1
|
Abdul Rahman IN, Khamis MF, Mohd Rokemi N. Assessing the Recordkeeping Quality at the School of Dental Sciences, Universiti Sains Malaysia. Cureus 2024; 16:e55087. [PMID: 38558581 PMCID: PMC10978150 DOI: 10.7759/cureus.55087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Dental records are an essential part of dental practice. The quality of dental recordkeeping is paramount in ensuring the delivery of high-quality dental care and is also important for medico-legal reasons. Should there be any dispute or need for review, detailed and well-maintained records can provide evidence of the care provided and the decision-making process. OBJECTIVE The study aimed to assess the quality of dental recordkeeping and dental charting practice at the dental clinic School of Dental Sciences. METHODS The study was conducted in a retrospective manner reviewing dental records of patients treated by specialists, dental officers, and postgraduate and undergraduate students at the Hospital Universiti Sains Malaysia over a five-year period. Eight key components of clinical dental records i.e. date of charting, legibility on the odontogram, no blank on the odontogram, whether any mistakes have been strikethrough and initials, medical history, dental history, investigation, and treatment plan were assessed. A modified CRABEL scoring system was used to assess the quality of data retrieved from dental records. RESULTS The study involved the analysis of 324 case files. Among these, 90 files obtained scores ranging from 60% to 80%, with 7.7% attributed to undergraduates, 9.6% to dental officers, 6.8% to postgraduates, and 3.7% to specialists. The remaining 234 files achieved scores between 80% and 100%, with a breakdown of 17% from undergraduates, 15.4% from dental officers, 18.2% from postgraduates, and 21.3% from specialists. CONCLUSION Even though the overall quality of recordkeeping in this study is good, with most records achieving a CRABEL score of 80% and above, it's important to acknowledge that ideally, each component assessed should achieve a perfect score of 100%, as it will reflect the practitioners's work.
Collapse
Affiliation(s)
| | - Mohd Fadhli Khamis
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, MYS
| | | |
Collapse
|
2
|
Abstract
During the 1990s, three Directives were enacted that aimed to harmonise the regulation of medical devices within the European Union (EU). Custom-made devices (CMDs) were subject to Council Directive 93/42/EEC of 14 June 1993 concerning medical devices (Medical Device Directive [MDD]), which was given effect in the UK by the Medical Devices Regulations 2002 (UK MDR 2002). Regulation (EU) 2017/745 (Medical Device Regulation [EU MDR]) replaced the MDD and was transposed into the Medical Devices (Amendment etc.) (EU Exit) Regulations 2019 in the UK. The UK left the EU on 31 January 2020 and entered an 11-month implementation period (IP), during which any new EU legislation that was enacted also took effect in the UK. The EU MDR was scheduled to be fully implemented on 26 May 2020 (during the IP) but this was deferred for one year, until 26 May 2021 (after the IP had concluded), as a result of the coronavirus disease 2019 (COVID-19) pandemic. Consequently, the EU MDR was removed from the UK statute book by a further amendment to the UK MDR 2002, the Medical Devices (Amendment etc.) (EU Exit) Regulations 2020. Since 1 January 2021, CMDs manufactured in Great Britain can conform to either the UK MDR 2002 (as amended) or the EU MDR (until 30 June 2023) while devices manufactured in Northern Ireland are subject to the EU MDR alone. CMDs must be supplied with a statement, a label and, depending on the risk class, instructions for use; this paper answers ten questions regarding this documentation following these legislative changes.
Collapse
Affiliation(s)
- James I J Green
- James I. J. Green DipSci (Den Tech), HNCSci (Den Tech), LBIDST, FOTA, MDTA Maxillofacial and Dental Laboratory Manager, Great Ormond Street Hospital for Children NHS Foundation Trust, London; Broomfield Hospital, Mid and South Essex NHS Foundation Trust, Chelmsford, UK
| |
Collapse
|
3
|
Ball R, Arya R, Patel J. Record-keeping in intravenous sedation: Are we meeting the standards? Prim Dent J 2022; 11:53-60. [PMID: 36073046 DOI: 10.1177/20501684221112481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
As primary care dental services continue to offer conscious sedation in practice, this article presents the findings from a record-keeping audit carried out at a dental teaching hospital in the UK. National guidance was used to set out the gold standards for record-keeping. Various shortcomings in terms of documentation were identified. This article enables dental practitioners involved in dental sedation to review their own sedation record-keeping to meet current national standards and ultimately improve clinical practice and the quality of patient care.
Collapse
Affiliation(s)
- Rebecca Ball
- Specialty Dentist in Oral Surgery, King's College Hospital, London, UK
| | - Richa Arya
- Dental Core Trainee, King's College Hospital, London, UK
| | - Jashme Patel
- Consultant in Oral Surgery, King's College Hospital, London, UK
| |
Collapse
|
4
|
Liew J, Winston M. Retrospective audit of midazolam dose and intravenous sedation record keeping in a primary care oral surgery service. Prim Dent J 2022; 11:50-57. [PMID: 35383494 DOI: 10.1177/20501684221085846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Regular and robust audit of conscious sedation practice is key to the delivery of safe and effective patient care in all clinical settings. Analysis of outcomes will help to highlight any necessary modifications to procedures and techniques. The Intercollegiate Advisory Committee for Sedation in Dentistry (IACSD) states that conscious sedation procedures must be the subject of robust and regular audit in which every member within the team takes part.1 This completed audit cycle highlighted the efficacy of intravenous (IV) midazolam in anxious patients undergoing oral surgical procedures and the suitability for its use in the primary care setting. No patient safety concerns or complications were recorded in this audit and midazolam was administered within the recommended dose range. By the conclusion of two audit cycles, all clinicians providing intravenous sedation within the service were aware of the missing elements in sedation record-keeping and were able to complete accurate contemporaneous records before, during and after conscious sedation, ensuring the continuous delivery of high-quality, safe, and patient-centred care.
