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Wilson A, Hoang H, Bridgman H, Crocombe L, Bettiol S. Clinical practice guidelines and consensus statements for antenatal oral healthcare: An assessment of their methodological quality and content of recommendations. PLoS One 2022; 17:e0263444. [PMID: 35113944 PMCID: PMC8812839 DOI: 10.1371/journal.pone.0263444] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 01/19/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To review the content of recommendations within antenatal oral healthcare guidance documents and appraise the quality of their methodology to inform areas of development, clinical practice, and research focus. METHOD A systematic search of five electronic databases, Google search engine, and databases from relevant professional and guideline development groups published in English, developed countries, and between 2010 and 2020 was undertaken to identify guidance documents related to antenatal oral healthcare. Quality of documents was appraised using the Appraisal of Guidelines Research and Evaluation II tool, and a 3-step quality cut-off value was used. Inductive thematic analysis was employed to categories discreet recommendations into themes. RESULTS Six guidelines and one consensus statement were analysed. Two documents developed within Australia scored ≥60% across five of the six domains of the quality appraisal tool and were recommended for use. Four documents (developed in the United States and Canada) were recommended for use with modifications, whilst one document (developed in Europe) was not recommended. A total of 98 discreet recommendations were identified and demonstrated considerable unanimity but differed in scope and level of information. The main content and number of recommendations were inductively categorised within the following clinical practice points: risk factor assessments (n = 2), screening and assessment (n = 10), pre-pregnancy care (referral, n = 1), antenatal care (health education and advice, n = 14; management of nausea and vomiting, n = 7; referral, n = 2), postnatal care (health education and advice, n = 1; anticipatory guidance, n = 6), documentation (n = 4), coordinated care (n = 4), capacity building (n = 6), and community engagement (n = 1). CONCLUSION The methodological rigour of included guidance documents revealed areas of strengths and limitations and posit areas for improvement. Further research could centre on adapting antenatal oral healthcare guidelines and consensus statements to local contexts. More high-quality studies examining interventions within antenatal oral healthcare are needed to support the development of recommendations.
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Affiliation(s)
- Annika Wilson
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Leonard Crocombe
- Dentistry & Oral Health, Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Silvana Bettiol
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Parvaie P, Osmani F. Dentistry during COVID-19: patients' knowledge and satisfaction toward health protocols COVID-19 during dental treatment. Eur J Med Res 2022; 27:3. [PMID: 35016707 PMCID: PMC8749922 DOI: 10.1186/s40001-021-00629-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/30/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) as an infectious disease primarily spreading through droplet infection in dental treatment. Patient satisfaction is an indicator of healthcare quality service. Quality of healthcare service and patient satisfaction has been affected by the COVID‑19 pandemic. This study aims to assess the knowledge and satisfaction toward health protocols COVID-19 during dental treatment among dental patients. METHODS An institutional-based cross-sectional study was conducted on 270 dental patients using a self‑designed questionnaire consisting of knowledge and satisfaction about health protocols COVID-19 during dental treatment through a random sampling technique. Data were imported to SPSS version 21 for analysis. Descriptive and analytical statistics were used to identify the factors associated with their knowledge and satisfaction. A p value < 0.05 was considered statistical significance. RESULTS Totally, 270 dental patients with mean age of 37.6 ± 6.7 years participated in the study. The mean knowledge score was 36.7 ± 3.5, as considerable number of participants were unaware about the risk associated with dental treatment as well as restrictions imposed on dental procedures. About 18% of participants experienced one or other form of dental complaints during the lockdown period. The overall level of patient satisfaction was 44.6%. CONCLUSION It can be concluded that, public knowledge is to be improved about risk of virus transmission that can be related with dental treatment and also people should be encouraged to use virtual facilities, such as teledentistry, so that no dental emergencies is left untreated during the pandemic time. In addition, the level of satisfaction was in a medium level for dental patients in the study area. Specifically, we deduced from the results that social/physical distancing measures are one of the mechanisms to decrease the fear of exposure to the COVID-19.
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Affiliation(s)
- Parvin Parvaie
- Dentistry Clinical Research Development Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Freshteh Osmani
- Dentistry Clinical Research Development Center, Birjand University of Medical Sciences, Birjand, Iran
- Infectious Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Jamleh A, Nassar M, Alissa H, Alfadley A. Evaluation of YouTube videos for patients' education on periradicular surgery. PLoS One 2021; 16:e0261309. [PMID: 34890439 PMCID: PMC8664221 DOI: 10.1371/journal.pone.0261309] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to evaluate the content of periradicular surgery-related YouTube videos available for patients' education. YouTube search was made for videos related to periradicular surgery using specific terms. After exclusions, 42 videos were selected, viewed and assessed by two independent observers. The videos were assessed in terms of duration, days since upload, country of upload, number of views, likes and dislikes, authorship source, viewing rate and interaction index. To grade the content of videos about periradicular surgery, a usefulness score was created with 10 elements based mainly on the American Association of Endodontists guidelines. Each element was given a score of 0 or 1. SPSS software (SPSS Inc, Chicago, IL, USA) was used to analyze data at a 95% confidence level. An inter-evaluator reliability analysis for the scoring system was performed using the Kappa statistic. The videos received an average of 35103.9 views (range: 9-652378) with an average duration of 338.71 seconds (range: 42-2081), respectively. Most videos were provided by individuals (57%). Half of the videos were posted by authors from the United States. The inter-evaluator reliability for usefulness scoring was 94.5%. No video covered the 10 scoring elements completely, presenting very low usefulness scores (mean: 3.2; range: 1-7). The most discussed elements were supporting media (100%) and steps of the procedure (90.5%) followed by indications and contraindications (45.2%) and symptoms (31%). None of the included videos discussed the procedure's cost or prognosis. In terms of usefulness score, no significant difference was detected between different sources of upload (chi-square test, P > 0.05). Information on periradicular surgery in YouTube videos is not comprehensive and patients should not rely on YouTube as the only source of information. Dental professionals should enrich the content of YouTube with good quality videos by providing full and evidence-based information that will positively affect patients' attitudes and satisfaction.
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Affiliation(s)
- Ahmed Jamleh
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
- * E-mail:
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hamad Alissa
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Abdulmohsen Alfadley
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Lin IH, Huang MS, Wang PY, Huang TS, Chong SY, Chen SLS, Tsai HH. A comparative study of propofol alone and propofol combined with midazolam for dental treatments in special needs patients. Medicine (Baltimore) 2021; 100:e26199. [PMID: 34087890 PMCID: PMC8183838 DOI: 10.1097/md.0000000000026199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 05/12/2021] [Indexed: 01/04/2023] Open
Abstract
Although dental treatment with sedation is performed increasingly in special needs patients, data on adding midazolam to intravenous propofol sedation are very limited for this group. The purpose of this study was to identify the factors and procedure time associated with the use of intravenous sedation with propofol alone or propofol combined with midazolam in dental patients with special needs.This was a retrospective data analysis. The sedation medications and relevant covariates, including demographic parameters, disability levels, oral health conditions, dental procedures, treatment time, and side effects, of 718 patients with special needs were collected between April 2013 and September 2014. The unfavorable side effects by sedation types were reported. Factors associated with procedure time and the sedation medications were assessed with multiple logistic regression analyses.Of 718 patients, 8 patients experienced unfavorable side effects (vomiting, sleepiness, or emotional disturbance) after the dental procedures; the rate was 0.6% in the 509 patients who received propofol only. In 209 patients who received propofol and midazolam, 2.4% experienced the side effects. Sedation time was associated with body mass index (BMI) < 25 (adjusted odds ratio [aOR] = 1.45, 95% confidence interval [CI]: 1.04-2.04) and the performance of multiple dental procedures (aOR = 1.44, 95% CI: 1.06-1.97) but not associated with the sedation types. A significant odds ratio for the combined use of propofol and midazolam was shown for adolescents (aOR = 2.22, 95% CI: 1.28-3.86), men (aOR = 2.05, 95% CI: 1.41-2.98), patients with cognitive impairment (aOR = 1.99, 95% CI: 1.21-3.29), and patients undergoing scaling procedures (aOR = 1.64, 95% CI: 1.13-2.39).With the acceptable side effects of the use of propofol alone and propofol combined with midazolam, multiple dental procedures increase the sedation time and the factors associated with the combined use of propofol and midazolam are younger age, male sex, recognition problems, and the type dental procedure in the dental treatment of patients with special needs.
