Journal of the Canadian Dental Association最新文献

Objectives: In early 2020, COVID-19 was classified a pandemic. During phase 1 (16 March-18 May 2020) in British Columbia (BC), dental services were restricted to those that were emergent and essential. Such services were provided by several university and hospital-based dental clinics affiliated with the University of British Columbia (UBC), including the BC Cancer Agency Department of Oral Oncology (BCCA), BC Children's Hospital Department of Dentistry (BCCH) and the UBC Oral Health Centre (OHC). This study was designed to describe the types of in-person dental visits during phase 1.

Methods: Data were collected from electronic health records on all in-person dental visits between 16 March and 18 May 2020. Information included date of visit, demographics, reason for the dental visit and treatment provided. Data are presented using descriptive statistics.

Results: During phase 1, 396 patients were seen: 263 at the BCCA, 58 at BCCH and 75 at the OHC. At the BCCA, the most frequent reason for an in-person dental visit was essential consultation related to oncology treatment. At BCCH, the most frequent reason was pediatric oral/maxillofacial trauma. At these 2 sites, the most frequent treatment provided was consultation. At the OHC, the most frequent reason for a visit was severe odontogenic pain and infection, and the most frequent treatment was oral surgery.

Conclusion: During phase 1, emergent and essential dental care was provided at 3 UBC-affiliated clinics. The most common reasons for an in-person visit were odontogenic infection, severe pain, trauma and essential consultations related to medical therapy. The most common treatments provided were consultations and oral surgery.

Aim: To evaluate level of compliance and reasons for non-compliance with measures to prevent dental injuries among ice hockey players.

Methods: Ice hockey players participated in an online, standardized, cross-sectional survey that addressed demographics, use and reasons for lack of use of facial and oral protective equipment and past oral injuries.

Results: Of the 169 survey respondents, 45.6% never wore a mouthguard, 23.1% always, 14.8% sometimes and 16.5% only when enforced. Major reasons for not wearing mouthguards included discomfort, impairment of function or seeming unnecessary. Over 57.4% of participants wore a full-face shield, 35.5% a half-face visor and 7.1% no facial equipment. Participants did not wear a full-face shield mostly because it hinders visibility. Past oral injury was reported by 31.4% of participants. The most common type of injury was laceration (61.5%), followed by contusions, broken and lost teeth. Of the injured, 57.7% were hit by a stick, 46.2% by a puck and 25% were checked by an opponent.

Conclusion: Compliance with wearing mouthguards and full-face shields is low because of issues surrounding player comfort, function and lack of visibility. Efforts should be made to work with hockey players and relevant industry to improve product design for protective measures and to enforce their use.

Practical implications: Reasons behind lack of protective equipment use by hockey players should be understood to enable dental professionals to communicate with patients and resolve challenges to the use of preventative measures to increase compliance and decrease incidence and severity of traumatic oral injuries.

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease in North America, next to Alzheimer's disease. Patients who suffer from PD typically present with neuromuscular, cognitive, postural and psychiatric deficits, which make oral hygiene challenging, but extremely important. Although the cardinal signs of PD are movement-related, manifestations in the orofacial complex are ubiquitous. Weakened facial musculature, gaunt appearance, tremors of the tongue, lips and eyes, erratic mandibular movements, bruxism, xerostomia, sialorrhea, dysphagia, dysgeusia and glossitis are examples of the plethora of atypical orofacial findings associated with PD. Further complications, including angular cheilosis, attrition, temporomandibular joint disorders, burning mouth syndrome, hyposmia and hypophonia, may arise as a consequence of these orofacial manifestations. The effects of PD on the orofacial complex may result in poor nutritional habits, which can exacerbate weight loss and contribute to a negative impact on physical, psychosocial and emotional health. Dentists should be able to identify signs of PD systemically, including but not limited to the orofacial region, to optimize the management of PD patients. Here, we report practical recommendations for the medical and dental management of patients with PD in accordance with the most recently published clinical practice guidelines.

