Self-reported periodontitis association with impaired smell and taste: A multicenter survey.

OBJECTIVES: To investigate the association between self-reported periodontitis and the senses of taste and smell among employees of one Danish and two American universities. MATERIALS AND METHODS: Data were collected through a digital survey. A total of 1239 individuals from Aarhus University - Denmark, the University of Iowa, and the University of Florida - USA were included. Self-reported periodontitis was the exposure. The perceived senses of taste and smell were the outcomes and were measured through a visual analog scale (VAS). Self-perceived halitosis was the mediator. Confounders were age, sex, income, education, xerostomia, COVID-19, smoking, body mass index, and diabetes. The total effect was decomposed into direct and indirect using a counterfactual approach. RESULTS: The total effect of periodontitis on an impaired sense of taste was OR 1.56 (95% CI [1.02, 2.09]), of which 23% was mediated by halitosis (OR 1.13; 95% CI [1.03, 1.22]). Additionally, individuals with self-reported periodontitis had a 53% higher chance of having impaired smell (OR 1.53; 95% CI [1.00, 2.04]), with halitosis mediating 21% of the total effect (OR 1.11; 95% CI [1.02, 1.20]). CONCLUSION: Our findings suggest that periodontitis is associated with distorted senses of taste and smell. Additionally, this association appears to be mediated by halitosis.

Empathy levels among health professional students at a large midwestern public university - a cross-sectional study.

BACKGROUND: Empathic care is considered extremely important by patients and providers alike but there is still an ample need for assessing empathy among healthcare students and professionals and identifying appropriate educational interventions to improve it. This study aims to assess empathy levels and associated factors among students at different healthcare colleges at the University of Iowa. METHODS: An online survey was delivered to healthcare students, including nursing, pharmacy, dental, and medical colleges (IRB ID #202,003,636). The cross-sectional survey included background questions, probing questions, college-specific questions, and the Jefferson Scale of Empathy-Health Professionals Student version (JSPE-HPS). To examine bivariate associations, Kruskal Wallis and Wilcoxon rank sum tests were used. A linear model with no transformation was used in the multivariable analysis. RESULTS: Three hundred students responded to the survey. Overall JSPE-HPS score was 116 (± 11.7), consistent with other healthcare professional samples. There was no significant difference in JSPE-HPS score among the different colleges (P = 0.532). CONCLUSION: Controlling for other variables in the linear model, healthcare students' view of their faculty's empathy toward patients and students' self-reported empathy levels were significantly associated with students' JSPE-HPS scores.

Translation and preliminary validation of a French version of an ageism scale for dental students.

BACKGROUND AND AIM: The World Health Organization considers ageism an important barrier to age-appropriate care for older adults. A new ageism scale for dental students (ASDS) has been validated in the United States, Brazil, Greece and Romania. The aim of this study was to validate a French version (ASDS-Fr). METHOD AND MATERIALS: The 27-item ageism scale was translated from English into French, and its content validity was investigated using the content validity index. The translated version was completed by 180 dental students in the Dental School of Clermont-Ferrand in France. Principal component analysis (PCA) was performed and internal consistency reliability was calculated. RESULTS: The final PCA model resulted in 10 items and three components that together accounted for 57.2% of the overall variance. The first component contained four items that point to a negative view of older adults; the second contained three items that appeared to reflect an absolving of responsibility for providing care to older adults; and the third contained three items that deal with gerodontology education. CONCLUSIONS: This preliminary validation of the ASDS-Fr produced a new 10-item scale with three components with acceptable validity and reliability.

Are Root-Supported Overdentures Still an Alternative to Implant-Supported Overdentures? A Scoping Review.

