RESUMO
OBJECTIVES: Antimicrobial resistance is an alarming global public health concern, threatening the effective treatment of common infections. This phenomenon is driven by the improper prescription of antibiotics. This study aimed to elucidate the patterns of antibiotic prescription in implant dentistry among European dentists and their awareness of antibiotic resistance. MATERIALS AND METHODS: An anonymous online validated questionnaire was distributed via e-mail to 6431 recipients through the European Association for Osseointegration. It comprised of 17 structured questions investigating demographic variables, working environment, clinical experience, attitude towards antibiotic prescription in particular in relation to implant dentistry and COVID-19 pandemic, and awareness of antibiotic resistance. Data were collected from April to May 2023. RESULTS: 281 dentists from 33 European countries completed the survey. Almost 80% affirmed to routinely prescribe antibiotics as prophylaxis as well as after dental implant placement, especially in medically compromised patients or in cases of bone grafting. Amoxicillin, alone (61%) or in combination with clavulanic acid (56%), was the most common antibiotic of choice. Awareness of penicillin resistance among respondents was high. For peri-implantitis treatment, more than half reported the use of systemic antibiotics. The large majority (95%) did not prescribe more antibiotics since the beginning of COVID-19 pandemic. Less than 40% declared to follow national guidelines for antibiotic prescription. CONCLUSION: This survey revealed a high prescription rate of antibiotics in implant dentistry, despite the awareness about antibiotic resistance among the respondents. The development and adherence to European guidelines has been identified as a potential strategy for improving antimicrobial stewardship.
Assuntos
Antibacterianos , Padrões de Prática Odontológica , Humanos , Antibacterianos/uso terapêutico , Inquéritos e Questionários , Europa (Continente) , Padrões de Prática Odontológica/estatística & dados numéricos , Masculino , Feminino , Adulto , COVID-19/prevenção & controle , Pessoa de Meia-Idade , Resistência Microbiana a Medicamentos , Implantação Dentária , Antibioticoprofilaxia/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Odontólogos/psicologia , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
BACKGROUND: During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables. METHODS: This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05. RESULTS: Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =-0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74-6.63 and APR = 3.68, 95% CI: 1.31-10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05). CONCLUSION: Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time.
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Esgotamento Profissional , COVID-19 , Odontólogos , Medo , Polícia , Humanos , Estudos Transversais , COVID-19/psicologia , COVID-19/epidemiologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Masculino , Feminino , Odontólogos/psicologia , Odontólogos/estatística & dados numéricos , Adulto , Peru/epidemiologia , Polícia/psicologia , Medo/psicologia , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: In Canada, a new federal public dental insurance plan, being phased in over 2022-2025, may help enhance financial access to dental services. However, as in many other countries, evidence is limited on the supply and distribution of human resources for oral health (HROH) to meet increasing population needs. This national observational study aimed to quantify occupational, geographical, institutional, and gender imbalances in the Canadian dental workforce to help inform benchmarking of HROH capacity for improving service coverage. METHODS: Sourcing microdata from the 2021 Canadian population census, we described workforce imbalances for three groups of postsecondary-qualified dental professionals: dentists, dental hygienists and therapists, and dental assistants. To assess geographic maldistribution relative to population, we linked the person-level census data to the geocoded Index of Remoteness for all inhabited communities. To assess gender-based inequities in the dental labour market, we performed Blinder-Oaxaca decompositions for examining differences in professional earnings of women and men. RESULTS: The census data tallied 3.4 active dentists aged 25-54 per 10,000 population, supported by an allied workforce of 1.7 dental hygienists/therapists and 1.6 dental assistants for every dentist. All three professional groups were overrepresented in heavily urbanized communities compared with more rural and remote areas. Almost all dental service providers worked in ambulatory care settings, except for male dental assistants. The dentistry workforce was found to have achieved gender parity numerically, but women dentists still earned 21% less on average than men, adjusting for other characteristics. Despite women representing 97% of dental hygienists/therapists, they earned 26% less on average than men, a significant difference that was largely unexplained in the decomposition analysis. CONCLUSIONS: Accelerating universal coverage of oral healthcare services is increasingly advocated as an integral, but often neglected, component toward achieving the health-related Sustainable Development Goals. In the Canadian context of universal coverage for medical (but not dentistry) services, the oral health workforce was found to be demarcated by considerable geographic and gendered imbalances. More cross-nationally comparable research is needed to inform innovative approaches for equity-oriented HROH planning and financing, often critically overlooked in public policy for health systems strengthening.
