and oral health indices. In all models, higher values of DMFT, DT and CPI indicated a shorter recall interval. The number of teeth were not so relevant. The association was not influenced when different combinations of other predictors (age, gender, socioeconomic status, chronic diseases) were included in the model. The severity of periodontitis predicted a short recall interval, for example, in the Model 1, CPI maximum value 4 was OR = 0.35 (95% confidence interval 0.31–0.40). Conclusions The oral health indices showed a clear association with the length of the IRI. Poor oral health reduced IRI. The indices provide information about the amount of oral health prevention required and are useful to health organisations.
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Affiliation(s)
- Anna Haukka
- Dental Care, Health Services, The Social Services and Health care, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Jari Haukka
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Minna Kaila
- Public Health Medicine, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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13
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Alzaid H, Elagra M, Alsabeh M, Altoub N, Binhowaimel S. Caries-related treatment decisions of general dental practitioners in Riyadh, Saudi Arabia. SAUDI JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.4103/sjos.sjoralsci_63_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Cortellini S, Favril C, De Nutte M, Teughels W, Quirynen M. Patient compliance as a risk factor for the outcome of implant treatment. Periodontol 2000 2019; 81:209-225. [PMID: 31407429 DOI: 10.1111/prd.12293] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Peri-implantitis can be explained using a multicausality model. Many factors are involved in the etiology of peri-implantitis, but patient compliance also plays a key role. Oral hygiene, attending recall visits, smoking behavior, and therapy comprehension are relevant factors that contribute to peri-implant health. The clinician should create the most optimal conditions for patients to facilitate adequate oral self-care and to help patients improve their oral hygiene skills. Implementation of a supportive periodontal therapy program is mandatory to control inflammation and plaque accumulation, as well as to keep the incidence of peri-implant diseases low. Patient compliance, including plaque control and dental follow-up, must be optimal. Consequently, precautions must be taken with patients treated with dental implants.
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Affiliation(s)
- Simone Cortellini
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Charlotte Favril
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Mathieu De Nutte
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
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15
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AlQobaly L, Sabbah W. The association between periodontal disease and root/coronal caries. Int J Dent Hyg 2019; 18:99-106. [PMID: 31627259 DOI: 10.1111/idh.12422] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 09/12/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine whether there is an association between periodontal disease and each of root caries and coronal caries among adults (aged 35 and over), using a nationally representative sample of adults in England, Northern Ireland and Wales. MATERIAL AND METHODS In this cross-sectional study, data from the Adult Dental Health Survey 2009 were used. Adults aged 35 years or older who had periodontal and caries assessment were included. Two sets of negative binomial regression were conducted for each of coronal caries and root caries adjusting for periodontal diseases, dental visits, country, sex, age, education, job classification, oral hygiene and smoking. RESULTS Overall, 4738 were included in the analysis. Periodontal disease was significantly associated with each of coronal and root caries. In the fully adjusted model, those with PD/ LoA ≥ 4 mm had 1.03 rate ratio (RR) for coronal caries (95% CI: 1.01-1.05). In the model pertaining to root caries, the RR for those with periodontitis was 1.23 (95% CI: 1.16-1.30). Smoking, sex, age and oral hygiene were the variables that showed a consistent and significant association with coronal and root caries. CONCLUSION Individuals with periodontal diseases appeared to be at higher risk of coronal and root caries. While root exposure could be a plausible explanation for the relationship between periodontitis and root caries, the association with coronal caries could be attributed to the irritation of carious cavities, or common risk factors such as poor oral hygiene, or co-occurrence of different health risk behaviours related to both caries and periodontitis and socioeconomic conditions.
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Affiliation(s)
- Lina AlQobaly
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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16
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Sistani MMN, Virtanen J, Yazdani R, Murtomaa H. Association of oral health behavior and the use of dental services with oral health literacy among adults in Tehran, Iran. Eur J Dent 2019; 11:162-167. [PMID: 28729786 PMCID: PMC5502558 DOI: 10.4103/ejd.ejd_332_16] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To assess the association of oral health behavior (OHB) and the use of dental services with oral health literacy (OHL) among Iranian adults. Methods: This was a cross-sectional population study of a random sample of 1031 adults aged 18–65 in Tehran, Iran. We collected data on tooth brushing frequency, the consumption of sugary snacks and beverages, and time since last dental visit. To measure OHL, we used a validated OHL adults’ questionnaire (OHL-AQ). In addition to descriptive analysis, we used multiple logistic regression models to assess the association of OHB and the most recent dental visit with OHL while controlling for socioeconomic and demographic factors. Results: The participants’ mean age was 36.3 (standard deviation 12.9), and 51% were women. Of the participants, 81.3% reported brushing their teeth daily (≥1/day), 37.6% consumed sugary snacks or beverages between meals less than once daily (<1/day), and 36.8% used dental services within the past 6 months. In the adjusted models, high OHL scores significantly correlated with daily (≥1/day) tooth brushing (odds ratio [OR] = 1.97, 95% confidence interval [CI]: 1.30–2.98), the consumption of sugary snacks or beverages (<1/day between meals) (OR = 1.56, 95% CI: 1.13–2.15) and the recent use of dental services (≤6 months) (OR = 1.59, 95% CI: 1.15–2.21), respectively. Conclusions: OHL relates significantly to improved OHB and the use of dental services. Oral health promotion programs should, therefore, take into account improvements in adults’ OHL, particularly in countries with developing health-care services.
