The oral health component of «100% santé¼ reform: initial descriptive elements / Le volet bucco-dentaire de la réforme 100 % santé : premiers éléments descriptifs

The "100% Santé" (100% Health) reform constitutes a major change to oral health pricing and insurance practices in France. The objective of this study was to observe the evolution of dental care consumption, and in particular prosthetic care, over a period including the years before and after the reform. This exploratory study, based on descriptive data, provides the first elements of analysis useful for evaluating the oral health component of the "100% Santé" reform. The study is based on the health care consumption data of 3,466,764 state health insurance beneficiaries aged three to twenty-five years in Occitania, covering the period from January 1, 2016, to December 31, 2020. The descriptive analysis of this data revealed that prosthodontic care is the only area to show an increase in the average amount of care consumed between 2019 and 2020: a relative increase of +4 percent among 3­25-year-olds and +6.7 percent among 21­25-year-olds. Moreover, among 21­25-year-olds, we observe a drop in the share of prostheses in the care consumed in 2019, and then a recovery approaching 0.3 percent of the initial share in 2020. Although it is not possible to conclude that there is an impact, these results show a positive trend whereby the reform's objective of increasing prosthodontic care consumption seems to have been achieved. This study highlights the importance of assessing the long-term impact of the COVID-19 crisis and the "100% Santé" reform on dental care consumption.

La réforme 100 % Santé est un choc important dans les pratiques tarifaires et assurantielles en santé orale en France. L'objectif de l'étude est d'observer l'évolution de la consommation de soins dentaires et notamment prothétiques sur une période regroupant des années ante- et post-réforme. Cette étude exploratoire, soutenue par des travaux de recherche descriptifs, fournit les premiers éléments d'analyse utiles pour évaluer la réforme 100 % santé sur le volet bucco-dentaire. Il s'agit d'une étude exploratoire reposant sur les données de consommation de soins de 3 466 764 bénéficiaires de 3-25 ans de l'Assurance maladie en Occitanie, sur la période allant du 1er janvier 2016 au 31 décembre 2020. L'analyse descriptive de ces données a permis de mettre en évidence que les soins prothétiques sont les seuls soins consommés dont la moyenne augmente entre 2019 et 2020 : hausse relative de +4 % chez les 3-25 ans et +6,7 % chez les 21-25 ans. De plus, chez les 21-25 ans, on observe un recul de la part des prothèses dans les soins consommés en 2019, puis un regain se rapprochant de 0,3 % de la part initiale en 2020. Malgré l'impossibilité de conclure à un réel effet, ces résultats montrent une tendance positive selon laquelle l'objectif d'augmentation de la consommation des soins prothétiques de la réforme semble se réaliser. Cette étude souligne l'importance d'évaluer les répercussions à long terme de la crise Covid et de la réforme 100 % Santé sur les consommations de soins dentaires.

The e-DENT teledentistry project: Achievements, lessons learned, and perspectives / Le projet de télémédecine bucco-dentaire e-DENT : réalisations, enseignements et perspectives

In October 2010, the decree n°2010­1229 relating to telemedicine, published in the "Journal officiel de la république française" (JORF) n°0245 of October 21, 2010, specified the terms of the application of telemedicine in France. The practice of remote oral medicine is now becoming more widespread in the country. Since 2010, the dental public health team of the University Hospital (CHU) of Montpellier and the University of Montpellier has been working on the subject, with nearly ten thousand telemedicine acts performed as part of the work of the "First consultation and telemedicine" Medical Activity Unit of the Center for Dental Care, Teaching and Research (CSERD) of the CHU of Montpellier. Various studies have been conducted with multiple target populations to evaluate the value of teledentistry in different settings. The practice of teledentistry should help fight against inequalities of access to care and prevention in France. It has shown to be beneficial for patients, health professionals, dentists and health institutions, but improvements are needed to structure and perpetuate this practice. The profession must make major decisions and relaunch discussions so that France remains one of the leaders in this field.