Collapse
Affiliation(s)
- Jonathan Liew
- Specialty Registrar in Oral Surgery, Edinburgh Dental Institute, Edinburgh UK
| | - Michael Winston
- Tier 2 Specialist in Oral Surgery, Cheshire and Merseyside Primary Care Oral Surgery Service, Liverpool, UK
| |
Collapse
|
5
|
Thomas TK, Lenaker D, Day GM, Wilson JC, Holck P, Newman J, Bruden D, Hennessy TW. Using electronic dental records to establish a surveillance system for dental decay in rural Western Alaska. J Public Health Dent 2021; 81:224-231. [PMID: 33283270 PMCID: PMC8337052 DOI: 10.1111/jphd.12435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 10/20/2020] [Accepted: 11/24/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Previous surveys have demonstrated high rates of early childhood caries (ECC) in the Alaska Native (AN) population of western Alaska. There are many challenges to providing dental care in this road-less Yukon-Kuskokwim Delta region. The regional Tribal Health Organization implemented an electronic dental record (EDR) system in the late 1990s. We explored use of the EDR to establish an oral health surveillance system in children. METHODS We contracted with EDR software developers to implement calculation of a summary count of decayed (d), missing (m) or filled (f) primary (dmft) score for each individual. We calculated the yearly average dmft scores for 2011-2019 for children aged 3 and 5 years with a comprehensive exam in a given year. We also assessed the number of children undergoing full mouth dental rehabilitation (FMDR). We used US census data population estimates for these age groups to calculate rates. RESULTS Over the 9-year period, 2,427 3-year-old children (47 percent of all 3-year olds over this period), received a comprehensive exam; increasing from 24 percent in 2011 to 62 percent in 2019. Their average dmft score over the 9-years was 6.4 with a significant annual decline over this period. Seventy percent of AN children who turned 6 between 2015 and 2019 had received at least one FMDR. CONCLUSIONS An oral health surveillance system has been established in western Alaska using the Electronic Dental Record. High rates of ECC and FMDR were observed. This surveillance system will allow assessments of ECC prevalence and impact of dental interventions.
Collapse
Affiliation(s)
| | - Dane Lenaker
- Yukon Kuskokwim Health Corporation, Bethel, AK, USA
| | - Gretchen M Day
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Peter Holck
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Dana Bruden
- Arctic Investigation Program, Centers for Disease Control and Prevention, Anchorage, AK, USA
| | - Thomas W Hennessy
- Arctic Investigation Program, Centers for Disease Control and Prevention, Anchorage, AK, USA
| |
Collapse
|
6
|
Abstract
A custom-made device (CMD) is a medical device intended for the sole use of a particular patient. In a dental setting, CMDs include prosthodontic devices, orthodontic appliances, bruxism splints, speech prostheses and devices for the treatment of obstructive sleep apnoea, trauma prevention and orthognathic surgery facilitation (arch bars and interocclusal wafers). Since 1993, the production and provision of CMDs have been subject to European Union (EU) Directive 93/42/EEC (Medical Device Directive, MDD) given effect in the UK by The Medical Devices Regulations 2002 (Statutory Instrument 2002/618), and its subsequent amendments. Regulation (EU) 2017/745 (Medical Device Regulation, EU MDR) replaces the MDD and the other EU Directive pertaining to Medical Devices, Council Directive 90/385/EEC (Active Implantable Medical Device Directive, AIMDD). The EU MDR was published on 5 April 2017, came into force on 25 May 2017 and, following a three-year transition period was due to be fully implemented and repeal the MDD on 26 May 2020, but was deferred until 26 May 2021 due to the coronavirus disease 2019 (COVID-19) pandemic.In the UK, in preparation for the country's planned departure from the EU, the EU MDR, with necessary amendments, was transposed into UK law (Medical Devices (Amendment etc.) (EU Exit) Regulations 2019, UK MDR). The UK left the Union on 31 January 2020 and entered a transition period that ended on 31 December 2020, meaning that, from 1 January 2021, dental professionals in Great Britain who prescribe and manufacture CMDs are mandated to do so in accordance with the new legislation while Northern Ireland remains in line with the EU legislation and implementation date. This paper sets out the requirements that relate to the production and provision of CMDs in a UK dental setting.
Collapse
Affiliation(s)
- James I J Green
- Maxillofacial and Dental Laboratory Manager, Great Ormond Street Hospital for Children, NHS Foundation Trust, London; Broomfield Hospital, Mid and South Essex NHS Foundation Trust, Chelmsford, UK
| |
Collapse
|
7
|
Baan F, van Meggelen EM, Verhulst AC, Bruggink R, Xi T, Maal TJJ. Virtual occlusion in orthognathic surgery. Int J Oral Maxillofac Surg 2020; 50:1219-1225. [PMID: 33358521 DOI: 10.1016/j.ijom.2020.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/08/2020] [Accepted: 12/09/2020] [Indexed: 11/25/2022]
Abstract
The aim of this retrospective study was to determine whether a virtually created occlusion is as accurate as a conventionally created occlusion. Seventeen orthognathic patients were included in the study, which was conducted in a university clinic. Plaster cast models were obtained and digitized. Two experienced observers created the conventional (gold standard) and virtual occlusion to assess inter-observer variability. One observer created the conventional and virtual occlusion a second time to assess the intra-observer variability. The criterion for accepting the virtual occlusion was that the difference between the gold standard and the virtual occlusion was not larger than the intra-observer variability for the gold standard. A non-parametric Kruskal-Wallis H test was performed to detect statistically significant differences between the intra- and inter-observer groups for both the conventional and virtual occlusion. No statistically significant differences were found between the different groups. The difference between the conventional and virtual occlusion group was 0.20mm larger than the intra-observer variability of the gold standard. The virtual occlusion tool presented here can be utilized in daily clinical practice and makes the use of physical dental models redundant.
Collapse
Affiliation(s)
- F Baan
- Radboudumc 3DLab The Netherlands, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - E M van Meggelen
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A C Verhulst
- Radboudumc 3DLab The Netherlands, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - R Bruggink
- Radboudumc 3DLab The Netherlands, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - T Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - T J J Maal
- Radboudumc 3DLab The Netherlands, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands; Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
8
|
Blaschke K, Seitz MW, Schubert I, Listl S. Methodological approaches for investigating links between dental and chronic diseases with claims data: A scoping study. J Public Health Dent 2019; 79:334-342. [PMID: 31418874 DOI: 10.1111/jphd.12335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 06/28/2019] [Accepted: 07/19/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The purpose of this study was to provide an overview of methodological approaches to assess the relationship between dental diseases and other noncommunicable diseases on the basis of claims data. METHODS Based on the methodological framework of Arksey and O'Malley, a scoping study was conducted. By searching electronic databases (PubMed, Web of Science, and LILACS), appropriate articles were identified. After extracting relevant information and entering it into a data-charting form, the study characteristics and the methodological approaches were summarized descriptively. RESULTS Fifty-one articles were identified for inclusion in the analysis. Most of the selected studies (78 percent) originated from Taiwan and employed a cohort design. The majority of studies considered dental diseases, particularly periodontal disease (PD) measures, but no common standard was identified for the definition of PD. Unmeasured confounding, misclassification, and surveillance bias were reported to be the main limitations of the claims data analyses. CONCLUSIONS Claims data provide a very useful information source to further delineate the relationship between PDs and other noncommunicable diseases. If diagnostic codes are available, they seem to be the most suitable tool to assess PD in claims-based studies. In databases that do not contain dental diagnostic codes, e.g., databases in Germany and the United States, the identification of PD is a particular challenge. The inclusion of dental diagnostic codes in all claims databases is strongly recommended. Due to the public health relevance of PD, there is a need for more comprehensive documentation of dental parameters within claims data.