The field of artificial intelligence (AI) has experienced spectacular development and growth over the past two decades. With recent progress in digitized data acquisition, machine learning and computing infrastructure, AI applications are expanding into areas that were previously thought to be reserved for human experts. When applied to medicine and dentistry, AI has tremendous potential to improve patient care and revolutionize the health care field. In dentistry, AI is being investigated for a variety of purposes, specifically identification of normal and abnormal structures, diagnosis of diseases and prediction of treatment outcomes. This review describes some current and future applications of AI in dentistry.

Objectives: We examined the surface gloss and roughness of a dental composite and human enamel after brushing with a new bioactive glass (BCF201) additive designed to treat dentine hypersensitivity.

Methods: We prepared 2 cohorts of samples: a resin-based composite (RBC) and human enamel. Each cohort received 20 000 brushing cycles with Colgate Optic White Enamel (Colgate Optic), Sensodyne Whitening Repair and Protect (Sensodyne), Colgate Enamel Health Sensitivity Relief (Colgate-EN) with and without BCF201 added or Germiphene Gel 7 HT (Gel 7) with and without BCF201 added. The average gloss and roughness of the enamel and RBC surfaces were measured before brushing and after 20 000 back-and-forth brushing cycles. A linear regression function was applied to the gloss results, and the data were analyzed using ANOVA and a Tukey post-hoc test (α = 0.05).

Results: After 20 000 brushing cycles, the control (Gel 7) had no significant effect on the gloss or roughness of the RBC. However, the choice of dentifrice had a significant effect on both gloss and roughness (p < 0.001). With respect to RBC, after brushing, surface roughness was ranked from smoothest to roughest: Gel 7 = Gel 7 plus BCF201 > Colgate-EN plus BCF201 = Colgate Optic = Colgate-EN > Sensodyne. With respect to enamel, the smoothest to the roughest surfaces after brushing were: Gel 7 plus BCF201 = Sensodyne = Colgate-EN plus BCF201 > Gel 7 = Colgate Optic = Colgate-EN.

Conclusion: The bioactive glass additive had no adverse effect on the surface roughness or gloss of human enamel or RBC.

Significance: The addition of BCF201 appears to have a polishing effect on RBC and enamel and reduced the abrasive effects of Colgate-EN on RBC and enamel.

Background: This study aimed to describe dental care provision and the perceptions of dentists in Nova Scotia, Canada, during 1 week of the COVID-19 pandemic, shortly after the closing down of non-emergency, in-person care.

Methods: A survey was distributed to all 542 registered dentists in Nova Scotia, asking about dental care provision during 19-25 April 2020. Most answers were categorical, and descriptive analyses of these were performed. Data from the 1 open-ended question were analyzed using an inductive approach to identify themes.

Results: The response rate was 43% (n = 235). Most dentists (181) provided care but only 13 provided in-person care. From the open-ended question, 4 concerns emerged: communication from the regulatory authority; respondents' health and that of their staff; the health of and access to care for patients; and the future of their business.

Conclusion: Most respondents remained engaged in non-in-person dental care using various modes. They expressed concerns about their health and that of their staff and patients as well as about the future of their practice.

Practical implications: Dentists and dental regulatory authorities should engage in discussions to promote the health of dental staff and patients and quality of care during the chronic phase of the pandemic.

Background: This study determined the fluoride content of green tea from various parts of Asia, where green tea originates.

Methods: We brewed 2.5 g each of 4 types of green tea (from China, South Korea, Japan and Sri Lanka) using deionized water heated to boiling. Water was cooled to 71°C, then tea was steeped for 2 minutes. This process was repeated 20 times, thus providing 20 samples for each tea type. In addition, 20 control samples of deionized water were brewed to the same specifications. Samples were analyzed using a fluoride probe, and statistical power was calculated.

Results: The tea samples from different countries varied in the amount of fluoride they contained. The Chinese sample contained the most fluoride, while the Japanese sample contained the least. Means and interquartile ranges of fluoride concentration were calculated for each sample: Sri Lanka 3.58 ppm (0.1425), Chinese 6.83 ppm (0.140), South Korean 5.36 ppm (0.0975), Japanese 1.88 ppm (0.1375) and control 0.33 ppm (0.0078).