Assuntos
Odontólogos , Humanos , Canadá , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Odontólogos/provisão & distribuição , Odontólogos/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Higienistas Dentários/provisão & distribuição , Higienistas Dentários/estatística & dados numéricos , Assistentes de Odontologia/provisão & distribuição , Assistentes de Odontologia/estatística & dados numéricosRESUMO
BACKGROUND: Early studies during the COVID-19 pandemic suggested dental occupations were among the highest risk for exposure to SARs-CoV-2 because of multiple factors increasing exposure, including close proximity to unmasked patients and performance of aerosol-generating procedures. However, to date, few studies have investigated COVID-19 deaths in United States dental occupations, and compared COVID-19 deaths among healthcare occupations. METHODS: We analyzed 2020 mortality data collected by the National Center for Health Statistics' National Vital Statistics System. Multivariable logistic regression was used to generate odds ratios (ORs) and 95% confidence intervals for COVID-19 as the underlying cause of death in relation to occupation in working-age decedents (≤65 years), after adjusting for age, sex, race/ethnicity, education, and medical conditions associated with severe COVID-19. RESULTS: Dental occupations did not have significantly higher risk for COVID-19 death when compared to all other occupations combined. Among healthcare occupations with frequent, direct patient- or client interactions, LPNs and LVNs, and speech and language pathologists had significantly elevated adjusted ORs for COVID-19 death when compared to dentists, dental hygienists, or dental assistants. Similarly, nurse practitioners had significantly higher ORs for COVID-19 mortality than dentists or dental hygienists, and approached significance when compared to dental assistants. Conversely, massage therapists and other health diagnosing and treating practitioners had significantly lower adjusted ORs for COVID-19 death compared with dental occupations. CONCLUSION: Our study highlights potential differences in work-related transmission of SARs-CoV-2 and subsequent COVID-19 deaths in healthcare occupations, and furthers a previously limited understanding of COVID-19 deaths in healthcare occupations in 2020, before COVID-19 vaccine availability. Our results indicate that dental occupations were not among the highest, nor lowest risk, healthcare occupations for COVID-19 deaths in 2020, despite their known risks of direct exposure.
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COVID-19 , Humanos , COVID-19/mortalidade , Estados Unidos/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , SARS-CoV-2 , Idoso , Ocupações em Saúde/estatística & dados numéricos , Odontologia/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Doenças Profissionais/mortalidade , Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Exposição Ocupacional/efeitos adversos , Causas de Morte , Adulto JovemRESUMO
BACKGROUND: Despite concerns such as allergic dermatitis and bans recommended by health authorities, latex gloves are used by dental professionals in many countries. There are published reports of the prevalence of latex allergy in health professionals including dental professionals; however, no systematic review and meta-analysis is available. OBJECTIVES: To determine the prevalence of latex allergy in dental professionals. METHOD: Two researchers independently searched articles using appropriate keyword combinations in three search engines; PubMed, Cochrane Library, and Google Scholar for observational studies on latex allergy in dental professionals reported in English or where complete translations in English were included. Percentage prevalence of latex allergy was the variable of interest. The risk of bias was assessed using the Hoy et al. (2012) tool and publication bias using a funnel plot. RESULTS: From 435 possible sources, a total of 14 studies were included in the review and meta-analysis. The prevalence of latex allergy, based on 6302 participants was 10.37% (95% CI: 7.31 to 13.88). Heterogeneity (I2) was high (94.13%); hence, REM was used. There was moderate risk of bias across studies and minimal publication bias. GRADE analysis indicated that the evidence was uncertain. CONCLUSIONS: The prevalence of latex allergy in dental professionals is about 10.37%. Evidence is of low quality due to high heterogeneity.