Collapse
Affiliation(s)
- Katja Blaschke
- PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Max W Seitz
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Ingrid Schubert
- PMV Research Group, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stefan Listl
- Section for Translational Health Economics, Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany.,Department of Dentistry - Quality and Safety of Oral Healthcare, Radboudumc (RIHS), Radboud University, Nijmegen, The Netherlands
| |
Collapse
|
9
|
Arora KS, Bansal R. The use of dental records as a tool for the Unique Identification Authority of India in personal identification: A proposal. J Forensic Dent Sci 2019; 10:119-122. [PMID: 31143058 PMCID: PMC6528540 DOI: 10.4103/jfo.jfds_80_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The Unique Identification Authority of India is a statutory authority established in 2009, which had started a campaign of issuing Aadhaar (unique identification) cards to every citizen of India under the slogan "Mera Aadhaar Meri Pehchaan" (my unique identification my identity). The government is taking all possible initiatives to make Aadhaar card the identity of an individual and is taking all measures of linking all the valid government-issued documents (such as driving license, PAN card, subsidies etc.) with this card. However, it is a matter of great sadness that some antisocial elements of the society forge or misuse the government-issued identity card and create a fake identity. To strengthen this initiative of unique identification, the dental records need to be amalgamated with this campaign. This article evaluates the importance of maintaining dental records and personal identification and also defines a proposal of linking these dental records to Aadhaar card in India.
Collapse
Affiliation(s)
- Karandeep Singh Arora
- Department of Oral Medicine and Radiology, M. M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Rahul Bansal
- Department of Oral Medicine and Radiology, M. M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| |
Collapse
|
10
|
Abstract
BACKGROUND When a dental practitioner is brought before a disciplinary body, a common finding is that dental records were poorly kept and inadequate to establish issues of consent for treatment or the nature of the treatment undertaken. Often this finding may be incidental to the actual issue that brought the practitioner before a regulatory body or the Courts. The aim of this study was to examine recent cases reported in the State of Victoria involving dental practitioners, specifically seeking those cases where the record keeping was found to be inadequate as an incidental finding. METHODS Published rulings of formal complaints and notification cases brought before disciplinary hearings in the State of Victoria for the period January 2000 to June 2014 were analysed with regards to orders made in respect to record keeping. RESULTS Complaints and notifications specific to dental record keeping accounted for less than 2% of formal complaints. And yet up to 75% of cases have made a finding of unprofessional conduct against a dental practitioner on the basis of inadequate record keeping, most often in combination with other breaches of conduct. CONCLUSIONS Adherence to the traditional format of handwriting or typing entries into patient records may contribute to the problem of poor record keeping in a clinical dental setting. Newer technologies such as digital intraoral and extraoral photography and audio-recording of patient interactions may offer a solution to the problems of record keeping.
Collapse
Affiliation(s)
- L F Brown
- School of Dentistry, The University of Queensland, Brisbane
| |
Collapse
|
11
|
Obadan-Udoh E, Simon L, Etolue J, Tokede O, White J, Spallek H, Walji M, Kalenderian E. Dental Providers' Perspectives on Diagnosis-Driven Dentistry: Strategies to Enhance Adoption of Dental Diagnostic Terminology. Int J Environ Res Public Health 2017; 14:E767. [PMID: 28703751 DOI: 10.3390/ijerph14070767] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/09/2017] [Accepted: 07/09/2017] [Indexed: 01/17/2023]
Abstract
The routine use of standardized diagnostic terminologies (DxTMs) in dentistry has long been the subject of academic debate. This paper discusses the strategies suggested by a group of dental stakeholders to enhance the uptake of DxTMs. Through unstructured interviewing at the 'Toward a Diagnosis-Driven Profession' National Conference held on 19 March 2016 in Los Angeles, CA, USA participants were asked how enthusiastic they were about implementing and consistently using DxTMs at their work. They also brainstormed on strategies to improve the widespread use of DxTMs. Their responses are summarized by recursive abstraction and presented in themes. Conference participants were very enthusiastic about using a DxTM in their place of work. Participants enumerated several strategies to make DxTMs more appealing including: the use of mandates, a value proposition for providers, communication and education, and integration with EHRs and existing systems. All groups across the dental healthcare delivery spectrum will need to work together for the success of the widespread and consistent use of DxTMs. Understanding the provider perspective is however the most critical step in achieving this goal, as they are the group who will ultimately be saddled with the critical task of ensuring DxTM use at the point of care.
Collapse
|
12
|
St. Sauver JL, Carr AB, Yawn BP, Grossardt BR, Bock-Goodner CM, Klein LL, Pankratz JJ, Finney Rutten LJ, Rocca WA. Linking medical and dental health record data: a partnership with the Rochester Epidemiology Project. BMJ Open 2017; 7:e012528. [PMID: 28360234 PMCID: PMC5372048 DOI: 10.1136/bmjopen-2016-012528] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The purpose of this project was to expand the Rochester Epidemiology Project (REP) medical records linkage infrastructure to include data from oral healthcare providers. The goal of this linkage is to facilitate research studies examining the role of oral health in overall health and quality of life. PARTICIPANTS Eight dental practices joined the REP between 2011 and 2015. The REP study team has linked oral healthcare information with medical record information from local healthcare providers for 31 750 participants who have resided in Olmsted County, Minnesota. Overall, 17 718 (56%) participants are women, 14 318 (45%) are 40 years of age or older and 26 090 (82%) are white. FINDINGS TO DATE A first study using this new information was recently completed. This resource was used to determine whether the 2007 guidelines from the American Heart Association affected prescription rates of antibiotics to patients with moderate-risk cardiac conditions prior to dental procedures. The REP infrastructure was used to identify a series of patients diagnosed with moderate-risk cardiac conditions by the local healthcare providers (n=1351), and to abstract antibiotic prescriptions from dental records both pre-2007 and post-2007. Antibiotic prescriptions prior to dental procedures declined from 62% to 7% following the change in guidelines. FUTURE PLANS Dental data from participating practitioners will be updated on an annual basis, and new dental data will be linked to patient medical records. In addition, we will continue to invite new dental practices to participate in the REP. Finally, we will continue to use this research infrastructure to investigate associations between oral and medical health, and will present findings at conferences and in the scientific literature.
