Systematically assessing the quality of dental electronic health record data for an investigation into oral health care disparities.

OBJECTIVES: This work describes the process by which the quality of electronic health care data for a public health study was determined. The objectives were to adapt, develop, and implement data quality assessments (DQAs) based on the National Institutes of Health Pragmatic Trials Collaboratory (NIHPTC) data quality framework within the three domains of completeness, accuracy, and consistency, for an investigation into oral health care disparities of a preventive care program. METHODS: Electronic health record data for eligible children in a dental accountable care organization of 30 offices, in Oregon, were extracted iteratively from January 1, 2014, through March 31, 2022. Baseline eligibility criteria included: children ages 0-18 with a baseline examination, Oregon home address, and either Medicaid or commercial dental benefits at least once between 2014 and 2108. Using the NIHPTC framework as a guide, DQAs were conducted throughout data element identification, extraction, staging, profiling, review, and documentation. RESULTS: The data set included 91,487 subjects, 11 data tables comprising 75 data variables (columns), with a total of 6,861,525 data elements. Data completeness was 97.2%, the accuracy of EHR data elements in extracts was 100%, and consistency between offices was strong; 29 of 30 offices within 2 standard deviations of the mean (s = 94%). CONCLUSIONS: The NIHPTC framework proved to be a useful approach, to identify, document, and characterize the dataset. The concepts of completeness, accuracy, and consistency were adapted by the multidisciplinary research team and the overall quality of the data are demonstrated to be of high quality.

Challenges and way forward for implementation of sugar taxation in the Middle East and North Africa (MENA).

BACKGROUND: Over consumption of added sugar beyond the World Health Organization (WHO) recommended level of 10% of daily energy intake has well-established negative health consequences including oral diseases. However, the average consumption of added sugar in the Middle East and North Africa region (MENA-World Bank's regional classification) is 70% higher than the WHO recommended level. Imposing taxes on added sugar has been proposed by the WHO to decrease its consumption. Yet, only 21.6% of the total MENA population are covered by taxation policies targeting added sugar. CHALLENGES: Well-recognized challenges for the implementation of sugar taxation in MENA include the tactics used by the food and beverage industry to block these type of policies. However, there are also other unfamiliar hurdles specific to MENA. Historically, there have been incidents of protest and riots partially sparked by increased price of basic commodities, including sugar, in MENA countries. This may affect the readiness of policy makers in the region to impose added sugar taxes. In addition, there are also cultural, lifestyle and consumption behavioural barriers to implementing added sugar taxation. Ultra-processed foods and sugar-sweetened-beverages (SSBs) rich in added sugar are perceived by many in MENA as essential treats regardless of their health risks. Furthermore, some countries even provide subsidies for added sugar. Also, (oral) healthcare providers generally do not engage in policy advocacy mainly due to limited training on health policy. WAYS FORWARD: Here, we discuss these challenges and suggest some ways forward such as (1) support from a health-oriented political leadership, (2) raising public awareness about the health risks of over consumption of sugar, (3) transparency during the policy-cycle development process, (4) providing a free and safe environment for a community dialogue around the proposed policy, (5) training of (oral) healthcare professionals on science communication and policy advocacy in local lay language/dialect, ideally evidence informed from local/regional studies, (6) selecting the appropriate political window of opportunity to introduce a sugar tax policy, and (7) clear and strict conflict of interest regulations to limit the influence of commercial players on health policy.

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 with focus on dental fear and dental caries in Swedish preschool child populations attending public dental health care: Trends over 30 years.

