Effects of continuity of care on the postradiotherapy survival of working-age patients with oral cavity cancer: A nationwide population-based cohort study in Taiwan.

OBJECTIVES: Cancer of the oral cavity, a well-known global health concern, remains one of most common causes of cancer mortality. Continuity of care (COC), a measurement of the extent to which an individual patient receives care from a given provider over a specified period of time, can help cancer survivors process their experiences of dealing with the illness and recuperation; however, limited research has focused on the survival rate of working-age patients with oral cancer. METHODS: A total of 14,240 working-age patients (20 0.38) and non-high COC (COCI ≤ 0.38) groups. After propensity-score matching, the mortality risk in the low and intermediate COC groups was also found to be significantly higher than that in the high COC group (aHR = 1.178, 95% CI = 1.074-1.292, p < 0.001 and aHR = 1.189, 95% CI = 1.107-1.277, p = 0.001, respectively). CONCLUSIONS: In Taiwan, COC and prior dental treatment before RT significantly affected the survival rate of working-age patients with oral cancer. This result merits policymakers' attention.

Medical care providers' perspectives on dental information needs in electronic health records.

BACKGROUND: The authors conducted this study to identify the most relevant patient dental information in a medical-dental integrated electronic health record (iEHR) necessary for medical care providers to inform holistic treatment. METHODS: The authors collected input from a diverse sample of 65 participants from a large, regional health system representing 13 medical specialties and administrative units. The authors collected feedback from participants through 11 focus group sessions. Two independent reviewers analyzed focus group transcripts to identify major and minor themes. RESULTS: The authors identified 336 of 385 annotations that most medical care providers coded as relevant. Annotations strongly supporting relevancy to clinical practice aligned with 18 major thematic categories, with the top 6 categories being communication, appointments, system design, medications, treatment plan, and dental alerts. CONCLUSIONS: Study participants identified dental data of highest relevance to medical care providers and recommended implementation of user-friendly access to dental data in iEHRs as crucial to holistic care delivery. PRACTICAL IMPLICATIONS: Identification of the patients' dental information most relevant to medical care providers will inform strategies for improving the integration of that information into the medical-dental iEHR.

The EORTC QLQ-OH17: a supplementary module to the EORTC QLQ-C30 for assessment of oral health and quality of life in cancer patients.

AIMS: Assessment of oral and dental problems is seldom routine in clinical oncology, despite the potential negative impact of these problems on nutritional status, social function and quality of life (QoL). The aim was to develop a supplementary module to the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-C30) focusing on oral health and related QoL issues in all cancer diagnoses. METHODS: The module development followed the EORTC guidelines. Phases 1&2 were conducted in France, Germany, Greece, Netherlands, Norway and United Kingdom, while seven countries representing seven languages were included in Phase 3. RESULTS: Eighty-five QoL-items were identified from systematic literature searches. Semi-structured interviews with health-care professionals experienced in oncology and oral/dental care (n=18) and patients (n=133) resulted in a provisional module with 41 items. In phase 3 this was further tested in 178 European patients representing different phases of disease and treatment. Results from the interviews, clinical experiences and statistical analyses resulted in the EORTC QLQ-OH17. The module consists of 17 items conceptualised into four multi-item scales (pain/discomfort, xerostomia, eating, information) and three single items related to use of dentures and future worries. CONCLUSION: This study provides a useful tool intended for use in conjunction with the EORTC QLQ-C30 for assessment of oral and dental problems. The increased awareness may lead to proper interventions, thereby preventing more serious problems and negative impact on QoL. The reliability and validity, the cross-cultural applicability and the psychometric properties of the module will be tested in a larger international study.

The "Interdisciplinary Orofacial Examination Protocol for Children and Adolescents": a resource for the interdisciplinary assessment of the stomatognatic system.

The Interdisciplinary Orofacial Examination Protocol for Children and Adolescents (Protocolo de exploración interdisciplinaria orofacial para niños y adolescents, Barcelona, 2008) is very useful in providing a fast, initial, expedient detection of possible morphological and functional disorders, and to guide the patient toward the appropriate professionals. With this tool it is possible to detect the risk factors which can negatively affect morphological and functional harmony and guide patients toward the necessary treatment as early as possible. This Protocol, developed by 4 orthodontists, 1 ENT and 3 speech language therapists, also contributes to the unification of concepts and nomenclature used by distinct specialists, thus making professional understanding easier and more dynamic.

A one-page orofacial myofunctional assessment form: a proposal.

The author presents her own proposal of a one-page orofacial myofunctional assessment and for each item on the list a brief rationale is provided. The protocol is an easy but comprehensive form that can be faxed or emailed to referral sources as needed. As science provides more objective assessment and evaluation tools, this one-page form can be easily modified.

Sample of a client intake information protocol: a synopsis and rationale.

