Journal of the Canadian Dental Association最新文献

Introduction: Views on silver diamine fluoride (SDF) have been studied in various settings worldwide but remain underexplored in the Canadian context. In this study, we explored awareness, acceptability, general and economic perception and potential patient acceptance of SDF for caries management in children and older adults. We also looked at the impact of an educational workshop on SDF for dental professionals in Northern Ontario.

Methods: A 42-item structured questionnaire was administered to attendees at a workshop on minimally invasive dentistry held in Thunder Bay, Ontario. It elicited information regarding respondents' demographics, their perception, acceptance and use of SDF and the workshop's influence on uptake of the material.

Results: Participants in this cross-sectional study were 53 dental professionals, mainly dental hygienists (45.3%) and dentists (35.8%). Their views on the use of SDF as a minimally invasive technique and on how it was accepted by their patients and patients' caregivers were generally positive. Respondents reported that the workshop made them more likely to choose SDF for treating children (82.4%) and older adults (87.8%). We noted differences between dentists and non-dentists, specifically regarding potential parental acceptance of SDF staining in anterior temporary teeth (p = 0.030), as well as SDF's benefits in older adults in long-term care (p = 0.007), with a higher proportion of non-dentists viewing SDF more favourably.

Conclusion: SDF awareness and acceptance were high among dental professionals in Northern Ontario who attended a workshop presenting the beneficial effects of SDF for children and older adults.

A symposium was organized to spotlight the efforts of four Canadian dental schools (Western University, University of Saskatchewan, University of Toronto, and McGill University) in integrating EDI-DI into their dental curricula.

Background: The development of multiple primary tumours (MPTs) is an important consequence of oral cancer and one of the leading causes of mortality among these patients. This study aimed to identify some of the risk factors for MPT development in oral cancer patients and to examine its impact on survival rates.

Methods: In this retrospective, population-based cohort study, we retrieved administrative data from the Alberta Cancer Registry database for 3549 patients diagnosed with primary oral cancer (POC) between 2005 and 2020.

Results: Among these patients, 513 developed MPTs for an overall incidence of 14.5%. The average time interval for development of the first MPT was 4.04 ± 3.67 years. The proportion of patients with any comorbid conditions was significantly higher in MPT patients compared with non-MPT patients. Advanced age, average income, comorbidities including chronic obstructive pulmonary disease, diabetes and cardiovascular disease, and increased time from diagnosis to treatment were found to be potential risk factors for MPT development. Analysis revealed a sharp decrease in survival rate of oral cancer patients after developing MPTs. Furthermore, age >45 years, body mass index <18.5, synchronous tumours, stage III and IV POC, >2 comorbid conditions and MPT developing in the digestive system were associated with poor disease-specific survival.

Conclusion: The development of MPTs significantly affects the survival of oral cancer patients. Advanced age, comorbidities and delayed initiation of treatment were identified as key risk factors for MPTs. The poor survival outcomes, particularly in patients with synchronous tumours, advanced-stage primary cancers and specific comorbid conditions, highlight the need for early detection and proactive management strategies to mitigate these risks and improve long-term survival in this population.

Objectives: To describe the development of an oral health helpline and preliminary outcomes from January 2021 to December 2022.

Methods: The Faculty of Dentistry at University of British Columbia (UBC) conducted a pilot project to develop a helpline providing free oral health information, referrals and aid navigating public dental benefits for underserved communities. Development included infrastructure, supporting documents and personnel. We reviewed service data alongside data from follow-up contacts and an online satisfaction survey.

Results: During the pilot period, 118 interactions took place with 72 individuals. Referrals to low-barrier community clinics were offered to 59 (81.9%) users, while 26 (36.1%) received information on public dental benefits, oral health, and helpline services and 5 (6.94%) were connected with their student provider. Of the 32 users seeking oral health care who could be followed up, 5 (15.6%) received dental services and 17 (53.1%) received dental hygiene services.

Conclusion: The helpline facilitated access to oral health care by providing oral health-related information and care navigation.

Objectives: This study evaluated the impact of blinding shade guide tabs on the accuracy of colour selection and the preference for shades in the A hue category.

Methods: Disc-shaped specimens were created in 8 shades: 4 in the A hue (A1, A2, A3, A4) and 4 in different hues (B1, B2, C2, D3). Using both blinded and unblinded guides, 15 dental students and 15 experienced dentists evaluated the specimens' shades. Colour accuracy was assessed using the overall colour difference (ΔE00) and individual colour coordinates (CIELCH system) between the selected shade tab and the actual specimen. The percentage of selections favouring the A hue was also calculated.

Results: Blinding the shade guide tabs did not significantly impact the accuracy of colour selection. However, unblinded evaluations resulted in a higher percentage of selections favouring the A hue (44%) compared with blinded evaluations (34%). No significant difference was found between the evaluations of dental students and experienced dentists.

Conclusion: Blinding shade guide tabs did not affect the precision of colour selection but reduced the tendency to choose shades in the A hue category.

Background: The role of oncogenic subtypes of the human papillomavirus (HPV) in the pathogenesis of cervical dysplasia, cervical cancer, anal intraepithelial neoplasia, penile intraepithelial neoplasia, vaginal intraepithelial neoplasia and oropharyngeal carcinomas (OPC) is well documented. The classification and management of HPV-positive OPC (HPV+ OPC) has been modified because of differences in the molecular, biological and clinical behaviour of this disease compared with HPV-negative OPC (HPV- OPC) and conventional oral squamous cell carcinoma (OSCC).

