Agreement Between Clinical and Histopathological Diagnoses of Oral and Maxillofacial Lesions and Influencing Factors: A Five-Year Retrospective Study.

Purpose: Diagnosing oral and maxillofacial lesions is a multi-step, multidisciplinary process. If a clinical diagnosis is achievable, then a histopathological diagnosis is indicated to support and confirm the diagnosis. Histopathological examination of tissue biopsies is therefore an essential part of the diagnosis and/or treatment plan. The purpose of this study was to investigate the agreement between the clinical and histopathological diagnoses of oral and maxillofacial lesions and the patient, lesion, and healthcare provider factors that may affect this agreement. Patients and Methods: This was an observational, cross-sectional study of all patients who had been referred to the Oral Pathology Central Laboratory at the Faculty of Dentistry and University Dental Hospital at King Abdulaziz University in Jeddah, Saudi Arabia, between 2018 and 2022 for diagnosis of oral and maxillofacial lesions. Data extracted included information about the referring dental provider such as their clinical experience (number of years), specialty, certification, and education. Agreement between the clinical and histopathological diagnoses was evaluated, and logistic regression was used to assess provider characteristics associated with the accuracy of diagnosis. Results: The clinical and pathological diagnoses were concordant in 44.1% (n=378) of cases, and concordance was highest for odontogenic tumors (72.7%, n=24), significantly higher than for inflammatory lesions (37.3%, n=111). The anatomical locations with the highest diagnostic accuracy were the ventral surface of the tongue (71.4%, n=5), followed by the lips (52.6%, n=20). Patient age and sex and the dentist's years of experience were not associated with diagnostic agreement (p=0.2, p=0.9, and p=0.08, respectively). However, concordant diagnoses were significantly associated with the dentist's rank (p=0.02) and specialty (p=0.01). Clinical diagnoses made by oral surgeons at the time of biopsy were 1.6-times more likely (p=0.01) to agree with the pathological diagnosis compared with those made by other specialties when controlling for education, certification, and years of experience. Conclusion: These data are a reminder that a clinical diagnosis alone is not sufficient to secure the final diagnosis and to plan treatment. Histopathological examination remains essential for most oral and maxillofacial lesions.

Musculoskeletal Disorders in the Clinical Practice of Dental Hygienists and Dentists, Prevention and Awareness among Italian Professionals: Focus on Enlarging Systems.

(1) Background: Musculoskeletal disorders of the upper limbs are a common medical condition among dental hygienists and dentists, making them a common occupational risk for dental professionals. The purpose of the work was to collect information about the dental professions and their habits to highlight what can be good practices to be carried out to prevent any musculoskeletal disorders. (2) Methods: To identify habits and problems inherent in the professional activity of dental hygienists and dentists, a questionnaire was formulated on the use of enlarging systems. (3) Results: The questionnaire was completed by 241 dental professionals. As for the use of magnifiers, 72.6% of participants use them: among dental hygienists, 67.8% use magnifiers, among dentists, 80.9% use magnifiers; there is a statistically significant difference. There is no statistically significant difference between professions regarding muscle disorders. (4) Conclusions: For a clearer assessment, it would be appropriate to submit the questionnaire to a wider sample of professionals, to define better the correlation between musculoskeletal disorders, work activity and the type of enlarging systems used.

A study of dentists' explanations and patient-dentist communication among older adults in Japan.

BACKGROUND: In recent years, the proportion of elderly people in the total patient population has been increasing owing to the rapid aging of Japanese society. However, little is known about the age-specific healthcare communication challenges within the field of dentistry. Therefore, this study aimed to examine the relationship between dentists' explanations and patient-dentist communication among elderly patients. METHODS: The study included 146 dentist-elderly patient pairs from Fukuoka Prefecture, Japan. A questionnaire was administered to pairs of dentists and patients. The survey was conducted between June 2021 and April 2022. We examined the relationships among the survey items: dentist demographics, patient demographics and sufficiency of the dentist explanations, and patient-dentist communication. The logistic regression analysis was conducted to examine the patient's mode of visiting the dentist as the objective variable, sufficiency of the dentist explanations, patient-dentist communication, dentist, and patient factors as explanatory variables. RESULTS: About 30% of patients felt that explanations of "Comparison with other treatment methods," "Treatment period," and "Treatment prognosis" were not sufficient. Among these items, a significantly higher percentage of respondents found the dentist's explanations sufficient when they were treated by more than one dentist. Many good communication factors were significantly associated with the dentist being younger and having a preventive practice. Multivariate analysis revealed a significant association between sufficiency of the dentist explanations and patients' regular dental visits. CONCLUSION: Adequate explanations by dentists for elderly patients were significantly associated with the dentist factor. Improving the quantity and quality of the dentists' explanations of treatment may improve patient satisfaction and promote regular dental visits.

