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The aim of this study was to determine the prevalence of musculoskeletal (MS) disorders in practicing German dentists and identify risk factors for pain chronification. This was a cross-sectional, quantitative, questionnaire-based study in which the validated German version of the Örebro Musculoskeletal Pain Questionnaire was sent out to practicing German dentists. Of the 8,072 questionnaires sent out, 576 dentists responded (60.2% men, 39.8% women; mean [SD] age, 50 [10.1] years; response rate, 7.1%). Overall, 344 dentists had current pain at 719 pain sites (point prevalence, 59.7%). The risk of chronic pain in dentists with current MS pain was high in 28.5% (n = 98), moderate in 30.5% (n = 105), and low in 41% (n = 141). The multivariate logistic regression analysis showed that specialization in restorative dentistry was associated with a significantly higher risk of experiencing pain chronification (odds ratio [OR], 3.94; P =.008), followed by specialization in pediatric dentistry (OR, 0.35; P =.048). A history of current pain, particularly current leg pain, was predictive of higher chronification risk (OR, 22.0; P <.001) and neck pain (OR, 4.51; P =.001). Almost two-thirds of practicing German dentists have MS pain, and one-third of these have a moderate through high risk of developing pain chronification. These health problems have an adverse impact on their ability to successfully perform dental services, with the potential for prolonged sick leave, disability, and early retirement. Accordingly, these problems deserve greater attention from the scientific community (identification of risk factors), universities (sensitization and education), and policy makers (development and implementation of appropriate countermeasures for MS disorders in the dental profession). Knowing the risk factors associated with acute and chronic MS pain may help dentists take preventive measures and thereby improve their physical well-being and work-related quality of life. [ABSTRACT FROM AUTHOR]

Patient–provider cost conversations can minimize cost-related barriers to health, while improving treatment adherence and patient satisfaction. The authors sought to identify factors associated with the occurrence of cost conversations in dentistry. This was a cross-sectional study using data from an online, self-administered survey of US adults who had seen a dentist within the past 24 months at the time of the survey. Multivariable hierarchical logistic regression analysis was used to identify patient and provider characteristics associated with the occurrence of cost conversations. Of the 370 respondents, approximately two-thirds (68%) reported having a cost conversation with their dental provider during their last dental visit. Cost conversations were more likely for patients aged 25 through 34 years (odds ratio [OR], 2.84; 95% CI, 1.54 to 5.24), 35 through 44 years (OR, 3.35; 95% CI, 1.50 to 7.51), and 55 through 64 years (OR, 3.39; 95% CI, 1.38 to 8.28) than patients aged 18 through 24 years. Cost conversations were less likely to occur during visits with dental hygienists than during visits with general or family dentists (OR, 0.25; 95% CI, 0.11 to 0.58). In addition, respondents from the South (OR, 1.90; 95% CI, 1.04 to 3.48) and those screened for financial hardship were more likely to report having cost conversations with their dental providers (OR, 6.70; 95% CI, 2.69 to 16.71). Within the study sample, cost conversations were common and were facilitated via financial hardship screening. Modifying oral health care delivery processes to incorporate financial hardship screening may be an effective way to facilitate cost conversations and provision of patient-centered care. [ABSTRACT FROM AUTHOR]

The purpose of this narrative review was to show that referred orofacial pain can be the chief symptom or a prominent symptom of visceral diseases of the chest and throat, with implications for dental and medical practice. A search of PubMed was performed to identify dentally relevant clinical case reports and case series using the following terms: jaw pain , orofacial pain , toothache , temporomandibular disorders , otalgia , neuralgia , and neuropathic pain crossed with angina , myocardial infarction , carotid artery , esophagus , mediastinum , thyroid , heart , pericardium , aorta , lung , thymus gland , and stomach. Numerous acute, visceral disorders of the throat and chest have been reported to produce pain in the orofacial region, which may be difficult to distinguish from dental-related diseases on the basis of symptoms alone. Chest organs and structures reported to cause such pain include the heart, aorta, esophagus, stomach, lungs, and mediastinum. Throat organs and structures reported to cause pain in the orofacial region include the thyroid gland, carotid arteries, and vagus and glossopharyngeal nerves. Coronary artery diseases, aortic and carotid dissection, mediastinal tumors, subacute thyroiditis, and gastroesophageal reflux disease have a predilection for referring pain orofacially. Misdiagnosis of referred visceral orofacial pain can lead to delayed diagnosis and unnecessary treatment. Dentists can play a key role in the management of these conditions by means of ruling out odontogenic facial pain, promptly referring patients to medical specialists, and educating patients. Future research is needed to determine the incidence and mechanism of orofacial pain in these disorders. Visceral pain referred to the orofacial region may not be as rare a phenomenon as is sometimes assumed. [ABSTRACT FROM AUTHOR]

