Journal of the Canadian Dental Association最新文献

Background: Despite increased efforts to improve the health of those with temporomandibular disorder (TMD), the focus remains on medical knowledge rather than patients' opinions and needs regarding quality of treatment and pain management.

Objectives: We aimed to identify what TMD patients want their dentists to know and do.

Methods: Open-ended questions were used to understand the perspectives of 6 TMD patients. Two researchers examined the transcripts using interpretive phenomenological analysis.

Findings: TMD participants consistently stressed the need for their dentists to listen and provide them with more advice and information to cope with TMD conditions. They also noted the need for dentists to be skilled in communications, particularly maintaining respectful doctor-patient relations and interpersonal communication.

Conclusions: Health care providers must acquire practical communication skills and expand their knowledge of TMDs to better support their patients. Improving relations between doctors and their TMD patients could result in positive health outcomes. The implications of this study will be to decrease medical crises and expensive interventions, provide better assistance to patients and refer them to other necessary health care professionals, an approach that will lead to lower care costs, more satisfaction and higher quality of life.

Background: Despite increased efforts to improve the health of those with temporomandibular disorder (TMD), the focus remains on medical knowledge rather than patients' opinions and needs regarding quality of treatment and pain management.

Objectives: We aimed to identify what TMD patients want their dentists to know and do.

Methods: Open-ended questions were used to understand the perspectives of 6 TMD patients. Two researchers examined the transcripts using interpretive phenomenological analysis.

Findings: TMD participants consistently stressed the need for their dentists to listen and provide them with more advice and information to cope with TMD conditions. They also noted the need for dentists to be skilled in communications, particularly maintaining respectful doctor-patient relations and interpersonal communication.

Conclusions: Health care providers must acquire practical communication skills and expand their knowledge of TMDs to better support their patients. Improving relations between doctors and their TMD patients could result in positive health outcomes. The implications of this study will be to decrease medical crises and expensive interventions, provide better assistance to patients and refer them to other necessary health care professionals, an approach that will lead to lower care costs, more satisfaction and higher quality of life.

Purpose: Early restorative interventions may have important implications in young patients, and the International Caries Classification and Management System strongly recommends non-surgical strategies in the management of dental caries. We aimed to assess management of interproximal and occlusal caries in children and adolescents (≤18 years of age) by Canadian dentists.

Methods: An electronic survey was created and sent to members of Canadian provincial regulatory dental bodies. The survey included 11 questions on demographic factors and 3 clinical situations on dental caries management.

Results: The response rate was 4.6% (n = 702). To treat interproximal carious lesions limited to enamel, 442 dentists (63.0%) reported using surgical caries removal on a permanent molar and 502 dentists (71.5%) did the same for a primary tooth. For occlusal carious lesions, the corresponding numbers were 300 dentists (42.7%) for a permanent molar and 269 (38.3%) for a primary molar. Age, year of graduation and province of practice appear to have a significant impact on the restorative threshold.

Conclusions: According to the latest evidence-based recommendations for caries management, the presence of cavitated enamel should be the main indication to restore, and non-surgical interventions for non-cavitated lesions confined to enamel should be prioritized. Results show that a good proportion of respondents have a lower restorative threshold, particularly for interproximal lesions.

The predominant mode of transmission of SARS-CoV-2 virus and coronavirus disease 2019 (COVID-19) is aerosols, and e-cigarettes/vaping products are a source of aerosols. There is a public health concern that the use of these products may increase the risk of COVID-19 transmission, susceptibility to COVID-19 and severity of the disease. Based on a review of existing literature, we found emerging evidence that suggests that people who vape are at higher risk of COVID-19, and, because of compromised lung function, their susceptibility to the disease and the severity of outcomes is increased. Aerosols generated by vaping products could be involved in the transmission of the virus when people are close to others who have been diagnosed with COVID-19 and are vaping. These findings may be useful to health care professionals, including dental professionals, in providing evidence to support informing patients about vaping and how the use of vaping products impacts the risk of COVID-19 transmission, infection susceptibility and severity of illness.