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Affiliation(s)
- I-Hsin Lin
- Department of Dentistry, Taipei Medical University Shuang Ho Hospital
| | - Mao-Suan Huang
- Department of Dentistry, Taipei Medical University Shuang Ho Hospital
| | - Pei-Yu Wang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University
| | - Ta-Sen Huang
- Department of Dentistry, Taipei Medical University Shuang Ho Hospital
| | | | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University
| | - Hung-Huey Tsai
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
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Abstract
BACKGROUND There is ongoing debate about the frequency with which patients should attend for a dental check-up and the effects on oral health of the interval between check-ups. Recommendations regarding optimal recall intervals vary between countries and dental healthcare systems, but 6-month dental check-ups have traditionally been advocated by general dental practitioners in many high-income countries. This review updates a version first published in 2005, and updated in 2007 and 2013. OBJECTIVES To determine the optimal recall interval of dental check-up for oral health in a primary care setting. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 17 January 2020), the Cochrane Central Register of Controlled Trials (CENTRAL; in the Cochrane Library, 2019, Issue 12), MEDLINE Ovid (1946 to 17 January 2020), and Embase Ovid (1980 to 17 January 2020). We also searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication when searching. SELECTION CRITERIA We included randomised controlled trials (RCTs) assessing the effects of different dental recall intervals in a primary care setting. DATA COLLECTION AND ANALYSIS Two review authors screened search results against inclusion criteria, extracted data and assessed risk of bias, independently and in duplicate. We contacted study authors for clarification or further information where necessary and feasible. We expressed the estimate of effect as mean difference (MD) with 95% confidence intervals (CIs) for continuous outcomes and risk ratios (RR) with 95% CIs for dichotomous outcomes. We assessed the certainty of the evidence using GRADE. MAIN RESULTS We included two studies with data from 1736 participants. One study was conducted in a public dental service clinic in Norway and involved participants under 20 years of age who were regular attenders at dental appointments. It compared 12-month with 24-month recall intervals and measured outcomes at two years. The other study was conducted in UK general dental practices and involved adults who were regular attenders, which was defined as having attended the dentist at least once in the previous two years. It compared the effects of 6-month, 24-month and risk-based recall intervals, and measured outcomes at four years. The main outcomes we considered were dental caries, gingival bleeding and oral-health-related quality of life. Neither study measured other potential adverse effects. 24-month versus 12-month recall at 2 years' follow-up Due to the very low certainty of evidence from one trial, it is unclear if there is an important difference in caries experience between assignment to a 24-month or a 12-month recall. For 3- to 5-year-olds with primary teeth, the mean difference (MD) in dmfs (decayed, missing, and filled tooth surfaces) increment was 0.90 (95% CI -0.16 to 1.96; 58 participants). For 16- to 20-year-olds with permanent teeth, the MD in DMFS increment was 0.86 (95% CI -0.03 to 1.75; 127 participants). The trial did not assess other clinical outcomes of relevance to this review. Risk-based recall versus 6-month recall at 4 years' follow-up We found high-certainty evidence from one trial of adults that there is little to no difference between risk-based and 6-month recall intervals for the outcomes: number of tooth surfaces with any caries (ICDAS 1 to 6; MD 0.15, 95% CI -0.77 to 1.08; 1478 participants); proportion of sites with gingival bleeding (MD 0.78%, 95% CI -1.17% to 2.73%; 1472 participants); oral-health-related quality of life (MD in OHIP-14 scores -0.35, 95% CI -1.02 to 0.32; 1551 participants). There is probably little to no difference in the prevalence of moderate to extensive caries (ICDAS 3 to 6) between the groups (RR 1.04, 95% CI 0.99 to 1.09; 1478 participants; moderate-certainty evidence). 24-month recall versus 6-month recall at 4 years' follow-up We found moderate-certainty evidence from one trial of adults that there is probably little to no difference between 24-month and 6-month recall intervals for the outcomes: number of tooth surfaces with any caries (MD -0.60, 95% CI -2.54 to 1.34; 271 participants); percentage of sites with gingival bleeding (MD -0.91%, 95% CI -5.02% to 3.20%; 271 participants). There may be little to no difference between the groups in the prevalence of moderate to extensive caries (RR 1.05, 95% CI 0.92 to 1.20; 271 participants; low-certainty evidence). We found high-certainty evidence that there is little to no difference in oral-health-related quality of life between the groups (MD in OHIP-14 scores -0.24, 95% CI -1.55 to 1.07; 305 participants). Risk-based recall versus 24-month recall at 4 years' follow-up We found moderate-certainty evidence from one trial of adults that there is probably little to no difference between risk-based and 24-month recall intervals for the outcomes: prevalence of moderate to extensive caries (RR 1.06, 95% CI 0.95 to 1.19; 279 participants); number of tooth surfaces with any caries (MD 1.40, 95% CI -0.69 to 3.49; 279 participants). We found high-certainty evidence that there is no important difference between the groups in the percentage of sites with gingival bleeding (MD -0.07%, 95% CI -4.10% to 3.96%; 279 participants); or in oral-health-related quality of life (MD in OHIP-14 scores -0.37, 95% CI -1.69 to 0.95; 298 participants). AUTHORS' CONCLUSIONS For adults attending dental check-ups in primary care settings, there is little to no difference between risk-based and 6-month recall intervals in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period (high-certainty evidence). There is probably little to no difference between the recall strategies in the prevalence of moderate to extensive caries (moderate-certainty evidence). When comparing 24-month with either 6-month or risk-based recall intervals for adults, there is moderate- to high-certainty evidence that there is little to no difference in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period. The available evidence on recall intervals between dental check-ups for children and adolescents is uncertain. The two trials we included in the review did not assess adverse effects of different recall strategies.
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Affiliation(s)
- Patrick A Fee
- Dundee Dental School, University of Dundee, Dundee, UK
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Janet E Clarkson
- Division of Oral Health Sciences, Dundee Dental School, University of Dundee, Dundee, UK
| | - Dwayne Boyers
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Paul V Beirne
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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Bakari WN, Danwang C, Temgoua MN. COVID-19 and dentistry in sub-Saharan Africa: an urgent need to strengthen preventive measures in oral health care settings. Pan Afr Med J 2020; 35:42. [PMID: 33623567 PMCID: PMC7875760 DOI: 10.11604/pamj.supp.2020.35.2.23459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Célestin Danwang
- Epidemiology and Biostatistic Unit, Institute of Experimental and Clinical Research, Catholic University Louvain, Brussels, Belgium
| | - Mazou Ngou Temgoua
- Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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Mallineni SK, Innes NP, Raggio DP, Araujo MP, Robertson MD, Jayaraman J. Coronavirus disease (COVID-19): Characteristics in children and considerations for dentists providing their care. Int J Paediatr Dent 2020; 30:245-250. [PMID: 32250505 PMCID: PMC7228382 DOI: 10.1111/ipd.12653] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The emergence of the novel virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease (COVID-19) has led to a global pandemic and one of the most significant challenges to the healthcare profession. Dental practices are focal points for cross-infection, and care must be taken to minimise the risk of infection to, from, or between dental care professionals and patients. The COVID-19 epidemiological and clinical characteristics are still being collated but children's symptoms seem to be milder than those that adults experience. It is unknown whether certain groups, for example children with comorbidities, might be at a higher risk of more severe illness. Emerging data on disease spread in children, affected by COVID-19, have not been presented in detail. The purpose of this article was to report current data on the paediatric population affected with COVID-19 and highlight considerations for dentists providing care for children during this pandemic. All members of the dental team have a professional responsibility to keep themselves informed of current guidance and be vigilant in updating themselves as recommendations are changing so quickly.
