Assessing the performance of Bing Chat artificial intelligence: Dental exams, clinical guidelines, and patients' frequent questions.

OBJECTIVES: Bing Chat is a large language model artificial intelligence (AI) with online search and text generating capabilities. This study assessed its performance within the scope of dentistry in: (a) tackling exam questions for dental students, (ii) providing guidelines for dental practitioners, and (iii) answering patients' frequently asked questions. We discuss the potential of clinical tutoring, common patient communication and impact on academia. METHODS: With the aim of assessing AI's performance in dental exams, Bing Chat was presented with 532 multiple-choice questions and awarded scores based on its answers. In evaluating guidelines for clinicians, a further set of 15 questions, each with 2 follow-up questions on clinical protocols, was presented to the AI. The answers were assessed by 4 reviewers using electronic visual analog scale. In evaluating answers to patients' frequently asked questions, another list of 15 common questions was included in the session, with respective outputs assessed. RESULTS: Bing Chat correctly answered 383 out of 532 multiple-choice questions in dental exam part, achieving a score of 71.99 %. As for outlining clinical protocols for practitioners, the overall assessment score was 81.05 %. In answering patients' frequently asked questions, Bing Chat achieved an overall mean score of 83.8 %. The assessments demonstrated low inter-rater reliability. CONCLUSIONS: The overall performance of Bing Chat was above the regularly adopted passing scores, particularly in answering patient's frequently asked questions. The generated content may have biased sources. These results suggest the importance of raising clinicians' awareness of AI's benefits and risks, as well as timely adaptations of dental education curricula, and safeguarding its use in dentistry and healthcare in general. CLINICAL SIGNIFICANCE: Bing Chat AI performed above the passing threshold in three categories, and thus demonstrated potential for educational assistance, clinical tutoring, and answering patients' questions. We recommend popularizing its benefits and risks among students and clinicians, while maintaining awareness of possible false information.

The use of dental anxiety management techniques during one-session treatment: a study on five video-recorded patient cases.

OBJECTIVE: The aim was to examine what kinds of dental anxiety management techniques dentists use in the context of one-session treatment. MATERIAL AND METHODS: The data consisted of videotaped treatment sessions for five dentally anxious adults. The treatment was conducted by two experienced dentists without formal training in the treatment of dentally anxious patients or behavioral management techniques. Theory-driven qualitative content analysis, based on the anxiety management classification of Milgrom et al. was used to identify and classify the techniques used during the treatments. RESULTS: Altogether, diverse categories of dental anxiety management techniques were identified under the main themes of enhancing trust and control and psychological management. Techniques that fell into enhancing trust and control included the categories of 'building a trustful relationship', 'informational control', and 'behavioral control'. These techniques were used consistently throughout the sessions. Additionally, psychological management techniques were identified and classified as 'behavioral strategies: relaxing the body' and 'cognitive strategies: relaxing the mind', which were regularly used in specific situations. CONCLUSION: The results indicate that a variety of dental anxiety management techniques were used during one-session treatments. The findings provide valuable insights for dentists in managing their patients with dental anxiety and improving their overall treatment experience.

Psychosocial factors, dentist-patient relationships, and oral health-related quality of life: a structural equation modelling.

BACKGROUND: Psychosocial factors and dentist-patient relationships (DPR) have been suggested to be associated with oral health outcomes. This study aimed to test a conceptual model which hypothesised relationships among psychosocial factors, DPR variables, and oral health-related quality of life (OHRQoL) in the 'distal-to-proximal' framework. METHODS: A total of 12,245 adults aged 18 years or over living in South Australia were randomly sampled for the study. Data were collected from self-complete questionnaires in 2015-2016. The outcome variable of Oral Health Impact Profile was used to measure OHRQoL. Psychosocial domain consisted of psychological well-being, social support, and health self-efficacy. DPR domain included trust in dentists, satisfaction with dental care, and dental fear. The hypothesised model was tested using the two-step approach in structural equation modelling. RESULTS: Data were analysed from 3767 respondents after the screening/preparing process (adjusted valid response rate 37.4%). In the first step of the analysis, confirmatory factor analyses produced acceptable measurement models for each of the six latent variables (GFI = 0.95, CFI = 0.98, RMSEA = 0.04). The final structural model indicated that better well-being, higher self-efficacy, and more satisfaction were associated with lower oral health impact (ß = - 0.12, - 0.07, - 0.14, respectively) whereas fear was positively associated (ß = 0.19). Among intermediates, support was positively associated with satisfaction within a small effect size (ß = 0.06) as compared to self-efficacy with trust (ß = 0.22). The invariance of the final model was also confirmed on participants' SES and dental service characteristics except the variable of 'last dental visit'. CONCLUSIONS: Psychosocial factors and DPR variables were associated with oral health impact in both direct and indirect paths. The framework of 'distal-to-proximal' actions is empirically supported from psychosocial factors via DPR variables to OHRQoL.

