Desirable clinical settings in general dentistry: moving towards the improvement of the educational program.

BACKGROUND: The main task of dental schools is to prepare professional dentists with a high social responsibility. This study provided some practical suggestions from experts regarding desirable clinical settings, in order to establish an infrastructure for practical studies in Endodontics, Periodontics, Oral and Maxillofacial Surgery, Restorative Dentistry, Pediatric Dentistry, Oral and Maxillofacial Medicine, Prosthodontics, Oral Health, and Social Dentistry. METHODS: This research was conducted using a modified Delphi technique in two rounds. The first round involved qualitative content analysis. Participants in interviews were selected purposeful and maximum diversity across the country. To determine the validity and reliability of the data, the four axes proposed by Lichon and Guba were utilized. The second round involved a researcher-made questionnaire, which consisted of 55 questions. This questionnaire was distributed to all dental schools across the country. The validity of the questionnaire were evaluated and by experts and then reviewed. The reliability of the tool was determined to be 0.96 using the alpha coefficient method. RESULTS: The final codes from the interviews of the first round were divided into two categories: settings and educational programs. The final results of research were placed into 2 section: educational settings and instructors, and educational infrastructures. 70% participants agreed to use the college's clinical morning sessions. More than 80% agreed to start up a main clinic with the proposed structure and professors. The use of the hospitalization area also had an agreement of more than 80%. Additionally, community areas such as health service centers, welfare centers, special patient centers, factories, schools, etc. obtained an agreement of over 70%. CONCLUSIONS: The results of this study are presented in the form of suggestions for improving the general dentistry program in relation to educational setting, educators, and educational infrastructures. The common agreement among participants regarding educational settings and their diversity, educational programs, and desired instructors reviewed in the research shows the necessity of reviewing and changing their educational programs in Endodontics, Periodontics, Oral and Maxillofacial Surgery, Restorative Dentistry, Pediatric Dentistry, Oral and Maxillofacial Medicine, Prosthodontics, Oral Health, and Social Dentistry.

Exploring the attitudes of general dental practitioners to providing dietary advice alongside oral rehabilitation for older adults.

OBJECTIVE: We aimed to capture General Dental Practitioners' (GDPs) views on delivering dietary advice to older adults in combination with treatment to replace missing teeth and identify solutions to help inform the development and implementation of future dietary interventions within primary dental care. BACKGROUND: As natural teeth are lost, older adults may need to choose softer, more manageable foods which might be of lower nutrient density. Previous research has indicated that prosthodontic rehabilitation can improve masticatory function but not the intake of nutrients, highlighting a potential need for a combined approach of oral rehabilitation and dietary counselling. MATERIALS AND METHODS: Semi-structured telephone interviews were conducted with a purposive sampling strategy of 12 GDPs. Interviews were digitally recorded and transcribed verbatim. An iterative coding process using theme-analytic methods was used. RESULTS: Twelve interviews were conducted with GDPs in the United Kingdom. The themes that emerged from the interviews included: the awareness of the importance of dietary advice among GDPs; the concerns GDPs had on patients' adherence to dietary advice; uncertainty over roles and responsibilities in the provision of dietary advice; and the limited time and remuneration for dietary advice in dental practice. A minor theme identified was the motivation of GDPs to implement dietary advice alongside oral rehabilitation. All reported that they were already providing dietary advice to their patients but that this was limited to caries prevention. CONCLUSION: The GDPs interviewed expressed positive attitudes towards providing dietary advice alongside oral rehabilitation for older adults. However, a lack of confidence, awareness, time and remuneration are barriers to its provision in primary dental care. To facilitate the implementation of dietary advice alongside oral rehabilitation, clear guidance on and training in delivering dietary advice and multidisciplinary cooperation are required.

A scoping review of dental practitioners' perspectives on perceived barriers and facilitators to preventive oral health care in general dental practice.

