The evaluation of clinical factors affecting oral health impacts on the quality of life of Iranian elderly patients visiting dental clinics: A cross-sectional study.

BACKGROUND: Iran will soon have an aging population. Healthcare providers must consider factors affecting the quality of life for those 60 and older. Understanding oral health as one of these factors can improve the elderly's quality of life. Oral health-related quality of life (OHRQoL) is a crucial reflection of individuals' general well-being and their overall quality of life linked to health. This study aimed to evaluate the OHRQoL among elderly Iranians referring to Azad University of Medical Sciences in Tehran. METHODS: In this cross-sectional study, 171 individuals over 65 (93 men and 78 women) were evaluated using OHIP-14 and GOHAI-12 questionnaires to analyze their quality of life. Gender, age, systemic diseases, using medications and dentures, the number of remaining teeth, and oral lesions were recorded. Salivary flow and xerostomia were analyzed with the spitting method and xerostomia index questionnaire, respectively. Also, four main flavor solutions were used to evaluate the taste perception. Data were analyzed using PASS11 and p value < .05 was the significance level. RESULTS: Based on OHIP-14 and GOHAI-12, Iranian older people's quality of life can be affected by cardiovascular diseases, hypertension, xerostomia, and the number of remaining teeth (p < .05). The results also showed a significant correlation between the OHIP-14 and GOHAI-12 scores (p < .001). Both indexes revealed that the number of remaining teeth, xerostomia, salivary flow, and taste perception greatly influenced participants' quality of life. More remaining teeth, improved salivary flow, and better perception of sweetness and sourness were all linked to a higher quality of life, while increased xerostomia, reduced salivary flow, and bitter taste perception were linked to a decline in overall well-being. Cardiovascular diseases, hypertension, and medication use were also found to significantly impact quality of life. CONCLUSION: This study's results indicate that cardiovascular diseases, hypertension, dry mouth, and tooth loss can negatively impact the elderly's quality of life. So, improving both systemic and oral health is vital for enhancing life quality in this age group.

Oral Health Status and Oral Health-Related Behaviours of Hong Kong Students with Vision Impairment.

This cross-sectional epidemiological study aimed to describe dental caries and oral hygiene conditions among visually impaired students in Hong Kong. Students aged 6-21 years from two specialised schools for those with vision impairment were invited. Information on sociodemographic background and oral health-related behaviours was collected through an online parent-reported questionnaire. Dental caries and oral hygiene were assessed using the Decayed, Missing and Filled Teeth (DMFT) index and the Visible Plaque Index (VPI), respectively. Chi-square, Mann-Whitney U and Kruskal-Wallis H tests were conducted to analyse the association between students' background and oral health status. A total of 73 participants were recruited, of whom 57.5% were male. Their mean (SD) age was 12.9 (4.7) years. Their mean DMFT score (SD) was 1.0 (1.8), and 43.8% had caries experience. The mean VPI (SD) was 0.76 (0.30). Their caries experience was significantly associated with their snacking habits (p = 0.013). Male participants had poorer oral hygiene than females (p = 0.048). In summary, dental caries is prevalent among visually impaired students in Hong Kong and their oral hygiene condition is unsatisfactory. Caries experience is significantly associated with snacking frequency, whereas oral hygiene is associated with gender. More specially designed preventive oral health measures should be provided for visually impaired students and their caretakers.

An ethnographic study of a community dentistry network serving Latine migrant farmworkers in Vermont: Barriers and access to care during the COVID-19 pandemic and beyond.

BACKGROUND AND OBJECTIVES: Primary dental healthcare services are not accessible for a majority of Latino/a/e migrant farmworkers in the United States. Unmet dental health needs are well documented in larger states like California, Florida and New York, but the dental healthcare picture in smaller states is not well understood. The goal of this qualitative ethnographic study was to understand the delivery model of a free dentistry network serving Latine farmworkers in rural Vermont and specific barriers experienced at the network during the COVID-19 pandemic. METHODS: Semi-structured ethnographic interviews were carried out with clinicians and transcripts were analysed using the constant comparison method to identify salient concerns and recommendations about barriers and delivery of care. RESULTS: Clinicians highlighted structural issues including farmworkers' lack of time off work and absence of transportation to attend appointments, concerns about COVID-19 safety, concerns about immigration surveillance and language barriers. Providers outlined steps for improved service delivery including mobile care at local farms, enhanced intercultural training for providers, recognizing dentistry as essential healthcare at the state level and the leverage of existing appointments for preventive health. Drawing on anthropological frameworks of place-based care and deservingness of healthcare, our ethnographic findings emphasize the role of community dentistry in bridging gaps in migrant healthcare during and beyond the COVID-19 pandemic.

