Indonesian dentists' views on providing oral health care for older adults.

BACKGROUND: With demographic changes in aging populations, dentists require special care protocols to treat older adults with diverse and complex oral health needs and problems. Knowledge, positive attitudes, and sufficient practice experience are essential components for promptly treating older adults. However, many dentists encounter multiple barriers influencing their willingness to provide care for older adults. This study assessed Indonesian dentists' knowledge, attitudes, and practices (KAP) in providing oral health care (OHC) for older adults, including their willingness and barriers. METHODS: A cross-sectional survey was conducted with 392 dentists employing an online questionnaire between April and June 2022. The respondents' KAP was categorised utilising a modified Blooms' cut-off point of ≥60%. Data were analysed using descriptive statistics, the x2 test, and logistic regression. RESULTS: Most dentists demonstrated adequate knowledge (62.2%), a positive attitude (95.4%), sufficient practice experience (91.6%), and a high willingness (98%) to provide OHC services for older adults. However, 91.4% encountered barriers primarily related to interpersonal communication, disease complexity and polypharmacy, and patient functional status. Significant associations were found between dentists' attitudes toward practices and willingness to attend geriatric dentistry training with knowledge. CONCLUSION: Implementation of continuing professional development (CPD) in geriatric dentistry, the inclusion of geriatric dentistry into the undergraduate curriculum, and enhancing clinic accessibility for older adults may improve dentists' preparedness and benefit the future provision of OHC for older adults in Indonesia.

Associations between disability type and untreated dental decay among community dwelling US adults.

OBJECTIVE: Individuals with disabilities face elevated risks of adverse oral health outcomes compared with the general population, including worse periodontal health, increased edentulism, and untreated dental decay. Given the varied impacts of different disabilities on people's health and well-being, this study aims to investigate diverse associations between untreated decay and cognitive, physical, emotional, and sensory disabilities among US adults. METHODS: This cross-sectional study analyzed questionnaire and clinical examination data on 7084 adults (≥20 years) from the 2015-18 National Health and Nutrition Examination Survey cycles. Sociodemographics, oral health behaviors, health conditions, and disability were all examined. The prevalence of tooth decay was calculated as the proportion of adults with untreated decay. Survey-weighted multivariable logistic regression was used to assess associations between disability and untreated decay. RESULTS: In general, untreated decay was more than twice as prevalent in individuals with three or more disabilities as in those without any disabilities (34.5% vs. 13.2%, p < 0.001). After adjusting for confounders, lack of functional dentition was the most significant predictor of untreated decay prevalence (adjusted odds ratio: 2.97, 95% CI: 2.37-3.72). Other significant factors were younger age (20-44), non-Hispanic black race or ethnicity, low-income status, having an underlying chronic condition, not having a past-year dental visit, symptomatic dental visits, and current tobacco use. CONCLUSION: No associations were found between disability type (cognitive, emotional, physical, and sensory) and untreated decay among community-dwelling US adults. Several health-related, social, and behavioral factors emerged as primary predictors of untreated decay. Further research is needed to explore disability types and dental caries determinants.

Analysis of Dental Prosthetic Treatment in Patients with Cancer Aged 65 Years and Older after Expanded Health Insurance Coverage: A Retrospective Clinical Study.

Background and Objectives: With increases in cancer incidence and the number of cancer survivors, the demand for cancer management is growing. However, studies on dental prosthetic treatment for patients with cancer are rare. We aim to investigate the dental prosthetic treatment in patients with cancer aged ≥65 years after expanded health insurance coverage. Materials and Methods: This retrospective study included patients who were treated with implants and removable dentures at Ulsan University Hospital in South Korea between June 2015 and June 2023. Data on age, sex, cancer location, comorbid systemic diseases, number of remaining teeth, dental prosthetic treatment history, type of dental prosthetic treatment, and insurance coverage status were extracted from patient medical records and panoramic radiographs. The influence of multiple variables on dental prosthetic treatment was analyzed using the Chi-square and Fisher's exact tests. Results: The study included 61 patients with cancer (32 men, 29 women; average age: 70.9 years). Among them, 56 (91.8%) had insurance coverage benefits, and 34 (55.7%) received treatments such as implants, removable partial dentures, or complete dentures for the first time. Treatment types included 37 (60.7%) cases of implant prostheses and 24 (39.3%) conventional removable dentures. No statistical differences were observed in the type of dental prosthetic treatment according to sex, age, cancer location, number of systemic diseases, and dental prosthetic treatment history (p > 0.05). Patients with <10 remaining teeth received treatment with conventional removable dentures, which was statistically significant (p < 0.001). Conclusions: Of the 61 patients, 56 (91.8%) received insurance benefits, and 34 (55.7%) underwent dental prosthetic treatment for the first time. Within the limitations of this retrospective study, the expanded health insurance coverage alleviated the unmet demand for dental prosthetic treatment. As cancer prevalence continues to increase, expanding customized health insurance coverage is crucial to meet this demand.