PURPOSE: To compare the outcomes of prosthodontic treatment for subjects wearing a complete maxillary denture opposing a root-supported mandibular overdenture (RSO) or an implant-supported mandibular overdenture (ISO). METHODS: A literature search was performed in seven electronic databases: MEDLINE via PubMed interface, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, and AgeLine. The search terms were developed by the primary investigators and the health sciences librarian, who then started with PubMed and adapted the original search strategy for the other databases. Included articles were those that compared the outcomes for mandibular RSOs and those with ISOs, for persons wearing a maxillary complete denture. RESULTS: Seven articles were included in the review. There were limitations in this review because of small sample sizes, short study durations, and different methodologies. Also, no comparative studies were identified for clinically important outcomes, such as survival rates of abutments, prosthodontics/maintenance problems, and longitudinal cost of care. For prosthodontic complications, patient satisfaction, and ability to clean, no differences were reported. For oral tactile sensibility, RSOs presented significantly improved sensibility, whereas ISOs had higher maximum bite force capability, but the difference was not statistically significant, except when subjects had a cross-bite or a lingualized occlusion. CONCLUSIONS: The results of this scoping review were not conclusive, except for maximum bite force, where ISOs seem to perform better than RSOs by the measured criteria. ISOs had higher survival rates than RSOs, and required less maintenance, but were more expensive. It was disappointing to find so few studies comparing these clinical treatment modalities, which suggests that either treatment may be clinically acceptable and depends upon a shared decision between patients and their dentists.

Translation and validation of the ageism scale for dental students in Romanian (ASDS-Rom).

AIMS: The aim of this paper was to validate the Romanian version of an ageism scale for dental students. MATERIALS AND METHODS: The initial 27-item ageism scale was translated into Romanian and administered to 210 dental students in Craiova. The data were analysed using principal components analysis (PCA) with an orthogonal, Varimax rotation. The answers were then compared across several demographic variables using a combination of independent samples t tests and one-way between-subjects analysis of variance (ANOVA). RESULTS: Adequate factorability was confirmed with a Kaiser-Meyer-Olkin (KMO) of 0.676 and a Bartlett's Test of Sphericity yielding P < 0.001. PCA revealed a 10-item scale distributed into three components that accounted for 58% of the overall variance. The first component contained 4 items related to the cost-benefit of providing care to older patients (α = 0.80). The second contained 3 items that revolved around the perceptions about older people and their value in the society (α = 0.59). The third contained 3 items related to gerodontology training (α = 0.46). Discriminant validity showed differences in the first component based on whether a student had an older family member. CONCLUSIONS: The 10-item, three components scale demonstrated acceptable validity and reliability.

Preliminary validation of the Dental Clinical Learning Environment Instrument in a Brazilian dental school.

INTRODUCTION: This study aimed to perform a preliminary validation of the Dental Clinical Learning Environment Instrument (DECLEI) in a Brazilian dental school. MATERIAL AND METHODS: Dental Clinical Learning Environment Instrument was translated into Brazilian-Portuguese, and Brazilian DECLEI's items relevance and content validity were assessed using the content validity index (CVI). DECLEI was then distributed to 155 Brazilian undergraduate dental students attending the 7th and 8th semester of dental studies. Principal Component Analysis (PCA) was used as an initial exploration of the Brazilian DECLEI's internal structure. Item-total correlations for the remaining items were calculated to identify items with poor discrimination coefficients. The internal consistency reliability for the final set of 17 items was calculated using Cronbach's alpha coefficient. The sensitivity of the instrument to measure differences between groups regarding year in dental school, race and sex was also assessed. RESULTS: The CVI was ≥0.80 for all 24 items of the Brazilian DECLEI indicating that all items were relevant to the local culture. Principal Components Analysis (PCA) provided evidence of a single dominant component containing 17 items (Cronbach's α = .86), and all 17 items met the benchmark of acceptable item-total correlation. Significant differences were found only when comparing 7th- and 8th-semester students. CONCLUSIONS: Dental Clinical Learning Environment Instrument has the potential to be used as a reliable instrument to measure clinical learning environments for Brazilian dental students.

Translation and preliminary validation of an ageism scale for dental students in Brazil (ASDS-Braz).

