Search

Results of a survey of Canadian (n=8) and United States (n=44) dental schools concerning the clinical and didactic curriculum time allotted to preventive dentistry are reported. Comparable time allocation, requirements, and evaluation procedures were found in the two countries, but Canadian schools devote more hours to teaching prevention. (MSE)

Purpose: The purpose of the study was to determine whether visiting only a pediatric dentist (as opposed to visiting only a general dentist) was associated with the provision of preventive dental services for a U.S.-based pediatric population (those 18 years and younger). Methods: This study analyzed pooled Medical Expenditure Panel Survey data from 2018 and 2019 to compare the use of certain preventive dental services (i.e., examination, radiographs, prophylaxis, dental sealant, and fluoride treatment) among those who reported visiting a pediatric dentist versus those who visited a general dentist. Survey procedures were used in Stata 14.0 to perform multivariable logistic regression analyses. Results: Controlling for demographic and insurance variables, children who visited only pediatric dentists had statistically significantly greater odds of receiving radiographs (adjusted odds ratio [AOR] equals 1.22; 95 percent confidence interval [95% CI] equals 1.01 to 1.48; P=0.04), fluoride treatment (AOR equals 1.57; 95% CI equals 1.30 to 1.90; P≤0.001), and sealants (AOR equals 1.63; 95% CI equals 1.24 to 2.16; P=0.001) compared to children who visited only general dentists. There was no statistically significant difference in the provision of periodic examinations and prophylaxis services. Conclusion: Based on the nationally representative data evaluated, pediatric dentists are more likely to provide more optimal preventive services than general dentists (i.e., radiographs, fluoride treatments, and sealants) to children in the United States. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence, distribution pattern, and development/progression of gingival recession in a population of dentists, followed up over an additional 15 years, after an initial and previously published follow‐up of 10 years. Methods: This 25‐year longitudinal gingival recession investigation started in 1994 at the Dental School with 60 final‐year dental students; among them, 40 were re‐examined in 2004, and 27 of those 40 were further examined in 2019 by the same examiner. A questionnaire session provided information on toothbrushing habits at each appointment. Results: In this study, 27 individuals aged 31–44 years (724 teeth) were followed up. The prevalence of gingival recession was 100% after 15 years. A total of 204 and 317 recessions found in 2004 and 2019, respectively, were valid for the longitudinal evaluation. The highest recession incidence was observed in the molars during both examinations (p < 0.0001). The mean recession heights were 1.66 ± 0.87 mm and 1.85 ± 1.08 mm, respectively (p = 0.024). The difference between the means was 0.19 mm after 15 years. The mean probing depth and bleeding on probing at the point of the maximum recession decreased (p < 0.0001). A multiple regression analysis on the tooth level was performed and indicated that the keratinized gingival width was negatively associated with the severity of the buccal recession height. Conclusions: Fifteen years after the initial follow‐up, the mean number of gingival recessions per dentist and the mean recession height increased, while toothbrushing habits remained nearly unchanged. [ABSTRACT FROM AUTHOR]

Dental fear and anxiety are highly prevalent among children and have been shown to lead to irregular use of dental services. Previous research has suggested that while touch can alleviate the patient's stress and help in accomplishing dental procedures, it can also be a source of stress or used to restrain the patient. In this study, we explore the emergence and intertwine of controlling and comforting touch in pediatric dental clinic settings in which patients show signs of resistance, distress, or fear. We use microanalysis of video-recorded interactions to unveil how the adults in the room—any combination of the dentist, dental assistant, hygienist, and caregiver(s)—deploy various types of touch on the child patient to perform the dental procedure while simultaneously comforting the child. Our data set covers video-recordings of naturally occurring dental clinic visits of 3- to 12-year-old child patients from four cultural contexts: Finland, China, Iraq, and the United States. Drawing on Merleau-Ponty's writings on intercorporeality and the interaffectivity of bodies, the study proposes that touch in pediatric dentistry unfolds as complex intercorporeal formations where the interaffectivity emerges not only through touch but also via vocal resonance. In contrast to clear boundaries between comforting and controlling touch, our analysis indicates that the line between comforting and controlling touch can be blurred. We suggest that touching a pediatric patient showing resistance toward a dental procedure requires careful affective attention to the patient's subtle and moment-by-moment bodily expressions and reactions to the touch. [ABSTRACT FROM AUTHOR]

Purpose: To survey pediatric dentists in the United States regarding adverse events during dental care for children. Methods: A selfadministered, anonymous online survey was sent to American Academy of Pediatric Dentistry members (n equals 6,327) using REDCap® software (between October and December 2019). The questionnaire (all items with radio-button numerical categories) included five items surveying pediatric adverse event occurrence and seven demographic items. Annualized occurrences of adverse events in US pediatric dental practices were extrapolated from the data collected. Results: The survey response was 11 percent (n equals 704), with 91 percent of respondents reporting that at least one child experienced an adverse event during dental treatment. The two most prevalent adverse events, each reported by 82 percent of respondents, were self-inflicted trauma to soft tissues after local anesthesia and nausea and vomiting, with annualized estimates of 7,816 and 7,003, respectively. Major adverse events (respiratory depression, cardiovascular depression, neurological damage, death) during pediatric dental treatment were reported by 14 percent of respondents (annualized estimate equals 443). "Wrong" errors (wrong tooth/wrong procedure/wrong patient) were reported by 24 percent of respondents (annualized estimate equals 600). Conclusions: Adverse events during pediatric dental care are of noticeable concern with some (wrong tooth/wrong procedure/wrong patient errors) that can be procedurally mitigated. [ABSTRACT FROM AUTHOR]