Estimating the magnitude of different barriers to dental care for special needs patients: A systematic review.

Quite often, it is seen that the number of special care individual in the dental OPD/clinics is quite low, as compared to their population. This can be due to specific barriers that restrict them in availing dental treatment. Our aim was to identify different barriers to dental care of persons with special needs through a systematic review and to quantify them. A systematic review was carried out according to PRISMA guidelines. PubMed data was searched with predefined keywords leading to retrieval of 576 records. Full length studies published in English language from 2010 onwards with mention of proportion of persons citing a barrier to dental care were included. Three studies published in peer reviewed journals from other data sources were also identified while retrieving the full length texts. Out of a total of 576 PubMed and three additional records, a total of 22 studies were included in the systematic review. Cost, communication, physical facilities, fear/uncooperativeness, unawareness, distant location/inaccessibility, unwilling dentist, transportation, and difficulty in getting appointment were identified as nine major barriers. Pooled proportions for different barriers ranged from 22.75% (Accessibility; 95%CI = 19.96-25.54) to 44.35% (Communication; 95% CI = 32.63-56.07A). There was a high heterogeneity across different studies for both fixed effects and random effects models. Communication, physical facilities, and unawareness were identified as the three most common barriers showing minimum heterogeneity in random effects model.

Atuação do cirurgião-dentista na atenção primária à saúde: experiências a partir da residência multiprofissional / Performance of the dentist in primary health care: experiences from the multiprofissional residency program / El rol del cirujano dentista en laatención primaria de salud: experiencias del programade residencia multiprofesional

Introdução:A inserção das equipes de saúde bucal na Estratégia Saúde da Família, embora tardia, representa um avanço significativo para a ampliação da cobertura e da qualidade dos serviços odontológicos no Brasil. No entanto, aindaexistem muitosdesafiosnas práticas do cirurgião-dentista na Estratégia Saúde da Família. A atuação majoritariamente clínica prejudica a realização deum trabalho humanístico, resolutivo, interdisciplinar e multiprofissional. Objetivo:Relatar a experiência de atuação de uma cirurgiã-dentista residente na Atenção Primária em Saúde no município de Santo Estêvão, Bahia, Brasil, durante o Programa de Residência Multiprofissional em Saúde da Família da Universidade Estadual de Feira de Santana. Metodologia:Trata-se de um estudo qualitativo, do tipo relato de experiência, que visa descrever as atividades desenvolvidas durante o Programa de Residência Multiprofissional em Saúde da Família, da Universidade Estadual de Feira de Santana, no município de Santo Estêvão, Bahia, Brasil, no período de março de 2022 a novembro de 2023. Resultados:As atividades descritas abrangem as diferentes possibilidades de trabalho do cirurgião-dentista na Atenção Primária, envolvendo ações assistenciais através das consultas individuais e levantamento epidemiológico, educação permanente e em saúde com atuação nos grupos operativos e capacitações com os profissionais da rede e as ações de planejamento e gestão, através do desenvolvimento de estratégias para fortalecer a rede de atenção à saúde. Conclusões:É preciso motivar os profissionais de saúde bucal a repensarem suas práticas, tendo como ponto de partida o investimento e o estímulo à educação permanente e continuada. A especialização em saúde da família permite que cirurgiões-dentistas que atuam ou têminteresse em trabalhar no serviço público desenvolvam habilidades e práticas voltadas para uma assistência integral e multiprofissional da saúde, contribuindo para a consolidação do Sistema Único de Saúde (AU).