An Exploration of Black Men's Attitudes and Experiences Communicating with Dentists about Oral and Pharyngeal Cancer.

BACKGROUND: Poor oral and pharyngeal cancer (OPC) survival among Black men is partially due to their limited knowledge about OPCs, which is exacerbated by dentists' limited training and discomfort in discussing OPC risk factors. The purpose of this study was to assess the attitudes and experiences that Black men have communicating with dentists about OPCs. METHODS: To qualitatively assess these attitudes and experiences, a focus group guide and recruitment strategy were developed using a community engagement approach. Data were analyzed using grounded theory. RESULTS: Twenty-three self-identified Black men participated in three focus groups through the Zoom platform (mean age of 46.1 years). Four main themes emerged, which identified that participants: (1) had little knowledge of OPCs; (2) felt that addressing OPC risk among Black men was not a priority for dentists; (3) stressed the importance of dentists acknowledging the complexity of how race and gender affects Black men's healthcare experiences; and (4) expressed a benefit to receiving information from multiple social networks. CONCLUSION: The focus groups provided context for how dentists might engage with Black men in discussions about OPC prevention and treatment.

Evaluation of a digital game for teaching behavioral aspects of clinical communication in dentistry.

INTRODUCTION: Traditionally, dental students learn the skills for dentist-patient interaction and communication via on-site contact with patients, when they start clinical training. However, preclinical students (who have not started clinical practice) have fewer chances to realize the context of dentist-patient interaction. It has remained unclear if a gamification approach via digital media, i.e., a computer role-playing game, can help to learn clinical communication skills. The intervention-based study investigates the effectiveness of the clinical dentist-patient communication (CDPC) game on students' motivation, beliefs, and self-efficacy to learn behavioral issues of clinical communication. METHODS: Fifty-two dental students (Preclinical group) and 18 dental interns and dentists (Clinical group) played the CDPC game, which consists of 16 scenes of clinical context about dentist-patient communication (less than 40 min for playing), via web browsers. Pre-test and post-test questionnaires were used to assess their motivation, beliefs, and self-efficacy to learn behavioral issues of clinical communication. The effectiveness was examined by comparing pre-test and post-test scores within-subject and between-group difference was compared between Preclinical and Clinical groups, via non-parametric statistical tests. RESULTS: (A) In the Preclinical group, participants showed a significant increase in motivation and self-efficacy in learning after playing the CDPC game (p < 0.05, adjusted of multiple comparison). (B) In contrast, the Clinical group did not show a significant difference before vs. after playing the game. (C) After playing the game, the Preclinical group showed a significant association between motivation and beliefs (p = 0.024) and between motivation and self-efficacy (p = 0.001); the Clinical group showed a significant association between motivation and beliefs (p = 0.033). CONCLUSIONS: The current evidence suggests that gamification of learning helps preclinical students to understand the context of clinical dentist-patient interaction and increase their motivation and self-efficacy to learn behavioral issues of clinical communication.

The dentist-patient relationship and oral health-related quality of life among older adults: A cohort study.

OBJECTIVES: To assess the association between aspects of the dentist-patient relationship at age 65 and Oral Impacts on Daily Performances (OIDP) at ages 65 and 70 and to examine whether dental avoidance behaviours play a role in explaining that association. BACKGROUND: Information about the quality of the dentist-patient relationship is important for dental care provision and healthy ageing. METHOD: Secondary data analysis of a cohort study of Norwegians born in 1942. The participation rate in 2007 (age 65) and 2012 (age 70) was, respectively, 58.0% (n = 4211) and 54.5% (n = 3733). A total of 70.0% (n = 2947) of the baseline participants responded in 2012. Dentist-patient relationship aspects were assessed in terms of communication with the dentist, satisfaction with dental care, unpleasant experiences and changes of dentist. Generalised Estimating Equations (GEEs) were used to account for repeated measurements. RESULTS: Prevalence of oral impacts (OIDP) was 29.0% in 2007 and 28.4% in 2012. Participants who received communication on oral hygiene during dental visits had a higher likelihood, whereas participants who reported satisfaction with dental care, no unpleasant experience and did not change dentist had a lower likelihood of reporting oral impacts over these 5 years. Corresponding odds ratios were: 1.2 (95% CI 1.0-1.5), 0.4 (95% CI 0.3-0.5), 0.6 (95% CI 0.5-0.7) and 0.5 (95% CI 0.3-0.6). Associations between dentist-patient relationship aspects and OIDP remained unchanged after adjustment for avoidance behaviours. CONCLUSION: Training dentists in relationship skills might improve social interaction with patients and the oral health-related quality of life of older people in Norway.

