Search Results (433)

Background/Objectives: There is a limited understanding of the variables relating to dental patients and the treatment provided during the initial phase of the COVID-19 lockdown in our region. This study aimed to qualitatively analyze these patient variables and determine the associations between treatment recommendations and the specialty of the doctor at the point of care. Methods: The present study was retrospective, cross-sectional, and analytical in nature. Data regarding symptoms, diagnosis, treatment, and the attending specialist were retrieved from the patient management software for patients seeking emergency dental services during the COVID-19 lockdown (23 March 2020 to 23 April 2020) in primary and tertiary public hospitals of the National Guard Health Affairs in Riyadh, Saudi Arabia. The association between exploratory (symptoms, diagnostic tool, specialist at point of care) and dependent variables (given diagnosis and treatment) was assessed using Fisher’s exact test and multinomial regression analysis. Results: A total of 151 dental patients attended the outpatient/emergency clinics during this period. The mean age of the patients in this study was 31.4 (±19.0) years. Compared to physicians, general dentists [OR 0.56, CI 0.29–10.47] were more likely to give an inappropriate diagnosis and treatment, whereas residents [OR 2.70, CI 1.65–98.17] and resident endodontists [OR 2.30, CI 1.28–78.11] were more likely to give an appropriate diagnosis and treatment. Conclusions: The findings of this study highlight the need for a greater number of endodontists at the forefront of screening and providing dental care during such health catastrophes. Full article

Background: Childsmile is Scotland’s national child oral health improvement programme designed to reduce inequalities in oral health and ensure universal access to NHS dental services by working closely with children and their families. Research has shown that parents with more dental concerns are less likely to bring their children for regular preventive dental check-ups.Therefore, a communication toolkit named ‘Chatterbox’ was created to help families access dental care services. Methods: This study aimed to evaluate the acceptability of Chatterbox from the perspective of parents with young children and from staff who work with them. Thirty parents of young children, volunteers, and staff affiliated with three third-sector family support organisations in Dundee participated in in-depth interviews, focus groups, and observations to assess the objectives of Chatterbox. A framework analysis was conducted to capture the themes, patterns, and findings triangulated using observations and field notes. Results: Chatterbox was found to promote effective communication, identify barriers to dental attendance, provide a platform for reflection, convey the complexities of daily life, and boost parents’ confidence to seek assistance. Conclusions: Chatterbox has the potential to help parents in accessing preventive dental care for their young children when used with trained support workers. Full article

Background/Objectives: This paper brings to light the results of extensive research on the dimension of dental care in Romania in terms of priorities and policies defined at the governmental level for a 25-year period (1999–2023). This research aims to present both individual and ecosystem perspectives on the influence of the way oral health strategies are shaped in Romania. Methods: The data collected are analyzed through the prism of the “iron triangle of healthcare”, focusing on the evolution of dental care from the perspective of the interrelationship of three important components: cost, quality, and access to healthcare services. Results: The paper provides insight and clarity into the context in which the doctor–patient relationship is constructed and developed, as well as a vision of how oral health policies should be designed to meet the individual needs of the patient, which will have an impact on the health and quality of life of the whole community. Conclusions: This study emphasizes the need to reconfigure oral health policies in Romania. Despite some input achievements like a considerable number of dentists, the systemic challenges that developed over these 25 years (such as insufficient funding, the reduced reimbursed procedures, and the limited dentists contracting with NHIH) have significantly contributed to a stagnation or decline of the oral health outcomes at the societal level. Full article

People experiencing, or at risk of, homelessness face challenges that result in poorer health outcomes compared to those in stable housing. This study provides the results of over 40 health measures that capture the health status of a group of people in temporary accommodation due to experiencing homelessness, aged 22 to 84 years, in an inner-city location, invited to participate in a comprehensive assessment of physical and psychological health. Evidence of accelerated ageing was found, with 44.2% of people being clinically frail, 63% having poor functional movement, and 36% having pain associated with oral health. Additionally, 90.6% of participants showed health risks due to nutritional deficiencies, over half reported poor sleep quality, 55.3% reported having psychological distress, and almost half reported fair or poor overall dental health. This study suggests a pathway to providing a relatively easily implemented series of health assessments to help respond to a group of underlying causes for accelerated ageing among a group of inner-city people experiencing homelessness. This work can be used to inform the prioritisation and development of community-based health services to address functional deficits that may contribute to accelerated ageing. Full article