Le décret no 2010-1229 relatif à la télémédecine, paru au Journal officiel de la République française (JORF) no 0245 du 21 octobre 2010, a précisé les modalités d'application de la télémédecine. La pratique de la médecine bucco-dentaire à distance commence à se faire une place en France. Depuis 2010, l'équipe de santé publique orale du Centre hospitalier universitaire (CHU) de Montpellier et de l'université de Montpellier travaille sur le sujet avec près de 10 000 actes de télémédecine réalisés dans le cadre de l'Unité d'activité médicale de « Première consultation et télémédecine ¼ du Centre de soins, d'enseignement et de recherche dentaire (CSERD) du CHU de Montpellier. Différentes études ont été menées auprès de multiples publics pour évaluer l'intérêt de la télémédecine bucco-dentaire dans différents milieux. La pratique de la télémédecine bucco-dentaire doit permettre de lutter contre les inégalités d'accès aux soins et à la prévention pour la population française. Des intérêts se dégagent pour les patients, les professionnels de santé, les chirurgiens-dentistes et les institutions de santé, mais des améliorations sont nécessaires pour cadrer et pérenniser cette pratique. La profession doit prendre des décisions majeures et relancer les discussions pour que la France reste dans le peloton de tête à l'échelle internationale dans cette pratique.

Interprofessional survey on knowledge and attitudes of midwives regarding oral health, in France.

INTRODUCTION: Oral health is essential for psychosocial well-being and general health. For expectant mothers, pregnancy increases the risk of oral diseases and has a subsequent impact on the oral health of a child once born. Midwives are in charge of pregnancy monitoring, childbirth and newborns' first days of life. They could have an important role in prevention. However, limited studies evaluating the knowledge, attitudes and practices on oral health among midwives have been conducted in Europe. METHODS: We performed a cross-sectional study using a self-administered questionnaire. Two local midwifery associations sent out the questionnaire by email and social media networks to all registered midwives and practicing in the department of Herault (n=613), between April and May 2022. Statistical analyses on quantitative data and descriptive analyses of qualitative free-text responses were performed. RESULTS: In total, 167 midwives were included. We found a lack of knowledge on many oral health topics and this was stated as the main reason that only 29% of midwives provided oral health information to their patients. Only 30% of the midwives had a training module on oral health during their initial training, and less than half of them considered the training adequate. To improve their lack of knowledge, participants expressed a preference for digital communication methods for themselves; however, they favored in-person interaction for public interventions. CONCLUSIONS: This study showed a lack of training and knowledge about oral health among midwives and a lack of oral health discussion with expectant mothers who are a high-risk population for oral diseases.

Interprofessional Survey on Knowledge and Attitudes on Oral Health among Nurses in France.

PURPOSE: Healthcare professionals (HCPs) play a key role in improving the health literacy of patients. Since oral health is an essential part of overall health, the objective of this study was to assess the knowledge and attitudes about oral health among registered nurses. MATERIALS AND METHODS: A four-component questionnaire was used to assess the oral health training, oral health knowledge and attitudes of registered nurses. Participants were recruited from the city of Montpellier, France, and the surrounding area between May and June 2022 via e-mail and social media. RESULTS: In total, 416 responses were included in our study. Only 35.8% of nurses reported that they had received specific training on oral health and 24.3% had never advised patients to consult a dentist. Participants demonstrated good overall knowledge, but stated there were weaknesses in a variety of areas, such as oral health in children. The nurses proposed methods to improve understanding of the importance of oral health, namely by setting up training courses and better interdisciplinary collaboration. CONCLUSION: Our study showed that some aspects of oral health are not well understood by nurses. Initial training should be improved and supplemental training should be offered to improve the knowledge, attitude and practices of nurses in order to improve patient care.

Teledentistry and Forensic Odontology: Qualitative Study on the Capacity of Implementation.

