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Oral health assessment of newly diagnosed oncology patients—Who are we missing? 新确诊肿瘤患者的口腔健康评估--我们漏掉了谁？
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-09-05 DOI: 10.1111/ipd.13246
L. Roocroft, C. Dixon, A. Shepherd, C. Hood
<p>An estimated 1:500 children are diagnosed with cancer each year.<span><sup>1</sup></span> When assessed on a global scale, there is a higher incidence of childhood cancer in countries of a high human development index (HDI), compared to that of a low development index (LDI).<span><sup>2</sup></span></p><p>In the UK, all children are treated at designated specialist Principal Treatment Centres (PTC), including Royal Manchester Children's Hospital (RMCH), to standardise clinical care and follow-up.<span><sup>3</sup></span> Approximately 120 new malignant disease diagnoses are seen per year at RMCH from across the region, all of whom require a range of treatment modalities including chemotherapy, radiotherapy, proton beam therapy, stem cell transplant and surgical management.<span><sup>4</sup></span></p><p>The Royal College of Surgeons England has recommended that all children diagnosed with cancer should have access to dental care, including a full initial assessment with radiographs at time of diagnosis, before commencement of treatment.<span><sup>4</sup></span> Paediatric dental units working with oncology centres should have a mechanism of notification for new patients.<span><sup>5</sup></span></p><p>During oncology treatment, oral care can become neglected with changes in oral health routines, particularly for children undergoing inpatient treatments.<span><sup>6</sup></span> Additional nutritional intake requirements and oral manifestations such as mucositis and opportunistic infections further impact oral health and increase caries risk. Poor oral health can adversely impact oncology treatment, increasing morbidity risk and length of inpatient hospital stays.<span><sup>3</sup></span> Furthermore, long-term oral complications following curative cancer treatments may require specialist-led care for oral rehabilitation in future.</p><p>Following an urgent general anaesthetic procedure for a child receiving cancer treatment with severe dental decay, it became apparent that not all newly diagnosed oncology patients at RMCH were referred for a baseline dental assessment at time of diagnosis. Analysis of the previous month highlighted multiple urgent ward visits for dental assessments for patients in pain who were unknown to the department and had not seen a dental practitioner for assessment prior to commencing cancer treatment. This highlighted a clinical need to improve dental care for this cohort, and thus provided stimulus for this quality improvement project which was conducted using the Plan-Do-Study Act (PDSA) model.</p><p>Improvements were made in each PDSA cycle for referral of children to the DHU at the point of cancer diagnosis, with an overall improvement of 48%. With 90% (<i>n</i> = 36) of children referred in Cycle 3, this improvement was felt to be supported by the integration of direct electronic referral into the new Trust wide electronic record system (Epic™). Previous cycles required an electronic document referral to be sent
2 在英国，所有儿童都在指定的专科主要治疗中心（PTC）接受治疗，包括曼彻斯特皇家儿童医院（RMCH），以实现临床治疗和随访的标准化。3 曼彻斯特皇家儿童医院每年接诊来自该地区的约 120 名新恶性疾病患者，他们都需要接受一系列治疗，包括化疗、放疗、质子束疗法、干细胞移植和外科手术治疗。英国皇家外科学院建议，所有被诊断患有癌症的儿童在开始治疗前都应获得牙科护理，包括在确诊时进行全面的初步评估并拍摄X光片。口腔健康状况不佳会对肿瘤治疗产生不利影响，增加发病风险和住院时间。3 此外，癌症根治性治疗后的长期口腔并发症将来可能需要口腔康复方面的专科护理。在对一名患有严重蛀牙的接受癌症治疗的儿童进行紧急全身麻醉手术后，我们发现 RMCH 医院并非所有新诊断的肿瘤患者在确诊时都接受了基线牙科评估。对上个月的分析显示，有多名疼痛患者紧急前往病房进行牙科评估，而这些患者在开始接受癌症治疗之前并不认识该部门，也没有见过牙科医生进行评估。这突显出临床上需要改善对这部分患者的牙科护理，从而推动了采用 "计划-实施-研究"（Plan-Do-Study Act，PDSA）模式开展的质量改进项目。在第 3 个周期中，90%（n = 36）的患儿被转诊，这一进步得益于将直接电子转诊整合到新的全信托电子记录系统（Epic™）中。在第二周期之后，我们实施了一套交叉核对系统，由肿瘤科团队每月提供一份新诊断患者的数字名单。这使 DHU 能够对患者进行核对，找出那些被遗漏的患者，并强调那些需要转诊的患者。此后，我们与肿瘤科团队密切合作，宣传口腔健康基线预防和评估的重要性，以改善这一人群的口腔健康状况。第一周期是在 COVID-19 大流行初期进行的，由于临床工作人员的能力和可用性降低，影响了转诊分流的数量。因此，最初接受牙科评估的转诊比例并不理想。接下来的周期显示，转诊儿童中被分流并获得牙科评估预约的比例有所增加，回顾性数据分别为 90%（n = 26）和 94%（n = 34）。由于每个周期的儿童人数较少，因此在绝对值变化相对较小的情况下，百分比变化却很大。因此，尽管这是一种最佳做法，但要 100%实现既定目标仍具有挑战性。在为期 3 年的项目中，转诊到 DHU 的儿童中约有四分之一有积极的治疗需求，其中三分之一的儿童需要牙科全身麻醉。通常情况下，口腔健康团队与 PTC 是分开的，进一步开展跨医疗学科的合作项目有助于进一步整合患者护理，让口腔回归身体。随着肿瘤团队转诊到口腔科的病人越来越多，口腔科正在努力确保 "迷你口腔护理计划 "得到有效利用。迷你口腔护理计划 "的原则将有助于加强各医疗部门的口腔健康宣传，确保为患者提供全面的护理，并确保在需要时转介适当的牙科人员进行基线评估。我们部门的目标是将口腔健康筛查扩展到其他医疗专科。
