Special Care in Dentistry最新文献

Aims: Identifying ageism among dental students is essential in gerodontology courses. This study aimed to perform a preliminary validation of a Malay version of the ageism scale for dental students (ASDS-My).

Methods and results: The 27-item ASDS were translated into Malay language and completed by 168 dental students. Exploratory factor analysis (EFA) with Promax rotation, Polychoric Correlation Matrix and Principal Axis Factoring was conducted. Internal consistency reliability and discriminative validity were analysed. Criterion validity was measured by comparing ASDS-My with Fraboni Scale of Ageism (FSA). A Kaiser-Meyer-Olkin of 0.612 and a Bartlett's Test of Sphericity yielding p < .001 confirmed the adequate factorability. EFA revealed a 15-items scale distributed into five-factors explaining 54.5% of overall variance, with acceptable reliability. The two factors involved cost-benefit of dental treatment on older patients and challenges during medical history taking. The third, fourth and fifth factors explained attitude towards older patients, negative views of older patients and exposure of dental students to Gerodontology training and experiences respectively. Most factors were significantly positively related to FSA. Discriminative validity revealed significant differences for gender, place of stay and year of study.

Conclusion: Preliminary validation of the ASDS-My produced a five-factors 15-items scale with acceptable validity and reliability.

Objective: To compare manual and powered toothbrushes in older adults and to culminate available clinical evidence concerning efficiency with respect to plaque removal and reduced gingivitis.

Background: Manual dexterity decreases with age, negatively impacting daily activities, including oral hygiene practices. Effective plaque control in this age group is directly related to nutrition and overall health. Therefore, developing oral health interventions tailored to the ageing population is essential.

Material and methods: This systematic review was registered with PROSPERO (Registration No. CRD42023415876). Five electronic databases were searched to identify randomized controlled trials published from inception until March 2023. The risk of bias was assessed using the Cochrane Risk of Bias Tool. Meta-analyses were also performed for gingival, plaque, and bleeding indices.

Results: A total of 2118 records were identified, and six eligible publications were retrieved. Comparison of Plaque Indices between powered and manual toothbrushes showed a Standard mean difference (SMD) of -0.10; 95% CI [-0.37, 0.18] (p = .38). Comparison of the gingival index and bleeding index between powered and manual toothbrushes showed an SMD of -0.28; 95% CI [-0.72, 0.16] (p = .22) and SMD of -0.03 [-0.38, 0.32] (p = .84), respectively.

Conclusion: According to the available literature, this study suggests the need for more streamlined research to support the superiority of either powered or manual toothbrushes in improving oral health (as measured by the indices) among the older population. The results will hence have significant reverberations for older adults looking to improve their oral hygiene practices.

Aim: To assess the effectiveness of waiting room based multisensory adapted dental environment (SADE) as a novel, non-invasive behavior management technique in alleviating anxiety levels in children with Down syndrome.

Materials and methods: This study was conducted in the Department of Pediatric and Preventive Dentistry, D.Y. Patil University School of Dentistry, Nerul, Navi Mumbai. A total of 40 children between 8 and 13 years of age diagnosed with Down syndrome were included in our study. Prior to the first dental evaluation, they were divided equally into two groups using simple randomization via lottery system. Group A (Intervention group): Patients were subjected to a sensory adapted environment (SADE) in the waiting room for 10 min prior to dental evaluation. Group B (Control group): Patients were subjected to a regular dental environment (RDE) in the waiting room for 10 min prior to dental evaluation. Outcome parameters evaluated at baseline and post dental evaluation were anxiety and behavior, using a pulse oximeter and the Modified Venham's Scale respectively. Data were subjected to statistical analysis using SPSS version 21.0 (SPSS Inc. Chicago, IL). The 'p' value < .05 was taken as significant at 95% confidence interval.