Affect and cognition as antecedents of patients' trust in the dentist: cross-sectional study

Aim: to evaluate the association of the patients' perception about dentist's affect and cognition on trust and, consequently, on intention to return and patient satisfaction with life. Methods: Analytical cross-sectional study conducted in patients' adults and elderly at of two dentistry clinics in the south of Brazil. Patients had to have a previous relationship with the dentist (at least one previous consult) and 18 years of age or older. The data were collected through self-administrated questionnaire using measures adapted from other research, using structural equation modeling. We test using a chi-square difference test (p-value<0,05). Results: The mean age of the 197 patients was 37.0 years (σ = 15.5). The affect perceived by the patient at the dentist had a positive effect (ß = .53) on the trust that the patient develops in relation to the dentist. The same is true for the effect of the rational or cognitive aspects perceived by the patient at the dentist (ß = .41). The trust positively influences the patient's intention to return to that dentist (ß = .82). In addition, the intention to return to the dentist positively influences the patient's satisfaction with life (ß = .49). Conclusions: Affective and cognitive aspects positively influenced the patient's trust in the dentist. The greater the patient's trust in the dentist, the greater the intention to return to that dentist. Furthermore, a good relationship with the dentist improve the patient's satisfaction with life

[Sexual trauma; treatability in the dental practice]. / Seksueel trauma; behandelbaarheid in de tandartspraktijk.

A patient with extreme fear of dental treatment and a history of sexual abuse as well presented at a Centre for Special Care Dentistry. A dentist specializing in dental anxiety and a clinical psychologist worked closely together during intake and treatment phases. The comorbid PTSS appeared to hamper the exposure therapy. In consultation with the patient, she was referred to a specialized inpatient unit for intensive trauma treatment. This trauma treatment took place parallel to the exposure treatment at the dentist's. When the trauma had been treated successfully, further treatment at the dentist's for anxiety counselling also proceeded much more smoothly. At the end of the anxiety treatment, the patient was referred back to the regular dental practice.

Exploring Young Adult Comfort with Oral Health Care Providers' Discussions Related to HPV: A mixed methods study.

Purpose: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States and oral healthcare providers (OHPs) have become increasingly focused on preventing oral health outcomes related to HPV through screening for oral cancer and recommending HPV vaccination. The purpose of this study was to explore the comfort of having HPV-related discussions with OHPs among a college-age population.Methods: Students enrolled in an introductory-level, personal health class at a large, public, mid-Atlantic institution were invited to participate in an anonymous survey. Ten items related to participant's perceptions of HPV discussions with an OHP were part of a larger 100 item online survey designed to measure various aspects of college student health. Comfort with an OHPs' discussion of various health issues (including oral cancer, the relationship between oral cancer and HPV, and HPV vaccination) was measured on a 5-point scale with follow up, open-ended questions. Descriptive statistics were used to analyze the data; thematic coding was used to analyze the open-ended items.Results: A total of 3,236 students were invited to participate during the two data collection waves; 2,198 surveys were fully completed, representing a 67.9% response rate. Participants reported having the greatest level of comfort discussing oral health prevention behaviors such as tooth brushing and flossing and the least comfort discussing HPV-related topics with OHPs. Among those expressing low levels of comfort, qualitative responses highlighted participants limited knowledge related to HPV and the HPV vaccination along with the belief that these discussions were better suited for physicians.Conclusions: Results from this study demonstrated that college-age students may be uncomfortable with HPV-related discussions in a dental care setting. However, given the relationship between HPV infection and poor oral health outcomes, it is important that this population be informed about the oral-systemic HPV relationship and of the HPV vaccination as means for primary prevention. These findings highlight the need to address the public's perceptions regarding the role that OHPs play in educating the public about oral-systemic health.

A Smart Device for a Preliminary Dental Examination Based on the Internet of Things.