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引用次数: 0
Virtual clinics in paediatric dentistry 儿童牙科虚拟诊所。
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-09-05 DOI: 10.1111/ipd.13245
Alexandra Lyne, Joe Noar
<p>During the COVID-19 pandemic, the National Health Service (NHS) had to adapt and innovate in ways to provide clinical care. A traditional healthcare model, where patients travel to a clinical building for their care, or a clinician travelled to the patients' home, was not possible. Instead, many Trusts established or expanded virtual ways of providing care; the patient and clinician connect remotely, via telephone, video call, or written communication.</p><p>Beyond the pandemic, virtual clinics and wards have become a routine part of NHS healthcare, with benefits for patients, staff, and the environment.<span><sup>1</sup></span></p><p>Dental procedures cannot be carried out virtually, so in this paper we refer to appointments that are for assessment, treatment planning, or review. In the speciality of paediatric dentistry, where patients have rapidly evolving dentitions and undergo rapid change, there is a high need for these types of appointments.</p><p>The aim of this paper is to highlight different formats of virtual clinics that are relevant to the field of paediatric dentistry, using example cases and quality improvement data from the virtual clinics at the Eastman Dental Hospital.</p><p>Virtual clinics can take many forms, and the value of different clinic types may depend on the case-mix for each paediatric dentistry service. All virtual clinics can be conducted in a clinical room, in a non-clinical room, or remotely.</p><p>For any appointment or interaction, appropriate patient documentation will need to be completed, such as clinical notes, letters, requesting follow up appointments, coding, and recording the referral-to-treat outcome. The authors also suggest asking parents to send in patient photographs in advance of a virtual clinic, as this aids the diagnostic value of the appointment.</p><p>For the sake of simplicity, the term ‘parent’ is used to refer to the adult most likely to accompany the patient and have parental responsibility. This is not the case for every patient, and so the term ‘parent’ should be substituted with the appropriate adult(s) for each child or young person.</p><p>Virtual working can have benefits for patients, parents, and staff. They are also associated with less costs both financially and environmentally. Admittedly, except for A&G, they require a similar amount of time as face-to-face appointments.</p><p>When planning a virtual clinic, a clear standard operating procedure should be written, and all stakeholders included to identify the important issues to be managed. This could include personnel, funding, administrative support, as well as the physical location and hardware required to run the virtual service. Each part of the pathway should be assessed from referrer to clinician to hospital capacity. The virtual service must fit in with the existing clinical service, recognising the clinical and administrative time needed.</p><p>Once this is in place, then clear guidance should be produced so that
在 COVID-19 大流行期间，国家医疗服务系统（NHS）不得不调整和创新提供临床护理的方式。传统的医疗保健模式，即病人前往临床大楼接受治疗，或临床医生前往病人家中，是不可能实现的。相反，许多信托机构建立或扩大了提供医疗服务的虚拟方式；病人和临床医生通过电话、视频通话或书面交流进行远程联系。除了大流行病之外，虚拟诊所和病房已经成为英国国家医疗服务体系医疗服务的常规部分，对病人、员工和环境都有好处。在儿童牙科这一专业领域，患者的牙齿状况发展迅速，变化也很快，因此非常需要这些类型的预约。本文旨在利用伊士曼牙科医院虚拟诊所的案例和质量改进数据，重点介绍与儿童牙科领域相关的虚拟诊所的不同形式。虚拟诊所可以有多种形式，不同诊所类型的价值可能取决于每个儿童牙科服务的病例组合。所有虚拟诊所都可以在临床诊室、非临床诊室或远程进行。对于任何预约或互动，都需要完成适当的患者文件记录，如临床笔记、信件、要求后续预约、编码和记录转诊到治疗的结果。作者还建议请家长在虚拟门诊前发送患者照片，因为这有助于提高预约的诊断价值。为简单起见，"家长 "一词指的是最有可能陪伴患者并承担家长责任的成年人。并非每位患者都是如此，因此 "家长 "一词应替换为每位儿童或青少年的适当成年人。虚拟工作对病人、家长和员工都有好处，而且在经济和环境方面的成本都较低。诚然，除 A&G 外，虚拟工作所需的时间与面对面预约的时间相近。这可能包括人员、资金、行政支持以及运行虚拟服务所需的物理位置和硬件。应评估从转介人到临床医生再到医院能力的路径的每个部分。虚拟服务必须与现有的临床服务相适应，并认识到所需的临床和行政时间。一旦准备就绪，就应制定明确的指南，以便所有利益相关者了解服务的目的、目标、限制和成果。与提供面对面门诊需要训练有素的护理人员一样，准备、预约和处理虚拟门诊也需要训练有素的行政人员。这需要所有利益相关者的参与，并对所有相关人员进行培训。以下是任何考虑采用虚拟工作方式的儿童牙科服务的一些主要注意事项。就虚拟诊所而言，与任何类型的服务设计或开发一样，质量改进方法的设计应旨在评估虚拟诊所的成功，并推动变革。表 2 展示了虚拟诊所可采用的一些有用的质量改进工具和成果。如果规划得当，虚拟诊所可以使患者、家属、员工、成本和环境受益。虚拟诊所有许多不同的形式，与任何新兴服务一样，可以通过质量改进方法对其进行评估和改进。
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引用次数: 0
From the editor 编辑的话
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-09-05 DOI: 10.1111/ipd.13244