The postmortem identification of people without an identity is performed either by using DNA, dental charts, or fingerprints (until advanced decomposition prevents their study). The lack of forensic dentists who can conduct identifications lead us to reflect on the use of digital technology in this area. The aim of this study was to validate the organizational capacity of using teledentistry for the identification of bodies in a forensic medicine department. A mixed observational study was conducted on 55 cases between July 2020 and February 2021 in the Forensic Medicine and Thanatology Department of Montpellier University Hospital. The protocol was structured in five steps: an initial interview with the agent (a forensic autopsy technician/caregiver specialized in forensic medicine), regarding the idea they had in terms of using telemedicine in their daily practice; agent training in the telemedicine system; realization of a clinical examination using an intra-oral camera by the agent; data analysis by a dental surgeon; final interview with the agent. The study was conducted on 55 subjects. The average age was 54 years old, with more than two-thirds of the patients being male (69%). The videos had an average duration of 29 min. There was an increase in visit duration when rigidity was high; this was also the case when there were many dental specificities in the oral cavity. The quality of the videos was either good or excellent. This study showed that remote identification could be considered as a new non-invasive identification tool. Many features were analyzed to create a training guide for forensic institutes.

Barriers and Enablers to Implementing Teledentistry From the Perspective of Dental Health Care Professionals: Protocol for a Systematic Quantitative, Qualitative, and Mixed Studies Review.

BACKGROUND: There is growing literature on the potential of digital technologies for improving access to, ensuring continuity and quality of health care, and to strengthen health systems. Some studies have reported the cost-effectiveness of teledentistry, its reliability for remote dental screening, diagnosis, consultation, and treatment planning. Nonetheless, current evidence suggests that teledentistry implementation faces many challenges and is not yet adopted by dental health care providers (DHCPs). Developing strategies to improve teledentistry adoption requires an understanding of the factors that promote or hinder its successful implementation. OBJECTIVE: This systematic review aims to identify and synthetize barriers and enablers to implementing teledentistry as perceived by DHCPs in their clinical practices, using the Theoretical Domains Framework (TDF) and the Capacity, Opportunity, and Motivation Behavior (COM-B) model. METHODS: This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Protocols) checklist. Literature will be searched in the following databases: PubMed, Cochrane Library, Web of Science, CINAHL, Embase, and PsycINFO. We will perform additional searches on Google, Google Scholar, and ProQuest Dissertations & Theses Global, screen the references of the included studies to capture additional relevant studies, and contact the authors of studies if we need more details. We will consider studies using qualitative, quantitative, and mixed methods. There will be no restrictions on the publication date and dental setting. We will include studies published in French, English, and Portuguese. Two independent reviewers will select the study, extract data, and assess methodological quality using the Mixed Methods Appraisal Tool's checklist. Data analysis will include a descriptive and a thematic content analysis. We will synthetize and categorize the barriers and enablers using the TDF and COM-B model and present a narrative synthesis of our results using tables, figures, and quotes. RESULTS: By March 2023, the literature search has retrieved 7355 publications. We will identify the range of barriers and enablers to implementing teledentistry through DHCPs' perspectives. Considering the critical need for theory-based implementation interventions to improve the use of evidence-informed practices, we will synthesize the factors influencing the adoption of teledentistry based on the TDF domains and the 3 essential conditions predicting behavior change in accordance with the COM-B model. As needed, we will include additional determinants if not included in the TDF. We will conduct some subgroups analyses if studies are sufficient. We expect to complete the review by July 2024. CONCLUSIONS: This review will provide some insights on the determinants of teledentistry implementation as perceived by DHCPs in dental settings. These findings will cater to patients, families, DHCPs, researchers, academic and professional decision-makers, and policy makers. The results of the systematic review could be used to develop theory-led interventions in improving teledentistry implementation. TRIAL REGISTRATION: PROSPERO CRD42021293376; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=293376. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/44218.

Dialogue with Key Stakeholders on Digital Technology for Oral Health: Meeting Report.

On September 7, 2022, the University of Montpellier in France hosted a meeting with digital oral health technology developers, Chief Dental Officers, policy makers, the World Health Organization, the International Telecommunication Union, and academia on digital oral health technologies.

Recreational Nitrous Oxide Use and Associated Factors among Health Profession Students in France.