Despite tlie attention it has garnered in recent years, the opioid epidemic in the United States has remained a challenge to healthcare professionals, prescribers. families, and patients alike. A recent publication in the dental literature urged oral healthcare practitioners (OHCPs) to take a leadership role in the face of this epidemic ariel consider carrying naloxone, a drug designed to rapidly reverse opioid overdose, in the dental o mee as the eighth essential medication in the minimal dental emergency kit. In 2023, the US Food and Drug Administration deregulated naloxone 4-mg nasal spray to nonprescription status to increase its availability and access. Given the anticipated expanded availability of naloxone, it is important for OHCPs to be knowledgeable about this potentially lifesaving therapy. This article - is intended to serve as a primer for dentists on the history, pharmacology, appropriate appropriate use, and administration of this critical niedication. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has resulted in a high level of mental health problems for the population worldwide including healthcare workers. Several studies have assessed these using measurements for anxiety for general populations. The COVID‐19 Anxiety Syndrome Scale (C‐19ASS) is a self‐report measure developed to assess maladaptive forms of coping with COVID‐19 (avoidance, threat monitoring and worry) among a general adult population in the United States. We used it in a prospective cohort study of COVID‐19 incidence rates in practising Canadian dentists. We therefore need to ensure that it is valid for dentists in French and English languages. This study aimed to evaluate the validity of the C‐19ASS in that population. Methods: Cross‐sectional data from the January 2021 monthly follow‐up in our prospective cohort study were used. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed. Results: The results of EFA revealed a 2‐factor structure solution that explained 47% of the total variance. The CFA showed a good model fit on the data in both English and French languages. The Cronbach's alpha indicated acceptable levels of reliability. Furthermore, the C‐19ASS showed excellent divergent validity from the Generalized Anxiety Disorder‐7 (GAD‐7) scale. Conclusions: The C‐19ASS is valid and reliable instrument to measure COVID‐19‐related anxiety in English and French among Canadian dentists. Practical implications: This validated measure will contribute to understanding of the mental health impact of the pandemic on dentists in Canada and enable the dental regulatory authorities and organizations to intervene to help dentists. [ABSTRACT FROM AUTHOR]

Mouthguards (MGs) are essential devices for the protection of sports-related orofacial injuries. Mapping of the literature on this subject may help to guide future studies; therefore, this review aimed to characterize the research trends of studies related to MGs and dental injuries in sports activities through bibliometric analysis of in vivo studies concerning the frequency of MG use; knowledge, awareness, perception, and/or attitude about MGs; and adaptation (fit) of MGs in the mouth and/or prevention of traumatic dental injuries (TDIs). A literature search was performed in 6 databases for studies published up to April 2022. Text mining and analysis software was used to extract and evaluate data related to the study author, country, keywords, journal of publication, and year. Additionally, data related to the type of study, outcome, study population, age group, evaluation method, type of MG, sport classification. and sport category were extracted and analyzed. Of 6140 records identified, 222 were included in the analysis. Most of the articles came from the United States (n = 39; 17.5%) and dentistry journals (n = 145; 65.3%). The journal Dental Traumatology (n = 60; 27 . 0%) presented the highest number of publications. Most studies were observational (n = 195; 87.8%) and evaluated the frequency of MG use (n = 163; 44.4%). Studies were carried out in athletes (n = 181; 82.6%) and adults (n = 169; 49.1%) using questionnaires or interviews for assessment (n = 206: 84.1%). Only 89 (40.1%) studies evaluated the type of MG, mostly involving contact sports. Custom-made MGs were most commonly studied. More studies involving coaches, dentists, and child and teenaged athletes are warranted to help prevent sports-related TDIs in young teeth, mainly through interventional studies on the perceptions of and knowledge about MGs among these populations. [ABSTRACT FROM AUTHOR]

Objectives: To understand patients' comfort with health risk assessments (HRAs) and patient and dentist factors associated with the provision of HRAs. Methods: In this cross‐sectional study, 857 patients seen by 30 dental practitioners in the United States National Dental Practice‐Based Research Network reported their comfort receiving HRA for six risk factors (tobacco use, alcohol use, dietary sugar intake, human immunodeficiency virus risks, human papillomavirus risks and existing medical conditions) and whether they discussed any of the risk factors during their visits. Multi‐level logistic models were used to examine the impacts of patient, practitioner, practice characteristics on the (1) number of risk factors patients were comfortable discussing and (2) number of risk factors assessed in the current dental visit. Results: Only a small percentage (4%) of patients reported being uncomfortable receiving any HRA during their dental visits. However, over half of the patients (53%) reported that they did not receive any HRAs during the current visit. In the regression analyses, patients who were older, male and from the suburban were more likely to be comfortable with more HRAs. Dentists were more likely to provide HRA if they were younger, not non‐Hispanic white, less likely to feel that providing HRAs was beyond their scope of practice, yet more likely to feel occasional discomfort in providing HRA. Conclusions: Interventions should focus on reducing dental practitioner perception that conducting HRAs is beyond their scope of practice and standardizing screening assessments for multiple risk factors. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Centers for Disease Control and Prevention (CDC) published the Clinical Practice Guideline for Prescribing Opioids for Pain—United States, 2022 (CDCCPG) to replace the 2016 guideline. This guideline was designed to serve as a clinical tool to improve communication between clinicians and patients and empower them to make informed, person-centered decisions regarding pain management and the prescribing of opioids. It is intended for primary care and other clinicians, including dentists, who provide pain management for adults with acute, subacute, and chronic pain. This article summarizes the CDCCPG, with an emphasis on information of relevance to dentistry. For dentists, the most important recommendations for pain management are that nonsteroidal anti-inflammatory medications are first-line medications for acute dental pain, interdisciplinary care for chronic orofacial pain is indicated, and opioids should only be prescribed for acute dental pain for a maximum of 3 days after risk assessment. The CDCCPG contains a great deal of relevant information that can help dentists and dental specialists make safe, effective, and evidence-based decisions in providing pain control for their patients. [ABSTRACT FROM AUTHOR]

