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Berryhill MB, Culmer N, Smith T, Kopycka-Kedzierawski D, Gurganus R, Curry G. Perceptions of mental health screening and referral to treatment in National Dental-Practice Based Research Network practices: A qualitative study. J Public Health Dent 2024; 84:124-135. [PMID: 38561327 PMCID: PMC11168878 DOI: 10.1111/jphd.12607] [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] [Received: 03/27/2023] [Revised: 11/27/2023] [Accepted: 01/05/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Dental practices can have additional positive impacts on public health by implementing mental health screening and referral to treatment in dental care workflows. In this study, we examined how dental practices identify and address adult patient mental health concerns, attitudes about implementing mental health screening and referral, and potential barriers and facilitators to treatment. METHODS We conducted semi-structured focus groups with 17 dentists, 10 dental hygienists, and 5 dental assistants/office staff in the South-Central region of the National Dental Practice-Based Research Network. Transcribed interviews were analyzed using thematic analysis. RESULTS We identified five main themes from dental practitioners and office staff responses. Practitioners and office staff: (1) discover patient mental health concerns through record review, patient/caregiver disclosure, and patient observation; (2) respond to patients' mental health concerns by making the patient more comfortable, documenting the concern in the patient's chart, and directly addressing the mental health concern; (3) want a systematic process for mental health screening and referral to treatment in their dental office; (4) recognize potential barriers in implementing health screening and referral to treatment processes; (5) desire training on mental health matters. An overarching theme emerged: developing a trusting relationship with patients. CONCLUSIONS Participants noted the importance of implementing systematic procedures for mental health screening and referral to services into dental practices, while also recognizing the potential barriers for integrating such processes. They also expressed a desire for quality training and resources that can support better care for patients with mental health concerns.
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Affiliation(s)
| | | | - Todd Smith
- The University of Alabama, Tuscaloosa, Alabama, USA
| | | | - Ria Gurganus
- The University of Alabama, Tuscaloosa, Alabama, USA
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Durham J, Ohrbach R, Baad-Hansen L, Davies S, De Laat A, Goncalves DG, Gordan VV, Goulet JP, Häggman-Henrikson B, Horton M, Koutris M, Law A, List T, Lobbezoo F, Michelotti A, Nixdorf DR, Oyarzo JF, Peck C, Penlington C, Raphael KG, Santiago V, Sharma S, Svensson P, Visscher CM, Yoshiki I, Alstergren P. Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing. J Oral Rehabil 2024; 51:785-794. [PMID: 38151896 DOI: 10.1111/joor.13652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/29/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings. OBJECTIVE To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management. METHODS An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium. RESULTS Within the physical axis (Axis 1), the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra-brief 11 item assessment. CONCLUSION The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.
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Affiliation(s)
- Justin Durham
- School of Dental Sciences, Newcastle University, Newcastle, UK
- Newcastle Hospitals' NHS Foundation Trust, Newcastle, UK
| | - Richard Ohrbach
- Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, New York, USA
| | - Lene Baad-Hansen
- Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark
| | - Stephen Davies
- Division of Dentistry, University of Manchester UK, Manchester, UK
| | - Antoon De Laat
- Department Oral health Sciences KU Leuven and Department Dentistry, UZ Leuven, Belgium
| | | | - Valeria V Gordan
- Restorative Dental Sciences Department, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Jean-Paul Goulet
- Faculty of Dental Medicine, Laval University, Quebec, Quebec, Canada
| | - Birgitta Häggman-Henrikson
- Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden
| | | | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Alan Law
- Endodontist, The Dental Specialists, Woodbury, Minnesota, USA
- Research Professor, Division of Endodontics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Thomas List
- Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden
- Skåne University Hospital, Specialized Pain Rehabilitation, Lund, Sweden
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ambra Michelotti
- Department of Neurosciences, School of Orthodontics, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
| | - Donald R Nixdorf
- Division of TMD & Orofacial Pain, School of Dentistry and Department of Radiology, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Juan Fernando Oyarzo
- TMD and Orofacial Pain Program, Faculty of Odontology, Universidad Andres Bello, Santiago, Chile
| | - Chris Peck
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Chris Penlington
- School of Dental Sciences, Newcastle University, Newcastle, UK
- Newcastle Hospitals' NHS Foundation Trust, Newcastle, UK
| | - Karen G Raphael
- Department of Oral and Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, New York, USA
| | - Vivian Santiago
- Department of Oral and Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, New York, USA
| | - Sonia Sharma
- Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, New York, USA
| | - Peter Svensson
- Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark
| | - Corine M Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Imamura Yoshiki
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Tokyo, Japan
| | - Per Alstergren
- Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden
- Skåne University Hospital, Specialized Pain Rehabilitation, Lund, Sweden
- Orofacial Pain Unit, Malmö University, Malmö, Sweden
