Nederlands tijdschrift voor tandheelkunde最新文献

This research focused on the applicability of the health behaviour change model Health Action Process Approach (HAPA) to promote the brushing of children's teeth by parents. Four topics were studied to this end: the perspective on oral health and oral health care among Dutch Moroccan mothers, the effects of previous HAPA-based interventions in dentistry, the development of a HAPA-based questionnaire for parents, and the importance of HAPA constructs in parents of children at high risk for caries. The study indicated that HAPA-based interventions, particularly when they strengthen parents' volitional ideas and skills, appear suitable for guiding parents in translating their motivation to brush their children's teeth into action. The findings of this study underline the potential of and the call for the development of a HAPA-based intervention in paediatric dentistry.

Diabetes mellitus is a metabolic disease characterized by abnormalities in the regulation of blood glucose levels. Average blood glucose levels over a longer period of time (2-3 months) can be assessed by measuring the HbA1c levels. Glycated hemoglobin is determined with the HbA1c levels. An HbA1c of over 7% may lead to serious general health complications, particularly when it is not or cannot be well regulated. Elevated blood glucose levels may also lead to oral health complications. Epidemiological studies have shown that periodontitis, salivary disorders, dental caries, tooth loss, edentulousness, peri-implant problems and (pre)malignant disorders occur more frequently in patients with diabetes mellitus compared to non-diabetic patients. Non-surgical treatment of periodontitis may have a positive and clinically significant effect on blood glucose levels. The actual magnitude of the association between diabetes mellitus and oral health complications is still unclear due to methodological limitations of research carried out so far.

'Temporomandibular disorders' is an umbrella term for disorders of the temporomandibular joints, the masticatory muscles, and the adjacent anatomical structures. On behalf of the International Network for Orofacial Pain and Related Disorders Methodology, this article gives an overview of key points for good clinical practice in the field of temporomandibular disorders. During an annual conference in March 2024, members of the aforementioned network drew up a list of 10 core principles. These core principles include knowledge about the causes, diagnosis and treatment of temporomandibular disorders. They summarize the current standard of care for the treatment of such conditions and are in keeping with the need to help increase the expertise of dentists working in general practice and to prevent incorrect treatment. The core principles can be regarded as a starting point for other national and international organisations to use to develop guidelines and recommendations for the treatment of temporomandibular disorders.

The relationship between occlusal and articulation concepts and masticatory muscle activity, especially during lateral articulation, has been discussed for decades. A distinction is made between canine guidance and group function. One theory suggests that mechanoreceptors in the periodontal ligament can trigger a muscle shutdown reflex when only the canine receives the lateral force. However, more recent theories suggest that muscle activity is centrally regulated and is not influenced by occlusion or articulation. An extensive literature review showed only limited reduction of masticatory muscle activity when canine guidance was applied, which also recovered to the previous level over time. In this part of the two-part article, the literature review is discussed.

Saliva has many functions, including moistening, aiding digestion and protecting the mouth. Three pairs of major salivary glands-the parotid, submandibular and sublingual glands-produce saliva which is secreted into the mouth through excretory ducts. Additionally, numerous minor salivary glands are scattered throughout the mouth and throat. The salivary glands are autonomously innervated: the facial and glossopharyngeal nerves provide parasympathetic stimulation, while sympathetic fibres originate in the superior cervical ganglion. Saliva production is primarily regulated parasympathetically and can be increased by stimuli, chewing for example. Dry mouth (xerostomia) may be a result of medications inhibiting parasympathetic activity. Stimulation and medications such as saliva substitutes or mouth sprays can help alleviate symptoms. Accurate diagnosis and collaboration among healthcare professionals are essential for effective treatment.

Typically, tooth extractions are carried out on the basis of clinical necessity. In some cases, however, non-dental reasons, such as aesthetic ones, financial problems or psychological factors, play a role. This raises complex ethical and legal questions. For this PhD study, the experiences and perspectives of both patients and practitioners were examined, in addition to the reasons for and frequency of such requests for extraction. It also sheds light on ethical guidelines, systematically analyses reasons for extractions, and compares the approaches of dentists to those of oral and maxillofacial surgeons in the Netherlands. Furthermore, the role of psychological factors in orthognathic surgery and their influence on patient satisfaction were examined. The results showed that extraction requests without dental necessity are rare, but require a clear ethical and professional approach. The research presented in this thesis also provides a valuable basis for the careful consideration of such irreversible treatments.

In a young patient with a mild intellectual disability and an autism spectrum disorder, adequate cooperation in a dental setting initially seemed unattainable. However, with the investment of time and energy by the dentist, parents, and patient to build a relationship of trust as well as an individual treatment plan, much progress was achieved. The application of behavioural management techniques, such as the 5W1H-principle, the 'tell-show-feel-do'-method and successive approximations provide perspective for non-sedation treatment of this patient population in the general dental practice.

Patients with a cognitive impairment and/or autism often process information differently from or more slowly than other patients. They may interpret certain words very literally. This requires special attention from the dental care provider for the way in which signals are perceived and information can be shared. The use of language is a pitfall: patients use concepts they do not understand themselves. In addition, it takes them more time to understand intentions. The capabilities of patients are often overestimated. Acknowledging a patient s impairment sometimes literally requires translation during treatment, in which the use of language must be supported by visual aids, such as pictures.

Bruxism, characterized by grinding teeth and clenching jaws, may be associated with various neurodegenerative diseases. This study aimed to systematically investigate the prevalence of bruxism in patients with neurodegenerative diseases. A systematic review of the literature was carried out across 4 databases. Original studies reporting the prevalence and related factors of bruxism in patients with neurodegenerative diseases were included. The literature search yielded 3,722 references, 43 of which fully met the inclusion criteria. Parkinson’s disease showed the highest prevalence rates, followed by multiple sclerosis, Alzheimer’s disease, chorea-acanthocytosis and frontotemporal dementia. This systematic review indicates a potential association between bruxism and neurodegenerative diseases. However, the available literature on the presence and characteristics of bruxism in this patient group is limited. Further research is needed to improve support for dental care providers in order to effectively assist this vulnerable group of patients in preventing and mitigating the adverse effects of bruxism.

People with a cognitive impairment or a developmental disorder often have poorer oral health than the general population due to factors such as inadequate oral hygiene, untreated caries and periodontal issues. Primary oral healthcare providers play an important role in improving the oral health of people with a disability. They can provide continuity of care, ranging from prevention and monitoring to restorative treatment and, if necessary, referral to specialized care. However, people with a disability often face barriers accessing primary care, partly due to a lack of knowledge and skills among oral healthcare providers. On the basis of 6 studies, various aspects of oral healthcare for people with a disability were analysed. The findings of these analyses can help primary oral healthcare providers expand their knowledge; they also offer practical guidelines for better oral healthcare for people with a disability. This article is an adaptation of the dissertation of the same name.