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Affiliation(s)
- Mohammad Mehdi Naghibi Sistani
- Department of Community Oral Health, Oral Health Research Center, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Jorma Virtanen
- Department of Community Dentistry, Research Unit of Oral Health Sciences, University of Oulu; Medical Research Center, Oulu University Hospital, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Reza Yazdani
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Heikki Murtomaa
- Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Helsinki, Finland
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17
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Talakey AA, Bernabé E. Long-term regular dental attendance and tooth retention among British adults: A cross-sectional analysis of national survey data. Int J Dent Hyg 2018; 17:64-70. [DOI: 10.1111/idh.12373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/28/2018] [Accepted: 10/28/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Arwa Ameen Talakey
- Faculty of Dentistry; Oral & Craniofacial Sciences, King’s College; London UK
- Department of Periodontics and Community Dentistry; King Saud University Dental College; Riyadh Saudi Arabia
| | - Eduardo Bernabé
- Faculty of Dentistry; Oral & Craniofacial Sciences, King’s College; London UK
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18
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Bozcuk Güzeldemirci G, Karataş Eray İ, Öztaş D. An Overview of Preventive Dental Services. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.409049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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19
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Flaherman VJ, Epstein J, Amendola L, Inge R, Featherstone JD, Okumura M. Preventive Dental Care at 6-Month Intervals Is Associated With Reduced Caries Risk. Clin Pediatr (Phila) 2018; 57:222-226. [PMID: 28952370 DOI: 10.1177/0009922817691823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | - Ronald Inge
- 3 Western Dental Services, Inc, San Francisco, CA, USA
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20
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Zangiabadi S, Costanian C, Tamim H. Dental care use in Ontario: the Canadian community health survey (CCHS). BMC Oral Health 2017; 17:165. [PMID: 29284491 PMCID: PMC5747094 DOI: 10.1186/s12903-017-0453-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 12/10/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Oral health is a significant measure of overall health, and regular dental visits are recommended for the maintenance of oral health. The purpose of this study is to determine the pattern (amount and type) of, and factors associated with dental care use among Ontarians. METHODS Data from the 2014 cycle of the Canadian Community Health Survey was used and analysis was restricted to individuals aged 12 and above residing in Ontario. Dental care use was defined by two distinct outcomes: not visiting a dentist within the past year and visiting a dentist only for emergencies. Multivariable logistic regression was performed to examine the association between socio-demographic, health behavior, oral health, and other health-related factors and the two outcomes. RESULTS More than a quarter of participants reported not visiting the dentist in the last year, and 19% reported usually visiting a dentist only for emergencies. Multivariable logistic regression analysis suggested that males, individuals of Aboriginal status, those with low educational attainment, low household income, no dental insurance, who smoked, less frequent teeth brushing, poor health of teeth and mouth, or had diabetes were at a significant increased likelihood of not visiting the dentist within the past year, and only visiting a dentist for emergency care. CONCLUSIONS Socioeconomic status, self-reported oral health, and general health behaviors were associated with dental care use. These findings highlight the need for focusing efforts toward improving dental care use among Ontarians.
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Affiliation(s)
- Safoura Zangiabadi
- School of Kinesiology and Health Sciences, York University, 4700 Keele Street, Toronto, ON M3J 1P3 Canada
| | - Christy Costanian
- School of Kinesiology and Health Sciences, York University, 4700 Keele Street, Toronto, ON M3J 1P3 Canada
| | - Hala Tamim
- School of Kinesiology and Health Sciences, York University, 4700 Keele Street, Toronto, ON M3J 1P3 Canada
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21
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Bidra AS, Daubert DM, Garcia LT, Gauthier MF, Kosinski TF, Nenn CA, Olsen JA, Platt JA, Wingrove SS, Chandler ND, Curtis DA. A Systematic Review of Recall Regimen and Maintenance Regimen of Patients with Dental Restorations. Part 1: Tooth-Borne Restorations. J Prosthodont 2017; 25 Suppl 1:S2-15. [PMID: 26711218 DOI: 10.1111/jopr.12417] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To evaluate the current scientific evidence on patient recall and maintenance of dental restorations on natural teeth, standardize patient care regimens, and improve maintenance of oral health. An additional purpose was to examine areas of deficiency in the current scientific literature and provide recommendations for future studies. MATERIALS AND METHODS An electronic search for articles in the English language literature from the past 15 years was performed independently by multiple investigators using a systematic search process. After application of predetermined inclusion and exclusion criteria, the final list of articles was reviewed in depth to meet the objectives of this review. RESULTS The initial electronic search resulted in 2161 titles. The systematic application of inclusion and exclusion criteria resulted in 12 articles that met the objectives of the study. An additional 4 articles were added through a supplemental search process for a total of 16 studies. Out of these, 9 were randomized controlled clinical trials and 7 were observational studies. The majority of the studies (14 out of 16) were conducted in the past 5 years, and most of the studies were conducted in Europe (10). Results from the qualitative data, on a combined 3569 patients, indicated that outcome improvements in recall and maintenance regimen were related to (1) patient/treatment characteristics (adherence to recall appointments, type of restoration and type of restorative material); (2) agent (chlorhexidine, fluoride, triclosan); and (3) professional interventions (repeated oral hygiene instruction, regular oral hygiene intervention). CONCLUSIONS There is minimal evidence related to recall regimens in patients with removable and fixed tooth-borne restorations; however, there is considerable evidence indicating that patients with tooth-borne removable and fixed restorations require lifelong dental professional maintenance to provide repeated oral hygiene instruction and regular oral hygiene intervention customized to each patient's treatment. Current evidence also indicates that use of specific oral topical agents like chlorhexidine, fluoride, and triclosan can aid in reducing risk for gingival inflammation, dental caries, and candidiasis. Therefore, these agents may aid in improvement of professional and at-home maintenance of various tooth-borne dental restorations. Furthermore, due to the heterogeneity of patient populations, restorations, and treatment needs, the evidence compels forethought of creating clinical practice guidelines for recall and maintenance of patients with tooth-borne dental restorations.
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Affiliation(s)
- Avinash S Bidra
- Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, CT
| | - Diane M Daubert
- Department of Periodontics, University of Washington School of Dentistry, Seattle, WA
| | - Lily T Garcia
- Office of the Dean, University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA
| | - Marissa F Gauthier
- L.M. Stowe Library, University of Connecticut Health Center, Farmington, CT
| | - Timothy F Kosinski
- Department of Restorative Dentistry, University of Detroit Mercy School of Dentistry, Detroit, MI
| | - Conrad A Nenn
- Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, WI
| | | | - Jeffrey A Platt
- Department of Biomedical and Applied Sciences, Division of Dental Biomaterials, Indiana University School of Dentistry, Indianapolis, IN
| | | | - Nancy Deal Chandler
- Executive Director, American College of Prosthodontists and ACP Education Foundation, Chicago, IL
| | - Donald A Curtis
- Department of Preventive & Restorative Dental Sciences, UCSF School of Dentistry, San Francisco, CA
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22
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Arino M, Ito A, Fujiki S, Sugiyama S, Hayashi M. Multicenter study on caries risk assessment in adults using survival Classification and Regression Trees. Sci Rep 2016; 6:29190. [PMID: 27381750 PMCID: PMC4933980 DOI: 10.1038/srep29190] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 06/13/2016] [Indexed: 12/02/2022] Open
Abstract
Dental caries is an important public health problem worldwide. This study aims to prove how preventive therapies reduce the onset of caries in adult patients, and to identify patients with high or low risk of caries by using Classification and Regression Trees based survival analysis (survival CART). A clinical data set of 732 patients aged 20 to 64 years in nine Japanese general practices was analyzed with the following parameters: age, DMFT, number of mutans streptococci (SM) and Lactobacilli (LB), secretion rate and buffer capacity of saliva, and compliance with a preventive program. Results showed the incidence of primary carious lesion was affected by SM, LB and compliance with a preventive program; secondary carious lesion was affected by DMFT, SM and LB. Survival CART identified high-risk patients for primary carious lesion according to their poor compliance with a preventive program and SM (≥106 CFU/ml) with a hazard ratio of 3.66 (p = 0.0002). In the case of secondary caries, patients with LB (≥105 CFU/ml) and DMFT (>15) were identified as high risk with a hazard ratio of 3.50 (p < 0.0001). We conclude that preventive programs can be effective in limiting the incidence of primary carious lesion.