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Culmer NP, Smith TB, Berryhill MB, Gurenlian J, Simpson L, Ogden S, Parrish J, Ryan L, White N, Bettis M, Greenwood C. Mental health screening and referral to treatment in dental practices: A scoping review. J Dent Educ 2024; 88:445-460. [PMID: 38282325 DOI: 10.1002/jdd.13444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE The purpose of this study was to conduct a scoping review to examine and summarize the characteristics of research related to mental health (MH) screenings and/or referrals to treatment in dental practices. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for Scoping Reviews and searched multiple databases for terms connected with dental care, MH concerns, screening, and referral. Included articles: (1) described care provided in a dental practice, (2) described a situation where the patient is experiencing the potential MH problem, (3) did not involve dental anxiety exclusively, and (4) involved some form of MH screening and/or referral to treatment. Article analysis included a summary of key study characteristics, types of evidence, study design, and central concepts and definitions. RESULTS The search generated 2050 records, with 26 ultimately included. Most studies involved only adults (22, 85%), but only three (12%) reported on rurality (two urban; one mixed) and only two each (8%) reported race or ethnicity. Fifteen (58%) articles were prospective and 11 (42%) were retrospective. The studies varied widely in study designs, from 11 (42%) cross-sectional methodologies to only one (4%) randomized controlled trial. Thirty-four screening tools were used to screen for symptoms of 43 MH conditions, with depression and anxiety screened for most frequently. Few articles discussed making referrals, practice workflows, or follow-up outcomes. CONCLUSIONS Included studies provide evidence of viable options for dental practitioners regarding MH screening, referring, and conducting follow-up, but lack specificity regarding these processes. Overall, more research is needed to clarify what workflows are most efficient for dental practitioners and efficacious in identifying patients with MH concerns.
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Affiliation(s)
- Nathan P Culmer
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Todd Brenton Smith
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA
| | - M Blake Berryhill
- Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, Alabama, USA
| | - JoAnn Gurenlian
- Education and Research Division, American Dental Hygienists' Association, Chicago, Illinois, USA
- Department of Dental Hygiene, Idaho State University, Pocatello, Idaho, USA
| | - Lance Simpson
- University Libraries, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Shawnna Ogden
- College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Jonathan Parrish
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA
- College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Lacey Ryan
- College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Nicole White
- Department of Psychology, The University of Mississippi, Oxford, Mississippi, USA
| | - Merrill Bettis
- College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Charlotte Greenwood
- College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
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Zechner MR, Singhal V, Murphy AA, York J, Karyczak S, Muhammad A. Dental pre‐doctoral student perceptions about serious mental illness: Concerns and role clarification. J Dent Educ 2022; 87:639-645. [DOI: 10.1002/jdd.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/26/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Michelle R. Zechner
- Department of Psychiatric Rehabilitation and Counseling Professions Rutgers School of Health Professions Piscataway New Jersey USA
| | - Vaishali Singhal
- Department of Community Health, Rutgers School of Dental Medicine and Department of Interdisciplinary StudiesRutgers School of Health Professions NewarkNew JerseyUSA
| | - Ann A. Murphy
- Department of Psychiatric Rehabilitation and Counseling Professions Rutgers School of Health Professions Piscataway New Jersey USA
| | - Jill York
- Department of Community Health Rutgers School of Dental Medicine Newark New Jersey USA
| | - Sean Karyczak
- Department of Psychiatric Rehabilitation and Counseling Professions Rutgers School of Health Professions Piscataway New Jersey USA
| | - Asiyah Muhammad
- Rutgers School of Environmental and Biological Sciences with a major in Biological Sciences and a minor in Health and Society New Brunswick New Jersey USA
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A Novel Method for Digital Reconstruction of the Mucogingival Borderline in Optical Scans of Dental Plaster Casts. J Clin Med 2022; 11:jcm11092383. [PMID: 35566508 PMCID: PMC9099921 DOI: 10.3390/jcm11092383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 12/14/2022] Open
Abstract
Adequate soft-tissue dimensions have been shown to be crucial for the long-term success of dental implants. To date, there is evidence that placement of dental implants should only be conducted in an area covered with attached gingiva. Modern implant planning software does not visualize soft-tissue dimensions. This study aims to calculate the course of the mucogingival borderline (MG-BL) using statistical shape models (SSM). Visualization of the MG-BL allows the practitioner to consider the soft tissue supply during implant planning. To deploy an SSM of the MG-BL, healthy individuals were examined and the intra-oral anatomy was captured using an intra-oral scanner (IOS). The empirical anatomical data was superimposed and analyzed by principal component analysis. Using a Leave-One-Out Cross Validation (LOOCV), the prediction of the SSM was compared with the original anatomy extracted from IOS. The median error for MG-BL reconstruction was 1.06 mm (0.49–2.15 mm) and 0.81 mm (0.38–1.54 mm) for the maxilla and mandible, respectively. While this method forgoes any technical work or additional patient examination, it represents an effective and digital method for the depiction of soft-tissue dimensions. To achieve clinical applicability, a higher number of datasets has to be implemented in the SSM.