The COVID-19 pandemic has threatened the lives of many people, especially the elderly and those with chronic illnesses, as well as threatening the global economy. In response to the pandemic, many medical centers, including dental facilities, have significantly reduced the treatment of patients by limiting clinical practice to exclusively urgent, nondeferred care. Dentists are more vulnerable to contracting COVID-19, due to the necessity of the dentist being close to the patient. One of the precautions that dentists take to avoid transmitting infections is to wear a mask and gloves. However, the basic condition for nontransmission of infection is to leave a safe distance between the patient and the dentist. This system can be implemented by using an Arduino microcontroller, which is designed as a preliminary device by a dentist to examine a patient's teeth so that a safe distance of three meters between the dentist and the patient can be maintained. The project is based on hardware and has been programmed through Arduino. The proposed system uses a small wired camera with a length of five meters that is connected to the dentist's mobile or laptop and is installed on a robotic arm. The dentist can control the movement of the arm in all directions using a joystick at a distance of three meters. The results showed the effectiveness of this system for leaving a safe distance between the patient and the dentist. In our future work, we will control the movement of the arm via Bluetooth, and we will use a wi-fi-based camera.

What Counts for the Old and Oldest Old?-An Analysis of Patient Criteria for Choosing a Dentist-Part II: Personal Characteristics and Soft Skills.

Soft skills include communication skills and personality traits that are important when choosing a dentist, but other factors within the dental office also seem to be important for patients. The aim of this study is to evaluate factors that are important to people in a dentist as well as characteristics of the ideal dentist and to evaluate possible age-, gender-, and residence of living specific differences. A telephone survey with participants aged 35 years or older (ag­age group: ag 1: 35−50 years, ag 2: 70−84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to gender and age. Most of the participants (n = 298, 64.2%), regardless of their own gender, age, or place of residence did not care about the gender of the dentist. In general, the price of the treatment does not play a role in choosing the ideal dentist. Women differ significantly from men in their choice of dentist (ANOVA p < 0.001 (preference of non-smoker), ANOVA p < 0.001 (preference, that the dentist does not smell of smoke, importance of appearance (ANOVA p < 0.001) and psycho-social skills, etc.). As age increases, professional experience and psycho-social competencies are rated as important. With the increase in age, the mean value of the desired years of professional experience increases without significant differences between age groups. The importance of advanced training (ANOVA p < 0.001; Bonferoni correction: significant difference between ag 1 and ag 2 p < 0.001, and ag 1 and ag 3 p < 0.001) decreases with age. Especially for participants aged 70 to 84 years, a relationship of trust is important. Between the places of residence, statistical differences for almost all surveyed items were found (e.g., importance that the dentist speaks the patients' native language ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig, Berlin and Mainz, and Leipzig and Mainz (each p < 0.001), dentist has a specialization ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig and Berlin and Mainz (each p < 0.001), etc.). Dentists should be trained to develop psycho-social skills to meet the special demands of the increasing older population.

Influence on the patient's oral hygiene depending on the treatment performed by either one or different pre-graduate practitioners - a randomized, controlled, clinical short-term trial.

OBJECTIVES: Plaque control by improved domestic oral hygiene is essential in periodontal treatment. However, changing treatment providers may interfere with building a dentist-patient relationship and in turn affect treatment success. The aim of this randomized, controlled, prospective short-term study was to determine the influence of either one or four different pre-graduate practitioners on patients' oral hygiene parameters during active periodontal therapy. MATERIAL AND METHODS: A total of 55 patients with periodontitis were allocated to two groups. Within the group "continuous treatment" (CT, n = 27), each patient was treated by one individual practitioner over the treatment period. For patients of the group "discontinuous treatment" (DT, n = 28), treatment in each session was performed by a different practitioner. Periodontal parameters (BOP, PBI, and PCR) were assessed at two timepoints: T1 (baseline) and T2 (end of active therapy). RESULTS: With CT, the PBI improved in 93% of the patients, compared to 71% with DT (p = 0.048). T1-T2 intragroup analysis showed a statistically significant improvement of all observed clinical parameters with no differences in ∆PBI, ∆BOP, and ∆PCR. Spearman's correlation analysis revealed a weak correlation between PCR and BOP of CT only. CONCLUSIONS: In the present study, improvement of all parameters was comparable between the groups. PBI, as a parameter displaying patient's domestic plaque control compliance, improved in more patients from CT than DT. This is possibly indicating an advantage of continuous treatment by one single practitioner. CLINICAL RELEVANCE: Treatment by either a single practitioner or by multiple, constantly changing practitioners might influence patients' compliance to modify their behaviour when medically necessary.