OBJECTIVES: To study changes in oral health with focus on reported dental fear prevalence and interrelationships between dental fear and prevalence of dental caries and performed restorative dental treatment in preschool child populations attending regular public dental health care between 1983 and 2013. METHODS: Every 10 years, random samples of about 100 children aged 3 and 5 years, respectively, took part in cross-sectional studies based on oral examination and a questionnaire. One question, put to the child and answered by the parent, mirrored dental fear: "What do you feel at the prospect of an appointment with a dentist?". Agreement to at least one of three alternatives, ill at ease, frightened and sick, indicated dental fear. Frightened and/or sick mirrored severe dental fear. 79%-94% of the samples answered the question and constituted the study group. Prevalence of caries and number of filled tooth surfaces were recorded. Dental parameters were presented in mean values. RESULTS: During the 30 years, dental fear prevalence was fairly constant. 21% of 3-year-olds and 15% of 5-year-olds reported dental fear in 2013. Positive relationships between dental fear prevalence and caries prevalence and number of filled tooth surfaces were found. Dental caries was reduced during the study time, but to a lesser degree in children with dental fear compared to children without dental fear. CONCLUSIONS: Although children were offered public dental health care, the prevalence of dental fear remained high. Children with dental fear are caries risk individuals.

Edentulism and Individual Factors of Active Aging Framework in Colombia.

BACKGROUND: While edentulism remains a serious public health problem for older adults in Colombia, few analyses have been conducted from the framework of active aging as a part of the positive discourse of aging. This study analyzed complete edentulism and its relationship with determinants including personal, behavioral, and health systems and social services. METHODS: This study included a total of 19,004 older adults. We used univariate, bivariate, and multivariate logistic regression type scores to investigate the relationships between the variables. The personal determinants included basic (Barthel scale) and instrumental activities of daily living (Lawton scale), public transportation, functional limitations, self-perceived health, and health problems. The behavioral factors included alcohol and tobacco use, mini nutritional tests, and physical activity. The last determinant was the healthcare system, while social services access included dental services. The analysis also included sociodemographic variables. RESULTS: The results revealed significant associations for the variables of the three determinants, including the risk of malnutrition (odds ratio [OR]=1.15), functional limitation (OR=1.15), moderate physical activity (OR=1.08), and access to dental services (OR=2.31). Sex, years of education, and race were also risk factors, among other variables. Personal determinants, behavior, and use and access to health services were related to edentulism in older adults. CONCLUSION: These findings support the need to include different analyses of edentulism from multicausality and to understand the oral cavity and the living conditions of aging adults.

Community Water Fluoridation in Focus: A Comprehensive Look at Fluoridation Levels across America.

Objective: This study reports on the number and percentage of community water systems (CWSs) meeting fluoride concentration standards set by the U.S. Department of Health and Human Services (DHHS). The study also explored changes in the population exposed to optimally fluoridated water in these systems between 2006 and 2020. Methods: This study analyzed U.S. Centers for Disease Control and Prevention data from 2006 to 2020, tabulating state-specific CWS fluoridation rates, ranking them, and calculating the percent change. Results: In 2020, 72.7% of the US population received CWS water, with 62.9% of those individuals served by a CWS system meeting DHHS fluoridation standards. This compares to 69.2% receiving CWS water in 2006 and 74.6% in 2012. The overall change in those receiving fluoridated water was 1.4%, from 61.5% in 2006 to 62.9% in 2020. State-specific percentages ranged from 8.5% in Hawaii to 100% in Washington DC in 2020 (median: 76.4%). Conclusions: Although endorsed by the American Dental Association, the percentage of individuals receiving fluoridated water did not increase substantially from 2006 to 2020, indicating that there has not been much progress toward meeting the Healthy People 2030 goal that 77.1% of Americans receive water with enough fluoride to prevent tooth decay.

Dental public health: Context, challenges, and perspectives / « Santé Publique Orale ¼ : contexte, enjeux et perspectives

The discipline of "dental public health" derives its epistemological legitimacy from the unique position of dental surgeons within the realm of health care. It serves as a crucial bridge between the domain of public health and the field of dental science. The development of "dental public health" holds a twofold significance. First, it acknowledges and assesses the evolving landscape of public health, societal changes, determinants of overall health, environmental challenges, and global concerns. Its purpose is to guide policy decisions, education, research, and dental practices toward the greater good, ensuring equitable access to care and fostering technical and social innovation. Second, "dental public health" has the potential to contribute to the broader health care domain by transferring the diverse insights gained from dental surgery and its historical context. The independence of dental surgery, while sometimes posing challenges to interdisciplinary collaboration, also offers opportunities for progress through innovative solutions. In an era of patient partnerships and a growing emphasis on equality, diversity, and inclusion, it is imperative to consider the inclusion of patient representatives within the "dental public health" community. This inclusion can further enhance the discipline's capacity to address contemporary health care challenges effectively.