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Häggman-Henrikson B, M Visscher C, Wänman A, Ljótsson B, C Peck C, Lövgren A. Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders. J Oral Rehabil 2021; 48:1193-1200. [PMID: 34462940 DOI: 10.1111/joor.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/28/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
AIMS Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophising, that is, exaggeration of negative consequences of a painful event. The aim was to investigate catastrophising in individuals with painful TMD compared to controls and the association between catastrophising and pain intensity, number of pain sites and functional limitations. METHODS A community-based sample of 110 individuals (83 women; 20-69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD) and 190 age- and gender-matched controls (119 women; 20-69 yrs) from the Public Dental services in Västerbotten, Sweden, participated. Associations between catastrophising and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain catastrophising Scale (PCS) with Jaw Functional Limitation Scale (JFLS-20), pain site number (whole-body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann-Whitney U test) of these variables were also calculated. RESULTS Levels of catastrophising were associated with TMD pain (OR 1.6, 95%CI 1.1-2.6). Among individuals with painful TMD, catastrophising was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294-0.321, p≤0.002), but not to number of pain sites. CONCLUSION Compared to controls, community-based individuals with painful TMD demonstrated higher levels of pain catastrophising, and this catastrophising was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophising suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.
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Affiliation(s)
- Birgitta Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.,Department of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - Corine M Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Anders Wänman
- Department of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Christopher C Peck
- The University of Sydney Westmead Initiative, The University of Sydney, Sydney, Australia
| | - Anna Lövgren
- Department of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden
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Rauch A, Jahn F, Roesner A, Hahnel S, Schierz O. Impact of the DC/TMD instructional video on the practical skills of undergraduate students-A single-blinded, randomized controlled trial. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:435-441. [PMID: 33053252 DOI: 10.1111/eje.12618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/06/2020] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Competencies in the clinical examination of patients with temporomandibular disorders (TMD) can be achieved by self-instruction. This study aimed to identify the impact of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) instructional video on the practical examination skills of undergraduate students. MATERIALS AND METHODS One week prior to completing an objective structured clinical examination (OSCE) addressing the examination of patients with TMD, undergraduate students in their third year received either the DC/TMD manual (control group) or additionally watched the instructional video once (intervention group). After passing the OSCE, a feedback questionnaire was completed by the students. RESULT Fifty undergraduates were recruited to take part in the OSCE prior to their first clinical course. The sum scores achieved in the stations were higher in the intervention group, but missed significance. Participants of the intervention group more often agreed that completing the OSCE stations was easy, which was significant for one station (P = .023). 95.8% of the participating students supported the implementation of the video in dental education. DISCUSSION Due to the conception of the study, the video was only presented once to ensure that the control group had no access to the medium at all. However, it might be interesting to investigate whether repeated watching of the video enhances its effect. CONCLUSIONS Clinical competencies in the examination of TMD patients can be achieved by self-instruction with the DC/TMD manual and instructional video. Watching the video for educational purposes was highly recommended by undergraduate students.
