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Roeschmann N, Rau A, Kesting MR, Maier E, Buchbender M. A Prospective Comparative Analysis Regarding the Assessment of Oral Mucosal Disease Using a Validated Questionnaire to Improve the Teaching of Dental Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9663. [PMID: 35955017 PMCID: PMC9368512 DOI: 10.3390/ijerph19159663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Structured examination and treatment are essential in medicine. For dental students, a structured approach to the assessment of oral mucosal lesions is missing thus far. To validate an approach, a structured questionnaire was compared with the habitually used free description of oral lesions (white lesions, ulcers, hyperplasia). Thirty-three dental students were divided into two groups (Group 1 (n = 17) used the free description; Group 2 (n = 16) used a guided questionnaire) to characterize mucosal lesions in patients and make a tentative diagnosis. Although no difference was found between the groups regarding the suspected diagnosis or the histopathological findings, there was a significant advantage of the structured questionnaire in all aspects of the description compared to the free description (p = 0.000018). Thus, a structured description is an important aspect in the evaluation of oral mucosal changes, and a guided questionnaire should be implemented in the study of dentistry.
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Affiliation(s)
- Nico Roeschmann
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054 Erlangen, Germany
| | - Andrea Rau
- Department of Oral and Maxillofacial Surgery, University of Greifswald, 17475 Greifswald, Germany
| | - Marco R. Kesting
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054 Erlangen, Germany
| | - Eva Maier
- Dental Clinic 1—Operative Dentistry and Periodontology, Friedrich-Alexander Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen, Germany
| | - Mayte Buchbender
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054 Erlangen, Germany
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Flores APDC, Roxo-Gonçalves M, Batista NVR, Gueiros LA, Linares M, Santos-Silva AR, Lopes MA, Flausino C, Meurer MI, Grando LJ, Molina-Bastos CG, Guattini VLDO, Carrard VC. Diagnostic accuracy of a telediagnosis service of oral mucosal diseases: A multicentric survey. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:65-72. [PMID: 35422409 DOI: 10.1016/j.oooo.2022.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The aim of this multicentric study was to assess the diagnostic accuracy of a telediagnosis service for oral mucosal disorders. STUDY DESIGN This study included 100 patients seen at the oral medicine outpatient clinic of 3 Brazilian Dental Schools (University of Campinas, Federal University of Pernambuco, and Federal University of Santa Catrina) from March 2019 to October 2019. In addition to the face-to-face assistance provided by graduate students and the final diagnosis validated by the professors of these institutions, a remote evaluation was requested for these patients through the EstomatoNet/TelessaúdeRS platform. RESULTS The sensitivity and specificity of telediagnosis were compared with those of the face-to-face approach and found to be 100% and 97.4%, respectively. The concordance between the examiners was 95%, and case management was relatively simple in approximately 60% of cases. CONCLUSIONS Based on the results, telediagnosis for oral diseases can be considered a reliable method, representing a promising alternative for the clinical support of health professionals, particularly in remote locations.