Patients' reasons for consulting a general practitioner at the time of having dental problems: a qualitative study.

INTRODUCTION: Many patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems. METHODS: The sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant's permission, no note-taking was done during the interviews, which allowed for greater focus on the participants' conversation. The obtained data was analyzed using the content analysis. RESULTS: A total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient's perceptions of general practitioner(GP) and dental practitioner's scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs. CONCLUSION: Most participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient's consult behaviors regarding dental problems.

Treatment of Traumatic Dental Injuries in the Public Dental Services-A Qualitative Exploration of Perceived Challenges and Needs.

BACKGROUND/AIM: This study explored perceived challenges in the management of traumatic dental injuries (TDI) among general dentists in the public dental service (PDS) of Vestland County in Western Norway and their needs for improving treatment care for TDI patients. PARTICIPANTS AND METHODS: This qualitative study conducted three focus group discussions. We recruited a purposive sample of seven general dentists employed in the PDS in Vestland County in Western Norway. The three focus groups consisted of two, two, and three participants, respectively. The focus group discussion took place via the Microsoft electronic platform Teams, and it was visual, and audio recorded. Transcripts of the interviews were analyzed using systematic text condensation. RESULTS: The general dentists in this study experienced the management of TDI as a set of complex procedures that require good theoretical knowledge, clinical experience, skills, and teamwork. We were able to group these challenges into three results categories: (1) proficiency challenges, (2) the challenge of stress and discomfort during dental procedures, and (3) the challenge of the organization of the PDS. The participants also expressed the need for practical courses, calibration, and refresher courses in dental traumatology. Their needs fell into two categories: (1) regular, clinically relevant continuing professional development and (2) collective efforts in TDI management. CONCLUSION: Increasing awareness of the challenges in TDI management and addressing the need for improved dental treatment for TDI patients may lead to targeted programs to enhance dentists' knowledge and skills. There is considerable potential for training dentists in dental traumatology.

Why don't patients with Dentine Hypersensitivity discuss the condition with their dentist?

OBJECTIVES: This qualitative study aimed to develop an understanding of patients' barriers and facilitators of conversations about dentine hypersensitivity (DH) with their dentist. METHODS: The Theoretical Domains Framework shaped the topic guide for 26 participants who were troubled (High H) or not particularly troubled (Low L) by DH. Inductive thematic analysis of anonymised, transcribed, online focus group conversations was undertaken to identify reasons for non-discussion of DH during dental consultations. RESULTS: Participants reported that dentists did not routinely discuss DH, nor did participants feel they could bring it up. There was a perception among participants that DH was not a 'proper' condition and DH pain was not worthy of dentists' attention. Participants reported dealing with DH through lifestyle changes, and had little faith that dentists could offer more than 'just toothpaste' and voiced a need for a 'miracle cure'. Dental anxiety was a reported barrier to conversations. A positive attitude to DH by a dental team that normalised the condition and acknowledged its impacts on patients was voiced as a potential facilitator to DH discussions. CONCLUSIONS: DH conversations do not routinely take place in dental practice because patients believe DH is not serious, DH pain is not legitimate and there is no credible solution dentists can offer. Patients and dental teams need to be supported through behavioural science tools to change these perceptions for DH conversations to take place more routinely. CLINICAL SIGNIFICANCE: As DH cannot be diagnosed by visual inspection of teeth, patients cannot be managed unless they raise the issue of their DH with their dentist. The paper helps clinicians manage patients who are reticent to discuss DH with them and suggests how dentists may intervene to help.

Multifactorial Contributors to the Longevity of Dental Restorations: An Integrated Review of Related Factors.