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Odontólogos , Hipersensibilidade ao Látex , Hipersensibilidade ao Látex/epidemiologia , Humanos , Prevalência , Odontólogos/estatística & dados numéricosRESUMO
OBJECTIVES: To determine how social factors influence career decisions of dental service providers, particularly focusing on examining the impact of dentists' origins. METHODS: Online survey of Hessian panel dentists, with pairwise comparisons to a set of factors impacting their decision-making process. An Analytic Hierarchy Process examined the weighting of influencing drivers in career choice. RESULTS: Dentists from rural backgrounds were more likely to establish practices in rural areas than those from urban origins. Origin correlated with entrepreneurial intentions and a strong association of rural origin. Dentists who grew up in rural areas were 4.19 times more likely to start a business. CONCLUSION: These findings may support efficient resource allocation and support for rural dental businesses.
Assuntos
Escolha da Profissão , Humanos , Alemanha , Feminino , Masculino , Inquéritos e Questionários , População Rural , Odontólogos/estatística & dados numéricos , Odontólogos/psicologia , Empresa de Pequeno Porte , Adulto , Área de Atuação Profissional , Pessoa de Meia-Idade , Serviços de Saúde RuralRESUMO
BACKGROUND: Studies documenting the treatments used by dentists in the management of temporomandibular disorders (TMDs) have been undertaken in some countries; however, no such research has been conducted in Australia. No similar studies have been documented for physiotherapists. OBJECTIVE: The aim of the study was to determine the treatment options and referral patterns used by Australian dentists and physiotherapists in managing people with TMDs. METHODS: Prospective nationwide online questionnaires targeting Australian dentists and physiotherapists were created for Australian dentists and physiotherapists. RESULTS: Seventy-eight respondents (27 dentists; 51 physiotherapists) completed all questions in the questionnaires. Sixty respondents reported actively treating people with TMDs. The treatment options used most frequently by dentists included advice and education, oral appliances, physical agents such as moist heat and medications. The treatment options most frequently used by physiotherapists included manual therapy, exercises, electrophysical agents and advice and education. Referrals were most frequently made to dentists and physiotherapists with experience and/or expertise in managing people with TMDs and to general dentists. CONCLUSIONS: Commonly used treatment options were mostly conservative, reversible and evidence-based. More responses are required to draw conclusions representative of Australian dentists and physiotherapists in the management of people with TMDs.
Assuntos
Odontólogos , Fisioterapeutas , Padrões de Prática Odontológica , Encaminhamento e Consulta , Transtornos da Articulação Temporomandibular , Humanos , Austrália , Fisioterapeutas/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/terapia , Padrões de Prática Odontológica/estatística & dados numéricos , Feminino , Masculino , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Prospectivos , Adulto , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Few reported studies evaluate the status of those who have a family dentist (FD) by regional differences and the socioeconomic factors associated with this status. This study aimed to assess the prevalence of having an FD among Japanese individuals across three samples of municipality type: urban, intermediate, and rural areas, and determine the factors associated with having an FD. METHODS: This was a cross-sectional study involving a web-based survey. In total, 2,429 participants (comprising men and women aged 20-69 years) were randomly selected from among the registrants of a web research company: 811 urban residents, 812 intermediate residents, and 806 rural residents. In each area, we categorized the participants into those who had an FD (FD group) and those who did not (non-FD group). A multivariate modified Poisson regression analysis was used to determine the factors associated with the FD group as compared to the non-FD group. RESULTS: The proportion of the FD group was lowest in rural areas (42.3%), followed by intermediate (48.6%) and urban areas (49.7%). The regression analysis revealed a statistically significant tendency between associated factors in the two groups; that is, the higher the household income, the more likely that the family belonged to the FD group (prevalence ratio (95%CI), JPY 4-6 million: 1.43 (1.00-2.03), JPY ≥ 8 million: 1.72 (1.21-2.44)). CONCLUSIONS: Rural areas have the lowest proportion of people with an FD among the three areas, and income inequality is associated with having an FD. Thus, when planning policies to encourage individuals to have an FD to manage their oral health, it is necessary to consider regional differences.