Collapse
Affiliation(s)
- Jennifer L St. Sauver
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Alan B Carr
- Department of Dental Specialties, Mayo Clinic, Rochester, Minnesota, USA
| | - Barbara P Yawn
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
- Department of Research, Olmsted Medical Center, Rochester, Minnesota, USA
| | - Brandon R Grossardt
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Lori L Klein
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Joshua J Pankratz
- Department of Information Technology, Mayo Clinic, Rochester, Minnesota, USA
| | - Lila J Finney Rutten
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter A Rocca
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
13
|
Abstract
Forensic odontology is the branch of dentistry which deals with the proper handling, examination, evaluation and presentation of dental findings in the interest of justice. After major disasters and perimortem assaults such as earthquakes, fires, severe head and neck trauma or gross decomposition, accurate and early identification of dead and injured becomes important. In the absence of other records in such cases, identification is based on restorations, missing teeth and prosthetic devices such as partial and complete removable/fixed prosthesis or implant retained devices. This brings out the major role of prosthodontics to investigate the identity of suspects in the criminal cases as well as the deceased human beings in traumatic injuries or in disasters. Denture identification systems are being used as means of postmortem identification of edentulous persons which has evolved from the inclusion of some form of printed label in a denture to more high-tech methods. The provision of implant retained complete lower denture, antemortem, and postmortem radiographs of edentulous persons and correlation of bite marks using special impression techniques provide another potential source of evidence for human identification. Hence, this literature review throws some light on the role played by prosthodontist in forensic odontology.
Collapse
Affiliation(s)
- Anshul Chugh
- Department of Prosthodotics and Crown and Bridge, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Anumeha Narwal
- Department of Dental, BKN Hospital, Rohtak, Haryana, India
| |
Collapse
|
14
|
Wadhwani S, Shetty P, Sreelatha SV. Maintenance of antemortem dental records in private dental clinics: Knowledge, attitude, and practice among the practitioners of Mangalore and surrounding areas. J Forensic Dent Sci 2017; 9:78-82. [PMID: 29263612 PMCID: PMC5717777 DOI: 10.4103/jfo.jfds_64_15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction With time, an increase in the number of crimes, mass disasters, and wars, has led to the identification of the deceased or assailant critical. In such circumstances, antemortem dental records play a crucial role. Materials and Methods A cross-sectional survey involved 95 dentists practicing in and around Mangalore. The structured questionnaire comprised 24 questions regarding the practice of maintenance of dental records. The questionnaire was given either personally or sent by post. The data obtained was subjected to descriptive analysis. Results With 87% of the dentists maintaining records, only 31% of them recorded all the details required to be present in a dental record. Of these 18% of them maintained the records for >5 years. Conclusion The results suggest that most of the practicing dentists in this area either do not maintain or maintain inadequate records, which is alarming. Thus, there is a need to set protocols to increase the awareness for maintaining good dental records.
Collapse
Affiliation(s)
- Surbhi Wadhwani
- Department of Oral Pathology and Microbiology, College of Dental Sciences, Indore, Madhya Pradesh, India
| | - Pushparaja Shetty
- Department of Oral Pathology and Microbiology, A. B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - S V Sreelatha
- Department of Oral Pathology and Microbiology, A. B. Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| |
Collapse
|
15
|
Schwei KM, Cooper R, Mahnke AN, Ye Z, Acharya A. Exploring Dental Providers' Workflow in an Electronic Dental Record Environment. Appl Clin Inform 2016; 7:516-33. [PMID: 27437058 DOI: 10.4338/aci-2015-11-ra-0150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 04/01/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A workflow is defined as a predefined set of work steps and partial ordering of these steps in any environment to achieve the expected outcome. Few studies have investigated the workflow of providers in a dental office. It is important to understand the interaction of dental providers with the existing technologies at point of care to assess breakdown in the workflow which could contribute to better technology designs. OBJECTIVE The study objective was to assess electronic dental record (EDR) workflows using time and motion methodology in order to identify breakdowns and opportunities for process improvement. METHODS A time and motion methodology was used to study the human-computer interaction and workflow of dental providers with an EDR in four dental centers at a large healthcare organization. A data collection tool was developed to capture the workflow of dental providers and staff while they interacted with an EDR during initial, planned, and emergency patient visits, and at the front desk. Qualitative and quantitative analysis was conducted on the observational data. RESULTS Breakdowns in workflow were identified while posting charges, viewing radiographs, e-prescribing, and interacting with patient scheduler. EDR interaction time was significantly different between dentists and dental assistants (6:20 min vs. 10:57 min, p = 0.013) and between dentists and dental hygienists (6:20 min vs. 9:36 min, p = 0.003). CONCLUSIONS On average, a dentist spent far less time than dental assistants and dental hygienists in data recording within the EDR.
Collapse
Affiliation(s)
- Kelsey M Schwei
- Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation , Marshfield, Wisconsin, USA
| | | | - Andrea N Mahnke
- Biomedical Informatics Research Center, Marshfield Clinic Research Foundation , Marshfield, Wisconsin USA
| | - Zhan Ye
- Biomedical Informatics Research Center, Marshfield Clinic Research Foundation , Marshfield, Wisconsin USA
| | - Amit Acharya
- Institute for Oral and Systemic Health, Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA; Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin USA
| |
Collapse
|
16
|
Al-Azri AR, Harford J, James H. Awareness of forensic odontology among dentists in Australia: are they keeping forensically valuable dental records? Aust Dent J 2016; 61:102-108. [PMID: 25823701 DOI: 10.1111/adj.12316] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Forensic odontologists provide an important service to the community by identifying unknown deceased people, allowing both legal outcomes and family closure. Non-visual identification may be achieved by comparison of post-mortem data with ante-mortem dental records provided by oral health practitioners. Success is dependent largely on the accuracy and adequacy of data in the dental records. METHODS An online self-administered questionnaire evaluated Australian dentists' knowledge and behaviours relevant to forensic odontology. Reported record keeping practices were assessed for detail, legibility, accessibility and retention. Behaviours were classified according to the frequency of response. RESULTS Dentists reported overall reasonable awareness of the major applications of forensic odontology. Personal information and details of restorative treatment were recorded at high levels, while tooth anomalies, photography, additional patient details and denture marking were recorded inadequately. Legible tooth coding was reported at a high level, while other key legibility practices were recorded inadequately. Few of the behaviours related to retention or to maximize accessibility were recorded at a high level. CONCLUSIONS Australian dentists have high expectations of the forensic value of their dental records; however, many processes that would enhance the diagnostic, medico-legal and forensic value of dental records are not routinely applied.