BACKGROUND: Oral health has an important role in the general health and well-being of individuals. Dental teams are ideally placed to support patients in preventing ill-health. Understanding the barriers and facilitators to the adoption, promotion and facilitation of preventive advice and treatment is key to improving oral health services. The Theoretical Domains Framework (TDF) is a useful psychological framework to help identify individual, interpersonal and environmental issues which could be impacting clinicians' ability to provide preventive advice and care. The aim of this review was to identify the perceived barriers and facilitators to preventive oral health care from the perspectives of the oral healthcare team within the general dental practice. METHODS: A search strategy was developed, piloted, and run in: Medline via Ovid, PsycInfo, Web of Science, SCOPUS, EMBASE, Conference Proceedings Citation Index- Science, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews and followed PRISMA guidelines. Identified records were screened independently by two researchers. Data were coded using the Theoretical Domains Framework (TDF) and analysed using narrative data synthesis. RESULTS: 5610 papers were identified, and 19 included in this review. Thirteen papers focussed on dentists. Of the 106 items mapped onto the TDF, 48 were facilitators. The domains most frequently represented were, environmental context and resources, beliefs about consequences, social professional role and identity, skills, beliefs about capabilities and knowledge. Six studies focussed on dental hygienists. There were 47 items mapped onto the TDF, 18 were facilitators. The domains most frequently represented were environmental context and resources, social influences, beliefs about consequences and knowledge. CONCLUSIONS: The review identified that the delivery of preventive activities did not focus solely on the patient and dental professional interaction as many previous studies have highlighted. The review found that multiple factors influence whether prevention is delivered to patients. The largest barrier and facilitator for the dental professionals identified in this review was the environmental context and resources. Further research is needed to evaluate the effectiveness of interventions that aim to promote preventive oral health care in primary care settings to understand whether they address the barriers identified in this review.

Continuing professional development in general dentistry-experiences of an online flipped classroom.

INTRODUCTION: Continuing professional development is a lifelong learning process. One pedagogical approach that can be used is active learning. Flipped classroom is a method that has been shown to improve deeper conceptual understanding. In an online setting, the method saves travel, time, and costs. To our knowledge, flipped classroom is rarely used in continuing professional education. This study in general dentistry explored experiences of an online flipped classroom course in continuing professional development. MATERIALS AND METHODS: Fifteen dental hygienists, clinically active in general dental care, were interviewed. They were recruited from an online course on the latest classification system for periodontal diseases. The course had been conducted using an active learning and flipped classroom model. The interviews were semi-structured. Data were extracted using qualitative content analysis. RESULTS: The experiences of the dental hygienists could be summarized in three themes: Stimulation of knowledge gain through self-paced studies, The ease of virtual networking among colleagues, and Fostering of direct practical application through collaboration. CONCLUSION: New and emerging communication technology seems to open new possibilities for continuing professional development in general dentistry. Study participants felt that, in an online environment, mixing asynchronous and synchronous communication in a flipped classroom model facilitated learning in continuing professional development. Online active learning seems to work well in continuous professional development in general dentistry. After the course, the participating dental hygienists stated that they were able to use their new knowledge clinically and felt confident doing so.

The use of miniplates for nontraditional orthodontic treatment: clinical considerations for referring general dentists.

Distalization of mandibular molars comes with significant challenges, especially in adult and young adult patients. In selected cases, third molar extraction procedures offer the opportunity to place miniplates for anchorage to distalize mandibular molars, providing additional solutions to the traditional extraction of premolars or a single incisor. This approach can be of special interest to adult patients, who may have life commitments and time restraints that limit traditional orthodontic and surgical treatment options, and it can improve the efficiency of dental care. This case series describes 3 clinical scenarios in which miniplates were placed with minimal invasiveness during the removal of impacted third molars, offering the patients nontraditional orthodontic treatment options. Awareness of these options is essential for general dentists so that they can explain all treatment possibilities and provide appropriate referrals to patients with impacted third molars.

[Diagnosing neuropathic orofacial pain in the general dental practice]. / Diagnosticeren van neuropathische orofaciale pijn in de algemene tandartspraktijk.