We applied a structural intersectionality approach to cross-sectionally examine the relationships between macro-level systems of oppression, their intersections, and access to oral care in the United States. Whether and the extent to which the provision of government-funded dental services attenuates the emerging patterns of associations was also assessed in the study. To accomplish these objectives, individual-level information from over 300,000 respondents of the 2010 US Behavioral Risk Factor Surveillance System was linked with state-level data for 2000 and 2010 on structural racism, structural sexism, and income inequality, as provided by Homan et al. Using multilevel models, we investigated the relationships between systems of oppression and restricted access to oral health services among respondents at the intersections of race, gender, and poverty. The degree to which extended provision of government-funded dental services weakens the observed associations was determined in models stratified by state-level coverage of oral care. Our analyses bring to the fore intersectional groups (e.g., non-Hispanic Black women and men below the poverty line) with the highest odds of not seeing a dentist in the previous year. We also show that residing in states where high levels of structural sexism and income inequality intersect was associated with 1.3 greater odds (95% confidence interval, 1.1–1.5) of not accessing dental services in the 12 mo preceding the survey. Stratified analyses demonstrated that a more extensive provision of government-funded dental services attenuates associations between structural oppressions and restricted access to oral health care. On the basis of these and other findings, we urge researchers and health care planners to increase access to dental services in more effective and inclusive ways. Most important, we show that counteracting structural drivers of inequities in dental services access entails providing dental care for all. [ABSTRACT FROM AUTHOR]

In this paper, we seek to understand feminization of the dentist workforce moving beyond previous research that has looked at gender in isolation. We contend that little consideration has been given to how gender interacts with other important social identities such as race/ethnicity to influence the opportunities and barriers that female dentists encounter during their dental career. We argue that the scholarly debate about the feminization of the dentistry has not acknowledged the intersectionality of women's lives. Intersectionality describes how multiple social identities (such as race/ethnicity, gender, and class) overlap and interact to inform outcomes, creating disadvantages and/or privileges. Our thesis is that the increasing feminization of the dentist workforce is complicated and paradoxical, creating both opportunities for women and gender imbalances and blockages within the profession. To support our thesis, we critically reviewed the literature on feminization and analysed UK and US workforce data. While the female dentist workforce in both the UK and the US has increased significantly over the past decade, the growth in the number of female dentists was not equal across all racial/ethnic groups. The largest increase in the number of female dentists was among White and Asian women. Viewing the feminization of the dentist workforce through an intersectionality lens exposes the multiple and complex experiences of women, as well as the power dynamics in dentistry. Feminization in dentistry demonstrates the importance of presence, privilege, and power. Based on our assessment of the dentist workforce, dentistry may be less inclusive, despite being perceived as more diverse. Further research should explore how power and privilege may operate in dentistry. Dentistry should embrace intersectionality to provide an inclusive evaluation of equity in the workforce. [ABSTRACT FROM AUTHOR]

The authors examined adults' perceptions about the importance of the human papillomavirus (HPV) vaccine in preventing oropharyngeal cancers and dental care providers' role in HPV prevention and identified associated factors. Adults (≥ 18 years) completed a national survey of consumer and patient attitudes, experiences, and behaviors on oral health. Descriptive and multivariable logistic regression models determined associations between perceptions regarding HPV and attitudes toward dental care providers' role and HPV knowledge, HPV vaccine recommendation, and sociodemographic characteristics. One in 3 adults (32.8%; n = 5,320) said the HPV vaccine was very important, 1 in 2 said it was somewhat important (48.1%), and 1 in 5 said it was not important (19.1%) in preventing mouth and throat cancers. More than one-half (56.7%) of adults had positive perceptions about dental care providers' role in HPV education and were comfortable discussing the HPV vaccine with a dental care provider (59.4%). Adults with knowledge about HPV and oral health linkage and those who received HPV vaccine recommendation from a dental care provider had 2.0 to 2.5 times higher odds of reporting positively for all 3 outcomes (P <.001). Most adults are comfortable discussing HPV and the HPV vaccine with their oral health care provider. Perceptions about the HPV vaccine's importance in preventing oropharyngeal cancers and the role of dental care providers in HPV prevention can be improved by means of increasing adults' knowledge about the relationship between HPV and oral health. Dental care providers' engagement in HPV conversations with patients may increase their knowledge about the HPV and oral health linkage and their understanding of the role of the HPV vaccine in preventing oropharyngeal cancers. [ABSTRACT FROM AUTHOR]

INTRODUCTION We investigated associations between counseling by a dentist or physician and quit intentions/attempts using longitudinal data. METHODS Analyses were performed with longitudinal data from the 2010-2011 Tobacco Use Supplement to the Current Population Survey (TUS-CPS). Participants were followed over a one-year period and provided repeated measurements. Multivariable logistic regression was used to measure associations between cessation counseling and study endpoints. All data were weighted to yield nationally representative estimates. RESULTS Of smokers who visited a dentist at both baseline and follow-up in TUS-CPS, 51.7% were not counselled on either occasion; only 19.2% were counselled on both occasions. In contrast, 52.6% of smokers who visited a physician at both baseline and follow-up at 1 year were counseled on both occasions and only 17.6% were not counseled on any occasion. Dentist-only advice at baseline was associated with higher odds of intention to quit in the next 30 days (AOR=1.96; 95% CI: 1.04-3.68), but not with a past-year quit attempt. Physician-only advice at baseline was associated with intention to quit in the next 6 months (AOR=1.52; 95% CI: 1.18-1.94), as was advice delivered by both a dentist and physician at baseline (AOR=1.54; 95% CI: 1.05-2.28). CONCLUSIONS Dental patients are less likely to receive cessation counselling at every visit than medical patients. Intensified efforts are needed to increase counselling within dental settings. [ABSTRACT FROM AUTHOR]