The first aim of this study was to investigate the recreational use of nitrous oxide (N2O) among health profession students at Montpellier University (France). The second aim was to identify the factors associated with N2O use. All students in medicine, dentistry, pharmacy and midwifery of the Montpellier University were contacted by email to participate in the survey. The students answered directly online by filling out anonymously a questionnaire including demographic information and questions about N2O, illicit drugs and alcohol use. Ethical approval was granted by the ethics committee of the Montpellier University. The sample comprised 593 students (mean age = 22.3 ± 2.6 yr), with 68.6% of females. Lifetime N2O use was reported by 76.6% and frequent alcohol use by 30.5% of the respondents. The lifetime use of cannabis, 'poppers', cocaine, ecstasy and LSD was 26.8%, 54.6%, 9.6%, 10.1% and 2.0% respectively. In multivariate analysis, the substances significantly associated with lifetime N2O were alcohol drinking and 'poppers' use. With respect to this self-nominated sample, our results indicate that respondents who were alcohol drinkers, were poppers users, follow longer studies, divert medical products for recreational use or were members of a students' corporation had higher odds of lifetime N2O use.

A national teledentistry study on the knowledge, attitudes, training and practices of private dentists.

Objectives: Nationally examine the self-perceived knowledge, attitudes and practices of TeleDentistry (TD) among dentists in private practice in France. Methods: A descriptive questionnaire-based survey was conducted nationwide from 10 November 2020 to 13 December 2020. The national scale survey was both anonymous and voluntary and was sent by the National Board of Dentists to 42,464 private dentists that were officially registered in France. The questionnaire included 36 questions divided into various sections: (i) general profile (gender, age range, and university, where respondents completed their dental studies), (ii) general knowledge of telemedicine, and (iii) familiarity with current regulations on telemedicine and activities that qualify as telemedicine. Results: Only 57.1% of dentists in private practice stated that they had never heard nor knew about TD (n=2,887). Only 1.5% (n=76) stated they had attended a training module on telemedicine and/or TD during their studies at university. Only 1.3% (n=26) of dentists who practised a TD activity stated that they knew about telemedicine regulations. Only 65.7% (n=2,020) of those who had never practised and 74.8% (n=1,485) who had practised TD acknowledged that they would like to practice TD. Conclusions: In conclusion, this study found a significant need for TD education and training as well as on regulations. It may be necessary in the future to ensure that all stakeholders in the field of dentistry work together to improve these two topics for dental practitioners. It is also worth noting that TD and telemedicine are public health tools and that they could provide inequitable access to medical care. However, TD must be implemented to decrease inequality and ensure it does not do the opposite.

Oral Hygiene Practices and Knowledge among Adolescents Aged between 15 and 17 Years Old during Fixed Orthodontic Treatment: Multicentre Study Conducted in France.

The aims of this study were to assess oral health knowledge, attitudes, and practices among orthodontic patients between the ages of 15 and 17 years old compared to adolescents without orthodontic treatment. This cross-sectional study included 392 adolescents drawn from various French teaching hospitals. A closed-ended questionnaire was used to collect data. Adolescents undergoing orthodontic treatment had a higher knowledge of oral health than adolescents without orthodontic treatment. The majority of adolescents for both groups (69%) claimed to brush their teeth twice a day. Regarding complimentary dental material, 81.9% of adolescents without orthodontic treatment never used an interdental brush and 78.8% never used dental floss. For those undergoing orthodontic treatment, 48.5% never used an interdental brush. Only 4% of adolescents without and 3% of adolescents with orthodontic treatment never consumed fizzy drinks, 4.9% and 3% never consumed sweets, and 4% and 8.4% never ate fast-food. Adolescents without treatment consumed more sodas (p = 0.048) and more fast food (p = 0.029). Adolescents had insufficient knowledge of oral health. Health education programmes should be implemented to improve adolescents' knowledge and individual oral prophylaxis with interdental brushes.

Effect of a Procedural Video on the Practical Fixed Prosthodontic Performance and Stress among Preclinical Dental Students.