Collapse
Affiliation(s)
- A R Al-Azri
- Forensic Odontology Unit, The University of Adelaide, South Australia, Australia.,Al-Nahdha Hospital, Ministry of Health, Muscat, Oman
| | - J Harford
- Australian Research Centre for Population Oral Health, The University of Adelaide, South Australia, Australia
| | - H James
- Forensic Odontology Unit, The University of Adelaide, South Australia, Australia
| |
Collapse
|
17
|
Wochna K, Smędra AK, Berent J, Szustowski S. Identification of unknown corpses through odontological examination - two case reports. Arch Med Sadowej Kryminol 2016; 66:158-71. [PMID: 28453169 DOI: 10.5114/amsik.2016.66400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The presented paper illustrates the significance of dental documentation which played a key role in the process of identification of two unknown male cadavers by means of dental features examination. Efficient operations of the district prosecutor's office, which in both cases provided ante mortem dental documentation of a missing person likely to be the victim, led to double positive identification. In the first presented case dental examination proved to be more effective than genetics and contributed to closure of the identification procedures. In the second case it confirmed identity equally with genetics. In addition, the paper discusses the basic rules of medical records handling and storage.
Collapse
|
18
|
Abstract
INTRODUCTION Forensic odontology or forensic dentistry is that aspect of forensic science that uses the application of dental science for the identification of unknown human remains and bite marks. Deaths resulting from mass disasters such as plane crash or fire incidence have always been given mass burial in Nigeria. This was obviously due to the fact that Forensic Pathologists whose roles involve disaster victim identification were not available at that time. However, in the DANA air crash in Lagos in 2012, the Forensic pathologist and dental teams were invited for the first time to identify the victims. The objectives of this paper are to identify the extent of victims' identification using Forensic odontology alone and its combination with DNA analysis. It also presents the pattern of fractures seen in the mandible and maxilla of the victims. METHODS The bodies were dissected using following the standard protocol dissection. Prior to this all the victims had Dental Radiological Examination. The oral cavities were exposed after which the Odontology team was invited for photographing first, followed by dental charting. Fractures of the mandible, maxilla including the anatomical regions were all recorded and photographed. Dental prosthesis, restorations, crowns and bridge and other findings were also noted, recorded and compared with ante mortem records where available. RESULTS A total of 152 bodies were recovered from the crash site while 148 victims were eventually identified through a combination of DNA analysis and forensic odontology. This represented 97.4%. Forensic odontology was the primary identifier in 10%. There were no fingerprinting information in this country at present therefore, it could not be used. A total of 89 (60%) were males while females accounted for 59(40%). This gives a ratio of 1.5:1. Most of the victims were in the age group 30-49 years; this represented 52% of the victims while the least involved age groups were victims above 60 years of age which accounted for only 4.7%. Mandibular fractures were seen in 29 victims, maxilla in 15, combined mandibullo/maxillary in 15 victims, while 89 victims had no jaw fracture. The most common area of fracture in the mandible was the body which accounted for 36.4%, closely followed by parasymphyseal region 31.9%, symphyseal 22.7% and the angle 9.0%. The most common fracture in the maxillae was palatal split fracture which accounted for 52%, this was followed by pterygoid 24%, alveolar 8% and multiple locations 16%. CONCLUSION A combination of DNA analysis and forensic odontology was able to identify a total of 148 victims out of 152 representing 97.4%. Forensic odontology was the primary identifier in only 10%. In the latter, poor and lack of dental records were responsible for this very low figure. The most common area of fracture in the mandible was the body which accounted for 36.4%, while that of the maxillae was palatal fracture which accounted for 52%. Padding of the back of the seats in the aircraft should be canvassed for to provide Cushing effect for passengers.
Collapse
Affiliation(s)
- John Oladapo Obafunwa
- Office of the Chief Medical Examiner, Department of Pathology and Forensic Medicine, Lagos State University College of Medicine and Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Victor Olabode Ogunbanjo
- Department of Oral Maxillofacial Surgery, Lagos State University College of Medicine and Teaching Hospital, Ikeja, Lagos
| | - Ogunbiyi Babatunde Ogunbanjo
- Department of Child Dental Health, Lagos State University College of Medicine and Teaching Hospital, Ikeja, Lagos
| | - Sunday Sokunle Soyemi
- Office of the Chief Medical Examiner, Department of Pathology and Forensic Medicine, Lagos State University College of Medicine and Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Francis Adedayo Faduyile
- Office of the Chief Medical Examiner, Department of Pathology and Forensic Medicine, Lagos State University College of Medicine and Teaching Hospital, Ikeja, Lagos, Nigeria
| |
Collapse
|
19
|
Abstract
Introduction: The patient’s record maintains all the diagnostic information with regards to patients and contains valuable information that can be beneficial to the dentist as well as legal authorities during forensic human identification. Aim: Objective of the study was to compare dental records with an ideal dental record form, as well as to compare between dental records of private clinics and academic hospitals and to assess the awareness and the knowledge of the dentists regarding the maintenance of their dental records accurate for medico-legal purposes. Material and Methods: A comparative cross-sectional study between records kept in private clinics and academic teaching hospitals in Khartoum locality. Results: Our results showed that Students are more likely to encounter accurate dental records more than dentists in private clinics. In conclusion Students are more aware regarding medicolegal purposes of maintenance of dental records. Accurate maintenance of dental records is more among dental students. Therefore, private clinics encounter dental records as financial documents.