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Affiliation(s)
- Masumi Arino
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
| | - Ataru Ito
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
| | - Shozo Fujiki
- The Japan Health Care Dental Association, 1-45-15 Sekiguchi, Bunkyo-ku, Tokyo 112-0014, Japan
| | - Seiichi Sugiyama
- The Japan Health Care Dental Association, 1-45-15 Sekiguchi, Bunkyo-ku, Tokyo 112-0014, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, 565-0871, Japan
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23
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Zhang Y, Wong MCM, Lo ECM. Pathways of oral health knowledge, attitudes, practices, and status in married couples. Community Dent Oral Epidemiol 2016; 44:400-7. [DOI: 10.1111/cdoe.12228] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/08/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Yan Zhang
- Dental Public Health; Faculty of Dentistry; University of Hong Kong; Hong Kong Hong Kong
| | - May C. M. Wong
- Dental Public Health; Faculty of Dentistry; University of Hong Kong; Hong Kong Hong Kong
| | - Edward C. M. Lo
- Dental Public Health; Faculty of Dentistry; University of Hong Kong; Hong Kong Hong Kong
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24
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Armitage GC, Xenoudi P. Post-treatment supportive care for the natural dentition and dental implants. Periodontol 2000 2016; 71:164-84. [DOI: 10.1111/prd.12122] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2015] [Indexed: 12/11/2022]
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25
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Wilder RS, Bray KS. Improving periodontal outcomes: merging clinical and behavioral science. Periodontol 2000 2016; 71:65-81. [DOI: 10.1111/prd.12125] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 02/03/2023]
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26
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Karimalakuzhiyil Alikutty F, Bernabé E. Long-term regular dental attendance and periodontal disease in the 1998 adult dental health survey. J Clin Periodontol 2016; 43:114-20. [PMID: 26932321 DOI: 10.1111/jcpe.12496] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 12/26/2022]
Abstract
AIM The aim of this study was to explore the association between long-term pattern of dental attendance and periodontal disease among British adults. METHODS We used data from 3272 adults who participated in the 1998 Adult Dental Health Survey in the UK. Participants were classified into four trajectories (current, always, former and never regular attenders) based on their responses to three questions on lifetime dental attendance patterns. The numbers of teeth with pocket depth (PD) ≥4 mm and loss of attachment (LOA) ≥4 mm were the outcome measures. The association between dental attendance patterns and each periodontal measure was assessed in crude and adjusted models using negative binomial regression. RESULTS Never and former regular attenders had more teeth with PD ≥4 mm (Rate Ratios with 95% Confidence Interval: 1.58 [1.28-1.95] and 1.34 [1.12-1.60] respectively) and LOA ≥4 mm (1.34 [1.04-1.72] and 1.37 [1.07-1.75] respectively) than always regular attenders, after adjustments for demographic (sex, age and country of residence) and socioeconomic factors (education and social class). However, no differences in periodontal measures were found between always and current regular attenders. CONCLUSION This analysis of national cross-sectional data shows that adults with different long-term patterns of dental attendance have different periodontal health status.
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Affiliation(s)
- Fazeena Karimalakuzhiyil Alikutty
- King's College London Dental Institute at Guy's, King's College and St Thomas Hospitals, Unit of Dental Public Health, London, United Kingdom
| | - Eduardo Bernabé
- King's College London Dental Institute at Guy's, King's College and St Thomas Hospitals, Unit of Dental Public Health, London, United Kingdom
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Bidra AS, Daubert DM, Garcia LT, Gauthier MF, Kosinski TF, Nenn CA, Olsen JA, Platt JA, Wingrove SS, Chandler ND, Curtis DA. A Systematic Review of Recall Regimen and Maintenance Regimen of Patients with Dental Restorations. Part 2: Implant-Borne Restorations. J Prosthodont 2015; 25 Suppl 1:S16-31. [DOI: 10.1111/jopr.12415] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2015] [Indexed: 01/21/2023] Open
Affiliation(s)
- Avinash S. Bidra
- Department of Reconstructive Sciences; University of Connecticut Health Center; Farmington CT
| | - Diane M. Daubert
- Department of Periodontics; University of Washington School of Dentistry; Seattle WA
| | - Lily T. Garcia
- Office of the Dean; University of Iowa College of Dentistry & Dental Clinics; Iowa City IA
| | | | - Timothy F. Kosinski
- Department of Restorative Dentistry; University of Detroit Mercy School of Dentistry; Detroit MI
| | - Conrad A. Nenn
- Department of General Dental Sciences; Marquette University School of Dentistry; Milwaukee WI
| | | | - Jeffrey A. Platt
- Department of Biomedical and Applied Sciences, Division of Dental Biomaterials; Indiana University School of Dentistry; Indianapolis IN
| | | | - Nancy Deal Chandler
- American College of Prosthodontists and ACP Education Foundation; Chicago IL
| | - Donald A. Curtis
- Department of Preventive & Restorative Dental Sciences; UCSF School of Dentistry; San Francisco CA
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Farooqi OA, Wehler CJ, Gibson G, Jurasic MM, Jones JA. Appropriate Recall Interval for Periodontal Maintenance: A Systematic Review. J Evid Based Dent Pract 2015; 15:171-81. [PMID: 26698003 PMCID: PMC4848042 DOI: 10.1016/j.jebdp.2015.10.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/01/2015] [Accepted: 10/06/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVES A systematic review of the literature was undertaken to assess the evidence to support a specific time interval between periodontal maintenance (PM) visits. METHODS Relevant articles were identified through searches in MEDLINE, EMBASE and PubMed using specific search terms, until April, 2014, resulting in 1095 abstracts and/or titles with possible relevance. Critical Appraisal Skills Programme (CASP) guidelines were used to evaluate the strength of studies and synthesize findings. If mean recall interval was not reported for study groups, authors were contacted to attempt to retrieve this information. RESULTS Eight cohort studies met the inclusion criteria. No randomized control trials were found. All included studies assessed the effect of PM recall intervals in terms of compliance with a recommended regimen (3-6 months) as a primary outcome. Shorter PM intervals (3-6 months) favored more teeth retention but also statistically insignificant differences between RC and IC/EC, or converse findings are also found. In the 2 studies reporting mean recall interval in groups, significant tooth loss differences were noted as the interval neared the 12 month limit. CONCLUSIONS Evidence for a specific recall interval (e.g. every 3 months) for all patients following periodontal therapy is weak. Further studies, such as RCTs or large electronic database evaluations would be appropriate. The merits of risk-based recommendations over fixed recall interval regimens should be explored.
