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.

Perceived Stress among French Dental Students and Their Opinion about Education Curriculum and Pedagogy.

OBJECTIVES: The purpose of this study was to identify the major sources of perceived stress and their relation to a student satisfaction questionnaire about the curriculum and the pedagogy among French dental students. MATERIALS AND METHODS: All dental students (n = 178) from years 4 to 6 at the University of Montpellier (France) participated in this exploratory survey. In spring 2016, a 3-part questionnaire was distributed during clinical sessions: the first part asked about sociodemographic and living conditions, the second part aimed to assess the students' perceived stress (Dental Environmental Stress questionnaire), and the third part was a satisfaction questionnaire exploring the clinical organization and the teaching methodologies (Student Course Experience Questionnaire). A Spearman's correlation test and a principal component analysis were used to assess the relation between the variables of the questionnaire. RESULTS: The response rate was 99.4%. The most stressful items were "the number of tasks to be performed during clinical practice," "the waiting time before opinion from teachers," and "the administrative part and computer problems." Fifty-four percent of the students claimed to be satisfied with their studies, showing a score of seven or higher. There was a negative correlation between the level of student satisfaction and the level of perceived stress. CONCLUSION: Although most of the students were globally satisfied with their curriculum, this study highlighted dysfunctions in the clinical education with a level of stress correlated with the student's dissatisfaction. Most of all, students found that examinations were too stressful and that the clinical requested task quotas were overestimated.

Teledentistry, new oral care tool for prisoners.

Purpose In France, all incarcerated prisoners are required to undergo a dental examination (Ministère de la santé et de la protection sociale, 2004 and Ministère de la justice, 2004). However, only one in two prisoners benefits from this oral health check-up. Oral teleconsultation could improve the quality of oral care in prisons. The paper aims to discuss these issues. Design/methodology/approach The focus of this study was therefore to apply oral teleconsultation as an experiment. Using an oral teleconsultation system, a dentist and a nurse were separately asked to give patients a score, according to how urgently their dental issue needed to be treated. This score will henceforth be referred to as the "dental emergency scores given". Findings The separate dental emergency scores given by the dentist and the nurse were compared and the results demonstrate the following: - 36.7 per cent (11) of the two scores were equal - 53.3 per cent (16) of the two scores differed by 1 point - 10 per cent (3) of the two scores differed by 2 points. The average score of the nurse was 2.23 and that of the dentist was 2.13. The small disparity should not obscure the fact that 63 per cent of the diagnoses turned out to be incorrect. Practical implications Dental care could easily be improved with oral teleconsultation as a care plan could be developed for each patient. Social implications The condition of one's dental health is, of course, very important for general health, but it also affects social aspects. Good oral hygiene and health are very important when looking for a job after having been released from prison. Originality/value This is the first study on oral teleconsultation in prisons. Dental care is rarely studied on prisoners. Telemedicine in dentistry is just beginning all over the world. This study is the first step of an extensive project in the University Hospital of Montpellier and the Villeneuve-les-Maguelone prison.

Pseudomonas aeruginosa and Achromobacter sp. clonal selection leads to successive waves of contamination of water in dental care units.

Dental care unit waterlines (DCUWs) consist of complex networks of thin tubes that facilitate the formation of microbial biofilms. Due to the predilection toward a wet environment, strong adhesion, biofilm formation, and resistance to biocides, Pseudomonas aeruginosa, a major human opportunistic pathogen, is adapted to DCUW colonization. Other nonfermentative Gram-negative bacilli, such as members of the genus Achromobacter, are emerging pathogens found in water networks. We reported the 6.5-year dynamics of bacterial contamination of waterlines in a dental health care center with 61 dental care units (DCUs) connected to the same water supply system. The conditions allowed the selection and the emergence of clones of Achromobacter sp. and P. aeruginosa characterized by multilocus sequence typing, multiplex repetitive elements-based PCR, and restriction fragment length polymorphism in pulsed-field gel electrophoresis, biofilm formation, and antimicrobial susceptibility. One clone of P. aeruginosa and 2 clones of Achromobacter sp. colonized successively all of the DCUWs: the last colonization by P. aeruginosa ST309 led to the closing of the dental care center. Successive dominance of species and clones was linked to biocide treatments. Achromobacter strains were weak biofilm producers compared to P. aeruginosa ST309, but the coculture of P. aeruginosa and Achromobacter enhanced P. aeruginosa ST309 biofilm formation. Intraclonal genomic microevolution was observed in the isolates of P. aeruginosa ST309 collected chronologically and in Achromobacter sp. clone A. The contamination control was achieved by a complete reorganization of the dental health care center by removing the connecting tubes between DCUs.

Influence of temperature and relative humidity on dentin and enamel bonding: a critical review of the literature. Part 1. Laboratory studies.

