Australian dental journal最新文献

Teledentistry has emerged as a promising approach to improving access to dental care, particularly for underserved populations. This systematic review aims to evaluate the effectiveness of teledentistry interventions in enhancing access to dental care. A comprehensive search across multiple databases was conducted to identify studies evaluating teledentistry interventions. Studies were included if they investigated the impact of teledentistry on dental care accessibility, utilization, or patient outcomes. Eligibility criteria were applied systematically to select relevant studies for inclusion. Forty-six studies met the inclusion criteria and were included in the review. The synthesized evidence showed the effectiveness of teledentistry interventions in improving access to oral healthcare services, facilitating timely diagnosis and treatment planning, and enhancing patient outcomes. Despite variations in study designs and methodologies, teledentistry interventions consistently exhibited high diagnostic accuracy and concordance rates compared to traditional face-to-face consultations. The findings highlight teledentistry's transformative potential in modernizing oral healthcare delivery and reducing access disparities.

The clinical spectrum of sleep-disordered breathing comprises a range of diverse conditions including obstructive sleep apnoea, central sleep apnoea and sleep-related hypoventilation syndromes. These distinct conditions have specific diagnostic features and are managed differently from one another. Therefore, it is useful for dental practitioners to have a working knowledge of sleep-disordered breathing beyond that of uncomplicated obstructive sleep apnoea (OSA). This review paper summarizes the diagnosis and management of commonly encountered clinical sleep-disordered breathing syndromes, with a particular focus on management from a dental perspective.

The purpose of the present manuscript is to provide an overview for researchers and clinicians summarizing the knowledge concerning the relationship between some of the main sleep-related conditions of dental interest: sleep bruxism (SB), obstructive sleep apnoea (OSA) and gastroesophageal reflux disease (GERD). Starting with the discussion of the evolving current knowledge on SB, the interconnections are discussed. Most of the available literature focused on the possible relationship between OSA and SB, but a clear pathophysiological connection or temporal relationship has not been identified. Despite the paucity of data on the possible commonalities, SB, OSA and GERD constitute a complex network of conditions that may affect the clinical and research dental practice, and they are rarely found in isolation. In this scenario, the key role of dental practitioners as sentinel in the case of these sleep-related conditions is important, thanks to their ability and the knowledge to identify signs, symptoms and risk factors that are signs of ongoing sleep-related conditions. Thus, dental practitioners are recommended to view bruxism as a potential gateway to medicine.

Sleep Medicine has evolved into a highly multidisciplinary field over the last few decades, involving respiratory physicians, neurologists, cardiologists, ENT surgeons, psychiatrists and psychologists to name a few. It is within this highly multidisciplinary context that we have seen an increasing role for dentists in the recognition, diagnosis and management of select sleep disturbances and disorders. Over the last couple of decades, this growing role for dentists has seen the informal emergence of a new interdisciplinary field of Dental Sleep Medicine-a field that bridges medicine and dentistry as it pertains to the diagnosis and management of sleep disorders. This article describes this new field in terms of its history, the evolving scope of practice for dentists, the implications for education and training, and the importance of multidisciplinary care that optimises outcomes for patients.

Background: Whether to replace or repair a composite restoration is controversial and varies among clinicians. This study was designed to collect information on the attitudes and practices of Australian dentists towards composite repair.

Methods: An electronic 16-item questionnaire was distributed online on Australian clinicians' dental forum with a URL address and instructions on completing the survey. The questionnaire remained accessible for 2 months. The data collected were analysed statistically using descriptive, average rank, Pearson chi-square and Kruskal-Wallis tests at α = 0.05.

Results: Repair of composite restorations was a widely accepted treatment modality among surveyed dentists. Despite this, approximately half of clinicians reported the prognosis of repaired restorations to be worse when compared to replacement. The most cited indications for repair were partial loss or fracture of the restoration, while the most common reason for repair was because this treatment modality was more conservative in terms of tooth structure removal. Most important patient factor influencing decision to repair composite restoration was caries risk of the patient (n = 50). Most significant situational factor to consider in decision whether to repair was previous (failed) attempts to repair (n = 74). The most important tooth level factor was the proximity of restoration to pulp (mean statistic rank 2.22). The most common composite surface treatment employed by participants bonding to old composite was acid etching (n = 87), and the main reason participants employed their chosen surface treatment was based on personal experience (n = 72).

Conclusion: The repair of composite restorations was a commonly performed procedure that is well accepted but may still be viewed as an inferior treatment to replacement by many Australian dentists. Most dentists agreed on indications for repair restorations and surface conditioning techniques, but there was wide variation in opinions overall. Due to the lack of high-quality evidence regarding composite repair techniques, dentists tend to rely on personal experience to guide their clinical decisions.

Obstructive Sleep Apnoea (OSA) is a common heterogenous sleep disorder that is associated with a wide range of comorbidities and consequences, including the development of neurocognitive and cardiometabolic disorders. The heterogeneity of OSA necessitates a precision medicine approach to accurately diagnose this condition and to effectively manage patients. One of the primary models of precision medicine is described by the P4 approach of predicting those who are susceptible to disease, preventing the occurrence of disease, personalizing treatment, and encouraging patients to participate in their individual healthcare journey. Recent advances in oral appliance therapy and OSA monitoring techniques have fostered an exciting opportunity for enhanced collaboration between dentists and sleep physicians to optimize OSA precision medicine care. This review aims to discuss the sources of heterogeneity among OSA patients, provide an overview of the growing applications of oral appliance therapy and tailored monitoring programs for OSA that are shifting treatment to a more personalized and participatory model of care, and outline the pivotal role of dentists in managing patients with OSA.

Both periodontal diseases (PDs) and obstructive sleep apnoea (OSA) are highly prevalent disorders with global impact, associated with a large burden at individual patient and health system levels. These disorders often co-exist, but there is growing evidence that the association between the disorders goes beyond an overlap between two highly prevalent diseases that have shared risk factors. Evidence suggests a potential causal relationship, although further research is required to verify this. Regardless of any causal relationship, the co-existence of these disorders is important to recognize since they may act in combination to heighten health risks, particularly cardiovascular risk. Thus, dentists have an important role in screening for OSA in patients presenting with PDs, and similarly, they need to evaluate periodontal health in patients requiring treatment for OSA. Here we provide a narrative review of the association between PDs and OSA to raise awareness among clinicians and promote multidisciplinary collaborations that aim at an evidence-based and effective management of such patients.

In dental sleep medicine several sleep disorders commonly coexist with pain, contributing to complex clinical presentations which might affect the provision of appropriate and timely treatment. There are associations between sleep disorders and pain in general, as well as with specific orofacial pain conditions. As many as five of six patients with orofacial pain can present with sleep problems. The comorbidity of orofacial pain and sleep disorders overlays a complex web of altered neurobiological mechanisms that predispose to the chronification of orofacial pain. This review discusses the relationship between orofacial pain and sleep disorders and highlights their interactions and the neurobiological mechanisms underlying those relationships.