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Affiliation(s)
| | - Michelle Roxo-Gonçalves
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Luiz Alcino Gueiros
- Oral Medicine Unit, Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, Brazil
| | - Matheus Linares
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Carolina Flausino
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Maria Inês Meurer
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Liliane Janete Grando
- Department of Pathology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | | | | | - Vinicius Coelho Carrard
- Oral Pathology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; TelessaudeRS-UFRGS, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
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Cardozo I, Silva VCD, Perdoncini NN, Torres-Pereira CC. Telehealth in Oral Medicine: report of an experience from public health care in a southern Brazilian state. Braz Oral Res 2022; 36:e031. [PMID: 35293497 DOI: 10.1590/1807-3107bor-2022.vol36.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/11/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe the telediagnosis of oral lesions through a telehealth program offered in the State of Paraná, southern Brazil. This report included all oral medicine-related teleconsultations between January 2015 and December 2019. Primary care dentists from the public health services of the state were trained to use the Telessaúde Brasil Redes platform, a national telehealth program that provides telediagnostic support through teleconsultations with specialists. Clinical information and images of oral lesions were solicited to each teleconsultation request. An oral medicine specialist evaluated the cases and provided diagnostic hypotheses, management, and referral suggestions. Finally, dentists were invited to evaluate the services. A total of 162 cases were submitted by 44 dentists. The patient's main complaint was described in 98.8% of cases, while the duration/evolution and the type of lesions were 64.81% and 40.12%, respectively. No images were attached to 19 (11.70%) patients. The information sent was sufficient for diagnostic reasoning in 125 (77.16%) requests. The specialist considered 78 cases (48.1%) to be resolved in primary care. Among respondents (45.7%), dentists considered that the teleconsultation "totally attended" their needs in 92% of requests. The description of the telehealth platform usage in oral medicine in Paraná showed the need to improve the participation of primary care dentists and the quality of clinical information provided as barriers to be overcome, aiming for the best usage of the platform.
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Affiliation(s)
- Ivy Cardozo
- Universidade Federal do Paraná - UFPR, Department of Stomatology, Curitiba, PR, Brazil
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Böhm da Costa C, da Silva Peralta F, Aurelio Maeyama M, Goulart Castro R, Lúcia Schaefer Ferreira de Mello A. Teledentistry System in Dental Health Public Services: A Mixed-Methods Intervention Study. Int J Med Inform 2021; 153:104533. [PMID: 34303136 DOI: 10.1016/j.ijmedinf.2021.104533] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/21/2021] [Accepted: 06/29/2021] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Health information and communication technologies, such as Teledentistry, can help expand access to dental health public services making it more effective. OBJECTIVE To analyze the factors that affect the implementation of a Teledentistry system in dental health public services. METHODS The study follows the Implementation Research methodological framework. A mixed-method approach was applied using a triangulation design-sequential model to collect, analyze, and interpret qualitative and quantitative data about the implementation of a Teledentistry system. A compulsory teleconsultation from the general dentist was planned to access periodontics specialized care. The study was developed in a South Brazilian capital city and the platform of the Santa Catarina Telehealth Center was used. Qualitative and quantitative data were collected sequentially to achieve a better understanding of implementation research issues. RESULTS In seven months, 68 teleconsulting was performed by 22% of the general dentists, prior to the referrals on periodontics. Only one reported not needing to refer the patient to the periodontist as a result of the teleconsulting guidance. Teledentistry system implementation and usage were influenced by the managers' political and administrative awareness to deploy and maintain the intervention. Lack of sufficient resource investment, lack of system integration, and internet failures were relevant limiting factors. The teleconsultant guidelines contributed to general dentistry's better decision-making regarding treatment, urgency of case management, and prioritization of referrals to the periodontists CONCLUSION: Identifying the factors that influence the implementation and finding solutions to overcome them, can prevent future failures and improve usage of the system.
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Affiliation(s)
- Christine Böhm da Costa
- Health Department, Joinville Municipality, Santa Catarina, Brazil. Address: Rua Dr. João Colin, 2700 - Santo Antônio. CEP, 89218-035 Joinville, SC, Brazil.
| | - Felipe da Silva Peralta
- Health Department, Joinville Municipality, Santa Catarina, Brazil. Address: Rua Dr. João Colin, 2700 - Santo Antônio. CEP, 89218-035 Joinville, SC, Brazil.
| | - Marcos Aurelio Maeyama
- Vale do Itajaí University, Itajaí, Santa Catarina, Brazil. Address: Rua Uruguai, 458 - Centro. CEP, 88302-901 Itajaí, SC, Brazil.
| | - Renata Goulart Castro
- Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil. Address: Campus Universitário João David Ferreira Lima. Post Graduation Program in Dentistry. Centro de Ciências da Saúde - Trindade. CEP 88040-900 Florianópolis, SC, Brazil.
| | - Ana Lúcia Schaefer Ferreira de Mello
- Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil. Address: Campus Universitário João David Ferreira Lima. Post Graduation Program in Dentistry. Centro de Ciências da Saúde - Trindade. CEP 88040-900 Florianópolis, SC, Brazil.