There is a movement to engage oral health care professionals in administering tests to identify people at risk of developing contagious diseases and other medical conditions. The purpose of this overview was to provide clinicians with fundamental concepts to understand how to evaluate a screening test's capability to give a correct result and its implications for practice (health outcomes). The authors reviewed epidemiologic and statistical articles addressing the purpose of performing screening tests for medical conditions with a special emphasis on understanding and interpreting test results on the basis of specific test characteristics. Tests with different sensitivities and specificities will provide different probabilities of correctly classifying people with or without a disease of interest. By understanding how to interpret tests results and how to communicate the consequences (that is, impact on health outcomes) of positive and negative test results, oral health care professionals will be able to generate appropriate medical referrals and determine the need for further testing, as well as provide a public service. An understanding by oral health care professionals of how to interpret screening test results will benefit their patients substantially and, in the case of contagious diseases, the public at large. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the multifaceted impact of the COVID-19 pandemic on dental practices and their readiness to resume dental practice during arduous circumstances. The authors distributed an observational survey study approved by The University of Texas Health Science Center at San Antonio Institutional Review Board to dental care practitioners and their office staff members using Qualtrics XM software. The survey was completed anonymously. The authors analyzed the data using R statistical computing software, χ2 test, and Wilcoxon rank sum test. Nearly all participants (98%) felt prepared to resume dental practice and were confident of the safety precautions (96%). Only 21% of dentists felt the COVID-19 pandemic changed their dental treatment protocols, with at least two-thirds agreeing that precautions would influence their efficiency adversely. Although most participants were satisfied with the resources their dental practice provided for support during the pandemic (95%), most were concerned about the impact on their general health and safety (77%) and to their dental practice (90%), found working during the pandemic difficult (≈ 60%), and agreed there are challenges and long-term impacts on the dental profession (> 75%). Dental care professionals, although affected by the COVID-19 pandemic and at high risk of developing COVID-19, were prepared to resume dental practice during most challenging circumstances. The pandemic has affected dental care practitioners substantially; thus, there is need to formulate psychological interventions and safety precautions to mitigate its impact. Further research should evaluate the long-term effects on dentistry and oral health and interceptive measures for better communication and programming around future challenges. [ABSTRACT FROM AUTHOR]

Although rates of COVID-19 have remained low among US dentists, the authors aimed to determine the risk of there being COVID-19 in patients seeking oral health care. The authors performed a retrospective chart review of all emergency department consultations from June 1, 2020, through December 31, 2020. They used Pearson correlation coefficients to compare rates with citywide prevalence (P <.05). The authors located 203 encounters with 149 tests and 10 cases of COVID-19. Cases were strongly correlated with the citywide positivity rate (r = 0.9147; P =.0039). All patients who tested positive were asymptomatic and afebrile, and one-half (50%) visited a dentist within a week of consultation. The rate of COVID-19 in a population seeking oral health care reflects the community positivity rate. Asymptomatic or presymptomatic patients pose risks to providers, staff members, and other patients. Dentists should remain vigilant during the ongoing COVID-19 pandemic, even with vaccination rollout. The Centers for Disease Control and Prevention maintains an accessible website with easy access to each state's positivity rate and caseload. [ABSTRACT FROM AUTHOR]