OBJECTIVE: The purpose of this article was to analyze the effect of an instructional video on practical tutorial and to ascertain whether an instructional video improves students' performance on practical performance and reduces the stress associated with learning. MATERIALS AND METHODS: A randomized controlled trial was conducted on a group of 78 first-year students. A pretest was conducted by administering questionnaires to evaluate the interest in the use of videos as well as the level of stress. Students were randomly assigned into two groups: control and test. Students assigned to the control group received conventional teaching, while the experimental group received both conventional teaching and watched a video. Thereafter, a satisfaction questionnaire was distributed to each of the groups, and they were awarded a grade. RESULTS: A total of 98.7% of students wished to learn fixed prosthodontics through instructional videos, as they believed that the videos could reduce their worry and stress levels. At the end of the first tutorial, the total grade was significantly lower for the test group (p = 0.003). However, the subjective value of stress was significantly lower in the test group (p = 0.0007) as well as the subjective value of tutorial difficulty (p = 0.0004). Students felt that they better understood the objectives of the tutorial "thanks to the video" (p = 0.0001). CONCLUSION: This study did not reveal any improvement in terms of performance when an instructional video was used for tutorials in comparison with the conventional teaching method. However, the results show a reduction in the level of stress.

The contribution of teledentistry in detecting tooth erosion in patients with eating disorders.

OBJECTIVE: The aim of this study was to demonstrate that including a teledentistry consultation in the standard care provided to patients in an eating disorder day hospital could be beneficial, notably for screening for particular pathologies and preventing dental erosion. METHODS: We included 50 patients from the eating disorders unit of the University Hospital of Montpellier, all of whom underwent a dental examination using asynchronous telemedicine. We recorded the data using teledentistry software for the medical file and an intraoral camera for the clinical videos. Remote diagnosis was performed using the Basic Erosive Wear Examination index. In addition, the participants completed a questionnaire to assess their risk factors for dental pathologies. RESULTS: We found dental erosion in 92% of the patients, and 50% had at least one tooth with BEWE 2 or 3 type erosion. CONCLUSIONS: Despite the fact that there can be wide variety within a group of individuals with similar risk factors, dental telemedicine could promote awareness within this at-risk population, as well as provide personalised prevention advice to each patient. Above all, it would make it possible to treat these patients' lesions at the earliest possible moment, thereby improving their outcomes.

Applications of teledentistry in a French inmate population: A one-year observational study.

Teledentistry oral examination protocol was evaluated for one year at the Villeneuve-lès-Maguelone Correctional Facility. The aim of the study was to simplify the obligatory dental consultation protocol at the entrance visit for new detainees. 1051 detainees were enrolled and 651 of them (58.9%) accepted an oral examination by teledentistry throughout the entire year of 2018. Only 1 inmate did not need treatment and 88.06% of those who have been examined had at least one untreated cavitated carious lesion. Forty-four percent of people who received a teledentistry check-up were referred to a dentist with a dental emergency. The use of teledentistry at the entry visit in a detention facility may facilitate the oral health screening without wasting the dentist's time, and may allow an optimization of the inmate's oral healthcare.

Concordance study between regular face-to-face dental diagnosis and dental telediagnosis using fluorescence.

BACKGROUND: Teledentistry consultations are an effective way to increase access to care. Whether it be for a screening, referral or even an adapted treatment plan for a certain number of patients whose access to care is complicated, demonstrating the reliability of remote consultations is essential in allowing the technique to become generalised. AIM: This study aimed to determine if teledentistry consultations using fluorescence are of the same quality as regular consultations in the diagnosis of caries. METHODS: Patients were seen in consultation in the dental care centre at the Montpellier University Hospital (France) and in the centre at Kyushu Dental University Hospital (Japan). The protocol was broken down into three parts: the regular consultation, the recording of videos with the Soprocare camera and the remote consultation. The regular consultation and the remote consultation were blinded and carried out by two different dentists. The recording of videos was carried out by a third dentist. The carious diagnosis was based on the International Caries Detection and Assessment System: a clinical rating system for the detection and assessment of caries. RESULTS: One hundred and ninety-five patients met the predefined inclusion criteria. Most patients had at least one surface at stage 3 or higher (73%) with a higher proportion amongst French patients (81% compared to 66%). However, they had good dental hygiene, given that dental hygiene was only deemed unsatisfactory for 10.8% (19% for French patients and 2% for Japanese patients). The odontogram (presence/absence of each tooth) seemed to be correctly identified during the remote consultation (reinterpretation). Out of the 195 patients, 168 (86.2%) were identified without error. CONCLUSIONS: Teledentistry consultations can represent acceptable diagnostic performance with regard to the detection of dental caries. The Soprocare camera enables an early diagnosis of carious lesions with optimal efficiency. Several areas still need to be improved, however, so that the use of the camera during remote consultations is as coherent and effective as possible, especially with regard to the organisational aspects of remote consultations.

