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The human papilloma virus (HPV) is the most common sexually transmitted infection, affecting nearly 50% of the world population. HPV can lead to tissue damage and is associated with many types of cancers. Healthcare professionals' knowledge regarding HPV infection are essential in assuring favorable outcomes for those exposed to HPV, either in prevention or in intervention efforts. In this cross-sectional, population-based study, we explored the levels of HPV knowledge among health professionals in a Brazilian municipality. In total, 260 individuals (90% women), aged 21–66 years (Mean = 40.10 ± 9.30) participated in this investigation and responded to standard questionnaires measuring HPV knowledge as well as sociodemographic and occupational data. Regarding HPV knowledge, 85 (32.8%) individuals were considered to have sufficient knowledge (scored good or very good according to percentile classifications), whereas 174 (67.2%) were labeled as having insufficient knowledge. Mann-Whitney tests showed higher HPV knowledge among those who reported not having children (p = 0.05) and lower levels in the group of community health workers (CHW; p < 0.001). Logistic regression analyses showed that having children (OR = 0.50; 95%CI: 0.26, 0.96) and being a CHW (OR = 0.52; 95%CI: 0.28, 0.97) were independently associated with insufficient knowledge about HPV. In conclusion, data reported in this study might aid in understanding factors associated with HPV management given the evidence collected from healthcare professionals, suggesting strategies to promote both health education and promotion. [ABSTRACT FROM AUTHOR]

Objectives: The Universal Coverage Health Scheme (UCS) was implemented in Thailand in 2002 to increase access to health services among the Thai population. This study aimed to evaluate socioeconomic inequalities in dental service utilization (DU) before and after UCS implementation and to assess factors associated with DU among Thai adults. Methods: This study is based on secondary data from four Thai national oral health surveys in 2000–2001, 2006–2007, 2012 and 2017. Whether an individual from a nationally representative sample of Thai adults aged 35–44 went to see the dentist during the past year was used to define DU. The slope index of inequality (SII) and relative index of inequality (RII) were used to assess and compare education and income‐related inequalities in DU. Poisson regression was used to assess factors associated with DU. Income inequalities were not reported for the year 2001 (Income data not available). Results: Although DU increased after UCS implementation, socioeconomic inequalities persisted. DU was concentrated among high‐education and income groups. Absolute educational inequalities were 0.16 (95% CI: 0.09–0.22), 0.21 (95% CI: 0.10–0.32), 0.26 (95% CI: 0.14–0.38) and 0.25 (95% CI: 0.18–0.32) in 2001, 2007, 2012 and 2017, respectively. Absolute income inequalities were 0.15 (95% CI: 0.04–0.26), 0.07 (95% CI: −0.04‐0.18) and 0.12 (95% CI: 0.05–0.19) in 2007, 2012 and 2017, respectively. Occupation, type of health insurance scheme, sex and oral health‐related behaviour were associated with DU. Conclusion: UCS has improved accessibility to dental services, but UCS alone might not narrow the inequalities gap for Thai adults. [ABSTRACT FROM AUTHOR]

Background: Hormonal and behavioral changes during pregnancy may impact the oral health of women, which can influence the pregnancy course. Prenatal care practitioners (PCP) must be aware of this bidirectional relation in order to include an oral assessment in routine prenatal care. Objectives: To characterize the knowledge and attitudes of PCP regarding oral health in pregnant women. Search Strategy: The search was carried out in PubMed, Web of Science, Lilacs, Scopus, and Embase on May 2022. Selection Criteria: Peer‐reviewed cross‐sectional studies published in English within the last 5 years that assessed the knowledge, attitudes, and practices of PCP towards oral health in pregnancy were selected. Data Collection and Analysis: Data were standardly extracted by the three reviewers from the selected articles and their bias was assessed. Main Results: From a total of 996 articles, 24 were selected. Overall, most PCP have an adequate level of knowledge regarding the importance of oral health during pregnancy. Although several professionals reported referring their patients to a dentist, the attitudes and practices of the majority of PCP were still inadequate. Conclusions: PCP are aware of the importance of oral health during pregnancy but still lack translating this knowledge into clinical practice. Synopsis: Prenatal care practitioners are aware of the importance of oral health during pregnancy but still lack its translation into clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: The dental and dental hygienist educational programs prepare students with knowledge on children's prophylactic pain treatment and pain management. Observing the students' understanding could help educational efforts to be more student oriented. The aim was to evaluate dental and dental hygienist students' knowledge and attitudes on pain prevention and pain management in children and adolescents, applying a multidimensional questionnaire previously used on general dental practitioners. Materials and Methods: Three hundred and four dental and dental hygienist students at Swedish universities were eligible for the survey. Written and oral information was given about the study's aim, methods, anonymity and voluntary participation. The multidimensional questionnaire included 47 closed questions. Results: The total responding rate was 65.4%; dental students 61.1% and dental hygienist students 92.8%. The total mean of knowledge and attitudes, beneficial for the treating of patient pain, varied between 57.1% and 83.3%. The biggest knowledge gap was identified regarding the items: Children under 2 years of age experience less pain than children over 2 years undergoing similar treatment(34.3%), The dentist is better suited than the parent to judge if a child is in pain (29.4%), and usually the child's pain experience diminishes when the parents are present (24.2%). Conclusion: Dental and dental hygienist students reported vastly spread knowledge and attitudes regarding pain prophylactic and pain management in children and adolescents, as measured by a multidimensional questionnaire previously used on GDPs. Knowledge on students' understanding of the young patient's pain could help educational efforts to be more student oriented. The questionnaire must be further modified and more extensively tested to meet each participating students' program level. [ABSTRACT FROM AUTHOR]

Introduction: Dentists educated outside the EU, EEA and Switzerland have the option to undergo proficiency testing to practice dentistry in Sweden. A standardised evidence‐based procedure for proficiency tests is crucial. This paper explores if the standard setting of the theoretical examination in the Swedish proficiency test for foreign dentists is fit to differentiate candidates who meet the acceptable standard for licensure from those who do not, by analysis of inter‐rater reliability and credibility of Angoff panels and the test's ability to differentiate candidates regarding learning outcomes and dental disciplines. Materials and Methods: In a cohort study design, test results were collected from seven examinations during 2018–2019 (n = 316), combined with Angoff judgements and demographic data from The National Board of Health and Welfare. Intraclass correlation, Pearson correlation and linear regression were calculated. Results: All exams demonstrated substantial judge inter‐rater reliability using the Angoff procedure (0.65–0.82). Item difficulty predicted by the expert panels showed significant positive correlations with the item difficulty by candidate results (0.69–0.77). Candidates who did not meet the requirements for pass mark in the theoretical test revealed a significantly reduced performance overall in professional qualifications (i.e., learning outcomes) and reduced performance within dental disciplines. Conclusions: The results indicate that a modified Angoff method is a feasible, simple, and defensible method for setting the pass mark for the theoretical examinations. The standard setting appears to differentiate candidates who do not meet the requirements of the professional qualifications of the dental degree. Adjustments could be undertaken to further discriminate for competence within single dental disciplines. [ABSTRACT FROM AUTHOR]