Objectives: This study describes the supply of Latino dentists in the United States from 1980 to 2019, as tabulated by the Census. The number of Latino dentists per 100,000 Latino population was compared to the number of non‐Hispanic White (NHW) dentists per 100,000 NHW population. These four‐decade comparisons were made for the entire country as well as the five states having the largest Latino populations. Methods: Data from the decennial census and the American Community Survey were used to identify the nationwide population, the number of dentists, and their respective Spanish‐language abilities, stratified by race/ethnic group (Latinos and non‐Hispanic Whites). Results: In 1980, there were only 18 Latino dentists for every 100,000 Latino population in the entire nation, compared to 70 NHW dentists per 100,000 NHW population. While there was an increase to 21 Latino dentists per 100,000 in 1990, the supply remained virtually the same over this almost 40‐year period, ending back at 18 per 100,000 in 2019. In comparison, there were about four times as many non‐Hispanic White dentists as Latino dentists. This national discrepancy was also reflected in the five states that were evaluated. Similarly, Latino dentists were far more likely to speak Spanish than NHW dentists at both the national and state levels. Conclusions: The Latino dentist supply, already inadequate in 1980, has remained virtually unchanged over the past almost 40 years. The authors believe that this deficiency will have profound consequences, and recommend that initiatives be undertaken to increase the number of Latino dentists. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify differences in usage trends for 2 specific pulpal therapy treatments in pediatric patients during an 11-year period from January 1, 2010, through December 31, 2020. Insurance data claims for children aged 2 through 12 years undergoing a pulpotomy or a pulpectomy performed by a general dentist (GD) or pediatric dentist (PD) from 2010 through 2020 were extracted from a dental data warehouse. The state where the provider was located was included in the extracted claim. Rates of undergoing a pulpotomy or pulpectomy declined from 2010 through 2020 (odds ratio [OR], 0.978 or 0.946, respectively; P <.001). PDs were more likely to perform pulpotomies than GDs (OR, 1.393; P <.001), but PDs were less likely to perform pulpectomies than GDs (OR, 0.225; P <.001). Younger patient age was a significant predictor for undergoing pulpotomy treatment for both GDs and PDs (ORs, 0.850 and 0.892, respectively; P <.001). With increasing patient age, PDs had increased odds of performing a pulpectomy (OR, 1.030; P <.001) and GDs had decreased odds of performing a pulpectomy (OR, 0.995; P =.04). When examining effects according to American Academy of Pediatric Dentistry national membership districts, the trends remained consistent with those above. The percentage of children undergoing pulpotomy and pulpectomy therapy declined from 2010 through 2020 among both GDs and PDs. These changes in pulpal therapy practice might indicate a teaching change in pulpal therapy guidelines, suggesting that less invasive pulpal therapy can be used rather than pulpotomies or pulpectomies. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore associations between allegations of malpractice and the severity of the alleged malpractice injury. The public-use data file of the National Practitioner Data Bank was used to identify 34,042 dentist malpractice reports from January 1, 2010, through December 31, 2020. Univariate descriptive analysis was conducted to identify frequencies of malpractice allegations when classified by the severity of the alleged malpractice injury, practitioner graduation year, and year of original report processing. Ordinal logistic regression analyses were conducted to explore associations between the malpractice allegation type and the severity of the alleged malpractice injury. A total of 15,183 valid reports were used in the analysis. Compared with treatment-related allegations, a surgery-related allegation proved 5.3 times more likely to result in minor permanent injury; a diagnosis-related allegation was 6.5 times more likely to result in significant permanent injury and 10.4 times more likely to result in major permanent injury; and an anesthesia-related allegation was 6.2 times more likely to result in major permanent injury. The confounding variable of graduation year proved significant with respect to major temporary and minor permanent injury. As the allegation group advanced from diagnosis-related to anesthesia-, treatment-, and surgery-related allegations, the odds of a higher severity of injury did not increase. Establishing a proper diagnosis and developing a treatment plan to manage the anticipated complications of the procedure to be performed are critical to a successful outcome. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the absence of a full spectrum of evidence-based guidelines for the appropriate use of antimicrobial agents, dentists, including periodontists, remain a highly frequent antibiotic prescribing group. With the goal of understanding antibiotic prescribing practices, the authors surveyed a convenience sample of dental practitioners and periodontists to identify differences between the 2 cohorts and assess the factors that affect prescribing practices. An institutional review board–approved 15-item survey was developed to capture antibiotic prescribing practices addressing the main research question, factors affecting systemic antibiotic prescription patterns, and prescription timing. The authors collaborated with the American Dental Association (ADA) and the American Academy of Periodontology (AAP) for survey dissemination. Responses were summarized using descriptive statistics. Multivariable models were developed to identify antibiotic prescription predictors. Overall, 32.4% of the participants prescribed systemic antibiotics with scaling and root planing. When comparing the 2 groups, the authors found that 46.4% and 18.7% of the AAP and ADA members, respectively, prescribed systemic antibiotics with scaling and root planing (P =.0001). The authors found a significant difference between the AAP and ADA groups in prescription timing (P =.01). The multivariable model revealed that practitioner sex (P =.03), AAP membership (P =.0001), and years of practitioner experience (P =.04) predicted antibiotic prescription practices. The geographic location, practice setting, and occupation type did not predict antibiotic prescription patterns. The authors found a lack of clarity related to prescription timing, factors determining prescription patterns, and selection of patient population who would benefit more from antibiotics. This study confirmed a lack of clarity related to antibiotic prescription patterns in combination with nonsurgical periodontal treatment. [ABSTRACT FROM AUTHOR]

The article focuses on the authorization and evolving role of dentists in vaccine administration across the U.S., particularly emphasizing their expanded role during and after the COVID-19 pandemic. It discusses how initial restrictions were lifted during the pandemic to meet urgent vaccination needs and highlights subsequent legislative changes in various states to continue allowing dentists to administer vaccines, including influenza, thereby enhancing healthcare accessibility.