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Rodrigues CRD, Fernandes PM, Santos-Silva AR, Vargas PA, Lopes MA. Evaluation of the quality of referral letters: experience of a Brazilian oral medicine service. Braz Oral Res 2021; 35:e037. [PMID: 33909859 DOI: 10.1590/1807-3107bor-2021.vol35.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 12/11/2020] [Indexed: 11/22/2022] Open
Abstract
Optimizing the quality of referral letters could be the first step to a correct clinical approach for patients. Referral letters should be legible and contain the necessary information to avoid delaying the patient's diagnosis and treatment. However, to date, few studies have been conducted on how referrals are performed in Brazil. Knowledge regarding the quality of referral letters can provide information to better guide health care professionals. This study was aimed at analyzing all referrals received by a single oral medicine service in Brazil. Referral letters were classified into poor, regular, good, and excellent based on key items concerning the primary morphology of the lesion, location, diagnostic hypothesis, symptomatology, time of evolution, consistency, size, and limits. A total of 500 referral letters were evaluated, including 271 (54.2%) from a private service and 229 (45.8%) from a public service. Dentists and physicians had written 475 (95%) and 25 (5%) referral letters, respectively. Among the 500 referrals analyzed in this study, the number of regular, poor, good, and excellent referrals was 236 (47.2%), 203 (40.6%), 58 (11.6%), and one (0.6%), respectively, showing a lack of important clinical information in referrals.
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Affiliation(s)
- Camila Real Delegá Rodrigues
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Patrícia Maria Fernandes
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Alan Roger Santos-Silva
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Pablo Agustin Vargas
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Marcio Ajudarte Lopes
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
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Carrard VC, van der Waal I. The role of the dentist in the diagnosis and management of patients with oral mucosal diseases. Med Oral Patol Oral Cir Bucal 2021; 26:e256-e260. [PMID: 33395400 PMCID: PMC7980288 DOI: 10.4317/medoral.24465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/28/2020] [Indexed: 11/05/2022] Open
Abstract
Based on a few case reports of oral mucosal diseases a number of questions is raised about the role of dentists-general practitioners in the diagnostic procedure and management of patients with such diseases. For instance, are dentists prepared to prescribe topical corticosteroids and should dentists be taught how and when to take a biopsy? And how about palpation of the neck? A strong recommendation is made to take clinical pictures for proper documentation and, if needed, for telediagnostic procedures. Another issue relates to the communication between dentists and dental specialists when dealing with patients with oral diseases. In case of a patient suffering from burning mouth syndrome or any other type of chronic orofacial pain, the question is raised whether dentists-general practitioners are prepared to manage such patients. Furthermore, there is a call for structuring the collaboration between dentists-general practitioners and dental specialists, including oral and maxillofacial surgeons.
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Affiliation(s)
- V-C Carrard
- Department of Oral and Maxillofacial Surgery and Oral Pathology VU University Medical Center P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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Meurer MI, Von Wangenheim A, Zimmermann C, Savaris A, Petrolini VA, Wagner HM. Launching a public statewide tele(oral)medicine service in Brazil during COVID-19 pandemic. Oral Dis 2020; 28 Suppl 1:947-949. [PMID: 32623802 PMCID: PMC7361396 DOI: 10.1111/odi.13528] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/12/2020] [Accepted: 06/24/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Maria Inês Meurer
- Department of Pathology, Oral Medicine Service at University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Aldo Von Wangenheim
- Department for Informatics and Statistics, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Caroline Zimmermann
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Alexandre Savaris
- Brazilian Institute for Digital Convergence, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Harley Miguel Wagner
- Brazilian Institute for Digital Convergence, Federal University of Santa Catarina, Florianópolis, Brazil
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