I am pleased to share with you this 4th edition of the BSPD Quality Improvement Briefing, which includes a collection of novel quality improvement projects in paediatric dentistry. This year's invited article on ‘Virtual clinics in paediatric dentistry’ has been authored by two leading innovators and experts in the area: Alexendra Lyne and Joe Noar. This excellent paper will provide a practical guide to setting up virtual clinics and advise on the use of quality improvement projects to continuously improve the standard of patient care in this format.

Once again, I am grateful to the many authors who submitted papers on a range of topics demonstrating their commitment to quality improvement. My heartfelt thanks to all our reviewers who kindly provided their time and expertise to deliver a comprehensive peer review for the papers submitted: Clarissa Dale, Carly Dixon, Chris Donnell, Maryam Ezzeldin, Julia Hurry, Clare Hutchison, Shrita Lakhani, Jessica Large, Emma Morgan, Rachel Osborne, Charlotte Schofield, Jessica Talbot, Laura Timms, Chris Wallace and Scott Wright.

I am thankful to my deputy editor Armaana Ahmad and assistant editor Claudia Heggie for their continued enthusiasm, support and commitment; producing this publication is truly a team effort. As my term as the editor if the Quality Improvement Briefing now comes to an end, I wish Armaana every success as she takes on this role. I am confident that the publication will continue to flourish and develop under her leadership in the coming years.

I hope you find enjoyment and value in reading this edition of the Quality Improvement Briefing.

