Evaluation of the Effectiveness of Children's Dental Care Programs: A Retrospective Study.

This study aimed to evaluate the long-term impact of children's dental care programs on children and adolescents to reduce oral health inequalities. It measured and assessed the improvement effects of children's dental care programs on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and children's dental care program between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. A frequency analysis was conducted for demographic characteristics, and a binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. The data were analyzed using PASW Statistics with the statistical significance level set at α = 0.05. Regarding oral health status based on the frequency of participation in children's dental care program for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health status in children's dental care program between primary and adolescent age groups, individuals under continuous oral health care showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, a binary logistic regression analysis revealed significant influences (p < 0.05) of the developmental stage and frequency of program participation on dental caries prevalence. Children's dental care programs are essential for alleviating oral health inequalities among children and adolescents and preventing oral diseases. Furthermore, the developmental stage of children and the frequency of program participation are crucial factors in preventing oral conditions, such as dental caries.

A systematic review of the association between food insecurity and behaviours related to caries development in adults and children in high-income countries.

OBJECTIVES: To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. METHODS: A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. RESULTS: Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. CONCLUSIONS: This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.

Association between oral health-related quality of life and symptoms of temporomandibular disorder among older adults: A cross-sectional study.

OBJECTIVE: Evaluate the association between oral health-related quality of life (OHRQoL) and self-reported symptoms of TMD. METHODS: Representative samples of older adults (≥60 years) were included (n = 569). Both TMD symptoms and OHRQoL were assessed by Fonseca Anamnestic Index (FAI) and Oral Health Impact Profile-14 (OHIP-14), respectively. Prevalence (those answering "frequently" or "always" in at least one question), severity (total means scores), and extent (number of questions answered as "frequently" or "always") of OHRQoL were estimated. RESULTS: Overall, 33.4% and 9.5% had mild or moderate/severe TMD symptoms. Those with any symptom of TMD had a prevalence ratio (PR) 38% higher for the worst OHRQoL (95% confidence interval [95%CI]:1.04-1.82) compared to those without TMD symptoms. Worst OHRQoL were observed for those with mild (PR:1.35; 95%CI:1.01-1.81) and moderate/severe TMD (PR:1.53; 95%CI:1.04-2.26). Similar results were detected in the severity and extent of OHRQoL. CONCLUSION: Severity TMD was associated with worse ORHQoL.

Disparities of Delayed Dental Visits and Severe Tooth Loss Among Older Native Hawaiians and Other Pacific Islanders in Hawai'i: A Cross-Sectional Study of Behavioral Risk Factor Surveillance System Data from 2012 to 2020.

Oral health is a major health concern in the US and globally, particularly among communities of color and low-income/low-education groups. General health disparities have been reported among Native Hawaiians (NHs) and Other Pacific Islanders (OPIs), although less is known about the specific racial/ethnic and socioeconomic trends that are relevant to oral health disparities for NHOPIs. We examined delayed dental visits and severe tooth loss among older NHOPI adults in relation to sociodemographic factors and community level disparities using five waves of data from the Hawai'i Behavioral Risk Factor Surveillance System collected between 2012 and 2020. Weighted Poisson regression was used to estimate the unadjusted and adjusted prevalence ratio of delayed dental service utilization and severe tooth loss. Relative to other racial/ethnic groups, older NHs had higher rates of delayed dental service utilization and severe tooth loss after adjusting for sociodemographic factors, and disparities were also found in rural communities.Awareness of the unique challenges and inequities faced by older Indigenous and racially/ethnically marginalized populations is critical for policymakers to develop strategies to achieve health equity.

Advancing dental care access for patients with disabilities: A global scoping review of predoctoral training.