BACKGROUND AND OBJECTIVE: Ageism is a major barrier for age-appropriate care. The aim of this study was to translate and perform a preliminary validation of an ageism scale for dental students (ASDS) in Brazil (ASDS-Braz). METHODS: The 27-item original ageism scale was translated from English into Brazilian Portuguese. A panel of five Brazilian dental educators revised the scale to establish content validity. The translated version was completed by 156 dental students in the Federal University of Pelotas in Brazil. Principal component analysis, internal consistency reliability and discriminant validity were estimated. RESULTS: All items in the Brazilian Portuguese version received a content validity index score ≥0.80 indicating that they were relevant to the topic. The principal component analysis produced a 12-item scale with three components that accounted for 51% of the overall variance. The first component contained six items associated with a negative view of older adults; the second component contained three items dealing with the complexity of providing care for older adults; and the third component contained three items associated with a positive view of older people. Discriminant validity did not show any differences related to demographic factors, the semester of studies and history of living with older people. CONCLUSIONS: The preliminary validation of the ASDS-Braz produced a 12-item scale with three components with acceptable validity and reliability. Future research in a larger, multi-institutional sample is now warranted.

Epidemiology of facial fractures among older adults: A retrospective analysis of a nationwide emergency department database.

BACKGROUND/AIMS: The prevalence of facial fractures among older adults has increased in recent years, and nationwide studies about the epidemiological profile and outcomes of hospital-based ED visits for facial fractures among older adults are scarce. The aim of this study was to provide USA-wide data of hospital-based Emergency Department (ED) visits for facial fractures among older adults, and to investigate the outcomes associated with these visits. MATERIAL AND METHODS: The Nationwide Emergency Department Sample (NEDS) for the years 2008-2014 was used for the present study. All ED visits with a diagnosis of facial fractures in any of the diagnoses fields and only patients aged 65 years and above were included. RESULTS: A total of 540 748 ED visits matched the criteria (62.7% were females). Public insurance-Medicare-(85.2%) was the most common payer. The three most frequent facial fractures included fractures of the nasal bones (61.3%), fractures of "other" facial bones (16.7%), and fractures of the orbital floor (15.0%). Falls were the most common causes of facial fractures (81.8%). Following ED visits, 64.1% were treated and released, and 30.6% were admitted into the hospital. The mean ED charge per visit was US$5507. Total ED charges across the entire United States was US$2 518 289 555. CONCLUSIONS: Among older adults, nasal bone fractures are the most common type of facial fracture. Facial fractures are mainly caused by falls. There was no significant trend in mortality rates over the study period, and there was a significant financial burden associated with the facial fracture-related ED visits.

Translation and validation of the Greek version of an ageism scale for dental students (ASDS_Gr).

OBJECTIVES: To describe the validation of a new 27-item ageism scale for dental students in Greece. BACKGROUND: A new ageism scale for dental students has been developed by American and European Gerodontology educators and was preliminary validated in the United States. METHODS: The scale was translated into Greek and administered to 8th- and 10th-semester dental students in Athens. Principal components analysis was used to explore the internal structure of the measure; internal consistency reliability was assessed using Cronbach's α coefficient; corrected item-total correlations were calculated to decide which low contributing items should be removed from the scale; and discriminant validity was tested investigating variation in relation to demographic and educational factors. RESULTS: A total of 152 students responded to the questionnaire. The Principal component analysis offered a 15-item scale distributed into four factors that accounted for 56.4%, of the total variance, produced stronger factor loadings, a comparable amount of overall component variance and logical sets of components. The four factors produced were values/ethics about older people (four items, α = 0.71), patient compliance (four items, α = 0.72), barriers to dental care (four items, α = 0.57) and dentist-older patient interaction (three items, α = 0.64). Discriminant validity revealed statistically significant differences in factors and items related to semester of studies, gender and family's permanent residence. CONCLUSION: The preliminary validation of the Greek version of the ageing scale for dental students revealed a 15-item questionnaire that demonstrated acceptable validity and reliability and could be further tested in larger samples.

Randomized Controlled Trials in Implant Dentistry: Assessment of the Last 20 Years of Contribution and Research Network Analysis.