IN THIS ISSUE

1. Virtual clinics in paediatric dentistry

Alexandra Lyne & Joe Noar

2. Oral health assessment of newly diagnosed oncology patients—Who are we missing?

L. Roocroft, C. Dixon, A. Shepherd & C. Hood

3. Improving dental trauma management in primary care: A team-based approach

V. Stevens

4. Dental screening pathway for paediatric nephrology patients: A service development and evaluation

C. K. Wallace & V. Hind

5. Development of a virtual orthodontic advice pathway in a community dental service

J. Zhao, D. Rosentha, J. Tomson, H. Patel & A. Ahmad

Editor: Cheryl Somani

Deputy Editor: Armaana Ahmad

Assistant Editor: Claudia Heggie

我很高兴与大家分享第四期《BSPD 质量改进简报》，其中包括一系列新颖的儿童牙科质量改进项目。今年的特邀文章 "儿童牙科虚拟诊所 "由该领域的两位领先创新者和专家撰写：Alexendra Lyne 和 Joe Noar。这篇优秀论文将为建立虚拟诊所提供实用指南，并就如何利用质量改进项目来不断提高这种形式的患者护理水平提出建议。我再次感谢许多作者提交了各种主题的论文，这表明了他们对质量改进的承诺。我衷心感谢所有审稿人，他们付出了宝贵的时间和专业知识，对所提交的论文进行了全面的同行评审：Clarissa Dale、Carly Dixon、Chris Donnell、Maryam Ezzeldin、Julia Hurry、Clare Hutchison、Shrita Lakhani、Jessica Large、Emma Morgan、Rachel Osborne、Charlotte Schofield、Jessica Talbot、Laura Timms、Chris Wallace 和 Scott Wright。我非常感谢我的副主编阿尔马纳-艾哈迈德（Armaana Ahmad）和助理编辑克劳迪娅-赫吉（Claudia Heggie），感谢他们一如既往的热情、支持和奉献；出版这本刊物确实是一个团队的努力。我作为《质量改进简报》编辑的任期即将结束，我祝愿阿尔玛娜在担任这一职务时一切顺利。我相信，在她的领导下，本刊物在未来几年将继续蓬勃发展。 本期内容 1.儿童牙科的虚拟诊所 Alexandra Lyne & Joe Noar 2.新诊断肿瘤患者的口腔健康评估--我们漏掉了谁？ L. Roocroft, C. Dixon, A. Shepherd & C. Hood 3.改善初级保健中的牙科创伤管理：以团队为基础的方法 V. Stevens 4.儿科肾病患者的牙科筛查路径：C. K. Wallace & V. Hind 5.在社区牙科服务中开发虚拟正畸建议路径 J. Zhao, D. Rosentha, J. Tomson, H. Patel & A. Ahmad Editor：Cheryl SomaniDeputy Editor：副主编：Armaana Ahmad 助理编辑：Claudia Heggie克劳迪娅-赫吉
{"title":"From the editor","authors":"","doi":"10.1111/ipd.13244","DOIUrl":"https://doi.org/10.1111/ipd.13244","url":null,"abstract":"<p>I am pleased to share with you this 4th edition of the BSPD Quality Improvement Briefing, which includes a collection of novel quality improvement projects in paediatric dentistry. This year's invited article on ‘Virtual clinics in paediatric dentistry’ has been authored by two leading innovators and experts in the area: Alexendra Lyne and Joe Noar. This excellent paper will provide a practical guide to setting up virtual clinics and advise on the use of quality improvement projects to continuously improve the standard of patient care in this format.</p><p>Once again, I am grateful to the many authors who submitted papers on a range of topics demonstrating their commitment to quality improvement. My heartfelt thanks to all our reviewers who kindly provided their time and expertise to deliver a comprehensive peer review for the papers submitted: Clarissa Dale, Carly Dixon, Chris Donnell, Maryam Ezzeldin, Julia Hurry, Clare Hutchison, Shrita Lakhani, Jessica Large, Emma Morgan, Rachel Osborne, Charlotte Schofield, Jessica Talbot, Laura Timms, Chris Wallace and Scott Wright.</p><p>I am thankful to my deputy editor Armaana Ahmad and assistant editor Claudia Heggie for their continued enthusiasm, support and commitment; producing this publication is truly a team effort. As my term as the editor if the Quality Improvement Briefing now comes to an end, I wish Armaana every success as she takes on this role. I am confident that the publication will continue to flourish and develop under her leadership in the coming years.</p><p>I hope you find enjoyment and value in reading this edition of the Quality Improvement Briefing.</p><p>\u0000 <b>IN THIS ISSUE</b>\u0000 </p><p>1. Virtual clinics in paediatric dentistry</p><p>\u0000 <i>Alexandra Lyne &amp; Joe Noar</i>\u0000 </p><p>2. Oral health assessment of newly diagnosed oncology patients—Who are we missing?</p><p>\u0000 <i>L. Roocroft, C. Dixon, A. Shepherd &amp; C. Hood</i>\u0000 </p><p>3. Improving dental trauma management in primary care: A team-based approach</p><p>\u0000 <i>V. Stevens</i>\u0000 </p><p>4. Dental screening pathway for paediatric nephrology patients: A service development and evaluation</p><p>\u0000 <i>C. K. Wallace &amp; V. Hind</i>\u0000 </p><p>5. Development of a virtual orthodontic advice pathway in a community dental service</p><p>\u0000 <i>J. Zhao, D. Rosentha, J. Tomson, H. Patel &amp; A. Ahmad</i>\u0000 </p><p><b>Editor:</b> Cheryl Somani</p><p><b>Deputy Editor:</b> Armaana Ahmad</p><p><b>Assistant Editor:</b> Claudia Heggie</p>","PeriodicalId":14268,"journal":{"name":"International journal of paediatric dentistry","volume":"34 S1","pages":"51"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ipd.13244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a virtual orthodontic advice pathway in a community dental service 在社区牙科服务中开发虚拟正畸咨询路径。