PURPOSE: This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors. MATERIALS AND METHODS: A search of the literature was performed using an electronic database, PubMed/Medline, Web of Science, and Scopus, on papers published between 1980 and 2024. The titles and abstracts of papers that evaluated aspects categorized into tooth-related, patient-related, and dentist-related factors influencing restoration failure were selected and screened. Full-text assessments were conducted, and the extracted data were compiled, summarized, and synthesized. The reference lists of the collected papers were also screened, and relevant citations were included in this review. Data were gathered from clinical and laboratorial studies, systematic reviews, and meta-analyses to provide a comprehensive understanding of restoration longevity. RESULTS: Among the tooth-related factors, multiple-surface restorations, deep margins, tooth location, and tooth vitality significantly impact restoration survival. Patient-related factors such as medical conditions, risk predictors of caries, age, sex, parafunctional habits, smoking, periodontal health, number of restorations, and socioeconomic status all play crucial roles. Regarding dentist-related factors, the decision-making process, age, experience, and dentist manual dexterity are vital aspects. Furthermore, the technique used, including isolation methods for moisture control, as well as the type of dental practice (large group vs. small practice), notably influenced the restoration survival. CONCLUSIONS: The longevity of dental restorations is influenced by a complex interplay of tooth-related, patient-related, and dentist-related factors. Strategies to improve restoration outcomes should consider all these multifactorial contributors. Continuing professional education, diligent patient guidance on the factors that influence restoration survival, careful material selection and restorative technique, and tailored individual treatment are crucial factors to reduce failure rates and improve the lifespan of restorations.

Effect of a Novel Ergonomic Sheath on Dental Device-Related Muscle Work, Fatigue and Comfort-A Pilot Clinical Study.

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with (a) piezoelectric scaling by hygienists with and without musculoskeletal disorders (MSDs), and (b) dental cavity preparation by healthy dentists using a dental micromotor. Materials and Methods: Two groups of ten hygienists each tested the piezoelectric scaler. Hygienists in Group 1 had no MSDs, while those in Group 2 had been diagnosed with MSDs. Additionally, ten dentists with no MSDs used a dental micromotor to prepare four standardized cavities. Time-based work in four muscles, comfort and fatigue were recorded in the presence and absence of an add-on soft, insulating handle sheath. Data were analyzed using a repeated measures analysis of variance model with Tukey's post-hoc test. Results: Comfort, fatigue and muscle work were significantly better for both devices when the sheath was used. While hygienists with MSDs used more muscle work to complete the set scaling task, and the sheath-related reduction in work was somewhat greater, these MSD-related differences did not quite reach significance. Conclusions: The results of this pilot study show that the ergonomic performance of an ultrasonic scaler and a dental micromotor may be improved by the use of an ergonomic handle sheath.

Gender inequalities in oral medicine and pathology research: Temporal trends of two decades.

OBJECTIVES: To analyze gender inequities and trends in the authorship of articles published in high-impact factor journals of the field of Oral Medicine and Pathology. METHODS: The gender and country of first and last authors were retrieved from original articles published between 2000 and 2022. Poisson regression models and classification and regression tree (CART) analysis were performed. RESULTS: A total of 6595 studies were analyzed for first authorship, and 6627 for last authorship. Only 39.2% (CI 95% 38.0-40.3) of the first authors and 24.1% (CI 95% 23.1-25.1) of the last authors were females. Females consistently faced underrepresentation throughout the 23-year evaluation. The only region where female first authors are not a minority is Latin America. Having a female as the last author increased the prevalence of females in the first author position by 42% (PR = 1.42, CI 95% [1.30-1.54]). The most important discriminant variable by CART was the first author region. CONCLUSION: Although a slight decrease in underrepresentation was noted over the period, after 2020, the gender gap tended to widen for both first and last authors. It is crucial to implement measures aimed at attracting, retaining, and advancing women in the field of science, while also actively monitoring advancements toward achieving gender equity.

The impact of virtual reality haptic simulators in pre-clinical restorative dentistry: a qualitative enquiry into dental students' perceptions.