Oral Health Workforce and American Indian and Alaska Native Communities: a Systematic Review.

OBJECTIVE: Understanding the oral health workforce representing and serving American Indian and Alaska Native (AI/AN) communities is vital to improving community dental health outcomes. No systematic review of recent published literature on the oral health workforce among this population has been completed. METHODS: We conducted a systematic review of published literature examining the oral health workforce representing and serving AI/AN communities in the USA. We analyzed 12 articles according to the PRISMA Statement. RESULTS: The studies suggested that AI/AN identity is an important aspect of routine and accessible oral healthcare. There are unique barriers and motivations that personnel in the oral health workforce face, let alone the distinctiveness of serving AI/AN communities. CONCLUSIONS: This review provides evidence that expanded oral health positions aid in community members receiving more routine and preventative care and is an upstream public health approach that has diversified the dental workforce.

A realist evaluation of policy interventions to reduce public subsidies of private dental care in Finland.

OBJECTIVES: The Finnish dental care market operates as a dual system, divided between a regulated, affordable public sector and a less regulated, more expensive private sector that receives public subsidies. In 2015 and 2016, two policy interventions were introduced to reduce these subsidies for private dental services. The aim of this study was to evaluate the impact of these policy changes on the dental care market. METHODS: This study was a realist evaluation. Context-Intervention-Mechanism-Outcome-configurations were applied to elicit an initial program theory (IPT) for the policy interventions. The IPT allowed a complicated system to be reduced to the main components, allowing for better understanding of the underlying mechanisms and the chain of events started by the interventions. The resulting hypotheses about the chain of events and outcomes were tested against a dataset collected from the Social Insurance Institution of Finland (SII) registries on public and private dental visits in the cities of Espoo, Helsinki and Oulu during the years 2010-2016. The used dataset consisted of N = 17 111 625 dental procedures or N = 8 139 990 individual visits (which can include several procedures) at a public (n = 9 097 407 procedures, n = 4 083 475 visits) or a private (n = 8 014 218 procedures or n = 4 056 515 visits) dental clinic. The system was studied during three time periods related to the two interventions in 2015 and in 2016. Changes were evaluated by statistically analysing changes in several key metrics: mean subsidy, mean out-of-pocket price, mean (non-subsidized) price, number of patients treated, number of professionals, procedures per professional, Case-Mix adjusted procedures per professional, patient-to-professional ratio, total procedures. RESULTS: The 2015 and 2016 reductions to the subsidization of private dental care reduced the average subsidies paid to the private dental sector by 49% [-49.1, -38.8]. A 26% [25.2, 26.7] increase in the out-of-pocket price paid in the private sector was observed. Over the 2 years, 12.2% of patients left the private sector and an increase of 13% was observed in the number of patients treated in the public sector. The public sector increased its number of dental care professionals by 2.3% and the patient-to-professional ratio increased by 9.9% over the 2 years, while the private sector lost 4.6% of its dental care professionals and increased its prices by 4.0% [3.5, 4.5]. CONCLUSIONS: The policy changes had tangible effects on both the private and public sectors of the Finnish dental care market. By reducing subsidies, the private sector became more expensive for patients, causing many to transition to the public sector for their dental needs. While the public sector increased its capacity to accommodate the rise in patients, the demand still outpaced the growth in professionals, hinting at capacity or resource constraints in the public sector. The results also show initial evidence that contrary to the objectives, the policy changes increased the cost to the public sector as subsidized patient cared for in the private sector costs less to the government than treating that same patient in the public sector.

A bibliometric analysis of Community Dentistry and Oral Epidemiology: Fifty years of publications.