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Affiliation(s)
- Sreekanth Kumar Mallineni
- Pediatric DentistryDepartment of Preventive Dental ScienceCollege of DentistryMajmaah UniversityAl‐ZulfiSaudi Arabia
| | - Nicola P. Innes
- Child Dental and Oral HealthSchool of DentistryUniversity of DundeeDundeeUK
| | - Daniela Procida Raggio
- Department of Paediatric DentistrySchool of DentistryUniversity of Sao PauloSao PauloBrazil
| | | | - Mark D. Robertson
- Child Dental and Oral HealthSchool of DentistryUniversity of DundeeDundeeUK
| | - Jayakumar Jayaraman
- Department of Developmental DentistryUniversity of Texas Health School of DentistrySan AntonioTXUSA
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Mattheus D, Shannon M, Lim E. Benefits of Oral Health Education at Women, Infant, and Children (WIC) Clinic Visits: Assessments of Parent's Oral Health Beliefs, Behaviors and Dental Access in O'ahu, Hawai'i. Hawaii J Health Soc Welf 2020; 79:32-39. [PMID: 32490383 PMCID: PMC7260877] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Improving oral health outcomes in Hawai'i for children and families remains a high priority. Children in the state are leading the nation with the highest caries rates, while women before, during, and after pregnancy are failing to receive regular and necessary dental care resulting in poor health outcomes. To answer for this need, an educational intervention was conducted among families enrolled in the Kapi'olani Medical Center for Women and Children's Women, Infant, and Children program (WIC) in O'ahu. The project included the following activities: (1) identification the oral health beliefs and behaviors of families, (2) providing oral health education to families, and (3) reassessing beliefs and behaviors in 3-6 months to document the impact of theeducation session. Participants consisted of 81 families resulting in the data on 176 children and 4 pregnant women. Of the 81 families, 40 representing84 children completed the follow-up oral health questionnaire. Results of the assessment and education demonstrated a positive impact on the family's oral health behaviors. Parents were 6.61 times as likely to report using fluoride toothpaste in the follow-up visit compared to their initial visit (95% confidence interval [CI] = 3.12-14.00). Additionally, statistically significant changes were noted in the frequency of children's daily tooth brushing (odds ratio [OR] = 2.15, 95% CI = 1.33-3.46), as well as in the incidence of children receiving fluoride varnish application over time (OR = 2.66, 95% CI = 1.50-4.73). These results provide further evidence that initiating a simple educational intervention can have a positive impact on oral health behaviors in groups that are at highest risk for developing dental disease in Hawai'i.
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Affiliation(s)
- Deborah Mattheus
- Correspondence to: Deborah Mattheus PhD, CPNP, APRN-Rx; 2528 McCarthy Mall, Webster Hall 437, Honolulu, HI 96822;
| | - Maureen Shannon
- School of Nursing, University of California at San Francisco, San Francisco, CA (MS)
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (EL)
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Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci 2020; 12:9. [PMID: 32127517 PMCID: PMC7054527 DOI: 10.1038/s41368-020-0075-9] [Citation(s) in RCA: 1035] [Impact Index Per Article: 258.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 02/05/2023] Open
Abstract
A novel β-coronavirus (2019-nCoV) caused severe and even fetal pneumonia explored in a seafood market of Wuhan city, Hubei province, China, and rapidly spread to other provinces of China and other countries. The 2019-nCoV was different from SARS-CoV, but shared the same host receptor the human angiotensin-converting enzyme 2 (ACE2). The natural host of 2019-nCoV may be the bat Rhinolophus affinis as 2019-nCoV showed 96.2% of whole-genome identity to BatCoV RaTG13. The person-to-person transmission routes of 2019-nCoV included direct transmission, such as cough, sneeze, droplet inhalation transmission, and contact transmission, such as the contact with oral, nasal, and eye mucous membranes. 2019-nCoV can also be transmitted through the saliva, and the fetal-oral routes may also be a potential person-to-person transmission route. The participants in dental practice expose to tremendous risk of 2019-nCoV infection due to the face-to-face communication and the exposure to saliva, blood, and other body fluids, and the handling of sharp instruments. Dental professionals play great roles in preventing the transmission of 2019-nCoV. Here we recommend the infection control measures during dental practice to block the person-to-person transmission routes in dental clinics and hospitals.
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Affiliation(s)
- Xian Peng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Biao Ren
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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10
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Bohm N, Karlsson C, Skoogh Andersson J, Almståhl A. Variations in odontological care routines for patients undergoing treatment for head and neck cancer in county councils/regions of Sweden. Clin Exp Dent Res 2020; 6:3-15. [PMID: 32067404 PMCID: PMC7025979 DOI: 10.1002/cre2.242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/11/2019] [Accepted: 08/02/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To investigate current odontological care routines for patients treated for head and neck cancers in the county councils/regions (C/Rs) of Sweden. METHODS An invitation to fill in a web-based questionnaire was sent to dentists/dental hygienists working in dental clinics in the 12 C/Rs, treating and responsible for the odontological care of patients undergoing treatment for cancer of the head and neck. The questionnaire started with two mandatory and one non-mandatory questions, followed by questions regarding routines before (n = 28), during (n = 23), and after (n = 9) treatment, plus two additional questions, totalling 65 questions. RESULTS Four dental hygienists and six dentists in 10 of the 12 C/Rs answered the questionnaire. Three C/Rs stated that they measure both the unstimulated and stimulated salivary secretion rate, and another C/R stated that they measure the stimulated secretion rate only. Similar recommendations were given regarding oral hygiene, salivary stimulants and substitutes, and extra fluoride. However, great variations were seen regarding recommendations for preventing and relieving oral mucositis. There were also discrepancies regarding information about the importance of avoiding smoking and alcohol. In seven C/Rs, patients visited the dental hygienist once a week during cancer treatment. CONCLUSION The results suggests that there are great variations in odontological care given to patients undergoing treatment for cancer of the head and neck region in different county councils/regions in Sweden. There is a need to develop and implement evidence-based guidelines to decrease the risk of oral complications and increase both the quality of life and the quality of care.