Dental pain is a common reason for patients to visit the dentist. This type of pain is usually easy to diagnose and treat. However, diagnosing and treating other forms of orofacial pain remains complicated. One of the most challenging types of orofacial pain to diagnose and treat is neuropathic orofacial pain: pain resulting from damage to nerve tissue. Recognizing this type of pain in a timely manner can prevent unnecessary invasive dental treatments and disappointment for patients who seek help for this type of pain. There are relatively simple tools for dentists to distinguish neuropathic pain from other types of orofacial pain. The treatment of neuropathic pain is primarily focused on symptom relief through medication.

The referral pattern and treatment modality for peri-implant disease between periodontists and non-periodontist dentists.

OBJECTIVES: This study is to investigate the referral pattern and treatment modality of dentists in the management of peri-implant diseases between periodontists and non-periodontist dentists (NPDs). MATERIALS AND METHODS: A total of 167 validated questionnaires were obtained from periodontists and NPDs, who had experience of placing implants for at least one year. Question I to IV asked how the dentist would respond if a patient came for treatment of their peri-implant diseases with four different scenarios according to resource of patient and disease severity. For each Scenario, dentists also replied which treatment procedures they would use if they decide to treat the patient. RESULTS: Periodontal training, resource of patient, and disease severity were shown to significantly influence the referral pattern and treatment modality in the management of peri-implant disease (p < 0.05). Periodontists were more likely to use variable treatment procedures, including occlusal adjustment (OR = 2.283, p < 0.01), oral hygiene instruction (OR = 3.751, p < 0.001), topical antiseptic agent (OR = 2.491, p < 0.005), non-surgical mechanical therapy (OR = 2.689, p < 0.001), surgical therapy (OR = 2.009, p < 0.01), and remove implant (OR = 3.486, p < 0.001) to treat peri-implant diseases, compared to NPDs. CONCLUSION: The periodontal specialty training, resource of patient, and disease severity significantly influenced the referral pattern and treatment modality of dentist treating an implant diagnosed with peri-implant disease. This study also highlighted the importance of educating basic periodontal and peri-implant disease-related knowledge to all dentists regularly performing dental implant treatments. CLINICAL RELEVANCE: Peri-implant diseases are highly prevalent among patients with dental implants. Periodontal specialty training could enhance using variable treatment procedures to treat peri-implant diseases for dentists.

Indicators of integrating oral health care within universal health coverage and general health care in low-, middle-, and high-income countries: a scoping review.

BACKGROUND: The World Health Organization (WHO) has recently devoted special attention to oral health and oral health care recommending the latter becoming part of universal health coverage (UHC) so as to reduce oral health inequalities across the globe. In this context, as countries consider acting on this recommendation, it is essential to develop a monitoring framework to measure the progress of integrating oral health/health care into UHC. This study aimed to identify existing measures in the literature that could be used to indicate oral health/health care integration within UHC across a range of low-, middle- and high-income countries. METHODS: A scoping review was conducted by searching MEDLINE via Ovid, CINAHL, and Ovid Global Health databases. There were no quality or publication date restrictions in the search strategy. An initial search by an academic librarian was followed by the independent reviewing of all identified articles by two authors for inclusion or exclusion based on the relevance of the work in the articles to the review topic. The included articles were all published in English. Articles concerning which the reviewers disagreed on inclusion or exclusion were reviewed by a third author, and subsequent discussion resulted in agreement on which articles were to be included and excluded. The included articles were reviewed to identify relevant indicators and the results were descriptively mapped using a simple frequency count of the indicators. RESULTS: The 83 included articles included work from a wide range of 32 countries and were published between 1995 and 2021. The review identified 54 indicators divided into 15 categories. The most frequently reported indicators were in the following categories: dental service utilization, oral health status, cost/service/population coverage, finances, health facility access, and workforce and human resources. This study was limited by the databases searched and the use of English-language publications only. CONCLUSIONS: This scoping review identified 54 indicators in a wide range of 15 categories of indicators that have the potential to be used to evaluate the integration of oral health/health care into UHC across a wide range of countries.

Knowledge and practice towards early orthodontic problems among general dentists and paediatric dentists.