Background: Diagnostic criteria for emergence agitation are sensitive but not specific; they misclassify patients who are angry or upset as having emergence delirium. Aims: The aim of this three‐phase study was to determine expert agreement on the behaviors that differentiate children with emergence delirium from those without. Methods: In the first phase of this observational study, pediatric dental patients were video recorded while awakening from anesthesia. In the second phase, salient 10 s segments of the recordings showing patient activity were shown to an expert audience of pediatric dentists, anesthesiologists and Post Anesthetic Care nurses, who scored the recordings as showing or not showing "true emergence delirium." In phase 3, the video segments were assessed by three research assistants using a behavior checklist for features that discriminate between those scored "true emergence delirium" and those scored "NOT true emergence delirium" by the experts. Results: One hundred and fifty‐four pediatric dental patients were included. Subsequently, an expert audience consisting of 10 anesthesiologists, 12 anesthesiology residents, 3 pediatric dentists, and 4 experienced Post Anesthesia Care Unit nurses rated each 10‐second video segment. This resulted in three groups of patients: a group for whom all experts agreed was "True emergence delirium" (n = 33; CI 21 to 45), a group for whom all agreed was "Not True emergence delirium" (n = 120; CI 107 to 133), and a group where experts disagreed (n = 11; CI 4 to 18). Three research assistants then completed a behavior checklist for each of the 33 "True emergence delirium" video segments and matched "Not True" controls. Twenty‐four behaviors were identified as significantly different between videos scored True emergence delirium and those scored Not True emergence delirium. Research assistants reached almost perfect agreement (0.81–1.00) on one behavior, and substantial agreement (0.61–0.80) on seven behaviors that characterized "True emergence delirium." Conclusions: Eight behaviors that differentiate pediatric dental patients with emergence delirium from those without were found. These discriminators may be used to develop a scale that will lead to better diagnosis and treatment of emergence delirium. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists describing the impact to oral health when living with an eating disorder and the availability of information or access to oral health services. This study investigated the perceptions of individuals with a lived experience of an eating disorder specifically to understand their needs and recommendations for improving access to early intervention and oral health promotion. Methods: Using purposive sampling a total of 12 semi-structured interviews were conducted with participants across Australia who had a lived experience of an eating disorder. A hybrid inductive and deductive approach to thematic analysis was used to construct salient themes and subthemes. Results: Most participants had experienced some oral health manifestation as part of their eating disorder hence, many felt quite knowledgeable on the topic. Following their eating disorder many participants felt confident in engaging with dental services, although, barriers including embarrassment, shame, and cost compromised access at times. Participants felt strongly that greater emphasis on oral health promotion during an eating disorder was important and this may be achieved by increasing the availability of resources and using trusted non-dental health professionals like dietitians. Conclusions: The need for oral health promotion while experiencing an eating disorder was evident, however, dentists can often be a costly option. Non-dental health professionals like dietitians working with clients with an eating disorder may be an acceptable alternative for closing this gap. Plain English summary: The link between eating disorders of any sub-type and poor oral health such as dental caries and enamel wear has been well established in the literature, but barriers such as embarrassment and dental fear can often deter individuals from seeking dental care. Non-dental health professionals such as general practitioners, nurses and allied health professionals including dietitians who work closely with individuals with an eating disorder may be able to play an active role in promoting oral health. The findings of this study provided insight into the experiences of individuals with an eating disorder and the impact this had on their oral health. Barriers to accessing oral health care included shame and embarrassment as well as the cost of dental services. However, many participants felt that having a trusted non-dental health professional such as their dietitian to provide education and referral to dental services would have been beneficial. Further research is needed to understand the requirements for dietitians and other non-dental health professionals to provide oral health promotion in eating disorder clinical areas. [ABSTRACT FROM AUTHOR]

Objectives: Professionals in the health sector have higher stress than others. The aim of this study was to evaluate the stress levels of dentists while treating with children under clinical, deep sedation, and general anesthesia. Materials and methods: Blood pressure (systolic, diastolic), pulse value, and O2 saturations were measured. Saliva samples were taken by the dentists 10 min before the treatment, at the 25th min of the treatment, and 30 min after the treatment under clinical, deep sedation, and general anesthesia. Salivary cortisol was measured by the electrochemiluminescence method. All data were analyzed statistically. Results: Cortisol values under the sedation were higher than clinical and general anesthesia (P < 0.05). As a result of the applied Dentist Job Stress Questionnaire, the stress level of dentists under sedation was higher than the clinical and general anesthesia (P < 0.05). Under sedation, systolic and diastolic blood pressures measured during the procedure were found to be high (P < 0.05). Conclusions: Dentists who care for pediatric patients are more stressed when applying treatment under deep sedation. The results suggest the need for more training and practice to strengthen the education given on general anesthesia/sedation in pediatric dentistry training. Clinical revelance: To increase the health and treatment quality of the dentists, who spend most of the day with the dental treatment of children, should be taken precautions. [ABSTRACT FROM AUTHOR]

Infective endocarditis is an inflammatory disease that affects the endocardium and may originate in the oral cavity, which is considered the most frequent source of microorganisms associated with bacteremia. The aim of this study was to assess the knowledge and practices adopted by dentists for the prevention of infective endocarditis (IE). Observational studies performed with dentists assessing their knowledge and practices for preventing IE were included, based on the American Heart Association (AHA) guidelines. Studies with dental students or other professionals, studies in which it was not possible to isolate AHA or dentist data, studies with non-infective endocarditis, all types of reviews, editorial letters, conference abstracts, pilot studies, case reports and case series, opinion articles, technical articles, and intervention studies, were excluded. Searches were performed in PubMed, Scopus, Web of Science, LILACS, BBO, CINAHL and gray literature. Two independent reviewers evaluated and participated in the selection and eligibility steps up to data extraction. The Joanna Briggs Institute checklist was used to assess methodological quality and risk of bias. Twentytwo of the 1085 studies identified, were included. Twelve studies approached knowledge of IE and practices adopted by professionals to prevent morbidity. Seven studies were considered to be at moderate risk of bias, and 15 at low risk. The results suggest that the knowledge and practices adopted by dentists for preventing IE are insufficient. [ABSTRACT FROM AUTHOR]

