Current Issue : April - June Volume : 2014 Issue Number : 2 Articles : 6 Articles
Background: Dentists in the US see an increasing number of patients with systemic conditions. These patients are\r\nchallenging to care for when the relationship between oral and systemic disease is not well understood. The\r\nprevalence of professional isolation exacerbates the problem due to the difficulty in finding expert advice or peer\r\nsupport. This study aims to identify whether dentists discuss the oral-systemic connection and what aspects they\r\ndiscuss; to understand their perceptions of and attitudes toward the connection; and to determine what information\r\nthey need to treat patients with systemic conditions.\r\nMethods: We retrieved 14,576 messages posted to the Internet Dental Forum from April 2008 to May 2009. Using\r\nnatural language processing and human classification, we identified substantive phrases and keywords and used them\r\nto retrieve 141messages on the oral-systemic connection. We then conducted coding and thematic analysis to identify\r\nrecurring themes on the topic.\r\nResults: Dentists discuss a variety of topics on oral diseases and systemic health, with the association between\r\nperiodontal and systemic diseases, the effect of dental materials or procedures on general health, and the impact\r\nof oral-systemic connection on practice behaviors as the leading topics. They also disseminate and share research\r\nfindings on oral and systemic health with colleagues online. However, dentists are very cautious about the nature of\r\nthe oral-systemic linkage that may not be causal. Nonetheless, they embrace the positive association as a motivating\r\npoint for patients in practice. When treating patients with systemic conditions, dentists enquire about the cause of less\r\ncommon dental diseases potentially in relation to medical conditions in one-third of the cases and in half of the cases\r\nseek clinical guidelines and evidence-based interventions on treating dental diseases with\r\nestablished association with systemic conditions.\r\nConclusions: Dentists� unmet information needs call for more research into the association between less studied\r\ndental conditions and systemic diseases, and more actionable clinical guidelines for well-researched disease\r\nconnections. To improve dissemination and foster behavioral change, it is imperative to understand what information\r\nclinicians need and in which situations. Leveraging peer influence via social media could be a useful strategy to achieve\r\nthe goal....
Background: The Dai people, one of the ethnic minorities in China, have a population of 1,260,000. They have the\r\nsame origin as one of the main ethnic groups of Laos and Thailand. Most of the Dai live in Yunnan province, which\r\nis located in the less-developed southwestern part of China. This study aimed to describe the oral health status of\r\nDai preschool children in China and the factors that influence their oral health status.\r\nMethods: An oral health survey was performed between 2011 and 2012 to select Dai five-year-old children using\r\nmulti-stage stratified sampling in Yunnan. Their dental caries experience was measured using the ââ?¬Å?dmftââ?¬Â index, and\r\nsevere caries was assessed using the ââ?¬Å?paââ?¬Â index, which is modified from the ââ?¬Å?pufaââ?¬Â index. Oral hygiene status was\r\nassessed using the visual plaque index (VPI). A questionnaire to study the childrenââ?¬â?¢s socio-demographic background\r\nand oral health-related behaviours was completed by the childrenââ?¬â?¢s parents.\r\nResults: A total of 833 children were examined. Their caries prevalence was 89% and 49% of the children had\r\ncarious tooth with pulp involvement. The mean (SD) dmft score was 7.0 (5.3). Higher dmft scores were found\r\namong children who were girls, were currently bottle-fed, took daily sweet snacks, had higher VPI scores, and had\r\nvisited a dentist within the last year.\r\nConclusions: The caries prevalence and experience of the five-year-old Dai children in Yunnan, China was high,\r\nand almost half had severe caries. The caries experience was associated with gender, snack habits, dental visit\r\nhabits, and oral hygiene status....
Background: Reliable caries detection is a cornerstone in the modern caries treatment schema. This study aimed\r\nto evaluate adopting traditional and new caries detection methods by third-year dental students.\r\nMethods: Fifty-seven students were given lectures on caries detection, after which they evaluated 27 extracted\r\ncarious teeth using traditional clinical assessment (CE), Nyvadâ��s, and ICDAS methods. On three teeth they also\r\nperformed DIAGNOdent pen�® (LF) scanning. Histological scores of the sectioned teeth (ICDAS, LF) and activity\r\nestimations of the lesions by the supervisors were used as golden standards (Nyvad, CE). For the ICDAS method ,\r\nsensitivity and specificity were calculated using dentine caries (D3) as a cut-off point. Mean ICC and kappa values\r\nwere calculated to evaluate interexaminer agreement for all lesions and methods. Spearmanâ��s correlation coefficient\r\nevaluated LF scanning.\r\nResults: ICDAS method presented good sensitivity (0.78) and specificity (0.87). The inter-examiner agreement for\r\ndifferent methods was fair or good (CE ICC = 0.69, ? = 0.53; Nyvadâ��s method ICC = 0.68, ? = 0.48, ICDAS ICC = 0.66,\r\n? = 0.47). Variation in LF values was the greatest with lesions extending to middle third of dentin. In that case, the\r\nSpearmanâ��s correlation coefficient was also the weakest.\r\nConclusions: To follow the guidelines by the European Core Curriculum on Cariology, the third year dental\r\nstudents are introduced to methods for detecting lesion depth and assessing lesion activity as well as using new\r\ncaries detection methods. Their performance in estimating lesion depth is good, and fair to good in estimating\r\nlesion activity even after basic training only...