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-09-05 DOI: 10.1111/ipd.13249
J. Zhao, D. Rosenthal, J. Tomson, H. Patel, A. Ahmad
<p>Whittington Health Dental Service (WHDS) provides specialist-led community-based paediatric dental services across 13 London boroughs. Virtual advice and guidance pathways were introduced for all specialties, to ensure patients can access specialist advice when necessary, across all of WHDS's 23 clinics.</p><p>Paediatric patients with compromised first permanent molars (cFPMs) often require orthodontic advice before commencing treatment.<span><sup>1</sup></span> This would have involved referral to a local orthodontic practice, taking 9–12 months to receive advice, and sometimes contributed to delayed care and patients being unable to receive treatment within the ideal treatment window.</p><p>In July 2021, WHDS collaborated with Dr Hemant Patel (HP), lead orthodontist of Angle House Orthodontics (AHO), to address this problem by introduction of the Rapid Orthodontic Advice Request (ROAR) pathway. AHO, is a group of 13 specialist orthodontic practices based across the same geographical location as WHDS and is one of the main orthodontic providers for these patients. The ROAR pathway involves the referring dentist sending a clinical summary with orthodontic photographs and radiographs to HP via email. HP would review the information and provide the advice needed to commence their dental treatment in the CDS, without the child having to wait for a face-to-face orthodontic appointment. The ROAR pathway is not commissioned, and it is therefore crucial to evaluate the pathway for effectiveness to minimise the number of referrals, such that HP's time, offered via goodwill, is used efficiently.</p><p>WHDS also provide a separate virtual advice pathway for specialist paediatric dentistry, the Paediatric Dental Advice Clinic (PDAC). It was noted that some patients were being referred through both pathways and involving the paediatric dental team in the ROAR pathway could improve efficiency.</p><p>A log of all ROAR requests is stored on an encrypted Microsoft Excel® (Microsoft Corporation, Redmond, USA) spreadsheet. The pathway was assessed through a SE in July 2022. Actions were taken to improve the virtual advice pathway to incorporate screening from the specialist paediatric dental team and a second SE was conducted in November 2023 to reassess the pathway (Table 1).</p><p>As services nationwide consider methods of incorporating virtual advice and guidance into their clinical pathways, these evaluations show the benefits of having a combined paediatric and orthodontic advice pathway. Paediatric screening of the orthodontic advice requests also provided an opportunity for teaching and upskilling the wider dental team.</p><p>Referrers highly valued feedback and advice from the paediatric team to improve their orthodontic referrals. Paediatric screening increased the time taken to receive advice from a maximum of 10–32 days. The longer response times coincided with periods of staff leave, and although the overall time for advice increased, it was still a
惠廷顿健康牙科服务（Whittington Health Dental Service，WHDS）在伦敦 13 个区提供以专科医生为主导的社区儿童牙科服务。所有专科都引入了虚拟咨询和指导路径，以确保患者在必要时能够在惠廷顿健康牙科服务的所有 23 个诊所中获得专家建议。1 患有受损第一恒磨牙（cFPM）的儿科患者在开始治疗前通常需要正畸建议。2021年7月，WHDS与Angle House Orthodontics（AHO）的首席正畸医生Hemant Patel博士（HP）合作，通过引入快速正畸建议请求（ROAR）途径来解决这一问题。Angle House Orthodontics 由 13 家专业正畸诊所组成，与 WHDS 位于同一地理区域，是这些患者的主要正畸服务提供商之一。ROAR 途径包括转诊牙医通过电子邮件向惠普公司发送一份临床摘要以及正畸照片和放射照片。惠普将审查这些信息，并提供所需的建议，以便在 CDS 开始牙科治疗，而儿童则无需等待面对面的正畸预约。ROAR路径没有经过委托，因此，评估该路径的有效性以尽量减少转诊数量至关重要，这样，通过善意提供的HP的时间就得到了有效利用。WHDS还为专科儿童牙科提供了一个单独的虚拟咨询路径，即儿童牙科咨询诊所（PDAC）。我们注意到，有些病人同时通过这两种途径转诊，因此让儿童牙科团队参与到 ROAR 途径中可以提高效率。所有 ROAR 请求的日志都存储在加密的 Microsoft Excel® （微软公司，美国雷德蒙德）电子表格中。2022 年 7 月，通过 SE 对该路径进行了评估。在全国范围内的服务机构都在考虑将虚拟建议和指导纳入其临床路径的方法时，这些评估显示了儿科和正畸联合建议路径的益处。对正畸咨询请求的儿科筛查也为更广泛的牙科团队提供了教学和提高技能的机会。转诊者非常重视儿科团队的反馈和建议，以改进他们的正畸转诊。儿科筛查增加了获得建议所需的时间，最长为 10-32 天。较长的响应时间与员工休假时间相吻合，尽管获得建议的总体时间增加了，但转诊者认为仍然非常快。许多 WHDS 的家长/监护人在语言和数字技术方面存在障碍，或者健康知识水平较低。以克服这些障碍的方式将家长/监护人和患者的意见纳入行动计划中。
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引用次数: 0
Development and validation of Tamil version of CARIES-QC questionnaire among socially marginalized school children in Chennai City. 在钦奈市社会边缘化学童中开发并验证泰米尔语版 CARIES-QC 问卷。
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-09-03 DOI: 10.1111/ipd.13262
Mohammed Meera Riyaz, Shyam Sivasamy, Preetha Elizabeth Chaly