OBJECTIVE: To examine predoctoral training programs that address the unique needs of patients with special healthcare needs (SHCN) and provide an overview of current global training initiatives, while exploring innovative approaches to enhance dental students' preparation in managing SHCN patients. METHODS: A scoping review (SR) was conducted focusing on three key concepts: dental education, pre-doctoral training, and intellectual disability/developmental disability. The search encompassed five databases including Medline, Embase, Dentistry and Oral Sciences Source (EBSCO), Global Health (EBSCO), and WHO Global Index Medicus, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. EndNote and Covidence were utilized to prevent duplication and facilitate title/abstract screening. RESULTS: After screening abstracts, a total of 2309 articles were initially identified with 28 articles meeting eligibility criteria for data extraction relevant to the research question. Two major categories characterized the key findings included in the review: 12 interventional studies and 16 perception-based studies. CONCLUSION: This SR revealed that dental students are not adequately trained to treat special needs populations; consequentially, dental students lack confidence in providing high-quality care to this demographic. The absence of standardized training poses a global challenge, exacerbating care disparities. Addressing this issue is crucial to better prepare dental students and advance equitable access and quality care for underserved populations.

Celiac Disease-Related Enamel Defects: A Systematic Review.

INTRODUCTION: This systematic review aims to elucidate the intricate correlation between celiac disease (CD) and dental enamel defects (DED), exploring pathophysiological mechanisms, oral health implications, and a dentist's role in early diagnosis. MATERIALS AND METHODS: Following PRISMA guidelines, a comprehensive search from 1 January 2013 to 1 January 2024 across PubMed, Cochrane Library, Scopus, and Web of Science identified 153 publications. After exclusions, 18 studies met the inclusion criteria for qualitative analysis. Inclusion criteria involved study types (RCTs, RCCTs, case series), human participants, English language, and full-text available. RESULTS: The search yielded 153 publications, with 18 studies meeting the inclusion criteria for qualitative analysis. Notable findings include a high prevalence of DED in CD patients, ranging from 50 to 94.1%. Symmetrical and chronological defects, according to Aine's classification, were predominant, and significant associations were observed between CD severity and enamel defect extent. CONCLUSIONS: The early recognition of oral lesions, particularly through Aine's classification, may signal potential CD even in the absence of gastrointestinal symptoms. Correlations between CD and dental health conditions like molar incisor hypomineralization (MIH) emphasize the dentist's crucial role in early diagnosis. Collaboration between dentists and gastroenterologists is essential for effective monitoring and management. This review consolidates current knowledge, laying the groundwork for future research and promoting interdisciplinary collaboration for improved CD-related oral health outcomes. Further large-scale prospective research is recommended to deepen our understanding of these issues.

Long-term effects of motivational interviewing vs. traditional counseling on dog owners' adherence to veterinary dental home care: a three-year follow-up study.

Introduction: Periodontal disease is one of the most common health issues in dogs. However, disease is largely preventable by eliminating dental plaque, best achieved by daily tooth brushing. Unfortunately, owner adherence is low to the recommendation of daily tooth brushing in dogs. Objective: This study aimed to evaluate the impact of various communication strategies, traditional advice (TA) versus motivational interviewing (MI), and compare them to a control group receiving no additional communication (CG), on dog owners' performance of dental home care and the oral health of their dogs. Methods: The study was conducted as a longitudinal clinical intervention study spanning 3 years, and involved 75 dog owners with young dogs who were randomly assigned to one of three groups: TA, MI, or CG. Intervention groups received annual telephone consultations based on their assigned methodology. A questionnaire was administered twice to all groups, and the dental health of the dogs was assessed at the study's conclusion. Result: Tooth brushing frequency demonstrated a significant increase in the MI group compared to the CG group (p < 0.01), albeit with a relatively low occurrence of daily brushing among owners. Dental health assessment revealed a significantly lower plaque index in the MI group compared to the CG group (p < 0.05), and a lower calculus index in the TA group compared to the CG group (p < 0.01). No statistically significant differences were observed between the MI and TA groups in terms of dental health. Conclusion: Regular veterinary communication appears to have a positive influence on dog owner adherence to veterinary recommendations concerning dental care in dogs. Communication with veterinarians (MI and traditional advice) improved owner knowledge, attitude, and decreased frequency of not brushing. Although dental health parameters improved, the effect size was small, suggesting the complexity of adherence. Personalized calls to dog owners offer potential for dental health improvement, warranting further comparison of MI with traditional advice.