La « santé publique orale ¼ est une discipline qui tire sa légitimité épistémologique de la place très particulière du dentiste dans le champ de la santé. Elle agit comme une charnière entre la santé publique et les sciences odontologiques. La pertinence du développement d'une « santé publique orale ¼ est bidirectionnelle. D'un côté, la « santé publique orale ¼ prend la mesure des évolutions sanitaires et sociétales, des déterminants de santé générale, des enjeux climatiques et planétaires, afin d'orienter les décisions politiques, la formation, la recherche et les pratiques odontologiques dans des directions favorisant le bien commun, l'équité dans l'accès aux soins et les innovations techniques et sociales. D'un autre côté, la « santé publique orale ¼ peut enrichir le domaine de la santé en général, en transférant les contributions diverses issues de la chirurgie dentaire et de ses spécificités historiques. Ainsi, l'indépendance de la chirurgie dentaire est à la fois un obstacle à la collaboration interdisciplinaire mais aussi un moyen de progresser grâce aux solutions nécessaires pour la transcender. Ajoutons qu'à l'heure des patients-partenaires et de la diffusion des enjeux d'équité, de diversité et d'inclusion, il est temps de considérer les représentants de patients comme faisant partie des acteurs de la « santé publique orale ¼.

Self-medication associated with toothache: a systematic literature review / Automedicação associada à dor de dente: uma revisão sistemática da literatura / Automedicación asociada al dolor de dientes: una revisión sistemática de la literatura

Introduction: Self-medication consists of selecting and using medication without a poprescription or guidance from a healthcare professional. This practice has been widely reported worldwide, which has contributed to a series of adverse health outcomes, such as delayed diagnosis, worsening of clinical conditions, drug interactions, intoxication, and adverse reactions, which tend to compromise patient safety. Objective:To analyze the prevalence of self-medication associated with toothache, the main factors associated with self-medication in dental patients, as well as outline the profile of medications used by these individuals, the preferred route of administration, and the main sources of medication.Methodology:Asystematic review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Relevant articles published in the last ten years, without limitations of language were searched using the following descriptors/MeSHterms and keywords: "self-medication" and (toothache or "dental pain") not Child. Results:The initial search returned 61 manuscripts. Fourteen papers, all cross-sectional studies, were eligible for inclusion in the systematic review.Conclusions:The prevalence of self-medication for toothache ranged from 6.5% to 100.0%. Cultural and economic factors, barriers to access, the high cost of dental treatments, lack of time and money, and the perception that dental problems are not a serious problem are among the main factors associated with the practice. Regarding the drugs used, the most used classes were paracetamol, especially anti-inflammatory drugs, particularly ibuprofen, and analgesics administered orally (AU).

Introdução:A automedicação consiste na escolha e uso de medicamentos sem prescrição ou orientação de um profissional de saúde. Essa prática tem sido amplamente divulgada em todo o mundo, o que tem contribuído para uma série de desfechos adversos à saúde, como atraso no diagnóstico, piora do quadro clínico, interações medicamentosas, intoxicações e reações adversas, que tendem a comprometer a segurança do paciente. Objetivo:Analisar a prevalência da automedicação associada à dor de dente, os principais fatores associados à automedicação em pacientes odontológicos, bem como traçar o perfil dos medicamentos utilizados por esses indivíduos, a via preferencial de administração e as principais fontes de medicação. Metodologia:Uma revisão sistemática foi desenvolvida de acordo com os itens de relatório preferidos para revisões sistemáticas e meta-análises (PRISMA). Foram pesquisados artigos relevantes publicados nos últimos dez anos, sem limitação de linguagem, utilizando os seguintes descritores/MeSHterms e palavras-chave: "self-medication" e (toothache or "dental pain") não Child. Resultados:A busca inicial encontrou61manuscritos. Quatorze artigos, de delineamento transversal,foram considerados elegíveis e incluídos para a revisão.Conclusões:A prevalência de automedicação para dor de dente variou de 6,5% a 100,0%. Fatores culturais e econômicos, barreiras de acesso, alto custo dos tratamentos odontológicos, falta de tempo e dinheiro e a percepção de que os problemas odontológicos não são um problema grave estão entre os principais fatores associados à prática. Em relação aos medicamentos utilizados, as classes mais utilizadas foram o paracetamol, principalmente os anti-inflamatórios, principalmente o ibuprofeno, e os analgésicos por via oral (AU).