OBJECTIVES: In celebration of the journal's 50th anniversary, the aim of the study was to review the whole collection of Community Dentistry and Oral Epidemiology (CDOE) publications from 1973 to 2022 and provide a complete overview of the main publication characteristics. METHODS: The study used bibliometric techniques such as performance and science mapping analysis of 3428 articles extracted from the Scopus database. The data were analysed using the 'Bibliometrix' package in R. The journal's scientific production was examined, along with the yearly citation count, the distribution of publications based on authors, the corresponding author's country and affiliation and citation count, citing source and keywords. Bibliometric network maps were constructed to determine the conceptual, intellectual and social collaborative structure over the past 50 years. The trending research topics and themes were identified. RESULTS: The total number of articles and average citations has increased over the years. D Locker, AJ Spencer, A Sheiham and WM Thomson were the most frequently published authors, and PE Petersen, GD Slade and AI Ismail published papers with the highest citations. The most published countries were the United States, United Kingdom, Brazil and Canada, frequently engaging in collaborative efforts. The most common keywords used were 'dental caries', 'oral epidemiology' and 'oral health'. The trending topics were healthcare and health disparities, social determinants of health, systematic review and health inequalities. Epidemiology, oral health and disparities were highly researched areas. CONCLUSION: This bibliometric study reviews CDOE's significant contribution to dental public health by identifying key research trends, themes, influential authors and collaborations. The findings provide insights into the need to increase publications from developing countries, improve gender diversity in authorship and broaden the scope of research themes.

Satisfacción del usuario en la atención odontológica comunitaria en Reynosa, Tamaulipas / User ́s satisfaction of community dental care in Reynosa,Tamaulipas

Resumen Objetivo: Evaluar el nivel de satisfacción en la atención recibida por los usuarios de la Clínica Odontológica de la Universidad México Americana del Norte (CO-UMAN) Allende. Material y método: El estudio fue descriptivo, observacional, transversal y prospectivo; se aplicó una encuesta de opinión a 200 pacientes, seleccionados mediante muestreo por conveniencia en 2019, sobre la estructura, proceso y resultados de la atención; así como bio-demográficos de cada paciente. Resultados: Predominaron pacientes con edades entre 21 y 60 años (71%), mujeres (63%), casados(as) (45%), empleados(as)/amas de casa (57%) y baja frecuencia de enfermedades concomitantes (10%). A mayor edad hubo mayor frecuencia de enfermedades concomitantes (r=0.26; p<0.05) y satisfacción en el servicio (r=0.26; p<0.05); con otras enfermedades concomitantes la satisfacción del paciente fue menor (r=-0.39; p<0.05). Los pacientes indican que hay más satisfacción (de 2.6 a 5.4 veces) al recibir un servicio adecuado o mejor. La satisfacción del paciente y la calidad de la atención de la clínica se asoció positivamente (p<0.05) con los trámites sencillos, trato por parte del odontólogo; confianza en la calidad de los servicios recibidos; relación costo/beneficio; puntualidad en la atención y efectividad del tratamiento odontológico recibido. Los coeficientes canónicos estandarizados indicaron mayor contribución en la satisfacción del usuario: las instalaciones e infraestructura de la clínica (0.479); atención del personal y proceso administrativo (0.543); atención del odontólogo (0.700); confianza en la atención y percepción del servicio recibido (0.660) y pobre relación con edad (0.078), género (0.030), estado civil (-0.040) y ocupación del paciente (0.065). Conclusión: No obstante que la cantidad y calidad del servicio de la CO-UMAN se ha incrementado y mejorado sustantivamente, es necesario desarrollar un plan de mejora continua para alcanzar estándares de calidad total.

Abstract Objective: To evaluate the level of satisfaction in the care received by the users of the Dental Clinic of the Universidad México Americana del Norte (DC-UMAN) Allende. Material and method: The study was descriptive, observational, cross-sectional, and prospective. In 2019, an opinion survey on the structure, proceedings, and results of the care, as well as bio-demographics of each patient was applied to 200 patients selected by convenience sampling. Results: Patients aged between 21 and 60 years (71%), women (63%), married (45%), employees/housewives (57%) and a low frequency of concomitant diseases (10%) predominated. At an older age, there was a higher frequency of concomitant diseases (r=0.26; p<0.05) and satisfaction in the service (r=0.26; p<0.05); with other concomitant diseases, patient satisfaction was lower (r=-0.39; p<0.05). Patients indicated that there is more satisfaction (from 2.6 to 5.4 times) when receiving an adequate or better service. Patient satisfaction and the quality of clinic care were positively associated (p<0.05) with simple procedures, treatment by the dentist, confidence in the quality of the services received, cost-benefit ratio, punctuality in the care and effectiveness of the dental treatment received. The standardized canonical coefficients indicated a greater contribution to user satisfaction from the facilities and infrastructure of the clinic (0.479), staff attention and administrative process (0.543), dental care (0.700), trust in care and perception of the service received (0.660) and poor relationship with age (0.078), gender (0.030), marital status (-0.040), and occupation (0.065) of the patient. Conclusion: Although the quantity and quality of the DC-UMAN service has increased and improved substantially, it is necessary to develop a continuous improvement plan to achieve total quality standards.