Dental patients as partners in promoting quality and safety: a qualitative exploratory study.

OBJECTIVE: Active patient involvement in promoting quality and safety is a priority for healthcare. We investigated how dental patients perceive their role as partners in promoting quality and safety across various dental care settings. METHODS: Focus group sessions were conducted at three dental practice settings: an academic dental center, a community dental clinic, and a large group private practice, from October 2018-July 2019. Patients were recruited through flyers or word-of-mouth invitations. Each session lasted 2.5 h and patients completed a demographic and informational survey at the beginning. Audio recordings were transcribed, and a hybrid thematic analysis was performed by two independent reviewers using Dedoose. RESULTS: Forty-seven participants took part in eight focus group sessions; 70.2% were females and 38.3% were aged 45-64 years. Results were organized into three major themes: patients' overall perception of dental quality and safety; patients' reaction to an adverse dental event; and patients' role in promoting quality and safety. Dental patients were willing to participate in promoting quality and safety by careful provider selection, shared decision-making, self-advocacy, and providing post-treatment provider evaluations. Their reactions towards adverse dental events varied based on the type of dental practice setting. Some factors that influenced a patient's overall perception of dental quality and safety included provider credentials, communication skills, cleanliness, and durability of dental treatment. CONCLUSION: The type of dental practice setting affected patients' desire to work as partners in promoting dental quality and safety. Although patients acknowledged having an important role to play in their care, their willingness to participate depended on their relationship with their provider and their perception of provider receptivity to patient feedback.

Assessing the role of dental insurance in oral health care disparities in Canadian adults.

Background: This study examines the association of dental insurance with oral health care access and utilization in Canada while accounting for income and sociodemographic factors. It contributes to a baseline of oral health care disparities before the implementation of the Canadian Dental Care Plan (CDCP). Data and methods: This retrospective study of Canadians aged 18 to 64 years is based on data from the 2022 Canadian Community Health Survey. Multivariable logistic regression was employed to evaluate the association of dental insurance with the recency and frequency of dental visits, as well as avoidance of dental care because of cost. Results: Overall, 65.7% of Canadians reported visiting a dental professional in the previous year: 74.6% of those with private insurance, 62.8% with public insurance, and 49.8% uninsured. Cost-related avoidance of dental care was 16.0%, 20.9%, and 47.4% for the privately insured, publicly insured, and uninsured, respectively. After adjustment, adults with private (odds ratio [OR]=2.54; 95% confidence interval [CI]: 2.32 to 2.78) and public (OR=2.17; 95% CI: 1.75 to 2.68) insurance were more likely to have visited a dental professional in the last year compared with those without insurance. Similarly, both private (OR=0.22; 95% CI: 0.20 to 0.25) and public (OR=0.22; 95% CI: 0.17 to 0.29) insurance holders showed a significantly lower likelihood of avoiding dental visits because of cost when compared with uninsured individuals. Interpretation: This study showed the significant association of dental insurance with access to oral health care in Canada, contributing to setting a critical benchmark for assessments of the CDCP's effectiveness in addressing oral health disparities.

Primary care dentistry: An Australian perspective.