Prevalence of sensitive teeth and associated factors: a multicentre, cross-sectional questionnaire survey in France.

BACKGROUND: As far as we know, little data, whether obtained from self-administered questionnaires or upon dental clinical examination, has been published on the prevalence of sensitive teeth (ST) in the French adult population. The objectives of the present work were to estimate ST prevalence and characteristics in the general population of France and to explore the associated factors. METHOD: A multicentre cross-sectional study was conducted between November 2011 and March 2013 in six French cities. Adult passers-by in public places were invited to answer an electronic questionnaire on a tablet computer. Only people who declared having at least one natural tooth were included in the study. A logistic regression model was used for the multivariate analysis. RESULTS: The prevalence of ST during the previous 12 months reported by the sample of 2413 participants was 42.2% [95% CI: 40.2-44.1%]. The final logistic regression model showed significant statistical associations between ST and female gender, use of tobacco, consumption of soft drinks, limited access to oral care and poor oral hygiene habits (p < 0.05). CONCLUSIONS: This study provides prevalence data on ST in a general population in France, which seems to remain high despite the existence of many therapies. It should alert professionals to a clinical manifestation that is becoming increasingly prevalent and that they will have to take into consideration to help reduce the discomfort arising from it.

Microbiota of interdental space of adolescents according to Risk of Caries: A cross-sectional study protocol.

Dental caries is a major oral disease resulting from a complex interaction between the commensal microbiota, host susceptibility (heredity, immunity, diseases, etc.) and environmental factors (diet, dental hygiene, etc.). To predict the patient's risk of new carious lesions or progression of existing lesions, the Caries Risk Assessment (CRA) takes account of clinical, biological and behavioural factors. Thus, the CRA can predict whether the patient is at high or low risk of developing caries. The practitioner can thus set up a follow-up adapted to the risk of the patient. However, although bacteria are the main etiological factor of carious lesions, the CRA does not consider bacterial quantification or just focus on the level of S. mutans in the saliva. As the majority of cavities are interproximal in adolescence, the aim of this trial is to identify and quantify the interdental microbiota of adolescents aged from 15 to 17 years with low or high carious risk. So, the quantification of new biomarkers associated with carious lesion could be added to the CRA to improve it.

Periodontal Pathogens as Risk Factors of Cardiovascular Diseases, Diabetes, Rheumatoid Arthritis, Cancer, and Chronic Obstructive Pulmonary Disease-Is There Cause for Consideration?

Cardiovascular diseases, chronic obstructive pulmonary diseases, diabetes, rheumatoid arthritis, and cancer are the most common noncommunicable diseases (NCDs). These NCDs share risk factors with periodontal disease (PD), a preventable risk factor linked to lifestyle. The discussion regarding the association between these chronic diseases is more complex. There is still a significant knowledge gap particularly of the causal relationship between PD and NCDs. In this paper, we present fundamental knowledge of the mechanisms and roles of putative periodontal bacteria to gather several hypotheses, evidence that clinical studies thus far have not produced. Although the causal hypotheses are not yet clearly established on a biological basis, prevention and prophylactic measures are recommended to prevent even the possibility of such potential risk factors.

Calibrated interdental brushing for the prevention of periodontal pathogens infection in young adults - a randomized controlled clinical trial.

