Special Care in Dentistry最新文献

Aim: To examine the association between disability status and dental treatments, and to explore the differences in dental expenses and sources of payment among individuals with and without disabilities in 2019.

Methods: Data included the adult population from the 2019 Medical Expenditure Panel Survey. We estimated the association between dental treatments and disability status using regressions adjusting for demographic and socioeconomic variables. The outcomes for expenditures were total dental expenditure and sources of payment.

Results: In 2019, 59.01% of adults with disabilities did not receive dental treatments. Individuals were less likely to receive any dental treatment when they had disabilities with vision (adjusted odds ratio [AOR] 0.78, 95% confidence interval [95% CI] 0.62-0.97), mobility (AOR 0.78, 95% CI 0.68-0.89), and independent living (AOR 0.72, 95% CI 0.60-0.88). Adults with cognitive disabilities had 1.28 times higher odds of receiving procedural treatment than adults without cognitive disabilities. Only 20% of the total dental expenditure was spent on individuals with disabilities, with 53.72% paid out of pocket.

Conclusions: Significant differences exist in the dental treatments and expenses between adults with and without disabilities. Expanding Medicaid coverage, improving reimbursement rates, and promoting oral health literacy may help reduce the oral health disparities in this population.

Purpose: To reassess the psychometric properties of ASDS-Braz in a large, multicenter sample of Brazilian dental students, aiming to evaluate its factorial structure's robustness and applicability across diverse contexts.

Methods: Data were collected around 2 years from multiple Brazilian centers, including responses to the ASDS-Braz and demographic variables, and additional questions regarding participants' experience living with or caring for older adults, as well as their clinical course experience. Data were consolidated for large-scale validation through secondary analysis. Exploratory factor analysis (EFA) was conducted, with factorability assessed using the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's test. Principal Axis Factoring with Varimax rotation was applied, and internal consistency was evaluated using Cronbach's alpha. Analyses were performed using SPSS v.28, with p < 0.05 considered statistically significant.

Results: The sample included 1539 dental students from 11 schools, predominantly white (66.3%) and female (72.4%), with most having clinical experience (87.4%). The ASDS-Braz was divided into four factors, with Factors 1 and 2 showing moderate reliability (α = 0.71) given the size of the study. However, other factors and the 10-item scale did not meet the acceptability threshold.

Conclusion: The ASDS-Braz did not exhibit satisfactory psychometric properties in a large, multicenter sample. It requires restructuring, refinement, and revalidation to ensure its suitability for national research and clinical application in Brazil.

Objective: This systematic review aimed to assess the available literature on the subgingival bacterial microbiota profiles of PLHIV undergoing HAART.

Materials and methods: This research was conducted in accordance with the PRISMA guidelines. Electronic searches were performed in the Cochrane Library, LILACS, PubMed, and Science Direct databases to identify primary studies evaluating the subgingival bacterial microbiota of individuals living with HIV-1 undergoing HAART. The search was performed by two independent researchers and covered the period from January 2001 to July 2022. Studies published in English, Portuguese, and Spanish were included.

Results: A total of 457 articles were initially retrieved. Of these, 9 met the eligibility criteria. The included studies revealed a high frequency of periodontal pathogens among individuals living with HIV-1 on HAART, including Treponema denticola (44%, n = 4 studies) and Porphyromonas gingivalis (33%, n = 3 studies), as well as species not commonly found in patients with periodontal disease, such as Enterococcus faecalis (33%, n = 2 studies).

Conclusions: According to the present findings, the most frequently identified subgingival bacterial species in patients living with HIV-1 and receiving antiretroviral therapy were T. denticola and P. gingivalis, without establishing a consistent or unique microbiological profile.

Introduction: Sexual and gender minorities are victims of discrimination in health services, which might be associated with disparities in subjective oral health measures.

Aims: This cross-sectional study aimed to identify the association between different forms of discrimination experienced by Brazilian LGBTQIA+ people, and other independent variables, with subjective oral health outcomes.