INTRODUCTION: Primary care dentistry is the first point of contact that someone has with the dental system and is predominantly focused on the treatment and prevention of dental caries and periodontal disease. The aim of this paper was to review the Australian primary dental care system. METHODS: This paper reviews the primary dental care system in Australia, drawing on data reporting on the dental workforce, funding sources for dental care, oral health outcome measures and dental visiting patterns. RESULTS: Primary dental health care in Australia is predominantly provided by dentists working in private practice, with the number of dentists per 100,000 people in Australia increasing from 46.9 in 2000 to 65.1 in 2022. However, there has been a gradual shift over the past twenty years towards greater service provision by other members of the dental team who now represent one quarter of the dental workforce, and some expansion of publicly funded dental care. Despite this dentistry remains isolated from the rest of primary health care, and the lack of government funding means that many people continue to miss out of necessary dental care, particularly those living in regional and rural Australia and from low-income groups. CONCLUSIONS: Australians should be able to access primary dental care services when and where they need it with adequate financial protection, from services that are well integrated into the broader primary health care system to ensure they are able to achieve optimal oral and general health. For many Australians, this is not currently the case. CLINICAL SIGNIFICANCE: Australia is at a crossroads with respect to access to dental care, and there is a need for stronger advocacy from stakeholders to improve oral health outcomes and reduce inequalities.

3D printing vs traditional workflow for the fabrication of mandibular implant overdentures: study protocol for a mixed-methods cross-over RCT.

BACKGROUND: Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies enhance oral healthcare access by the elderly. Despite promising in vitro reports on digital denture materials, evidence from randomized clinical trials (RCTs) is lacking to verify their performance. This cross-over RCT will investigate whether 3D-printed implant-retained mandibular overdentures (IMO) are more satisfactory for edentulous seniors than those made through traditional methods. METHODS/DESIGN: We will recruit 26 completely edentulous participants (any sex/gender) based on the following eligibility criteria: age ≥ 60 years, no tooth extraction in the past 12 months, two implants in the lower jaw, and need for new dentures in both jaws. Each participant will receive two denture pairs, either manufactured by 3D printing or traditionally, to be worn in a random order. A timeline of 3 months with each denture pair will be considered for outcome assessment (total: 6 months). Patient satisfaction with dentures will be measured by the McGill Denture Satisfaction Questionnaire. We will evaluate other patient-reported outcomes (including oral health-related quality of life) as well as clinician-assessed quality and cost. At the end of the trial, participants will choose which denture pair they wish to keep and interviewed about their experiences with the 3D-printed IMO. The quantitative and qualitative data will be incorporated through an explanatory mixed-methods strategy. A final quantitative assessment will happen after 12 months with the preferred IMO to assess the long-term performance and maintenance needs. DISCUSSION: This mixed-methods RCT will explore patient experiences with 3D-printed IMOs, aiming to assess the potential for altering clinical practice and dental public health policies. Our results will inform policies by showing whether 3D printing offers comparable outcomes at lower costs, facilitating greater access to oral care for the elderly. TRIAL REGISTRATION: ClinicalTrials.gov, NCT06155630, Registered on 04 December 2023. https://classic. CLINICALTRIALS: gov/ct2/show/NCT06155630.

Factors associated with the use of oral health care services among Canadian children and youth.

Background: This study investigates the association between dental insurance, income, and dental care access for Canadian children and youth aged 1 to 17 years. It contributes to a baseline understanding of oral health care use before the implementation of the Canadian Dental Care Plan (CDCP). Data and methods: This study used data from the 2019 Canadian Health Survey on Children and Youth (n=47,347). Descriptive statistics and logistic regression models were employed to assess the association of dental insurance, adjusted family net income, and other sociodemographic factors on oral health care visits and cost-related avoidance of oral health care. Results: A large percentage of children under the age of 5 had never visited a dentist (79.8% of 1-year-olds to 16.4% of 4-year-olds). Overall, 89.6% of Canadian children and youth aged 5 to 17 had visited a dental professional within the past 12 months: 93.1% of those who were insured and 78.5% of those who were uninsured. Insured children and youth had a 4.5% cost-related avoidance of dental care, contrasting with 23.3% for uninsured children and youth. After adjustment for sociodemographic variables, children and youth with dental insurance were nearly three times more likely (odds ratio [OR]: 2.94; 95% confidence interval [CI]: 2.60 to 3.33) to have visited a dental professional in the past 12 months than uninsured children and youth. Having dental insurance (OR: 0.19; 95% CI: 0.16 to 0.21) was protective against barriers to seeing a dental professional because of cost. There was a strong income gradient for both dental service outcomes. Interpretation: The study emphasizes the significant association of dental insurance and access to oral health care for children and youth. It highlights a significant gap between insured and uninsured children and youth and points out the influence of sociodemographic and income factors on this disparity.