Assuntos
Renda , Humanos , Estudos Transversais , Pessoa de Meia-Idade , Feminino , Masculino , Adulto , Japão/epidemiologia , Idoso , Renda/estatística & dados numéricos , Adulto Jovem , Odontólogos/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Prevalência , Fatores Socioeconômicos , População do Leste AsiáticoRESUMO
BACKGROUND: This study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups. METHODS: A single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study's aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents. RESULTS: The analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults. CONCLUSION: The oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya.
Assuntos
Odontólogos , Líbia , Humanos , Odontólogos/provisão & distribuição , Odontólogos/estatística & dados numéricos , Atenção à Saúde , Serviços de Saúde Bucal/estatística & dados numéricos , Serviços de Saúde Bucal/organização & administração , Setor Privado , Setor Público , Técnicos em Prótese Dentária , Assistência Odontológica/economia , Criança , Financiamento Governamental , Especialidades Odontológicas , Saúde Bucal , Enfermeiras e Enfermeiros , Auxiliares de Odontologia/estatística & dados numéricosRESUMO
OBJECTIVE: To determine the prevalence of work-related musculoskeletal disorders among dentists. METHODS: The cross-sectional study was conducted in Islamabad, Pakistan, from January to March 2023 after approval from the ethics review committee of the Islamic International Dental Hospital, Islamabad, and comprised dentists associated with 4 major dental teaching hospitals in the city. Data was collected using a self-administered questionnaire adapted from literature. Prevalence of work-related musculoskeletal disorders was explored along with its association with variables, like age, gender, experience, designation and history of injury. Data was analysed using SPSS 26. RESULTS: Of the 250 forms distributed, 188 (75.2%) were returned duly filled, while the remaining participants either did not respond or partially filled out the forms. Among the respondents, 64(34%) were males and 124(66%) were females, and the overall prevalence of work-related musculoskeletal disorders was 172(91.5%). There was no significant difference among the variables based on anatomic site-specific data, except the designation variable, with individuals having a history of injury to neck (p=0.027) or shoulder (p=0.001) and those designated as professor (p=0.040) were significantly at risk of developing pain due to work-related musculoskeletal disorders. CONCLUSIONS: A significantly high number of dentists were found to have some form of work-related musculoskeletal disorder.
Assuntos
Odontólogos , Hospitais de Ensino , Doenças Musculoesqueléticas , Doenças Profissionais , Humanos , Feminino , Paquistão/epidemiologia , Masculino , Doenças Musculoesqueléticas/epidemiologia , Estudos Transversais , Doenças Profissionais/epidemiologia , Prevalência , Adulto , Hospitais de Ensino/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Aim: To research how the future dentists' professional self-determination (reflects the cognitive-reflexive component of higher medical education applicants' readiness to use digital technologies in their professional activities) develops within the formation of information technology competence in the modern realities of Ukraine. PATIENTS AND METHODS: Materials and Methods: The author's questionnaire consisted of 15 questions. The questionnaire surveys covered 98 future dentists who studied 'Medical Informatics' and 'Information Technology in Dentistry' at the Ivano-Frankivsk National Medical University in the September-December 2017-2018 and September- December 2022-2023 academic years. The research results were assessed according to the algorithm described. The research used such methods as analysis, synthesis, comparison, concretisation, systematisation, and generalisation, as well as methods of mathematical statistics for evaluating data, namely correlation analysis, Kolmogorov-Smirnov test, Cronbach's alpha, Fisher's test (F-test of equality of variances), Student's t-test and ranking. RESULTS: Results: The research found positive dynamics of the professional self-determination levels (in 2022 compared to 2017, the low level decreased by 20.5%, the satisfactory level - by 19.0%, the average level increased by 20.6%, the high level - by 18.9%) and their quality, which within the research increased by 39.5%. CONCLUSION: Conclusions: By forming information technology competence, future dentists changing the priorities of professional self-determination in the modern realities of Ukraine and acquiring readiness (within the cognitive-reflexive component) to use digital technologies in professional activities.