Patient satisfaction with access to a student-run free-service dental clinic.

Background: The Student Health Initiative for the Needs of Edmonton (SHINE) dental clinic is a student-volunteer-operated clinic offering free oral care to low-income individuals. However, little is known about how SHINE impacts access to care. Drawing on Penchansky and Thomas' theory of access, this study assessed patient satisfaction to measure access. For further context, patient-reported oral health concerns and alternative oral care options if SHINE were not available were recorded. Methods: The University of Alberta's Research Ethics Board (Pro 00101981) approved the study. Surveys adapted from Penchansky and Thomas were distributed over 12 weeks to all presenting patients. Survey data were triangulated with observations. Data were represented using descriptive statistics, and variables were compared using Chi-squared tests of independence. Results: A response rate of 77% (140/170) was achieved. The survey revealed that patients were generally satisfied with access to SHINE. However, observations revealed physical accessibility barriers. Dissatisfaction was correlated with attending SHINE without receiving treatment. Patients primarily presented to SHINE for pain (55%, 76/139). If SHINE were not available, 38% (46/121) of patients reported they would seek care from an alternative oral health professional, 32% (39/121) through an emergency department or physician, and 27% (33/121) would not attain oral health care at all. Conclusion: SHINE could be seen as addressing the need for access to oral health care services. The remaining barriers to care include long waiting times and clinic capacity to deliver care. A faster triage process may reduce waiting times. However, SHINE cannot provide more oral health care due to clinic capacity. Lastly, access to clinics such as SHINE may reduce visits to emergency departments for oral health care.

Introduction: La clinique dentaire « Student Health Initiative for the Needs of Edmonton (SHINE) ¼ est une clinique dirigée par des étudiants bénévoles qui offre des soins buccodentaires gratuits aux personnes à faible revenu. Néanmoins, on sait peu de choses sur l'incidence de la clinique SHINE sur l'accès aux soins. S'appuyant sur la théorie de l'accès de Penchansky et de Thomas, cette étude a évalué la satisfaction des patients pour mesurer l'accès. Pour plus de clarté, les problèmes de santé buccodentaire déclarés par les patients et les autres options de soins buccodentaires, s'ils n'étaient pas offerts par SHINE, ont été consignés. Méthodes: Le comité d'éthique en recherche de l'Université de l'Alberta a approuvé l'étude (Pro 00101981). Des sondages adaptés de la théorie de Penchansky et de Thomas ont été distribués sur 12 semaines à tous les patients qui se sont présentés. Les résultats ont ensuite été corroborés avec des observations. Les données ont été représentées à l'aide de statistiques descriptives, et les variables ont été comparées à l'aide du test d'indépendance chi carré. Résultats: Le taux de réponse a été de 77 % (140/170). Le sondage a révélé que les patients étaient généralement satisfaits de l'accès à SHINE. Toutefois, les observations ont révélé des obstacles physiques à l'accessibilité. L'insatisfaction était corrélée au fait de faire appel à SHINE sans recevoir de traitement. Les patients ont principalement fait appel à SHINE en raison de douleurs (55 %, 76/139). Si SHINE n'était pas disponible, 38 % (46 sur 121) des patients ont déclaré qu'ils iraient chercher des soins auprès d'un autre professionnel de la santé buccodentaire, 32 % (39 sur 121) par l'entremise d'un service d'urgence ou d'un médecin, et 27 % (33 sur 121) n'obtiendraient pas du tout de soins buccodentaires. Conclusion: La clinique SHINE peut être considéré comme une solution au besoin d'accès aux services de soins de santé buccodentaire. Les autres obstacles aux soins comprennent les longs temps d'attente et la capacité du programme à fournir des soins. Un processus de triage plus rapide pourrait réduire le temps d'attente. Toutefois, SHINE ne peut pas fournir plus de soins buccodentaires en raison de sa capacité d'accueil. Enfin, l'accès à des cliniques comme SHINE peut réduire le nombre de visites aux urgences pour des soins buccodentaires.

Using Policy Briefs to Communicate Dental Research Findings to Policymakers.