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Affiliation(s)
- Angelika Rauch
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Franziska Jahn
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Anuschka Roesner
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Sebastian Hahnel
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Oliver Schierz
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
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Ettlin DA, Napimoga MH, Meira E Cruz M, Clemente-Napimoga JT. Orofacial musculoskeletal pain: An evidence-based bio-psycho-social matrix model. Neurosci Biobehav Rev 2021; 128:12-20. [PMID: 34118294 DOI: 10.1016/j.neubiorev.2021.06.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 12/13/2022]
Abstract
Pain is a multidimensional experience comprising sensory-discriminative, affective-motivational, and cognitive-evaluative dimensions. Clinical and research findings have demonstrated a complex interplay between social burdens, individual coping strategies, mood states, psychological disorders, sleep disturbances, masticatory muscle tone, and orofacial musculoskeletal pain. Accordingly, current classification systems for orofacial pain require psychosocial assessments to be an integral part of the multidimensional diagnostic process. Here, we review evidence on how psychosocial and biological factors may generate and perpetuate musculoskeletal orofacial pain. Specifically, we discuss studies investigating a putative causal relationship between stress, bruxism, and pain in the masticatory system. We present findings that attribute brain structures various roles in modulating pain perception and pain-related behavior. We also examine studies investigating how the nervous and immune system on cellular and molecular levels may account for orofacial nociceptive signaling. Furthermore, we review evidence pointing towards associations between orofacial musculoskeletal pain and neuroendocrine imbalances, sleep disturbances, and alterations of the circadian timing system. We conclude with several proposals that may help to alleviate orofacial pain in the future.
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Affiliation(s)
- Dominik A Ettlin
- Clinic of Masticatory Disorders, Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland.
| | - Marcelo Henrique Napimoga
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro De Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | - Miguel Meira E Cruz
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro De Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil; Sleep Unit, Cardiovascular Center of University of Lisbon, Lisbon School of Medicine, Lisbon, Portugal
| | - Juliana Trindade Clemente-Napimoga
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro De Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
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Perception of Old Age in German Undergraduate Dental Students-A Comparison of Two Cohorts 10 Years Apart. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063279. [PMID: 33810017 PMCID: PMC8004841 DOI: 10.3390/ijerph18063279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/09/2021] [Accepted: 03/18/2021] [Indexed: 11/24/2022]
Abstract
Previous studies revealed that students’ willingness to provide dental services for older patients is mainly influenced by their individual perception of elders rather than their knowledge about old age. The aim of this study was to estimate students’ perception of old and young age as well as their hopes and fears associated with old age and to compare two cohorts that participated in the study 10 years apart. Data were obtained from a questionnaire completed by two cohorts of undergraduate dental students from 2006 to 2008 (T1, n = 207) and 2016 to 2018 (T2, n = 135). Participants were asked to define the ages that they consider a man or woman to be old and young. Moreover, they had to specify their fears and hopes associated with old age. Reported thresholds for old age differed significantly between T1 and T2. In contrast to T1 students, T2 students defined a person to be old at a higher age and barely differentiated between the old ages of men and women. Furthermore, T2 students presented more fears related to aging than T1 students, e.g., psychological problems or loss of independence. The perception of age appears to be a multifactorial process and significantly changed between students of T1 and T2. Fears of dental students regarding old age should be addressed in, e.g., gerodontological curricula, to foster positive experiences in interaction with older people and highlight the important and rewarding aspects of gerodontology.
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10
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Bhalang K, Steiger B, Lukic N, Zumbrunn Wojczyńska A, Hovijitra RS, Ettlin DA. The Pain-to-Well-Being Relationship in Patients Experiencing Chronic Orofacial Pain. Front Neurol 2020; 11:557415. [PMID: 33343482 PMCID: PMC7744627 DOI: 10.3389/fneur.2020.557415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/26/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction: Orofacial pain features may negatively influence a person's well-being and vice versa. Some aspects of well-being can be measured with axis II instruments that assess patients' psychosocial and behavioral status. The aim of this study was to investigate associations between pain features and psychosocial variables as indicators of well-being. Materials and Methods: Seven hundred ninety-nine anonymized datasets collected using the Web-based Interdisciplinary Symptom Evaluation (WISE) of patients reporting to the Interdisciplinary Orofacial Pain Unit, University of Zurich, between March 19, 2017 and May 19, 2019, were analyzed. Pain features including intensity, number of locations, impact, and duration were evaluated. Psychometric measures assessed pain-related catastrophizing and disability, illness perception, distress, anxiety, depression, injustice experience, dysmorphic concerns, and insomnia. Results: Most patients were between 30 and 59 years old (58.3%), female (69.8%), working (66.0%), and experienced pain for more than 6 months (68.5%). Pain intensities were higher in women than men and higher in disabled than working patients. Scores indicating elevated stress and depression were also observed in disabled patients. The sample prevalence rates of clinically relevant axis II instrument scores were as follows: Graded Chronic Pain Scale for the Head (GCPS-H), 27%; Patient Health Questionnaire 4 (PHQ4), 21%; PHQ9, 21%; Pain Catastrophizing Scale (PCS), 20%; General Anxiety Disorder 7 (GAD7), 15%; Insomnia Severity Index (ISI), 15%; Injustice Experience Questionnaire (IEQ), 14%; GCPS for the Body (GCPS-B), 13%; PHQ for Stress (PHQstr), 6%; and Dysmorphic Concern Questionnaire (DCQ), 2%. Noteworthy results of correlation analysis of the clinically relevant axis II scores and pain measures were as follows: the PHQstr had moderate associations (0.34-0.43) with the sum of pain intensity at rest and during function, number of pain locations, and typical pain intensity. The IEQ scores were moderately associated with typical pain intensity at 0.39. The DCQ scores were moderately associated with pain extension at 0.41. Conclusions: Moderate correlations of certain pain and well-being measures were found in patients reporting clinically relevant stress, injustice experience, and dysmorphic concern, all of which reflect impaired well-being. PHQ4 is suitable for routine distress screening in the clinical setting.