Methods and results: Seven hundred sixty-two individuals responded to an online questionnaire about their sociodemographic characteristics, discriminatory experiences on a daily basis and in dental services, access to these services, and oral health. Binary and multinomial logistic regression analyses estimated the association between independent variables and outcomes. The results were presented in odds ratios (OR) and respective 95% confidence intervals (95% C.I.). The emotional state was the category with the highest prevalence of impact (39.8%). Discrimination in dental services and self-perceived need for treatment were associated with both self-perceived oral health and its impacts on daily activities. Gender identity was associated with self-perceived oral health, and sexual orientation was associated with oral impacts on daily performance.

Conclusion: The study indicated oral health disparities in this population, associated with discrimination, gender identity, and sexual orientation, and the need for more welcoming dental services.

Aim: The aim of this qualitative descriptive study was to identify the perceived barriers of Swiss dental hygienists (DHs) in providing domiciliary dental care (DDC) to care-dependent institutionalized (LTCF) older adults.

Methods and results: This study used a qualitative thematic analysis approach that elicited rich and in-depth information from participants. Twenty-two DHs (mean age: 46.5 ± 11.5) working in Switzerland were interviewed following a topic guide. The interviews were recorded, transcribed, and analyzed. Six overarching major themes emerged: patient-related barriers, infrastructure-related barriers, difficult working conditions, LTCF-related barriers, financial factors, and factors related to training and education. Findings revealed that DDC provision required strong self-motivation and a service-oriented mindset, with care providers demonstrating empathy, dedication, and a genuine desire to help rather than solely for financial gain. The DHs who provided DDC were passionate about geriatric dentistry and/or strived to excel in this field.

Conclusion: This qualitative study concludes that improving domiciliary dental care by dental hygienists in Switzerland requires targeted strategies to enhance training, ensure adequate infrastructure, reduce workload, address financial and systemic barriers, and strengthen collaboration with long-term care facilities.

Aims: Developmental defects of enamel (DDEs) can negatively affect both the esthetics and function of teeth, especially in children with neurological impairments. The impact of dental treatments on caregivers' emotional well-being is an important but often overlooked aspect. Herein, we describe the esthetic and functional management of DDEs in a child with hydrocephalus and cerebral palsy (CP), using a minimally invasive resin infiltration technique, and the impact of the treatment on the maternal caregiver.

Methods: A 10-year-old male patient presented to the dental clinic accompanied by his mother, who reported concern regarding the presence of whitish stains on the anterior teeth. Clinical examination identified DDEs consistent with molar-incisor hypomineralization (MIH) and fluorosis. Lesion characteristics were assessed by transillumination. A minimally invasive resin infiltration protocol (Icon) was performed, resulting in immediate esthetic improvement and effective masking of enamel opacities. Caregiver-reported outcomes, assessed through a qualitative interview, revealed a significant emotional impact, including enhanced satisfaction and improved quality of life.

Conclusion: This case highlights the potential of resin infiltration as a minimally invasive treatment for enamel defects in patients with disabilities, improving esthetics, psychosocial well-being, and reinforcing the importance of a family-centered approach in dental care.

Aim: There is a well-documented link between oral health and cognitive ability; however, evidence on oral health factors linked with cognitive and physical function decline remains limited. The aim is to determine the oral health factors linked to cognitive ability and physical function.

Methods: This cross-sectional study involved people 60 years old and above with a Charlson Comorbidity Index score of ≤ 1.2. A multistage sampling technique and a WHO-structured questionnaire were administered. Oral examination, short physical performance battery (SPPB), and mini-mental state examination (MMSE) were done. sociodemographics, oral hygiene habits, perception of oral health, decayed, missing, and filling teeth (DMFT), and use of professional dental care data were analyzed using SPSS version 26 (t-test, ANOVA, Pearson correlation) with statistical significance set at p < 0.05.

Results: An assessment of 426 participants was done, with an average age of 69.29 ± 7.73 years (minimum age is 60 years and maximum age is 95 years), and 68.5% were females. A significant association was found between higher socioeconomic status (p = 0.0001) and cognitive function. Younger age (p = 0.03) and toothbrush use (p = 0.04) were significantly associated with better physical function.

Conclusions: Toothbrush use appears to be associated with physical function. Sociodemographic factors such as age and socioeconomic status may be linked to physical and cognitive function.