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 United States of America has traditionally attracted people from various countries, including physicians and dentists, who wish to further their education and career in the U.S. international medical graduates' (IMGs) role has been shown to be vital in medical academics and healthcare delivery systems. IMGs' demographics, contribution to the U.S. healthcare system, education and research, and challenges in the U.S. medical system have been extensively investigated. However, similar data are limited to foreign-trained dentists (FTDs). This study reviews the current literature related to IMGs and FTDs and proposes some recommendations for future studies. [ABSTRACT FROM AUTHOR]

Abstract: Although nonsteroidal anti inflammatory drugs are superior to opioids in dental pain management, opioids are still prescribed for dental pain in the United States. Little is known about the serious adverse outcomes of short-acting opioids within the context of dental prescribing. The objective of this study was to evaluate adverse outcomes and persistent opioid use (POU) after opioid prescriptions by dentists, based on whether opioids were overprescribed or within recommendations. A cross-sectional analysis of adults with a dental visit and corresponding opioid prescription (index) from 2011 to 2018 within a nationwide commercial claims database was conducted. Opioid overprescribing was defined as >120 morphine milligram equivalents per Centers for Disease Control and Prevention guidelines. Generalized estimating equation models were used to assess adverse outcomes (emergency department visits, hospitalizations, newly diagnosed substance use disorder, naloxone administration, or death within 30 days from index) and POU (≥1 prescription 4-90 days postindex). Predicted probabilities are reported. Of 633,387 visits, 2.6% experienced an adverse outcome and 16.6% had POU. Adverse outcome risk was not different whether opioids were overprescribed or within recommendations (predicted probability 9.0%, confidence interval [CI]: 8.0%-10.2% vs 9.1%, CI: 8.1-10.3), but POU was higher when opioids were overprescribed (predicted probability 27.4%, CI: 26.1%-28.8% vs 25.2%, CI: 24.0%-26.5%). Visits associated with mild pain and those with substance use disorders had the highest risk of both outcomes. Findings from this study demonstrate that dental prescribing of opioids was associated with adverse outcomes and POU, even when prescriptions were concordant with guidelines. Additional efforts are required to improve analgesic prescribing in dentistry, especially in groups at high risk of opioid-related adverse outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the prevalence of anxiety and depression symptoms and understand factors influencing mental health among dental health care workers (DHCWs) in the United States (US) during the COVID-19 pandemic. Methods: Beginning in June 2020, dentists (DDS) and dental hygienists (DH) in the US were invited to participate monthly in an anonymous, longitudinal, web-based survey. The Patient Health Questionaire-4 (PHQ-4) was used to estimate rates of anxiety and depression symptoms. Changes in mental health over time and differences by demographic and practice characteristics, COVID-19 community transmission level and COVID-19 vaccination status were tested using χ² tests and multilevel multivariable logistic regression. Results: A total of 8,902 DHCWs (DH, DDS) participated in the survey for a response rate of 6.7%. Anxiety symptom rates peaked in November 2020 (28% DH; 17% DDS) and declined to 12% for both professions in May 2021. Depression symptoms were highest in December 2020 (17% DH; 10% DDS) and declined to 8% in May 2021. Controlling for gender, age, race, ethnicity and community COVID-19 transmission levels, DDS respondents had lower odds of anxiety symptoms (aOR 0.82; 95% CI 0.70 to 0.95) and depression symptoms (aOR 0.79; 95% CI 0.67 to 0.93) than DHs. Compared to vaccinated respondents, DHCWs who were unvaccinated but were planning on getting vaccinated had significantly higher rates of anxiety (aOR 1.71; 95% CI 1.20 to 2.44) and depression symptoms (aOR 1.57; CI 1.07 to 2.29). Conclusions: The mental health status of DHCWs fluctuated during the COVID-19 pandemic. Anxiety and depression were associated with the demographic and professional characteristics of the DHCW as well as the perceived risk of COVID-19 infection. Mental health support should be made available for all DHCWs. [ABSTRACT FROM AUTHOR]

Background Private practice dentists represent 72% of United States dentists. We conducted a prospective cohort study of private practice dentists comparing antibiotic use before and after dental antibiotic stewardship education by infectious diseases (ID) antibiotic stewardship experts. Methods Study phases were as follows: phase 1 (preeducation), 3 months of retrospective antibiotic data and a presurvey assessed baseline antibiotic knowledge; phase 2 (education), dentists attended 3 evening Zoom sessions; phase 3, (posteducation/interventions), 3 months of prospective audits with weekly feedback; phase 4, postsurvey and recommendations to reach more dentists. Results Fifteen dentists participated. Ten had practiced >20 years. Presurvey, 14 were unfamiliar with dental stewardship. The number of antibiotic prescriptions pre/post decreased from 2124 to 1816 (P  < .00001), whereas procedures increased from 8526 to 9063. Overall, appropriate use (prophylaxis and treatment) increased from 19% pre to 87.9% post (P  < .0001). Appropriate prophylaxis was 46.6% pre and 76.7% post (P  < .0001). Joint implant prophylaxis decreased from 164 pre to 78 post (P  < .0001). Appropriate treatment antibiotics pre/post improved 5-fold from 15% to 90.2% (P  = .0001). Antibiotic duration pre/post decreased from 7.7 days (standard deviation [SD], 2.2 days) to 5.1 days (SD, 1.6 days) (P  < .0001). Clindamycin use decreased 90% from 183 pre to 18 post (P  < .0001). Postsurvey responses recommended making antibiotic stewardship a required annual continuing education. Study participants invited ID antibiotic stewardship experts to teach an additional 2125 dentists via dental study clubs. Conclusions After learning dental antibiotic stewardship from ID antibiotic stewardship experts, dentists rapidly optimized antibiotic prescribing. Private practice dental study clubs are expanding dental antibiotic stewardship training to additional dentists, hygienists, and patients across the United States. [ABSTRACT FROM AUTHOR]