Background: The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), which was developed to assess dental caries-specific Child Oral Health Related Quality of Life (COHRQoL), has been translated into few world languages.

Aim: To develop and validate the Tamil version of Caries Impacts and Experience Questionnaire for Children (CARIES-QC).

Design: This cross-sectional study was conducted among socially marginalized school children in Chennai City. The initial translation of the English CARIES-QC questionnaire to Tamil was made by two independent translators followed by an expert committee discussion to derive a prefinal version of the Tamil questionnaire. Subsequently, content validation was performed by bilingual subject experts followed by preliminary pilot testing among 30 school children aged 8-10 years studying in Adidravidar Welfare High School, Chennai, to produce the final version of the questionnaire. Convergent validity, discriminant validity, and test-retest reliability of the translated questionnaire were tested among 191 children.

Results: The content validation process revealed that the translated version had relevant questions and content coverage (Scale-wise Content Validity Index score = .91). The children with and without dental caries had mean CARIES-QC scores of 5.39 + 3.7 and 3.71 + 5.1, respectively, and their statistically significant difference (p-value = .04) between them indicates the scale's satisfactory discriminant validity. The Cronbach's alpha was .87 indicating the questionnaire's good internal consistency.

Conclusion: The newly developed Tamil CARIES-QC questionnaire is a valid and reliable tool for assessing COHRQoL among Tamil-speaking school children.

背景：目的：开发并验证泰米尔语版的儿童龋齿影响和经历问卷（CARIES-QC）：这项横断面研究在钦奈市的社会边缘化学童中进行。由两名独立翻译人员将英文版 CARIES-QC 问卷初步翻译成泰米尔文，然后由专家委员会进行讨论，得出泰米尔文问卷的最终版本。随后，由双语学科专家进行了内容验证，并在钦奈市阿迪德拉维达福利中学 30 名 8-10 岁的学童中进行了初步试点测试，最终确定了问卷的最终版本。在 191 名儿童中测试了翻译问卷的收敛效度、区分效度和重复测试可靠性：内容验证过程显示，翻译版本的问题和内容覆盖面相关（量表内容效度指数得分 = .91）。有龋齿儿童和无龋齿儿童的 CARIES-QC 平均得分分别为 5.39 + 3.7 和 3.71 + 5.1，两者之间的差异具有统计学意义（P 值 = 0.04），表明量表的判别效度令人满意。Cronbach's alpha 为 0.87，表明问卷具有良好的内部一致性：结论：新开发的泰米尔语 CARIES-QC 问卷是评估泰米尔语学童 COHRQoL 的有效、可靠的工具。
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引用次数: 0
Impact of manual dexterity on toothbrushing efficacy in typically developing children: A cross-sectional study. 手部灵活性对发育正常儿童刷牙效果的影响：横断面研究
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-08-27 DOI: 10.1111/ipd.13260
J Jasmin Winnier, Shilpa S Naik, Ashveeta Shetty, Diksha Patil, Sonal Tandel, Priya Gore

Background: Manual dexterity includes gross motor skills (GMS) and fine motor skills (FMS). Literature reports manual dexterity as a contributing factor for improved oral hygiene and that the required dexterity for toothbrushing develops above 8 years of age. Research suggests grip force, movement speed, and motor coordination should be assessed to improve knowledge on kinetics of brushing teeth.

Aim: To assess the impact of manual dexterity on toothbrushing efficacy in 7 to 12 year old children.

Design: The cross-sectional study included 150 typically developing 7-12 year old children. Oral health status was recorded using the Decayed, Missing, and Filled Teeth index. GMS and FMS were evaluated using the MInnesota Manual Dexterity Test (MMDT) and Archimedes spiral test (AST), respectively. Toothbrushing efficacy was determined by Turesky modification of Quigley-Hein Plaque Index- difference in mean scores from before and after toothbrushing.

Results: Assessment of GMS, FMS, and toothbrushing efficacy using ANOVA showed a significant increase with age (p value: 0.000); unpaired t-test showed an association of toothbrushing efficacy with GMS and FMS irrespective of age (p value: 0.000).

Conclusion: Manual dexterity was significantly associated with toothbrushing efficacy in typically developing children. AST, a simple test to determine FMS, may help paediatric dentists to guide parents on the supervision of toothbrushing for their child.

背景：手的灵活性包括粗大运动技能（GMS）和精细运动技能（FMS）。文献报道，手的灵活性是改善口腔卫生的一个因素，而刷牙所需的灵活性在 8 岁以上才开始形成。研究表明，应评估握力、移动速度和运动协调性，以提高对刷牙动力学的认识：这项横断面研究包括 150 名发育正常的 7-12 岁儿童。使用龋齿、缺失牙和填充牙指数记录口腔健康状况。分别使用明尼苏达手动灵活性测试（MMDT）和阿基米德螺旋测试（AST）评估GMS和FMS。刷牙效果通过 Turesky 对 Quigley-Hein 牙菌斑指数的修正--刷牙前后平均得分的差异来确定：结果：使用方差分析对 GMS、FMS 和刷牙效果进行的评估显示，刷牙效果随年龄的增长而显著增加（p 值：0.000）；非配对 t 检验显示，刷牙效果与 GMS 和 FMS 相关，与年龄无关（p 值：0.000）：结论：在发育正常的儿童中，手的灵活性与刷牙效率有很大关系。AST 是一种用于确定 FMS 的简单测试，可帮助儿科牙医指导家长监督孩子刷牙。
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引用次数: 0
Orthodontic aligner therapy outcomes in children with autism spectrum disorder. 自闭症谱系障碍儿童的正畸矫治器治疗效果。
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-08-06 DOI: 10.1111/ipd.13257
Stephanie A Meuffels, Anne Marie Kuijpers-Jagtman, Stephen T H Tjoa, Paola L Carvajal Monroy

Background: Children with autism spectrum disorder (ASD) face unique challenges in oral care. Aligner therapy offers a promising alternative to conventional approaches for this patient group.