Purpose: The aim of this study was to explore a classification system for children requiring full-mouth dental rehabilitation (FMDR) in the operating room (OR) and its association with adverse events.

Methods: Patients treated at a pediatric dental residency clinic and determined to need FMDR in the OR were classified on initial examination, based on the extent of caries, pain and the presence of a dental abscess. On the treatment date, parents were given a questionnaire concerning adverse events that occurred while waiting for treatment. Χ2 tests of independence were used to determine associations between classification (OR code) and the occurrence of adverse events. The Pearson's r test was used to determine relations among adverse events and wait time.

Results: The study included 82 patients (age range 2-10 years, mean 4.73 years, median 4 years). The average wait time was 55.6 days. The most common OR classification was caries in the outer third of dentin without pain or abscess, and the most common adverse event was difficulty eating or drinking. The OR code category most closely associated with negative outcomes was the presence of a dental abscess, followed by caries depth, then pain. Wait time was not associated with the occurrence of adverse events.

Conclusions: These data provide evidence to support the need for a classification system for children requiring FMDR in the OR. Dental abscess, caries depth and pain were associated with adverse events.

Purpose/objective: On 11 March 2020, the World Health Organization declared COVID-19 a pandemic, and universities transitioned to online learning. The objective of this study was to evaluate the experience of students with the online education program offered during the initial phase of the pandemic.

Methods: In April 2020, an anonymous online survey was distributed to 248 undergraduate dental and dental hygiene students in Dalhousie University's faculty of dentistry. The survey contained 10 Likert-type and 3 open-ended questions asking students to evaluate their online learning experience and their preferences regarding in-person and online learning.

Results: The response rate was 62.5%. Two-thirds (65.8%) of respondents reported that their educational experience in a virtual setting was very or somewhat positive, while only 14.8% said it was negative or somewhat negative. However, 60.6% agreed or strongly agreed that they preferred face-to-face learning over virtual classroom learning. Students were evenly split on whether online teaching should replace classroom teaching where possible (38.1% agreed/strongly agreed, 39.3% disagreed/strongly disagreed). Analysis of the responses to open-ended questions gave rise to 6 themes: online teaching and assessment methods; helpful online instructor behaviours/traits; advantages of online learning; disadvantages of online learning; combining online and in-person learning; online learning during the pandemic.

Conclusions: Although the sudden transition to online learning was generally well received by students, there still appears to be support for maintaining some form of traditional, face-to-face learning methods in dental education. Students felt that ensuring faculty were creative, understanding and flexible was paramount in the transition to teaching in an online format.

Objectives: This investigation aimed to determine whether fluoride concentration in water at the user endpoint remains the same as at the adjusted source, i.e., water treatment facilities.

Methods: Daycares in Alberta, Canada, were used as the endpoint to measure fluoride concentration. They were randomly selected from a list of 400 licensed daycares provided by the Ministry of Children's Services. All water samples collected from the daycares were sent to the accredited Alberta Centre for Toxicology (ACFT) for analysis within 7 days of collection. ACFT used ion chromatography to determine fluoride concentration levels. Statistics analyses were conducted using the software SPSS 25.

Results: Water samples were collected from 141 daycares in 35 municipalities. In municipalities that adjust fluoride content, public water is supplied by 8 Alberta Environment & Parks regulated water systems. Fluoride concentration in water samples examined at the endpoint ranged from 0.58 mg/L to 0.79 mg/L. The differences between fluoride concentration at the water treatment facilities and the daycares ranged from -0.03 to 0.22 mg/L.

Conclusions: This study confirms that the concentration of fluoride adjusted at water treatment facilities in Alberta is maintained at endpoints at the approximate optimal level of 0.7 mg/L.