This study was designed to assess the prevalence of anxiety and depression symptoms and understand factors influencing mental health among dental health care workers (DHCWs) during the COVID-19 pandemic. Beginning in June 2020, 8,902 DHCWs participated monthly in an anonymous longitudinal, web-based survey (response rate, 6.7%). The Patient Health Questionnaire-4 was used to estimate rates of anxiety and depression symptoms. Changes in mental health over time and differences by demographic and practice characteristics, COVID-19 community transmission level, and COVID-19 vaccination status were tested using χ2 tests and multilevel multivariable logistic regression. Anxiety symptom rates peaked in November 2020 (28% of dental hygienists, 17% of dentists) and declined to 12% for both professions in May 2021. Depression symptom rates were highest in December 2020 (17% of dental hygienists, 10% of dentists) and declined to 8% in May 2021. Controlling for gender, age, race or ethnicity, and COVID-19 community transmission level, the authors found that dentists had significantly lower odds of anxiety symptoms (adjusted odds ratio [aOR], 0.82; 95% CI, 0.70 to 0.95) and depression symptoms (aOR, 0.79; 95% CI, 0.67 to 0.93) than dental hygienists. Compared with vaccinated respondents, those who were unvaccinated but planning on getting vaccinated had significantly higher rates of anxiety (aOR, 1.71; 95% CI, 1.20 to 2.44) and depression (aOR, 1.57; 95% CI, 1.07 to 2.29) symptoms. DHCWs' mental health fluctuated during the pandemic. Anxiety and depression in DHCWs were associated with demographic and professional characteristics as well as perceived risk of COVID-19. Mental health support should be made available for DHCWs. This clinical trial was registered at ClinicalTrials.gov. The registration numbers are NCT04423770 and NCT04542915. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate access to care and financial considerations associated with the endodontic treatment of immature permanent teeth., Methods: Surveys were distributed to endodontists (n = 2,457) and pediatric dentists (n = 3,974) in the United States. Data were analyzed using X 2 analysis and logistic regression. The level of significance was set to 0.05., Results: The response rate was 13% (n = 840). Respondent specialist groups were similar by age and years since specialty residency completion, but significantly different with regard to primary practice setting (eg private practice, Federally Qualified Health Center, hospital), (P = .001). The majority (91%) of respondents reported participation with dental insurance. Pediatric dentists (69%) were significantly more likely than endodontists (17%) to participate with public-payer dental insurance (P < .001). The majority of respondents (82%) indicated that patients reported economic factors (time or money) as a barrier to accessing endodontic treatment. Pediatric dentists were significantly more likely to consider economic factors when planning for treatment (P < .001). Pediatric dentists were more likely than endodontists to have the opinion that endodontic procedures for treatment of necrotic immature permanent teeth should cost less than root canal therapy (apexification, P < .001; regenerative endodontic procedures, P = .002). Pediatric dentists (33%) reported encountering barriers when attempting to refer their patients to an endodontist. Inability to find an endodontist that participates with dental insurance was the most frequently cited barrier., Conclusions: Limited clinician participation with dental insurance and gaps in insurance coverage for endodontic procedures appear to contribute to access to care barriers for pediatric patients., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The objective of this study was to analyze the association between tooth loss and uncontrolled diabetes among US adults. The authors used National Health and Nutrition Examination Survey data from 2011 through 2018. The sample included 16,635 participants 20 years and older who represent 187,596,215 people in the United States in a probability weighted sample. The authors used bivariate analysis and multiple regressions to analyze factors associated with edentulism and number of missing teeth. The multiple logistic regression model significantly predicted edentulism using diabetes status (adjusted odds ratio controlled diabetes, 1.44 [95% CI, 1.12 to 1.86]; adjusted odds ratio uncontrolled diabetes, 2.26 [95% CI, 1.33 to 3.85]), missing annual dental visits, seeing a dentist only for treatment, family income below 200% of the federal poverty guideline, being female, being 65 years or older, tobacco smoking, and no college education. After controlling for the same covariates, multiple Poisson regression analysis showed that dentate adults with controlled and uncontrolled diabetes had higher relative risk of tooth loss than those without diabetes (adjusted risk ratio controlled diabetes, 1.52 [95% CI, 1.35 to 1.71]; adjusted risk ratio uncontrolled diabetes, 1.57 [95% CI, 1.35 to 1.83]). US adults with uncontrolled (glycated hemoglobin ≥ 9%) and controlled diabetes (glycated hemoglobin < 9%) were more likely to be edentulous and experience tooth loss than adults without diabetes. US health policy officials should adopt benefits policies to provide regular dental examinations to people who have diabetes, have low income (< 200% of the federal poverty guideline), or are 65 years or older to reduce tooth loss and improve their quality of life. Dentists should work with physicians to help patients control glycemic levels. [ABSTRACT FROM AUTHOR]

Objectives: Medicaid's Early and Periodic Screening, Diagnostic and Treatment (EPSDT) pediatric benefit is designed to meet children's medically necessary needs for care. A 2018 Centers for Medicare & Medicaid Services (CMS) Bulletin advised Medicaid programs to ensure that their dental payment policies and periodicity schedules include language that highlights that medically necessary care should be provided even if that care exceeds typical service frequency or intensity. We assessed the extent to which Medicaid agencies' administrative documents reflect EPSDT's flexibility requirement. Methods: From August 2018 through July 2019, we retrieved dental provider manuals, periodicity schedules, and fee schedules in all 50 states and the District of Columbia; analyzed these administrative documents for consistency with the CMS advisory; and determined whether instructions were provided on how to bill for services that exceed customary frequencies or intensities. Results: Dental-specific periodicity schedules were not evident in 11 states. Eighteen states did not include flexibility language, for example, as advocated by the American Academy of Pediatric Dentistry. Flexibility language was not evident in 24 dental provider manuals or in 47 fee schedules. Only 8 states provided billing instructions within fee schedules for more frequent or intensive services. Conclusion: Updating Medicaid agency administrative documents—including dental provider manuals and periodicity and fee schedules—holds promise to promote individualized dental care as ensured by EPSDT. [ABSTRACT FROM AUTHOR]