Collapse
Affiliation(s)
- Petro Waleed
- Department of oral Maxillofacial Sciences. Al Farabi Colleges. Kingdom of Saudi Arabia, Riyadh
| | - Feras Baba
- Department of orthodontics, Faculty of Dentistry, Aleppo, Syria
| | - Salem Alsulami
- Department of oral Maxillofacial Sciences. Al Farabi Colleges. Kingdom of Saudi Arabia, Riyadh
| | - Bassel Tarakji
- Department of oral Maxillofacial Sciences. Al Farabi Colleges. Kingdom of Saudi Arabia, Riyadh
| |
Collapse
|
20
|
Hebballi NB, Ramoni R, Kalenderian E, Delattre VF, Stewart DCL, Kent K, White JM, Vaderhobli R, Walji MF. The dangers of dental devices as reported in the Food and Drug Administration Manufacturer and User Facility Device Experience Database. J Am Dent Assoc 2015; 146:102-10. [PMID: 25637208 PMCID: PMC4313571 DOI: 10.1016/j.adaj.2014.11.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/29/2014] [Accepted: 11/07/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The authors conducted a study to determine the frequency and type of adverse events (AEs) associated with dental devices reported to the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. METHODS The authors downloaded and reviewed the dental device-related AEs reported to MAUDE from January 1, 1996, through December 31,2011. RESULTS MAUDE received a total of 1,978,056 reports between January 1, 1996, and December 31, 2011. Among these reports, 28,046 (1.4%) AE reports were associated with dental devices. Within the dental AE reports that had event type information, 17,261 reported injuries, 7,777 reported device malfunctions, and 66 reported deaths. Among the 66 entries classified as death reports, 52 reported a death in the description; the remaining were either misclassified or lacked sufficient information in the report to determine whether a death had occurred. Of the dental device-associated AEs, 53.5% pertained to endosseous implants. CONCLUSIONS A plethora of devices are used in dental care. To achieve Element 1 of Agency for Healthcare Research and Quality's Patient Safety Initiative, clinicians and researchers must be able to monitor the safety of dental devices. Although MAUDE was identified by the authors as essentially the sole source of this valuable information on adverse events, their investigations led them to conclude that MAUDE had substantial limitations that prevent it from being the broad-based patient safety sentinel the profession requires. PRACTICAL IMPLICATIONS As potential contributors to MAUDE, dental care teams play a key role in improving the profession's access to information about the safety of dental devices.
Collapse
|
21
|
Abstract
BACKGROUND AND OVERVIEW Dentists have much invested in their practices. They need to protect their practices from fraud and noncompliance. The author provides practical suggestions for how to significantly reduce the risk of fraud and theft in the practice without disrupting day-to-day operations. CONCLUSIONS By adhering to nonintrusive policy and procedure changes, dental practice owners can reduce inherent risks of fraud and theft, while increasing financial and human resource knowledge regarding their practice. PRACTICAL IMPLICATIONS Practice owners with the appropriate policies and procedures benefit from significantly lower risk of loss from fraud and theft. Furthermore, they have a better understanding of their practice's finances and human resources.
Collapse
|
22
|
Riley AD. The role of the dentist in identifying missing and unidentified persons. Gen Dent 2015; 63:54-57. [PMID: 25574720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The longer a person is missing, the more profound the need for dental records becomes. In 2013, there were >84,000 missing persons and >8,000 unidentified persons registered in the National Crime Information Center (NCIC) database. Tens of thousands of families are left without answers or closure, always maintaining hope that their relative will be located. Law enforcement needs the cooperation of organized dentistry to procure dental records, translate their findings, and upload them into the NCIC database for cross-matching with unidentified person records created by medical examiner and coroner departments across the United States and Canada.
Collapse
|
23
|
Abstract
Forensic odontology plays a major role in the identification of those individuals who cannot be identified visually or by other means. The unique nature of dental anatomy and placement of custom restorations ensure accuracy when the techniques are correctly employed. It is evident that identification of victims in accidents and natural calamities is of utmost importance and is a challenging task. The teeth may also be used as weapons and under certain circumstances; they may provide information regarding the identity of the biter. Dental professionals play a major role in keeping accurate dental records and providing all necessary information so that legal authorities may recognize malpractices, negligence, fraud child abuse and also, identify an individual. In this article, we will discuss such evolvement of the subject.
Collapse
Affiliation(s)
- Shalini Gupta
- Department of Oral Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Archana Agnihotri
- Department of Forensic Science, Sam Higginbotom Institute of Agriculture, Technology and Sciences (Deemed University), Allahabad, Uttar Pradesh, India
| | - Akhilesh Chandra
- Department of Oral Pathology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Om Prakash Gupta
- Department of General Surgery, Carrier Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| |
Collapse
|
24
|
Modesti LDM, Vieira GM, Galvão MF, de Amorim RFB. Human identification by oral prosthesis analysis with probability rates higher than DNA analysis. J Forensic Sci 2014; 59:825-9. [PMID: 24749854 DOI: 10.1111/1556-4029.12404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 01/11/2013] [Accepted: 04/20/2013] [Indexed: 11/27/2022]
Abstract
Several techniques are used to perform an appropriate and reliable human identification. Forensic dentistry has achieved great relevance over the past years. The aim of this article is to report the method used for the identification of a male body found in the colliquative stage of putrefaction. The identification of the victim was succeeded confronting the dental findings found in the corpse with the data present on dental records provided by his dentist. The major elements for the identity's recognition were a metal core and a prosthetic crown that were being fabricated. These elements associated with the dental records were compelling for the elucidation of the case, and a positive body identification was achieved with high levels of probability. In the present case, cadaveric analysis of stomatognathic system structures achieved a probability value higher than DNA identification techniques, emphasizing the importance of forensic dentistry.
Collapse
Affiliation(s)
- Luana D M Modesti
- University of Planalto Central (UNIPLAC), SHIS, QI 07 Conjunto 10 Bloco E, Lago Sul Brasília, Brazil
| | | | | | | |
Collapse
|
25
|
Sengupta S, Sharma V, Gupta V, Vij H, Vij R, Prabhat K. Forensic odontology as a victim identification tool in mass disasters: A feasibility study in the Indian scenario. J Forensic Dent Sci 2014; 6:58-61. [PMID: 24695834 PMCID: PMC3970390 DOI: 10.4103/0975-1475.127774] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aim: The aim of this study was to evaluate the awareness of practicing dentists about the subject of forensic odontology and to assess their willingness to maintain and share patient records. Materials and Methods: A blind questionnaire survey was carried out among 100 randomly selected practicing dentists in district Ghaziabad, Uttar Pradesh. Results: Most of the dentists interviewed were familiar with the subject of forensic odontology and its relation to dentistry, despite forensic dentistry having been newly introduced since 2007 into the undergraduate dental curriculum in India. However, dental records are maintained by only a few dentists, and only a very small percentage of them reported to have shared records, which may have helped in the identification of victims in a mass disaster. Conclusion: The result of our survey concluded that more awareness needs to be developed among practicing dentists regarding maintaining and sharing patient records for forensic odontology to succeed as a victim identification tool.
