International journal of dental hygiene最新文献

Purpose: In 2019, Thames Valley & Wessex dental directorate, National Health Service England, South East (TV&W NHSE), launched a 'Return to Therapy' (RTT) scheme. This was aimed at dental therapists who had not used their full scope of practice for an extended period. A service evaluation was undertaken in 2023 to determine if the schemes (2019, 2021) were fit for purpose and met the needs of participants.

Methods: Semi-structured interviews were undertaken using a grounded theory methodology and thematic analysis. Interviews were conducted with a group of RTT participants and educational supervisors. Transcripts were analysed in accordance with the principles of thematic analysis by Braun and Clarke.

Results: At the start of the programme, participants identified low confidence levels in a range of clinical procedures, and this was a motivating factor in their undertaking of the course. On completion of the scheme, all participants reported improvement in confidence, skillset, and safety, but expressed the need for more exposure to paediatric extractions. On completion, 50% of participants were successful in securing employment as a dental therapist using their full scope of practice, whereas the remaining 50% reverted to providing periodontal treatment only. Educational supervisors reported an increased understanding of the scope of practice of a dental therapist for themselves and their teams.

Conclusion: Return to Dental Therapy schemes enable workforce development, job satisfaction, and skill mix. Further development of the educational and clinical programme is needed to address knowledge gaps and improve confidence in providing clinical procedures, and recommendations have been made.

Research aim: To determine if dental care professionals working in National Health Service (NHS) practices are more at risk of stress, wellbeing concerns and burnout than their private practice counterparts.

Introduction: In dentistry, stress, anxiety, and wellbeing concerns have been apparent for many years with burnout and poor mental health in dental registrants being described as early as the 1980s.

Methodology: An online platform-based questionnaire was used to administer the chosen scales. Data from 201 participants were analysed (N = 201). The sample consisted of 31 dental nurses and 170 dental hygienists and dental therapists.

Results and conclusions: A one-way multivariate analysis of variance (MANOVA) determined that there was no statistically significant difference between private and mixed practice dental professionals on the combined scales F (3, 190) = 0.76, p = 0.59, Wilks Lambda = 0.97, partial eta squared = 0.12. Dental hygienists, dental therapists and dental nurses working in mixed private and NHS dentistry are not more susceptible to stress, wellbeing issues and anxiety than their private counterparts according to the data set. This suggests that there are other factors associated in the mental health concerns of registered dental care professionals raised by the literature examined. The feelings and frustrations of dental registrants are likely to have lasting consequences for the provision of dentistry if working practices and hierarchical conditions do not improve patient access to both private and NHS dentistry. More research into the stress, wellbeing and burnout levels across dental registrants would be beneficial to explore the effects on the entire dental team, with a focus on solely working in NHS provision.

Oral dryness is common in persons with untreated obstructive sleep apnoea (OSA) as well as in those using positive airway pressure (PAP). OSA with or without PAP treatment could therefore be a risk factor of dental caries.

Objectives: To describe and compare the prevalence of dental caries among persons with or without PAP-treated OSA.

Methods: Cross-sectional data derived from a clinical examination of 121 adults without OSA, and with or without long-time experience of PAP treated OSA (> 10 years) were used. The participants responded to a questionnaire and were clinically and radiographically examined. Decayed, missing, and filled teeth, decayed surfaces, gingivitis and presence of dental plaque were registered. Descriptive analyses were performed to describe dental caries prevalence among groups. To compare groups, one-way ANOVA and Kruskal-Wallis tests was conducted.

Results: Participants (52% females, mean age 69.5 ± 5.8 years) were categorised into groups based on OSA status; non-OSA (n = 49), non-PAP-treated OSA (n = 38), and PAP-treated OSA (n = 34). Dental caries prevalence showed no statistically significant differences among groups, except for occlusal caries, where the PAP-treated OSA group had a higher mean compared to the non-OSA group (p = 0.033). Most participants did not report xerostomia, but the highest prevalence was found in the non-PAP-treated OSA group (31.6%).

Conclusions: The prevalence of dental caries was slightly higher in persons with PAP treated OSA compared to non-PAP-treated OSA and persons without OSA, but the results were not statistically significant.

Background: Amidst numerous recent advancements in toothpaste formulations and active ingredients, some clinicians may believe all toothpastes are similar despite differences in their active ingredients and corresponding clinical application.

Aim: This umbrella review aims to provide clinicians with an overview of toothpaste ingredients and evidence of efficacy for a variety of oral conditions, including gum health issues, caries, dentine hypersensitivity, tooth surface loss, oral malodour and tooth whitening (staining).