Introduction:The oral health team inclusion in the Family Health Strategy represents a significant advance in expanding the coverage and quality of dental services in Brazil. However, there arestill many challenges in the dental surgeons practices in the Family Health Strategy. The ppredominantly clinical approach hinders the achievement of ahumanistic, problem-solving, and interdisciplinary and multidisciplinary. Objective:To report the experience of a dental surgeon resident in Primary Health Care in the city of Santo Estêvão, Bahia, Brazil, during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana. Methodology:This is a qualitative study, experience report type, which aims to describe the activities developed during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana, in the city of Santo Estêvão, Bahia, Brazil, from March 2022 to November 2023. Results:The activities described cover the different work possibilities of dental surgeons in Primary Care, involving assistance actions through individual consultations and epidemiological surveys, ongoing health education with work in operative groups and training with network professionals, and planning and management actions through the development of strategies to strengthen the health care network. Conclusion:It is necessary to motivate oral health professionals to rethink their practices, with investment and encouragement for permanent and continuing education as a starting point. Specialization in family health allows dental surgeons who work or are interested in working in the public service to develop skills and practices aimed at comprehensive and multidisciplinary health care, contributing to the consolidation of the Unified Health System (AU).

Introducción: La inclusión de los equipos de salud dental en la Estrategia de Salud Familiar, aunque tardía, representa un avance significativo en la ampliación de la cobertura y la calidad de los servicios dentales en Brasil. Sin embargo, los cirujanos dentistas siguen enfrentándose a muchos retos em la Estrategia de Salud Familiar. El enfoque mayoritariamente clínico obstacualiza la realización de um enfoque humanista, resolutivo, interdisciplinario y multiprofesional.Objetivo:Reportar la experiencia de un cirujano dentista residente en Atención Primaria de Salud en el ayuntamiento de Santo Estêvão, Bahía, Brasil, durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana.Metodología:Se trata de un estudio cualitativo, del tipoinforme de experiencia, que tiene como objetivo describir las actividades desarrolladas durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana, en el ayuntamiento de Santo Estêvão, Bahía, Brasil, de marzo de 2022 a noviembre de 2023. Resultados:Las actividades descritas abarcan las diferentes posibilidades de trabajo del cirujano dentista en la Atención Primaria, implicando actividades asistenciales mediante consultas individuales y encuestas epidemiológicas, educación sanitaria continuada con actuación en los grupos operativos y capacitaciones con los profesionales de la red y actividades de planificación y gestión mediante el desarrollo de estrategias de fortalecimiento de la red de atención sanitaria.Conclusiones:Es necesario motivar a los profesionales de la salud dental a replantear sus prácticas, con la inversión y el fomento de la formación permanente y continua como punto de partida. La especialización en salud familiar permite a los cirujanos dentistas que trabajan o están interesados en trabajar en el servicio público desarrollar competencias y prácticas dirigidas a la atención sanitaria integral y multiprofesional, contribuyendo a la consolidación del Sistema Único de Salud (AU).

The child dental care reform in Israel - service uptake from 2011 to 2022.

BACKGROUND: The 2010 Child Dental Care Reform of the National Health Insurance Law marked a turning point in the Israeli oral healthcare system by establishing Universal Health Coverage of dental care for children. Initially, the reform included children up to age 8 and gradually expanded to age 18 in 2019. The basket of services includes preventive and restorative treatments provided by the four Health Maintenance Organizations (HMO). The aim of this study was to examine the uptake of child dental services during the first decade of the reform. METHODS: A retrospective analysis was conducted to determine the treatment uptake, type and amount of the services delivered based on annual service utilization reports submitted by the HMOs to the Ministry of Health in the years 2011-2022. RESULTS: The number of insured children increased from 1,546,857 in 2011 to 3,178,238 in 2022. The uptake of dental services gradually increased during the study period with a slight decrease in 2020. The percentage of children who used the services gradually increased from 8 to 33%, with the incremental inclusion of additional age groups. From 2012 onwards the most common treatments provided were preventive, however the single most common treatment was dental restoration. In 2022 35% of the population of Israel was under the age of 18. Out of these, about a third received dental treatment via the HMOs. This is a significant achievement, since before the reform all treatments were paid out-of-pocket. After a short period of increasing uptake, a stable service utilization pattern was evident that can indicate better public awareness and service acceptance. CONCLUSION: Although this is a reasonable uptake, additional efforts are required to increase the number of children receiving dental care within the public insurance. Such an effort can be part of a multi-disciplinary approach, in which pediatricians and public health nurses can play a vital role in dental caries prevention, enhancement of awareness and service utilization.