Collapse
Affiliation(s)
- Shamindra Sengupta
- Department of Oral and Maxillofacial Pathology, D. J. College of Dental Sciences and Research, Ghaziabad, Uttar Pradesh, India
| | - Vandana Sharma
- Department of Oral and Maxillofacial Pathology, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Vineeta Gupta
- Department of Oral and Maxillofacial Pathology, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Hitesh Vij
- Department of Oral and Maxillofacial Pathology, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Ruchieka Vij
- Department of Oral and Maxillofacial Pathology, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Kanika Prabhat
- Department of Oral and Maxillofacial Pathology, Institute of Dental Studies and Technologies, Modinagar, Ghaziabad, Uttar Pradesh, India
| |
Collapse
|
26
|
Rush WA, Schleyer TKL, Kirshner M, Boyle R, Thoele MJ, Lenton PA, Asche S, Thyvalikakath T, Spallek H, Durand EC, Enstad CJ, Huntley CL, Rindal DB. Integrating tobacco dependence counseling into electronic dental records: a multi-method approach. J Dent Educ 2014; 78:31-39. [PMID: 24385522 PMCID: PMC6697074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Dentistry has historically seen tobacco dependence as a medical problem. As a consequence, dentistry has not adopted or developed effective interventions to deal with tobacco dependence. With the expanded use of electronic dental records, the authors identified an opportunity to incorporate standardized expert support for tobacco dependence counseling during the dental visit. Using qualitative results from observations and focus groups, a decision support system was designed that suggested discussion topics based on the patient's desire to quit and his or her level of nicotine addiction. Because dental providers are always pressed for time, the goal was a three-minute average intervention interval. To fulfill the provider's need for an easy way to track ongoing interventions, script usage was recorded. This process helped the provider track what he or she had said to the patient about tobacco dependence during previous encounters and to vary the messages. While the individual elements of the design process were not new, the combination of them proved to be very effective in designing a usable and accepted intervention. The heavy involvement of stakeholders in all components of the design gave providers and administrators ownership of the final product, which was ultimately adopted for use in all the clinics of a large dental group practice in Minnesota.
Collapse
Affiliation(s)
- William A Rush
- HealthPartners Institute for Education and Research, 8170 33rd Ave. S., Mail Stop 21111R, Minneapolis, MN 55425;.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Hoogeveen RC, Guicherit PJ, Gopie SR, van der Stelt PF, Berkhout WER. Validation of anatomically shaped cranial collimation (ACC) in orthodontic lateral cephalography. Dentomaxillofac Radiol 2014; 43:20130396. [PMID: 24720607 PMCID: PMC4064623 DOI: 10.1259/dmfr.20130396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/01/2014] [Accepted: 01/08/2014] [Indexed: 11/05/2022] Open
Abstract
The use of an anatomically shaped cranial collimator (ACC) to reduce patient dose in orthodontic lateral cephalography was investigated in this study. The aim was to evaluate the potential interference of the ACC on landmark identification for orthodontic cephalometry. Consecutive orthodontic patients underwent a total of 100 cephalograms using an ACC mounted on a Veraviewepocs(®) 3D X550 (J. Morita Co., Kyoto, Japan) X-ray unit. 10 observers were asked whether the identification of 5 landmarks close to the collimated area was hindered or rendered impossible by the presence of the collimator. Of the 500 landmarks that were judged by the 10 observers, 496 (99.2%) were reported to lack hindrance. In three landmarks, a minority of the observers reported hindrance. In 1 landmark, 8 of the 10 observers reported hindrance by the collimator. In no instance did the observers state that the identification of landmarks was impossible as a result of the collimation. Application of the ACC on the cephalostat of the X-ray unit is a viable way of reducing patient dose, as it only marginally interferes with the diagnostic yield of the exposure. The need to retake images when the ACC is applied was found to be extremely low.
Collapse
Affiliation(s)
- R C Hoogeveen
- Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam, Amsterdam, Netherlands
| | | | | | | | | |
Collapse
|
28
|
Hoogeveen RC, van der Stelt PF, Berkhout WER. Anatomically shaped cranial collimation (ACC) for lateral cephalometric radiography: a technical report. Dentomaxillofac Radiol 2013; 43:20130203. [PMID: 24170799 PMCID: PMC3887481 DOI: 10.1259/dmfr.20130203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Lateral cephalograms in orthodontic practice display an area cranial of the base of the skull that is not required for diagnostic evaluation. Attempts have been made to reduce the radiation dose to the patient using collimators combining the shielding of the areas above the base of the skull and below the mandible. These so-called “wedge-shaped” collimators have not become standard equipment in orthodontic offices, possibly because these collimators were not designed for today's combination panoramic–cephalometric imaging systems. It also may be that the anatomical variability of the area below the mandible makes this area unsuitable for standardized collimation. In addition, a wedge-shaped collimator shields the cervical vertebrae; therefore, assessment of skeletal maturation, which is based on the stage of development of the cervical vertebrae, cannot be performed. In this report, we describe our investigations into constructing a collimator to be attached to the cephalostat and shield the cranial area of the skull, while allowing the visualization of diagnostically relevant structures and markedly reducing the size of the irradiated area. The shape of the area shielded by this “anatomically shaped cranial collimator” (ACC) was based on mean measurements of cephalometric landmarks of 100 orthodontic patients. It appeared that this collimator reduced the area of irradiation by almost one-third without interfering with the imaging system or affecting the quality of the image. Further research is needed to validate the clinical efficacy of the collimator.