Results: Mann-Whitney U test was used to carry out the inter group analysis which showed a significant increase in the heart rate (26.00, p = .00) in Group B and a significant decrease in the Modified Venham Scale score (90.00, p = .001) in Group A. The Wilcoxon Signed ranks test was used to carry out the intra group analysis for which a significant difference between the two time intervals for heart rate (-3.69, p = .00) and Modified Venham Scale score (-1.46, p = .03) was obtained in Group A whereas a significant difference was obtained only in the heart rate (-3.04, p = .002) in Group B.

Conclusion: Multisensory-adapted dental environment (SADE) in the waiting room effectively improves behavior, reduces anxiety and sensory discomfort among children with Down syndrome.

Aims: The quality of prenatal dental services is essential for improving the oral health of both mothers and children. However, a lack of a reliable tool to assess the quality of prenatal oral care has hindered research in this area. To address this gap, the study aimed to validate the Organizational Determinants of Prenatal Dental Services Questionnaire (OD_PDS) in Iranian pregnant women.

Methods: Literature reviews, interviews, and a cross-sectional survey with 300 pregnant women were conducted. To evaluate the validity; face, content and construct validity were assessed. Cronbach's alpha coefficient and the Test-retest method were used for reliability assessment.

Results: The final version of the OD_PDS comprises 12 items, and four subscales, which are Costs (four items), Access to Equipment and services (three items), Review of the service delivery process (two items), and Professional Behavior (three items). Questions with a factor loading of less than 0.3 were excluded. The obtained fit indices were acceptable (X2/pdf = 3.383, RMSEA: 0.089, CFI = 0.869, and TLI = 0.820). The content reliability was demonstrated by Cronbach's α  = 0.702 and 0.713 and the ICC  =  0.724.

Conclusion: The current study indicates that the OD_PDS is a valid and reliable tool for Prenatal Dental Services assessment in health centers.

Aims: The oral health needs of frail older adults are increasing with an aging population in Canada. The objective of this study was to explore the perceptions of dentists in British Columbia regarding their view of geriatric dentistry as a distinct scope of practice and in relation to special needs dentistry.

Methods and results: Qualitative data were gathered thorough semi guided interviews of a purposeful sample of dental clinicians, educators and members of organized dentistry with specialized knowledge of oral health for frail older adults. Interviews were transcribed, coded, and analyzed using a thematic approach. Thematic saturation was reached with the 10 participants in this study. Through the method of interpretative description, patient, dentist, and systemic factors that shaped scope of practice for geriatric dentistry were identified as well as the broader skill sets required for geriatric dentistry.

Conclusion: The study found that participants perceived geriatric dentistry as unique scope of practice from general dentistry requiring special knowledge in the management of challenges associated with aging with frailty as well as the ability to work in long-term care. Similar to special needs dentistry, geriatric dentistry requires person-centered care and emphasized the need for interprofessional collaboration in alternative care settings.

Aim: This study aimed to evaluate the oral health of care-dependent institutionalized older adults receiving domiciliary dental care.

Methods and results: Dental health records of institutionalized adults receiving regular domiciliary dental care were examined (observation period: 5 years). Relevant demographic and oral health information were extracted. Statistical analyses included descriptive and non-parametric tests (α = .05). Records of 398 nursing home residents (mean-age: 84.9 ± 6.4 years) were included. Average time spent by the residents in the institution was 2.8 ± 1.5 years. The mean number of teeth present and the overall DMF-T score was 14.7 ± 9.1 and 27.4 ± 6.2, respectively. The DMF-T score increased until the 3-year recall, with a significant increase in the number of decayed teeth (2-year: p = .013; 3-year: p = .010). An improvement in the residents' periodontal health was seen during the observation period but was not statistically significant.

Conclusion: The findings of this cross-sectional study confirmed that regular domiciliary dental care provision to institutionalized older adults helps maintain gingival and periodontal health. However, the incidence of dental caries might still be a problem that needs to be addressed with effective measures that improve the daily oral care provision to these older adults.