Assuntos
Odontólogos , Ucrânia , Humanos , Inquéritos e Questionários , Odontólogos/psicologia , Odontólogos/estatística & dados numéricos , Feminino , Autonomia Profissional , Masculino , AdultoRESUMO
OBJECTIVE: Aim: To find any association between specific ABO blood groups and FUT2 secretory status and COVID-19 in a sample of Iraqi dentists. PATIENTS AND METHODS: Materials and Methods: For each participant, a questionnaire including demography, COVID-19 status, blood grouping, and RH factor, with chemo-sensitive symptoms was recorded. The saliva samples were collected and DNA was extracted from leukocytes. Sequencing of molecular detection of the FUT2 gene by real-time PCR and the data was done, whilst drawing the phylogenetic tree. RESULTS: Results: Out of 133, most of the dentists were female 61%, most were just under 35 years of age. The most participants in this study were predominantly with blood group O (40%), followed by B, A, and AB, with (90%) of them were RH+. All blood grouping and RH factor were high significantly associated with COVID-19 infection and its frequency (p<0.001). A significant association between smell dysfunction and infected blood group A and RH+ (p =0.044, 0.038) while taste dysfunction was negatively and significantly correlated with AB group (r=-0.73; p=0.008). The FUT2 secretor showed a significant association with COVID-19 infection and frequency. The majority of COVID-19-infected participants experienced a significant loss of both smell and taste with fast recovery within 2 weeks. CONCLUSION: Conclusions: The COVID-19 infection susceptibility and reinfection are associated with FUT2 secretory status and greatly associated to olfactory and gustatory sense loss.
Assuntos
COVID-19 , Odontólogos , Fucosiltransferases , Galactosídeo 2-alfa-L-Fucosiltransferase , SARS-CoV-2 , Adulto , Feminino , Humanos , Masculino , Sistema ABO de Grupos Sanguíneos/genética , COVID-19/genética , COVID-19/epidemiologia , Odontólogos/estatística & dados numéricos , Fucosiltransferases/genética , Iraque/epidemiologia , Saliva/virologia , SARS-CoV-2/genéticaRESUMO
The dental profession is associated with occupational health problems. The working environment of a dentist is associated with ergonomic risk factors that can significantly reduce the dentist's working ability and even cause the termination of his/her professional activity. Numerous studies have been conducted in different countries (Sweden, Denmark, Germany, Poland, Australia, etc.) to assess the prevalence of musculoskeletal disorders in dentists, though no studies related to the principles of ergonomics in dentistry have been carried out in Georgia. The study aimed to assess the ergonomics of the working environment of dentists in Tbilisi (capital city of Georgia) clinics and to identify the prevalence of musculoskeletal disorders among them. An observational descriptive study was conducted in April-July 2023 in Tbilisi. A special questionnaire of 40 questions was designed based on international experience. The survey was conducted by random sampling in selected dental clinics. Dentists were asked to fill out the questionnaire during their free time between patient appointments. Those who agreed to participate were provided with electronic versions of the questionnaire. Five hundred dentists were invited to participate in the survey, of whom 314 (62.8%) agreed to fill out the questionnaire. A total of 291 fully completed questionnaires were used for the descriptive statistical analysis. Our study shows that in Tbilisi clinics dentists work on average for 5-6 days (48.8% - 6 days, 37.1% - 5 days) or 40-48 hours a week. A majority of respondents said their workplace met the requirements of ergonomics (it had a good lighting, the chair had a back, instruments could be easily reached), yet most of them rarely lean on the backrest, never or rarely use the hand rest method, and never or rarely do light physical exercise during breaks. The survey shows that 53.6% of dentists most frequently suffer from pain in the back, followed by pain in the neck (50.9%), shoulders (47.9%) and lower back (47.1%). Most of them said they had to work less because of the pain. Introduction of the principles of ergonomics in dental profession is vital for preventing occupational musculoskeletal disorders. It is important to provide continuing professional development programs and information booklets for dentists and thematic online webinars for the management of dental clinics in Georgia.