The utilization of standardized comprehensive forms in the field of orofacial myology is crucial as this profession continues to grow and establish assessment and treatment protocols. This article formally presents a comprehensive health history intake form currently in use, and highlights the rationale for each particular question within this form in an effort to explore the evidence-based theory behind each question utilized. Highlighting the importance of obtaining a thorough health history as it pertains to our profession, personally allows the clinician to ultimately best plan a therapeutic strategy and assess the individual criteria necessary for successful orofacial myofunctional habituation.

Proposta de documentação fotográfica em motricidade oral / Oral motricity photographic registration proposal

Objetivo: propor um protocolo específico para documentação fotográfica do paciente na área deMotricidade Oral. Método: foi utilizada uma câmera digital fixada em um tripé e foram realizadasfotografias padronizadas corporais e de face. Realizou-se ainda, a teleradiografia lateral contrastadacom bário sobre a língua. Resultados: as fotografias facilitaram a visualização dos nossos resultadosterapêuticos. Conclusão: concluiu-se que a documentação proposta auxilia no diagnóstico e no estudodo prognóstico do paciente, bem como, pode ser utilizado como material auxiliar nas orientaçõesaos responsáveis e ao paciente.

Purpose: to propose a specific protocol for photographic register of Oral Motricity patients. Methods:a digital camera mounted on a tripod was used. Standardized photos of body and face were taken. Atele-radiography modified by using contrast with barium which was spread over the patient’s tonguewas taken. Result: the pictures made easy the visualization of our therapeutic results. Conclusion:so far it is possible to conclude that the proposed documentation helps in the diagnosis process andprognosis analysis, and it may be used as supplementary material for guiding patients and parents onthe best treatment to follow.

Inter-relação entre a odontologia e afonoaudiologia na motricidade orofacial / Interrelation between Odontology and Speech- Language Pathology in Orofacial Myology

Objetivo: abordar aspectos da inter-relação entre a Odontologia e a Fonoaudiologia na MotricidadeOrofacial. Métodos: foi realizada pesquisa na forma de questionário dirigido a 49 cirurgiões-dentistasespecialistas em Ortodontia/Ortopedia Facial e 40 em Odontopediatria, bem como a 14 fonoaudiólogasespecialistas em Motricidade Orofacial, todos de Campo Grande/MS. Resultados: houve unanimidadena opinião dos pesquisados em relação à necessidade da interação entre as áreas, sendo o SistemaEstomatognático o campo comum de atuação desses profissionais. Os motivos de encaminhamentospara tratamento fonoaudiológico estão mais relacionados às questões funcionais, mas há,supostamente, resistência tanto dos pacientes quanto dos cirurgiões-dentistas em encaminhar e/ouconsultar o fonoaudiólogo; e os casos de recidivas ortodônticas, na sua maioria, são decorrentes dafalta de acompanhamento fonoaudiológico. Conclusão: existe trabalho integrado do cirurgião-dentistae do fonoaudiólogo, mesmo que ainda sejam necessários ajustes quanto aos critérios de alta emconjunto e de julgamento das recidivas. O trabalho em equipe continua sendo um caminho para aintegração destes profissionais visando o tratamento adequado do paciente.

Purpose: approaching aspects concerning interrelation between Odontology and Speech-LanguagePathology in Orofacial Myology. Methods: the research was carried out using a questionnaire directedto 49 dentists specialized in orthodontics/facial orthopedics and 40 in pediatric dentistry, as well as to14 speech-language pathologists (SLP) specialized in orofacial myology, all from Campo Grande/MS.Results: there was an opinion consensus among those interviewed concerning the need forinterrelationship among the areas, being the stomatognathic system the common performance field ofthese professionals. The main reasons for SLP treatment are functional questions, but there issupposedly resistance on the part of the patients and dentists in referring to and/or consulting a SLP;and the cases of orthodontic relapses are caused by lack of further treatment in speech-languagetherapy. Conclusion: there is an integrated practice between the dentist and the SLP, although it isnecessary to adjust the rules about the correlated discharge and judgment of relapses . A equipmentwork is still a way to the integration of these professionals looking at adjusted treatment for the patient.

[The correlations between the electromyographic display and the aspects involved with masticatory muscle contraction and phosphorus-calcium metabolism]. / Corelatii între reflectari electromiografice si unele aspecte legate de contractia muschilor manducatori si metabolismul fosfo-calcic.

The neuromuscular activity at the level of the stomatognathic system has a specific complexity, due to the multiple systemic functions, realizing the statistical and dynamical mandibular positions and the integration of the stomatognathic system at the level of the human body. Knowing that the neuroendocrine system represents an important factor for the over-systemic coordination of the stomatognathic muscular activity, we want to establish the implication and the neuroendocrine correlation in the stomatognathic muscular dysfunctions determined by some endocrine diseases.