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Affiliation(s)
- Niklas Bohm
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Charlott Karlsson
- Clinic of Oral and Maxillofacial Surgery, Department of Orofacial Medicine, Institute of OdontologyJönköping UniversityJönköpingSweden
| | - Jessica Skoogh Andersson
- Department of Periodontology, Institute of Odontology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Annica Almståhl
- Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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Rutkauskas JS, Rutkauskas JS. Federal Trust Relationship at the Heart of Delivering Promised Quality Oral Care to Native Americans. Pediatr Dent 2019; 41:424-425. [PMID: 31882026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- John S Rutkauskas
- Senior, College of Agriculture and Life Sciences Cornell University Ithaca, New York
| | - John S Rutkauskas
- Chief Executive Officer American Academy of Pediatric Dentistry Chicago, Illinois
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Robinson PG, Douglas GVA, Gibson BJ, Godson J, Vinall-Collier K, Pavitt S, Hulme C. Remuneration of primary dental care in England: a qualitative framework analysis of perspectives of a new service delivery model incorporating incentives for improved access, quality and health outcomes. BMJ Open 2019; 9:e031886. [PMID: 31585977 PMCID: PMC6797242 DOI: 10.1136/bmjopen-2019-031886] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This study aimed to describe stakeholder perspectives of a new service delivery model in primary care dentistry incorporating incentives for access, quality and health outcomes. DESIGN Data were collected through observations, interviews and focus groups. SETTING This was conducted under six UK primary dental care practices, three working under the incentive-driven contract and three working under the traditional activity-based contract. PARTICIPANTS Observations were made of 30 dental appointments. Eighteen lay people, 15 dental team staff and a member of a commissioning team took part in the interviews and focus groups. RESULTS Using a qualitative framework analysis informed by Andersen's model of access, we found oral health assessments influenced patients' perceptions of need, which led to changes in preventive behaviour. Dentists responded to the contract, with greater emphasis on prevention, use of the disease risk ratings in treatment planning, adherence to the pathways and the utilisation of skill-mix. Participants identified increases in the capacity of practices to deliver more care as a result. These changes were seen to improve evaluated and perceived health and patient satisfaction. These outcomes fed back to shape people's predispositions to visit the dentist. CONCLUSION The incentive-driven contract was perceived to increase access to dental care, determine dentists' and patients' perceptions of need, their behaviours, health outcomes and patient satisfaction. Dentists face challenges in refocusing care, perceptions of preventive dentistry, deployment of skill mix and use of the risk assessments and care pathways. Dentists may need support in these areas and to recognise the differences between caring for individual patients and the patient-base of a practice.
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Affiliation(s)
- Peter G Robinson
- School of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | | | - Barry J Gibson
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Jenny Godson
- School of Dentistry, University of Leeds, Leeds, UK
- Dental Public Health, Public Health England, Leeds, UK
| | | | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Claire Hulme
- Health Economics Group, University of Exeter, Exeter, UK
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Suzuki H, Matsuo K, Okamoto M, Nakata H, Sakamoto H, Fujita M. Preoperative periodontal treatment and its effects on postoperative infection in cardiac valve surgery. Clin Exp Dent Res 2019; 5:485-490. [PMID: 31687181 PMCID: PMC6820569 DOI: 10.1002/cre2.212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/02/2019] [Accepted: 06/04/2019] [Indexed: 11/09/2022] Open
Abstract
Objectives Oral infection control is important for patients undergoing cardiac valve replacement (CVR) as prophylaxis for postoperative complications. This study examined the changes in oral health status by preoperative periodontal treatment and its effects on postsurgical complications in CVR patients. Material and methods We recruited 64 patients undergoing CVR who received preoperative periodontal treatment at our hospital as the intervention group and retrospectively reviewed the medical records of 38 patients who had undergone CVR surgery without dental intervention as the control group. Oral health status was assessed at the first visit to our dental office, 1 day before surgery, and >7 days after surgery. Days of high fever, antibiotics use, and postoperative hospitalization were recorded for the intervention and control groups for statistical comparisons. Results In the intervention group, oral health status significantly improved from the initial visit to >7 days after surgery. There were significantly fewer days of high fever (>37.5°C) in the intervention group than in the control group, with comparable results for other events. Conclusions This study's findings suggest that preoperative periodontal treatment can improve oral health status surrounding CVR surgery and could be the contributor of the reduction in the risk of postoperative infection.
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Affiliation(s)
- Hitomi Suzuki
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeJapan
- Doctorate Course for Oral Health and WelfareNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
- Department of Dentistry and Oral‐Maxillofacial SurgeryFujita Health University HospitalToyoakeJapan
| | - Koichiro Matsuo
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeJapan
| | - Mieko Okamoto
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeJapan
| | - Haruka Nakata
- Department of Dentistry and Oral‐Maxillofacial Surgery, School of MedicineFujita Health UniversityToyoakeJapan
- Doctorate Course for Oral Health and WelfareNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
- Department of Dentistry and Oral‐Maxillofacial SurgeryFujita Health University HospitalToyoakeJapan
| | - Hitomi Sakamoto
- Department of Dentistry and Oral‐Maxillofacial SurgeryFujita Health University HospitalToyoakeJapan
| | - Mirai Fujita
- Department of Dentistry and Oral‐Maxillofacial SurgeryFujita Health University HospitalToyoakeJapan
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Damiano P, Reynolds J, Herndon JB, McKernan S, Kuthy R. The patient-centered dental home: A standardized definition for quality assessment, improvement, and integration. Health Serv Res 2019; 54:446-454. [PMID: 30306558 PMCID: PMC6407358 DOI: 10.1111/1475-6773.13067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To develop the first standardized definition of the patient-centered dental home (PCDH). DATA SOURCES/STUDY SETTING Primary data from a 55-member national expert panel and public comments. STUDY DESIGN We used a modified Delphi process with three rounds of surveys to collect panelists' ratings of PCDH characteristics and open-ended comments. The process was supplemented with a 1-month public comment period. DATA COLLECTION/EXTRACTION METHODS We calculated median ratings, analyzed consensus using the interpercentile range adjusted for symmetry, and qualitatively evaluated comments. PRINCIPAL FINDINGS Forty-nine experts (89%) completed three rounds and identified eight essential PCDH characteristics, resulting in the following definition: "The patient-centered dental home is a model of care that is accessible, comprehensive, continuous, coordinated, patient- and family-centered, and focused on quality and safety as an integrated part of a health home for people throughout the life span." CONCLUSIONS This PCDH definition provides the foundation for developing measures for research, care improvement, and accreditation and is aligned with the patient-centered medical home. Consensus among a broad national expert panel-including provider, payer, and accreditation stakeholder organizations and experts in medicine, dentistry, and quality measurement-supports the definition's usability and its potential to facilitate medical-dental primary care integration.
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Affiliation(s)
- Peter Damiano
- Public Policy Center, Preventive and Community DentistryUniversity of IowaIowa CityIowa
| | - Julie Reynolds
- Preventive and Community Dentistry and Public Policy CenterUniversity of IowaIowa CityIowa
| | | | - Susan McKernan
- Preventive and Community Dentistry and Public Policy CenterUniversity of IowaIowa CityIowa
| | - Raymond Kuthy
- Preventive and Community Dentistry and Public Policy CenterUniversity of IowaIowa CityIowa
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15
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Macdonald ME, Keboa MT, Nurelhuda NM, Lawrence HP, Carnevale F, McNally M, Singhal S, Ka K, Nicolau B. The Oral Health of Refugees and Asylum Seekers in Canada: A Mixed Methods Study Protocol. Int J Environ Res Public Health 2019; 16:E542. [PMID: 30781882 PMCID: PMC6406538 DOI: 10.3390/ijerph16040542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/07/2019] [Accepted: 02/10/2019] [Indexed: 11/16/2022]
Abstract
Canada received over 140,000 refugees and asylum seekers between 2015 and 2017. This paper presents a protocol with the purpose of generating robust baseline data on the oral health of this population and build a long-term program of research to improve their access to dental care in Canada. The three-phase project uses a sequential mixed methods design, with the Behavioral Model for Vulnerable Populations as the conceptual framework. In Phase 1a, we will conduct five focus groups (six to eight participants per group) in community organizations in Ontario, Canada, to collect additional sociocultural data for the research program. In Phase 1b, we will use respondent-driven sampling to recruit 420 humanitarian migrants in Ontario and Quebec. Participants will complete a questionnaire capturing socio-demographic information, perceived general health, diet, smoking, oral care habits, oral symptoms, and satisfaction with oral health. They will then undergo dental examination for caries experience, periodontal health, oral pain, and traumatic dental injuries. In Phase 2, we will bring together all qualitative and quantitative results by means of a mixed methods matrix. Finally, in Phase 3, we will hold a one-day meeting with policy makers, dentists, and community leaders to refine interpretations and begin designing future oral health interventions for this population.