Introduction: In the rural population of South India, tooth loss affects 48.7% of people. In addition, there are now more patients with more than five congenitally missing adult teeth. This may cause a person's quality of life to decline and cause them to experience both physical and psychological discomfort. Materials and Methods: The current cross-sectional descriptive study was conducted over a period of month using a questionnaire-based survey (February 2022). Using G-POWER software version 3.1, the minimum sample size was calculated as 100 people, considering a study with an 80% power and a = 0.5. Results: Around 59.6% have answered right when asked about the source of dental stem cells (DSCs). 13.5 percentage have no idea about sourcing of stem cells, 6.7% state dental pulp stem cell, a very small population state periodontal tissue to be the source, while a minor group state it to be from apical papilla, <1% have no idea. Conclusion: Data of this study indicate that although there is typically good awareness regarding DSCs origins, uses, and clinical research best practises, there is not a comprehensive comprehension of these topics. The respondents have shown a quite favorable attitude toward improving their understanding of DSCs. [ABSTRACT FROM AUTHOR]

Background: Periodontitis ranks as the sixth most prevalent global ailment, impacting around 750 million individuals and standing as a prominent cause of adult dental loss. This study aims to investigate the dental awareness, viewpoints, and recognition of severe oral ailments with potential systemic health implications among distinct medical specialists: Gynecologists, Diabetologists, and Psychiatrists. Materials and Methods: A questionnaire based survey among three groups of specialist's, viz. gynecologists (Group A), diabetologists (Group B), and psychiatrists (Group C) was done to gather insights into the participants' knowledge of periodontal disease and its links to systemic conditions. The collected data were subjected to descriptive statistical analysis using Microsoft excel 2013. Results: The findings revealed that 100% of diabetologists were cognizant of the correlation between periodontal health and its systemic implications. Among gynecologist's 67% recognized the relationship between periodontal health, pregnancy, and women's well-being. Meanwhile, the majority of psychiatrists demonstrated appropriate referral practices when necessary. In contrast, only 47% of diabetologists who were aware of the connection initiated referrals for oral health assessments by dentists. Conclusion: Enhancing awareness and referral rates to dental professionals could potentially foster improved oral health, impacting diverse medical conditions. However, there exists an opportunity to motivate patients to seek dental care independently of their primary healthcare provider's specialization. [ABSTRACT FROM AUTHOR]

Thromboembolic events represent a significant healthcare concern, encompassing conditions such as deep vein thrombosis, pulmonary embolism, stroke, and myocardial infarction. The management of patients with a history of thromboembolic events in the dental setting requires careful consideration and collaboration between dentists and healthcare providers. This review article delves into the intricate relationship between thromboembolic events and dentistry. We explore the importance of patient assessment, emphasizing the need for a comprehensive evaluation of medical history, risk factors, and medication regimens. Special attention is given to anticoagulant therapy, and the role of International Normalized Ratio (INR) monitoring in maintaining safe levels of anticoagulation during dental procedures. We discuss the critical timing of dental interventions and the use of local hemostatic measures to minimize bleeding risk. By elucidating these key aspects, this review article aims to provide dental professionals with a comprehensive understanding of thromboembolic events in dentistry, fostering safe and effective oral healthcare for this patient population. [ABSTRACT FROM AUTHOR]

Objective: This study explored the factors influencing the development of empathy in a dentist-patient relationship. Design: An exploratory qualitative study. Place and duration of the study: Khyber Medical University KPK, Pakistan October 2019 to April 2020.was conducted during 2019-2020. Methodology: This exploratory qualitative study was conducted during 2019-2020. It was conducted on 12 dental surgeons, recruited from four major dental clinical specialties. A purposive sampling technique was used. In -depth interviews were conducted through a semi-structured format. The interviews were audio recorded, transcribed verbatim and analyzed, using the thematic analysis framework. Results: Three themes were extracted from the data. 1) Institutionalization of empathy 2) Barriers in the path of empathetic attitude and 3) Cultivating a Culture of empathy for better health care provision. The participants of the study observed tha t the development of empathy in a dentist-patient relationship includes a wide range of factors, ranging from curricular, personal, social, organizational, and cultural. These factors elaborate that empathy is a multidimensional phenomenon with roots deeply entrenched in professional and personal domains. Conclusion: Various factors are involved in developing an empathetic relationship between a dentist and a patient. The content about empathy in our present dental curriculum is very deficient. Contextual academic workload and time constraints affect the execution of empathy. However, empathy is a teachable attribute, hence the factors hampering empathy can be addressed, modified, and re-employed to enhance empathy. [ABSTRACT FROM AUTHOR]

The increase in dental healthcare facilities and the use of single-use equipment have increased the production of healthcare waste. Their mismanagement exposes healthcare workers, waste managers, and the population to an infectious risk and negatively impacts the environment. Therefore, a correct management procedure has to be adopted from separation through storage to disposal. This study aimed to investigate dentists' knowledge, attitudes, and practices regarding managing infectious healthcare waste in private dental offices. A descriptive and analytical cross-sectional survey was conducted between December 2020 and March 2021 among private dentists registered at the Moroccan National Council of Dentists in the Rabat-Salé-Kénitra region. A questionnaire was developed to assess waste management in dental offices. Of the 500 questionnaires distributed, 190 completed and exploitable questionnaires were collected. Only 27.3% of healthcare waste managers in dental practices received training, 21,5% of practitioners assimilated the used gloves into household waste, 71.5% disposed of the waste generated by their offices directly into public bins, and 86.4% were unaware of Moroccan law 28-00 on waste management and disposal. This study highlights dentists' apparent lack of knowledge regarding healthcare waste management, and significant gaps were identified between actual practices and recommended regulations. To address these issues, developing a comprehensive medical waste management plan is crucial to encourage the practical cooperation of all stakeholders in this sector. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis B continues to be a serious occupational concern for dental healthcare practitioners, with the possibility of transmission occurring during patient care practices. The incidence of hepatitis B amongst dentists, the factors raising their occupational risk, and the efficiency of vaccination programs in reducing this risk are all examined in this paper’s methodical evaluation of the body of prior research. This study addresses the important confluence of hepatitis B infection, occupational exposure, and vaccination status amongst dentists. In addition, it provides methods for improving the protection of dental professionals against hepatitis B infection by summarizing major findings and highlighting gaps in current knowledge, assuring the safety of both healthcare workers and their patients. The main objective of the study is to assess the relationship between Hepatitis B vaccination status and immunization level as measured by anti-HBs titer among a population of 192 dentists in Lebanon. Materials & Methods: 192 dentists, underwent the anti-HBs titer blood test. This test, which is Elecsys Anti-HBs, was used for the quantitative assessment of antibodies against the HBsAg. Results: The chi-square test was used to assess the association between being vaccinated against Hepatitis B and being immunized against the disease. A significant association was found between vaccination and immunity status. Among those vaccinated against Hepatitis B, 86.7% were found to be immune based on the blood test results versus 36.0% of those not vaccinated (p<0.001). Conclusion: the current study’s It highlights how crucial it is to keep up efforts to increase vaccination rates and promote immunization in order to improve population health and well-being in general. A dentist can play a part in hepatitis prevention by treating each and every patient as a possible hepatitis carrier. [ABSTRACT FROM AUTHOR]