Introducción: La automedicación consiste en seleccionar y utilizar medicamentos sin receta ni orientación de un profesional sanitario. Esta práctica ha sido ampliamente reportada a nivel mundial, lo que ha contribuido a una serie de resultados adversos para la salud, como retraso en el diagnóstico, empeoramiento de las condiciones clínicas, interacciones medicamentosas, intoxicaciones y reacciones adversas, que tienden a comprometer la seguridad del paciente.Objetivo: Analizar la prevalencia de automedicación asociada al dolor de muelas, los principales factores asociados a la automedicación en pacientes odontológicos, así como delinear el perfil de medicamentos utilizados por estos individuos, la vía de administración preferida y las principales fuentes de medicación. Metodología: Se desarrolló una revisión sistemática de acuerdo con los Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Se buscaron artículos relevantes publicados en los últimos diez años, sin limitaciones de idioma, utilizando los siguientes descriptores/MeSHterms y palabras clave: "self-medication" y (toothache or "dental pain") not Child. Resultados: La búsqueda inicial arrojó 61 manuscritos. Catorce artículos, todos estudios transversales, fueron elegibles para su inclusión en la revisión sistemática.Conclusiones: La prevalencia de automedicación para el dolor de muelas osciló entre 6,5% y 100,0%. Los factoresculturales y económicos, las barreras de acceso, el alto costo de los tratamientos dentales, la falta de tiempo y dinero, y la percepción de que los problemas dentales no son un problema grave se encuentran entre los principales factores asociados con la práctica. En cuanto a los fármacos utilizados, las clases más utilizadas fueron el paracetamol, especialmente los antiinflamatorios, especialmente el ibuprofeno, y los analgésicos por vía oral (AU).

The oral health landscape in Singapore: A commentary on key features, challenges and future policies.

Over the last decade, Singapore has grappled with substantial healthcare challenges, chiefly a bourgeoning aging population and a mounting burden of chronic diseases. The oral health landscape has also changed, with the Ministry of Health placing a greater focus on a life-course approach supported by policies that facilitate Singaporeans to receive dental care appropriately and affordably. A pivotal oral health policy is the National Dental Strategy, a comprehensive framework governing dental services in the public sector. This strategy encompasses aspects such as financing, workforce management, and capacity considerations. To facilitate affordability and accessibility to dental services in the public sector, the government extends subsidies to reduce out-of-pocket costs. Those attending private dental clinics also benefit from the Community Health Assist Scheme, introduced in 2012, which alleviates treatment costs for enrolled Singaporeans. Furthermore, additional age-banded subsidies have been introduced for older Singaporeans born before 1960, enhancing financial support when accessing dental services in both private and public sectors. In 2019, a national adult oral health survey was commissioned to gauge the oral health status of Singaporeans aged 21 and above. The findings reported 34.8% having untreated dental caries, and 15.7% and 41.2% experiencing moderate and severe periodontitis, respectively. While over half (53.9%) of respondents visited the dentist at least annually, about 60% of eligible individuals did not utilize their government dental subsidies. In response, the Ministry of Health is committed to strengthening oral disease prevention, integrating oral health into general healthcare services, expanding dental financing schemes to enhance service utilization, improving the quality and transparency of dental care, and leveraging advancements in tele-dentistry and other modes of dental services. It is imperative to adapt Singapore's oral health policies and service delivery models to meet the evolving needs of the population and ensure a sustainable, equitable and resilient oral healthcare system.