Background: Peri-implantitis (PI) is a growing concern in the dental community worldwide. The study aimed to compare U.S. versus European periodontists' considerations of risk factors, diagnostic criteria, and management of PI.Methods: A total of 393 periodontists from the United States and 100 periodontists from Europe (Germany, Greece, Netherlands) responded to anonymous surveys electronically or by mail.Results: Compared to U.S. periodontists, European respondents were younger, more likely to be female and placed fewer implants per month (9.12 vs 13.90; P = 0.003). Poor oral hygiene, history of periodontitis, and smoking were considered as very important risk factors by both groups (rated > 4 on 5-point scale). European periodontists rated poor oral hygiene (4.64 vs 4.45; P = 0.005) and history of periodontitis (4.36 vs 4.10; P = 0.006) as more important and implant surface (2.91 vs 3.18; P = 0.023), occlusion (2.80 vs 3.75; P < 0.001) and presence of keratinized tissue (3.27 vs 3.77; P < 0.001) as less important than did U.S. periodontists. Both groups rated clinical probing, radiographic bone loss, and presence of bleeding and suppuration as rather important diagnostic criteria. They rated implant exposure/mucosal recession as relatively less important with U.S. periodontists giving higher importance ratings than European periodontists (3.99 vs 3.54; P = 0.001). Both groups nearly always used patient education, plaque control and mechanical debridement when treating PI. U.S. periodontists were more likely to use antibiotics (3.88 vs 3.07; P < 0.001), lasers (2.11 vs 1.68; P = 0.005), allograft (3.39 vs 2.14; P < 0.001) and regenerative approaches (3.57 vs 2.56; P < 0.001), but less likely to use resective surgery (3.09 vs 3.53; P < 0.001) than European periodontists.Conclusions: U.S. and European periodontists' considerations concerning risk factors, diagnosis and management of PI were evidence-based. Identified differences between the two groups can inform future educational efforts. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about use or acceptance of minimally invasive dentistry (MID) in the USA, particularly in public health settings. The purpose of this study was to assess opinions concerning MID among dentists in public-health practices.Materials and Methods: A cross-sectional study was conducted to assess the views of dentists in public-health practices concerning MID using an online survey instrument among National Network for Oral Health Access (NNOHA) and American Association of Community Dental Programs (AACDP) members. Specific questions focused on diagnostic and preventive techniques, and whether MID was considered to meet the standard of care in the US Results: Overall, 86% believed that MID met the standard of care for primary teeth, and 77% did so for permanent teeth. The majority of respondents also agreed that fluoride varnish prevents caries and atraumatic restorative techniques (ART) are an effective caries treatment for children and adults. According to logistic regression results, dentists who had continuing education courses in MID and agreed that ART was an effective treatment for adults were more likely to report that MID met the standard of care for permanent teeth. Subjects who believed that fluoride varnish was effective as caries prevention for children were more likely to view MID as meeting the standard of care for primary teeth.Conclusions: There appears to be a paradigm shift toward a MID philosophy, and most responding public health dentists believed that MID meets the standard of care for primary and permanent teeth in the US. [ABSTRACT FROM AUTHOR]

Introduction: It is unknown whether certain dentists account for disproportionate shares of dental opioid prescriptions and high-risk prescriptions. Identifying and characterizing such dentists could inform the targeting of initiatives to improve the appropriateness and safety of dental opioid prescribing.Methods: In May 2021, the authors conducted a cross-sectional analysis using the IQVIA Longitudinal Prescription Database, which reports dispensing from 92% of U.S. pharmacies, and 2 provider databases (IQVIA OneKey, National Plan and Provider Enumeration System). Analyses included opioid prescriptions from dentists dispensed in 2019 to patients aged >12 years. High-risk prescriptions were those considered high risk by any of 3 metrics (prescriptions to opioid-naïve patients exceeding a 3-day supply, prescriptions with daily opioid dosage ≥50 morphine milligram equivalents, opioid prescriptions with benzodiazepine overlap). Among all prescriptions and high-risk prescriptions, the authors calculated the proportion accounted for by high-volume dentists -- those with prescription counts in the 95th percentile or higher. Using logistic regression, the characteristics associated with being a high-volume dentist were identified.Results: In 2019, a total of 141,345 dentists accounted for 10,736,743 opioid prescriptions dispensed to patients aged >12 years; 4,242,634 (39.5%) were high-risk prescriptions. The 7,079 high-volume dentists, a group representing 5.0% of the 141,345 dentists, accounted for 46.9% of all prescriptions and 47.5% of high-risk prescriptions. Male sex, younger age, non‒Northeast location, and specialization in oral and maxillofacial surgery were associated with a higher risk of being a high-volume dentist.Conclusions: In 2019, high-volume dentists accounted for almost half of dental opioid prescriptions and high-risk prescriptions. Quality improvement initiatives targeting these dentists may be warranted. [ABSTRACT FROM AUTHOR]

While racial/ethnic oral health inequities have been documented for many years in the United States, the potential role of racism has not been examined until recently. In fact, the common practice has been to attribute racial/ethnic disparities in oral health to low socioeconomic position and/or the lack of access to care. In contrast, racism is considered a fundamental cause of a broad range of adverse health outcomes for racial/ethnic minorities. Emerging evidence on oral health suggests that racism can affect access to oral health and clinical decision‐making by acting as a social determinant of health (SDoH). Specifically, SDoHs may affect access to quality dental care due to the lack of dental insurance, low dentist‐population ratio in racial/ethnic minority communities and the lack of diversity in the dental profession. We describe potential mechanisms through which racism can affect important SDoHs that are essential to oral health equity, outline recommendations to mitigate its existing negative effects and propose interventions to minimize pathogenic effects of racism on oral health outcomes in the population. [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]