Methods: The focused question for the review was 'What is the efficacy of common toothpaste active ingredients in preventing or treating oral conditions including gum health issues, caries, dentine hypersensitivity, tooth surface loss, oral malodour and tooth whitening (stain removal)?'. Therefore, an umbrella review design was followed focused on review articles, that is, systematic and/or narrative reviews of randomised clinical trials, observational or in vitro studies whenever available. Seventy-two reviews were identified through electronic search of OVID. Quality assessment was performed based upon the PRISMA checklist. Data was extracted according to relevance to the listed oral conditions.

Results: Nineteen toothpaste ingredients were identified to treat six oral conditions, including six types of fluoride. Evidence of efficacy of active ingredients varied and with six reported to have significant benefits for the prevention or treatment of the targeted oral condition. Differences were particularly evident in the efficacy of types of fluoride.

Conclusions: Toothpaste active ingredient efficacies are diverse. As such, oral healthcare providers should consider recommendation of toothpastes containing appropriate active ingredients by effectively targeting oral conditions/diseases according to each patient's needs.

Objectives: To evaluate the effects of verbal and video-based oral hygiene instructions (OHIs) on the improvement of the oral hygiene status (OHS) in children of different age groups in the mixed dentition period.

Methods: In total, 202 children aged 6-9 and 10-12 years (n = 101 each) were included. Before providing the OHIs, the baseline OHS was determined using the Simplified Oral Hygiene Index (OHI-S). From each age group, approximately half of the participants were randomly assigned to the verbal (n = 50 and n = 51 from the 6-9-year and 10-12-year age groups, respectively) or video-based (n = 51 and n = 50 from the 6-9-year and 10-12-year age groups, respectively) OHI groups. Children were recalled after 30 days and post-instruction OHI-S were recorded. Data were analysed using Shapiro-Wilk, Mann-Whitney U, and Wilcoxon signed-rank tests. The statistical significance level was set at 5%.

Results: For both OHI methods, no significant difference was found between the age groups in terms of the OHI-S at both the pre- and post-instruction timepoints (verbal OHIs: p = 0.354, p = 0.860 and video-based OHIs: p = 0.174, p = 0.632, respectively). In both age groups, a significant difference was found between the baseline (pre-) and post-instruction OHI-S for both OHI methods (p < 0.001); the post-instruction OHS was found to be better than the pre-instruction OHS. In both age groups, video-based OHIs resulted in a significantly higher improvement in the OHS, compared with verbal OHIs (p = 0.004 and p < 0.001, respectively).

Conclusion: OHIs are effective in improving the OHS of children. In addition, video-based education is preferable to verbal instruction for improving the OHS of children.

Trial registration: ClinicalTrials.gov identifier: NCT06449950.

Objective: The aim of this systematic review is to explore the effectiveness of different methods of reducing contamination and biofilms in dental unit waterlines (DUWLs) and to provide reference for future standardisation of disinfection practices in dental clinic.

Methods: This systematic review searched PubMed and Web of Science databases for DUWL disinfection studies from 2013 to 2023, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Synthesis Without Meta-analysis, additional extracting relevant data based on predefined inclusion and exclusion criteria.

Results: The study review identified 8442 articles, with 58 included after rigorous screening. Disinfection methods for DUWLs were categorised into 14 physical and 90 chemical methods. Peroxides, chloramine-based, and biguanide methods were frequently used, often in combination. The effectiveness of these methods varied; for instance, phenolic was effective, while alcohol was not, in reducing bacterial and biofilm contamination. Biguanide, when used alone or combined with chlorine-based or alcohol, showed mixed results. Chlorine-based methods, particularly when combined with quaternary ammonium salt or enzymes, were generally effective. Enzymes and iodophor also demonstrated efficacy, though with some inconsistencies. Mechanical systems, peroxides, quaternary ammonium salts, silver, and tube coatings had varying degrees of success. Other innovative methods, such as Aloe vera and slightly acidic electrolysed water, showed promise in some studies, but the effectiveness of flushing was questioned. This comprehensive analysis highlights the diversity and complexity of disinfection strategies for DUWLs.

Conclusion: Future studies should focus on how material composition and tubing design affect biofilm development and the effectiveness of disinfection methods to guide the design of advanced dental units.

Aim of the study: The aim of the study is to investigate the effectiveness of virtual reality (VR) in mitigating pain associated with dental scaling procedures. Furthermore, the study aims to evaluate individuals' tolerance levels to VR during dental scaling sessions.

Materials and methods: A randomised split-mouth design study was conducted on 29 systemically healthy adult patients aged 18 years and above. Dental scaling was performed in two quadrants while wearing VR glasses, with the remaining quadrants undergoing the procedure without VR. The sequence of procedures was determined by random allocation. Patients were provided with VR glasses loaded with a mobile phone. After the procedure, patients were asked to complete a VR questionnaire. The primary outcome variables included pain scores with and without VR, while secondary variables included VR experience scores, baseline heart rate (HR), difference in HR, systolic blood pressure (BP), diastolic BP, difference in systolic BP, and difference in diastolic BP.