Mandibular fracture in medication-associated osteonecrosis following infliximab therapy: A case report.

INTRODUCTION: Medication-associated osteonecrosis of the jaws (MRONJ) is characterized by the presence of exposed bone or an intraoral or extraoral fistula in the maxillofacial region in patients with a history of treatment with anti-resorptive and anti-angiogenic drugs, such as monoclonal antibodies, and without a history of radiotherapy or metastatic diseases in the area. OBJECTIVE: The aim of this study is to report a case of a pathological mandibular fracture in an area of MRONJ in a patient diagnosed with Crohn's disease treated with infliximab. CASE REPORT: A 53-year-old male patient, an active smoker for 35 years, diagnosed with Crohn's disease, undergoing intravenous administration of infliximab 300 mg for 1 year and 3 months, with no previous history of anti-angiogenic or anti-resorptive medication, presenting with an extraoral fistula in the submandibular region for 4 months, with painful symptoms, diagnosed as MRONJ. He was initially treated conservatively, using antimicrobial photodynamic therapy (aPDT), antibiotic therapy, and the PENTO protocol. However, the patient evolved with a pathological fracture in the mandibular parasymphysis, requiring surgical reconstruction. FINAL CONSIDERATIONS: Pathological fracture of the mandible is a complication of MRONJ that compromises the patient's quality of life. The management of patients with MRONJ is complex and challenging.

Knowledge about dental care in patients with head and neck cancer among senior dental school students: a cross-sectional descriptive study.

BACKGROUND: The dentist's central role in treating head and neck cancer patients is to care for the patient's oral cavity before, during, and after radio/chemotherapy. This research aimed to determine dental students' knowledge about head and neck cancer patients' dental care. METHODS: One hundred and four fifth and sixth-year dental students participated in this cross-sectional descriptive study. The data collection tool was a questionnaire that collected demographic information (gender, year of study) and four questions consisting of attendance to courses or workshops, passing a dedicated course at the university, willing to participate in a course or workshop on the treatment of head and neck cancer patients and self-evaluating information about the treatment of head and neck cancer patients. Final part 36 questions about oral and dental care for head and neck cancer patients before, after, and during treatment. The data were analyzed with SPSS 26 statistical software and using t-tests, ANOVA, and linear regression at the 0.05 significance level. RESULTS: Most of the participants were in their sixth year (48.9%). A total of 48.1% of the people reported that their information about dental treatments in patients with head and neck cancer was bad. 85% of participants agreed with the necessity of evaluating the patient's mouth and teeth before starting the treatment. The lowest percentage of correct answers was related to the ideal duration of tooth extraction and a poor prognosis before the start of cancer treatment. The regression analysis revealed a significant relationship between years of education, willingness to participate in courses, and students' knowledge evaluation and knowledge. CONCLUSION: The findings showed that students' awareness of oral and dental treatment and care for patients with head and neck cancer is insufficient. It is recommended that teaching staff pay more attention to the lack of knowledge and effort to educate students by holding special courses and workshops.

To appreciate the influence of contributed determinants on dental care utilization in the context of socio-economic inequalities.