In 2020, the Centers for Disease Control and Prevention and the American Dental Association released COVID-19 infection control interim guidance for US dentists, advising the use of optimal personal protection equipment during aerosol-generating procedures. The aim of this longitudinal study was to determine the cumulative prevalence and incidence rates of COVID-19 among dentists and to assess their level of engagement in specific infection control practices. US dentists were invited to participate in a monthly web-based survey from June through November 2020. Approximately one-third of initial respondents (n = 785) participated in all 6 surveys, and they were asked about COVID-19 testing received, symptoms experienced, and infection prevention procedures followed in their primary practice. Over a 6-month period, the cumulative COVID-19 infection prevalence rate was 2.6%, representing 57 dentists who ever received a diagnosis of COVID-19. The incidence rates ranged from 0.2% through 1.1% each month. The proportion of dentists tested for COVID-19 increased over time, as did the rate of dentists performing aerosol-generating procedures. Enhanced infection prevention and control strategies in the dental practice were reported by nearly every participant monthly, and rates of personal protection equipment optimization, such as changing masks after each patient, dropped over time. US dentists continue to show a high level of adherence to enhanced infection control procedures in response to the ongoing pandemic, resulting in low rates of cumulative prevalence of COVID-19. Dentists are showing adherence to a strict protocol for enhanced infection control, which should help protect their patients, their dental team members, and themselves. COVID-19 infections among practicing dentists will likely remain low if dentists continue to adhere to guidance. [ABSTRACT FROM AUTHOR]

The article focuses on the significant underrepresentation of Black and Hispanic/Latinx dentists in the US dentist workforce, highlighted by a report from the American Dental Association. Topics discussed include the lack of diversity in dental professionals and the disparities observed among different racial and ethnic groups in dentistry education and practice.

Background and Overview. A 9-year-old girl underwent comprehensive resection and rehabilitation of a central giant cell granuloma that required phased interprofessional collaborative care to optimize treatment decisions and outcome. Case Description. The interprofessional treatment team included an oral and maxillofacial surgeon, maxillofacial prosthodontist, dentist, orthodontist, and speech-language pathologist, and treatment spanned 9 years. Treatment included surgical resection of a central giant cell granuloma and obturation with a removable interim prosthesis. After adequate growth and development, the patient then underwent a surgical free-tissue transfer reconstruction by using virtual surgical planning, followed by dental implant placement and a transitional restoration, subsequent orthodontic therapy, and eventual definitive rehabilitation with an implant-retained fixed hybrid prosthesis. Conclusions and Practical Implications. The interprofessional phased and collaborative treatment facilitated an optimal functional and esthetic process in a young patient with transitional and definitive treatments that considered long-term quality-of-life implications. [ABSTRACT FROM AUTHOR]

Background. To describe antibiotic prescribing behaviors in dentistry, including clinical and nonclinical indications for their use, the type and regimen of antibiotics prescribed, and factors influencing their prescription, the authors conducted a scoping review. Types of Studies Reviewed. The authors conducted a scoping review of published literature by searching multiple databases. Key search terms included dentist, antibiotic, antimicrobial, antibacterial, prophylaxis, prescription, pattern, habit, knowledge, and practice. Two authors independently reviewed titles and abstracts by using detailed eligibility criteria. The authors placed no restrictions on study design or publication year. The authors qualitatively assessed studies by using a modified version of the Center for Evidence-Based Management's critical appraisal of a survey checklist. Results. The authors identified 1,912 studies but considered only 118 studies eligible for review. Most included studies were either cross-sectional surveys (81 studies) or prescription audits (25 studies) from various geographic locations. Publication dates ranged from 1982 through 2017. The authors examined prophylactic and therapeutic antibiotic use in 48 and 29 studies, respectively. Another 29 studies examined the use of both prophylactic and therapeutic antibiotics in dentistry. Overall, dentists prescribed a wide variety of antibiotic regimens for various clinical and nonclinical indications. Dentists have acquired their prescribing knowledge from a variety of sources and have changed their antibiotic prescribing practices throughout their careers for various reasons. Conclusions and Practical Implications. Considering the seriousness of antibiotic resistance, the authors highlight trends in antibiotic prescribing practices, characterize factors contributing to the use and misuse of antibiotics in dentistry, provide insight into the importance of antibiotic stewardship in the oral health setting, and encourage dentists to reflect on their antibiotic prescription practices. [ABSTRACT FROM AUTHOR]