Objective: This article introduced a systematic approach to matching composite and tooth shades to create esthetic restorations that visually integrate seamlessly with the patient's tooth and surrounding dentition. A basic explanation of color science was presented to aid the clinician in adopting this systematic approach to color matching. To demonstrate the need for custom shade guides, an objective analysis of composites from different companies was performed by recording the color coordinate values of multiple composites and then calculating CIEDE2000 color differences. Different locations on the tooth were analyzed using the same identified shade from different companies, as well as using the same composite shade applied in different thicknesses. A case report documented the clinical application of these shade matching techniques. Clinical Considerations: Shade matching, particularly in the anterior esthetic region, can be challenging, which can result in patient dissatisfaction with the esthetic result. Stock shade tabs are not a reliable indicator of actual composite shades. Conclusions: The most predictable esthetic results were achieved by using custom shade guides as an entry point, followed by a direct composite color mockup intraorally. Clinical Significance: To consistently meet the esthetic demands of today's patients, dentists need reliable tools when selecting a composite shade for restorations. Composites with the same shade designation vary in color and shade designation cannot be relied upon for accurate shade selection. The use of custom shade guides and an intra‐oral mockup can enhance the esthetic outcome. [ABSTRACT FROM AUTHOR]

Objective: This article describes the importance of identifying inflammation‐inducing conditions in the dental office that are prevalent in the population and have significant systemic health risks for the patient. The role of the dental biofilm will be presented, as will the clinical protocols for treating an unhealthy biofilm. Methods for testing and maintaining a healthy biofilm are also presented. Clinical Considerations: Periodontal disease, dental caries, and periapical infections are inflammation‐inducing diseases that can be identified in the dental office. Additionally, sleep apnea has been linked to chronic systemic inflammation. Dentists can identify risk factors and provide treatments that lower the risk of serious systemic outcomes, such as atherosclerosis, cardiac arrest, and stroke. Conclusions: A thorough dental examination, including a comprehensive periodontal evaluation, can provide important information that can be used to improve or maintain a patient's systemic health. Treatments provided to improve oral health have been shown to improve systemic indicators of cardiovascular health. This is the basis of integrative oral medicine, a collaboration between the medical and dental providers, which can offer patients the best opportunity for improved health outcomes. Clinical Significance: Periodontal disease, caries, periapical infections, and sleep apnea all have negative systemic health consequences for the patient (DiMatteo, Inside Dent, 2017, 13, 30; Nakano, Oral Microbiol Immunol, 2009, 24, 64; El Ouarti, BMC Oral Health, 2021, 21, 124; Lamberg, Steve). Periodontal disease, caries, and root end infections influence the health of the oral biofilm. If the biofilm becomes pathogenic the host inflammatory response can be stimulated, resulting in a cascade of inflammatory processes that damage the supporting structures of the teeth and harm the patient's overall health. A thorough dental exam that includes a comprehensive periodontal evaluation will identify patients with active inflammation or oral conditions that contribute to chronic inflammation. Dentists can integrate this information into treatment strategies that reduce the inflammatory burden and assist in better overall health outcomes. [ABSTRACT FROM AUTHOR]

In support of the benefit of the nurse + engineer collaborating as community health workers, a recent systematic review [for a description of review types, see Page et al. ([21])] by Berini et al. ([5]) noted that "community health workers can improve access to care in rural settings and may represent a cost-effective investment for the healthcare system." As part of this review, one study was identified where education was delivered by community health workers resulting in improved dental health ([23]). As environmental engineers work to expand our current technological solutions for drinking-water fluoridation, nurses are a natural ally when we foster informed action including behavioral change at the level of individuals, families, communities, and populations. While the public often associates engineers with driving trains or building things ([9]), in fact, according to the Code of Ethics for Engineers, the first fundamental canon of engineering is to "hold paramount the safety, health, and welfare of the I public i " ([11] emphasis added). [Extracted from the article]

Periodontal disease is one of the most common diseases worldwide. Hence, regular and thorough periodontal screening and care is imperative and should be a basis of all oral examinations. General dental practitioners often being the first to diagnose periodontal disease, might play a significant role in the management of periodontally affected patients. It is also necessary to focus on management of the risk factors and modifying factors which might affect periodontal disease and its treatment plan. Irrespective of the treatment being administered by a specialist or general practitioner, it should be ensured that the patients receive the same and best quality treatment. The level of speciality education being limited in the curriculum for undergraduates, general dentists need to be well acquainted with the criteria of timely and appropriate referrals to periodontists. The speciality of periodontology is growing in diverse aspects and various advancements in this field of dentistry have given success predictability level to previously considered unsalvageable periodontal issues. The present article provides useful guidelines for periodontal referral. It elaborates the levels of complexity associated with periodontal treatment and care of periodontally compromised patients in a secondary care setting. [ABSTRACT FROM AUTHOR]

Background: Dentists may be at a higher risk of developing carpal tunnel syndrome (CTS) because of their use of frequent wrist and vibratory instruments at work; however, this issue remains unclear. Therefore, we conducted this study to clarify it. Methods: Taiwan National Health Insurance Research Database was used for this nationwide population-based study. We identified 11,084 dentists, 74,901 non-dentist healthcare professionals (HCPs), and identical number of age- and sex-matched participants from the general population. Participants who had the diagnosis of CTS before 2007 were excluded. Between 2007 and 2011, the risk of developing CTS among dentists, non-dentist HCPs, and the general population was compared by following their medical histories. Results: The cumulative incidence rate of CTS among dentists was 0.5% during the 5-year follow-up period. In dentists, the risk was higher in women (women: 0.7%; men: 0.4%) and older individuals (≥60 years: 1.0%; <60 years: 0.4%). After adjusting for age, sex, and underlying comorbidities, dentists had a lower risk of CTS than the general population (adjusted odds ratio [AOR]: 0.65, 95% confidence interval [CI]: 0.45–0.92). Dentists had a higher risk for CTS compared with non-dentist HCPs, although the difference was not statistically significant (AOR: 1.21; 95% CI: 0.90−1.64). Conclusions: In CTS, dentists had a lower risk than the general population and a trend of higher risk than non-dentist HCPs. The difference between dentists and non-dentist HCPs suggests that we should pay attention to dentists for potential occupational risk of this disease. However, further studies are warranted to better clarify it. [ABSTRACT FROM AUTHOR]

