Journal of the Canadian Dental Association最新文献

Introduction: The literature indicates that youth with intellectual/developmental disabilities (IDD), such as Down syndrome or autism, have poor oral health. A number of factors influence their oral health, including the use of medically required dental treatments.

Methods: This paper describes the first use of population-level administrative health data to examine the use of medically required dental services by youth with IDD compared with youth without IDD in Canada.

Results: Youth with IDD had 4-9 times the odds of a medically required dental treatment compared with youth without IDD. Odds varied with age and type of IDD.

Conclusions: Youth with IDD used medically required dental services to a greater extent than youth without IDD. Use of medically required dental treatments by youth with IDD declined with age; this may indicate greater difficulty accessing services when youth transition from pediatric to adult services. These findings provide baseline information on the use of medically required dental treatments and can contribute to future assessments of dental services for youth with IDD.

Introduction: Human papillomavirus (HPV), as the most common form of sexually transmitted infection, has been implicated in almost one-third of oropharyngeal cancers. One way to prevent HPV infections is through vaccination. This study aimed to investigate whether dentists in British Columbia (BC) were willing to discuss, refer and administer the vaccine in a dental practice setting.

Methods: Our cross-sectional study used a survey consisting of 14 questions pertaining to demographics, scope of practice, barriers to discussing the HPV vaccine and willingness to engage in HPV vaccination. On 1 April 2021, the survey was distributed to all practising dentists in BC via a URL link; the link remained active for 30 days. Descriptive and inferential statistics were used to analyze results, and statistical significance was set at p < 0.05.

Results: Of the 201 respondent who completed a survey, 168 (84%) agreed that discussing the link between HPV and oropharyngeal cancer falls within their scope of practice. Fewer agreed that recommending (74%) and administering (39%) the HPV vaccine were within their scope of practice. Barriers that may contribute to this unwillingness included lack of professional policies and guidelines. Although a significant proportion of respondents were willing to educate patients on HPV, they were unwilling to discuss sexual history in a dental setting (p = 0.02).

Conclusions: Despite a willingness to discuss and refer patients for HPV vaccination, most respondents were unwilling to administer the vaccine in a dental setting, as they perceived the act to fall outside their scope of practice. There remains a reluctance to engage in vaccination activities in dental settings in BC.

Background: Studies show concerning rates of occupational violence against oral health care workers, but few studies of this nature have been conducted on dental students in university clinics.

Methods: We surveyed 3rd-, 4th- and 5th-year dental students in the 2020-2021 academic year at the dental teaching clinic of the University of Montreal, using a 17-item self-report questionnaire exploring 4 types of aggression: physical, verbal, reputational and sexual.

Results: Of 239 students, 45 (19%) responded to the online questionnaire, and 28 (62% of respondents) reported some form of aggression in the previous year. Verbal aggression and sexual aggression were each reported by 21 (47%) students. No differences were found between rates of aggression based on ethnicity. Women (74%) reported higher rates of aggression than men (47%), although this difference did not reach statistical significance. Of the 6 students who said they speak a language other than French (the workplace language) at home, 5 (83%) reported experiencing sexual aggression.

Conclusion: Most students surveyed reported experiencing some form of patient aggression in the past year. The most common forms of aggression were verbal and sexual. Women and students who speak a language other than French at home may be particularly vulnerable to patient aggression in the clinical setting. This study has implications for dental education and points to the need for training and new solutions to prevent and respond to patient aggression at university dental clinics.

The COVID-19 pandemic has resulted in amended regulations and guidelines governing the practice of dentistry and dental hygiene to ensure the protection of both patients and clinicians from transmission of the SARS-CoV-2 virus. These guidelines include changes in personal protective equipment and, under some guidelines, the institution of a fallow period after any aerosol-generating procedure (AGP). This study aimed to investigate the effect of both ventilation and 4-handed dentistry in clinical practice with patients undergoing supportive periodontal therapy (SPT) by air polishing, ultrasonic and hand instrumentation in a closed operatory. We studied 34 patients during SPT using either 2- or 4-handed dentistry in an operatory with either 0 or 20 additional air changes/h (ACH). Under clinical conditions, 20 additional ACH are adequate to eliminate aerosols produced during an SPT and before the cessation of the AGP. The presence of an assistant had no significant effect on the time needed for aerosol particles to return to baseline values following the AGP. This study supports the efficacy of 20 additional ACH during the process of AGP, but does not support the need for an extended fallow period or 4-handed dentistry to provide additional high-volume evacuation throughout the procedure.

Background: Community water fluoridation is one component of a multifactorial approach to preventing dental caries. Yet, fluoridation monitoring in Canada has historically been fragmented, and recent national estimates give little indication of trends at the provincial or municipal levels. We aimed to quantify fluoridation exposure trends in Alberta from 1950 to 2018 at both the population and municipal levels. Insights have implications for dental public health surveillance.

Methods: Drawing from various public sources, we compiled a list of all Alberta municipalities, noting type of municipality and annual population count from 1950 to 2018. We recorded fluoridation status (excluding naturally occurring fluoride) by year for each municipality, based on the start and end (if ever) dates. We calculated annual fluoridation exposure at the population level (% of Alberta population exposed) and the municipality level (number of municipalities exposed) to visually assess trends over time.

Results: Population exposure to fluoridation in Alberta generally increased from 1950 to 2010. A sharp drop occurred in 2011, after which exposure fluctuated at around 43-45%. Municipality exposure generally increased from 1958 to 2006 and from 2012 to 2018, except for small declines during 2007-2008 and 2010-2011. Challenges concerning data completeness were considerable.

Conclusion: Our findings illuminate the substantial variation in fluoridation exposure of Albertans over time, and they elucidate the complexities of estimating such exposure. They speak to the value of centralized fluoridation monitoring mechanisms as a key part of dental public health surveillance infrastructure.