Conclusion: The origin of tea and environmental factors, such as pollution, groundwater, air and the soil in which it was grown appear to directly affect the amount of fluoride that accumulates in the plants. Considering the fluoride content revealed by this study, green tea consumption habits should be taken into account when prescribing adjunct fluoride therapy as part of a preventative program for patient care.

Background: To investigate, among Ontario dentists, (1) self-reported barriers to access to sedation and general anesthesia (GA) services and (2) their current use of sedation and GA.

Methods: Of Ontario dentists practising, 3001 were randomly selected to complete a 16-question survey by mail or online in 2011. Mixed analysis of variance (ANOVA) followed by independent-sample t tests or 1-way ANOVA evaluated the relation between dentists' views and demographic variables including sex, clinical experience and size of primary practice.

Results: Of the participants (n = 1076; 37.9% response rate), 69.7% were male, 84.4% were general practitioners, mean time in practice was 20.6 years (0.5-42 years) and 42.2% were in cities of over 500 000 people. Most dentists (60.2%) provided anesthesia services, although 38.2% indicated lack of training and the belief that there is no patient demand (25.3%) as reasons not to use anesthesia in their offices. Nitrous oxide was used 17.5% of the time for all dental procedures except implants. Barriers to referral of patients for anesthesia services included high costs associated with sedation/GA (72.2%) and patient fear of anesthesia (33.5%).

Conclusion: This study identified a perceived lack of patient demand, lack of dentist training, high costs of sedation/GA and patient fear of sedation/GA as primary barriers to use of sedation/GA in Ontario dental practices. The use of various anesthesia modalities is diverse, with 60.2% of dentists providing sedation/GA.

Objectives: This scoping review provides a comprehensive overview of oral cavity cancer (OCC) and oropharyngeal cancer (OPC) in Alberta.

Methods: A database search was conducted up to 2018 using Web of Science, Scopus, Medline, PubMed and Embase, along with a manual search of gray literature. Data from the Alberta Cancer Foundation's dedicated fund for research, Cancer Surveillance and Reporting and Alberta Cancer Registry were also collected.

Results: Our review included 8 published papers and 14 other sources, including data on 3448 OCC and OPC patients from Surveillance and Reporting and Alberta Cancer Registry. Cancer registry data (2005-2017) showed that most OCC and OPC lesions were diagnosed at an advanced clinical stage, with a significantly large number of advanced OPC lesions in stage IV (OCC 45.2%, OPC 82.4%); 47.9% of these patients died. Survival rates were lowest in rural and First Nations areas. In Alberta, 35% of HPV-associated cancers were linked to OPCs, which were more prevalent in men and younger age groups. No routine public oral cancer screening program currently exists in Alberta. General practitioners and dentists refer patients to specialists, often with long waiting times.

Conclusion: OCC and OPC patients in Alberta continue to be diagnosed in stage IV and experience high mortality rates.

Objective: To investigate pedagogical approaches and perceived barriers to teaching about caries-control medications, particularly silver diamine fluoride (SDF), in Canadian undergraduate dental and dental hygiene programs.

Methods: In summer 2018, a 9-item questionnaire was distributed to all 10 dental schools and 32 dental hygiene programs in Canada. It enquired about the types of caries-control medications used, teaching methods and perceived barriers to instruction on managing active caries with SDF.

Methods: In summer 2018, a 9-item questionnaire was distributed to all 10 dental schools and 32 dental hygiene programs in Canada. It enquired about the types of caries-control medications used, teaching methods and perceived barriers to instruction on managing active caries with SDF.

Results: The response rate was 80% (n = 8) from dental schools and 72% (n = 23) from dental hygiene programs. All curricula included information about conventional caries-control medications: fluoride, silver nitrate and povidone iodine. In all programs, instruction regarding SDF was predominantly didactic: 93% of programs presented lectures on SDF and 30% of programs included clinical teaching and use of SDF in primary dentition only. The lack of consensus on clinical protocols outlining the number and frequency of SDF applications to arrest caries was cited by 43% of the programs as a barrier to clinical teaching.

Conclusion: There is some variation across Canada in pedagogical approaches to caries-control medications and the inclusion of SDF in curricula. Poorly defined clinical protocols were reported as the main barrier to didactic and clinical use of SDF in undergraduate dental education programs.