Characterization of oral microbiota in 6-8-month-old small breed dogs.

BACKGROUND: Periodontitis is the most common oral disease in dogs, and its progression and severity are influenced by risk factors, such as age and body size. Recent studies have assessed the canine oral microbiota in relation to different stages of periodontitis and niches within the oral cavity. However, knowledge of the bacterial composition at different ages and body sizes, especially in puppies, is limited. This study aimed to characterize the oral microbiota in the healthy gingiva of small breed puppies using next-generation sequencing. Additionally, we assessed the impact of dental care practices and the presence of retained deciduous teeth on the oral microbiota. RESULTS: In this study, plaque samples were collected from the gingival margin of 20 small breed puppies (age, 6.9 ± 0.6 months). The plaque samples were subjected to next-generation sequencing targeting the V3-V4 region of the 16 S rRNA. The microbiota of the plaque samples was composed mostly of gram-negative bacteria, primarily Proteobacteria (54.12%), Bacteroidetes (28.79%), and Fusobacteria (5.11%). Moraxella sp. COT-017, Capnocytophaga cynodegmi COT-254, and Bergeyella zoohelcum COT-186 were abundant in the oral cavity of the puppies. In contrast, Neisseria animaloris were not detected. The high abundance of Pasteurellaceae suggests that this genus is characteristic of the oral microbiota in puppies. Dental care practices and the presence of retained deciduous teeth showed no effects on the oral microbiota. CONCLUSIONS: In this study, many bacterial species previously reported to be detected in the normal oral cavity of adult dogs were also detected in 6-8-month-old small breed dogs. On the other hand, some bacterial species were not detected at all, while others were detected in high abundance. These data indicate that the oral microbiota of 6-8-month-old small breed dogs is in the process of maturating in to the adult microbiota and may also have characteristics of the small dog oral microbiota.

Utilization of dental care and dentate status in diabetic and nondiabetic patients across US states: An analysis using the 2020 Behavioral Risk Factor Surveillance System.

OBJECTIVE: This study examines the differences, by state, in dental care utilization and tooth retention between adults with and without diabetes mellitus (DM). METHODS: We conducted a secondary analysis of data from the 2020 Behavioral Risk Factor Surveillance System, an annual, state-based, random telephone survey of noninstitutionalized US civilian adults. The predictor variable was DM status. The outcome variables were time since the last dental appointment and tooth loss. We utilized multiple multinomial logistic regression models followed by postestimation procedures to determine state-level adjusted proportions for dental visits within the last year and complete teeth retention among DM and non-DM adults. RESULTS: Among adults with DM, 60.0% reported dentist visits within a year of survey participation, while 53.6% had complete tooth retention. As education and income levels increased, dental attendance and tooth retention increased among adults with DM. Most Southern states had a higher prevalence of DM, a lower proportion of dentist visits, and worse tooth retention among DM adults. Nationally, DM individuals were 4.3 percentage points less likely to visit a dentist and were 7 percent less likely to have complete teeth retention than non-DM adults. Compared with the national average, 25/50 states had greater disparities in dental visits between DM and non-DM adults, and 27/50 states had greater disparities in tooth loss between DM and non-DM adults. CONCLUSION: State-level variations indicate geographical and dental coverage influences on DM and dental outcomes. There is a need for state-specific interventions to improve dental access and outcomes for adults with DM.

A global survey of national oral health policies and its coverage for young children.