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Affiliation(s)
- Mary Ellen Macdonald
- Faculty of Dentistry, McGill University, 500-2001 McGill College, Montréal, QC H3A 1G1, Canada.
| | - Mark T Keboa
- Faculty of Dentistry, McGill University, 500-2001 McGill College, Montréal, QC H3A 1G1, Canada.
| | - Nazik M Nurelhuda
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada.
| | - Herenia P Lawrence
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada.
| | - Franco Carnevale
- Ingram School of Nursing, McGill University, 680 Sherbrooke West 1800, Montréal, QC H3A 2M7, Canada.
| | - Mary McNally
- Faculty of Dentistry, Dalhousie University, 5981 University Avenue, Halifax, NS B3H 4R2, Canada.
| | - Sonica Singhal
- Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada.
| | - Khady Ka
- Faculty of Dentistry, McGill University, 500-2001 McGill College, Montréal, QC H3A 1G1, Canada.
| | - Belinda Nicolau
- Faculty of Dentistry, McGill University, 500-2001 McGill College, Montréal, QC H3A 1G1, Canada.
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Abstract
Constructing an evidence-based dental practice requires leadership, commitment, technology support, and time, as well as skill practice in searching, appraising, and organizing evidence. In mastering the skills of evidence-based dentistry, clinicians can implement high-quality science into practice through a variety of opportunities including the development of clinical care guidelines, procedural technique protocols, and electronic dental record auto-note templates, as well as treatment planning, care prioritization, and case presentation. The benefits of building an evidence-based dental practice are many, including improvements in patient care and satisfaction, increased treatment predictability and confidence in care approaches, as well as potential cost savings.
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Affiliation(s)
- Jane Gillette
- Sprout Oral Health, PO Box 1028, Bozeman, MT 59771, USA.
| | - Ben Balevi
- Private Practice, 805 West Broadway, Suite 306, Vancouver, British Columbia V5Z 1K1, Canada; University of British Columbia, 306-805 West Broadway, Vancouver, British Columbia V5Z 1K1, Canada
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Delineation of Privileges. Pediatr Dent 2018; 40:516-7. [PMID: 32074936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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American Dental Association–Appointed Members of the Expert Writing and Voting Panels Contributing to the Development of American Academy of Orthopedic Surgeons Appropriate Use Criteria. American Dental Association guidance for utilizing appropriate use criteria in the management of the care of patients with orthopedic implants undergoing dental procedures. J Am Dent Assoc 2017; 148:57-9. [PMID: 28129802 DOI: 10.1016/j.adaj.2016.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/03/2016] [Indexed: 11/18/2022]
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Abstract
Objective With the increasing awareness of the importance of oral health, patients have an increasing need for integrated care from dentists. In China, the dentistry examination consists of two parts: a practical skills examination and a comprehensive medical examination; to date, no assessment methods that are based on specialized dentistry competencies, unlike the United States, Canada, and other countries, have been established. Therefore, the purpose of this study was to construct a competency model for dentists in China in order to guide the development, admission, training and assessment of dentists. Methods Using a literature review, focus group interviews and in-depth personal interviews, a dentist competency index was developed with an expert consultation questionnaire. A panel of 20 specialist experts was chosen from ten national medical universities to carry out two rounds of Delphi expert analysis, using the boundary value method to filter the indicators and the Analytic Hierarchy Process to calculate the weights of the primary indicators. Results Two rounds of Delphi results showed that the expert authority, enthusiasm, and coordination coefficients were high. Constructs of the competency model that included seven primary indicators and 62 secondary indicators determined the weight of each index. The seven primary indicators included the following: clinical skills and medical services, disease prevention and health promotion, interpersonal communication skills, core values and professionalism, medical knowledge and lifelong learning ability, teamwork ability and scientific research ability. Conclusion In conclusion, the use of the Delphi method to construct an initial model of Chinese physician competency is scientific and feasible. The initial competency model conforms to the characteristics and quality requirements of dentists in China and has a strong scientific basis. The dentist competency model should be used in the National Dental Licensing Examination in China.
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Affiliation(s)
- Yunxia Geng
- School of Health Administration and Education, Capital Medical University, Beijing, China
| | - Liying Zhao
- School of Stomatology, Capital Medical University, Beijing, China
| | - Yu Wang
- School of Stomatology, Capital Medical University, Beijing, China
| | - Yiyuan Jiang
- School of Health Administration and Education, Capital Medical University, Beijing, China
| | - Kai Meng
- School of Health Administration and Education, Capital Medical University, Beijing, China
- * E-mail: (KM); (DXZ)
| | - Dongxiang Zheng
- School of Stomatology, Capital Medical University, Beijing, China
- * E-mail: (KM); (DXZ)
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Munro S, Haile-Mariam A, Greenwell C, Demirci S, Farooqi O, Vasudeva S. Implementation and Dissemination of a Department of Veterans Affairs Oral Care Initiative to Prevent Hospital-Acquired Pneumonia Among Nonventilated Patients. Nurs Adm Q 2018; 42:363-372. [PMID: 30180083 DOI: 10.1097/naq.0000000000000308] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Implementation and dissemination of an oral care initiative enhanced the safety and well-being of Veterans at the Salem VA Medical Center by reducing the risk of non-ventilator-associated hospital-acquired pneumonia (NV-HAP). The incidence rate of non-ventilator-associated hospital-acquired pneumonia decreased from 105 cases to 8.3 cases per 1000 patient-days (by 92%) in the initial VA pilot, yielding an estimated cost avoidance of $2.84 million and 13 lives saved in 19 months postimplementation. The team was successful in translating this research into a meaningful quality improvement intervention in 8 VA hospitals (in North Carolina, Texas, and Virginia) that has promoted effective and consistent delivery of oral care across hospital service lines and systems, improved the health of Veterans, and driven down health care costs associated with this largely preventable illness. The steps needed for successful replication and dissemination of this nurse-led, evidence-based practice are summarized in this article.
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Affiliation(s)
- Shannon Munro
- Department of Veterans Affairs Medical Center, Salem, Virginia (Drs Munro, Farooqi, and Vasudeva), Atlas Research, Contractor Support for the Department of Veterans Affairs Diffusion of Excellence Initiative, Washington, District of Columbia (Mss Haile-Mariam, Greenwell, and Demirci); and Prometheus Federal Services, Contractor Support for the Department of Veterans Affairs Diffusion of Excellence Initiative, Chantilly, Virginia (Ms Demirci)
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Shen J, Listl S. Investigating social inequalities in older adults' dentition and the role of dental service use in 14 European countries. Eur J Health Econ 2018; 19:45-57. [PMID: 28064379 PMCID: PMC5773639 DOI: 10.1007/s10198-016-0866-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/13/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Oral disease, despite being largely preventable, remains the most common chronic disease worldwide and has a significant negative impact on quality of life, particularly among older adults. OBJECTIVE This study is the first to comprehensively and at a large scale (14 European countries) measure the social inequalities in the number of natural teeth (an informative oral health marker) in the over 50-year-old population and to investigate the extent to which such inequalities are attributable to dental service use. METHODS Using Wave 5 of the Survey of Health, Ageing and Retirement in Europe, which included internationally harmonized information on over 50,000 individuals across 14 European countries, we calculated Gini and Concentration indices (CI) as well as the decompositions of CIs by socioeconomic factors. RESULTS Sweden consistently performed the best with the lowest inequalities as measured by Gini (0.1078), CI by income (0.0392), CI by education (0.0407), and CI by wealth (0.0296). No country performed the worst in all inequality measures. However, unexpectedly, some wealthier countries (e.g., the Netherlands and Denmark) had higher degrees of inequalities than less-wealthy countries (e.g., Estonia and Slovenia). Decomposition analysis showed that income, education, and wealth contributed substantially to the inequalities, and dental service use was an important contributor even after controlling for income and wealth. CONCLUSIONS The study highlighted the importance of comprehensively investigating oral health inequalities. The results are informative to policymakers to derive country-specific health policy recommendations to reduce oral health inequalities in the older population and also have implications for oral health improvement of the future generations.