Background. The purpose of this study was to assess dental antibiotic prescribing trends over time, to quantify the number and types of antibiotics dentists prescribe inappropriately, and to estimate the excess health care costs of inappropriate antibiotic prescribing with the use of a large cohort of general dentists in the United States. Methods. We used a quasi-Poisson regression model to analyze antibiotic prescriptions trends by general dentists between January 1, 2013, and December 31, 2015, with the use of data from Express Scripts Holding Company, a large pharmacy benefits manager. We evaluated antibiotic duration and appropriateness for general dentists. Appropriateness was evaluated by reviewing the antibiotic prescribed and the duration of the prescription. Results. Overall, the number and rate of antibiotic prescriptions prescribed by general dentists remained stable in our cohort. During the 3-year study period, approximately 14% of antibiotic prescriptions were deemed inappropriate, based on the antibiotic prescribed, antibiotic treatment duration, or both indicators. The quasi-Poisson regression model, which adjusted for number of beneficiaries covered, revealed a small but statistically significant decrease in the monthly rate of inappropriate antibiotic prescriptions by 0.32% (95% confidence interval, 0.14% to 0.50%; P = .001). Conclusions. Overall antibiotic prescribing practices among general dentists in this cohort remained stable over time. The rate of inappropriate antibiotic prescriptions by general dentists decreased slightly over time. Practical Implications. From these authors' definition of appropriate antibiotic prescription choice and duration, inappropriate antibiotic prescriptions are common (14% of all antibiotic prescriptions) among general dentists. Further analyses with the use of chart review, administrative data sets, or other approaches are needed to better evaluate antibiotic prescribing practices among dentists. [ABSTRACT FROM AUTHOR]

Background. Dentists wrote 6.4% of all opioid prescriptions in the United States in 2012. The purpose of this study was to examine opioid prescription rates, dosage of opioids prescribed, type of opioid drug prescribed, and type of dental visit at which dentists prescribe opioids. Methods. The authors used the 2010 through 2015 Truven Health Marketscan Research databases and the Prescription Drug Monitoring Program (PDMP) Training and Technical Assistance Center conversion data set. The authors conducted descriptive analyses for days' supply, quantity prescribed, and daily morphine milligram equivalent dose. Results. The opioid prescription rate per 1,000 dental patients increased from 130.58 in 2010 to 147.44 in 2015. Approximately 68.41% of all opioids prescribed were during surgical dental visits and approximately 31.10% during nonsurgical dental visits. During nonsurgical dental visits at which dentists prescribed an opioid, most of the procedures were restorative. Conclusions. Among a population of dental patients with private insurance, opioid prescribing rates in the United States increased slightly from 2010 to 2015. The largest increase was among 11- through 18-year-olds. Almost one-third of opioid prescriptions written by dentists were associated with nonsurgical dental visits. Practical Implications. Use of PDMP resources and use of nonopioid analgesics could help reduce the number of opioid prescriptions in dentistry. [ABSTRACT FROM AUTHOR]

Background. Antibiotic prescribing practices among general dentists and dental specialists in the United States remains poorly understood. The purpose of this study was to compare prescribing practices across dental specialties, evaluate the duration of antibiotics dentists prescribed, and determine variation in antibiotic selection among dentists. Methods. The authors performed a retrospective cross-sectional analysis of dental care provider specialties linked to deidentified antibiotic claims data from a large pharmacy benefits manager during the 2015 calendar year. Results. As a group, general dentists and dental specialists were responsible for more than 2.9 million antibiotic prescriptions, higher than levels for several other medical and allied health care provider specialties. Antibiotic treatment duration generally was prolonged and commonly included broad-spectrum agents, such as amoxicillin clavulanate and clindamycin. Although amoxicillin was the most commonly prescribed antibiotic among all dental specialties, there was substantial variation among other antibiotics each specialty selected. The most common antibiotic treatment durations were 7 and 10 days. Conclusions. This study's results demonstrate that dentists frequently prescribe antibiotics for prolonged periods and often use broad-spectrum antibiotics. Further studies are necessary to evaluate the appropriateness of these antibiotic prescribing patterns. Practical Implications. The clinically significant variation in antibiotic selection and treatment duration identified among all dental specialties in this study population implies that further research and guidance into the treatment of dental infections is necessary to improve and standardize antibiotic prescribing practices. [ABSTRACT FROM AUTHOR]