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Affiliation(s)
- Kanokporn Bhalang
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Beat Steiger
- Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Aarau, Switzerland
| | - Nenad Lukic
- Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | - Ray S Hovijitra
- Dental Center, Bumrungrad International Hospital, Bangkok, Thailand
| | - Dominik A Ettlin
- Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,São Leopoldo Mandic Institute and Research Center, São Paulo, Brazil.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland
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11
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Günther T, Schierz O, Hahnel S, Rauch A. Field-testing a psychosocial assessment scoring form for TMD patients - summarizing axis II instruments. BMC Oral Health 2020; 20:267. [PMID: 32998738 PMCID: PMC7528229 DOI: 10.1186/s12903-020-01248-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 09/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background The etiology of temporomandibular disorders (TMD) can be explained on the basis of a biopsychosocial model. However, psychosocial assessment is challenging in daily dental practice. The purpose of the current study was to field-test the practicability of a novel psychosocial assessment scoring form regarding the reliability of scoring procedures and the opinion of examiners. The working hypotheses were that the scoring results of inexperienced undergraduate students were similar to the results collected by a gold standard and that the scoring form was easy to use. Methods A psychosocial assessment scoring form was developed in accordance with guidelines of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), including results of the Graded Chronic Pain Scale (GCPS), Patient Health Questionnaires (PHQ), and Generalized Anxiety Disorders (GAD). Inexperienced operators (undergraduate students) examined patients with TMD-associated complaints and rated the practicability of the scoring form. The scoring results were recalculated by two experienced operators and a consensus was defined as a gold standard. Reliability coefficients were determined comparing results of the gold standard and the inexperienced operators. Results Sixty-five examiners used the scoring form to obtain results for patients with TMD-associated complaints. Of the patients, 78.8% received a diagnosis according to DC/TMD decision trees. Two-thirds of the operators (62.9%) stated that the form was easy to complete, and 83.0% would use it in their dental practice. The reliability coefficients ranged between 0.81–1.00. Conclusions Within the limitations of the present study, the psychosocial assessment scoring form seems to be an easy-to-use and practicable tool. The vast majority of the inexperienced examiners recommended the application.
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Affiliation(s)
- Tamara Günther
- Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Oliver Schierz
- Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Sebastian Hahnel
- Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Angelika Rauch
- Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
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Häggman-Henrikson B, Liv P, Ilgunas A, Visscher CM, Lobbezoo F, Durham J, Lövgren A. Increasing gender differences in the prevalence and chronification of orofacial pain in the population. Pain 2020; 161:1768-1775. [PMID: 32701837 PMCID: PMC7365674 DOI: 10.1097/j.pain.0000000000001872] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/12/2020] [Accepted: 03/12/2020] [Indexed: 12/17/2022]
Abstract
Although a fluctuating pattern of orofacial pain across the life span has been proposed, data on its natural course are lacking. The longitudinal course of orofacial pain in the general population was evaluated using data from routine dental check-ups at all Public Dental Health services in Västerbotten, Sweden. In a large population sample, 2 screening questions were used to identify individuals with pain once a week or more in the orofacial area. Incidence and longitudinal course of orofacial pain were evaluated using annual data for 2010 to 2017. To evaluate predictors for orofacial pain remaining over time, individuals who reported pain on at least 2 consecutive dental check-ups were considered persistent. A generalized estimating equation model was used to analyze the prevalence, accounting for repeated observations on the same individuals. In total, 180,308 individuals (equal gender distribution) were examined in 525,707 dental check-ups. More women than men reported orofacial pain (odds ratio 2.58, 95% confidence interval [CI] 2.48-2.68), and there was a significant increase in the prevalence of reported pain from 2010 to 2017 in both women and men. Longitudinal data for 135,800 individuals were available for incidence analysis. Women were at higher risk of both developing orofacial pain (incidence rate ratio 2.37; 95% CI 2.25-2.50) and reporting pain in consecutive check-ups (incidence rate ratio 2.56; 95% CI 2.29-2.87). In the northern Swedish population studied, the prevalence of orofacial pain increases over time and more so in women, thus indicating increasing differences in gender for orofacial pain.
