Current Issue : April - June Volume : 2016 Issue Number : 2 Articles : 5 Articles
Background: In England and Scotland, dental extraction is the single highest cause of planned admission to the\nhospital for children under 11 years. Traditional dental services have had limited success in reducing this disease\nburden. Interventions based on motivational interviewing have been shown to impact positively dental health\nbehaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The\nobjective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated\ninterview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing\nthe re-occurrence of dental decay in young children with previous dental extractions.\nMethods/Design: This 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants,\ninitially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under\ngeneral anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be\nconducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services\nacross the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of\nmotivational interviewing) delivered between enrolment and 6 weeks post-extraction, followed by directed\nprevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be\nthe dental caries experienced by 2 years post-enrolment at the level of dentine involvement on any tooth in either\ndentition, which had been caries-free at the baseline assessment.\nDiscussion: The participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of\nengagement with dental care makes the children and their families scheduled for extraction particularly difficult to\nrecruit to an RCT. Variations in service delivery between sites have also added to the challenges in implementing\nthe Dental RECUR protocol during the recruitment phase....
Background: Periodontal disease is a significant public health issue worldwide. Motivational techniques in\ncombination with financial incentives are shown to lead to effective behavior change. The current study\nsought to examine whether a brief oral health promotion program (self-management cues that were based\non self-efficacy and self-regulatory skills) in combination with an incentive (free dental treatment) would make a\ndifference in the adoption of regular dental flossing in a population of Indian periodontal disease outpatients.\nMethods: One hundred and twelve participants (n = 55 oral health promotion intervention group; n = 57 control\ngroup) were assigned to the intervention (self-management cues + incentive) or control groups, and follow-up\nassessments were performed three weeks later. Flossing frequency, behavioral intentions, and perceived self-efficacy\nserved as dependent variables. Data were analyzed with mixed models, ANCOVAs, and path analyses.\nResults: The intervention yielded effects on flossing frequency (p < 0.01) and flossing intentions (p < 0.01) at follow-up.\nWomen developed stronger intentions than men. Moreover, by path analysis a sequential mediation chain was found\nthat demonstrated an indirect effect of the intervention on flossing via self-efficacy and intentions: the intervention\npredicted changes in self-efficacy which, in turn, were associated with changes in intentions, predicting flossing\nfrequency at follow up, while controlling for baseline behavior, gender, and age.\nConclusions: Combining incentives with minimal self-management cues has been found effective in improving\ninterdental cleaning intentions and habits in periodontal disease patients, and the facilitating role of dental self-efficacy\nhas been demonstrated....
Background: The present study was conducted to prospectively assess the association between health-related\nquality of life (HRQoL) and the development of dental caries in adults in northern Sweden. The SF-36 questionnaire\nwas used to estimate HRQoL.\nMethods: Adults who had (i) participated in a population-based health screening in northern Sweden between\n2003 and 2009 and had completed the SF-36 questionnaire, and (ii) received a dental check-up within 1 year\n(n = 15,615) were included in the study. Of these, 9,838 had a second caries examination 2ââ?¬â??7 years after the baseline\nrecording. Information regarding SF-36, lifestyle factors and medical conditions was retrieved by questionnaires, and\nanthropometric status and blood lipid levels were measured. The association between dental caries (outcome) and\nSF-36 scores (exposure) with the inclusion of potential confounders was analysed by linear and logistic regression.\nResults: Caries increment increased significantly with decreasing scores for both physical and mental dimensions of\nSF-36 in women, but no association was seen in men. However, lifelong caries experience (DMFS) increased linearly with\ndecreasing physical HRQoL in both men and women; this was also observed for the single dimension of mental HRQoL.\nThe crude odds ratio for being in the highest caries quintile compared to the lowest when having the poorest physical\nHRQoL compared with the best physical HRQoL was 1.88 (95 % CI: 1.54ââ?¬â??2.3). Several factors were identified as potential\nconfounders in the associations between DMFS and SF-36 scores, including education level, smoking, age, medications,\nhigher levels of total cholesterol, triglycerides, systolic blood pressure, body mass index and sugar intake. Except for\neducation level and smoking, the effect sizes for the association between gradually decreasing SF-36 scores and\nincreasing caries were generally moderate.\nConclusions: Increased development of caries was associated with low physical HRQoL and some aspects of mental\nHRQoL. The mechanisms underlying these associations, which are likely confounded by both biological and lifestyle\nfactors, remain to be elucidated. The study implies that, when possible, subjects with poor HRQoL would benefit from\ncaries prevention measures meeting the underlying situation....