Background. Dentists prescribe approximately 10% of outpatient antibiotics, but little is known about dentists' antibiotic prescribing patterns. The authors conducted a study to characterize prescribing by dentists according to antibiotic agent and category, patient demographic characteristics, and geographic region in the United States. Methods. The authors identified oral antibiotic prescriptions dispensed during 2013 in the Xponent (QuintilesIMS) database. The authors used the total number of prescriptions and county-level census population denominators to calculate prescribing rates. In addition, the authors analyzed prescribing according to individual agent, drug category, and patient demographic characteristics and the total number of prescriptions calculated for general dentists overall. Results. Dentists prescribed 24.5 million courses of antibiotics in 2013, a prescribing rate of 77.5 prescriptions per 1,000 people. Penicillins were the most commonly prescribed antibiotic category. Dentists prescribed most antibiotics for adults older than 19 years. The Northeast census region had the highest prescribing rate per 1,000 people. The District of Columbia had the highest prescribing rate of 99.5 per 1,000 people, and Delaware had the lowest prescribing rate of 50.7 per 1,000 people. Conclusions. Dentists prescribe large quantities of antibiotics in outpatient settings, and there is considerable geographic variability. Additional study is needed to better understand the reasons for this variability and identify areas of possible intervention and improvement. Practical Implications. Continued efforts to combat antibiotic resistance will require all prescribers, including dentists, to examine prescribing behaviors for appropriateness and the effectiveness of guidelines to identify opportunities to optimize antibiotic use. [ABSTRACT FROM AUTHOR]

Background. In this study, the authors compared the odds of exposure to Legionella pneumophila among currently active dental practitioners with that of nonpractitioners and evaluated demographic and clinical practice predictors of exposure. Methods. The authors obtained demographic characteristics and dental practice behaviors from participants in the annual American Dental Association Health Screening Program survey administered from 2002 through 2012. The authors assayed serum samples obtained from participants for L pneumophila antibodies. The authors used an adjusted logit model to evaluate predictors of positive results. Results. Among 5,431 participants, approximately 10% were positive for L pneumophila, with no significant differences between dental practitioners and nonpractitioners. Geographic location was the only significant predictor of seropositivity, with no increased risk of being exposed to L pneumophila associated with age, race, sex, years in practice, hours of practice per week, use of barrier protection, or infection control practices. Conclusions. Prevalence of L pneumophila antibodies was 10.4% among dental and nondental personnel. US Census division was the only significant predictor of seropositivity. The authors conclude that provision of dental care did not increase the risk of being exposed to Legionella. Practical Implications. Dentists should be aware of the prevalence of Legionella species in their practice areas to understand their personal risk of developing an infection. [ABSTRACT FROM AUTHOR]

Background. Investigators use questionnaire surveys to evaluate treatment philosophies in dental practices. The aim of this study was to evaluate the management strategies California dentists use for approximal and occlusal carious lesions. Methods. In May 2013, the authors e-mailed a questionnaire that addressed approximal and occlusal carious lesion management (detection and restorative threshold, preferred preparation type, and restorative materials) to 16,960 dentists in California. The authors performed a χ² statistical analysis to investigate the relationship between management strategies and respondent demographic characteristics. Results. The authors received responses from 1,922 (11.3%) dentists; 42.6% of the respondents would restore approximal lesions at the dentinoenamel junction, and 33.4% would wait until the lesion reached the outer one-third of dentin. The preferred preparation type was the traditional Class II preparation. Dentists who graduated more recently (20 years or less) were more likely to delay approximal restorations (P < .0001); 49.9% of the more recent graduates would wait to restore an occlusal lesion until the outer one-third of dentin was involved, and 42.6% would restore a lesion confined to enamel. Conclusions. There is wide variety among California dentists regarding their restorative treatment decisions, with most dentists restoring a tooth earlier than the literature would advise. More recent dental graduates were more likely to place their restorative threshold at deeper lesions for approximal carious lesions. Practical Implications. Clinical evidence shows that noncavitated carious lesions can be remineralized; therefore, early restorative treatment may no longer be necessary or appropriate. Noninvasive and minimally invasive measures should be taken into consideration. [ABSTRACT FROM AUTHOR]