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Affiliation(s)
- Jing Shen
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
| | - Stefan Listl
- Quality and Safety of Oral Care, Radboud University, Nijmegen, The Netherlands
- Translational Health Economics, Heidelberg University, Heidelberg, Germany
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Chenot R. [Pay for performance in dental care: A systematic narrative review of quality P4P models in dental care]. Z Evid Fortbild Qual Gesundhwes 2017; 127-128:42-55. [PMID: 28838794 DOI: 10.1016/j.zefq.2017.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/02/2017] [Accepted: 06/05/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Pay for performance (P4P) links reimbursement to the achievement of quality objectives. Experiences with P4P instruments and studies on their effects are available for the inpatient sector. A systematic narrative review brings together findings concerning the use and the effects of P4P, especially in dental care. METHODS A systematic literature search in PubMed and the Cochrane Library for reimbursement models using quality indicators provided 77 publications. Inclusion criteria were: year of publication not older than 2007, dental sector, models of quality-oriented remuneration, quality of care, quality indicators. 27 publications met the inclusion criteria and were evaluated with regard to the instruments and effects of P4P. The database search was supplemented by a free search on the Internet as well as a search in indicator databases and portals. The results of the included studies were extracted and summarized narratively. RESULTS 27 studies were included in the review. Performance-oriented remuneration is an instrument of quality competition. In principle, P4P is embedded in an existing remuneration system, i.e., it does not occur in isolation. In the United States, England and Scandinavia, models are currently being tested for quality-oriented remuneration in dental care, based on quality indicators. The studies identified by the literature search are very heterogeneous and do not yield comparable endpoints. Difficulties are seen in the reproducibility of the quality of dental care with regard to certain characteristics which still have to be defined as quality-promoting properties. Risk selection cannot be ruled out, which may have an impact on structural quality (access to care, coordination). CONCLUSION There were no long-term effects of P4P on the quality of care. In the short and medium term, adverse effects on the participants' motivation as well as shifting effects towards the private sector are described. A prerequisite for the functioning of P4P is the definition of clear targets and measuring parameters. Furthermore, evidence-based quality indicators have to be developed that validly depict quality differences. It is yet unknown whether P4P will have long-term effects or whether the quality of dental care will increase.
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Affiliation(s)
- Regine Chenot
- Zentrum Zahnärztliche Qualität (ZZQ), Berlin, Deutschland.
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Adolescent Oral Health Care. Pediatr Dent 2017; 39:213-20. [PMID: 29179360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Policy on Infection Control. Pediatr Dent 2017; 39:144. [PMID: 29179352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents. Pediatr Dent 2017; 39:188-96. [PMID: 29179356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Neumann A, Kalenderian E, Ramoni R, Yansane A, Tokede B, Etolue J, Vaderhobli R, Simmons K, Even J, Mullins J, Kumar S, Bangar S, Kookal K, White J, Walji M. Evaluating quality of dental care among patients with diabetes: Adaptation and testing of a dental quality measure in electronic health records. J Am Dent Assoc 2017. [PMID: 28624074 DOI: 10.1016/j.adaj.2017.04.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patients with diabetes are at increased risk of developing oral complications, and annual dental examinations are an endorsed preventive strategy. The authors evaluated the feasibility and validity of implementing an automated electronic health record (EHR)-based dental quality measure to determine whether patients with diabetes received such evaluations. METHODS The authors selected a Dental Quality Alliance measure developed for claims data and adapted the specifications for EHRs. Automated queries identified patients with diabetes across 4 dental institutions, and the authors manually reviewed a subsample of charts to evaluate query performance. After assessing the initial EHR measure, the authors defined and tested a revised EHR measure to capture better the oral care received by patients with diabetes. RESULTS In the initial and revised measures, the authors used EHR automated queries to identify 12,960 and 13,221 patients with diabetes, respectively, in the reporting year. Variations in the measure scores across sites were greater with the initial measure (range, 36.4-71.3%) than with the revised measure (range, 78.8-88.1%). The automated query performed well (93% or higher) for sensitivity, specificity, and positive and negative predictive values for both measures. CONCLUSIONS The results suggest that an automated EHR-based query can be used successfully to measure the quality of oral health care delivered to patients with diabetes. The authors also found that using the rich data available in EHRs may help estimate the quality of care better than can relying on claims data. PRACTICAL IMPLICATIONS Detailed clinical patient-level data in dental EHRs may be useful to dentists in evaluating the quality of dental care provided to patients with diabetes.
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Ramoni RB, Etolue J, Tokede O, McClellan L, Simmons K, Yansane A, White JM, Walji MF, Kalenderian E. Adoption of dental innovations: The case of a standardized dental diagnostic terminology. J Am Dent Assoc 2017; 148:319-327. [PMID: 28364948 DOI: 10.1016/j.adaj.2017.01.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 01/05/2017] [Revised: 01/21/2017] [Accepted: 01/24/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Standardized dental diagnostic terminologies (SDDxTs) were introduced decades ago. Their use has been on the rise, accompanying the adoption of electronic health records (EHRs). One of the most broadly used terminologies is the Dental Diagnostic System (DDS). Our aim was to assess the adoption of SDDxTs by US dental schools by using the Rogers diffusion of innovations framework, focusing on the DDS. METHODS The authors electronically surveyed clinic deans in all US dental schools (n = 61) to determine use of an EHR and SDDxT, perceived barriers to adoption of an SDDxT, and the effect of implementing an SDDxT on clinical productivity. RESULTS The response rate was 57%. Of the 35 responses, 91% reported using an EHR to document patient care, with 84% using axiUm; 41% used the DDS. Fifty-four percent of those who did not use an SDDxT had considered adopting the DDS, but 38% had not, citing barriers such as complexity and compatibility. CONCLUSIONS Adoption of an SDDxT, particularly the DDS, is on the rise. Nevertheless, a large number of institutions are in the Rogers late majority and laggards categories with respect to adoption. Several factors may discourage adoption, including the inability to try out the terminology on a small scale, poor usability within the EHR, the fact that it would be a cultural shift in practice, and a perception of unclear benefits. However, the consolidation of the DDS and American Dental Association terminology efforts stands to encourage adoption. PRACTICAL IMPLICATIONS The successful adoption of dental innovation depends not only on the intrinsic merit of the innovation, as some useful innovations do not achieve widespread traction. As such, it is important for health care providers to understand how to disseminate their ideas in order to ensure traction and widespread adoption.