BACKGROUND: To appreciate dental care utilization in |the context of socio-economic inequalities, it is imperative to identify sources of inequalities and evaluate the extent to which dental care utilization is still related to socio-economic status. This study aimed to quantify the influence of contributed determinants on dental care utilization in the context of socio-economic inequalities amongst adults residing in Tehran metropolis. METHODS: In this cross-sectional community-based study, a stratified random sample of 1,510 subjects aged over 18 years was investigated by the zero-inflated Poisson analysis to measure the effect of determinants on utilization of dental care, and concentration index as well as the decomposition approach to identify the contributions of deterministic variables to the socio-economic inequality. Data was obtained by employing a phone interview survey. Individuals who were not willing or able to answer the questions in the telephone interview due to hearing or neurological problems did not participate in the interview. Dental care utilization was measured using the number of dental appointments. RESULTS: Gender (male), oral health-related behaviors (such as brushing and dental flossing), experience of toothache, and concern about dental appearance were associated with an increased likelihood of utilizing dental care. Individuals who belonged to advanced age groups and lived alone significantly underutilized dental care. The concentration index equaling 0.05 (SE = 0.05) corroborates a pro-rich inequality. Decomposition analysis demonstrated the impact of oral health-related behaviors (i.e. dental brushing and use of dental flossing), concern about dental appearance, toothache, gender (male), insurance coverage of dental care, and smoking habit on the poor-rich gap in the dental care utilization. CONCLUSIONS: The influence of socio-economic inequalities on dental care utilization is discernable along the entire spectrum of socio-economic status. Individuals with lower socio-economic status experience more underutilization of dental care. Community subgroups, particularly the more deprived bracket, require consideration from key stakeholders, including policymakers and health professionals for the enhancement of dental care utilization as revealed by underlying determinants.

O trabalho das equipes de saúde bucal na pandemia da covid-19 segundo gestores de saúde / The work of oral health teams in the COVID-19 pandemic according to health managers

RESUMO Este estudo objetivou caracterizar o trabalho dos profissionais das equipes de saúde bucal da rede pública na pandemia da covid-19 do ponto de vista dos gestores. Trata-se de um estudo quantitativo-qualitativo, com 163 gestores municipais de saúde da Bahia, que responderam a um questionário virtual, de junho a outubro de 2020. Foi realizada análise descritiva dos dados quantitativos utilizando o Statistical Package for the Social Science, e Análise Temática das respostas subjetivas, com auxílio do IRaMuTeQ. Um escopo de atuação das equipes de saúde bucal, que atuam em todos os níveis de atenção à saúde, foi reconhecido como mais abrangente que o tradicional nesse período. A pandemia deu ênfase às fragilidades crônicas nas condições de trabalho dos cirurgiões-dentistas, técnicos e auxiliares de saúde bucal da rede pública, como a insuficiência de instrumentais odontológicos e de insumos, a precária manutenção dos equipamentos odontológicos, a fragilidade dos vínculos empregatícios e a estrutura física inadequada nas unidades de saúde, comprometendo a biossegurança. Assim, abre-se uma oportunidade para identificar e implementar mudanças necessárias não apenas no contexto de crise sanitária, mas também no período pós-pandemia.

ABSTRACT This study aimed to characterize the work of professionals from oral health teams in the public service, in the COVID-19 pandemic, from the point of view of managers. This is a cross-sectional, quantitative-qualitative study, with 163 municipal health managers in Bahia, who answered a virtual questionnaire, from June to October 2020. The descriptive analysis of the quantitative data was performed using the Statistical Package for the Social Science, and Thematic Analysis was applied to the subjective responses, using IRaMuTeQ. The scope of action of oral health teams, which operate at all levels of health care, was recognized as broader than the traditional in this period. The pandemic emphasized the chronic problems in the working conditions of dentists, technicians, and oral health assistants in the public service, such as the lack of dental instruments and supplies, the precarious maintenance of dental equipment, the fragility of employment relationships, and the inadequate physical structure in the health units, compromising biosecurity. Thus, there is an opportunity to identify and implement necessary changes not only in the context of a health crisis, but in the post-pandemic period.

Eficacia de un programa de salud bucal para cuidadores de personas con discapacidad / Effectiveness of an oral health program for caregivers of people with disabilities

Objetivo. Evaluar la eficacia del programa de salud bucal para los cuidadores de las personas con discapacidad. Métodos: Estudio cuasi experimental de intervención directa, longitudinal, con control antes y después, con un muestreo no probabilístico. Se diseñó, aplicó y evaluó un programa educativo de salud bucal a los cuidadores de personas con discapacidad, mediante una encuesta diseñada al efecto, antes y después de su implementación, en 111 cuidadores, así como la evaluación del Índice de Higiene Bucal de sus familiares con discapacidad, en el periodo de octubre a diciembre de 2020. La información fue procesada utilizando las herramientas de Excel y el programa SPSS versión 25. Los datos numéricos fueron resumidos en tablas descriptivas y los datos categóricos en tablas de frecuencia. Resultados: Antes de la intervención 9,9 % de las personas con discapacidad asistían cada seis meses al dentista, lo cual se incrementó a 76,5 %. Antes del programa 102 personas solo usaban cepillos y pasta dentales para la limpieza bucal, después 109 continuaron usando los mismos productos, sin embargo, se incrementó en un 6 % el uso del hilo dental. El Índice de Higiene bucal se mantuvo como regular, aunque disminuyó de 2.30 a 1.68. Conclusiones: La aplicación del programa cambió positivamente la situación de la salud bucal de los discapacitados ya que los cuidadores demostraron la adquisición de los nuevos conocimientos para una adecuada higiene de la cavidad bucal, la constancia en la aplicación del proceso y la necesidad de asistir a la atención odontológica por hábito y no por necesidad puntual.