Background: Numerous strategies have been proposed to decrease orthodontic treatment time.\nPhotobiomodulation (PBM) has previously been demonstrated to assist in this objective. The aim of this study was\nto test if intraoral PBM increases the rate of tooth alignment and reduces the time required to resolve anterior\ndental crowding.\nMethods: Nineteen orthodontic subjects with Class I or Class II malocclusion and Littleââ?¬â?¢s Irregularity Index (LII) ââ?°Â¥\n3 mm were selected from a pool of applicants, providing 28 total arches. No cases required extraction. The test\ngroup (N = 11, 18 arches, 10 upper, 8 lower) received daily PBM treatment with an intraoral LED device (OrthoPulseââ??¢,\nBiolux Research Ltd.) during orthodontic treatment, while the control group (N = 8, 10 arches, 3 upper, 7 lower)\nreceived only orthodontic treatment. The PBM device exposed the buccal side of the gums to near-infrared light with\na continuous 850-nm wavelength, generating an average daily energy density of 9.5 J/cm2. LII was measured at the\nstart (T0) of orthodontic treatment until alignment was reached (T1, where LII ââ?°Â¤ 1 mm). The control group was mostly\nbonded with 0.018-in slot self-ligating SPEED brackets (Hespeler Orthodontics, Cambridge, ON. Canada), while\nconventionally-ligating Ormco Mini-Diamond twins were used on the PBM group (Ormco, Glendora, Calif. USA). Both\ngroups progressed through alignment with NiTi arch-wires from 0.014-in through to 0.018-in (Ormco), with identical\narch-wire changes. The rate of anterior alignment, in LII mm/week, and total treatment time was collected for both\ngroups. Cox proportional hazards models were used to compare groups and while considering age, sex, ethnicity, arch\nand degree of crowding.\nResults: The mean alignment rate for the PBM group was significantly higher than that of the control group, with an\nLII change rate of 1.27 mm/week (SD 0.53, 95 % CI Ã?± 0.26) versus 0.44 mm/week (SD 0.20, 95 % CI Ã?± 0.12), respectively\n(p = 0.0002). The treatment time to alignment was significantly smaller for the PBM group, which achieved alignment\nin 48 days (SD 39, 95 % CI Ã?± 39), while the control group took 104 days (SD 55, 95 % CI Ã?±19, p = 0.0053) on average.\nThese results demonstrated that intraoral PBM increased the average rate of tooth movement by 2.9-fold, resulting in a\n54 % average decrease in alignment duration versus control. The average PBM compliance to daily treatments was\n93 % during alignment.\nConclusions: Under the limitations of this study, the findings suggest that intraoral PBM could be used to decrease\nanterior alignment treatment time, which could consequently decrease full orthodontic treatment time. However, due\nto its limitations, further research in the form of a large, randomized trial is needed....
Background: Implant patients with congenitally missing teeth share some common charateristics and deserve\nspecial attention.\nMethods: The PICO question was ââ?¬Å?In patients with congenitally missing teeth, does an early occlusal rehabilitation\nwith dental implants in comparison to tooth autotransplants, conventional prosthetics on teeth or preservation of\ndeciduous teeth have better general outcomes in terms of survival, success and better patient centered outcomes\nin terms of quality of life, self-esteem, satisfaction, chewing function?ââ?¬Â\nAfter electronic database search, a total of 63 relevant studies were eligible, of which 42 qualified for numerical data\nsynthesis, 26 being retrospective studies. A data synthesis was performed by weighted means for survival/success/\nannual failure rates.\nResults: The mean survival of implants was 95.3 % (prosthesis survival 97.8 %), autotransplants 94.4 %, deciduous teeth\n89.6 %, and conventional prostheses 60.2 %. The implant survival in children, adolescents, and adults was 72.4, 93.0, and\n97.4 %. Annual failure rates of implants 3.317 %, autotransplants 1.061 %, deciduous teeth 0.908 %, and conventional\nprostheses 5.144 % indicated better results for natural teeth and more maintenance needs for the both prosthetic\ntreatments. The mean OHIP score was 27.8 at baseline and a mean improvement of 14.9 score points was reported after\nimplant prosthetics. The mean satisfaction rates were 93.4 (implants), 76.6 (conventional prostheses), 72.0\n(autotransplants), and 65.5 % (orthodontic space closure).\nConclusions: In synopsis of general and patient-centered outcomes, implants yielded the best results,\nhowever, not in children <13 years. Autotransplants and deciduous teeth had low annual failure rates and are\nappropriate treatments in children and adolescents at low costs. Conventional prosthetics had lower survival/\nsuccess rates than the other options. Due to heterogeneity and low number of studies, patient-reported\noutcomes in this review have to be interpreted with caution....
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