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Affiliation(s)
| | - Carolyn J Wehler
- VA Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA; Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA 02118, USA
| | - Gretchen Gibson
- Veterans Health Care System of the Ozarks, Dental (160), Fayetteville, AR 72703, USA
| | - M Marianne Jurasic
- VA Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA; Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA 02118, USA
| | - Judith A Jones
- VA Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA; Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA 02118, USA
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Abstract
BACKGROUND The aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures. METHODS A mapping of systematic reviews (SR) of literature was carried out in PubMed and the Cochrane library through April 2014 using established MeSH-terms and disease-related search words in various combinations. The search was restricted to SR's published in English or Scandinavian and all age groups were considered. The reference lists of the selected papers were hand-searched for additional review articles of potential interest. Meta-analyses, guidelines and treatment recommendations were considered only when SR's were lacking. In the event of updates or multiple systematic reviews covering the same topic, only the most recent article was included. No quality assessment of the systematic reviews was carried out. The quality of evidence was rated in four levels according to the GRADE scale. RESULTS In total, 39 SR were included. For primary caries prevention, the quality of evidence was high for the use of fluoride toothpaste (with and without triclosan) and moderate for fluoride varnish and fissure sealants. The quality of evidence for fluoride gel, fluoride mouth rinse, xylitol gums and silver diamine fluoride (SDF) was rated as low. For secondary caries prevention and caries arrest, only fluoride interventions and SDF proved consistent benefits, although the quality of evidence was low. Likewise, the GRADE score for preventing erosions located in the enamel with fluoride supplements was low. The quality of evidence for various professional and self-care methods to prevent and manage dentine hypersensitivity was very low. CONCLUSIONS There are knowledge gaps in many domains of cariology and preventive dentistry that must be addressed and bridged through clinical research of good quality.
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Affiliation(s)
- Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Arino M, Ataru I, Fujiki S, Sugiyama S, Hayashi M. Multicenter study on caries risk assessment in Japanese adult patients. J Dent 2015. [PMID: 26199997 DOI: 10.1016/j.jdent.2015.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES This study was conducted to identify significant risk factors for the onset and the accumulation of new caries in adult patients undergoing regular preventive therapy. METHODS The data of 732 patients from nine Japanese general dental practices were retrospectively analyzed. Classification and regression tree (CART) analysis was applied to develop a caries prediction model using the following patient parameters: age, number of teeth with caries experience (DMFT), levels of mutans streptococci (SM) and lactobacilli (LB), saliva flow rate and buffer capacity, and compliance with a preventive program. Poisson regression analysis was conducted to identify factors affecting caries accumulation within three years. RESULTS CART analysis identified patients at high risk for primary caries with an odds ratio of 3.08 (95%CI, 1.55-5.79; p=0.0018) according to SM levels and compliance; and those for secondary caries with an odds ratio of 3.69 (95%CI, 2.29-5.91; p<0.0001) according to LB and SM levels. Poisson regression analyses showed that accumulation of primary caries was affected by compliance (p<0.001), SM (p<0.001) and LB (p=0.013). Accumulation of secondary caries was affected by DMFT (p<0.001), SM (p<0.001) and LB (p<0.001). CONCLUSIONS CART is an important tool in identifying the risk of caries development in individual adult patients. Cariogenic bacteria are important factors for both the onset and accumulation of primary and secondary caries. CLINICAL SIGNIFICANCE Participation in a regular preventive program limits the onset and the accumulation of primary caries in adult patients.
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Affiliation(s)
- Masumi Arino
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita 565-0871, Japan
| | - Ito Ataru
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita 565-0871, Japan
| | - Shozo Fujiki
- The Japan Health Care Dental Association, 1-45-15 Sekiguchi, Bunkyo-ku, Tokyo 112-0014, Japan
| | - Seiichi Sugiyama
- The Japan Health Care Dental Association, 1-45-15 Sekiguchi, Bunkyo-ku, Tokyo 112-0014, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita 565-0871, Japan.
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Kreider B, Moeller J, Manski RJ, Pepper J. The effect of dental insurance on the use of dental care for older adults: a partial identification analysis. HEALTH ECONOMICS 2015; 24:840-58. [PMID: 24890257 PMCID: PMC4247826 DOI: 10.1002/hec.3064] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 02/11/2014] [Accepted: 04/24/2014] [Indexed: 05/16/2023]
Abstract
We evaluate the impact of dental insurance on the use of dental services using a potential outcomes identification framework designed to handle uncertainty created by unknown counterfactuals-that is, the endogenous selection problem-and uncertainty about the reliability of self-reported insurance status. Using data from the health and retirement study, we estimate that utilization rates of adults older than 50 years would increase from 75% to around 80% under universal dental coverage.
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Affiliation(s)
| | - John Moeller
- Division of Health Services Research University of Maryland Dental School
| | - Richard J. Manski
- Division of Health Services Research University of Maryland Dental School
| | - John Pepper
- Department of Economics University of Virginia
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Rosing K, Hede B, Christensen LB. A register-based study of variations in services received among dental care attenders. Acta Odontol Scand 2015; 74:14-35. [PMID: 25924843 DOI: 10.3109/00016357.2015.1034771] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate whether receipt of dental services, among attenders, reflects variations in dental health or whether and to what degree it is associated with socioeconomic status, with irregular or regular dental attendance and with the availability of dentists in residential areas. MATERIALS AND METHODS This retrospective register-based study followed two Danish cohorts, aged 25 and 40, with a dental examination in 2009 (n = 32,351). The dental service data were registered during 2005-2009. The number of dental examinations, individual preventive services (IPS), tooth extractions, root fillings and composite fillings were analyzed in relation to socioeconomic status, irregular/regular dental attendance, inhabitant/dentist ratio and to DMFT at age 15 (DMFT15) and change in DMFT (ΔDMFT) from age 15 to age 25 and age 40, respectively. Poisson regression and negative binomial regression analyses were used. RESULTS The variations in number of services received in the study population were small (SD = 0.2-2.7). However, with a few exceptions, high levels of DMFT15 and ΔDMFT were associated with receipt of more dental services. Socioeconomically-privileged individuals received more dental examinations but fewer tooth extractions, root fillings and composite fillings compared to disadvantaged persons, when controlled for dental health levels. Irregular attenders received fewer IPS and composite fillings but had more extractions compared to regular attenders. CONCLUSIONS Variations in dental care services were found to reflect variations in dental health, but the variations were also related to individual socioeconomic status, residential area and dental attendance patterns.