Collapse
Affiliation(s)
- R C Hoogeveen
- Department of Maxillofacial Radiology, Academic Center for Dentistry, Amsterdam ACTA, Amsterdam, Netherlands
| | | | | |
Collapse
|
29
|
Abstract
Anecdotal evidence suggests that, during the clinical care process, many dental practices record some data that are also collected in dental practice based research network (PBRN) studies. Since the use of existing, electronically stored data for research has multiple benefits, we investigated the overlap between research data fields used in dental PBRN studies and clinical data fields typically found in general dental records. We mapped 734 unique data elements from the Dental Information Model (DIM) to 2,487 Common Data Elements (CDE) curated by the NIDCR's PBRNs in the Cancer Data Standards Registry and Repository (caDSR). Thirty-three percent of the DIM data elements matched at least one CDE completely and 9% partially, translating to about 9% and 2%, respectively, of all data elements used in PBRN studies. The most frequently used CDEs found in the DIM included data about dental anatomy, medications, and items such as oral biopsy and caries. Our study shows that a non-trivial number of data elements in general dental records can be mapped either completely or partially to data fields in research studies. Further studies should investigate the feasibility of electronic clinical data for research purposes.
Collapse
Affiliation(s)
- K Liu
- Center for Dental Informatics, Department of Dental Public Health, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15261, USA.
| | | | | | | |
Collapse
|
30
|
Abstract
BACKGROUND The randomized case presentation (RCP) study is designed to assess the degree of diagnostic accuracy for described periodontal cases. This is to lay the basis for practitioner calibration in the Practitioners Engaged in Applied Research and Learning (PEARL) Network for future clinical studies. METHODS The RCP consisted of 10 case scenarios ranging from periodontal health to gingivitis and mild, moderate, and severe periodontitis. Respondents were asked to diagnose the described cases. Survey diagnoses were compared to two existing classifications of periodontal disease status. The RCP was administered via a proprietary electronic data capture system maintained by the PEARL Data Coordinating Center. Standard analytic techniques, including frequency counts and cross-tabulations, were used for categorical data with mean and standard deviation and median values reported for continuous data elements. RESULTS Demonstrable variations in periodontal assessment for health, gingivitis, and mild, moderate, and severe periodontitis were found among the 130 PEARL general practitioners who participated in the RCP survey. The highest agreement for diagnosis among dentists was for severe periodontitis (88%) and the lowest for gingivitis (55%). The highest percentage of variation was found in cases with health and gingivitis. CONCLUSIONS There was variation among PEARL practitioners in periodontal diagnosis that may affect treatment outcomes. Our findings add clinical support to recent publications suggesting a need for standardization of terminology in periodontitis diagnosis.
Collapse
Affiliation(s)
- John A. Martin
- Practitioners Engaged in Applied Research and Learning (PEARL) Network, private practice, State College, PA
- PreViser, Mt. Vernon, WA
| | - Ashley C. Grill
- Department of Dental Hygiene, New York City College of Technology, City University of New York, Brooklyn, NY
- PEARL Network, College of Dentistry, New York University, New York, NY
| | | | - Don Vena
- PEARL Network, EMMES Corporation, Rockville, MD
| | - Van P. Thompson
- Currently, PEARL Network, King’s College London Dental Institute, London, UK; previously, PEARL Network, Department of Biomaterials and Biomimetics, College of Dentistry, New York University
| | - Ronald G. Craig
- PEARL Network, Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University
| | - Frederick A. Curro
- PEARL Network, Department of Oral Pathology, Medicine and Radiology, College of Dentistry, New York University
| |
Collapse
|
31
|
Kuthy RA, Pendharkar B, Momany ET, Jones MP, Askelson NM, Chi DL, Wehby GL, Damiano PC. Factors affecting age at first dental exam for Medicaid-enrolled children seen at Federally Qualified Health Centers. Pediatr Dent 2013; 35:E100-6. [PMID: 23756303 PMCID: PMC4209902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The purpose of this study was to estimate age at first dental visit (FDV) and identify variables predicting earlier visits for Medicaid-enrolled children at Iowa Federally Qualified Health Centers (FQHC). METHODS Statewide Medicaid claims data were used to draw a random sample of children who received their FDV prior to six years old at a FQHC, were Medicaid-enrolled within the first two months of life, and remained continuously enrolled over the study period. Forty children from each of five FQHCs had their dental charts abstracted and merged with other Medicaid records and birth certificate data. The logarithmic age at FDV was regressed against several predictor variables. RESULTS Mean and median ages for FDV were 25.6 and 23 months old, respectively. When controlling for other variables, there were differences in FDV age according to: mother's marital status (P=.04); whether the child had any medical well-child visits (MCVs) at a FQHC prior to the FDV (P<.001); and which FQHC the child visited. Only approximately 28 percent of these children, however, had any MCV at the FQHC. CONCLUSIONS Medicaid-enrolled children who visited Federally Qualified Health Centers for their first dental visit were seen at an earlier age than previously recorded for such health centers (mean=four years old). Children who also received any medical well-child visits at FQHCs were more likely to have earlier FDVs.
Collapse
Affiliation(s)
- Raymond A Kuthy
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Dar-Odeh N, Ryalat S, Shayyab M, Abu-Hammad O. Analysis of clinical records of dental patients attending Jordan University Hospital: Documentation of drug prescriptions and local anesthetic injections. Ther Clin Risk Manag 2011; 4:1111-7. [PMID: 19209291 PMCID: PMC2621415 DOI: 10.2147/tcrm.s3727] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES THE AIM OF THIS STUDY WAS TO ANALYZE CLINICAL RECORDS OF DENTAL PATIENTS ATTENDING THE DENTAL DEPARTMENT AT THE UNIVERSITY OF JORDAN HOSPITAL: a teaching hospital in Jordan. Analysis aimed at determining whether dental specialists properly documented the drug prescriptions and local anesthetic injections given to their patients. METHODS Dental records of the Dental Department at the Jordan University Hospital were reviewed during the period from April 3rd until April 26th 2007 along with the issued prescriptions during that period. RESULTS A total of 1000 records were reviewed with a total of 53 prescriptions issued during that period. Thirty records documented the prescription by stating the category of the prescribed drug. Only 13 records stated the generic or the trade names of the prescribed drugs. Of these, 5 records contained the full elements of a prescription. As for local anesthetic injections, the term "LA used" was found in 22 records while the names and quantities of the local anesthetics used were documented in only 13 records. Only 5 records documented the full elements of a local anesthetic injection. CONCLUSION The essential data of drug prescriptions and local anesthetic injections were poorly documented by the investigated group of dental specialists. It is recommended that the administration of the hospital and the dental department implement clear and firm guidelines for dental practitioners in particular to do the required documentation procedure.
Collapse
Affiliation(s)
- Najla Dar-Odeh
- Department of Oral and Maxillofacial Surgery Oral Medicine and Periodontics, Faculty of Dentistry, University of Jordan, Jordan
| | | | | | | |
Collapse
|