Knowledge, Attitude, Practices, and Preparedness of Dental Professionals in Prescribing Nicotine Replacement Therapy.

OBJECTIVE: To assess the knowledge, practice, attitude, and preparedness of dental professionals in prescribing nicotine replacement therapy (NRT). Methodology. A prevalidated voluntary web-based questionnaire was generated as a link through Google Drive and was sent to 117 dental professionals in North India using Whatsapp, Messenger, and Instagram social media platforms. A total of 94 responses were received and out of which 76 responses were analyzed (18 forms were excluded due to incomplete or duplicate responses). Frequency analysis was done using SPSS software version 21. RESULT: The participation rate was found to be 80.3%. More than half of the study population were familiar with the term NRT (77.6%) and its uses (67.1%), but approximately less than half of the total study subjects knew the duration (32.9%), cost (27.6%), dosage (25%), and contraindications (36.8%) of the NRT. Approximately 56.6% of the study participants showed a positive attitude towards helping patients to quit smoking through tobacco cessation counseling. Nearly one-fourth of the study population, i.e., 27.6%, were confident in explaining the negative impacts of tobacco, while 22.4% knew about the tobacco cessation protocol. Among the participants, only 27.6% reported that they practice NRT and out of which approximately less than 20% of the study participants were prescribing correct dose of NRT. CONCLUSION: Though study subjects had an ample knowledge regarding NRT use in tobacco cessation, it does not reflect their current attitude and preparedness. Thus, there is a need for continuing education to further train dental professionals for prescribing NRT.

Integralidade do atendimento odontológico à mulher em situação de violência: revisão narrativa da conduta profissional / Dental care integrality for women in violent situations: a narrative review of professional conduct

O desempenho de atributos profissionais de integralidade do atendimento de mulheres em situação de violência depende de como os cirurgiões-dentistas (CDs)estruturam suas práticas de cuidado e como compreendem a violência. Por isso, o objetivo desta revisão foi acumular evidências da responsabilidade profissional e obrigações sociais do CDe sua imprescindibilidade no enfrentamento da violência contra a mulher. Foram selecionados artigos nas bases de dados PubMed, SciELOe LILACS, a partir de Descritores emCiências da Saúde, para fundamentar e aprofundar as perspectivas sobre a integralidade do atendimento odontológico, considerando os conflitos sociais subentendidos na queixa principal. Constatou-se que a violência contra a mulher é resultante de processoshistóricos-sociais de desigualdade entre os gêneros; a agressão física sobressai-se entre as principais queixas e mulheres agredidas por seu parceiro têm alta prevalência de sofrer injúrias na cabeça e na face. As sequelas da violência vão além dos vestígios físicos e difundem-se a inúmeros problemas orais. Verificou-se pouca aptidão dos cirurgiões-dentistas para identificar, conduzir e propor alternativas de tratamento global à paciente, mesmo com protocolos para naturalização da investigação por meio da anamnese. A ampliação do conhecimento e discussão das políticas de ensino são oportunidades para consolidar a humanização e a integralidade de saúde, evitando exames e tratamentos mecânicos, sem afeto ou respeito. Essa estratégia faz parte da construção coletiva para o estabelecimento e manutenção do compromisso ético e social do Ensino em Odontologia, em que o CD compreende a magnitude de sua profissão e presta seus serviços articulado com a realidade social (AU).

Improving integrality on dental care for women in a violent situation depends on how the dentist conducts the care practices and how to comprehend the violence. For that reason, the goal of this review was to gather evidence and concerns about the role of dentists in addressing violence against women, professional responsibilities, and social obligation. At PubMed, SciELO, and LILACS were selected research and studies to substantiate and deepen perspectives about integrality on dental care attendance considering the social conflicts implied in the main complaint. Violence against women is produced in gender inequality arising from historical and social processes. Physical aggression is the main complaint. Women assaulted by their partners have a high prevalence of suffering head and face injuries. The violence's sequelae spread to countless problems beyond the physical traces. Dentists do not be able to identify, conduct, and purpose alternatives of global treatment even though with protocols of investigationthrough the anamnesis. Multiprofessional discussion expands the knowledge and it is an opportunity to reinforce oral health inclusive criteria avoiding mechanicaltreatment with no respect or affect. Thus, this is a collective construction strategy to establish and maintenance of the ethical and social commitment of Dentistry, on what dentists improve the dental care screening, intervening, and changing behavior according to the real demand of our society (AU).