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Affiliation(s)
- Kasper Rosing
- a 1 Section for Periodontology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Børge Hede
- a 1 Section for Periodontology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
- b 2 Department for Special Care Dentistry , City of Copenhagen, Denmark
| | - Lisa Bøge Christensen
- a 1 Section for Periodontology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
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Twetman S, Fontana M, Featherstone JDB. Risk assessment - can we achieve consensus? Community Dent Oral Epidemiol 2015; 41:e64-70. [PMID: 24916679 DOI: 10.1111/cdoe.12026] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The object of this conference paper was to review and discuss caries risk assessment in general practice from the questions i) 'Why', ii) 'When', and iii) 'How'. METHOD Narrative review. RESULTS i) Patient caries risk assessment is the basic component in the decision-making process for adequate prevention and management of dental caries and for determination of individual recall intervals. ii) Caries risk assessment should always be performed at a child's first dental visit and then regularly throughout life, and especially when social or medical life events are occurring. iii) There are several risk assessment methods and models available for but the evidence for their validity is limited. Although there is no clearly superior method for predicting future caries, the use of structured protocols combining socioeconomy, behavior, general health, diet, oral hygiene routines, clinical data, and salivary tests or computer-based systems are considered best clinical practice. The accuracy ranges between 60% and 90%, depending on age. Caries risk assessment is more effective in the selection of patients at low risk than those with high caries risk. CONCLUSION As evidence suggests that past caries experience is far from ideal but the most important single risk component for more caries at all ages, any clinical sign of likely active demineralization on smooth, occlusal, and proximal tooth surfaces should be taken as a signal for the implementation of individually designed preventive and disease management measures.
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Affiliation(s)
- Svante Twetman
- Institute of Dentistry, Department of Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Hänsel Petersson G, Ericson E, Twetman S. Preventive care delivered within Public Dental Service after caries risk assessment of young adults. Int J Dent Hyg 2015; 14:215-9. [PMID: 25727487 DOI: 10.1111/idh.12135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics. The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables 'oral health information', 'additional fluoride' and 'professional tooth cleaning', a cumulative score was constructed and dichotomized to 'basic prevention' and 'additional prevention'. RESULTS More additional preventive care was provided to the patients in the 'low-risk' and 'some risk' categories than to those classified as 'high' or 'very high' risk (OR = 2.0, 95% CI 1.4-3.0; P < 0.05). Professional tooth cleaning and additional fluorides were most frequently employed in the 'low-risk' and 'some risk' categories, respectively. Around 15% of the patients in the high-risk categories did not receive additional preventive measures over the 3-year period. There was an insignificant tendency that patients with additional prevention developed less caries than those that received basic prevention in all risk categories except for the 'very high-risk' group. CONCLUSION The caries risk assessment process was not accompanied by a corresponding targeted individual preventive care in a cohort of young adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention.
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Affiliation(s)
- G Hänsel Petersson
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - E Ericson
- Public Dental Service, Region Skåne, Malmö, Sweden
| | - S Twetman
- Department of Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Maxillofacial Unit, Halland Hospital, Halmstad, Sweden
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Rwakatema DS, Ananduni KN, Katiti VW, Msuya M, Chugulu J, Kapanda G. Oral health in nursing students at Kilimanjaro Christian Medical Centre teaching hospital in Moshi, Tanzania. BMC Oral Health 2015; 15:23. [PMID: 25881237 PMCID: PMC4367970 DOI: 10.1186/s12903-015-0008-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 02/10/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aimed to determine the prevalence and severity of dental caries, oral hygiene levels and assessment of the oral health knowledge and practices of nursing students at Kilimanjaro Christian Medical Centre teaching hospital in Moshi, Tanzania. METHODS A cross-sectional survey was done on 217 student nurse population at Kilimanjaro Christian Medical Centre Teaching Hospital in Moshi, Tanzania in 2014. Ethical approval was obtained from the Kilimanjaro Christian Medical University College Ethical Committee. A questionnaire probing on socio-demographic characteristics, knowledge and practices on selected oral health issues was administered to the students. Students were also examined for oral hygiene and dental caries using Simplified Oral Hygiene Index (OHI-S) and WHO 1997 recommended method respectively. RESULTS There were 214 (98.6%) respondents aged between 18 and 53 years (mean age was 27.2 SD ± 7.35 years). About 72% of the respondents were in the young age group (below 31 years), 63.1% were pursuing Diploma in Nursing while the rest were pursuing Bachelor of Science in Nursing. Although oral health knowledge of the respondents was generally poor, more students pursuing Bachelor of Science in Nursing had significant adequate oral health knowledge than those who were pursuing Diploma in Nursing (p = 0.05). Population Oral Hygiene Index- Simplified was 0.41 meaning good oral hygiene in the current population. Overall, caries prevalence was 40.2%. The mean population DMFT was 1.34 (SD ± 2.44). The decay component was 0.53 (SD ± 1.29), whereas the missing component was 0.67 (SD ± 1.34) and filled component was 0.14 (SD ± 0.69). Significantly more students in the older age group had more missing and filled teeth than their counterparts in the young age group (p ≤ 0.05). CONCLUSION Majority of the students in this population had good oral hygiene and a very low DMFT. There was poor basic oral health knowledge and poor recall visit to dental personnel. Curriculum development in these school programmes should strengthen or encompass comprehensive oral health education components. This will empower nursing professional with basic oral health knowledge and promotive oral health behaviors and hence to disseminate to the clients.
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Affiliation(s)
| | | | - Victor William Katiti
- Faculty of Nursing, Kilimanjaro Christian Medical University College of Makumira University, Arusha, Tanzania.
| | - Marycelina Msuya
- Faculty of Nursing, Kilimanjaro Christian Medical University College of Makumira University, Arusha, Tanzania.
| | - Juliet Chugulu
- Faculty of allied Health Sciences, Kilimanjaro Christian Medical University College of Makumira University, Arusha, Tanzania.
| | - Gibson Kapanda
- Faculty of Medicine, Kilimanjaro Christian Medical University College of Makumira University, Arusha, Tanzania.