Background. Although the overall rate of antibiotic prescribing has been declining in British Columbia, Canada, the authors conducted a study to explain the increased rate of prescribing by dentists. Methods. The authors obtained anonymized, line-listed data on outpatient prescriptions from 1996 to 2013 from a centralized, population-based prescription database, including a variable coding prescriber licensing body. Analyses used Anatomical Therapeutic Classification standard codes and defined daily dose (DDD) values. The authors normalized prescribing rates to the population and expressed the rates in DDDs per 1,000 inhabitants per day (DID). The Canadian Dental Association released a webinar that invited correspondence from dentists about the drivers of the trend. Results. From 1996 to 2013, overall antibiotic use declined from 18.24 DID to 15.91 DID, and physician prescribing declined 18.2%, from 17.25 DID to 14.11 DID. However, dental prescribing increased 62.2%, from 0.98 DID to 1.59 DID, and its proportionate contribution increased from 6.7% to 11.3% of antibiotic prescriptions. The rate of prescribing increased the most for dental patients 60 years or older. Communication from dentists in Canada and the United States identified the following explanatory themes: unnecessary prescriptions for periapical abscess and irreversible pulpitis; increased prescribing associated with dental implants and their complications; slow adoption of guidelines calling for less perioperative antibiotic coverage for patients with valvular heart disease and prosthetic joints; emphasis on cosmetic practices reducing the surgical skill set of average dentists; underinsurance practices driving antibiotics to be a substitute for surgery; the aging population; and more dental registrants per capita. Conclusions. Emerging themes for dental prescribing should be explored further in future studies; however, themes already identified may guide priorities in antibiotic stewardship for continuing dental education sessions. Practical Implications. Antibiotic prescribing should be reviewed to make sure that we are compliant with guidelines. Most practitioners will find opportunities to prescribe less often and for shorter durations. [ABSTRACT FROM AUTHOR]

Background and Overview. There is a deficit in clinical research on the potential risks involved in treating dental patients who use cannabis for either medicinal or recreational purposes. The aim of this case report is to illustrate the need for additional education for oral health care professionals so they can understand the wide variety of available cannabis options and their potential effects on dental treatment. Case Description. A 27-year-old man sought care at the dental clinic with a nonrestorable molar requiring extraction. During the review of his medical history, the patient reported taking a "dab" of marijuana approximately 5 hours before his appointment. Because of the admission of recent illicit drug use, no treatment was rendered. The patient was offered an appointment the next day but he refused, citing bias in regard to his cannabis use. Conclusions and Practical Implications. The number of Americans using marijuana is increasing rapidly. Twenty-three states and the District of Columbia have laws legalizing cannabis to some degree, and Alaska, Colorado, Oregon, and Washington have legalized marijuana for recreational use. This drastic upswing in availability and usage will require dentists to address the possible effects of cannabis on dental practices. It is imperative that dental care providers make clinical decisions based on scientific evidence regarding the pharmacologic and psychological effects of marijuana, not on the societal stigma associated with illegal drug use. Dentists should be familiar with popular delivery systems and understand the differences between various marijuana options. Clinical guidelines may need to be developed to help providers assess the patient's degree of cognitive impairment. Dentists should be able to advise patients on the potential consequences of this habit on their oral health. [ABSTRACT FROM AUTHOR]

Background. The nature and organization of dental practice is changing. The aim of this study was to explore how job satisfaction among dentists is associated with dental practice setting. Methods. A survey measured satisfaction with income, benefits, hours worked, clinical autonomy, work-life bal ance, emotional exhaustion, and overall satisfaction among dentists working in large group, small group, and solo practice settings; 2,171 dentists responded. The authors used logistic regression to measure differences in reported levels of satisfaction across practice settings. Results. Dentists working in small group settings re ported the most satisfaction overall. Dentists working in large group settings reported more satisfaction with in come and benefits than dentists in solo practice, as well as having the least stress. Conclusions. Findings suggest possible advantages and disadvantages of working in different types of practice settings. Practical Implications. Dentists working in different practice settings reported differences in satisfaction. These results may help dentists decide which practice setting is best for them. [ABSTRACT FROM AUTHOR]