OBJECTIVES: To assess the knowledge, practice and challenges faced by general dental practitioners (GDPs), paediatric dentists (PDs) and postgraduate paediatric dentistry students (PGPDSs) in diagnosing and managing early orthodontic problems. DESIGN: Cross-sectional study. METHODS: A total of 159 dentists were enrolled in this study (121 GDPs, 21 PDs and 17 PGPDSs). Data were collected using a self-administered questionnaire involving two sections. Section A included questions regarding demographic features and orthodontic practice. Section B included photos of 12 orthodontic cases that needed early intervention. Knowledge and practice were assessed using six questions for each case that was then rated using predefined scores of poor (score <50%), average (score 50%-75%) and good (score >75%). RESULTS: The knowledge scores regarding the identification of early orthodontic problems were average among the three groups with GDPs having the lowest score (P = 0.0001). The knowledge scores regarding the selection of optimal treatment time were average among the PDs and PGPDSs, and poor among GDPs. GDPs tended to refer most of their cases to an orthodontist except for cases of thumb sucking. PDs and PGPDSs were more confident in treating anterior crossbite, thumb sucking habits and delayed eruption of incisors. All participants scored 'poor' regarding the selection of an appropriate orthodontic appliance. There was no significant correlation between knowledge and practice (P > 0.05). CONCLUSION: PDs and PGPDSs showed higher knowledge and practice scores when compared to GDPs. For all three groups included in this study, lack of clinical skills was the main reason for not treating early orthodontic problems.

[Brief description of the personnel potential of healthcare in Greece, Spain and Bulgaria].

The article presents a brief descriptive overview of the human resources of healthcare in Greece, Spain and Bulgaria. It is noted that they differ in the redundancy of specialist doctors with a relative shortage of general practitioners. The medical personnel of these countries are characterized by aging, a tendency to migrate to other countries, a shortage of secondary medical personnel, an excess of the required number of dentists, which is especially pronounced in Bulgaria. In addition, the availability of medical care and the limits on the number of patients for a certain time period with one doctor, established in Greece, reduce. The salary level of doctors in these countries varies from the minimum (Greece, Bulgaria) to the maximum in Spain. At the same time, the training of medical personnel is carried out according to the Bologna system (bachelor's degree, master's degree, etc.) and is characterized by a long period (4-5 years) of preparing a doctor for independent work.

Present status and future directions: Managing endodontic emergencies.

Endodontic emergencies are common in both general dental practices and specialist Endodontic practices. The aim of this review is to provide an overview of endodontic emergencies. Endodontic emergencies can be a result of many different conditions of the pulp, root canal and periradicular tissues. They may occur before endodontic treatment has been started, between appointments when treatment is being performed over multiple visits, or after endodontic treatment has been completed. In the latter situation, the emergency may be very soon after the treatment or it may occur many years later, in which case it is usually a new disease process as a result of the root canal system becoming infected. An emergency can be a stressful situation for both the patient and the dentist (or endodontist) as it is usually an unexpected event. It is incumbent on dental professionals to provide timely assistance to patients who have an emergency, and it is also important to allow sufficient time to manage the situation comprehensively. Management of endodontic emergencies should follow the principles of the 3D's-Diagnosis, Definitive dental treatment and Drugs-and in that sequence. An accurate diagnosis, the first "D", is essential so the appropriate treatment can be provided. Diagnosis requires a thorough understanding of the various conditions that can cause the emergency and this can be helped by having a comprehensive classification of the various conditions. The diagnosis should also direct the clinician to the appropriate Definitive dental treatment, the second "D". Root canal treatment will not always be required as some cases can be managed conservatively. Other cases may require root canal re-treatment. The specific details of how the treatment are done can also vary, according to the diagnosis. The final "D" is Drugs-the use of drugs should also be dependent on the diagnosis and the dental treatment. Drugs should only be an adjunct following the treatment. The clinician must also differentiate between inflammation and infection in order to provide the appropriate treatment and to prescribe the appropriate medication for effective pain relief and resolution of other symptoms or signs such as swelling.