With the growing understanding of the relationship between oral and systemic diseases there is an increasing interest in integrating dental providers more completely into the health care delivery system. Technology advancements in traditional dental disease diagnosis and management as well as in salivary diagnostics for systemic disease provide great opportunities for the profession but numerous challenges for dental educators who are impacted by the intersection of numerous, sometimes competing interests. While economic factors play a significant role in curricular innovation and change, in the United States the accrediting process for dental education programs can be an equally vexing challenge. Movement away from primarily a competency-based assessment model to a model focusing on the establishment of Entrustable Professional Activities (EPAs) may provide a needed catalyst to enhance dental education to graduate dentists who embrace an expanded role as primary care providers., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Mark Latta have served as a peer reviewer for the Journal of Dentistry. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

BACKGROUND: Recent national data are lacking on the prevalence, safety, and prescribers of opioid prescriptions dispensed to children and young adults aged 0 to 21 years. METHODS: We identified opioid prescriptions dispensed to children and young adults in 2019 in the IQVIA Longitudinal Prescription Database, which captures 92% of US pharmacies. We calculated the proportion of all US children and young adults with $1 dispensed opioid prescription in 2019. We calculated performance on 6 metrics of high-risk prescribing and the proportion of prescriptions written by each specialty. Of all prescriptions and those classified as high risk by $1 metric, we calculated the proportion written by high-volume prescribers with prescription counts at the $95th percentile. RESULTS: Analyses included 4 027 701 prescriptions. In 2019, 3.5% of US children and young adults had $1 dispensed opioid prescription. Of prescriptions for opioid-naive patients, 41.8% and 3.8% exceeded a 3-day and 7-day supply, respectively. Of prescriptions for young children, 8.4% and 7.7% were for codeine and tramadol. Of prescriptions for adolescents and young adults, 11.5% had daily dosages of $50 morphine milligram equivalents; 4.6% had benzodiazepine overlap. Overall, 45.6% of prescriptions were high risk by $1 metric. Dentists and surgeons wrote 61.4% of prescriptions. High-volume prescribers wrote 53.3% of prescriptions and 53.1% of high-risk prescriptions. CONCLUSIONS: Almost half of pediatric opioid prescriptions are high risk. To reduce high-risk prescribing, initiatives targeting high-volume prescribers may be warranted. However, broad-based initiatives are also needed to address the large share of high-risk prescribing attributable to other prescribers. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. High-risk type HPV infections can cause many types of cancers, including oropharyngeal cancer. The HPV vaccine is the most effective method for the prevention of HPV-related cancers. However, HPV vaccination rates remain low in the United States. Dental professionals are well positioned to be at the forefront of educating patients about HPV, discussing the HPV vaccine and promoting vaccination with their patients. [ABSTRACT FROM AUTHOR]

Introduction: The National Academy of Medicine recommends, and Joint Commission requires, offering non-pharmacologic approaches to pain management, including acupuncture, to reduce opioid overuse in the United States. This study describes 2019 state training requirements to evaluate how they represent opportunities and barriers to increasing access to acupuncture. Methods: We searched publicly available databases to identify Acupuncture Practice Acts and additional statutes and regulations pertaining to acupuncture training requirements on state licensure board websites. We then extracted state-specific acupuncture training requirements for individuals with and without a healthcare-related professional license. Results: Thirty-three states allow physicians to provide acupuncture without requiring any additional training requirements, 11 states and the District of Columbia (DC) require 200–300 training hours, and three require physicians to obtain a separate acupuncture license. Three states have no regulatory agency ruling. Forty states require non-healthcare professionals to complete an accredited program of more than 1900 h and pass an examination. Twenty-three states have an Acupuncture Detoxification Specialist designation allowing individuals without a clinical professional license to provide auricular acupuncture for substance use disorder treatment after a 70-h training course. Discussion: State-level training requirements are intended to increase safe and effective care, but variations represent a potential barrier to increasing the number of acupuncture providers in the United States. Allowing non-physician medical professionals to complete reduced training requirements for specific indications could be a model to increase access to acupuncture. The influence of training requirements on acupuncture access and opioid overuse needs examination. [ABSTRACT FROM AUTHOR]

Background: The enrollment of international periodontal students in U.S. dental schools has been increasing in recent years. Interest in applying to a periodontics specialty program may differ between U.S and international dental school graduates. The purpose of this study is to assess, from the perspective of periodontal residents, (1) factors that interest dental students to apply to periodontics programs and (2) differences in background and interest between U.S and international graduates. Methods: A 20-question survey was sent out electronically to periodontics residents. The survey questions were designed to obtain information on the participants' backgrounds, factors that influenced them to specialize in periodontics, and their preferred features of graduate periodontics programs. The data were analyzed using descriptive statistics for socio-demographic variables, a Wilcoxon two sample test to compare mean Likert scale scores, and Fisher's exact test for associations between comparison groups. Results: Of the two hundred residents invited to participate, 28% responded. The majority of the respondents stated that interest in implantology, previous exposure to periodontal procedures, interest in improving periodontal surgery skills, a good relationship with periodontics faculty, the residency curriculum, advanced program and faculty reputation as influencing factors in selecting periodontics as specialization. The majority of international graduates have up to $50,000 dollars in student debt; by comparison, half of the domestic graduates have a debt of over $250,000 dollars (p ≤ 0.05). Working experience as a dentist was significantly greater among international residents (73%) in comparison to U.S graduates (32%). In contrast with international graduates, U.S graduates more frequent reported that good relationships with the periodontics predoctoral faculty contributed to their interest in periodontics (p ≤ 0.05). Program cost and location had a greater impact on the decision of U.S. graduates than international graduates (p ≤ 0.05). Conclusions: Overall, factors associated with personal finance and predoctoral education have a greater impact on the decision of American graduates than international graduates to pursue an advanced education in periodontics, which may influence the increased enrollment of international students. [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]