Background: No research has been conducted to assess whether antibiotic prophylaxis prescribing differs by dental setting. Therefore, the goal of this study was to compare the prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-Veterans Affairs settings. Methods: This was a retrospective study of veteran and non-veteran dental patients with cardiac conditions or prosthetic joints between 2015–2017. Multivariable log binomial regression analysis was conducted to compare concordant prescribing by setting with a sub-analysis for errors of dosing based on antibiotic duration (i.e., days prescribed). Results: A total of 61,124 dental visits that received a prophylactic antibiotic were included. Most were male (61.0%), and 55 years of age or older (76.2%). Nearly a third (32.7%) received guideline concordant prophylaxis. VA dental settings had a lower prevalence of guideline concordant prescribing compared to non-VA settings in unadjusted results (unadjusted prevalence ratio [uPR] = 0.92, 95% CI: 0.90–0.95). After adjustment, prevalence of guideline concordant prescribing was higher in those with prosthetic joints in the VA setting (adjusted prevalence ratio [aPR] = 1.73, 95% CI: 1.59–1.88), with no difference identified in those without a prosthetic joint (aPR = 0.99, 95% CI: 0.96–1.01). Concordance of dosing was higher in VA compared to non-VA settings (aPR = 1.11, 95% CI: 1.07–1.15). Conclusions: VA has a higher prevalence of guideline concordant prescribing among those with prosthetic joints and when assessing dosing errors. Though the presence of an integrated electronic health record (EHR) may be contributing to these differences, other system or prescriber-related factors may be responsible. Future studies should focus on to what extent the integrated EHR may be responsible for increased guideline concordant prescribing in the VA setting. [ABSTRACT FROM AUTHOR]

Objective: The aim of this retrospective study was to evaluate the oral health-related quality of life (oHRQoL) and patient-reported outcome measures (PROMs) after 10 years of supportive periodontal care (SPC). Material and methods: Patients were re-examined 120±12 months after active periodontal therapy. Dental and periodontal status and oHRQoL by completing Oral Health Impact Profile-G49 (OHIP-G49) and PROMs by marking a visual analogue scale (VAS) for self-perceived esthetics (VASe), chewing function (VASc), and hygiene ability (VASh) were assessed. Patient- and tooth-related factors (age, insurance status, number of SPC, compliance, change of therapist, smoking, tooth loss, need for surgery or antibiotic intake, bleeding on probing (BOP), periodontal inflamed surface area) influencing oHRQoL and PROMs were evaluated. Results: One hundred eight periodontally compromised patients (59 female, mean age 65.4±10.7 years) lost 135 teeth during 10 years of SPC. At re-examination, 1.8% of all sites showed PPD ≥6mm. The mean OHIP-G49 sum score was 17.6±18.5, and VAS resulted in 76.0±22.5 (VASe), 86.3±16.3 (VASc), and 79.8±15.8 (VASh). Linear regression analyses identified a positive correlation with oHRQoL and/or PROMs for private insurance status (OHIP-G49, p=0.015, R2=0.204; VASc, p=0.005, R2=0.084; VASh, p=0.012, R2=0.222) and compliance to SPC (VASe, p=0.032; R2=0.204), as well as a negative correlation for active smoking (VASc, p=0.012, R2=0.084), increased BOP (VASh, p=0.029, R2=0.222) at the start of SPC, and number of lost molars (VASh, p=0.008, R2=0.222). Conclusion: It is realistic to obtain satisfactory oHRQoL and PROM values in most of the patients after 10 years of SPC. The identified factors may help to predict patient satisfaction in the long-term course of therapy. Clinical relevance: Systematic therapy of periodontally compromised patients provides values for oHRQoL and PROMs in a favorable range 10 years after therapy. This should encourage dentists to implement SPC in their daily routine. Clinical trial number: NCT03048045 [ABSTRACT FROM AUTHOR]

Objectives: The prevalence of root caries is increasing globally, especially in the elderly population, and even though the number of patients with root caries lesions is augmenting, there are still many discrepancies in how dentists manage this condition. The present study aimed to develop and validate a questionnaire to evaluate how dentists diagnose, record and manage root caries lesions, and to verify the validity and reliability of this questionnaire. Materials and methods: An expert panel developed a self-administered questionnaire survey with three domains: (1) dentists' knowledge on diagnosis, recording, and managing root caries; (2) information about their current general clinical routines; (3) their demographics. The original English [E] version was translated into three different languages (French [F], German [G], Italian [I]), and subsequently back-translated into English by independent dentists. For the validation, 82 dentists (20–22 for each of the translated versions) accepted to answer the questionnaire at two different time-points (with 1-week interval). The data was quality checked. Construct validity, internal reliability, and intra-class correlation (ICC) were assessed. Results: Seventy-seven dentists completed the questionnaire twice [E: 17; F: 19; G: 19; I: 22]. The mean ICC (standard deviation) was 0.98(0.03) for E, 0.90(0.12) for F, 0.98 (0.04) for G, and 0.98 (0.01) for I. Overall, the test–retest reliability was excellent (mean ICC (SD): 0.96 (0.08)). Furthermore, the questionnaire demonstrated good internal reliability (inter-observer reliability; Fleiss kappa: overall:0.27(fair); E:0.30 (fair); F: 0.33(fair); G: 0.33(fair); I: 0.89 (almost perfect)). Conclusion: The questionnaire was validated and is suitable to be used in the four languages to assess the knowledge of dentists on diagnosing, recording and managing root caries. Clinical significance: The present questionnaire was validated and seems to be a good tool to evaluate how dentists diagnose, record, and manage root caries lesions both in its original (English) and its translated (French, German, and Italian) versions. [ABSTRACT FROM AUTHOR]

There is limited literature and no reviews on oral health promotion activities in the workplace to guide planning and practice. This review summarizes evidence about oral health promotion activities in the workplace (nature and extent), its impact and the factors that facilitate or act as barriers to implementation. Using the PRISMA-ScR guidelines, scientific articles written in English and published in peer-reviewed journals up to April 2021, from six databases (Medline, PubMed, CINAHL, Scopus, EMBASE and Emcare) were screened and selected. The full texts of 95 articles were then considered; 21 articles met the inclusion criteria of using oral health status or oral health predisposing factors as primary outcome after an intervention in the workplace. Almost all included articles took a quantitative approach (n  = 18), two used a qualitative design and another used a mixed-method approach. The most common activities were personalized or group oral health education interventions and oral health screenings conducted by a dental professional. Two studies reported the cost-benefit of workplace oral health promotion (WOHP). The literature indicated that WOHP interventions can be successful in achieving improvements in oral health, measured using a range of clinical (plaque accumulation, gingival inflammation, periodontal inflammation) and self-rated oral health indicators. Based on the limited literature available, WOHP may have benefits for employee oral health and employers, and the support of managers and organizations potentially improves the success of programmes. The workplace would appear to be an ideal setting to promote oral health. However, there is limited information to guide oral health promotion planning and implementation, and policy. [ABSTRACT FROM AUTHOR]