OBJECTIVES: New scientific knowledge is not always available to decision makers. Policy briefs are a way that dental researchers can communicate research findings to policymakers. This study compares usefulness of 2 types of policy briefs about sugar-sweetened beverage (SSB) intake and tooth decay. METHODS: We developed 2 policy brief types (data focused and narrative focused) and emailed a randomly assigned policy brief to 825 policymakers and staff from 3 levels of government (city, county, and state) in Washington State. Participants completed a 22-item online questionnaire. There were 4 study outcomes: whether the brief was understandable, whether the brief was credible, likelihood of use, and likelihood to be shared (each measured on a 5-point Likert-like scale). The t test was used to evaluate whether outcomes differed by policy brief type and government level (α = 0.05). RESULTS: There were 108 respondents (adjusted response rate 14.6%). About 41.6% of participants were in city government, 26.9% were in county government, and 29.6% were in state government. Participants reported that both data- and narrative-focused briefs were understandable (mean rating [MR] and standard deviation [SD]: 4.15 ± 0.68 and 4.09 ± 0.81, respectively; P = 0.65) and credible (MR and SD: 4.13 ± 0.70 and 4.09 ± 0.70, respectively; P = 0.74), but they were not likely to use (MR and SD: 2.71 ± 1.15 and 2.55 ± 1.28, respectively; P = 0.51) or share it (MR and SD: 2.62 ± 1.04 and 2.66 ± 1.30, respectively; P = 0.87). The likelihood of sharing briefs differed significantly by level of government (P = 0.017). Participants at the state level were more likely to share information from the briefs (mean rating and SD: 3.10 ± 0.80) than city- and county-level participants (MR and SD: 2.62 ± 1.27, and 2.24 ± 1.21, respectively). CONCLUSION: Both data- and narrative-focused policy briefs may be a useful way to communicate dental research findings to policymakers, but additional steps are needed to ensure that briefs are used and shared. KNOWLEDGE TRANSFER STATEMENT: Researchers should disseminate their research findings to maximize scientific impact. Our study findings indicate that policy briefs may be a useful way to communicate dental research findings to policymakers, but additional research is needed on the best ways to disseminate findings.

Factors related to the waiting time for scheduling an oral biopsy in Brazil: a multilevel analysis.

BACKGROUND: Timely diagnosis of oral cancers is critical, and performing biopsies of oral lesions with suspected malignancy is a crucial step in achieving this goal. The waiting time for the diagnosis may be related to the progression and prognosis of malignant neoplasms. OBJECTIVE: The aim of this observational, cross-sectional, national-level study was to identify the factors associated with the waiting time for scheduling an oral biopsy, based on the identification of its need. METHODS: We used secondary data from the Brazilian public health system, obtained from the 2nd cycle of the National Program to Improve Access and Quality of Dental Specialty Centers (PMAQ-CEO). The study outcome was the waiting time for scheduling an oral biopsy, starting from the identification of the need for the exam. We analyzed individual and contextual variables using multilevel statistical analysis. RESULTS: In 51.8% of DSC the waiting time for scheduling a biopsy was non-immediate; in 58.1% of CEOs, the sum of the weekly workload of dentists working in the Stomatology specialty is up to 20 h per week; in terms of coverage, 67.1% of the CEOs have only municipal coverage and 34.0% are references for up to 12 oral health teams in primary health care; only the coverage variable remained significant in the multivariate model (p < 0.05). Of the contextual variables, none of the variables remained significant (p > 0.05). When these were analyzed together, only the coverage remained significant (p < 0.05); CONCLUSION: Our analysis indicates that the waiting time for scheduling an oral biopsy is longer in CEOs that cover only one municipality and is not related to contextual factors.

Accuracy of Artificial Intelligence-Based Photographic Detection of Gingivitis.

OBJECTIVES: Gingivitis is one of the most prevalent plaque-initiated dental diseases globally. It is challenging to maintain satisfactory plaque control without continuous professional advice. Artificial intelligence may be used to provide automated visual plaque control advice based on intraoral photographs. METHODS: Frontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement. RESULTS: A total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50. CONCLUSIONS: Artificial intelligence could identify specific sites with and without gingival inflammation, with high sensitivity and high specificity that are on par with visual examination by human dentist. This system may be used for monitoring of the effectiveness of patients' plaque control.

Dental opioid prescription patterns in academic and community settings.