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Fredericks-Younger JM, Handelman-Yellin ML, York JA. Developing a Relevant Taxonomy to Assess Dental School Clinic Patient Complaints. J Dent Educ 2017; 81:318-325. [PMID: 28250038] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 10/16/2016] [Indexed: 06/06/2023]
Abstract
The aims of this study were to categorize and analyze the most frequent patient complaints at the Rutgers School of Dental Medicine (RSDM) clinic in an effort to identify areas in need of improvement. A retrospective review of patient complaints reported to the RSDM Office for Clinical Affairs from July 1, 2011 to June 30, 2015 was conducted. A total of 148 unduplicated patients were selected for evaluation because they made at least one official complaint. In total, 193 patient complaints were made during this period. A published complaint taxonomy was used to categorize RSDM patient complaints into domains, categories, and subcategories, highlighting frequent issues of complaint. Of the 193 complaints made, 256 issues were identified. The results showed that the most frequent domain of complaint was Management, followed by Clinical, then Relationships. Institutional Issues and Quality were the most recurring categories coded. Of the 26 subcategories, nearly 70% of the complaints were coded into one of four: Finance and Billing, Delays, Patient Journey, and Quality of Care. While the results were effective in identifying broad areas of improvement, there were limitations to using the traditional taxonomy in the dental school setting. Based on these data, the RSDM Patient Complaint Taxonomy, specific to the needs of a dental school environment, was created in an effort to gain increased specificity and further enhance quality improvement measures. It is the hope of the research team that this tool will be used across dental schools, opening the door for future collaborations and ultimately improving patient care.
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Affiliation(s)
- Janine M Fredericks-Younger
- Dr. Fredericks-Younger is Director of Clinics, Office for Clinical Affairs and Assistant Professor, Department of Restorative Dentistry, Rutgers School of Dental Medicine; Dr. Handelman-Yellin is Instructor, Department of Restorative Dentistry, Rutgers School of Dental Medicine; and Dr. York is Assistant Dean for Extramural Clinics, Hunterdon Endowed Chair for Dental Public Health, and Associate Professor, Department of Community Health, Rutgers School of Dental Medicine.
| | - Marisa L Handelman-Yellin
- Dr. Fredericks-Younger is Director of Clinics, Office for Clinical Affairs and Assistant Professor, Department of Restorative Dentistry, Rutgers School of Dental Medicine; Dr. Handelman-Yellin is Instructor, Department of Restorative Dentistry, Rutgers School of Dental Medicine; and Dr. York is Assistant Dean for Extramural Clinics, Hunterdon Endowed Chair for Dental Public Health, and Associate Professor, Department of Community Health, Rutgers School of Dental Medicine
| | - Jill A York
- Dr. Fredericks-Younger is Director of Clinics, Office for Clinical Affairs and Assistant Professor, Department of Restorative Dentistry, Rutgers School of Dental Medicine; Dr. Handelman-Yellin is Instructor, Department of Restorative Dentistry, Rutgers School of Dental Medicine; and Dr. York is Assistant Dean for Extramural Clinics, Hunterdon Endowed Chair for Dental Public Health, and Associate Professor, Department of Community Health, Rutgers School of Dental Medicine
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Breault MR. Dental Quality Alliance: A Practitioner's Perspective. N Y State Dent J 2017; 83:11-14. [PMID: 29920025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Ono S, Ishimaru M, Yamana H, Morita K, Ono Y, Matsui H, Yasunaga H. Enhanced Oral Care and Health Outcomes Among Nursing Facility Residents: Analysis Using the National Long-Term Care Database in Japan. J Am Med Dir Assoc 2017; 18:277.e1-277.e5. [PMID: 28082034 DOI: 10.1016/j.jamda.2016.11.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 11/08/2016] [Revised: 11/25/2016] [Accepted: 11/28/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Although oral care may have salutary effects among frail elderly people, access to dental care is often limited in long-term care facilities. In 2009, the Japanese long-term care insurance system introduced an additional reimbursement scheme for enhanced oral care supervised by dentists in nursing facilities. The aim of this study was to examine whether enhanced oral care provided by trained nursing facility staff members is sufficient to improve health outcomes among nursing facility residents. DESIGN, SETTING, AND PARTICIPANTS This was a quasi-experimental study using a nationwide long-term care database. Using facility-level propensity score matching, we identified 170,874 residents in 742 facilities that provided enhanced oral care and 167,546 residents in 742 control facilities that provided only standard care from 2009 to 2012. We used a resident-level difference-in-differences approach to analyze the impact of enhanced oral care on health outcomes among nursing facility residents. RESULTS After controlling for resident characteristics and background time trends, no significant differences were found between residents admitted to the facilities with and without enhanced oral care in the incidence of critical illness, transfer to a hospital, mortality, or costs. Yearly change in the odds of discharge to home was significantly increased for residents with enhanced oral care (odds ratio = 1.07; 95% confidence interval: 1.02-1.12; P = .008). CONCLUSION The results suggest that enhanced oral care provided by trained nursing facility staff members may improve the general condition of elderly residents in nursing facilities and promote their discharge to home.
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Affiliation(s)
- Sachiko Ono
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan.
| | - Miho Ishimaru
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Hayato Yamana
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Kojiro Morita
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
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Abstract
The paper discusses features and criteria of dental care according to legislative acts in Russian Federation. The study contains detailed assessment of safety, cost/effectiveness ratio and adequate timing as features and adhesion to standards, absence of complications and patients satisfaction as criteria for dental care quality.
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Affiliation(s)
- V D Vagner
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - E A Bulycheva
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Driscoll CF. A shared commitment to patient care. Gen Dent 2016; 64:8. [PMID: 27814248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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33
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Guideline on Oral Health Care for the Pregnant Adolescent. Pediatr Dent 2016; 38:59-66. [PMID: 28206883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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34
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Policy on Third-party Reimbursement of Medical Fees Related to Sedation/General Anesthesia for Delivery of Oral Health Services. Pediatr Dent 2016; 38:103-5. [PMID: 27931438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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35
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Policy on Infection Control. Pediatr Dent 2016; 38:131. [PMID: 27931450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Guideline on Adolescent Oral Health Care. Pediatr Dent 2016; 38:155-62. [PMID: 27931454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Vidone L, Hunt RJ, Ojha D. An Emerging Era in Dentistry Quality Measurement. J Mass Dent Soc 2016; 65:18-21. [PMID: 29847045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Policy on Medically-Necessary Care. Pediatr Dent 2016; 38:18-22. [PMID: 27931407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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39
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Guideline on Oral Health Care for the Pregnant Adolescent. Pediatr Dent 2016; 38:163-70. [PMID: 27931455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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40
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Hussein H, Brown RS. Risk-benefit assessment for antibiotic prophylaxis in asplenic dental patients. Gen Dent 2016; 64:62-65. [PMID: 27367636] [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: 06/06/2023]
Abstract
A review of the published literature revealed that discourse on the topic of antibiotic prophylaxis guidelines for the asplenic dental patient is limited and that guidelines regarding this issue have not been updated for years. The review determined that the professional protocol for the treatment of asplenic dental patients has changed over the last 30 years, particularly with reference to adult patients. Furthermore, as dentists and physicians now understand that blood-borne bacteremias are produced from everyday occurrences such as chewing and toothbrushing, bacteremias secondary to dental procedures are no longer viewed as seriously as in the past; therefore, the guidelines for antibiotic prophylaxis have changed. Antibiotic prophylaxis is not routinely indicated prior to dental procedures for asplenic adult dental patients without risk factors. However, antibiotic prophylaxis should be considered for young children, immunocompromised patients with underlying causative disease, or any patient during the first 3 years after a splenectomy.