Childhood caries is associated with poor health and a faster pace of aging by midlife.

OBJECTIVES: Childhood caries is associated with poorer self-rated general health in adulthood, but it remains unclear whether that holds for physical health and aging. The aim of this study was to identify whether age-5 caries is associated with (a) biomarkers for poor physical health, and (b) the pace of aging (PoA) by age 45 years. METHODS: Participants are members of the Dunedin Multidisciplinary Health and Development Study birth cohort. At age 45, 94.1% (n = 938) of those still alive took part. Data on age-5 caries experience and age-45 health biomarkers were collected. The PoA captures age-related decline across the cardiovascular, metabolic, renal, immune, dental and pulmonary systems from age 26 to 45 years. We used (a) generalized estimating equations to examine associations between age-5 caries and poor physical health by age 45 years, and (b) ordinary least squares regression to examine whether age-5 caries was associated with the PoA. Analyses adjusted for sex, perinatal health, childhood SES and childhood IQ. RESULTS: High caries experience at age-5 was associated with higher risk for some metabolic abnormalities, including BMI ≥30, high waist circumference, and high serum leptin. Those with high caries experience at age-5 were aging at a faster rate by age 45 years than those who had been caries-free. CONCLUSIONS: Oral health is essential for wellbeing. Poor oral health can be an early signal of a trajectory towards poor health in adulthood. Management for both conditions should be better-integrated; and integrated population-level prevention strategies should be foundational to any health system.

Modelling a Consultant Workforce for the United Kingdom: needs-based planning for Dental Public Health.

OBJECTIVE: To develop a needs-based workforce planning model to explore specialist workforce capacity and capability for the effective, efficient, and safe provision of services in the United Kingdom (UK); and test the model using Dental Public Health (DPH). BASIC RESEARCH DESIGN: Data from a national workforce survey, national audit, and specialty workshops in 2020 and 2021 set the parameters for a safe effective DPH workforce. A working group drawing on external expertise, developed a conceptual workforce model which informed the mathematical modelling, taking a Markovian approach. The latter enabled the consideration of possible scenarios relating to workforce development. It involved exploration of capacity within each career stage in DPH across a time horizon of 15 years. Workforce capacity requirements were calculated, informed by past principles. RESULTS: Currently an estimated 100 whole time equivalent (WTE) specialists are required to provide a realistic basic capacity nationally for DPH across the UK given the range of organisations, population growth, complexity and diversity of specialty roles. In February 2022 the specialty had 53.55 WTE academic/service consultants, thus a significant gap. The modelling evidence suggests a reduction in DPH specialist capacity towards a steady state in line with the current rate of training, recruitment and retention. The scenario involving increasing training numbers and drawing on other sources of public health trained dentists whilst retaining expertise within DPH has the potential to build workforce capacity. CONCLUSIONS: Current capacity is below basic requirements and approaching 'steady state'. Retention and innovative capacity building are required to secure and safeguard the provision of specialist DPH services to meet the needs of the UK health and care systems.

Public Health Dentistry as a Career Choice - Attitude of Dental Undergraduate Students in Puducherry.

Background: To pursue further education in a particular specialty of dentistry, it is important for dental students to be aware of the "expectation" associated with any specific specialty in dentistry. Therefore students 'attitudes' towards 'expectations' of various specialties, to a large extent enables a meaningful understanding that facilitates appropriate planning in the dental sector for the community. Materials and Methods: A cross-sectional questionnaire based survey was conducted, which included, final year and dental interns studying in two dental institutions, in the State of Puducherry. It consisted of 27 questions that were graded using 5-point Likert scale. The responses for the attitude questions toward selecting Public Health Dentistry for post-graduation were categorized into three factors, negative attitude (includes score 0-21), neutral attitude (score 22-44), and positive attitude (score 45-64). Differences between groups were examined using t-test for proportions. The level of statistical significance was set at p < 0.05. Results: Among 221 respondents, 73 (33.0) were males and 148 (67.0) females. About (52.2%) of the respondents had positive attitude toward selecting Public Health Dentistry as their future career and (76.7%) had neutral attitude, around (5 %) had negative attitude towards the speciality for pursuing post-graduation in both the two institutions. Conclusion: Our study could highlight many factors namely gender, year of study etc which influence the attitude of students for selecting PHD as career choice. These specific factors could be kept in mind while course planning for government or private institutions so that maximum interest can be fetched among students.