OBJECTIVES: Reports of interventions to improve dental opioid prescribing have come primarily from academic settings, but most opioid prescriptions are written by community dentists. This analysis compares prescription characteristics between these two groups to inform interventions to improve dental opioid prescribing in community settings. METHODS: State prescription drug monitoring program data from 2013 to 2020 were used to compare opioid prescriptions from dentists at academic institutions (PDAI) to prescriptions from dentists in non-academic settings (PDNS). Linear regression was used to assess daily morphine milligram equivalents (MME), total MME, and days' supply, adjusting for year, age, sex, and rurality. RESULTS: Prescriptions from dentists at the academic institution accounted for less than 2% of over 2.3 million dental opioid prescriptions analyzed. Over 80% of prescriptions in both groups were written for <50 MME per day and for ≤3 days' supply. On average, in the adjusted models, prescriptions from the academic institution were written for about 75 additional MME per prescription and nearly a full day longer duration. Compared to adults, adolescents were the only age group who received both higher daily doses and longer days' supply. CONCLUSIONS: Prescriptions from dentists at academic institutions accounted for small percentage of opioid prescriptions, but prescription characteristics were clinically comparable between groups. Interventional targets to reduce opioid prescribing in academic institutions could be applied to community settings.

Síndrome de Burnout en estudiantes de la Clínica de Odontología / Burnout Syndrome in Dental Clinic Students

Introducción: El Síndrome de Burnout es considerado una fatiga generalizada de la persona, se acompaña de agotamiento que produce decepción, pérdida de interés en la actividad laboral que desarrolla. Objetivo: Determinar la prevalencia del Síndrome de Burnout en estudiantes de 8vo semestre Clínica V de la Facultad de Odontología de la Universidad de Las Américas. Materiales y métodos: investigación descriptiva, comparativa, prospectiva y transversal, muestra de 69 alumnos; se utilizó test de Maslash Burnout Inventory para evaluación; test de signos y síntomas para determinar prevalencia y severidad; se compara Síndrome con género, hora y tipo de tratamientos clínicos que realiza el estudiante. Resultados: Nivel de cansancio emocional alto 53,6%; despersonalización bajo 46,4%; realización personal medio 44,9%. Los estudiantes encuestados presentaron Burnout alto 14,5%; medio 82,6%, bajo 2,9%; pruebas de Chi cuadrado de Pearson, no logró determinar la significancia, resultados similares entre la variable de género, tratamientos realizado y hora; en Síndrome con signos y síntomas, se determinaron algunas patologías: insomnio parcial, cefaleas; mialgias, dolor en cuello, dolor en extremidades superiores e inferiores, flatulencias, gastritis, presencia de nauseas, vómito. Conclusiones: el Síndrome de Burnout se presenta en ambos géneros, independiente de hora y acción clínica que realiza el estudiante. (AU)

Introduction: Burnout Syndrome (SB)* is considered a generalized fatigue of the person, is accompanied by exhaustion that causes disappointment, loss of interest in the work activity that develops. Objective: Determine the prevalence of Burnout Syndrome in students of 8 semester Clinical V of the Faculty of Dentistry of the University of the Americas. Methods: Descriptive, comparative, prospective and transversal study, sample of 69 students; Maslash Burnout Inventory test was used for evaluation; tests of signs and symptoms to determine prevalence and severity; it compares syndrome with gender, time and type of clinical treatments performed by the student. Results: High emotional fatigue level 53.6%; depersonalization under 46.4%; average staffing 44.9%. Students surveyed presented burnout high 14.5%; average 82.6% and low 2.9%; Pearson's Chi squared tests, failed to determine significance, the results were similar among the gender variable, treatments performed and hour; in Syndrome with signs and symptoms, some pathologies were determined: partial insomnia, headaches; myalgia's, neck pain, pain in upper and lower extremities, flatulence, gastritis, presence of nausea, vomiting. Conclusions: Burnout Syndrome is presented in both genres, independent of the time and clinical action that the student performs. (AU)

Web-Based Interventions Reduced Dental Anxiety among Adults in Lithuania and Norway: A Pilot Study.

Dental anxiety (DA) is a prevalent public health issue. However, there is a lack of self-administered DA interventions. The aim of this study was to evaluate the short-term effects of web-based interventions aiming to reduce DA in adults in two European countries. A pretest posttest design was used. Tailor-made websites were developed in Lithuania and Norway. Volunteers who self-reported DA were invited to participate. DA levels measured by the Modified Dental Anxiety Scale (MDAS) were assessed at baseline and after two weeks via online questionnaires. The interventions were completed by 34 participants in Lithuania and 35 participants in Norway. In Lithuania, the median posttest MDAS score (9.5, IQR 5.25) decreased compared to the median pretest MDAS score (14.5, IQR 8; Z value = -4.246, p < 0.001). The same was found in Norway-the median posttest MDAS score (12, IQR 9) was lower compared to the median pretest MDAS score (15, IQR 7; Z value = -3.818, p < 0.001). The present study demonstrated that two tailor-made web-based interventions had the potential to reduce dental anxiety levels when assessed in the short term in Lithuania and Norway. Studies with more controlled designs assessing long-term outcomes are needed to validate the results of this pilot study also in other cultures.