Aim: To evaluate orthodontic aligner therapy outcomes in children with ASD using the Peer Assessment Rating (PAR) Index and the Index of Complexity, Outcome, and Need (ICON), and to investigate whether concomitant disorders affect ICON, PAR scores, and treatment duration.

Design: Two calibrated observers assessed digital dental casts and intraoral pictures of 37 children with ASD before (T0) and after (T1) their treatment. At T0, the participants' average age was 12.9 years (SD = 1.68); at T1, post-therapy, the average age was 14.9 years (SD = 1.51). All participants underwent orthodontic aligner therapy. Statistical methods employed in this study included descriptive analysis, Wilcoxon tests, and univariate linear regression.

Results: Posttreatment, median ICON scores decreased significantly from 74 to 14, and median PAR scores from 36 to 8 (p < .0001), demonstrating "excellent to substantial" improvement in 89.2% (n = 33) of the children. Comorbidities, present in 62% of patients, did not significantly affect treatment duration (22.6 ± 11.02 months).

Conclusion: Children with ASD significantly benefit from orthodontic aligner therapy, emphasizing the need for tailored orthodontic care.

背景：患有自闭症谱系障碍（ASD）的儿童在口腔护理方面面临着独特的挑战。目的：使用同伴评估评分（PAR）指数和复杂性、结果和需求指数（ICON）评估自闭症谱系障碍儿童的正畸矫治效果，并研究伴随疾病是否会影响ICON、PAR评分和治疗持续时间：设计：两名经过校准的观察者分别在治疗前（T0）和治疗后（T1）对 37 名患有 ASD 的儿童的数字牙模和口内照片进行评估。T0时，参与者的平均年龄为12.9岁（SD=1.68）；T1时，即治疗后，参与者的平均年龄为14.9岁（SD=1.51）。所有参与者都接受了正畸矫治器治疗。本研究采用的统计方法包括描述性分析、Wilcoxon 检验和单变量线性回归：治疗后，ICON 评分中位数从 74 分显著降至 14 分，PAR 评分中位数从 36 分显著降至 8 分（p 结论：治疗后，ICON 评分中位数从 74 分显著降至 14 分，PAR 评分中位数从 36 分显著降至 8 分：患有 ASD 的儿童从正畸矫治器治疗中获益匪浅，强调了量身定制正畸护理的必要性。
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引用次数: 0
Special education teachers' involvement and perceived barriers to delivering oral health education for students with disabilities-A cross-sectional study. 特殊教育教师在为残疾学生提供口腔健康教育方面的参与情况和感知障碍--横断面研究。
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-08-06 DOI: 10.1111/ipd.13258
Faris Yahya I Asiri, Marc Tennant, Estie Kruger

Background: Dental caries is prevalent among children, including those with disabilities. Although the World Health Organization recommends school-based oral health promotion (OHP) programmes involving teachers, limited research has explored teachers' roles and perspectives.

Aim: To assess special education teachers' involvement and difficulties regarding oral health education (OHE), attitudes towards OHP and barriers to oral healthcare access for students with disabilities (SWDs).

Design: This descriptive cross-sectional study, conducted in Al-Ahsa, Saudi Arabia, involved 264 special education teachers using a validated, self-administered questionnaire, and descriptive and analytical statistics were used for data analysis.

Results: Only 39% of teachers incorporated OHE into their teaching, and just 20.8% received training for OHE delivery. Teachers showed strong support for integrating OHE into the curriculum (84.1%) and a no-sugar policy (78%). There was, however, less support for school-based toothbrushing (39%). OHE barriers included insufficient resources (56.1%), limited knowledge (29.2%) and misconceptions about primary teeth removal (47.4%). The three most common barriers to oral healthcare access were extended waiting lists (75.0%), long waiting times (73.1%) and fear of dental equipment (67.4%).

Conclusion: This study highlights the need for collaboration between healthcare professionals, educators and parents to enhance OHE and reinforce OHP for SWDs within special education and beyond.

背景：龋齿在包括残疾儿童在内的儿童中普遍存在。目的：评估特殊教育教师参与口腔健康教育（OHE）的情况和困难、对口腔健康教育的态度以及残疾学生（SWDs）获得口腔保健的障碍：这项描述性横断面研究在沙特阿拉伯的 Al-Ahsa 进行，共有 264 名特殊教育教师参与，使用了一份经过验证的自填式问卷，并使用描述性和分析性统计进行数据分析：结果：只有 39% 的教师将职业健康教育纳入了教学，只有 20.8% 的教师接受过职业健康教育培训。教师们非常支持将职业健康教育纳入课程（84.1%）和无糖政策（78%）。但对校本刷牙的支持率较低（39%）。口腔保健的障碍包括资源不足（56.1%）、知识有限（29.2%）和对拔除乳牙的误解（47.4%）。获得口腔保健服务的三个最常见的障碍是等候时间过长（75.0%）、等候时间过长（73.1%）和害怕牙科设备（67.4%）：本研究强调了医护专业人员、教育工作者和家长之间合作的必要性，以加强特殊教育及特殊教育以外的社 会特殊儿童的口腔健康教育和口腔保健。
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引用次数: 0
Effectiveness of a message service on child oral health practice via a social media application: A randomized controlled trial. 通过社交媒体应用程序为儿童口腔健康实践提供信息服务的效果：随机对照试验
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-08-05 DOI: 10.1111/ipd.13256
K Choonhawarakorn, P Kasemkhun, P Leelataweewud

Background: Early establishment of healthy oral health behaviours is important to reduce early childhood caries risk. Two-way social media applications can economically assist caregivers.