Associations and discrepancies between global self-ratings of oral health and general health: a Bayesian approach.

OBJECTIVE: To estimate the discrepancies between global ratings of oral health and general health and investigate the factors associated with self-rated oral health (SROH) and self-rated general health (SRGH). METHODS: Data were collected from 502 participants aged 18 to 81 years. A structured questionnaire was used to obtain data regarding sociodemographic characteristics and self-reported conditions. Global self-ratings of oral health and general health were the main outcomes. Discrepancies between self-ratings of oral health and general health were stratified by independent variables. Bayesian ordinal logistic regression models were fitted to estimate the posterior distributions of parameters and 95% credible intervals (95% CrI). RESULTS: The proportion of participants who rated their oral health worse than general health was 28.6% (95% CrI: 24.7-32.3). Negative discrepancies between SROH and SRGH were associated with being men, reporting gingivitis, and lower income. Sex (95% CrI: 1.12-2.25) impacted only on SRGH. Income (SROH - 95% CrI: 1.52-6.40; SRGH - 95% CrI: 1.08-4.56), tertiary education (SROH - 95% CrI: 1.13-2.53; SRGH - 95% CrI: 1.01-2.32), self-reported missing teeth (SROH - 95% CrI: 1.57-3.46; SRGH - 95% CrI: 2.21-4.92), self-reported gingivitis (SROH - 95% CrI: 1.10-2.40; SRGH - 95% CrI: 1.71-3.82), and self-reported chronic health problem (SROH - 95% CrI: 1.38-3.08; SRGH - 95% CrI: 1.61-3.59) impacted on both outcomes. CONCLUSIONS: Substantial discrepancies between self-rated oral health and self-rated general health were found and were associated with being male, reporting gingivitis, and having lower income.

Dental Health Services Victoria value-based health care principles for oral health models of care.

BACKGROUND: Efforts to progress oral healthcare reform can be challenging with competing interests of governments and service providers to achieve the intended outcomes. The value-based health care approach has been adopted in many areas of healthcare but has had limited applications to oral healthcare systems. Dental Health Services Victoria, an Australian state government funded entity, commenced its journey to value-based health care in 2016, to shift away from traditional dental service models that reward activity and volume towards a stronger emphasis on value and outcomes. AIMS: To maintain the value-based health care agenda focus, Dental Health Services Victoria developed three key principles, which can be adopted by other organisations engaged in reforming oral healthcare, to improve the oral health for the population it serves. MATERIALS & METHODS: In 2018, Dental Health Services Victoria developed a value-based health care framework, which has informed strategic organisation priorities for action. In 2023, the following three key principles are identified as being essential to support the operationalisation and development of effective models of oral healthcare: Principle 1 - Care is co-designed with the person or population Principle 2 - Prevention and early intervention are prioritised. Principle 3 - Consistent measurement of health outcomes and costs are embedded. DISCUSSION: The exploration of the three key principles is an important communication tool to translate value-based health care into practice with key stakeholders. Further work is required to socialise them to within dental teams. CONCLUSION: Organisations looking to commence the value-based health care agenda can apply Dental Health Services Victoria's three key principles as a first step.

Fit for Purpose? The Suitability of Oral Health Outcome Measures to Inform Policy.

KNOWLEDGE TRANSFER STATEMENT: Oral health research and program evaluation should consider alternative outcome measures for population oral health other than the DMFT index.