The aim of this study was to evaluate the characteristics of randomized controlled trials (RCTs) regarding implant-supported single tooth or fixed partial dentures. We performed searches (PubMed/MEDLINE and Web of Science) to identify all RCTs published from 1996 to 2016 and assessed publication details, study characteristics, international collaboration networks, and characteristics related to the implant-supported treatment. Two reviewers independently screened the titles/abstracts and selected full texts. A total of 122 RCTs were included, and most of the authors were from Europe (72%). Most trials did not report a trial registering number (89.9%) or sample size calculation (58.2%). The use of the CONSORT Statement increased over the past 9 years. Trials were mostly conducted at universities (54.9%), and only 13.1% compared 2 or more implant brands. Loading protocol was the most prevalent main comparison among the included studies, and most of the RCTs did not clearly report whether they excluded patients with known risk factors. The studies reviewed here presented different methodological and publication characteristics, and many did not show aspects aligned with current research practices.

Patient Expectation and Satisfaction with Different Prosthetic Treatment Modalities.

PURPOSE: To investigate the relationships between gender, age, patients' perceptions about the dentists' conduct, number of adjustments, treatment type, and expectation prior to prosthetic treatment and patient satisfaction with their treatments. MATERIALS AND METHODS: Data were integrated from four studies that measured patient expectations before treatment and satisfaction after treatment using a visual analog scale (VAS) from 0 to 10. These scores were given for each of four aspects of the therapeutic outcomes: chewing, esthetics, phonetics, and comfort. Patients' perceptions about the dentists' conduct was also assessed using a Likert-scale questionnaire. The total sample size, after combining the data from all four studies, was 223 subjects. Bivariate and multivariable analyses were performed. The covariates entertained were gender, age, treatment type, patients' perceptions about the dentists' conduct, number of adjustments, and expectation prior to denture fabrication. RESULTS: In the entire sample, 115 (51.57%) patients were females and 108 (48.43%) were males. They ranged in age from 28 to 81 years old; the mean age was 53.2 years (SD = 11.5). Combining four treatments together, there was no significant difference between patients' expectation and satisfaction scores for all four items. There were no significant differences between expectation and satisfaction for different genders. Multivariable analysis showed that patient expectation, satisfaction and the difference (satisfaction score-expectation score) scores for all four aspects were associated with treatment type (implant treatments were favored), and expectation prior to prosthetic treatment (the higher the expectation, the higher the satisfaction) was associated with satisfaction and difference scores. Satisfaction and difference scores for chewing were associated with number of adjustments and satisfaction, and satisfaction and difference scores for phonetics and comfort were associated with how well the dentist explained the intended treatment before performing it. CONCLUSIONS: Patient satisfaction was associated with treatment type (implant treatments were favored), expectations prior to prosthetic treatment (the higher the expectation, the higher the satisfaction), and how well the dentist explained the intended treatment before performing it.

Patients' esthetic expectations and satisfaction with complete dentures.

STATEMENT OF PROBLEM: Understanding the factors affecting patients' satisfaction with their dentures is essential to achieving higher satisfaction rates. PURPOSE: The purpose of this clinical study was to test for possible relationships between the esthetic satisfaction of complete denture therapy and factors including age, sex, and esthetic expectations. MATERIAL AND METHODS: Data were integrated from 4 previous studies of complete denture satisfaction, and a secondary data analysis was performed. All studies, which had similar methodologies, recorded patients' esthetic expectation and satisfaction scores using a 0 to 10 visual analog scale. The Sign test was used to test the difference between satisfaction and expectations. The Fisher exact, Spearman rank correlation, Wilcoxon rank sum, and Kruskal-Wallis tests, as well as the Cochran-Mantel-Haenszel test using ridit scores, were used to assess the relationships regarding the heterogeneity among studies, satisfaction, and factors of interest. RESULTS: Of the 283 participants studied, 52% were female, and the median age was 58 years. The satisfaction scores exceeded expectation scores significantly (P<.001), although they were both high. Age, sex, and expectations were different among studies (P<.008); age also differed between sexes (P=.004). After adjusting for the study, men had higher expectations than women (P=.005); there was no sex difference in level of satisfaction. Only in men was satisfaction positively correlated with expectations (r=0.300; P<.001). CONCLUSIONS: Overall, patients were more esthetically satisfied than they expected after completing denture therapy; esthetic satisfaction did not differ between sexes or with age. The expectation of men was higher than that of women and was positively correlated with their level of satisfaction.