Objective: Determine the level of knowledge of caregivers of people with disabilities about oral health before and after applying a program of educational workshops on the subject. Methods: It was a quasi-experimental study of direct intervention, longitudinal, with control before and after, with non-probabilistic sampling. An educational oral health program for caregivers of people with disabilities was developed, applied, and evaluated through a survey before and after its implementation, in 111 caregivers, as well as the evaluation of the Oral Hygiene Index of their relatives with disabilities, in the period from October to December 2020. Results: Before the intervention, 9.9% of people with disabilities attended the dentist every six months, which increased to 76.5%. Before the program, 102 people only used toothbrushes and toothpaste for oral cleaning, after 109 continued using the same products, however, the use of dental floss increased by 7 people. The Oral Hygiene Index remained regular, although it decreased from 2.30 to 1.68. Conclusion: The application of the oral health program had a favorable impact on caregivers, improving the knowledge regarding oral hygiene of their relatives with disabilities, improving the Oral Hygiene Index.

Comparison of initial dental treatment decisions between in-person and asynchronous teledentistry examinations for people with special health care needs.

BACKGROUND: People with special health care needs in long-term care settings have difficulty accessing a traditional dental office. The goal of the authors was to assess initial treatment decision concordance between dentists conducting traditional in-person examinations using mobile equipment and additional dentists conducting examinations using asynchronous teledentistry technology. METHODS: Six dentists from Access Dental Care, a North Carolina mobile dentistry nonprofit, saw new patients on-site at 12 participating facilities or asynchronously off-site with electronic dental records, radiographs, and intraoral images, all captured by an on-site dental hygienist. Off-site dentists were masked to other dentists' treatment need decisions; 3 through 5 off-site examinations were conducted for each on-site examination. Demographic and binary treatment need category data were collected. For the 3 most prevalent treatment types needed (surgery, restorative, and new removable denture), the authors calculated the percentage agreement and κ statistics with bootstrapped CIs (1,000 replicates). RESULTS: The 100 enrolled patients included 47 from nursing homes, 45 from Programs of All-Inclusive Care for the Elderly, and 8 from group homes for those with intellectual and developmental disabilities. Mean (SD) age was 73.9 (16.5) years. Among dentate participants, the percentage agreement and bootstrapped κ (95% CI) were 87% and 0.74 (0.70 to 0.78) for surgery and 78% and 0.54 (0.50 to 0.58) for restorative needs, respectively, and among dentate and edentulous participants, they were 94% and 0.78 (0.74 to 0.83), respectively, for new removable dentures. CONCLUSIONS: The authors assessed the initial dental treatment decision concordance between on-site dentists conducting in-person examinations with a mobile oral health care delivery model and off-site dentists conducting examinations with asynchronous dentistry. Concordance was substantial for surgery and removable denture treatment decisions and moderate for restorative needs. Patient characteristics and facility type were not significant factors in the levels of examiner agreement. PRACTICAL IMPLICATIONS: This evidence supports teledentistry use for patients with special health care needs and could help improve their access to oral health care.

The EORTC QLQ43 and FACT H&N questionnaires of quality of life at 1 and 5 years after treatment and dental care in head and neck cancer patients: a pilot study.