Introducing dental students to dental public health: An analysis of US predoctoral course syllabi.

Dental public health competencies in predoctoral dental education ensure that students have the skills to succeed in an increasingly complex professional environment. This study examined existing public health curricula in US dental education and their alignment with national recommendations from the American Association of Public Health Dentistry (AAPHD) and guidance from the Healthy People Curriculum Task Force for health professions education programs. We contacted all US dental schools (N = 66) in November 2020-January 202 and requested syllabi for schools' first course with dental public health content. We received 34 syllabi, which provided textual data for content analysis. The authors used an initial content analysis tool to extract descriptive course characteristics. Then, direct and emergent coding was performed to summarize course content. Direct codes included the 23 dental public health topics specified by AAPHD recommendations. Uncategorized content was coded using an inductive approach to identify emergent course themes. Frequently covered topics included principles of dental public health (79% of syllabi) and access to care (79%). "Health disparities" was the most common emergent theme, with 50% of courses including related content. There was little consistency in how courses approached each topic. For example, the topic "access to care" covered healthcare delivery systems, determinants of health, legislative reform, and advocacy. Dental public health was often taught alongside unrelated content. Recommendations for dental public health competencies should be updated to include new educational priorities, align with current national recommendations, and align with Commission on Dental Accreditation Standards more clearly.

Caries Preventive Interventions and Oral Health Inequalities: A Scoping Review.

INTRODUCTION: Dental caries remains one of the most prevalent but preventable diseases among children worldwide and especially affects children with a lower socioeconomic status or ethnic minority background. It is important that all groups of children are reached by preventive interventions to reduce oral health inequalities. So far, it is unknown whether children from different social and ethnic groups benefit equally from potentially effective oral health interventions. OBJECTIVES: This scoping review aimed to identify European public health interventions that report their effect on dental caries across different social groups. METHODS: Four databases were searched for studies evaluating the effect of oral health interventions on dental caries among children from 0 to 12 y, and studies were included when results were presented by children of different social groups separately. RESULTS: A total of 14 studies were included, representing 4 different countries: 3 randomized and 11 nonrandomized studies. Most studies were performed at schools. Six studies showed results indicative of a reduction in oral health inequalities, 4 studies showed results that potentially widen oral health inequalities, and 5 studies showed results that were indicative of no impact on oral health inequalities. Interventions that contain early approaches, with a high frequency, approaching multiple levels of influence, and including at least the broader organizational or public policy level, may have the potential to reduce oral health inequalities among children from birth to young adolescence. CONCLUSION: We recommend researchers to perform high-quality intervention studies and to evaluate the effectiveness of oral health intervention always in different socioeconomic or ethnic groups separately, to better understand their contribution toward oral health (in)equalities. KNOWLEDGE TRANSFER STATEMENT: This review offers insight in the differential effects that oral health interventions might have across different social groups. Its results can be used to develop interventions that might reduce oral health inequalities among children. Also, we recommend future researchers to always evaluate the effects of any preventive oral health measure in different social groups separately.

The impact of dentists' availability in delivering dental care in Florida Elementary Schools.

OBJECTIVE: This study evaluates the dentists' availability to deliver preventive dental care to children in schools and the impact of school-based programs on access. METHODS: The study population included Florida elementary-school children, differentiated by dental insurance (Medicaid, CHIP, private, or none). We considered the implementation of school-based programs using optimization modeling to (re)allocate the dentists' caseload to schools to meet demand for preventive care under resource constraints. We considered multiple settings for school-based program implementation: (i) school prioritization; and (ii) dentists' participation in public insurance. Statistical inference was used to identify communities to improve access and reduce disparities. RESULTS: School-based programs reduced unmet demand (3%-12%), being more efficient if prioritizing schools in communities targeted to improve access. The access improvement varied by insurance status and geography. Uninsured urban children benefited most from school-based programs, with 15%-75% unmet need reduction. The percentage of urban communities targeted to improve access decreased by 12% against no-school program. Such percentage remained large for suburban (15%-100%) and rural (50%-100%) communities. Disparity in access for public-insured vs. private-insured children persisted under school-based programs (32%-84% identified communities). CONCLUSION: School-based programs improve dental care access; the improvement was however different by insurance status, with uninsured children benefiting the most. Accounting to the dentists' availability in prioritizing schools resulted in effective resource allocation to school-based programs. Access disparities between public and private-insured children did not improve; school-based programs shifted resources from public-insured to uninsured. School-based programs are effective in addressing access barriers to those children experiencing them most.