PURPOSE: In the realm of restorative dentistry, the integration of virtual reality haptic simulation (VRHS) for learning operative skills has garnered varied perceptions among dental students. Therefore, the aim of this study was to delve deep into undergraduates dental students' perceptions related to the impact of VRHS in pre-clinical restorative dentistry. METHODS: A homogeneous purposive sampling method was utilized to gather data from third-year undergraduate dental students (n = 23) at the College of Dental Medicine, Qatar University, to thoroughly investigate their views on the impact of VRHS on their learning experience in preparing a standard class I cavity. An explorative qualitative method using face-to-face focus group sessions were conducted in English during 2023. Focus group sessions were recorded and transcribed using Microsoft Teams. Two authors independently read the transcripts, coded the text, and manually analyzed text using an inductive thematic approach. RESULTS: A total of 21 (91.3%) students participated in this study. Analysis of 3 focus group interviews revealed five primary themes summarized with the term "MASTR" (M = manual dexterity, A = assessment, S = sequence, T = training, and R = realism). Based on frequency of reported themes, students perceived realism/ lifelike nature of VRHS requiring further enhancement to achieve the desired learning objective. CONCLUSION: Although, VRHS play a crucial role in modern dental education, offering innovative solutions for training, evaluation, and feedback, the need to enhance their ability to simulate real-life dental procedures and learning environment (realism), coupled with interactive and immersive learning experiences were the most frequently raised theme by students. In terms of curriculum design and learning pedagogies, dental educators should consider the appropriate sequence when integrating VRHS within the undergraduate curricula.

The effect of antibiotic premedication on postoperative complications following dental extractions.

OBJECTIVES: We aimed to evaluate the association between antibiotic prophylaxis and adverse outcomes following tooth extraction within the Veterans Affairs Healthcare System. METHODS: We conducted a retrospective cohort study of patients undergoing dental extractions in 2015-2019. The primary exposure was antibiotic prophylaxis. The primary outcome was post-extraction complication within 7 days (e.g., alveolar osteitis and surgical site infection); the secondary outcome was subsequent medical care relating to a post-extraction oral complication within 7 days. Multivariable logistic regression models assessed the independent effect of antibiotic prophylaxis on each outcome. RESULTS: Of 385,880 visits with a dental extraction, 122,810 (31.8%) received antibiotic prophylaxis. Overall, 3387 (0.9%) experienced a post-extraction complication and 350 (0.09%) received medical care relating to a post-extraction oral complication within 7 days. In multivariable regression, diabetes was a statistically significant (p = 0.01) effect modifier of the association between antibiotic prophylaxis and post-extraction complication. Among visits for patients without diabetes, antibiotic prophylaxis was significantly associated with an increased odds of post-extraction complication (odds ratio [OR] = 1.25, 95% confidence interval [CI]: 1.13-1.38), but among visits for patients with diabetes no significant effect was observed (OR = 1.03, 95% CI: 0.92-1.15). Antibiotic prophylaxis was not significantly associated with post-extraction medical care (OR = 1.04; 95% CI: 0.83-1.30). CONCLUSIONS: In this large retrospective cohort, we observed no significant protective effect of antibiotic prophylaxis on post-extraction complications or subsequent medical care utilization in a setting with low complication rates. These data suggest that use of antibiotic prophylaxis in similar settings may need to be re-evaluated to minimize unnecessary antibiotic use.

The interplay of stress- and work-related musculoskeletal disorders in dental practitioners.

OBJECTIVES: Prevalence of work-related musculoskeletal disorders (WRMSDs) among dentists and orthodontists is approximated to range between 64%-93%. Etiology of WRMSDs in the mentally and physical demanding occupation remains unclear, for which reason aim of the study was to clarify the interplay of physical, psychological, and mental factors on WRMSDs Material and Methods: Of 94 orthodontists and 187 dentists, (Mage=35 years) questioned using an online-survey, 84% reported persisting tension or pain in the back, neck, or shoulders. While 71% of females were employed (29% self-employed), solely 39% of male participants were employed. Cluster analysis was used to characterize dentists according to their movement profile and the moderating effect of stress on WRMSDs scrutinized. RESULTS: Three movement profiles of dentists and orthodontists were significantly predictive of WRMDS. The minority could be characterized as healthy (n=45), whereas twice as many reported nearly twice as much pain (n=90). Stress proved to be a strong, significant moderator of WRMDs in relation to gender, employment status, and BMI. CONCLUSION AND OUTLOOK: Prevalence of WRMSDs found in this study is alarming. Given the feminization of dentistry the being a female, stressed and an employee (rather than self-employed) a significant predictor of WRMSDs represents a serious danger to the German health system.