This cross-sectional study intends to evaluate dentists' perceptions of COVID-19's effects on the use of emergency dental care both during and after Kuwait's lockdown periods. A convenience sample of dentists employed by the Ministry of Health's various emergency dental clinics and School Oral Health Programs (SOHP) throughout Kuwait's six governorates were invited to take part in this study. To determine the impact of various demographic and occupational characteristics on the mean perception score of the dentist, a multi-variable model was developed. The study was conducted between June–September 2021, and a total of 268 dentists (61% males and 39% females) participated in this study. When compared to pre-lockdown periods, the overall number of patients seen by dentists had significantly decreased after the lockdown period. After lockdown, there were significantly more cases of acute pulpitis with apical periodontitis, abscesses, and pericoronitis than there were before lockdown (p < 0.05). After the lockdown, a significantly higher percentage of dentists (p < 0.05) reported using fewer droplets-generating procedures to manage patients with dental emergencies. After correcting for the other variables in the model, female dentists (β = 0.146; 95% CI = 0.071 to 1.451) and non-Kuwaiti dentist (β = 0.012; 95% CI = 0.234 to 1.854) had a significantly (p < 0.05) more positive perception of the utilization of dental services than others after adjusting for the other variables in the model. The majority of dentists perceive that the COVID-19 pandemic has had a negative impact on Kuwait's use of emergency dental services. [ABSTRACT FROM AUTHOR]

Aim: To explore the implications for dentists and family doctors of the association between periodontal and systemic diseases and the role of dentists and family doctors in managing non‐communicable diseases (NCDs) and promoting healthy lifestyles. Materials and Methods: The consensus reports of the previous Focused Workshops on the associations between periodontitis and diabetes (2017) and periodontitis and cardiovascular diseases (2019) formed the technical reviews to underpin discussions on both topics. For the association with respiratory diseases, a systematic review was specifically commissioned for the Workshop discussions. Working groups prepared proposals independently, and then the proposals were discussed and approved at plenary meetings. Results: Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD), obstructive sleep apnea and COVID‐19 complications. Dentists and family doctors should collaborate in managing NCDs, implementing strategies for early detection of periodontitis in primary care centres and of cardiovascular diseases or diabetes in dental settings. Family doctors should be informed about periodontal diseases and their consequences, and oral health professionals (OHPs) should be informed about the relevance of NCDs and the associated risk factors. Conclusions: Closer collaboration between OHPs and family doctors is important in the early detection and management of NCDs and in promoting healthy lifestyles. Pathways for early case detection of periodontitis in family medicine practices and of NCDs in dental practices should be developed and evaluated. [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]

Objectives: Maintaining the oral health of dependent older adults is challenging, with limited access to dental care and limited focus on preventive oral health programmes. This study aimed to evaluate the attitudes of General Dental Practitioners (GDPs), working in Switzerland, to caring for dependent older adults with a focus on the use of silver diamine fluoride (SDF) as a caries preventive agent and more widely on the provision of domiciliary dental care (DDC). Methods: Seventeen GDPs working in Switzerland were interviewed. Each interview was semi‐structured by a topic guide, digitally recorded, and transcribed. The transcribed data were analysed using a thematic analysis. Results: Three major themes to the widespread use of SDF in this population were identified: lack of basic knowledge including indications for use; aesthetic concerns and product availability. Those who had knowledge about the product believed that using it in the treatment of frail older adults had advantages, especially in the preservation and/or prolongation of the life of teeth without invasive treatments. The biggest barrier was its availability. The GDPs identified three major barriers related to DDC provision: lack of infrastructure, poor financial rewards and safety concerns (patient and operator safety). Those who provided this service stated that they were doing it because of self‐motivation, kindness, or as a role in community service. Conclusions: The potential use of SDF was viewed positively by the majority of the GDPs interviewed but confusion exists over its availability in Switzerland, and other barriers were identified to more widespread use in this patient group. The GDPs interviewed in this study reported that a lack of infrastructure and a low level of remuneration continue to be barriers to more of them undertaking DDC for dependent older adults. [ABSTRACT FROM AUTHOR]

This study identified factors that influence dentists' decisions regarding less invasive caries removal techniques such as stepwise removal (SW) and selective removal (SE) using a marketing research technique, conjoint analysis. A survey was sent to 1,434 dentists practicing in Iowa. Dentists were randomly assigned to receive a questionnaire to rate the likelihood they would use either SW/SE in hypothetical clinical scenarios. The scenarios were carefully created by conjoint design and included three relevant attributes: depth of lesion, hardness of carious dentin, and patient age. Descriptive and conjoint analyses were performed to assess trade-offs between these attributes, using SPSS. The study revealed that depth of lesion was the most important factor in the dentists' decisions (49 importance value) when choosing a SW to treat a deep carious lesion, followed by hardness of carious dentin and patient age (21 importance value). For the SE group, depth of the lesion was also the predominant factor when selecting a treatment. The study also identified that a high proportion of dentists (24.9%) indicated they would never consider using SW or SE under any circumstances. Our survey showed that depth of lesion was the most important reason to select a less invasive caries removal method. The high proportion of dentists indicating they would never consider selective caries removal (SE) techniques suggests that these less invasive options are underutilized. [ABSTRACT FROM AUTHOR]

Objective: To examine the factors that account for differences in dentist earnings between White and minoritized dentists. Data Sources: We used data from the American Dental Association's Survey of dental practice, which includes information on 2001–2018 dentist net income, practice ZIP code, patient mix between private and public insurance, and dentist gender, age, and year of dental school graduation. We merged the data on dentist race and ethnicity and school of graduation from the American Dental Association masterfile. Based on practice ZIP code, we also merged the data on local area racial and ethnic composition from the American Community Survey. Study Design: We used a linear Blinder‐Oaxaca decomposition to assess observable characteristics that explain the gap in earnings between White and minoritized dentists. To assess differences in earnings between White and minoritized dentists at different points of the income distribution, we used a re‐centered influence function and estimated an unconditional quantile Blinder‐Oaxaca decomposition. Data Extraction Methods: We extracted data for 22,086 dentists ages 25–85 who worked at least 8 weeks per year and 20 hours per week. Principal Findings: Observable characteristics accounted for 58% of the earnings gap between White and Asian dentists, 55% of the gap between White and Hispanic dentists, and 31% of the gap between White and Black dentists. The gap in earnings between White and Asian dentists narrowed at higher quantiles of the income distribution. Conclusions: Compared to other minoritized dentists, Black dentists have the largest earnings disparities relative to White dentists. While the level of the explained component of the disparity for Black dentists is comparable to the explained part of the disparities for other minoritized dentists, the excess percentage of the unexplained component for Black dentists accounts for the additional amount of disparity that Black dentists experienced. Persistent income disparities could discourage minoritized dentists from entering the profession. [ABSTRACT FROM AUTHOR]