PURPOSE: This study aimed to examine health-related quality of life (HRQoL) in head and neck cancer patients at 1 and 5 years after successful treatment of their tumors, and to explore the usefulness of 2 instruments for assessing the need of dental care services. METHODS: This cross-sectional pilot study included 20 adult patients with head and neck cancer who completed the Functional Assessment of Cancer Therapy-Head and Neck (FACT H&N) Symptom Index and the European Organization for Research and Treatment of Cancer Quality of Life Head and Neck Module (EORTC QLQ-H&N43) after 1 and 5 years of treatment. RESULTS: Mean (standard deviation, SD) scores of the FACT H&N Symptom Index were higher (better HRQoL) at 5 years than at 1 year (24.1 [4.4] vs. 21.1 [6.4]; p = 0.236). Only three of the ten items of FACT H&N (swallow, pain in mouth/throat or neck, and solid foods) evaluated oral health. In the EORTC QLQ-H&N43 questionnaire, scores were lower at 5 years (better HRQoL) in almost all multi- and single-item symptoms. This questionnaire includes four multi-item scales (pain in the mouth, social eating, swallowing, and problems with teeth) measuring dental and orthodontic needs. CONCLUSION: HRQoL in patients with head and neck cancer improved with the length of follow-up. The EORTC QLQ-H&N43 has more items addressing oral health compared to the FACT H&N Symptom Index and may be more adequate to assess the need of dental therapy in clinical practice.

Is there an association between head and neck cancer diagnosis and self-reported dental fear? A dual-center cross-sectional study.

Introduction: Mental distress is highly reported in cancer patients, resulting in anxiety and depression most of the time. Both conditions, in turn, are recognized to be related to dental fear in adults; however, there are no studies on patients suffering from head and neck cancer. Thus, the present study aimed to investigate whether newly diagnosed patients with head and neck cancer are more prone to self-reported dental fear. Material and Methods: This dual-center cross-sectional study was conducted with 25 healthy outpatients and 25 patients with a recent diagnosis of head and neck cancer, all requiring dental care. The patients were informed at the first appointment about their dental therapy planning and the Brazilian Portuguese Version of the Dental Fear Survey (DFS) questionnaire was then applied after appropriate instructions. Results: The DFS total scores did not differ statistically between the groups (Mann-Whitney U test, P = 0,120) but the Cancer Group presented a slightly higher mean score (32.2 ± 10.0) than the Control Group (30.0 ± 14.2). Conclusion: Within the limitations of this study, newly diagnosed patients with head and neck cancer and healthy individuals seem to experience similar self-reported dental fear.

Surgical outcomes of the surgical techniques following management of iatrogenic trigeminal nerve injuries: A systematic review.

Objective: To investigate the effectiveness of the microsurgical treatment in restoring full sensory recovery following trigeminal nerve injuries caused by iatrogenic oral and maxillofacial surgical interventions. Methods: A detailed search was conducted on the Cochrane central register of controlled trials, Medline and Embase. Clinical studies with at least twelve months of follow up were included and assessment of risks of bias was made using the Robbin I assessment tool. Results: Six studies were identified in the searches which include 227 patients. The lingual nerve was the most common injured nerve, followed by the inferior alveolar nerve. Third molar removal was the most frequent cause of nerve injury, followed by root canal treatment, pathology excision, coronectomy, orthognathic surgery, dental implants and then local anaesthetic injections. Overall, surgical interventions for nerve injuries showed neurosensory improvement postoperatively in the majority of patients. Conclusion: Direct neurorrhaphy is still the gold-standard technique when the tension at the surgical site is minimal. Promising results have been noted on conduit applications following traditional repair or grafting. Further research is needed on the efficacy of allografting and conduit applications in nerve repair.

Dental robotics: a groundbreaking technology with disruptive potential - review article.

Dental Robotics represent a groundbreaking technological frontier with the potential to disrupt traditional paradigms in oral healthcare. This abstract explores the transformative impact of robotic applications in dentistry, focussing on precision, reproducibility, and reliability. A comprehensive search was conducted on the PubMed database, Dental and Oral Science, and CINAHL to identify pertinent studies exploring the implications of robotics in dentistry. Studies incorporated in this analysis highlighted the significance of broadening the research scope beyond implantology. This review underscores the importance of integrating robotic dentistry into educational frameworks and advancing technological preparedness. As we navigate these challenges, the abstract underscores the pivotal role of robotic dentistry in shaping the future of oral healthcare. Robotic dentistry promises transformative advancements in oral healthcare with precision and reliability. Challenges like limited system availability and expertise highlight the need for increased dentist-engineer collaboration. Diversifying research, emphasizing non-invasive technologies, and integrating robotic dentistry into education are crucial for wider acceptance. Public awareness and regulatory clarity are pivotal for seamless integration, unlocking the vast potential of robotic technologies in the future of dental care.

