The effect of clinical interventions on the oral health-related quality of life in older adults.

This paper reviews the literature to assess the effectiveness of oral health interventions in influencing oral health-related quality of life (OHRQoL) in older adults. Clinical studies published in 2010 onwards reporting oral health interventions in older adults and subsequent changes in OHRQoL were systematically searched in Medline, Web of Science and EMBASE databases. Reporting followed Preferred Reporting Items for Systematic Review and Meta-Analysis criteria. Eligibility evaluation and data abstraction from eligible studies were guided by predefined PICO questions and bias assessment by the Quality in Prognosis Studies tool. The search retrieved 144 articles. Of the 20 articles that met the eligibility criteria, 45% (9) reported a statistically significant improvement in OHRQoL. The majority of studies were conducted in adults with complete edentulism (70%) and mainly focused on implant provision to support a removable prosthesis (30%). The search indicates the limited scope of current literature on geriatric dental interventions, focusing mainly on denture realignments, denture fabrication and implant placement. Although the majority of the oral health interventions focused on edentulism and removable prostheses, there are many areas of oral health interventions and their potential impact on OHRQoL in this demographic group that have yet to be explored. © 2022 Australian Dental Association.

Perspectives of the public dental workforce on the dental management of people with special needs.

BACKGROUND: People with special health care needs continue to have difficulties accessing regular dental care partly due to oral health professionals feeling they lack the knowledge and experience to provide treatment to these individuals. METHODS: Qualitative interviews and focus groups provided an insight into the types and nature of supports that oral health professionals working in the Australian public dental system desired and felt may improve their willingness and/or ability to treat patients with special needs. RESULTS: Although participants did not identify one group of patients with special needs that were more difficult to treat, they did report a feeling of being unsupported. Clinicians felt that improved training and access to ongoing education in Special Needs Dentistry, opportunities for greater support from specialists or other health professionals, either through networking or other media such as telehealth, and fostering a more supportive clinical environment, particularly in relation to appointment lengths and productivity pressures, may improve their willingness and ability to treat patients with special needs. CONCLUSIONS: Additional support, in the form of greater interaction with specialists and reduced time and productivity pressures, may improve the willingness of oral health professionals in the public dental system to treat patients with special needs.

"Spontaneous" medication-related osteonecrosis of the jaw; two case reports and a systematic review.

Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse drug effect consisting of bone destruction of the maxilla and/or mandible. The most common precipitating event described in the literature is the extraction of a tooth followed by "spontaneous" occurrence with no clear predisposing event. Current studies are investigating methods of managing dental extractions in patients at risk of MRONJ; however, no studies to date examine the aetiology and management of "spontaneous" MRONJ. This paper describes two cases of "spontaneous" MRONJ seen at the Dental Unit in the Alfred Hospital and systematically reviews the current literature. No significant interactions (P > 0.05) were detected between variables: age, sex, bone disease, antiresorptive, antiresorptive duration, jaw, location and stage. "Spontaneous" cases were commonly associated with the mylohyoid ridge, palatal tori and other anatomical sites, and tended to occur in those generally considered at low risk of developing MRONJ. The review suggests that perhaps the term "spontaneous" is a misnomer and thorough history taking is critical in establishing a precipitating event.