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Abstract
Tooth extraction is a treatment that can be carried out by general dental practitioners. It is suspected that the number of referrals to OMF-surgeons for simple tooth extractions has increased in the Netherlands in recent years. In a study, the health records of 2 groups of outpatients treated at the Oral and Maxillofacial Surgery department of a university medical centre between 1996 and 2014 were investigated. Patients who had undergone tooth extractions were included. The complexity of the tooth extractions was analyzed according to 4 criteria. The results of the study show a significant increase in simple tooth extractions by OMF surgeons in 2014 in comparison with 1996. The complexity of the total number of tooth extractions in 2014 was lower than in 1996. Reasons for these results could not be unambiguously determined. Possible significant aspects are the risk of per-operative complications, insufficient affinity of general dental practitioners with tooth extractions or financial considerations on the part of both the general dental practitioners and the patients.
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42
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Rapporten medische missers moeten openbaar: blaming and shaminig?]. Ned Tijdschr Tandheelkd 2016; 123:335. [PMID: 27498428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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43
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Brands WG. [Health care plan: a treatment as a piece of a puzzle. Considerations with respect to judgement of the Central Disciplinary Board for Health Care]. Ned Tijdschr Tandheelkd 2016; 123:286-289. [PMID: 27275658 DOI: 10.5177/ntvt.2016.06.16131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
When faced with the question whether a particular treatment is indicated, dentists have to ask themselves to what extent it fits within a health care goal. If it does not, then the indication is usually rejected because it is in conflict with professional standards. Dentists who nevertheless consider such an indication have to bear the responsibility to make clear to the patient not only the general risks of a certain treatment but also the additional risks associated with the hazardous indication.
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Grisanti SM, Boyd LD, Rainchuso L. An Assessment Model for Evaluating Outcomes in Federally Qualified Health Centers' Dental Departments: Results of a 5 Year Study. J Dent Hyg 2016; 90 Suppl 1:22-32. [PMID: 27458315] [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: 06/06/2023]
Abstract
PURPOSE The purpose of this report was to establish baseline data on 10 oral health performance indicators over 5 fiscal years (2007 to 2008 through 2011 to 2012) for an Iowa health center. The baseline data provides an assessment model and reports outcomes based on the use of the model. Performance indicators show evidence of provider performance, accountability to stakeholders and provide the benchmarks required for dental management to develop future goals to improve oral health outcomes for atrisk populations. METHODS Using descriptive statistic, this report extrapolated data from the Iowa Health Center's computer management systems software, HealthPro, and Centricity electronic medical records, and analyzed using IBM® SPSS® 19. This report describes the change in utilization for number and type of visits for uninsured and Medicaid patients over 5 fiscal years (a fiscal year is measured from November 1 through October 31). RESULTS The number of patients receiving at least 1 dental visit in a measurement year showed n=81,673 procedures with 21% (17,167) being unduplicated patients. Preventive averaged 46%, restorative 18%, urgent care 22% and other procedures 14%. CONCLUSION Federally qualified health centers (FQHCs) with a dental component serve populations with the greatest health disparities. This population includes ethnic and racial minorities, uninsured, underinsured, rural residents, Medicaid and Medicare. Establishing baseline data for FQHCs provides a foundational tool that will allow dental management to analyze successes as well as deficiencies in the goal to provide increased utilization to oral health care for at-risk populations.
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Kadi G. THE INVISIBLE NUMBERS THAT IMPACT PRACTICE SUCCESS. Tex Dent J 2016; 133:306-308. [PMID: 27476236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Melgaço-Costa JLB, Martins RC, Ferreira EF, Sobrinho APR. Patients' Perceptions of Endodontic Treatment as Part of Public Health Services: A Qualitative Study. Int J Environ Res Public Health 2016; 13:E450. [PMID: 27128932 PMCID: PMC4881075 DOI: 10.3390/ijerph13050450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/06/2016] [Accepted: 04/22/2016] [Indexed: 11/16/2022]
Abstract
Evaluations by patients constitute an important part of the process of improving health services. This study examined patients' perceptions of secondary dental care in three cities in Minas Gerais, Brazil based on the endodontic treatment received. Data were collected using semi-structured interviews (addressing access, treatment and results) and a field diary (direct observations and report of professionals). The interviews were audiotaped, fully transcribed, and analyzed using content analysis. Two principal themes were identified: access to service and quality of service. The difficulties in accessing service were associated with the insufficient number of professionals to meet the high demand for endodontic treatment, problems in referring from primary to secondary care and geographic barriers. Service quality was related to the presence/absence of pain and anxiety that patients experienced, the time and number of sessions required to complete treatment, how patients were treated by dentists, and whether those patients would recommend the service to other patients. Access to endodontic treatment was a problem emphasized by users, and satisfaction with the quality of the service was more related to how patients were treated than to the technical competence of the dentist.
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Affiliation(s)
- José Leonardo Barbosa Melgaço-Costa
- Departament of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 31270 901, Brazil.
| | - Renata Castro Martins
- Departament of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 31270 901, Brazil.
| | - Efigênia Ferreira Ferreira
- Departament of Social and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 31270 901, Brazil.
| | - Antônio Paulino Ribeiro Sobrinho
- Departament of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais 31270 901, Brazil.
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47
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Crall JJ. Advancing Measurement and Quality Improvement in Dentistry. J Calif Dent Assoc 2016; 44:220-222. [PMID: 27265977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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48
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Ojha D, Aravamudhan K. Leading the Dental Quality Movement: A Dental Quality Alliance Perspective. J Calif Dent Assoc 2016; 44:239-244. [PMID: 27265980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Changing regulatory priorities set forth by the Affordable Care Act and recent activities of the Centers for Medicare and Medicaid Services clearly prioritize the need to improve the quality of health care in both the public and private sectors. As the largest multistakeholder organization focused on oral health care quality measurement and improvement, the Dental Quality Alliance is leading the way in establishing standardized and valid quality measures applicable in both private and public sectors.
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Amundson CW. Dental Quality Measurement--A Practitioner Perspective. J Calif Dent Assoc 2016; 44:233-237. [PMID: 27265979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article reviews the HealthPartners Dental Group's experience with clinical quality measurement and provides information on the administrative infrastructure that supports measurement within the group. Some examples of the role measurement plays in operations and clinical practice are also reviewed.
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50
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Tianviwat S, Hintao J, Chongsuvivatwong V, Thitasomakul S. A randomized controlled trial of cluster audit and feedback on the quality of dental sealant for rural schoolchildren. Community Dent Health 2016; 33:27-32. [PMID: 27149770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
THE OBJECTIVE To examine whether audit and feedback could improve the quality of the application of dental sealant in rural Thai school children. RESEARCH DESIGN A single blind, cluster randomized controlled trial was conducted. CLINICAL SETTING Hospital-based and school-based school sealant applied by dental nurses in Southern province of Thailand. PARTICIPANTS Dental nurses and school children who received dental sealant were involved. INTERVENTION The intervention consisted of confidential feedback of data and tailor-made problem-solving workshops. MAIN OUTCOME MEASURES Sealant quality was measured by sealant retention and caries on sealed surfaces at six-month after sealing. The teeth examinations were done among different groups of children prior and after the intervention. RESULTS After the intervention, the sealant retention rate increased dramatically in the intervention group, whereas in the control group the rate was similar to that found at baseline. The rate of caries after the intervention was stable in the intervention group and increased slightly in the control group. At the beginning of the study, the adjusted odds ratio of complete sealant retention between the intervention and control group was 0.47 which increased to 1.99 at the end of the study. However, no effect on caries on sealed surfaces was observed. CONCLUSIONS The intensive focus on actual problems during the audit and feedback improved the dental nurses' performance and the quality of the dental service, although it had no statistical impact on the incidence of caries.
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