Objectives: The aims of this study were to characterize the type and frequency of oral and maxillofacial malignancies in an outpatient oral pathology service and to examine the impact of COVID-19 on the diagnosis of such malignancies by dentists in Ontario, Canada.

Study design: Our study included 775 malignancies submitted to an outpatient oral pathology service. Demographic and diagnostic data, including age, sex, submitting clinician type, anatomic site and diagnosis, were collected and analyzed for 2 periods, 2015-2019 and 2020.

Results: Malignancies represented 2% of total submissions to our biopsy service. Oral surface epithelial malignancies were the most common, followed by hematologic and salivary gland malignancies. During the period in which dental offices were restricted (April-May 2020), 59% fewer malignancies were submitted compared with the preceding 5 years. Despite this reduction, total malignant submissions for 2020 and post-lockdown (July-September 2020) were significantly elevated compared with previous years (p = 0.0006 and p = 0.0008, respectively).

Conclusions: Our study reaffirms the important role that dentists play in the diagnosis of oral and maxillofacial malignancies. Our assessment of 2020 data highlights the impact of dental office closures on the diagnosis of oral and maxillofacial malignancies during the COVID-19 pandemic.

Objectives: In most North American jurisdictions, guidelines for use of biologic indicators (BIs) in general dental practice have recommended testing at least weekly. However, in 2011, Alberta mandated a change to daily testing, and other provinces have adopted similar protocols. This study of general dental practices in Alberta assessed factors related to implementation of the changed requirement.

Methods: A survey of 705 randomly selected dental offices queried factors related to implementation of the daily BI testing protocol, including the number of positive test results. We compared findings to analogous data from external laboratory BI tests obtained on a weekly or monthly basis over the preceding 10 years.

Results: The response rate was a 32.6%. The survey results indicated almost complete compliance with the daily testing requirement and a universal shift to in-office testing. A commensurate 76-fold increase in testing was accompanied by a 15-fold decrease in positive results compared with previous laboratory data. However, although not statistically significant, more offices identified defective sterilizer function through internal testing compared with less-frequent external laboratory testing (5.7% vs 3.2%). The offices reporting positive test results had a significantly higher mean number of repeat positive tests (internal 3.1, SD 1.9 vs. external 1.1, SD 0.11).

Conclusions: The daily testing requirement was accompanied by a concomitant universal shift from external laboratory to internal office testing. A large decline in the rate of positive testing results was observed, although possibly more offices identified defective sterilizer function.

Introduction: Occupational characteristics of dental care - including closed environment, proximity to staff and patients and the use of aerosol-generating procedures - put workers at high risk of COVID-19 exposure and transmission. We describe the frequency of workplace situations that potentially increase the risk of exposure to COVID-19 in dental care compared with other occupations including health care.

Methods: We conducted a cross-sectional study using sociodemographic and occupational data from the 2016 Canadian census linked to workplace characteristics from the Occupational Information Network (O*NET) dataset. We assessed frequency of workplace indicators using an intensity score from 0 (low) to 100 (high) from O*NET on exposure to infection or disease, physical proximity to others, indoor controlled environments, standard protective equipment and specialized protective equipment.

Results: In 2016, 87 815 Canadians worked in the 5 dentistry occupations of interest: dentists; denturists; dental hygienists and dental therapists; dental technologists, technicians and laboratory assistants; and dental assistants. These occupations were routinely ranked in the top 10 of all occupations examined in terms of exposure to workplace indicators that increase the risk of exposure to COVID-19. Dental hygienists and dental therapists, dental assistants, dentists and denturists, rank as the top 4 occupations, in that order, with the highest exposure to disease or infection and physical proximity to others combined.

Conclusions: Compared with other occupations, dental care workers are at a higher risk of occupational exposure to COVID-19. These results support the development of workplace guidance to reduce the risk of COVID-19 transmission and enhance the well-being of the dental care workforce.