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Saban A, Ridic O, Karamehic J, Saban O, Delic-Sarac M, Dzananovic N, Coric J, Ridic G, Panjeta M. Assessments of the socioeconomic status and diet on the prevalence of dental caries at school children in central bosnian canton. Mater Sociomed 2015; 26:309-12. [PMID: 25568628 PMCID: PMC4272836 DOI: 10.5455/msm.2014.26.309-312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 10/20/2014] [Indexed: 11/03/2022] Open
Abstract
AIM The main aim of this research was to determine the influence of socioeconomic status and residence/living conditions on the status of oral health (e.g. health of mouth and teeth) in primary school students residing in Canton Central Bosnia. METHODS The study was designed as a cross-sectional study. Our research included two-phased stratified random sample of 804 participants. The quantitative research method and newly designed survey instrument were utilized in order to provide data on the oral health of the examined children. The alternate hypothesis foresaw that "there were significant statistical differences between the levels of incidence of dental caries in comparison to the incidence in children of different socioeconomic status. RESULTS The Chi square () of 22.814, degree of freedom (Df) = 8, coefficient of contingency of 0.163 and T-test (Stat) of-0.18334 showed that there were no significant statistical differences at p < 0.05 level between the primary school children from urban and rural areas. The obtained results showed that the caries indexes in elementary schools in Central Bosnia Canton were fairly uniform. Research showed that there were a difference in the attitudes towards a regular dental visits, which correlated with social-educational structure of the children's' families. CONCLUSION According to the results, we can see that the socioeconomic status of patients had an effect on the occurrence of dental caries and oral hygiene in patients in relation to the rural and urban areas, because we can see that by the number of respondents, the greater unemployment of parents in both, rural and urban areas, caused a host of other factors, which were, either, directly or indirectly connected with the development of caries.
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Affiliation(s)
- Aida Saban
- Primary Health Care Center Travnik, Travnik, Bosnia and Herzegovina
| | - Ognjen Ridic
- International University of Sarajevo (IUS), Sarajevo, Bosnia and Herzegovina
| | - Jasenko Karamehic
- Institute for Clinical Immunology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Orhan Saban
- General Hospital Travnik, Travnik, Bosnia and Herzegovina
| | - Marina Delic-Sarac
- Institute for Clinical Immunology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Nejra Dzananovic
- Institute for Clinical Immunology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Jozo Coric
- Department for Chemistry and Biochemistry, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Goran Ridic
- Faculty of Economics, Sarajevo School of Science and Technology (SSST), Sarajevo, Bosnia and Herzegovina
| | - Mirsad Panjeta
- Department for Chemistry and Biochemistry, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Aldossary A, Harrison VE, Bernabé E. Long-term patterns of dental attendance and caries experience among British adults: a retrospective analysis. Eur J Oral Sci 2014; 123:39-45. [DOI: 10.1111/eos.12161] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Arwa Aldossary
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St Thomas’ Hospitals; London UK
| | - Victoria E. Harrison
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St Thomas’ Hospitals; London UK
| | - Eduardo Bernabé
- Division of Population and Patient Health; King's College London Dental Institute at Guy's; King's College and St Thomas’ Hospitals; London UK
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Afshari FS, Schelkopf S, Yuan JCC, Marinis A, Syros G, Campbell SD, Sukotjo C. Current Status of Patient Recall in U.S. Predoctoral Dental School Clinics. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.10.tb05810.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Fatemeh S. Afshari
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry
| | | | - Judy Chia-Chun Yuan
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry
| | - Aristotelis Marinis
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry
| | - George Syros
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry
| | - Stephen D. Campbell
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry
| | - Cortino Sukotjo
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry
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Sahrmann P, Ronay V, Schmidlin PR, Attin T, Paqué F. Three-Dimensional Defect Evaluation of Air Polishing on Extracted Human Roots. J Periodontol 2014; 85:1107-14. [DOI: 10.1902/jop.2014.130629] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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40
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Raittio E, Kiiskinen U, Helminen S, Aromaa A, Suominen AL. Dental attendance among adult Finns after a major oral health care reform. Community Dent Oral Epidemiol 2014; 42:591-602. [DOI: 10.1111/cdoe.12117] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 05/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Arpo Aromaa
- Institute for Health and Welfare (THL); Helsinki Finland
| | - Anna Liisa Suominen
- University of Eastern Finland; Kuopio Finland
- Institute for Health and Welfare (THL); Helsinki Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
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41
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Åstrøm AN, Ekback G, Ordell S, Nasir E. Long-term routine dental attendance: influence on tooth loss and oral health-related quality of life in Swedish older adults. Community Dent Oral Epidemiol 2014; 42:460-9. [PMID: 24712734 DOI: 10.1111/cdoe.12105] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/10/2014] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Few studies have investigated the effect of long-term routine dental attendance on oral health between middle-aged and older adults, using a prospective cohort design. This study aimed to assess routine dental attendance (attending dentist in the previous 12 months for dental checkups) from age 50 to 65 years. Moreover, this study examined whether long-term routine dental attendance contributes to oral health-related quality of life, OHRQoL, and major tooth loss independent of social factors and the type of treatment sector utilized. Whether oral health impacts of long-term routine attendance varied with type of treatment sector utilized was also investigated. METHOD In 1992, a census of the 1942 cohort in two counties of Sweden participated in a longitudinal questionnaire survey conducted at age 50 and again after 5, 10, and 15 years. Information was collected on a wide range of health- and oral health-related aspects. Of the 6346 subjects who completed the 1992 survey, 4143 (65%) completed postal follow-ups in 1997, 2002, and 2007. RESULTS Routine dental attendance decreased from 69.1% at age 50-64.2% at age 65. Adjusted logistic regression analyses revealed that individuals reporting long-term routine attendance (routine attendance in both 1992 and 2007) were 0.3 (95% CI 0.2-0.5) times less likely than their counterparts who were nonroutine attenders to report oral impacts. According to generalized estimating equations (GEE), individuals who reported long-term routine attendance were 0.6 (95% CI 0.4-0.7) times less likely than nonroutine attenders to have major tooth loss across the survey years. The effect of long-term routine attendance on OHRQoL was stronger in public than in private dental healthcare attenders. CONCLUSION Routine attendance decreased from age 50-65 years. Long-term routine attendance had positive impact on major tooth loss and OHRQoL supporting the principle of encouraging annual dental attendance for preventive checkups among older people.