Evaluation of Occupational Burnout and Job Satisfaction among Endodontists in Iran.

Introduction: Occupational burnout has been introduced as one of the most critical social problems. The present study aimed to evaluate occupational burnout among a group of Iranian endodontists. Material and Methods: Seventy-two Iranian endodontists participated in this cross-sectional study by completing the abbreviated Maslach Burnout Inventory (aMBI), consisting of one questionnaire in three domains. The data were analyzed with SPSS 21, using the chi-squared test, correlation test, and linear regression. Results: Concerning occupational burnout, 2.9% of the participants had severe emotional exhaustion, 4.2% exhibited an intense feeling of decreased accomplishment, 67.2% exhibited moderate occupational burnout, and 78.9% of the participants were satisfied with their job. Of all the variables, only the years elapsed since graduation had an inverse and significant correlation with occupational burnout among endodontists. Conclusion: The overall mean scores of endodontists showed a moderate rate of occupational burnout compared to the standard mean scores in this field. Recent graduates exhibited higher scores.

Dentists' knowledge about domestic violence against women: A questionnaire-based study.

BACKGROUND: Dentists are the first healthcare professionals to identify cases of domestic violence and abuse (DVA) with head and neck injuries. OBJECTIVES: The aim of this study was to assess dentists' knowledge regarding behavioral and physical findings in female victims of DVA. MATERIAL AND METHODS: The study included 558 volunteer dentists who completed a two-part questionnaire designed to assess their knowledge and awareness of DVA against women. The first part of the questionnaire inquired about the participants' demographic data, including age, sex, specialty, and the duration of professional practice. The second part assessed 15 statements on a 5-point Likert scale, concerning both behavioral (5/15) and clinical aspects (10/15) of DVA. For each statement, if a minimum of 70% of respondents selected the same option, it was interpreted as being agreed upon by the participants. The level of statistical significance was set at p < 0.05. RESULTS: Most of the participants were between the ages of 31 and 40 (29.1%). The study sample was predominantly female (70.4%), with 57.2% of the participants being married. The statement "Abused women tend to avoid eye contact" had the highest agreement rate (70.6%) for the behavioral assessments. However, the participants were mostly "undecided" on the remaining 4 statements in this section. In contrast, the agreement rate for 5 statements related to the clinical assessment of head, neck and intraoral injuries exceeded 70%. One-fifth of the behavioral assessment statements and half of the clinical assessment statements were negatively correlated with the age of the participants (p < 0.05). CONCLUSIONS: The findings of this study indicate that dentists can recognize and diagnose DVA symptoms to a certain extent. However, they may encounter difficulties in identifying the suspicious behavior that is indicative of DVA.

Dentists' knowledge and attitudes regarding PFPT: A single study in East Java, Indonesia.

Objective: Pigmented fungiform papillae of the tongue (PFPT) are infrequently encountered and inadequately documented pigmented lesions that pose challenges in diagnosis and subsequent treatment planning. The study was aimed at analyzing dentists' knowledge and attitudes regarding PFPT morphologies, to determine diagnosis and subsequent treatment planning. Methods: A cross-sectional study was conducted among dentists in East Java through an online questionnaire. Four clinical photographs of PFPT were presented, accompanied by seven questions assessing dentists' knowledge of PFPT, including lesion types, tongue structure involvement, Holzwanger classification, lesion patterns, suspected diagnoses and the nature of the lesion (benign or malignant). Additional questions to evaluate attitudes included prior experience with PFPT in practice, potential malignant transformation, diagnostic investigation and required treatment. Knowledge-associated attitude differences were statistically analyzed with the Mann-Whitney test with a threshold of p < 0.05. Result: A total of 117 dentists participated, most of whom were women (69.23%) and were 26-30 years of age (44.44%). Dentists 41-50 years of age had superior knowledge to those 20-30 years of age (p = 0.005). Practitioners with 1-5 years of experience showed significant differences in knowledge regarding PFPT (p < 0.05). No significant differences in knowledge level and attitudes were observed, particularly regarding PFPT treatment and supporting investigation (p > 0.05). However, prior encounters with PFPT cases were significantly associated with treatment decisions and supporting investigations for diagnosis (p < 0.05). Conclusion: Most participating dentists had substantial knowledge of PFPT cases. Dentists' understanding, as reflected in their attitudes toward investigating and treating PFPT, was notably influenced by prior encounters with PFPT cases.