Background. Attitudes and views are critical to the adoption of innovation. Although there have been broadening calls for a standardized dental diagnostic terminology, little is known about the views of private practice dental team members regarding the adoption of such a terminology. Methods. The authors developed a survey by using validated questions identified through literature review. Domain experts' input allowed for further modifications. The authors administered the final survey electronically to 814 team members at a multioffice practice based in the US Pacific Northwest. Results. Response proportion was 92%. The survey had excellent reliability (Cronbach a coefficient = 0.87). Results suggested that participants showed, in general, positive attitudes and beliefs about using a standardized diagnostic terminology in their practices. Additional written comments by participants highlighted the potential for improved communication with use of the terminology. Conclusions. Dental care providers and staff in 1 multi-office practice showed positive attitudes about the use of a diagnostic terminology; specifically, they believed it would improve communication between the dentist and patient, as well as among providers, while expressing some concerns about whether using standardized dental diagnostic terms helps clinicians to deliver better dental care. Practical Implications. As the dental profession is advancing toward the use of standardized diagnostic terminology, successful implementation will require that dental team leaders prepare their teams by gauging their attitude about the use of such a terminology. [ABSTRACT FROM AUTHOR]

The article focuses on the need for knowing how to perform a procedure should not supersede the process of clinical decision making, which determines why we are doing the procedure. Topics include factors associated with good continuing education (CE) course such as superior skills and increase in income; introduction to the instruction on how to critically review scientific literature in undergraduate dental programs; and educational arms of our national organizations to monitor CE.

Background. Dental care providers may diagnose diseases and conditions that affect a patient's general health. The authors reviewed issues related to breaking bad medical news to dental practice patients and provide guidance to clinicians about how to do so. Methods. To help reduce the potentially negative effects associated with emotionally laden communication with patients about serious health care findings, the authors present suggestions for appropriately and sensitively delivering bad medical news to both patients and their families in a supportive fashion. Results. Preparing to deliver bad news by means of education and practice is recommended to help prevent or reduce psychological distress. One form of communication guidance is the ABODE model, which involves Advance preparation, Building a therapeutic relationship or environment, Communicating well, Dealing with patient and family reactions, and Encouraging and validating emotions. An alternative model is the six-step SPIKES sequence-Setting, Perception, Invitation or Information, Knowledge, Empathy, and Strategize and Summarize. Using either model can assist in sensitive and empathetic communication. Conclusions. For both practitioners' and patients' well-being, empathetic and effective delivery of bad medical news should be included in dental school curricula and continuing education courses. Practical Implications. Dental care providers should be familiar with the oral manifestations of diseases and the care needed before the patient undergoes medical treatment and use effective communication necessary to share bad news with patients. [ABSTRACT FROM AUTHOR]

The article focuses on the practitioner's guide to help enhance and develop their critical appraisal skills in the dental and medical literature. It states that various challenges may emerge when translating research into clinical practice including the evaluation and access of evidence and institutions' and practitioners' resistance to change. It says that systematic reviews is an efficient method of presenting the evidence.

An American Dental Association (ADA) continuing education quiz on fissure sealants, postextraction implant, and effect of smoking to the metronidazole.

The article focuses on the study that examines the materials used by dentists in The Dental Practice-Based Research Network (DPBRN) in putting the first restoration on permanent posterior tooth surfaces. A cross-sectional study was conducted by DPBRN practitioner-investigators and informed consent was sought to patients. The study indicates that amalgam was more often used by practitioner-investigators than direct resin-based composite (RBC) for posterior carious lesions.

The dental office potentially possesses all transmission risk factors for severe acute respiratory syndrome coronavirus 2. Anticipating the future widespread use of COVID-19 testing in dental offices, the authors wrote this article as a proactive effort to provide dental health care providers with current and necessary information surrounding the topic. The authors consulted all relevant and current guidelines from the Centers for Disease Control and Prevention and the US Food and Drug Administration, as well as online resources and review articles. Routine COVID-19 screening and triage protocols are unable to detect all infected people. With the advancements in diagnostic tools and techniques, COVID-19 testing at home or in the dental office may provide dentists with the ability to evaluate the disease status of their patients. At-home or point-of-care (POC) tests, providing results within minutes of being administered, would allow for appropriate measures and rapid decisions about dental patients' care process. In this review, the authors provide information about available laboratory and POC COVID-19 screening methods and identify and elaborate on the options available for use by dentists as well as the regulatory requirements of test administration. Dentists need to be familiar with COVID-19 POC testing options. In addition to contributing to public health, such tests may deliver rapid, accurate, and actionable results to clinical and infection control teams to enhance the safe patient flow in dental practices. Oral health care must continue to offer safety in this or any future pandemics. Testing for severe acute respiratory syndrome coronavirus 2 at the POC offers a control mechanism contributing to and enhancing the real and perceived safety of care in the dental office setting. [ABSTRACT FROM AUTHOR]