Periodontal disease is clearly correlated with systemic disease. The presence of periodontal pathogens in interdental spaces in young, healthy adults is a strong indicator of the need to introduce daily interdental prophylaxis. Twenty-five subjects (aged 18-35 years), diagnosticated clinically as periodontally healthy, were enrolled in this study. One hundred interdental sites were included. Among these sites, 50 "test" sites were cleaned daily with calibrated interdental brushes (IDBs), whereas the other 50 sites were not cleaned and considered "controls". The interdental biofilm at these interdental sites was collected at the beginning of the study (basal) and at 1 week, 2 weeks, 3 weeks, 4 weeks, and 3 months. Real-time polymerase chain reaction (PCR) methodology was used to quantify (i) 19 periodontal bacteria, including Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, and (ii) total bacteria. In the test sites, the quantity of total bacteria decreased over time with the use of IDBs. The bacteria from the red and orange Socransky complexes, which are associated with periodontal disease, significantly decreased in the test sites but not in the control sites. Bacteria from the yellow, and purple Socransky complexes, which are associated with periodontal health, increased significantly in both groups whereas bacteria from the blue Socransky complex increased significantly only in the test sites. Furthermore, at basal, 66% of test sites and 68% of control sites bled during interdental brushing. These percentages decreased by 85% in 3 months for the test sites and by 27% in the control sites. In conclusion, the daily use of calibrated IDBs can reduce periodontal pathogens, reestablish symbiotic microbiota and, decrease interdental inflammation in interdental sites of healthy young adults.

The Oral Bacterial Microbiome of Interdental Surfaces in Adolescents According to Carious Risk.

Adolescence is closely associated with a high risk of caries. The identification of specific bacteria in an oral microniche, the interdental space of the molars, according to carious risk can facilitate the prediction of future caries and the anticipation of the progression or stabilization of caries in adolescents. A cross-sectional clinical study according to the bacteriological criteria of interdental healthy adolescents and carious risk factors-low and high-using a real-time polymerase chain reaction technique was conducted. The presence of 26 oral pathogens from the interdental microbiota of 50 adolescents aged 15 to 17 years were qualitatively and quantitatively analyzed. Bacteria known to be cariogenic (Bifidobacterium dentium, Lactobacillus spp., Rothia dentocariosa, Streptococcus cristatus, Streptococcus mutans, Streptococcus salivarius, Streptococcus sobrinus, and Streptococcus wiggsiae) did not present differences in abundance according to carious risk. Periodontal bacteria from the red complex are positively correlated with carious risk. However, only 3 bacteria-S. sobrinus, E corrodens and T. forsythia-presented a significant increase in the highest group. Estimating the risk of caries associated with bacterial factors in interdental sites of molars in adolescents contributes to the better definition of carious risk status, periodicity and intensity of diagnostic, prevention and restorative services.

Pedagogical Evaluation of Digital Technology to Enhance Dental Student Learning.

OBJECTIVE: A large number of digital tools supporting students have emerged over recent years which are encouraged in tutoring. A study conducted at the University of Montpellier (France) among 3rd, 4th, and 5th year dentistry students aimed primarily to identify the type of pedagogical support the students preferred according to their discipline. The secondary aim was to evaluate the student satisfaction after establishing a new pedagogical support. MATERIALS AND METHODS: A total of 165 questionnaires were completed. The main questions concerned pedagogical use of information technology and multimedia tools, choice of dentistry disciplines most justifying their use, and pedagogical gaps in these disciplines. Next, a program of pedagogical videos was developed for the most corresponding discipline. A satisfaction survey was finally conducted. RESULTS: Nearly 95.7% of students found online classes and E-learning via the virtual learning environment useful, with the most requested type being video. Demand was stronger in conservative dentistry and endodontics (27%), prosthetics (19%), and periodontology (18%). The most apprehended disciplines were endodontics in the 3rd year, endodontics and prosthetics in the 4th year, and prosthetics in the 5th year. Regarding satisfaction, 100% of students appreciated these videos and 99.4% considered they fulfilled expectations. CONCLUSION: All students requested videos, especially for clinical subjects such as endodontics. With digital technology, our world is experiencing a technological revolution resulting in many daily life changes. With students evolving in a digitally saturated society, our ways of learning and teaching need rethinking. Digital technology can help improve learning effectiveness and develop pedagogical practices more adapted to today's students.