Odontologia hospitalar: uma análise crítica sobre a inserção do cirurgião dentista na atenção terciária no estado do Rio Grande do Sul, Brasil / Hospital dentistry: a critical analysis of the role of the dental surgeon in tertiary care in the state of Rio Grande do Sul, Brazil

Objetivo: analisar a inserção do cirurgião dentista na atenção terciária no estado do Rio Grande do Sul, Brasil. Método: estudo descritivo ecológico, com uso de dados secundários registrados pelo Cadastro Nacional de Estabelecimentos de Saúde no ano de 2023. A coleta de dados foi realizada em duas etapas. Na primeira etapa também foram coletados os dados do CNES referentes à presença do cirurgião dentista, tipo de vínculo contratual e especialidades ofertadas pelos serviços. Já na segunda etapa os dados coletados foram referentes aos indicadores sociodemográficos dos profissionais com habilitação em odontologia hospitalar utilizando as informações disponibilizadas pelo Sistema WSCFO do Conselho Federal de Odontologia. A análise dos dados foi realizada com o suporte do software TabWin, versão 3.6, e do software estatístico R v. 4.2.3. Os dados foram analisados por meio de análise descritiva. Resultados: apenas 6,11% das instituições são certificadas e consideradas Hospitais de Ensino. A maioria dos estabelecimentos (87,14%) oferece atendimento pelo SUS. Quanto à presença de cirurgiões dentistas nos estabelecimentos, 64,63% dos estabelecimentos relataram tê-los, enquanto 35,37% não possuem esse profissional em sua equipe. Neste estudo, constatamos que uma correlação positiva do cirurgião dentista com o número de leitos de UTI adulto e ao maior porte do hospital. Conclusão: observa-se que ainda há necessidade de estruturação da atenção terciária no Estado do Rio Grande do Sul, no que se refere à odontologia hospitalar. Há poucos os cirurgiões dentistas com uma carga horária dedicada exclusivamente ao atendimento hospitalar clínico a beira leito.(AU)

Objective: To analyze the inclusion of dental surgeons in tertiary care in the state of Rio Grande do Sul, Brazil. Method: a descriptive ecological study using secondary data recorded by the National Register of Health Establishments in 2023. Data was collected in two stages. In the first stage, data was also collected from the CNES regarding the presence of a dental surgeon, the type of contractual relationship and the specialties offered by the services. In the second stage, data was collected on the sociodemographic indicators of professionals qualified in hospital dentistry using the information provided by the WSCFO System of the Federal Council of Dentistry. The data was analyzed using TabWin software, version 3.6, and R v. 4.2.3 statistical software. The data was analyzed using descriptive analysis. Results: only 6.11% of institutions are certified and considered Teaching Hospitals. The majority of establishments (87.14%) provide care through the SUS. As for the presence of dental surgeons in the establishments, 64.63% of the establishments reported having them, while 35.37% did not have this professional on their team. In this study, we found a positive correlation between the number of adult ICU beds and the size of the hospital. Conclusion: There is still a need to structure tertiary care in the state of Rio Grande do Sul, in terms of hospital dentistry. There are few dental surgeons with a workload dedicated exclusively to bedside clinical hospital care.(AU)

Adjusting the british triage system for dental care in South Korean correctional institutions: a cross-sectional study.

BACKGROUND: The oral health status of inmates in South Korean correctional institutions is poor, mainly due to limited resources and an unestablished triage system. Hence, this study aimed to develop a newly structured dental triage system for South Korean correctional institutions, using the British triage system as a reference. METHODS: This study included 32 public health dentists working at correctional institutions in South Korea in 2020, accounting for the entire population of public health dentists that year. Data on the dentists' evaluation of resources and perceptions of dental service items were collected using a self-administered online survey including 19 dental service items from the British triage system to assess the level of agreement on dental triage items. All responses were recorded within 1 week of request, and a hierarchical cluster analysis was performed to develop a new dental triage system. RESULTS: The survey included 31 respondents working at 47 correctional institutions; 16, 14, and one respondent provided dental services at one, two, and three institutions, respectively. Among the correctional institutions, 2%, 74%, and 23% were the National Forensic Hospital, prisons, and detention centres, respectively. The hierarchical cluster analysis identified four adjusted dental triage categories: emergency, urgent, routine, and checkups, mainly in accordance with those in the British system, but a few items were reallocated. The new dental triage system was compared to the existing system and found to have higher specificity and sensitivity, indicating that it may be more effective at meeting the oral health needs of inmates in South Korean correctional institutions. CONCLUSIONS: This study developed a newly structured dental triage system by adjusting the British system and evaluated its efficacy compared to the existing system. The new system may help improve the oral health status of inmates in South Korean correctional institutions by providing a more organized approach to dental care provision.