Oral and oropharyngeal cancers have been recognized as a major global health problem and are the sixth most common cancers in the world, with increasing rates of incidence and mortality. Dentists have an important role and responsibility in the early diagnosis of oral cancer. This study aimed to assess knowledge, awareness, and attitudes regarding oral cancer among dentists in North Cyprus. This study was conducted via a questionnaire that was distributed to the dentists in different provinces of Northern Cyprus. The questionnaire comprised 19 main items about the demographic information, dentist's oral cancer knowledge, attitude, opinions, and practices. The study consisted of 120 dentists and an overall response rate of 81.6% (98) was achieved. Nearly, all respondents were knowledgeable about tobacco use (98%) and previous oral cancer history (98%). The percentage of correct answers to questions concerning knowledge about risk factors of oral cancer ranged from 4.1% (family history of cancer) to 98%. Two-thirds of the participants pointed out correctly that the tongue and floor of the mouth are the most affected sites for oral cancers and leukoplakia and erythroplakia are two lesions most commonly correlated with oral cancer. However, 47% of participants were able to identify squamous cell carcinoma as the most frequent form of oral cancer. In conclusion, dental faculty curriculums and continuing education programs should aim at managing oral cancer need to address not only increase the knowledge and awareness about oral cancers but also include the clinical cases and practices. [ABSTRACT FROM AUTHOR]

Background: Many patients with temporomandibular disorders (TMD) find it difficult to undergo dental care due to challenges caused by their condition, previous temporomandibular joint surgery or invasive dental procedures, and the impact of comorbid conditions. Managing routine dental care for some patients with TMD can be seen as challenging by some dental practitioners. Objective: The objective of this study was to work with patients experiencing TMD and clinicians to co‐produce recommendations aimed at helping general dentists to provide routine dental care for patients with TMD. Methods: A modified Delphi process was used to co‐produce recommendations. Six patients experiencing TMD, patient advocates and seven clinicians took part, including international TMD clinicians. Two meetings were held with patient participants, mediated by a trained facilitator. Recommendations suggested by patient participants were distributed to clinicians who were asked to add additional suggestions, but not to modify patients' recommendations unless to aid clarity. Additional themes were identified from the existing literature, and the recommendations were then reviewed by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) consortium. Results: Recommendations were given to support patients before, during and after dental treatment. Participants identified specific and practical recommendations to help patients with TMD receive routine dental care, but also emphasised the need for professionals to listen sensitively to patients' concerns and work with patients in an empathetic and non‐judgmental way. Conclusion: These recommendations, co‐developed with patients experiencing TMD, should help dental professionals to provide supportive general dental care for patients with TMD. [ABSTRACT FROM AUTHOR]

Background: Timely diagnosis of oral cancers is critical, and performing biopsies of oral lesions with suspected malignancy is a crucial step in achieving this goal. The waiting time for the diagnosis may be related to the progression and prognosis of malignant neoplasms. Objective: The aim of this observational, cross-sectional, national-level study was to identify the factors associated with the waiting time for scheduling an oral biopsy, based on the identification of its need. Methods: We used secondary data from the Brazilian public health system, obtained from the 2nd cycle of the National Program to Improve Access and Quality of Dental Specialty Centers (PMAQ-CEO). The study outcome was the waiting time for scheduling an oral biopsy, starting from the identification of the need for the exam. We analyzed individual and contextual variables using multilevel statistical analysis. Results: In 51.8% of DSC the waiting time for scheduling a biopsy was non-immediate; in 58.1% of CEOs, the sum of the weekly workload of dentists working in the Stomatology specialty is up to 20 h per week; in terms of coverage, 67.1% of the CEOs have only municipal coverage and 34.0% are references for up to 12 oral health teams in primary health care; only the coverage variable remained significant in the multivariate model (p < 0.05). Of the contextual variables, none of the variables remained significant (p > 0.05). When these were analyzed together, only the coverage remained significant (p < 0.05); Conclusion: Our analysis indicates that the waiting time for scheduling an oral biopsy is longer in CEOs that cover only one municipality and is not related to contextual factors. [ABSTRACT FROM AUTHOR]

Background: Hormonal alterations and lowered immunity during pregnancy aggravated by poor oral hygiene increase the risk of pregnant women of developing oral diseases. We conducted this cross-sectional study to examine the role of oral and prenatal health providers in promoting dental care for pregnant women attending primary healthcare centers (PHCs) in Saudi Arabia. Methods: An online questionnaire was sent to a random sample of women who attended PHCs in Jeddah, during 2018–2019. From a total of 1350 women who responded to our questionnaire, 515 women reported having a dental visit before pregnancy. These women comprised our study sample. Bivariate analyses and multiple logistic regression models were conducted to examine associations between oral practices of dental and prenatal health providers (exposures) and women's utilization of dental care during pregnancy (outcome). Covariates included age, education (< 12 years of education, 12 years of education, and > 12 years of education), family income (≤ 5,000, 5,001–7,000, 7,001–10,000, and > 10,000 Saudi Riyals), health insurance (yes/no), nationality (Saudi Arabian/non-Saudi Arabian), and presence of dental problems, such as toothache, dental caries, gingival inflammation, and the need for dental extractions. Results: Only 30.0% of women were informed by a dentist during their dental visit before pregnancy about the importance of visiting a dentist during pregnancy. About 37.0% of women were asked about oral health, 34.4% were informed about the importance of dental care during pregnancy, and 33.2% had their mouths inspected by prenatal health providers. Women informed by dentists about the importance of dental visits during pregnancy were twice as likely (Odds ratio [OR]: 2.42, 95% confidence interval [CI]: 1.63–3.60) to visit a dentist during pregnancy. Women who were referred to dentists, had their mouth inspected, or were advised to visit a dentist during pregnancy by prenatal providers were 4.29 (95% CI: 2.67–6.88), 3.79 (95% CI: 2.47–5.82), and 3.37 (95% CI: 2.16–5.27) times as likely to visit a dentist during pregnancy. Conclusion: The partaking of oral and prenatal healthcare providers in evidence-based oral health promotion practices, antenatal-dental collaboration, and closing the referral loop increase pregnant women's access to and utilization of preventive and treatment dental services. [ABSTRACT FROM AUTHOR]