Background: Chronic periodontitis (CP) and metabolic dysfunction-associated steatotic liver disease (MASLD) have emerged as interconnected conditions with shared mechanisms, such as systemic inflammation and metabolic dysregulation. However, the risk of CP in the newly classified subgroups of steatotic liver disease (SLD), including MASLD and metabolic alcohol-associated liver disease (MetALD), has not been extensively studied. This study investigated the association between SLD subtypes and the incidence of CP in a nationwide cohort. Methods: This retrospective cohort study used data from the Korean National Health Insurance Service database. The study included 115,619 participants aged 40 and older who underwent health screenings between 2009 and 2010. The participants were classified into four groups: normal without risk factors, normal with risk factors, MASLD, and MetALD. The primary outcome was the incidence of CP as defined by ICD-10 codes and dental treatment records. Hazard ratios (HRs) were calculated using the Cox proportional hazards model and adjusted for demographic, clinical, and lifestyle factors. Results: Over a mean follow-up of 7.4 years, individuals with MASLD and MetALD had significantly higher risks of developing CP compared with the normal group without risk factors (MASLD: adjusted HR 1.14, 95% confidence interval (CI): 1.11–1.17; MetALD: adjusted HR 1.21, 95% CI: 1.15–1.27). The risk was more pronounced for severe CP, particularly for those with MetALD (adjusted HR 1.29, 95% CI: 1.22–1.36). Subgroup and sensitivity analyses confirmed these findings across the various definitions of hepatic steatosis and metabolic risk factors. Conclusions: This study reveals that individuals with MASLD and MetALD are at an elevated risk of developing CP, highlighting the need for integrated care strategies that address both periodontal health and metabolic liver conditions. These findings underscore the importance of periodontal health management in reducing the risk of CP among SLD populations. Full article

This study aimed to evaluate the effectiveness of a patient-centered standardized prophylaxis process in improving patient satisfaction and intentions to return to dental clinics. Conducted in a first-tier city in China from 9 June to 26 July 2023, the cross-sectional survey included 826 patients from 38 dental clinics. Among the respondents, 438 received standardized prophylaxis services, while 388 were in the non-standardized group, with a mean age of 38.2 ± 12.1 years and 50.24% male participation. The results revealed that patients in the standardized prophylaxis group reported significantly higher satisfaction scores (average 4.74 vs. 3.34, p < 0.0001) and greater intentions to return (average 4.77 vs. 4.10, p < 0.0001) compared to those receiving non-standardized care. The ordinal logistic regression analysis identified patient satisfaction as a strong predictor of return intention, with an odds ratio of 24.487, while the standardized service group had an odds ratio of 16.063, indicating a substantial positive effect on satisfaction. Age was also found to significantly affect return intention, reflected in an odds ratio of 0.969. Furthermore, the model showed strong predictive accuracy, which was supported by a Somers’ D value of 0.806. Additionally, an impressive 89.9% of the observations were correctly ordered, which strengthens the reliability of the findings. These outcomes highlight the significant contribution of patient-centered, standardized practices to the satisfaction of the patients as well as the development of their desire to return for follow-up care. However, the findings should be interpreted with caution due to the study’s cross-sectional nature, which limits causal inferences, and the specific demographic characteristics that may affect the general applicability of the results. Further research is needed to explore these dynamics across diverse populations and settings. Full article