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Affiliation(s)
- Anne N Åstrøm
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Riley P, Worthington HV, Clarkson JE, Beirne PV. Recall intervals for oral health in primary care patients. Cochrane Database Syst Rev 2013:CD004346. [PMID: 24353242 DOI: 10.1002/14651858.cd004346.pub4] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The frequency with which patients should attend for a dental check-up and the potential effects on oral health of altering recall intervals between check-ups have been the subject of ongoing international debate in recent decades. Although recommendations regarding optimal recall intervals vary between countries and dental healthcare systems, six-monthly dental check-ups have traditionally been advocated by general dental practitioners in many developed countries.This is an update of a Cochrane review first published in 2005, and previously updated in 2007. OBJECTIVES To determine the beneficial and harmful effects of different fixed recall intervals (for example six months versus 12 months) for the following different types of dental check-up: a) clinical examination only; b) clinical examination plus scale and polish; c) clinical examination plus preventive advice; d) clinical examination plus preventive advice plus scale and polish.To determine the relative beneficial and harmful effects between any of these different types of dental check-up at the same fixed recall interval.To compare the beneficial and harmful effects of recall intervals based on clinicians' assessment of patients' disease risk with fixed recall intervals.To compare the beneficial and harmful effects of no recall interval/patient driven attendance (which may be symptomatic) with fixed recall intervals. SEARCH METHODS The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 27 September 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 9), MEDLINE via OVID (1946 to 27 September 2013) and EMBASE via OVID (1980 to 27 September 2013). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (http://www.who.int/ictrp/en/) for ongoing trials. Reference lists from relevant articles were scanned and the authors of some papers were contacted to identify further trials and obtain additional information. We did not apply any restrictions regarding language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) assessing the effects of different dental recall intervals. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the search results against the inclusion criteria of the review, extracted data and carried out risk of bias assessment. We contacted study authors for clarification or further information where necessary and feasible. If we had found more than one study with similar comparisons reporting the same outcomes, we would have combined the studies in a meta-analysis using a random-effects model if there were at least four studies, or a fixed-effect model if there were less than four studies. We expressed the estimate of effect as mean difference with 95% confidence intervals (CIs) for continuous outcomes. We would have used risk ratios with 95% CI for any dichotomous outcomes. MAIN RESULTS We included one study that analysed 185 participants. The study compared the effects of a clinical examination every 12 months with a clinical examination every 24 months on the outcomes of caries (decayed, missing, filled surfaces (dmfs/DMFS) increment) and economic cost outcomes (total time used per person). As the study was at high risk of bias, had a small sample size and only included low-risk participants, we rated the quality of the body of evidence for these outcomes as very low.For three to five-year olds with primary teeth, the mean difference (MD) in dmfs increment was -0.90 (95% CI -1.96 to 0.16) in favour of 12-month recall. For 16 to 20-year olds with permanent teeth, the MD in DMFS increment was -0.86 (95% CI -1.75 to 0.03) also in favour of 12-month recall. There is insufficient evidence to determine whether 12 or 24-month recall with clinical examination results in better caries outcomes.For three to five-year olds with primary teeth, the MD in time used by each participant was 10 minutes (95% CI -6.7 to 26.7) in favour of 24-month recall. For 16 to 20-year olds with permanent teeth, the MD was 23.7 minutes (95% CI 4.12 to 43.28) also in favour of 24-month recall. This single study at high risk of bias represents insufficient evidence to determine whether 12 or 24-month recall with clinical examination results in better time/cost outcomes. AUTHORS' CONCLUSIONS There is a very low quality body of evidence from one RCT which is insufficient to draw any conclusions regarding the potential beneficial and harmful effects of altering the recall interval between dental check-ups. There is no evidence to support or refute the practice of encouraging patients to attend for dental check-ups at six-monthly intervals. It is important that high quality RCTs are conducted for the outcomes listed in this review in order to address the objectives of this review.
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Affiliation(s)
- Philip Riley
- Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Coupland III Building, Oxford Road, Manchester, UK, M13 9PL
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Holmén A, Strömberg U, Magnusson K, Twetman S. Tobacco use and caries risk among adolescents--a longitudinal study in Sweden. BMC Oral Health 2013; 13:31. [PMID: 23855639 PMCID: PMC3723799 DOI: 10.1186/1472-6831-13-31] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 07/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking and the use of smokeless tobacco have a detrimental impact on general and oral health. The relationship to dental caries is however still unclear. As caries is a multi-factorial disease with clear life-style, socio-economic and socio-demographic gradients, the tobacco use may be a co-variable in this complex rather than a direct etiological factor. Our aim was to analyze the impact of tobacco use on caries incidence among adolescents, with consideration to socio-economic variables by residency, using epidemiological data from a longitudinal study in the region of Halland, Sweden. METHODS The study population consisted of 10,068 adolescents between 16-19 years of age from whom yearly data on caries and tobacco use (cigarette smoking and use of smokeless tobacco) were obtained during the period 2006-2012. Reported DMFS increment between 16 and 19 years of age (∆DMFS) for an individual was considered as the primary caries outcome. The outcome data were compared for self-reported never vs. ever users of tobacco, with consideration to neighborhood-level socio-economy (4 strata), baseline (i.e., 16 years of age) DMFS and sex. The region consists of 65 parishes with various socio-economic conditions and each study individual was geo-coded with respect to his/her residence parish. Neighborhood (parish-level) socio-economy was assessed by proportion of residing families with low household purchasing power. RESULTS ∆DMFS differed evidently between ever and never users of tobacco (mean values: 1.8 vs. 1.2; proportion with ∆DMFS > 0: 54.2% vs. 40.5%; p < 0.0001). Significant differences were observed in each neighborhood-level socio-economic stratum. Even after controlling for baseline DMFS and sex, ∆DMFS differed highly significantly between the ever and never users of tobacco (overall p < 0.0001). CONCLUSION Tobacco use was clearly associated with increased caries increment during adolescence. Hence, this factor is relevant to consider in the clinical caries risk assessment of the individual patient as well as for community health plans dealing with oral health.
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Affiliation(s)
- Anders Holmén
- Department of Research and Development, Halland Hospital, SE-301 85 Halmstad, Sweden
| | - Ulf Strömberg
- Department of Research and Development, Halland Hospital, SE-301 85 Halmstad, Sweden
- Department of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden
| | - Kerstin Magnusson
- Section of Community and Preventive Dentistry, Maxillofacial Unit,Halland Hospital, SE-301 85 Halmstad, Sweden
| | - Svante Twetman
- Section of Community and Preventive Dentistry, Maxillofacial Unit,Halland Hospital, SE-301 85 Halmstad, Sweden
- Department of Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Institute of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Denmark
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Banerjee A, Doméjean S. The contemporary approach to tooth preservation: minimum intervention (MI) caries management in general practice. Prim Dent J 2013; 2:30-37. [PMID: 24340496 DOI: 10.1308/205016813807440119] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The minimum intervention (MI) approach summarises a clinical, evidence-based rationale for the preventive and cause-related approach to oral diseases in general and to caries in particular. MI oral care with respect to the management of patients suffering from dental caries is a concept based on an updated understanding of the histopathological carious process as well as the development of diagnostic technologies and adhesive, bioactive restorative materials. A patient-centred MI care plan for use in general dental practice is described, detailing the four phases of identifying disease, controlling/preventing disease, refurbishing/repairing tooth surfaces/restorations and recall consultations.