Description: HPV+ OPC is associated with significant morbidity, mortality and cost burden on individual patients and the health care system. Preventive measures and efficient screening programs aim to reduce this burden, and oral health care providers are expected to play a pivotal role in this context. Just as they are involved in tobacco and alcohol counseling and cessation, they should support such public health initiatives as HPV screening, detection of potentially premalignant and malignant lesions, patient education about the risk of HPV infection and promotion of HPV vaccination.

Practical implications: The advent of HPV vaccines has modified the epidemiologic landscape and the management of cervical dysplasia and cancer. Similar changes are expected with HPV+ OPC. In this paper, we review HPV+ OPC and discuss how oral health care providers can be effectively involved in the fight against this disease.

Purpose: A specialized temporomandibular joint (TMJ) dental clinic was created at the Centre hospitalier universitaire (CHU) Sainte-Justine to optimize care of patients with juvenile idiopathic arthritis (JIA). In this article, we characteristics of patients with JIA and the resources available in Canadian pediatric hospitals for JIA patients with TMJ involvement.

Methods: To determine patient characteristics, we compiled retrospective data on patients seen at the TMJ clinic. Regarding resources available for patients with JIA, we sent questionnaires to the departments of rheumatology and dentistry of 13 Canadian pediatric hospitals.

Results: Of the 86 JIA patients included in our study, 42% (95% confidence interval 32-52%) had TMJ involvement. Panoramic radiography was the imaging prescribed most often for patients with JIA (91%) and frequency of follow up was most often every 6 months. In the second part of the study, 7 hospitals were included; 2 had a specialized TMJ clinic. In many cases, reports of types of imaging and available dental specialists differed between the rheumatology and dentistry questionnaires for the same hospital.

Conclusion: Few Canadian pediatric hospitals have a specialized TMJ clinic for JIA, and there seems to be a gap in the knowledge of primary care physicians regarding TMJ diagnosis and the management of patients with JIA.

Objectives: The diagnosis, symptom onset, treatment, prognosis, radiographic features and effect of litigation on patients suffering temporomandibular disorders (TMDs) following motor vehicle accidents (MVAs) are still unknown yet highly debated. This review summarizes literature on this topic and provides evidence-based guidance to dental practitioners.

Methods: We applied PRISMA guidelines and their extension for scoping reviews (PRISMA-ScR). The search strategy was defined, and the electronic search included PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus. Extracted data were organized into categories, and we present a narrative summary of the main findings.

Results: We included 37 articles in the review: 15 assessed the diagnosis of TMD following an MVA; 6 assessed onset of symptoms; 13 analyzed treatment options; 10 reviewed prognosis; 6 reviewed imaging findings; and 4 reviewed litigation factors.

Conclusion: The review revealed heterogeneous results regarding the diagnosis, treatment, prognosis, imaging and litigation factors in MVA-related TMD patients. Future studies are recommended, and no definitive conclusions were drawn.

Background: Tooth bleaching is a common cosmetic procedure, but it can result in colour mismatches with existing resin composite restorations. However, single-shade composite resins are designed to adapt to the colour of bleached teeth, potentially eliminating the need to replace restorations.

Objectives: To evaluate the effect of tooth bleaching on colour matching of single-shade resin composite restorations using instrumental and visual assessments.

Methods: Round restoration preparations on the buccal and palatal surfaces of intact molars were restored with Charisma Diamond One or Palfique Omnichroma composite resins. Colour measurements were taken using a cell phone and image-processing software before and after restoration and again after 3 applications of a 35% hydrogen peroxide bleaching agent. Colour changes were calculated using whiteness (WID) and CIELAB colour difference (ΔE00) indexes. Visual assessments of colour match were also conducted by evaluators.

Results: Both restorations and enamel exhibited comparable WID values after bleaching, and no significant changes in ΔE00 values were observed. However, evaluators assigned better colour matches to unbleached restorations.

Conclusion: Instrumental colour measurements indicated that tooth bleaching did not significantly affect the colour match of single-shade resin composite restorations. However, visual assessments revealed poorer colour matching after bleaching.

Introduction: The Mandibular Function Impairment Questionnaire (MFIQ) was developed for clinical assessment of functional impairment in patients with temporomandibular disorder (TMD). It allows patients to rank difficulty performing 17 jaw-related functions as low, moderate or severe. Our study was designed to determine whether the MFIQ is also helpful in differentiating TMD from other causes of orofacial pain in a clinical setting.

Methods: A retrospective study was conducted at a private oral medicine/orofacial pain clinic. New patients who attended with orofacial pain complaints were selected (n = 174). All patients had filled out the MFIQ as part of new patient intake forms.

Results: The study population consisted of 120 TMD patients, 25 patients with burning mouth syndrome (BMS), 19 with oral lesions (OLs) and 10 with trigeminal neuralgia (TN). TMD patients had significantly greater difficulty taking a large bite, yawning, chewing hard and resistant foods including meat, raw carrot, and apples compared with OL and BMS patients. The MFIQ alone was not able to distinguish between TMD and TN.

Conclusions: The MFIQ is a short questionnaire that is openly accessible and can be completed relatively quickly by patients in a general dentistry clinic. High ranking of difficulty for items associated with taking a large bite, chewing hard or resistant food and yawning in the presence of complaint of orofacial pain should raise suspicion of TMD and TN as a possible source of the pain.