(1) Background: Completion of the full oral health course of care (CoC) is essential to prevent further deterioration of oral and overall health. Understanding these patterns, particularly in public oral healthcare services, is crucial for improving access to and the delivery of care. This study aims to identify the socio-demographic and clinical characteristics of adult patients who did not complete required dental treatments within a 12-month period at Monash Health Dental Services (MHDS), Melbourne, Victoria. (2) Methods: Data were collected on patients’ course of care (CoC), socio-demographic characteristics, and clinical information from the MHDS Titanium electronic database. This study represents a secondary data analysis from adult patients who attended MHDS between November 2022 and October 2023, excluding emergency dental care visits. Logistic regression analyzed the socio-demographic and clinical variables affecting CoC. (3) Results: Our findings identified several significant predictors of incomplete CoC; being a non-priority group, mental health clients, refugees, and identifying as Aboriginal or Torres Strait Islanders (OR = 1.41; 95% CI: 1.08–1.84). Conversely, speaking a language other than English increased the odds of completing treatment (OR = 0.85; 95% CI: 0.74–0.98). By age, patients in the 36-to-55- or the 56-to-75-year-old age groups were more likely to be in the incomplete group (OR = 1.65; 95% CI: 1.37–1.98; and OR = 1.43; 95% CI: 1.22–1.66, respectively). (4) Conclusions: This study identified predictors of discontinued care, emphasizing accessibility and equitable outcomes for users of public oral healthcare. The findings indicate that the predictors of course of care (CoC) completion differ from barriers to accessing care. This highlights key objectives in public health dentistry, focusing on improving accessibility and promoting equitable oral health outcomes for vulnerable populations. Full article

Background/Objectives: Dental emergencies significantly impact public oral health, particularly in the post-COVID-19 context. This study aimed to analyze the patterns of dental emergencies presenting to the Emergency Dental Service in Bihor, Romania, during the years 2022 and 2023, focusing on demographic characteristics and the frequency of diagnoses. Methods: A retrospective analysis of medical records from the Emergency Dental Service at Oradea County Emergency Clinical Hospital was conducted. Inclusion criteria encompassed patients presenting with dental emergencies during the specified period. Data regarding demographics, diagnoses, and living environments were collected and statistically analyzed. Results: A total of 4769 patients were analyzed, with acute pulpitis (39.2%, n = 1869) and acute apical periodontitis (37.5%, n = 1788) identified as the most common diagnoses. The study population included 52.3% males and 47.7% females, with a larger proportion residing in urban areas (58.0%) compared with rural areas (42.0%). Significant age-related patterns were evident: pulpitis was more common among patients aged 10–39 years, trauma was associated with patients aged 0–9 years, and gingival infections were prevalent in the 70–79 age group. Diagnoses also varied by dentition type, with abscesses, caries, trauma, and rhizolysis occurring more frequently in deciduous teeth, while pulpitis and post-extraction alveolitis were predominant in permanent teeth. However, no statistically significant differences were found in diagnosis frequency between genders or between rural and urban patients, indicating equitable access to emergency services across environments. Conclusions: The findings underscore the need for targeted interventions in pediatric populations to address early childhood caries, which remains a significant burden. Enhanced public health strategies and preventive education are essential to mitigate the prevalence of dental emergencies, particularly in the aftermath of the COVID-19 pandemic. Full article

Background/Objectives: Older adults need specialised dental care due to age-related changes and chronic conditions, but inadequate coordination and capacity hinder access to domiciliary oral care. This review explores the characteristics, barriers, facilitators, caregiver education, and outcomes of domiciliary oral care to improve services for frail older adults. Methods: A systematic scoping search was conducted following the PRISMA guidelines. A literature search was performed to identify the key search terms and the databases that were relevant to the objectives. A total of 454 documents were retrieved, 31 of which were included in the final synthesis. Results: Overall, the barriers and facilitators in delivering domiciliary dental service for the elderly can be categorised into four groups: system, oral healthcare provider, caregiver, and patient. Having policies or guidelines supporting domiciliary oral care was one of the most frequently reported factors. Six studies reported outcomes of educational programme for caregivers and all were with positive results. Conclusions: The review highlights the need for a multi-pronged approach involving the healthcare system, oral healthcare providers, caregivers, and older adults themselves to improve access to and quality of oral healthcare services for this vulnerable population. Full article