Fluoride hesitancy: A mixed methods study on decision-making about forms of fluoride.

OBJECTIVES: To investigate whether professionally applied topical fluoride-hesitant caregivers are also hesitant about other forms of fluoride for their child. METHODS: This was a mixed methods study of 56 caregivers hesitant about professionally applied topical fluoride for their child recruited from the University of Washington Center for Paediatric Dentistry and Seattle Children's Hospital's Odessa Brown Children's Dental Clinic. A 32-item semi-structured interview script was piloted and finalized. One-time interviews with caregivers were conducted by phone in 2019. Associations between hesitancy of topical fluoride, fluoridated water and toothpaste were assessed quantitatively via two-tailed chi-squared tests. Qualitative data were coded using an inductive approach and content analytic methods to investigate reasons for hesitancy. RESULTS: There were significant associations between hesitancy in all three pairwise comparisons of fluoride form (p < .01). Similar proportions of caregivers strongly or somewhat opposed fluoridated water compared with toothpaste (75% and 65%, respectively), but four times as many caregivers strongly or somewhat favoured fluoridated toothpaste compared to water for their child (25% and 7%, respectively). Concerns about harm were the most common reason caregivers opposed both fluoridated water and toothpaste. However, fluoride-hesitant caregivers reported being more comfortable with fluoridated toothpaste because amount and frequency can be controlled, and ingestion can be prevented. CONCLUSIONS: Professionally applied topical fluoride hesitancy is significantly associated with fluoridated water and toothpaste hesitancy, but caregivers who were hesitant about topical fluoride was more comfortable with fluoridated toothpaste than fluoridated water for their child.

Experiencia educativa de una estructura didáctica en la carrera de Estomatología para visitas domiciliarias / Educational experience of a didactic structure in the Dentistry career to visit the family

Fundamento: en el entorno educativo las investigaciones relacionadas con los modos de actuación de los estudiantes adquieren especial significación. Los estudiantes de cuarto año de la carrera de Estomatología del escenario docente del policlínico "Docente de Playa" de la Facultad de Ciencias Médicas "Victoria de Girón" necesitan formarse del modo más cercano posible a los modos de actuación del futuro egresado, al tener en consideración problemas teóricos y metodológicos objetos de la profesión. Objetivo: describir una experiencia educativa sobre la aplicación de una estructura didáctica para el desarrollo de la visita a la familia como modalidad de la educación en el trabajo con estudiantes de cuarto año de Estomatología. Métodos: la investigación se desarrolló durante los cursos comprendidos entre el año 2014 al 2019. Se utilizaron métodos del nivel teórico, empírico y estadístico. La estructura didáctica centrada en el desarrollo de la visita a la familia consta de cuatro etapas con los correspondientes objetivos y acciones. Resultados: se reconoce la educación en el trabajo como forma fundamental de organización de la enseñanza para la carrera de Estomatología y la visita a la familia como una de las modalidades, lo cual constituye una pauta a seguir en la estructura didáctica propuesta. Conclusiones: el análisis y valoración de los resultados obtenidos luego de la aplicación, permitió constatar cambios significativos y transformaciones cualitativas a partir de la estructura didáctica, lo cual constituye una alternativa para el mejoramiento de los modos de actuación de los estudiantes de cuarto año de la carrera de Estomatología.

Background: in the educational environment, research related to students' modes of action acquire special meaning. The fourth-year students of the Dentistry degree in the teaching setting of the Victoria de Girón "teachin polyclinic of the ""Playa Faculty of Medical Sciences need to be trained as closely as possible to the modes of action of the future graduate, by taking into consideration theoretical and methodological problems objects of the profession. Objective: to describe an educational experience on the application of a didactic structure for the development of family visits as a modality of the in-service training with fourth-year dentistry students. Methods: the research was developed during the courses from 2014 to 2019. Theoretical, empirical and statistical methods were used. The didactic structure focused on the development of the visit to the family consists of four stages with the corresponding objectives and actions. Results: education at work is recognized as a fundamental way of organizing teaching for the Dentistry career and visiting the family as one of the modalities, which constitutes a guideline to follow in the proposed didactic structure. Conclusions: the analysis and assessment of the results obtained after the application allowed us to verify significant changes and qualitative transformations from the didactic structure, which constitutes an alternative for the improvement of the modes of action of the fourth year students of the Dentistry career.