Background: There is no accessible information on countries with oral health policies. The purpose of this study was to identify World Dental Federation (FDI) member countries with oral health policies and their scope and extent of coverage of oral health care for young children. Methods: This international survey recruited chief dental officers, oral health advisors to national ministries of health, and other key informants of the 158 FDI member countries between December 2020 and December 2021. The survey tool was administered online to the study participants. Key questions explored the following outcome measures: countries with oral health policies; the thrusts of the oral health policies; policy thrusts targeting young children; and dental care plans as a component of a universal health care plan. Descriptive statistics were conducted to determine the number of countries with any of the study outcome measures and coverage per country. Results: Sixty (38%) of the 158 FDI member-countries responded to the survey. Forty-eight (55.2%) of the 60 countries had a national oral health policy document or position statement on oral health; 54 (62.1%) countries had plans on universal health care, and 42 (48.3%) included dental care within their universal health care plan. The most common policy thrusts addressing the oral health needs of children were the promotion of oral hygiene (71.7%), provision of fluoride products for children (53.3%), collaboration with primary care providers (35%), and prenatal oral health education (50%). There were differences in the scope of oral health care coverage and the coverage for young children between continents as well as between countries. Europe had many countries with children-friendly oral health policy coverage. Conclusions: About half of the surveyed countries had a national oral health policy. There were variations in the scope of oral health care coverage, particularly for young children, both between continents and among individual countries. These findings underscore the importance of understanding the landscape of oral health policies globally. Such insights can help inform targeted interventions to enhance oral health policies, thereby contributing to improved oral health outcomes on a global level.

Pediatric Oral Health Service Access in Racial/Ethnic Minority Neighborhoods: A Geospatial Analysis in Washington, D.C., USA.

Oral health plays a crucial role in overall well-being. One of the goals set by the US Department of Health and Human Service, Healthy People 2030 is to reducing dental caries in children and adolescents. The study aims to investigate the accessibility of pediatric dental care in neighborhoods with mixed-race and predominantly African American populations in the Washington District of Columbia (DC) area. Our objective is to uncover and highlight the disparities that exist in pediatric dental care within these communities. We have specifically examined the geographic and socio-demographic aspects of pediatric dental care facilities, utilizing geospatial tools such as modeling and mapping, as well as data from the clinical database at Howard University College of Dentistry. The detailed analysis of dental care access revealed significant disparities among various Wards in the region. Specifically, Wards 5, 7, and 8 stood out as having both the highest concentrations of African American residents and the lowest availability of pediatric dentistry providers when compared to the more affluent Wards 1, 2, and 3. Howard University College of Dentistry's pediatric dentistry department played a crucial role in providing dental care services to the community. Over the course of the year 2022, they recorded a total of 3,855 visits from residents of the DC area. Notably, a substantial portion of these visits, specifically 1,566 visits, were from individuals residing in Wards 5, 7 and 8. This data underscores the significant demand for pediatric dental services in these underserved communities and highlights the importance of addressing the disparities in access to care.

Professional practices of dentists and unscheduled dental care in Nouvelle-Aquitaine (France) / Pratiques professionnelles et soins dentaires non programmés en Nouvelle-Aquitaine.

In a context of saturation of private dental practices and medical demography issues, responses to requests for emergency dental care are a poorly documented problem. In partnership with the Observatoire Regional de la Santé, the URPS Chirurgiens-Dentistes Nouvelle-Aquitaine, a union, conducted a survey of private dentists in May and June 2022. The objective was to estimate the volume of requests for unscheduled dental care and to describe the responses provided by professionals. More than eight out of ten professionals said they were often called upon for unscheduled care and more than four out of ten set aside specific time slots to provide it. More than a quarter of them said they provided care in 90 percent of cases, in response to requests of this type, and 40 percent provided care in at least half of the cases. For most professionals, the average waiting time for patients requesting unscheduled care was less than 24 hours. Respondents cited patient education as a general avenue for improvement, in addition to the creation of a specific pricing structure for unscheduled care. This survey provides a better understanding of the difficulties faced by professionals on a subject not yet investigated by the dental profession. It documents the acceptability of possible responses in terms of improving professional practices and institutional organizations.