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Odontólogos , Ergonomia , Doenças Musculoesqueléticas , Doenças Profissionais , Humanos , República da Geórgia/epidemiologia , Odontólogos/estatística & dados numéricos , Doenças Musculoesqueléticas/epidemiologia , Doenças Musculoesqueléticas/prevenção & controle , Masculino , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Feminino , Inquéritos e Questionários , Adulto , Clínicas Odontológicas , Pessoa de Meia-Idade , Prevalência , Local de Trabalho , Fatores de RiscoRESUMO
BACKGROUND: Opioids are generally an inappropriate acute pain management strategy in children, particularly because of the risk for diversion and subsequent misuse and abuse. OBJECTIVES: To examine associations between Medicaid plan type [coordinated care organization (CCO), managed care (MC), fee-for-service (FFS)] and whether a child received an opioid prescription. RESEARCH DESIGN: Secondary analysis of Oregon Medicaid data (January 1, 2016 to December 31, 2017). SUBJECTS: Medicaid-enrolled children ages 0-17 (N=200,169). MEASURES: There were 2 outcomes: whether a child received an opioid prescription from (a) any health provider or (b) from a visit to the dentist. Predictor variables included Medicaid plan type, age, sex, race, and ethnicity. RESULTS: About 6.7% of children received an opioid from any health provider and 1.2% received an opioid from a dentist visit. Children in a CCO were significantly more likely than children in a MC (P<0.01) or FFS (P=0.02) plan to receive an opioid from any health provider. Children in a CCO were also significantly more likely than children in MC or FFS to receive an opioid from a dentist visit (P<0.01). CONCLUSIONS: Pediatric opioid prescriptions vary by plan type. Future efforts should identify reasons why Medicaid-enrolled children in a CCO plan are more likely to be prescribed opioids.
Assuntos
Analgésicos Opioides/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Planos de Pagamento por Serviço Prestado/estatística & dados numéricos , Programas de Assistência Gerenciada/estatística & dados numéricos , Medicaid/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Odontólogos/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Oregon , Pediatria , Estados UnidosRESUMO
INTRODUCTION AND OBJECTIVES: Hepatitis B virus (HBV) is endemic in Lao PDR, with up to 10% chronic infections in adults. Dentists have high risk of exposure and transmission to their patients. The aim was to investigate the serological profiles of vaccination, exposure and susceptibility to HBV. In addition, we determined the knowledge, attitude and practice (KAP) of Lao dentists toward HBV. MATERIALS AND METHODS: Dentists and dental assistants were recruited from 186 private dental clinics in Vientiane Capital. They completed a KAP questionnaire and serum was tested by ELISA for HBV markers (anti-HB surface antigen, anti-core antigen, HBV surface antigen). RESULTS: 206 dentists and 111 dental workers aged between 18-63 years were included. Serology data showed that 37.8% had previous exposure (49.0% of males and 32.4% of females) and 5.0% were chronically infected (7.7% of males and 3.8% of females). Less than 15% had serological evidence of vaccination and 66.8% were unprotected against infection. Knowledge of HBV was mostly low, for example 61.8% were aware of the childhood HBV vaccine. Just over half said that they should give dental care to HBV carriers. About one quarter reported accidental blood exposure during the last 6 months but knowledge about procedures after exposure was low. CONCLUSIONS: Lao dentists are at high risk of occupational exposure to HBV but have low awareness and serological protection. There is a need to introduce mandatory vaccination, to strengthen occupational health in health care providers and to further develop the academic curricula of dental students.