The article offers information on the concept of oral health in children. It mentions children have the best access to restoration of diseased teeth and proven effective methods of preventive care to improving the health of our community; and also mentions healthy teeth during childhood is important for eating, speech development, and a positive self-image.

Little is known about antibiotic prescribing practices of dentists. The objective of this study was to gain a better understanding of dentists' beliefs and behaviors regarding the use of antibiotic prophylaxis (AP) before invasive dental procedures. A multidisciplinary team developed and disseminated a questionnaire to 3,584 dentist members of the National Dental Practice-Based Research Network. Overall, 2,169 network dentists (61%) responded. Respondents saw patients at risk of developing infective endocarditis (IE) and prosthetic joint infection (PJI) at least once per week (35% and 65%, respectively). Although 78% of dentists agreed that the 2007 American Heart Association guidelines for the prevention of IE are well-defined and clear, only 49% agreed concerning PJI guidelines. Differences for the IE and PJI patient populations also existed for questions regarding dentists' understanding of the specific patient groups at risk, the recommended antibiotic regimens, and the need to consult with a patient's cardiologist or orthopedic surgeon. The survey results indicate that decision making regarding the use of AP occurs frequently among dentists. Moreover, dentists reported uncertainty about the appropriate use of AP as defined by both IE and PJI guidelines, which may have resulted in a lack of concordance between dentists' beliefs and their practice behaviors. The results reported by the authors highlight the need to develop better educational programs that address antimicrobial stewardship in AP for patients at risk of developing IE and PJI and target the dental profession. [ABSTRACT FROM AUTHOR]

The authors' objective in this systematic review was to investigate the barriers involved in the application of evidence-based dentistry principles, as reported by dentists. The authors registered the protocol in the PROSPERO database. Eligible studies included qualitative and quantitative approaches, constituting information about barriers, collected through interviews, questionnaires, or conversation sessions. The authors searched databases and reference lists of preselected studies. After the selection process, the authors evaluated the included studies for potential risk of bias and collected either qualitative or quantitative data. After the selection process, the authors included 35 studies, of which 16 were reported in this article. The authors synthesized and classified the barriers in 4 categories: self-related, evidence-related, context-related, and patient-related barriers. Shortage of time and financial constraints were the barriers most frequently studied. However, the quantification of these barriers, as well as others, was not possible because of the variability of the results and methodological issues of the included studies. The authors suggest the development of valid questionnaires and their use in representative samples to quantify the effects of specific barriers. The authors encourage practitioners to participate in educational programs focused on training in evidence-based dentistry abilities, in addition to seeking accessible and synthesized formats of reliable scientific knowledge. [ABSTRACT FROM AUTHOR]

A Continuing Education Unit (CEU) from the "Journal of the American Dental Association" (JADA) for February 2019 on oral health care, geospatial distribution of periodontists and oral human papillomavirus detection is presented.

The article discusses how to become more efficient as a dentist and practice leader. It states that dentists are hesitant to hire additional personnel until there is an absolute need due to which they get into the habit of performing nonclinical activities. It advices to build a more effective team and gives tools that can help staff members learn new skills. Dentists should delegate administrative tasks to staff members to help their practices.

The article offers information on various dentists in the U.S. in 2012 including doctor (Dr.) Patricia L. Blanton, who was elected American College of Dentists president, Dr. James Conrardy who received the 2011 Wisconsin Dental Association (WDA) Lifetime Achievement Award, and Dr. Matthew Kutz, who was awarded the WDA Community Outreach Award.

A clarification to a letter regarding the requirement for a display of an automated external defibrillator (AED) at the dentist's office in the state of New York that was published in the January 1, 2012 issue is presented.