Dans un contexte de saturation des cabinets dentaires libéraux et de démographie médicale tendue, l'apport de réponses aux demandes de soins dentaires non programmés constitue une réelle problématique assez peu documentée. En partenariat avec l'Observatoire régional de la santé, l'URPS Chirurgiens-dentistes Nouvelle-Aquitaine a mené en mai-juin 2022 une enquête auprès de chirurgiens-dentistes libéraux. L'objectif était d'estimer le volume des demandes de soins non programmés en soins dentaires et de décrire les réponses apportées par les professionnels. Plus de huit professionnels sur dix ont déclaré être souvent sollicités pour des soins non programmés, et plus de quatre sur dix prévoyaient des créneaux spécifiques pour les assurer. Plus d'un quart d'entre eux ont déclaré répondre à 90 % des sollicitations pour ce type de soins et 40 % répondre à moins de la moitié des demandes. Les soins non programmés étaient pris en charge dans les 24 heures en moyenne pour la majorité des professionnels. L'éducation des patients a été citée comme une piste d'amélioration générale ou institutionnelle, devant la création d'une cotation spécifique pour les soins non programmés. Cette enquête permet de mieux connaître les difficultés des professionnels sur un sujet non encore investigué auprès de la profession dentaire. Elle documente l'acceptabilité de pistes de réponses pouvant être apportées pour améliorer les pratiques professionnelles et les organisations institutionnelles.

Ultrasound-Guided Selective Glossopharyngeal Nerve Block for Severe Gag Reflex During Dental Treatment: A Report of Two Cases.

The ultrasound-guided selective glossopharyngeal nerve block (UGSGNB) has been developed as an approach to overcome the drawbacks of the conventional glossopharyngeal nerve block. The UGSGNB may be performed when a gag reflex occurs during dental treatment. Case 1 involved a 67-year-old man with a medical history of cervical spondylosis and dilated cardiomyopathy. Dental treatment with conscious sedation and the UGSGNB was performed three times. Case 2 involved a 25-year-old woman who was scheduled for dental treatment under general anesthesia because of dental phobia and gagging. Because the patient experienced severe tooth pain and desired urgent treatment, anesthesia was induced with intravenous sedation and the UGSGNB. In both cases, treatments were completed without intraoperative gagging or any complications. Our observations indicate that the UGSGNB can suppress the gag reflex during dental treatment; it may allow surgeons to avoid inducing general anesthesia and deep sedation in patients with a severe gag reflex.

Predictors influencing dental clinic utilization in primary health care: A retrospective analysis of 233,069 patient records in Riyadh, Saudi Arabia.

Aim: This study aims to identify and address the predictors that promote or prevent the utilization of dental services in primary health care (PHC) centers located in Riyadh, Saudi Arabia, with an ultimate goal to increase the uptake of oral health care (OHC) services. Methodology: Registration data from 99 PHC centers was used. For each patient visiting a PHC center, information on the number of dental visits was captured. Continuous data was summarized as means, medians, and ranges, and categorical data as frequencies (%). The strength of association was reported as an incidence rate ratio (IRR) with 95% confidence interval (CI) and a p-value. Further analysis was conducted to illustrate the association between dental care visits and factors found independently significant in the final multivariate model using Karl Pearson correlation coefficient and t-test. All tests were two-sided and a p-value of p < 0.05 was considered significant. Results: The comorbidity profile of patients shows that 11,751(5%) were diabetic, while hypertension amounted to 10,712(4.6%). A statistically significant inverse correlation was observed between dental care visits and both age (r = -0.025, p < 0.001) and BMI (r = -0.013, p < 0.001). Mean dental care visits were significantly higher in patients without hypertension compared with those with hypertension (p < 0.001). Moreover, there was an approximate 4% increase in dental care visits among females compared to males, although this difference was not statistically significant. Conclusion: The study identified three predictors contributing to the low utilization of dental services in PHC centers in Riyadh. These include an inverse association between both age and body mass index (BMI) and the utilization of OHC. Additionally, the mean dental care visits were significantly higher for patients without hypertension in comparison to hypertensive patients.

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.