Hypertension is a serious chronic illness that affects more than a third of the world's population. The high prevalence of hypertension coupled with its lack of initial clinical symptoms can make managing a hypertensive patient in a dental setting difficult. The dentist's role in managing hypertensive patients encompasses more than simple treatment modifications. Because of the frequency of dental checkups, dentists play an integral role in the detection of elevated blood pressure and appropriate subsequent referral. As such, it is imperative that dentists are aware of risk factors associated with hypertension to council patients early. In addition, antihypertensive medications pose a risk in dental treatment. Such drugs may produce various oral presentations and interact negatively with drugs commonly prescribed by the dentist. It is critical to recognize these changes and avoid possible interactions. Furthermore, dental treatment can often induce fear and anxiety resulting in an increase in blood pressure; this can further complicate management of patients with pre-existing hypertension. As research and recommendations are constantly changing, dentists must stay informed on how to appropriately administer care. This article is intended to provide the dental team with clear guidelines on the overall management of a hypertensive patient in a dental clinic.

On September 7, 2022, the University of Montpellier in France hosted a meeting with digital oral health technology developers, Chief Dental Officers, policy makers, the World Health Organization, the International Telecommunication Union, and academia on digital oral health technologies.

Objectives: The aims of this study were to determine demographic profiles, tumour characteristics and treatment factors related to oral cavity and oropharyngeal cancer (OCC and OPC) and comparatively analyze these cancers in the adult population of Alberta, Canada, over 12 years.

Methods: Demographic, tumour characteristics and treatment data regarding OCC and OPC incidence in Alberta residents ≥18 years in 2005-2017 were extracted from the Alberta Cancer Registry database. Age-standardized incidence and mortality rates (ASIR and ASMR) were computed.

Results: Among 3448 OCC and OPC cases, mean (standard deviation) age at diagnosis was 63.9 (14.4) and 60.1 (10.2) years, respectively. There was a male predilection for both OCC (58.2%) and OPC (81.7%). With some fluctuations, ASIR remained the same for OCC but increased for OPC. ASMR increased for both. The most common site for OCC was tongue and for OPC tonsil. Squamous cell carcinoma was the most common diagnosis for OCC and OPC. Involvement of at least 1 lymph node was observed in 38.5% of OCC and 85.8% of OPC cases. For 45.2% of OCC and 82.3% of OPC cases, diagnosis occurred at stage IV. The most common initial treatments for OCC were surgery, alone or combined with radiation, whereas radiation with chemotherapy was the main treatment modality for OPC.

Conclusion: The incidence of OPC in younger males was higher than that of OCC. Although incidence of OPC per 100 000 population increased over the 12-year study period, it remained largely unchanged for OCC. For both cancers, initial diagnoses were made at advanced stages, with almost twice as many stage IV OPC cases than OCC cases.

Objectives: Portfolios, collected evidence of students' learning and achievement, have been widely used in health profession education for learning and assessment purposes. However, little has been documented on their use to foster self-reflection in preclinical dental education. This exploratory study assessed students' views of portfolio assignments to foster self-reflection in preclinical operative dentistry courses.

Methods: Participants were first- (Y1) and second-year (Y2) undergraduate dental students who completed a preclinical operative course in the College of Dentistry at the University of Saskatchewan. These students were asked to answer an online post-course survey to assess their view of the portfolio assignments that were part of the course. Specifically, they were asked to rate 13 statements related to experiential and instrumental outcomes of portfolio assignments (outcome evaluation) and their level of comfort with the activities involved in completing the assignments (process evaluation) on a 5-point Likert scale from strongly agree (1) to strongly disagree (5). Descriptive statistics (standard deviation, mean) were used to report the data. A t test was performed to assess statistical differences between Y1 and Y2 dental students.

Results: Of the 69 students enrolled in the preclinical courses, 25 Y1 and 25 Y2 students completed the survey (72.5%). No statistically significant differences between the ratings of Y1 and Y2 students were observed (p ≥ 0.05). Their combined ratings showed that students enjoyed the portfolio assignments, found them beneficial and felt comfortable performing the activities involved in developing the portfolios (mean scores 1.54-2.42).

Conclusion: Students viewed portfolio assignments as a learning tool to foster self-reflection in preclinical operative dentistry courses. Further research is needed to measure the effects of portfolio assignments on student learning, including self-reflection.

Introduction: The rate of general anesthesia (GA) use for pediatric dental treatment in Saskatchewan is among the highest in Canada. Although the prevalence of and risk factors for early childhood caries (ECC) has been reviewed nationally, few studies have focused on Saskatchewan. The objective of this study was to determine the prevalence of and predictive factors for dental treatment under GA in Saskatchewan.

Methods: This retrospective review focused on pediatric patients who required dental treatment under GA in Saskatchewan between 2015 and 2018. Demographic, dental diagnostic and treatment data and number of previous exposures to GA were collected and analyzed.

Results: We reviewed 570 patient records. Dental treatment needs among the sample were complex; children had 10.85 ± 3.56 (mean ± standard deviation) teeth treated, for an average cost of $3231.72 ± $898.95 per child. Children who lived in less accessible or remote locations had a significantly higher caries experience, number of teeth treated and cost of treatment. In addition, children who lived in such locations were more likely to have had previous dental treatment under GA (odds ratio [OR] 1.29, 95% CI 1.029-1.645) compared with those who lived in easily accessible/accessible areas (OR 0.81, 95% CI 0.700-0.953).

Conclusion: Our findings confirm previous research that children who require dental treatment under GA have extensive caries and treatment needs. Our results suggest that children who live in less accessible and more remote areas of the province have a higher burden of disease and are more likely to require repeated GA exposures for dental treatment.