International journal of dental hygiene最新文献

Objectives: In the United Kingdom (UK), Dental Hygienists (DHs) and Dental Therapists (DTs) are required by the UK's regulatory body, the General Dental Council, to "… be appropriately supported when treating patients". However, what is deemed 'appropriate support', and the need for that support, has been 'open to interpretation', and consequently, the support dental business owners provide for the DHs and DTs they employ or contract varies. The objective of this perspective is to initiate a discourse within the international community in order to gain a deeper appreciation regarding the matter of Dental Nurse (DN) chairside support for DHs and DTs beyond the UK.

Methods: The British Society of Dental Hygiene and Therapy (BSDHT) canvassed its members, inviting voluntary, anonymous statements to reflect their real-world experiences, both positive and negative, of working with or without DN chairside support in their roles. The statements from a sample of the membership were subsequently subjected to qualitative thematic analysis.

Results: The analysis revealed three themes: (1) Competency Factors; (2) Conduct Factors and (3) Contextual Factors. These thematic outcomes were congruent with the General Dental Council's Risk in Dentistry Report (2014).

Conclusions: The discussion elucidates the complexity of the matter of DN chairside assistance for DH and DT BSDHT members. The authors of this perspective welcome dialogue from our international colleagues regarding how DN chairside support for both DHs and DTs is of benefit to them and impacts their clinical role.

Introduction: The first signs of mental health issues in dentistry manifest as early as undergraduate training, thus it is essential to delve into the concept of resilience to equip those studying and working in dentistry with the resources to cultivate a positive mindset.

Materials and methods: A focus group was conducted with a homogenous purposive sample of eight undergraduate dental profession students from all 3 years of study at the University of Portsmouth Dental Academy (UPDA). The six-phase Braun and Clarke's thematic analysis was adopted to interpret patterns in data.

Results: Four themes of: 'definition of resilience'; 'factors enhancing resilience'; 'factors challenging resilience' and 'developing resilience in dentistry'; and 23 subthemes were identified. Students defined resilience as an ability to bounce back from adversity and perceived it as a dynamic and contextual phenomenon that fluctuated due to an interplay of personal, social and environmental factors.

Conclusion: The findings of this study showed undergraduate dental profession students' perceptions of resilience, factors influencing it and strategies to develop it. These findings may inform the curriculum of resilience training programmes targeted towards this population.

Introduction: Anecdotally, it is currently accepted that many dental hygienists and dental therapists in the UK do not work consistently, if at all, to their full scope of practice, as determined by the General Dental Council and in line with their pre-registration training and post-qualification continuing professional development.

Aim: Consider the professional demographics of the BSDHT and investigate the types of clinical skills that are being utilised in a particular setting, in addition to the members' usual daily practice, how consistently they are employing them, and any potential barriers and facilitators for working consistently to a full scope of practice.

Method: BSDHT members (n = 2487) were invited to complete an online questionnaire and take part in an individual 30-min semi-structured online interview with the investigator. The quantitative data was collected on a master Excel spreadsheet, and qualitative data following the interviews were available as digital recordings and AI transcripts.

Results: The response rate was 12.5% (n = 312), of which 64% (n = 200) were dental hygienists and 36% (n = 112) dental therapists: 70% (n = 19) of the dental hygienists who work in an NHS practice never work to their full scope, in comparison to 48% (n = 9) of dental therapists. Of those that would like to work to their full scope, 51% (n = 103) were dental hygienists and 31% (n = 35) were dental therapists. Of the 312 members who responded to the questionnaire, 24.7% (n = 77) indicated that they would be willing to take part in the online semi-structured interviews.

Conclusion: The skills of dental hygienists and dental therapists are often underutilised across all dental practice settings. However, dental therapists are more likely than dental hygienists to work to their full scope of practice in both NHS and mixed dental practice settings. Further studies are needed to investigate and understand the barriers that prevent all dental hygienists and dental therapists from working to their full scope of practice and identify possible facilitators that could offer greater opportunities.

Objectives: To describe the prevalence, extent and severity of periodontitis in an adult Norwegian population, using the 2017 EFP/AAP and CDC/AAP case definitions, and their associations with potential risk factors for periodontitis. A secondary aim was to explore how the stage and grade of periodontitis shifted when complexity and risk factors were added.

Material and methods: A subsample of participants (≥ 40 years, n = 21,083) in a cross-sectional health study (Tromsø7, 2015-2016) was invited to an oral health examination (n = 3946). Radiographic bone loss and four site measurements of periodontal probing depth (PPD) and bleeding on probing were recorded for 3701 adults.

Results: According to EFP/AAP, 89% of participants had periodontitis (21% stage III-IV), while 74% had periodontitis defined by CDC/AAP (12% severe periodontitis). Five percent of stage III/IV cases and 22% of severe cases had generalised disease. Higher age, frequent use of dental care, smoking and higher body mass index were associated with periodontitis for both definitions. PPD contributed to a shift to more severe stages. Smoking contributed the most to the shifting of grade, with 7% of cases shifting to grade C.

Conclusions: Periodontitis was highly prevalent according to both case definitions. Associations with known risk factors remained relatively consistent between the two case definitions. Complexity and risk factors played a significant role in the shifting of stage and grade of periodontitis.

Objective: To provide an updated narrative review of current concepts relative to the impact of female hormones on the periodontium throughout the life stages of the female patient. To analyse the implications for the clinician and to amalgamate the main findings from a wide range of empirical studies and theoretical perspectives.

Method: Narrative review of the literature synthesising the findings of an extensive collection of literature, published between 2000 and 2024, retrieved from searches of computerised databases, hand searches, authoritative texts and personal communication. Earlier citations outside of the reference range are used to provide historical background to current opinion. The subjects included oestrogen, progesterone, testosterone, puberty, menstruation, contraception, pregnancy, menopause, and periodontal disease, periodontium, inflammation, and the inflammatory cascade.

Results: Drawing from an extensive collection of literature, this review offers insights into the dual function of oestrogen, progesterone, and testosterone in mediating inflammatory and anti-inflammatory responses to local factors, primarily plaque biofilm, and the regulation of the inflammatory cascade. These responses differ between the life stages of puberty, menstruation, contraception, pregnancy, and menopause.

Conclusions: Key findings demonstrate that hormone fluctuations have a direct and indirect impact on the periodontium, altering the bacterial flora of plaque biofilm to a composition more conducive to the development of periodontal disease and modifying the tissue response to local factors, producing anatomic changes in the gingivae that compromise the periodontium and influencing the regulation of the inflammatory cascade. These factors increase the risk of periodontal disease and susceptibility to other oral conditions associated with female hormone fluctuations.

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.