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Recursos Humanos em Odontologia/estatística & dados numéricos , Odontólogos/estatística & dados numéricos , Vírus da Hepatite B/isolamento & purificação , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Adulto , Estudos Transversais , Recursos Humanos em Odontologia/psicologia , Odontólogos/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Humanos , Laos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Oral health is affected by dietary practices and may impact quality of life. Collaboration between dietetics and dental professionals for oral health promotion and disease prevention is recommended. The present study aimed to determine the knowledge and practice of dentists and dietitians on diet and dental health. METHODS: The study comprised a cross-sectional online questionnaire, which was disseminated electronically to dentists and dietitians in the UK and Ireland, via national networks. Questions assessed participants' knowledge of the cariogenicity of different foods, snacking behaviours, familiarity with UK dietary guidelines, dietary advice and their recommendations for cross-professional consistency. RESULTS: In total, 418 responses were received (60% dentists, 40% dietitians). Inter-profession knowledge differences were observed for the cariogenicity of sports drinks (p < 0.001), chocolate/confectionary (p < 0.001), yoghurt (p < 0.001) and sugar-coated breakfast cereals plus milk (p < 0.0001). Dentists showed greater concern over the timings and frequency of food consumption than dietitians. A greater proportion of dentists felt nutrition and oral health counselling is a key component of regular patient care (58.4% versus 8.2%, p < 0.001). Only 18% of dietitians, compared to 56% of dentists, considered that they had received sufficient training about diet and dental health. Both professions indicated the need for multi-disciplinary training. CONCLUSIONS: Dietitians and dentists differ with respect to their knowledge about the effects of snacks and snacking behaviours on dental health, as well as how they prioritise this in their clinical practice. Both professions show a willingness to work collaboratively to ensure accurate and consistent advice-giving and expertise-sharing.
Assuntos
Odontólogos/psicologia , Dieta/normas , Conhecimentos, Atitudes e Prática em Saúde , Nutricionistas/psicologia , Saúde Bucal , Adulto , Aconselhamento/estatística & dados numéricos , Estudos Transversais , Odontólogos/estatística & dados numéricos , Dieta Cariogênica/efeitos adversos , Feminino , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Política Nutricional , Nutricionistas/estatística & dados numéricos , Lanches , Inquéritos e Questionários , Reino UnidoRESUMO
The aim of this study was to investigate the awareness and experience, among dental practitioners, of adverse events resulting from dental treatment of patients undergoing therapy with drugs that affect the immune system [angiogenesis inhibitors, biological agents, immunosuppressants, and disease-modifying anti-rheumatic drugs (DMARDs)]. For this purpose, a nationwide questionnaire survey was conducted. Questionnaires were sent to 2,050 dentists, of which 206 (10.1%) were completed and returned. The results showed that most dentists were aware of complications associated with dental treatment of patients treated with drugs that affect the immune system, and about half had actually experienced such complications. Delayed wound healing, osteonecrosis of the jaw (ONJ), and postoperative infections were reported. Whereas approximately 50% of dentists did not discontinue the drugs during dental treatment, about 18% did. During temporary drug discontinuation, some patients experienced aggravation of the primary disease, such as worsening of rheumatism, growth of tumors, and rejection reactions of transplanted organs. As for medical cooperation, only less than half of the dentists were asked for oral hygiene management by a physician prior to starting the drug treatment. Prospective studies are needed because evidence for dental treatments in patients treated with these drugs remains limited.
Assuntos
Inibidores da Angiogênese/efeitos adversos , Odontólogos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Imunossupressores/efeitos adversos , Procedimentos Cirúrgicos Bucais , Complicações Pós-Operatórias/etiologia , Humanos , Japão , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic with more than 53,973 people affected in West Bengal state of India. OBJECTIVES: The aim of present study was to assess the Knowledge, Attitudes and Practices (KAP) of dental practitioners in Kolkata city, West Bengal, India regarding COVID-2019 pandemic. MATERIALS AND METHOD: Online questionnaire was distributed among dentists across West Bengal city, using a combination of convenience and snowball sampling. The questionnaire had 17 questions: (1) Section A was 'General section' which comprised of socio-demographic and professional details of the subjects; and (2) Section B comprised of 14 questions depicting knowledge, awareness attitude and practice regarding COVID-19. The data collected was subjected to statistical analysis with level of significance at p=0.05. The descriptive statistical analysis was done to compute frequency and percentages. Intergroup comparison was determined by Chi-square statistical analysis to determine the level of significance for responses of each question. RESULTS: Around 70.4% undergraduates participated in the study. Only 4.3% showed accurate knowledge with respect to the incubation period of coronavirus. Coughing and sneezing was considered to be the most common mode of transmission. 98.9% of dentists considered fever to be the characteristic symptom of the disease. Hand washing and alcohol rubs was advocated by 99.5% of the dentist. Emergency procedures were considered necessary by 90.8% dentists. 75.1% of dentists agree that their practice has been affected by the pandemic. CONCLUSION: A constant update regarding COVID-19 should be made available to dental health care professionals through webinars, seminars, discussions and articles. Dentists should keep themselves updated and help to fight against this pandemic.