Background: Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality\r\nof life. However, few studies on perception of oral health have been conducted among Japanese young adults. This\r\nstudy investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated\r\nwith self-rated oral health in Japanese young adults.\r\nMethods: This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at\r\nOkayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed.\r\nResults: In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT)\r\nsignificantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective\r\nsymptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly\r\ninduced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral\r\nHygiene Index-simplified were not related to self-rated oral health.\r\nConclusion: Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health\r\nbehavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in\r\nroutine dental examination to improve self-rated oral health in university students...
Background: Frailty has been demonstrated to negatively influence dental service-use and oral self-care behavior\r\nof older people. The aim of this study was to explore how the type and level of frailty affect the dental service-use\r\nand oral self-care behavior of frail older people.\r\nMethods: We conducted a qualitative study through 51 open interviews with elders of varying frailty in the\r\nEast-Netherlands, and used a thematic analysis to code transcripts, discussions and reviews of the attributes and\r\nmeaning of the themes to the point of consensus among the researchers.\r\nResults: Three major themes and five sub-themes emerged from our analyses. The major themes indicate that frail\r\nelders: A) favor long-established oral hygiene routines to sustain a sense of self-worth; B) discontinue oral hygiene\r\nroutines when burdened by severe health complaints, in particular chronic pain, low morale and low energy; and\r\nC) experience psychological and social barriers to oral health care when institutionalized. The subthemes associated\r\nwith the discontinuation of oral care suggest that the elders accept more oral pain or discomfort because they: B1)\r\nlack belief in the results of dental visits and tooth cleaning; B2) trivialize oral health and oral care in the general\r\ncontext of their impaired health and old age; and B3) consciously use their sparse energy for priorities other than\r\noral healthcare. Institutionalized elderly often discontinue oral care because of C1) disorientation and C2) inconveniencing\r\nsocial supports.\r\nConclusion: The level and type of frailty influences people�s perspectives on oral health and related behaviors. Frail\r\nelders associate oral hygiene with self-worth, but readily abandon visits to a dentist unless they feel that a dentist\r\ncan relieve specific problems. When interpreted according to the Motivational Theory of Life Span Development,\r\ndiscontinuation of oral care by frail elderly could be viewed as a manifestation of adaptive development. Simple\r\nmeasures aimed at recognizing indicators for poor oral care behavior, and providing appropriate information and\r\nsupport, are discussed....
Background: Oral diseases are a health problem worldwide. Differences in oral health status may vary with\r\ngeographical locations, but also within the same country and between groups with different social backgrounds.\r\nThe specific aims were to describe secular trends in oral health status regarding number of remaining teeth and\r\nalso to describe differences in socio-economic status, among 38- and 50-year-old women, over a 36-year period.\r\nMethods: Cross-sectional health surveys were performed at four occasions; 1968/69 (n = 746), 1980/81 (n = 532),\r\n1992/93 (n = 165) and 2004/05 (n = 500), including randomly selected women aged 38 and 50 years. The number\r\nof teeth was determined using panoramic radiographs and self-reported measures of marital status, social class,\r\neducational level, and income were recorded.\r\nResults: The mean number of teeth among women has increased significantly. The educational level has increased\r\nwhile fewer women are married/cohabiting over time. There has been a shift in the social group the women\r\nbelong to, where proportionally more women were categorized in a higher social group in 2004/05 than in 1968/69.\r\nMoreover, there is a significant relationship between fewer teeth and a lower social group, and among the 50-year-old\r\nwomen, this was irrespective of examination year. However, multivariate analyses showed that the risk to be edentulous\r\nor not, or to have fewer remaining teeth was significantly higher for women of lower social group, or living alone,\r\nin all studies over the 36 year-period. This was independent of age group, even though the risk diminished over the\r\nstudy period.\r\nConclusions: Cohort comparisons of women aged 38 and 50 years during 36 years showed that dental status\r\nimproved, with (i) a decreasing prevalence of edentulism and, (ii) an increasing number of remaining teeth in dentate\r\nindividuals over time. Differences due to social group and education were still present, with more remaining teeth in\r\nthe women in the higher social group. A time trend analysis indicated that in the later examination years the\r\nindividuals had fewer teeth lost, irrespective of age, marital status and, social group....
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