Strategies for Effective Dentist-Patient Communication: A Literature Review.

The effectiveness of high-quality dental care predominantly lies on the communication between dentist and patient. However, little literature has reported the importance of these "soft skills" in dental practice. The aim of this literature review is to explore strategies for effective dentist-patient communication. Dentist-patient communication is a bidirectional process involving the exchange of ideas that should be clear (easy to understand), correct (accurate), concise (to the point), complete (with essential information), and cohesive (well-organized). Effective communication empowers patients with the knowledge required to make an informed decision about their own oral health. It not only improves the dentist's efficiency and boosts patient confidence, but also alleviates patients' dental anxiety and fear, addresses patients' needs and preferences, increases patients' adherence, and enhances patient satisfaction. To enhance dentist-patient communication, dentists should take the patient-centered approach as a premise. The approach comprises understanding patients' illnesses, shared decision-making, and mindful intervention at the patient's own pace. In addition, dentists should use simple, succinct language, proper body posture, gestures, facial expressions, and eye contact when interacting with patients. Dentists should show empathy, encourage questions and feedback, employ visual aids, and give ample time to patients. Nowadays, dentists and their patients use messaging applications in their communication. This form of telecommunication is not only a convenient way of communication but also reduces the costs associated with a dentist visit. In conclusion, effective dentist-patient communication is vital for the success of dental practice. Dentists who prioritize communication and build positive relationships with their patients are more likely to achieve positive outcomes and foster the expansion of their dental practice.

A Cross-Sectional Survey of the Use of Clear Aligners by General Dentists in Australia.

OBJECTIVES: The primary aim of the investigation was to survey clear aligner therapy (CAT) use among general dentists in Australia. A secondary aim was to evaluate the factors that influenced general dentists in Australia not to provide CAT. MATERIAL AND METHODS: General dentists registered with the Australian Health Practitioner Regulation Agency were invited to participate in a structured cross-sectional electronic survey. The survey covered demographics, preferred CAT systems and practices, relevant treatment planning and retention protocols, patient-reported CAT issues, pertinent respondent opinions, and reasons for not providing CAT. Descriptive statistics were computed via GraphPad Prism v10 (GraphPad Software Inc., La Jolla, CA, USA). RESULTS: Most of the 264 (n = 172; 65.2%) respondents indicated that they provided CAT. The majority (n = 82; 58.6%) reported that they treated between 1 and 20 patients with CAT annually. Invisalign was the most used system (n = 83; 61.2%), with 55 (41.7%), indicating that they used more than one system. Most (n = 124; 98.4%) were comfortable using CAT for mild crowding, whereas 73.4% (n = 94) were not comfortable in treating severe crowding with CAT. The median (IQR) number of patients per respondent treated with extraction of a permanent incisor or premolar was 0 (0). Issues regarding tooth positions were reportedly always or mostly in need of change in the initial treatment plan by 68.7%. Problems regarding patient compliance with CAT wear protocols (n = 67; 45.6%) and the predictability of treatment outcomes (n = 31; 21.1%) were the most identified themes of the free-text comments. Over 80% of those who did not provide CAT indicated that they preferred to refer to an orthodontist for management. CONCLUSION: Almost two-thirds of the respondents provided CAT. Invisalign was the most used system. The majority use CAT combined with nonextraction treatment. Most of those who did not provide CAT preferred to refer to an orthodontist for patient management.

How trustworthy is online dental information for individuals with Down syndrome from Ibero-American countries?

BACKGROUND: Internet has become an indispensable source of health-related information. However, several studies have shown there to be a lack of quality control for webpages related to disability. Specifically, available content concerning Down syndrome (DS) and dentistry is limited and of dubious quality. OBJECTIVE: The aim of the present study was to assess the quality of online content in Spanish and Portuguese on dental care for individuals with DS. METHODS: A simultaneous search in Google and Bing using the terms "Down syndrome" and "odontology/dentist/dental treatment" in Spanish and Portuguese was conducted in seven Ibero-American countries (Argentina, Brazil, Chile, Colombia, Spain, Mexico, and Portugal). The first 100 consecutive pages of results from the three combinations of terms in each of the search engines were accessed and selected by applying conventional exclusion criteria. The selected pages were classified according to their authorship, specificity and dissemination potential. The quality of the online content was assessed using the DISCERN questionnaire and the Questionnaire to Evaluate Health Web Sites According to European Criteria (QEEC). The presence of the Health On Net (HON) and Accredited Medical Website (AMW) seals was also assessed. RESULTS: The mean DISCERN score was 2.51 ± 0.85 and 2.57 ± 0.86 for the Spanish and Portuguese webpages, respectively. The mean readability score was 3.43 ± 1.26 and 3.25 ± 1.08 for the Spanish and Portuguese webpages, respectively. None of the selected webpages presented the HONcode or AMW trust seals. CONCLUSIONS: The content available online in Spanish and Portuguese regarding Down syndrome and dentistry is scarce and of highly questionable quality.