Introduction: Human papillomavirus (HPV) is an epidemic currently affecting 80 million people in the United States. The HPV virus can be passed from one person to another via sexual intercourse, oral sex, open mouth kissing and skin-to-skin contact. In some cases, the infection is not eliminated by the immune system and can cause cancer of the head and neck, cervix, anus, and genitals. There has been a rise in oropharyngeal cancer (OPC) associated with HPV, which can be missed on conventional dental screening examinations. Dentists should engage in promoting HPV vaccination as a primary measure for OPC prevention. The goal of this HPV pilot program was to educate and offer same day HPV vaccination to dental patients by using a multidisciplinary approach in a hospital setting.

Methods: Patients 18 through 26 years of age who presented to the Erie County Medical Center's dental clinic were approached and educated on HPV. Eligible patients received a direct recommendation for the HPV vaccine. Those interested in same day vaccination were referred to the division of infectious diseases' YOU Center for Wellness. A retrospective chart review was completed for patients who were HPV educated from March 5, 2020, through December 15, 2021. Charts were evaluated for age, sex, race, ethnicity, reason for visit, HPV vaccine referral, and HPV vaccine administration.

Results: 326 patients were included in the chart review. The prominent sex, race, and ethnicity were male, Black or African American, and non-Hispanic origin. The median age was 23. Most patients presented to the dental clinic for an emergency visit and were not previously vaccinated against HPV. 110 patients were unvaccinated, and 44 patients were referred to the division of infectious disease for same day vaccination. Of these 44, 24 patients initiated the vaccination process. Five patients received all three doses, three patients received two doses, and 16 patients received one dose.

Conclusion: This pilot program successfully vaccinated 24 patients with at least a single dose of the HPV vaccine. This multidisciplinary model can be implemented in other health care settings.

Aims: The objective of this study was to identify the presence of human herpesvirus (HHV) in the plasma and saliva of hepatic-cirrhosis patients and correlate it with clinical data and laboratory tests. This is a pilot, observational, and cross-sectional study.

Methods and results: Specimens of plasma and saliva from 72 cirrhotic individuals were analyzed by means of polymerase chain reaction. The patient population had a mean age of 54.84 years old (SD ± 10) and was 70% males (51/72). Approximately 47% (n = 34) of the patients had leukopenia and HHV was not identified in the plasma specimens. The main species of HHV identified in the saliva were HHV-7 (n = 42, 62%) and Epstein-Barr virus (EBV) (n = 30, 41%). Moreover, there was a significant decrease in the total number of leukocytes and lymphocytes in saliva containing EBV (P = .038 and P = .047, respectively).

Conclusion: The results show that the presence of EBV in the saliva of cirrhotic patients was correlated with their circulating immune status. It may be possible that the immune dysfunction displayed by the cirrhotic patients plays a role in the shedding of EBV into saliva.

Aims: This study aimed to examine whether surgical treatment for a facial disfigurement influenced an individual's quality of life.

Methods and results: One-on-one interviews were conducted with the aim of synthesizing participant's medical experiences into common themes. Additionally, participants completed the World Health Organization's Quality of Life Brief Version (WHOQOL-BREF) questionnaire. The WHOQL-BREF is a standardized testing instrument with four domains of 26 questions, meant to analyze participants' overall quality of health, physical health, psychological status, social relationships, and environmental health. Our study revealed that women with visible facial differences experienced a quality of life below the average of the general population. However, in those who reported above-average quality of life, a key theme emerged: active participation in the choice to undergo surgical treatment. Participants who felt this sense of agency in the decision-making process also reported a more positive healthcare experience. They felt more respected by others, indicating a strong connection between personal agency, surgical choices, and overall well-being.

Conclusions: These findings reveal that personal agency plays an important role in the decision-making process for patients undergoing surgical treatment for facial differences, as it improves quality of life and has a positive impact on overall healthcare experience and well-being.