Results: All 29 subjects successfully completed the study. Paired analysis of outcome variables with and without VR glasses revealed a statistically significant difference in pain scores (two-tailed p < 0.001). Additionally, a strong positive correlation was observed between VR experience score and difference in pain score (γ = 0.78, p < 0.001). While positive correlations between modified dental anxiety scale (MDAS) score and pain scores were observed, they were not highly significant (without VR: γ = 0.31 p = 0.097, with VR: γ = 0.34 p = 0.072).

Conclusions: The VR environment significantly diminished pain perception during dental scaling. Participants who experienced the VR setting more positively reported an even greater decline in pain scores, highlighting the profound impact of immersive technology on patient comfort.

Objective: This study was conducted to identify changes in the personal protective equipment (PPE)-wearing behaviour of dental staff after the coronavirus disease (COVID-19) outbreak in Korea.

Methods: This study used a self-administered questionnaire for 257 dental staff (dentists, dental hygienists and other assistants) in regions of Korea. The questionnaire investigated the change in the frequency of wearing of PPE after COVID-19 (masks, gloves, goggles, face shields and protective clothing), and the PPE change cycle of dental staff compared with that before COVID-19.

Results: In the case of masks, if there was an infection control manager, the change in wearing was 4.583(1.658-12.667) times higher. In case of goggles and face shields, those with infection control education experienced a 2.982(1.087-8.178) increase in wearing these. Regarding protective clothing, it was 3.831(1.537-9.553) times higher when there was an infection control manager and it was 3.103(1.481-6.504) times higher when there was a visit to a patient with confirmed COVID-19.

Conclusions: It is necessary to prepare guidelines for wearing PPE in consideration of the type of infectious disease and the institution's characteristics, to periodically conduct infection control education to maintain this state of alert, and to prepare for personal protection to prevent the spread of new infectious diseases.

Objective: In this clinical study, chlorhexidine gluconate (CHX) was chosen as the positive control group, and the clinical and biochemical efficacy of mouthwashes with green tea, white tea and essential oil (EO) as the active ingredients were aimed to be examined comprehensively.

Methods: A total of 112 participants with gingivitis were randomly assigned to four different groups and different mouthwashes were used for 4 weeks: CHX-MW group (as a positive control group), EO-MW group, GT-MW group and WT-MW group. The effects of the mouthwashes on plaque, inflammation and dental staining were evaluated by indexed scores at the beginning and 4th week. Markers related to gingival inflammation and oxidative stress were evaluated on samples from the gingival crevicular fluid.

Results: In the 4th week, significant improvements in clinical parameters were found in all groups (p < 0.05) with the more pronounced improvement in the CHX-MW group (p < 0.05). However, only the CHX caused a significant discolouration of both teeth and tongue (p < 0.05). The levels of IL-1β and MMP-8 were found to be lower in all groups compared to the first measurements (p < 0.05). Furthermore, the antioxidant effect of EO mouthwash was found significantly low compared to the other three mouthwashes (p < 0.05).

Conclusion: Green and white tea extracts provided clinical benefits in the short term (1 month) with no statistical difference from each other and mouthwash with EO as the active ingredient while they provided a lower clinical benefit compared to CHX. Products with tea as the active ingredient may be an alternative to EO mouthwash for short-term and long-term use.

Objective: To evaluate the efficacy of subgingival erythritol powder air polishing (EPAP) for inducing initial healing of shallow-to-moderate periodontal pockets and its effect on gingival crevicular fluid (GCF) β-catenin, 8-hydroxy-deoxyguanosine (8-OHdG) and total antioxidant capacity (TAC) levels.

Methods: This randomised, split-mouth clinical trial involved 22 periodontitis patients. Periodontal pockets (4-6 mm) were treated either by scaling and root planing (control) or EPAP followed by subgingival instrumentation 1 month later (test). Clinical periodontal variables were recorded, and GCF samples were collected from the selected sites at baseline, week 4 and week 12 visits. The GCF levels of β-catenin, 8-OHdG and TAC were estimated via enzyme-linked immunosorbent assay (ELISA).

Results: Compared with those at baseline, both groups showed non-different significant reductions in clinical variables at week 4 and week 12 after treatment. GCF β-catenin and 8-OHdG levels at both the test and control sites significantly decreased at week 4 and continued to further decrease at week 12. A greater reduction in GCF β-catenin was detected at the control sites at the week 12 visit. Conversely, GCF TAC was only significantly increased at week 12 in both groups, but the difference between the groups was not significant.

Conclusion: Using of EPAP has the potential to induce initial healing in shallow-to-moderate pockets as it offers non-different changes in clinical outcomes and GCF biomarkers compared to conventional method.

Trial registration: ClinicalTrials.gov identifier: NCT05798871.