Exploring young adults' fears related to healthcare and dental procedures.

Background and Purpose: Fear and anxiety related to dental and healthcare procedures are common among young adults and can negatively impact dental and healthcare consumership, resulting in poor health outcomes. Purpose: This cross-sectional study aimed to examine young adults' experiences of fear related to dental and healthcare procedures and the potential relationships between the two forms of fear experiences and demographic factors. Methods: Young adults (252) were recruited from a large public university and completed a survey about their dental and healthcare fear/anxiety as well as their confidence in healthcare professionals. Descriptive and correlational analyses were completed to describe the experiences of young adults and the relationships between variables. Results: Ten types of fear/anxiety were identified related to healthcare procedures, with the most common being needles and pain. Nine fears/anxieties were identified for dental visits, of which pain and sensory experiences other than pain were most common. Female participants were significantly more likely to report fear/anxiety related to dental procedures, and there was a statistically significant relationship between fear/anxiety related to healthcare procedures and that related to dental procedures. There was also a significant negative relationship found between confidence in healthcare providers and fear/anxiety related to healthcare procedures. Conclusions: Young adults experience fear/anxiety related to healthcare and dentist visits, and this fear/anxiety can impact their confidence in healthcare providers, such as primary physicians. The findings of the current study suggest primary care providers should be aware of potential fears/anxieties and offer patients appropriate supports.

Time series analysis of COVID-19's impact on physician and dentist visits in Iran.

This study aimed to assess the impact of the COVID-19 pandemic on general practitioner (GP), specialist, and dentist visits among 40 million Iranians covered by the Social Security Organization (SSO). A monthly interrupted time series analysis was conducted over a period of 72 months, including-47 months before the pandemic and 25 months after its onset. The outcomes variables were monthly number of GP, specialist, and dentist visits per 1000 SSO-insured individuals. The analysis was performed by total visits, visits to the SSO direct sector, and visits to the indirect sectors. The study found that in the first month of the pandemic, the number of visits per 1000 insured individuals significantly decreased for visits to GPs (by 51.12, 95% CI -64.42 to -37.88), visits to specialists (by 39.11, 95% CI -51.61 to -26.62), and visits to dentists (by 6.67, 95% CI -8.55 to -4.78). However, during the subsequent months of the pandemic, there was a significant increase in the number of monthly visits for all three categories, with GPs experiencing the highest increase (1.78 visits per 1000 insured), followed by specialists (1.32 visits per 1000 insured), and dentists (0.05 visits per 1000 insured). Furthermore, prior to the pandemic, the number of monthly GP visits per 1000 insured individuals was statistically significantly lower in the indirect sector compared to the direct sector (45.79, 95% CI -52.69 to -38.89). Conversely, the direct sector exhibited lower rates of specialist visits (25.84 visits per 1000 insured individuals, 95% CI 22.87 to 28.82) and dentist visits (0.75 visits per 1000 insured individuals, 95% CI 0.12 to 1.36) compared to the indirect sector. Additionally, the study found that in the first month of the pandemic, the monthly number of GP visits in the indirect sector significantly increased by 34.44 times (95% CI 24.81 to 44.08) compared to the direct sector. For specialist visits and dentist visits, the increase was 3.41 (95% CI -5.87 to 12.69) and 5.01 (95% CI 3.48 to 6.53) per 1000 insured individuals, respectively. Overall, the findings of this study demonstrate statistically significant disruptions in GP, specialist, and dentist visits during the COVID-19 pandemic, although some recovery was observed. Both the direct and indirect sectors experienced decreased visits.