PURPOSE: The aim of this literature review was to investigate the results from in vitro laboratory studies on the influence of temperature and relative humidity present before polymerization on enamel and dentin bonding systems. MATERIALS AND METHODS: A systematic search was carried out including articles published in English, in peer reviewed journals, and indexed in MEDLINE/PubMed database. The search was carried out using the terms: relative AND humidity AND dental. In vitro studies were retrieved and divided into laboratory simulation studies and studies on physical properties. Laboratory simulation studies were addressed by subtopic: resin-enamel bond strength, resin-dentin bond strength, and dentin-enamel microleakage. Studies on physical properties tested the influence of humidity and temperature through polymerization contraction, flexural strength, and dentin wettability. RESULTS: Laboratory simulation studies demonstrated a strong influence of humidity and temperature on dentin and enamel bond strength and microleakage with dental adhesives systems. The studies on physical properties failed to demonstrate any influence of humidity on the adhesion performance, except for wettability measurement. CONCLUSION: The clinical relevance of these in vitro results remains to be demonstrated. A review of in vivo clinical studies will complete the literature data presented here.

Factors associated with the use of emergency dental care facilities in a French public hospital.

This study was undertaken to qualitatively analyze patients' profiles and to identify the sociodemographic and oral health factors associated with emergency visits to the public dental service in Montpellier, France. A cross-sectional survey was conducted in the dental care service at Montpellier Hospital. Socioeconomic and clinical variables were compared between the patients using the emergency dental care service and those utilizing the general dental services, which were by appointment. An evaluation of the results indicated that younger patients and people from lower socioeconomic groups used the emergency dental service more frequently. Unemployed people (OR = 1.60) and manual workers (OR = 1.86) were also more likely to use this service. The need for treatment of caries was significantly higher in the group that used the emergency service. It appeared that the two groups of patients had different attendance behavior and showed significantly different socioeconomic and oral health status.

Tooth loss and associated factors in long-term institutionalised elderly patients.

OBJECTIVE: To compare partial and total tooth loss in dependent institutionalised elderly patients and identify any associated factors. BACKGROUND: A poor oral health status, together with a reduction of autonomy can seriously affect the general health and increase the risk of death in elderly people. Those with total tooth loss and in need of assistance are the most at risk. MATERIALS AND METHODS: In 2004, a cross-sectional study of 321 elderly patients was conducted in long-term hospital services provided in Montpellier, France. Socio-demographic, behavioural, medical and oral health information was recorded for each patient. Multivariate logistic regression models were performed to test the relationship between those covariates and partial or total tooth loss. Pearson chi-squared tests were used for bivariate analyses. RESULTS: The proportion of edentulousness was 26.9%; among these12.6% had no dentures. The factors significantly associated with edentulism were: an age 'older than 87 years' [odds ratio (OR) = 9.4], the presence of a nephropathy (OR = 6.8), and inadequate oral hygiene (OR = 0.1). The factors most significantly associated with partial tooth loss (at least 21 missing teeth) were 'cancerous disease' (OR = 9.9), the presence of a nephropathy (OR = 5.6) and the presence of a neurological disease (OR = 4.1). The factors significantly related to dentate status (20 or more natural teeth retained) were 'hypertension treatment' (OR = 2.4), and 'cortisone treatment' (OR = 0.2). CONCLUSION: General health problems as well as a poor oral condition were significant risk indicators for tooth loss among the long-term institutionalised elderly. This suggests that the number of remaining teeth has a strong effect on oral health-related quality of life.

Oral hygiene and the need for treatment of the dependent institutionalised elderly.

OBJECTIVE: To assessing the oral hygiene and treatment needs of a geriatric institution in southern France. BACKGROUND: For various reasons, the care demand from elderly people is low and difficult to determine, whereas their oral status would need long and complicated treatments. MATERIALS AND METHODS: From 2003 to 2004, a cross-sectional study of 321 elderly patients was conducted at several geriatric services of Montpellier, France. The clinical evaluation of dental status was recorded together with medical information. Dental and prosthetic hygiene, status of dentures, caries experience, dependence conditions and treatment needs were evaluated. RESULTS: The prevalence of edentulism was 27%, with no gender difference (23% of the men and 29% of the women). Among them, 16.7% (upper jaw) and 18.1% (lower jaw) were totally edentulous with no denture. The mean number of decayed and missing teeth was 3.7 for men and 2.8 for women and 21.5 for men and 21.0 for women, respectively. The mean number of filled teeth was 0.8 for men and 1.3 for women, with no statistical difference according to gender for the three indexes. Most of the subjects needed prostheses (53%), 45.1% extractions and 30.6% conservative treatments. Only 2.4% did not need any treatment. CONCLUSION: The prevalence of edentulism was relatively low, while the need for prosthodontic rehabilitation, especially for men, was still very high. The dental hygiene was globally inadequate. This evaluation emphasises the care demand and the need for help in oral hygiene procedures for the dependent institutionalised elderly.