Dental pedagogy in the 'new normal' COVID-19 era: a transition template of teaching protocols.

AIMS: Delivery of clinical dental education, as opposed to clinical medicine, is particularly challenging due to the obligatory aerosol-generating procedures (AGPs) used in dentistry, which are known to facilitate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, using AGPs and working in close proximity to patients for extended periods in dental hospital/university settings with multiple teaching clinics have been a formidable prospect for all stake holders. Therefore, several professional and governmental organizations have promulgated variations of infection control guidelines for general practice dentistry in the pandemic era to mitigate SARS-CoV-2 transmission. MATERIALS AND METHODS: In the absence of unified guidelines for modified infection control/clinical procedures for dental education. We implemented a clinical protocol template and modified operating procedures (MOP) for teaching clinical dentistry to fit the infection control requirements during the pandemic/post-pandemic period at the Sharjah University, College of Dentistry, UAE. MOPs ranged from various engineering control measures (e.g., negative-pressure ventilation systems in operatories) to administrative control measures featuring post-procedure fallow periods of treatment-abeyance between patient sessions. RESULTS: The new MOPs for clinical dentistry in the COVID-19 pandemic era, trialled in a UAE dental teaching hospital, have successfully eliminated infection transmission amongst the students, clinicians, ancillary staff, or attending patients, thus far. CONCLUSIONS: The proposed MOPs that complement the standard operating protocols in clinical dentistry were an attempt to mitigate nosocomial infection transmission and protect four different groups of stakeholders, i) the patients, ii) the dental students, iii) the clinical academics, and iv) the para-dental personnel/assistants. Due to the endemicity of the COVID-19 in many regions of the World, the suggested MOPs need periodic review and revision, to fit the emerging data on the disease. Finally, as there are no studies to date comparing the relative efficacy of the MOPs in various dental academic institutions, there is an urgent need for future workers to address this issue.

Influence of dental education on adoption and integration of technological aids in the delivery of endodontic care by dental practitioners: a survey.

OBJECTIVE: To investigate adoption and integration of technological aids during endodontic treatment and where dental practitioners (DPs) learnt to use this technology. MATERIALS AND METHODS: An electronic questionnaire was distributed to all 459 dentists who graduated from University of Bergen between 2008 and 2018. The respondents were divided into two cohorts, older graduates (2008-2013) and newer graduates(2014-2018). RESULTS: A total of 314(68.4%) DPs answered the questionnaire. Magnification in the form of dental operating microscopes (DOM) and dental loupes was used by 180 (59.6%), electronic apex locators (EAL) by 271(89.7%) and motor-driven files by 281 (93.4%) DPs. The most frequent response, as to where they learnt to use them was: during undergraduate dental (UG) education. Significantly more newer graduates (90.7%) performed instrumentation based on what they learnt during UG education (p < .001). Older graduates based their instrumentation method equally on what they learnt during UG education (51.9%) and continuing dental education(42.6%). Rubber dam was used during all treatment procedures by 93% of the DPs. CONCLUSIONS: UG education is a communication channel with long-lasting importance for adoption and integration of technology by DPs. Exposure to innovations (awareness) during UG education is adequate for integration of technology. Continuing dental education is as valuable as UG education for adoption of technology for older graduates.

General dentists' attitudes and perceived barriers in providing domiciliary dental care to older adults in long-term care facilities or their homes in Northern Ireland: A descriptive qualitative study.