Background: Oral diseases remain among the most common non-communicable diseases worldwide, affecting almost half of the world’s population. This is partly because there has been a separation of the mouth from the rest of the body and human health, and psychological aspects such as personality, thoughts, and emotions are not taken into account in the dental office. The objective was to analyze the relationship between oral health conditions and personality traits in adult patients who underwent dental treatment at the Center for Health Studies and Services. Methods: This was a descriptive, observational, and correlational study, carried out at the Center for Health Studies and Services. A total of 184 patients who attended the dentistry area in the period from October 2022 to May 2023 participated in the study, of which 59.78% were women and 40.21% men. The age of the population was 18 to 79 years, with the age range of 21–40 years being the most prevalent (48.37%). Results: The results show that although the hygiene of the population treated was good (0.77 ± 0.79) and that the perception of oral health was positive (14.34 ± 9.43), the means and percentages of oral pathologies and parafunctional habits were high (i.e., DMFT: 9.98 ± 5.40; attrition: 87.50%; onychophagia: 45.10%). It is noteworthy that both the correlation, network, multiple line regression, and logistic regression analyses showed associations of the personality, gender, and age variables with a history of caries and oral hygiene as well as with parafunctional habits. Conclusions: Therefore, variations in both the personality and the age and gender of the patients treated have repercussions on oral health conditions, which can be used in the prevention of oral diseases and in health promotion. Full article

Introduction: People with special care needs often face significant barriers in accessing dental care due to physical and cognitive limitations, leading to high rates of dental issues like caries. Despite the growing recognition of these challenges, unmet dental care needs remain prevalent. This review aims to explore the global landscape of special care dentistry to identify gaps and opportunities for improving dental services for this population. Methodology: A systematic search was conducted across three online databases—PubMed, Embase, and Scopus—to identify relevant articles from their inception through May 2024. Reference lists of the selected studies were also screened for additional sources. A thematic synthesis approach was applied to derive both descriptive and analytical themes. The scoping review was guided by the Arksey and O’Malley framework to examine the scope and nature of studies and documents related to dental care for individuals with special care needs. Furthermore, a Google search was performed to include accessible theses and official government documents from various countries. Results: A total of 49 studies from 11 countries were reviewed, all centered on providing dental care for people with special needs. The analysis revealed three main themes: Human resources, care delivery model, and management. Within these, nine subthemes emerged: Mid-level oral care providers, dentists, special care dentistry as a specialty, tele-dentistry, mobile dentistry, hospital care, levels of healthcare provision, financial support, and education. These themes and subthemes highlight essential areas for enhancing services for those people. Conclusions: A holistic approach is essential to enhance dental care for people with special needs. Critical strategies, including the involvement of mid-level oral care providers, the adoption of tele-dentistry and mobile units, and the availability of hospital-based services for complex cases, are crucial. To truly transform care for those people, each country must adapt these strategies to its specific context, aligning resources and policies to create an inclusive, accessible, and effective system. Full article

Background/Objectives: Unmet dental needs involve cases wherein someone needed dental care and did not receive it. Published data on unmet dental needs are limited. This cross-sectional study investigates unmet dental needs in Greece before and during the COVID-19 pandemic. Methods: For this study, a questionnaire was created and distributed to a non-random sample. It was completed by 277 individuals. The questionnaire was based on the European Union Statistics on Income and Living Conditions (EU-SILC) tool, which is used to investigate unmet health needs. It was enriched with questions about unmet dental needs before and during the COVID-19 pandemic. Results: Of the 277 participants, 23.1% reported unmet dental needs before the onset of the COVID-19 pandemic, which decreased to 13.4% after the onset of the pandemic. However, a significant proportion of the sample (48.3%) reported no need for dental care after the onset of the COVID-19 pandemic. It is also worth noting that there were instances of dental visit avoidance, both when symptoms were present and for standard check-up/follow-up purposes, at rates of 17% and 27.8%, respectively. Conclusions: Unmet dental needs occurred at lower rates after the onset of the COVID-19 pandemic than those recorded before the pandemic. The main reasons for unmet needs before the pandemic were the cost of dental services and fear of treatment procedures or the visit to the dentist, while after the onset of the COVID-19 pandemic, lack of time and fear of coronavirus transmission were added. Full article