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Affiliation(s)
- Birgitta Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå , Umeå , Sweden
| | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Aurelia Ilgunas
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå , Umeå , Sweden
| | - Corine M. Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Justin Durham
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle, United Kingdom
| | - Anna Lövgren
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå , Umeå , Sweden
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Elliott E, Sharma S, Omar A, Hurst D. How confidently do students address patients with psychiatric conditions in the dental clinic? A service evaluation in a UK dental school. Br Dent J 2020; 228:376-380. [PMID: 32170260 DOI: 10.1038/s41415-020-1319-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Extensive literature covers the relationship between psychiatric and dental health, but little research explores the ability of dental practitioners to confidently address patient mental health. This paper explored self-reported confidence of dental students when addressing patient mental health in a university setting.Methods Mixed-method approach involving a quantitative scenario-based survey and focus groups. Research participants were from years three, four and five of the Bachelor of Dental Surgery (BDS) degree.Results Survey data showed low confidence among dental students. Focus group themes included lack of education, prejudice and rejecting responsibility. Participants suggested communication skills workshops to help improve confidence.Discussion Self-reported confidence among dental students when addressing patient mental health was low, echoing wider literature findings. Focus groups highlighted an absence of patient mental health from the curriculum. Systematic reviews have recommended greater education around screening tools for 'assessing psychological comorbidity'. Using best practice, focus group data and psychologist guidance, we developed a communication skills case-based workshop for service improvement.Conclusion Low student confidence likely originates from limited focus within the BDS curriculum. The research will be expanded into other UK dental schools to explore the confidence of dental students nationally and to evaluate and trial the developed workshop.
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Affiliation(s)
- Emma Elliott
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Dental Hospital, Turner Street, London, E1 2AD, UK.
| | - Sathyam Sharma
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Dental Hospital, Turner Street, London, E1 2AD, UK
| | - Alya Omar
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Dental Hospital, Turner Street, London, E1 2AD, UK
| | - Dominic Hurst
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Dental Hospital, Turner Street, London, E1 2AD, UK
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Sharma S, Breckons M, Brönnimann Lambelet B, Chung J, List T, Lobbezoo F, Nixdorf DR, Oyarzo JF, Peck C, Tsukiyama Y, Ohrbach R. Challenges in the clinical implementation of a biopsychosocial model for assessment and management of orofacial pain. J Oral Rehabil 2019; 47:87-100. [DOI: 10.1111/joor.12871] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/18/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Sonia Sharma
- Department of Oral Diagnostic Sciences, School of Dental Medicine University at Buffalo Buffalo NY USA
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology Malmö University Malmö Sweden
| | | | - Ben Brönnimann Lambelet
- Psychiatric Services of District Aargau Ambulatory Center for Psychiatry and Psychotherapy Aarau Switzerland
| | - Jin‐Woo Chung
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry Seoul National University Seoul Korea
| | - Thomas List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology Malmö University Malmö Sweden
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Donald R. Nixdorf
- Division of TMD and Orofacial Pain, School of Dentistry University of Minnesota Minneapolis MN USA
| | - Juan Fernando Oyarzo
- TMD and Orofacial Pain, Faculty of Odontology Universidad Andres Bello Santiago Chile
| | - Christopher Peck
- Faculty of Dentistry The University of Sydney Surry Hills NSW Australia
| | - Yoshihiro Tsukiyama
- Section of Dental Education, Faculty of Dental Science Kyushu University Fukuoka Japan
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, School of Dental Medicine University at Buffalo Buffalo NY USA
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