OBJECTIVE: Many older patients, housebound or living in long-term care facilities (LTCFs) have limited access to dental care. This descriptive qualitative study aimed to understand general dental practitioners (GDPs) attitudes and perceived barriers to undertaking Domiciliary Dental Care (DDC) for those patients in Northern Ireland (NI). METHODS: Semi-structured telephone interviews were conducted with a purposive sample of 12 GDPs in Northern Ireland. Interviews were digitally recorded and transcribed verbatim. An iterative coding process using theme-analytic methods was used. RESULTS: The data were characterised into four major themes-risk of professional litigation, remuneration for those undertaking DDC, complexity of treatment, and the overall framework of the dental care system in NI. Two minor themes identified were practice culture and reasons for undertaking DDC. The GDPs in the study identified a number of barriers to undertaking DDC including a legal requirement to transport oxygen, lack of organisation and limited oral hygiene care provision in LTCFs, and confusion around their responsibilities for provision of DDC. Those GDPs who were providing DDC indicated that they did so out of kindness and a sense of loyalty to their long-standing patients. CONCLUSION: The GDPs in this study identified a number of significant barriers to provision of DDC at organisational, structural and clinical levels. The GDPs indicated that they required clarification of their responsibilities around DDC with clear guidelines necessary given the increase in demand for this service.

A New Home for Dentistry and Dental Qualifications in the United Kingdom.

The first dental qualification in the UK was awarded by the Royal College of Surgeons of England in 1860. From then on dentistry was closely aligned with, and partly under the thumb, of the medical profession. It thus differed from the USA. Over the years there was slow separation, resulting in 2021 in a new College of General Dentistry.

Ontario Dentists' Practice of Sedation and General Anesthesia: Barriers to Access and Use.

BACKGROUND: To investigate, among Ontario dentists, (1) self-reported barriers to access to sedation and general anesthesia (GA) services and (2) their current use of sedation and GA. METHODS: Of Ontario dentists practising, 3001 were randomly selected to complete a 16-question survey by mail or online in 2011. Mixed analysis of variance (ANOVA) followed by independent-sample t tests or 1-way ANOVA evaluated the relation between dentists' views and demographic variables including sex, clinical experience and size of primary practice. RESULTS: Of the participants (n = 1076; 37.9% response rate), 69.7% were male, 84.4% were general practitioners, mean time in practice was 20.6 years (0.5-42 years) and 42.2% were in cities of over 500 000 people. Most dentists (60.2%) provided anesthesia services, although 38.2% indicated lack of training and the belief that there is no patient demand (25.3%) as reasons not to use anesthesia in their offices. Nitrous oxide was used 17.5% of the time for all dental procedures except implants. Barriers to referral of patients for anesthesia services included high costs associated with sedation/GA (72.2%) and patient fear of anesthesia (33.5%). CONCLUSION: This study identified a perceived lack of patient demand, lack of dentist training, high costs of sedation/GA and patient fear of sedation/GA as primary barriers to use of sedation/GA in Ontario dental practices. The use of various anesthesia modalities is diverse, with 60.2% of dentists providing sedation/GA.

Effects of an individualised training course in endodontics on the knowledge and insights of dentists in Public Dental Service in Norway.

OBJECTIVE: To evaluate the knowledge and insights of general dental practitioners regarding endodontic diagnosis and treatment principles before and after attending a 2-days continuing education course. MATERIALS AND METHODS: Sixty-seven dentists employed in the Public Dental Service in Møre and Romsdal county, Norway, were invited to a continuing education course in endodontics. Before and after the course, they answered a questionnaire weighing the importance of factors influencing the prognosis of endodontic treatment. The same questionnaire was answered by specialists in endodontics (n = 56; Spec Group) and a reference group consisting of general dental practitioners from both private and public practice (n = 21; Ref Group). The Test Group answered both before and after the course, while the Spec and Ref Groups completed the questionnaire once. The responses were compared using the Wilcoxon Sign test and Mann-Whitey U test. RESULTS: Of the 67 dentists in the Test Group, 49 (73%) completed the course and answered both questionnaires. Before attending the course, the Test Group differed significantly from the Spec Group in 18 out of 27 prognostic factors (p ≤ .05). After the course, there was only moderate improvement in the Test Group responses. On only three factors, they agreed significantly more with the specialists than before attending the course (p ≤ .05). After the Test Group participants had attended the course, their responses were comparable to the responses of the Ref Group. CONCLUSIONS: A two-days continuing education course only marginally improved dentists' level of knowledge and insights regarding the influence of prognostic factors in endodontics.

Survival of root filled teeth in general dentistry in a Swedish county: a 6-year follow-up study.