Aim: To evaluate the effectiveness of a LINE™ messaging service (MS) on promoting good oral health behaviors in Thai children.

Design: One hundred and ninety caregiver-child dyads (children aged 6-36 months) who attended a university dental hospital and two other hospitals were randomly assigned to receive age-appropriate dental health education via MS or through traditional on-site visits. Infographic posters, video clips, and supportive messages were delivered weekly to the MS group. Parental oral health knowledge and children's oral health status and practice were assessed at baseline and 6-month follow-up.

Results: The MS group showed significantly better scores in feeding habits (p = .034) and toothbrushing practice (p = .007). Parental knowledge increased in both groups; however, knowledge increased significantly in the control group (p = .001). Both groups exhibited improvements in the debris score but not in caries progression. The caregivers rated both methods as high to the highest satisfaction.

Conclusions: The MS yielded comparable outcomes to traditional dental visits in promoting oral health behaviours.

背景：早期建立健康的口腔卫生行为对降低儿童早期龋齿风险非常重要。目的：评估 LINE™ 信息服务（MS）对促进泰国儿童良好口腔健康行为的有效性：设计：在一所大学牙科医院和另外两所医院就诊的 190 个护理人员-儿童二人组（儿童年龄为 6-36 个月）被随机分配到通过 MS 或传统的现场就诊方式接受与年龄相适应的口腔健康教育。信息海报、视频剪辑和支持性信息每周向 MS 组提供。在基线和 6 个月的随访中，对家长的口腔健康知识、儿童的口腔健康状况和做法进行了评估：结果：MS 组在喂养习惯（p = 0.034）和刷牙习惯（p = 0.007）方面的得分明显更高。两组家长的知识水平都有所提高，但对照组的知识水平明显提高（p = .001）。两组在碎屑评分方面都有所改善，但在龋病进展方面没有改善。护理人员对这两种方法的满意度都很高：在促进口腔健康行为方面，MS 的效果与传统的牙科就诊效果相当。
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引用次数: 0
Orthodontic extrusion with fixed appliances for treatment of intrusive luxation injuries: A prospective study of 28 permanent maxillary incisors. 使用固定矫治器进行正畸挤压以治疗侵入性Luxation损伤：对 28 颗上颌恒切牙的前瞻性研究。
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
International journal of paediatric dentistry
Pub Date : 2024-08-03 DOI: 10.1111/ipd.13254
Jingjing Zhang, Nan Wang, Xuemei Gao, Man Qin

Background: Limited evidence exists on the treatment options of tooth repositioning after intrusive luxation.

Aim: The study aimed to investigate the outcomes and complications of orthodontic extrusion in treating intruded maxillary permanent incisors.

Design: A prospective study was conducted involving 28 intruded maxillary permanent incisors treated with orthodontic extrusion, compared with a retrospective control group of 29 teeth that underwent spontaneous re-eruption. The success rate of tooth repositioning, as well as pulp condition, periodontal healing, and root development were assessed and compared.

Results: The success rate of orthodontic extrusion was 96.4%, excluding one tooth that was ankylosed before treatment. There were no significant differences in pulp condition between the orthodontic extrusion and control groups for teeth with immature root development. Teeth with mature root development in the orthodontic group, however, showed a significantly higher rate of pulp necrosis (100%, p < .05). Periodontal healing outcomes were similar across both groups, regardless of the maturity of root development. The root length continued increasing during orthodontic extrusion treatment.

Conclusions: Orthodontic extrusion treatment could effectively reposition moderately to severely intrusive permanent incisors, without increasing the risk of complications compared with spontaneous re-eruption.

背景：目的：该研究旨在调查正畸挤压法治疗上颌恒切牙内陷的结果和并发症：设计：进行了一项前瞻性研究，涉及28颗接受正畸挤压治疗的入侵上颌恒切牙，并与29颗接受自发再拔牙治疗的回顾性对照组进行了比较。对牙齿复位成功率、牙髓状况、牙周愈合和牙根发育情况进行了评估和比较：结果：正畸挤压的成功率为 96.4%，其中不包括一颗治疗前已强直的牙齿。对于牙根发育不成熟的牙齿，正畸挤压组和对照组的牙髓状况没有明显差异。然而，正畸组牙根发育成熟的牙齿的牙髓坏死率明显更高（100%，P 结论：正畸挤压治疗可有效改善牙髓坏死率，并减少牙髓损伤：与自发再萌相比，正畸挤压治疗可以有效地将中度至重度侵入性恒切牙复位，而不会增加并发症的风险。
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引用次数: 0
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