Background and Aims: To study the unknown influencing factors of delayed medical treatment behavior in oral cancer patients in western China and to develop a prediction model on the risk of delayed medical treatment in oral cancer patients. Method: We investigated oral cancer patients attending a tertiary Grade A dental hospital in western China from June 2022 to July 2023. The logistic regression and four machine learning models (nearest neighbors, the RBF SVM, random forest, and QDA) were used to identify risk factors and establish a risk prediction model. We used the established model to predict the data before and after the COVID-19 pandemic and test whether the prediction effect can still remain stable and accurate under the interference of COVID-19. Result: Out of the 495 patients included in the study, 122 patients (58.65%) delayed seeking medical treatment before the lifting of the restrictions of the pandemic, while 153 patients (53.13%) did so after the lifting of restrictions. The logistic regression model revealed that living with adult children was a protective factor for patients in delaying seeking medical attention, regardless of the implementation of pandemic control measures. After comparing each model, it was found that the statistical indicators of the random forest algorithm such as the AUC score (0.8380) and specificity (0.8077) ranked first, with the best prediction performance and stable performance. Conclusions: This study systematically elucidates the critical factors influencing patient delay behavior in oral cancer diagnosis and treatment, employing a comprehensive risk prediction model that accurately identifies individuals at an elevated risk of delay. It represents a pioneering large-scale investigation conducted in western China, focusing explicitly on the multifaceted factors affecting the delayed medical treatment behavior of oral cancer patients. The findings underscore the imperative of implementing early intervention strategies tailored to mitigate these delays. Furthermore, this study emphasizes the pivotal role of robust social support systems and positive family dynamics in facilitating timely access to healthcare services for oral cancer patients, thereby potentially improving outcomes and survival rates. Full article

Background/Objectives: School-based caries prevention can increase access to critical dental services and reduce oral health inequities. However, little is known regarding the incidence of dental caries in children participating in school caries prevention, and caries diagnosis is often interval censored. Methods: In this paper, we used data from a longitudinal, school-based, randomized clinical trial of minimally invasive treatments for dental caries to estimate the per-visit incidence rate and compare the hazard of dental caries in children receiving either silver diamine fluoride or glass ionomer dental sealants. To account for interval censoring, we used semiparametric transformation models for univariate failure time data and imputed caries incidence using G-imputation. Results: There were 3040 children that met inclusion criteria for analysis, 1516 (49.9%) of which were randomly assigned to receive silver diamine fluoride and 1524 (50.1%) were assigned to receive glass ionomer dental sealants and atraumatic restorations. There were no differences in the hazard of caries between treatments (HR = 0.99, 95% CI = 0.72, 1.24), while children with caries at baseline had a significant increase in the hazard of new caries (HR = 2.54, 95% CI = 2.26, 2.83) compared to those that were caries free. The per-visit caries incidence ranged from 4.8 to 11.1 at the individual level and increased with each successive study observation. Conclusions: School-based caries prevention can positively affect caries incidence, and the results can be used to inform future program design and implementation. Full article

Objectives: To assess the prevalence of systemic pathologies associated with periodontal diseases to determine multimorbidity patterns and risk factors for periodontal care. Methods: A single-center cross-sectional study analyzed patient records from 1 January 2019 to 31 December 2021 at the Department of Periodontology, part of the Dental Service of a hospital-based dental school in Lyon, France. The anonymized data included patient-reported medical history (questionnaire) and billing for periodontal procedures. Data were compared between patients in the Department of Periodontology and from Other Departments of the Dental Service. The association between clinically relevant pathologies, as defined as multimorbidity, and admission in the Department of Periodontology were assessed with logistic regression. Prevalences between the Department of Periodontology and the Other Departments of the Dental Service were compared with chi-squared tests. Relationship among pathologies was described through correlation analysis. Statistical analyses were conducted using R software with a significance level set at p < 0.05. Results: This study included records of 20,945 patients in the Dental Service with 1205 periodontal procedures performed in the Department of Periodontology. Patients admitted for periodontal care were older and mostly female (p-value < 0.001). The most frequent systemic pathologies were hypertension and diabetes in the Department of Periodontology. Hypertension associated with diabetes was the most frequent multimorbidity pattern, while the most frequent triad of multimorbidity was hypertension/diabetes/cardiac rhythm disorders. Patients with diabetes had a 1.49 times higher likelihood of admission to the Department of Periodontology (OR = 1.49 [1.20; 1.86]), with age also being a significant risk factor but with a smaller effect size (OR = 1.02 [1.01; 1.03]). Conclusions: Within the limitations of this study, hypertension, diabetes, cardiac rhythm disorders, and chronic renal insufficiency were identified as prevalent multimorbidity in the Department of Periodontology. Multimorbidity including diabetes seems to constitute a risk factor requiring periodontal care. Full article