Los servicios de odontología en los tiempos del COVID- 19 en Colombia: análisis de país / Oral and dental services in times of COVID-19 in Colombia: a national analysis

Se desconoce el impacto que produjo la pandemia por el COVID-19 en la prestación y en la consulta de los servicios odontológicos y analizados según el sistema integrado de protección social o SISPRO en Colombia. El objetivo fue Determinar los cambios en la cobertura y los patrones de atención odontológica, entre los años pre pandemia (2017-2019) y los años de pandemia (2020-2021). Se analizaron los registros de las atenciones odontológicas reportadas en el sistema SISPRO del Ministerio de Salud de Colombia en periodos prepandemia y postpandemia por el COVID-19. En el año 2019 la tasa de cobertura por cada 100 habitantes en el estudio era de 31,14; sin embargo, la cobertura de atención odontológica se redujo al 17% en el 2020 y al 9% en el 2021 y las atenciones de urgencias disminuyeron drásticamente en los años 2020 y en el 2021. Se requiere que los tomadores de decisión promuevan los servicios de odontología para recuperar los niveles de cobertura previos a la pandemia. Se identificó una disminución en la cobertura odontológica asociada a la pandemia de la COVID-19 en los años 2020 y 2021 y desconocen cuales son los posibles efectos en la morbilidad bucal de los Colombianos.

Introduction. The COVID-19 pandemic affected Colombian dental services from March 2019 to now, but its magnitude is unknown. Objective. To determine dental care coverage in Colombia during the pandemic period and compare these data with the pre-pandemic period 2017-2019. Methods. Dental coverage and consultation services registered in the "Sistema Integrado de Protección Social" or SISPRO from 2017 to 2021 were analyzed. Results. The whole dental service coverage rate was nearly 20% before Covid-19 pandemic and even registered a slight increase from 2017 to 2018 at national and at department levels. This dental national coverage was 31,14% for every 100 habitants in 2019. However, there was a sharp reduction to 17% in 2020 and to 9% in 2021, revealing a clear and negative impact of the pandemic in dental coverage services and in dental emergency services. Conclusion. A decrease in dental coverage during to the COVID-19 pandemic is revealed, with a concomitant reduction in dental emergency consultations during 2020 and 2021 at country level. The consequences of this disruption on the oral and dental epidemiological profile of Colombians is still unknown and might require urgent preventive, promotional and curative care actions to recover the pre-pandemic dental coverage levels.

Prospective Cohort Study Identifies Medical Predictors of Treatment-Related Oral Toxicities in Oral and Oropharyngeal Cancer Patients.

The dental treatment of patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC) may be challenging for dentists. This study aimed to characterize systemic changes in patients with OOPSCC undergoing dental treatment prior to cancer therapy, with a specific focus on laboratory assessments. The primary objectives included identifying potential adverse events, such as infections or bleeding, resulting from dental procedures. Additionally, the study aimed to correlate baseline patient characteristics with treatment-related toxicities. This was a prospective cohort study that included 110 OOPSCC patients referred to the Dental Oncology Service at São Paulo State Cancer Institute, Brazil, between November/2019 and December/2020. Comorbidities, sociodemographic data, medication in use, cancer treatment-related toxicities, and altered laboratory tests results were correlated. The most common comorbidities and altered laboratory results were hypertension, dyslipidemia, diabetes, as well as elevated levels of C-reactive protein, hemoglobin, and hematocrit. Toxicities exhibited a progressive pattern over time, encompassing oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis. No correlation between comorbidities and cancer treatment-related toxicities, a positive correlation between medications in use and OM, and a negative correlation between medications and dysgeusia were found. OM was associated with altered thyroxine (T4) and free thyroxine (FT4), calcium, urea, creatinine, alkaline phosphatase, and syphilis. Family income and housing were OM predictors. Altered T4/FT4/urea/calcium/alkaline phosphatase/creatinine/syphilis may be useful clinical predictors of OM. Despite the elevated prevalence of comorbidities and abnormal laboratory findings, dental treatment prior to cancer treatment yielded no adverse events.