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Affiliation(s)
- Avijit Banerjee
- King's College Dental Institute at Guy's Hospital, King's Health Partners, London
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Passia N, Stampf S, Strub JR. Five-year results of a prospective randomised controlled clinical trial of posterior computer-aided design-computer-aided manufacturing ZrSiO4
-ceramic crowns. J Oral Rehabil 2013; 40:609-17. [DOI: 10.1111/joor.12075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2013] [Indexed: 11/29/2022]
Affiliation(s)
- N. Passia
- Department of Prosthodontics; School of Dentistry; University Medical Center Freiburg; Freiburg Germany
| | - S. Stampf
- Institute of Medical Biometry and Medical Informatics; University Freiburg; Freiburg Germany
| | - J. R. Strub
- Department of Prosthodontics; School of Dentistry; University Medical Center Freiburg; Freiburg Germany
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Heaven TJ, Gordan VV, Litaker MS, Fellows JL, Brad Rindal D, Firestone AR, Gilbert GH. Agreement among dentists' restorative treatment planning thresholds for primary occlusal caries, primary proximal caries, and existing restorations: findings from The National Dental Practice-Based Research Network. J Dent 2013; 41:718-25. [PMID: 23743181 DOI: 10.1016/j.jdent.2013.05.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 05/23/2013] [Accepted: 05/26/2013] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aim of this study was to quantify the agreement among individual National Dental Practice-Based Research Network dentists' self-reported treatment decisions for primary occlusal caries, primary proximal caries, and existing restorations. METHODS Five hypothetical clinical scenarios were presented: primary occlusal caries; primary proximal caries; and whether three existing restorations should be repaired or replaced. We quantified the probability that dentists who recommended later restorative intervention for primary caries were the same ones who recommended that existing restorations be repaired instead of replaced. RESULTS Dentists who recommended later restorative treatment of primary occlusal caries and proximal caries at a more-advanced stage were significantly more likely to recommend repair instead of replacement. Agreement among dentists on a threshold stage for the treatment of primary caries ranged from 40 to 68%, while that for repair or replacement of existing restorations was 36 to 43%. CONCLUSIONS Dentists who recommended repair rather than replacement of existing restorations were significantly more likely to recommend later treatment of primary caries. Conversely, dentists who recommended treatment of primary caries at an earlier stage were significantly more likely to recommend replacement of the entire restoration. Between-dentist agreement for primary caries treatment was better than between-dentist agreement for repair or replacement of existing restorations. CLINICAL IMPLICATIONS These findings suggest consistency in how individual dentists approach the treatment of primary caries and existing restorations. However, substantial variation was found between dentists in their treatment decisions about the same teeth.
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Affiliation(s)
- Tim J Heaven
- University of Alabama at Birmingham, Department of Restorative Sciences, 1919 7th Avenue South, AL 35294-0007, United States.
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Ito A, Hayashi M, Hamasaki T, Ebisu S. How regular visits and preventive programs affect onset of adult caries. J Dent Res 2012; 91:52S-58S. [PMID: 22699669 DOI: 10.1177/0022034511435701] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
If it is to be effective, preventive dental treatment must be based on an individual's risk of caries and periodontal disease. However, hitherto, preventive treatment has been generally conducted without proper caries-risk assessment because of lack of knowledge about an individual's caries risk. This study sought to identify high-risk adult patients and examine the effectiveness of preventive programs. Data for 442 patients from a single general practice who met the inclusion criteria were analyzed. Multiple logistic-regression analysis showed that high levels of mutans streptococci (SM) correlated with the onset of primary and secondary caries, with odds ratios of 2.34 (95%CI: 1.15-4.76, p = 0.019) and 2.22 (95%CI: 1.06-4.62, p = 0.034), respectively. Lactobacilli (LB) also correlated with secondary caries, with an odds ratio of 3.34 (95%CI: 1.35-6.85, p = 0.007). When the patients were checked after three years of a preventive program, the correlation with SM and LB disappeared. Survival analyses by Cox regression models and Kaplan-Meier methods showed that secondary caries was difficult to control by conventional preventive programs alone in patients with high levels of cariogenic bacteria. In conclusion, cariogenic bacteria play an important role in the incidence of caries, and additional intensive preventive treatment should be considered for high-risk patients.
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Affiliation(s)
- A Ito
- Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita 565-0871, Japan
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Teich ST. Risk Assessment-Based Individualized Treatment (RABIT): A Comprehensive Approach to Dental Patient Recall. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2013.77.4.tb05490.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Tobias CR, Fox JE, Walter AW, Lemay CA, Abel SN. Retention of people living with HIV/AIDS in oral health care. Public Health Rep 2012; 127 Suppl 2:45-54. [PMID: 22547876 DOI: 10.1177/00333549121270s207] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We identified factors associated with retention in oral health care for people living with HIV/AIDS (PLWHA) and the impact of care retention on oral health-related outcomes. METHODS We collected interview, laboratory value, clinic visit, and service utilization data from 1,237 HIV-positive patients entering dental care from May 2007 to August 2009, with at least an 18-month observation period. Retention in care was defined as two or more dental visits at least 12 months apart. We conducted multivariate regression using generalized estimating equations to explore factors associated with retention in care. RESULTS In multivariate analysis, patients who received oral health education were 5.91 times as likely (95% confidence interval 3.73, 9.39) as those who did not receive this education to be retained in oral health care. Other factors associated with care retention included older age, taking antiretroviral medications, better physical health status, and having had a dental visit in the past two years. Patients retained in care were more likely to complete their treatment plans and attend a recall visit. Those retained in care experienced fewer oral health symptoms and less pain, and better overall health of teeth and gums. CONCLUSIONS Retention in oral health care was associated with positive oral health outcomes for this sample of PLWHA. The strongest predictor of retention was the receipt of oral health education, suggesting that training in oral health education is an important factor when considering competencies for new dental professionals, and that patient education is central to the development of dental homes, which are designed to engage and retain people in oral health care over the long term.
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Affiliation(s)
- Carol R Tobias
- Health & Disability Working Group, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA.
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Friedman JW. Assessing Prevention in Clinical Dentistry. J Evid Based Dent Pract 2012; 12:53-4. [DOI: 10.1016/j.jebdp.2012.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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