OBJECTIVE: The purpose of the present study was to investigate the survival rate of root filled teeth in general dentistry in a Swedish county and to identify risk predictors with a significant influence on the survival rate. MATERIALS AND METHODS: This is a retrospective 6-year follow-up study on 1642 recall patients with 1720 teeth root filled in general dentistry in the Public Dental Service in the county of Stockholm, Sweden. Background variables were collected from the database at baseline as potential predictors of tooth loss. The outcome variables were extraction during the 6-year follow-up period and the reason for the extraction. Stepwise Cox regression analysis was adopted in order to investigate the influence of the potential risk predictors on the risk for tooth extraction. RESULTS: Nine percent of the root filled teeth were lost after 6 years. The most frequent reason for tooth loss was fracture and/or cracks (58%). The survival rate of the root filled teeth increased significantly for younger patients, root filled teeth with metal crowns (96%) and high quality of the root filling (93%). The survival rate differed significantly between tooth groups with the lowest survival for molars (83%). Composite fillings were significantly associated with lower quality of the root fillings. CONCLUSIONS: Ninety-one percent of the root filled teeth survived after 6 years. The survival rate was significantly higher for teeth with root-fillings of high quality and metal crowns as well as for root filled teeth in younger patients. The lowest survival rate was found for molars.

Radiographic outcome of root canal treatment in general dental practice: tooth type and quality of root filling as prognostic factors.

OBJECTIVE: This study evaluated the radiographic outcome of root canal treatments (RCTs) performed by general dental practitioners (GDPs) with focus on tooth type and quality of root filling. MATERIALS AND METHODS: The target population included all patients receiving root filling by GDPs in City of Helsinki in 2010-2011. Equal numbers of each tooth type (anteriors, premolars, molars) by jaw were included, resulting in 426 teeth. Pre- and post-operative periapical radiographs were assessed to evaluate periapical status and quality of root filling. Statistical evaluation utilized Chi-squared tests, Cohen's kappa and logistic regression modelling. RESULTS: The overall success rate of RCT was 67.4%, being 76.8%, 69.7% and 55.6% (p < .001) for anteriors, premolars and molars, respectively. The quality of root fillings varied by tooth type (p < .001); optimal fillings were least frequent (43%) in molars. In multifactorial analysis, RCTs were more likely to succeed in non-molars (OR = 1.8), in teeth with optimal root fillings (OR = 3.6) and in teeth without apical periodontitis (OR = 3.2). CONCLUSION: The quality of root fillings and radiographic outcome of RCTs varied considerably according to tooth type; success was least likely in molars. Improvement is needed in quality of RCTs by GDPs.

Current Knowledge and Awareness of Healthcare Professionals of Oral Cancer: a Study at a UK District General Hospital.

The aim of this study was to assess the levels of awareness of oral cancer in healthcare staff at a district general hospital in the UK. This excluded those staff involved in head and neck cancer management. The study identified the areas where there was a deficiency in knowledge and quantified any differences across the professions. Following a literature review utilising the National Institute for Health and Care Excellence (NICE) Healthcare Databases Advanced Research (HDAS) tool, a questionnaire was designed, which was piloted amongst healthcare professionals on one ward. The feedback from the respondents was used to test the suitability of the survey format and modified before implementation across the hospital. One hundred fifty-five completed surveys were collected. The respondents were divided into doctors, nursing staff, and healthcare assistants (HCAs). There were generally low to middle levels of subjective individual confidence in identifying oral cancer. There was confusion on the clinical signs of oral cancer, with 29% of respondents believing that toothache was a sign. Almost half of all the respondents believed that dental decay was a risk factor for oral cancer. Although the significance of an early diagnosis was recognised as being important, a number of respondents were not aware of the likely differences in morbidity and mortality based on the stage of disease on diagnosis. This study has demonstrated that the healthcare workforce has gaps in knowledge both in of the presentation of oral cancer and the morbidity and mortality associated with a delay in diagnosis. Further learning opportunities for all healthcare staff will help to reduce future disease burden.