Sleep bruxism associated with obstructive sleep apnea syndrome in children.

AIMS: Sleep bruxism (SB) and obstructive sleep apnea syndrome (OSAS) are often observed in children and may have several health implications. The aim of this paper is to evaluate their prevalence and to test for possible associations between these two conditions. METHODOLOGY: The sample consisted of 496 children randomly selected among the preschoolers of Taubaté, Brazil; 249 (50·2%) were boys and 247 (49·8%) were girls. Diagnoses of SB and OSAS were made by clinical examinations and questionnaires filled out by the children's parents in a cross-sectional design. Analysis of variance and Chi-square tests were applied to verify possible association among the variables in question. RESULTS: The average age was 4·49 years (SD: ±1·04 years). A total of 25·6% were diagnosed with SB, while 4·83% were diagnosed with OSAS, and only 2·82% presented both conditions. A statistical association was found between SB and OSAS (P<0·001; Chi-square test): 11·03% of subjects with SB also presented with OSAS, and 97·18% of subjects without SB did not present with OSAS. No association was found among children's gender and age and the presence of SB or OSAS. CONCLUSIONS: Within the limits of this study, SB was associated with OSAS.

Patients' Evaluations of Complete Denture Therapy and Their Association with Related Variables: A Pilot Study.

PURPOSE: Patient satisfaction is an important goal in complete denture therapy, and many factors influence this parameter. This study aimed to evaluate expectations before and satisfaction after therapy with complete dentures. As a secondary objective, other variables that may interfere with patient satisfaction were also evaluated. MATERIAL AND METHODS: A representative sample of 99 patients assigned visual analog scale (VAS) scores to their expectations before and satisfaction after therapy regarding chewing, esthetics, comfort, and phonetics. Demographic data and answers to a questionnaire concerning the dentists' conduct were recorded. Multiple linear regression was used to evaluate the association among studied variables and patients' expectation and satisfaction with their dentures. RESULTS: The average VAS scores were high for both expectations and satisfaction, and satisfaction exceeded expectations. Patients' expectations about esthetics and comfort were associated with age and self-reported time of using complete dentures. Patient satisfaction regarding chewing was associated with the number of postdelivery adjustments. Also, patient satisfaction regarding esthetics was associated with gender and esthetic expectations. In regard to phonetic satisfaction, associations were verified among self-reported time of using complete dentures, comfort and phonetics expectations, and dentists' explanations. Comfort satisfaction was associated only with educational level. CONCLUSIONS: Patient satisfaction regarding complete dentures exceeded expectations and an expressive majority of positive evaluations of the dentists was noticed. Many patient-related variables seemed to influence their evaluations of their dentures.

Patients' perceptions of benefits and risks of complete denture therapy.

PURPOSE: The aim of this study was to assess patients' perceptions of benefits and risks concerning complete denture therapy. A secondary objective was to assess the influence of clinical and sociodemographic variables on patients' perceptions. MATERIALS AND METHODS: The sample was composed of 104 volunteers who presented themselves for complete denture treatment at a dental school. The average age of the volunteers was 69.2 years (±) 9.3. Patient opinions concerning the benefits of complete denture therapy were recorded using a previously reported questionnaire. The answers were evaluated in three domains: (1) benefits (positive perceptions); (2) risks (negative perceptions); and (3) consequences of no treatment. RESULTS: The average time of use of the previous dentures was 20 years (SD ±12.9). Risk factors (negative perceptions) received lower scores by the patients, while the consequences of no treatment received higher scores. No association was found among evaluations of the previous dentures and educational level, marital status, and gender; however, patients' evaluation about their previous dentures was significantly different depending on age (p = 0.001) and previous dentures' time of use (p = 0.038). CONCLUSIONS: Patients presented a positive perception of complete denture therapy, and the risk factors (negative perceptions) received the lowest scores. Patient perception regarding complete denture therapy was not influenced by educational level, evaluation of the previous dentures, or marital status.

Dental school department strategic planning: A department driven approach.