Assuntos
Atitude do Pessoal de Saúde , COVID-19/prevenção & controle , Odontólogos/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Papel Profissional , COVID-19/epidemiologia , Estudos Transversais , Odontólogos/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia , Masculino , Higiene Bucal/estatística & dados numéricosRESUMO
BACKGROUND: The second wave of Novel Coronavirus disease (COVID-19, SARS-CoV-2) is proving more disastrous than the first because of the new mutant stains. Under these circumstances, vaccination is the only effective solution that can save millions of lives across the globe. OBJECTIVES: The present study was conducted to assess the attitude and acceptance/willingness of health care professionals (medical and dental) towards COVID-19 vaccine. MATERIALS AND METHODS: An online questionnaire survey was conducted among medical and dental professionals working in different hospitals of two states of India. A total of 520 subjects constituted the final sample size. A self-constructed questionnaire (divided into 2 parts) containing 12 questions was administered to obtain information from the subjects regarding their attitude and willingness towards COVID 19 vaccine. Statistical analysis was done using chi-square test and multiple liner regression analysis. Odds ratio with 95% CI were also generated. Statistical significance was set at p≤0.05. RESULTS: Majority of the subjects (67% of dental and 73% of medical) had full confidence on the effectiveness of COVID-19 vaccine. Willingness to get vaccinated was shown by 63% of subjects and 65% had positive attitude towards vaccine. Some subjects (45.5% dental and 48.4% medical) showed concern regarding unforeseen effects of the vaccine. Willingness to get vaccinated was 3.45 higher in subjects who were involved in COVID duties. Subjects giving less preference to natural immunity over vaccine showed more willingness (OR: 2.98) towards getting the vaccine. CONCLUSION: The findings of the study showed that acceptance and attitude of subjects regarding COVID 19 vaccine was suboptimal as there were various factors which contributed towards subjects' hesitancy to get vaccinated. There is an utmost need to address various issues regarding vaccine safety to promote high uptake.
Assuntos
Atitude do Pessoal de Saúde , Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Odontólogos/psicologia , Médicos/psicologia , Adulto , COVID-19/epidemiologia , COVID-19/psicologia , Estudos Transversais , Odontólogos/estatística & dados numéricos , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Médicos/estatística & dados numéricosRESUMO
The aim of this survey was to describe the attitudes and self-reported practices of French dentists towards antibiotic use and resistance and to compare practices with national guidelines. A nationwide cross-sectional internet-based survey was conducted among the 41,800 French dentists. The online questionnaire was distributed through professional networks from April 2017 to April 2018. Seven-hundred seventy-five dentists participated but only 455 questionnaires were complete enough to be included in the analyses. Amoxicillin was the most frequently prescribed antibiotic (65.8%, 1783/2711), followed by spiramycin + metronidazole fixed-dose combination (11.6%, 312/2711) and amoxicillin-clavulanic acid (10.3%, 279/2711). The main indications for use were abscess (349/423, 82.5%), cervicofacial cellulitis (74.2%, 314/423), and pericoronitis (58.6%, 239/408). Most dentists (90.5%, 381/421) considered that antibiotic resistance is of concern but only half of them (56.3%, 238/423) felt adequately informed about antibiotic use. Many dentists did not comply with the national guidelines: the majority of them declared inappropriate antibiotic prescriptions for 11/17 clinical situations. They did not prescribe antibiotics for 5/6 clinical situations requiring prophylaxis. They reported that the publication of clinical guidelines is the main factor influencing their prescriptions (71.0%, 299/421). They wished to receive regular updates of national guidelines in the form of practical sheets (93.0%, 172/185). French dentists should urgently be targeted by antibiotic stewardship initiatives.