A Systematic Review of Clinical Practice Guidelines for Caries Prevention following the AGREE II Checklist.

Untreated oral diseases are detrimental to overall well-being and quality of life and are in close relationship with social and economic consequences. The presence of strong evidence for caries primary and secondary prevention is a compulsory tool for the development of clinical practice guidelines (CPGs). This paper was aimed to assess systematically the importance of clinical practice guidelines in caries prevention management considering both the adult and pediatric populations and evaluate them using the Appraisal of Guidelines for Research and Evaluation (AGREE II) Checklist. Records were extracted from EMBASE, SCOPUS, PubMed/Medline and seven other relevant guideline databases between 6 January and 14 February 2023. Two reviewers independently conducted the appraisal using the web-based platform My AGREE PLUS. Twenty-one guidelines/papers met the inclusion criteria and were reviewed. Eight CPGs included both primary and secondary prevention interventions, whereas thirteen presented a single preventive model. Overall, 12 guidelines were published in the USA. The mean AGREE II scores ranged from 35.4% to 84.3%. Of the total twenty-one included guidelines, twelve were classified as "Recommended", ranging from 56.3% to 84.3%, the others were described as "Recommended with modification", ranging from 35.4% to 68.9%. From the AGREE II analysis carried out, the CPGs included in this survey adopted a punctual methodological rigor but lacked applicative power. The present survey showed that the public, as the primary beneficiary, played a limited role in the development of the twenty-one CPGs. Hence, methodological improvement can better support high-quality CPG development in the future.

Implications of ChatGPT in Public Health Dentistry: A Systematic Review.

An artificial intelligence (AI) program called ChatGPT that generates text in response to typed commands has proven to be highly popular, as evidenced by the fact that OpenAI makes it available online. The goal of the present investigation was to investigate ChatGPT's potential applications as an outstanding instance of large language models (LLMs) in the fields of public dental health schooling, writing for academic use, research in public dental health, and clinical practice in public dental health based on the available data. Importantly, the goals of the current review included locating any drawbacks and issues that might be connected to using ChatGPT in the previously mentioned contexts in healthcare settings. Using search phrases including chatGPT, implications, artificial intelligence (AI), public health dentistry, public health, practice in public health dentistry, education in public health dentistry, academic writing in public health dentistry, etc., a thorough search was carried out on the Pubmed database, the Embase database, the Ovid database, the Global Health database, PsycINFO, and the Web of Science. The dates of publication were not restricted. Systematic searches were carried out for all publications according to inclusion and exclusion criteria between March 31, 2018, and March 31, 2023. Eighty-four papers were obtained through a literature search using search terms. Sixteen similar and duplicate papers were excluded and 68 distinct articles were initially selected. Thirty-three articles were excluded after reviewing abstracts and titles. Thirty-five papers were selected, for which full text was managed. Four extra papers were found manually from references. Thirty-nine articles with full texts were eligible for the study. Eighteen inadequate articles are excluded from the final 21 studies that were finally selected for systemic review. According to previously published studies, ChatGPT has demonstrated its effectiveness in helping scholars with the authoring of scientific research and dental studies. If the right structures are created, ChatGPT can offer suitable responses and more time to concentrate on the phase of experimentation for scientists. Risks include prejudice in the training data, undervaluing human skills, the possibility of fraud in science, as well as legal and reproducibility concerns. It was concluded that practice considering ChatGPT's potential significance, the research's uniqueness, and the premise-the activity of the human brain-remains. While there is no question about the superiority of incorporating ChatGPT into the practice of public health dentistry, it does not, in any way, take the place of a dentist since clinical practice involves more than just making diagnoses; it also involves relating to clinical findings and providing individualized patient care. Even though AI can be useful in a number of ways, a dentist must ultimately make the decision because dentistry is a field that involves several disciplines.