Drafting strategic plans for dental school departments traditionally involves a committee-led or leadership-driven process, often overlooking input from the majority of departmental members. In this manuscript, the authors advocate for a novel approach wherein departmental activities undergo comprehensive review and analysis, and the establishment of novel objectives through diverse forums of engagement with both faculty and staff, conducted collectively and individually over a concise time limit. This methodology endeavors to solicit input from all departmental constituents through varied channels, fostering an environment wherein all members feel empowered to express their viewpoints, resulting in a strategic plan that resonates with the entire department and enhances the likelihood of successful implementation.

Translation and validation of the ageism scale for dental students in Iran (ASDS-Persian).

AIMS: A longer life and the growing population of older adults are the achievements of the 20th century. The World Health Organization considers ageism an important barrier to age-appropriate care for older adults. The aim of this study was to translate and validate the ageism scale for dental students in Iran (ASDS-Persian). METHODS: The 27-question ASDS was translated from English into Persian (Farsi) and completed by 275 dental students from two universities in Isfahan, Iran. Principal component analysis (PCA), internal consistency reliability, and discriminant validity were estimated. Furthermore, in this study we conducted an analytical cross sectional study among dental students of Isfahan province (two universities) with the aim of proving data regarding their ageism beliefs and attitudes. RESULTS: PCA revealed an 18-question, four-component scale with acceptable validity and reliability. The four components are 'barriers/concerns on dental treatment in older adults', 'opinions about older adults', 'practitioner's perspective,' and 'older adults' perspective'. CONCLUSION: This preliminary validation of ASDS-Persian produced a new 18-question scale with four components with acceptable validity and reliability. This instrument could be further tested in larger samples in Farsi speaking countries.

Ageism scale for dental students (ASDS): A focus group review of content validity.

PURPOSE/AIM: Improve content validity of the Ageism Scale for Dental Students (ASDS) and identify barriers to using the scale. METHODS: Thematic analysis of transcripts of three purposively sampled focus groups of 1) geriatric dentistry specialists, 2) older adult dental patients, and 3) dental students. RESULTS: Twenty-five participants engaged in focus groups. No new concepts to define ageism were identified. Experts found the scale acceptable and appropriate, yet they raised specific potential revisions to scale questions. Commonly reported themes already addressed by ASDS included the importance of tailoring decision-making to patient preference and not making assumptions about older adults' capacity or preferences for dental care. Barriers to identifying ageism or using the scale included experiential differences in interpreting scale items, cultural differences in attitudes towards older adults, and potential overlap with social determinants of health. Secondary findings include recommendations for older-adult focused training for dental students to provide positive, concrete guidance on caring for older adults. CONCLUSION: There are opportunities to refine the Ageism Scale for Dental Students and to allow tailoring of the scale for specific national or cultural contexts.

Translation and validation of ageism scale for dental students into Malay language.

AIMS: Identifying ageism among dental students is essential in gerodontology courses. This study aimed to perform a preliminary validation of a Malay version of the ageism scale for dental students (ASDS-My). METHODS AND RESULTS: The 27-item ASDS were translated into Malay language and completed by 168 dental students. Exploratory factor analysis (EFA) with Promax rotation, Polychoric Correlation Matrix and Principal Axis Factoring was conducted. Internal consistency reliability and discriminative validity were analysed. Criterion validity was measured by comparing ASDS-My with Fraboni Scale of Ageism (FSA). A Kaiser-Meyer-Olkin of 0.612 and a Bartlett's Test of Sphericity yielding p < .001 confirmed the adequate factorability. EFA revealed a 15-items scale distributed into five-factors explaining 54.5% of overall variance, with acceptable reliability. The two factors involved cost-benefit of dental treatment on older patients and challenges during medical history taking. The third, fourth and fifth factors explained attitude towards older patients, negative views of older patients and exposure of dental students to Gerodontology training and experiences respectively. Most factors were significantly positively related to FSA. Discriminative validity revealed significant differences for gender, place of stay and year of study. CONCLUSION: Preliminary validation of the ASDS-My produced a five-factors 15-items scale with acceptable validity and reliability.