A situation analysis among which a cross-sectional survey of dental practitioners working in primary healthcare centers found that while 127 (94.8%) out of 134 respondents consider fissure sealants effective yet, most of them have misconceptions regarding which teeth to consider carious and which to seal as only 15 (11.2%) recognized that initial carious and non-cavitated carious lesions are the same and only around half sealed either. Fissure sealants are provided for free in primary healthcare centers, but they seem underutilized as only 35 (37.6%) dentists use them very often. To address these issues and others raised by dentists and dental hygienists on the indications and the use of fissure sealants; evidence-based clinical recommendations are provided keeping in mind the high level of caries among children and adolescents in Bahrain and the services provided in primary healthcare centers. Further studies will be needed to evaluate different reasons affecting dental practitioners' knowledge and use of fissure sealants as a method of preventing and controlling caries. [ABSTRACT FROM AUTHOR]

Background: This research looks at the connection between psychological stress and the prevalence of hand eczema (HE) among physicians and dentists (surgeons, non-surgeons). Methods: This cross-sectional field study involved 185 participants: physicians (surgeons, non-surgeons), dentists (surgeons, non-surgeons) and controls. Hand lesions were examined using the Osnabrueck Hand Eczema Severity Index (OHSI), and participants answered the Nordic Occupational Skin Questionnaire (NOSQ) and Perceived Stress Scale (PSS). Patch tests were performed using commercial contact allergens. Results: The estimated prevalence of HE (self-reported) was 43.9% (physicians 44.6%; dentists 43.2%). HE was significantly more reported by surgeons than controls (p < 0.004; V = 0.288). Degrees of perceived stress (PSS) did not differ significantly between the groups, though physicians non-surgeons most exhibited high stress (50%), and physicians surgeons most exhibited low stress (22.5%). High stress was associated with 2.5 higher odds for self-reported HE (p = 0.008). Low stress was greater among physicians/dentists who did not report eczema (41.0% vs. 24.6%); moderate stress was more common among those who reported eczema (72.3% vs. 51.8%; p = 0.038; V = 0.210). Conclusions: Since high stress levels may negatively influence physicians'/dentists' work and quality of life, measures to decrease stress could be introduced into the treatment of healthcare workers who are prone to it. [ABSTRACT FROM AUTHOR]

Introduction: Children with learning difficulties (LD) have poorer oral health compared to those without LD due to barriers in maintaining oral care. However, the scarcity of data for this population in Malaysia has left a huge gap in understanding their problems and how to overcome those barriers. Therefore, this study was conducted to evaluate the unmet dental needs and barriers to care perceived by the guardians of children with learning difficulties (CWLD) attending the Special Education Integrated Programmes of a mainstream primary school, in comparison to children without learning difficulties. Methods: This cross-sectional study surveyed the guardians of CWLD (case) and those without LD (control), aged 6-12 years old. A total of 225 questionnaires were distributed to the guardians with a response rate of 40.4% (N=91). Unmet dental needs and barriers in both groups were analysed using the chi-square test. Barriers with significant Chi-square results were further tested with logistic regression to investigate possible confounders. Results: Unmet dental needs of 23.1% of CWLD were found. Most of the guardians agreed that regular dental check-ups were the most needed dental treatment (27.1%) compared to other treatments. The child's behaviour and the unwillingness of the dentists to treat were among the significant barriers to dental care within the CWLD group. Conclusion: Despite regular dental visits, guardians of CWLD perceived that their children had the most unmet dental needs compared to other children without LD, with significant barriers in terms of accessing professional dental services. [ABSTRACT FROM AUTHOR]

Radiotherapy for head and neck cancer usually involves a total dose of 6000-7000 cGy, delivered daily in 6-7 weeks, and is known to cause several oral complications. These include oral mucositis, oral pain, insufficient saliva production, increased risk of dental caries, decreased mouth opening, and osteoradionecrosis. This is a cross-sectional study conducted among Saudi dental professionals using an online survey; 463 dentists from Riyadh City were utilized in this study. Findings reported that almost equal numbers of males (51.9%) and females (48.1%) participated in the study; the majority of them were working as general dentists in the government sector. A significantly significant proportion of them thought that oral assessment is a necessity before radiotherapy and that the ideal time for a complete oral evaluation is after the diagnosis of cancer. In the present study, we concluded that the majority of dentists thought that oral assessment is necessary before radiotherapy and that the ideal time is after the diagnosis. The evaluation must include extraction of teeth with poor prognosis, and radiotherapy after oral surgery should be started after 3-4 months. Teeth cleaning was recommended, and most dentists were not confident in treating oral cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: Achieving a high grade in the final‐year comprehensive clinical care (CCC) course is not only important for the individual candidate but also to ensure competency of students as they transition from dental school into independent practice. Here, we aimed to identify predictors of success in the CCC that might prove useful to identify which, if any, students need focused intervention to improve their performance in the CCC. Materials and methods: This was a cross‐sectional study of two consecutive cohorts (2017–2018 and 2018–2019) of final‐year (Year six) dental students (n = 180 females and n = 150 males) attending [King Abdulaziz University], Saudi Arabia. Age, gender, cumulative GPA to the start of Year six and assessment results were tabulated and analysed as independent variables in binary logistic regression to identify predictors of the final case grade (≤69% or >70%). Results: Year five GPA (OR 1.07, 95% CI 1.02–1.12; p =.004) and female gender (OR 2.21, 95% CI 1.12–4.36; p =.02) were significantly associated with an increased odds of achieving a final case grade >70%. In particular, female students were over twice as likely as male students to achieve a higher score in their final case assessment. Discussion: This study suggests that gender may influence final performance in the CCC. The better performance of females in the final CCC course than their male counterparts suggests that there may be a narrowing or even reversal of the historical gender gap in dental school performance. Conclusions: Both cognitive (GPA) and other (i.e. gender) factors influence clinical dental performance. Further work is required to establish what instructional modifications are required to accommodate these gender differences in CCC courses to pave the way for personalised teaching approaches to optimise educational outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The curriculum of the three dental schools in the Netherlands consists of a three‐year bachelor's and three‐year master's course. The education programmes focus inter alia on clinical dental reasoning, thinking and acting scientifically, general oral healthcare activities, and communication and (inter)professional cooperation. This study examined how recently graduated dentists, in the light of their work experience, evaluate their education in retrospect. Materials and Methods: All 1074 dentists who graduated between 2012 and mid‐2017 were invited by e‐mail to answer a web survey. Of those, 314 (29%) took part in the study. Results: The majority of dentists were positive about their knowledge of general and clinical oral healthcare fields when they graduated (70% and 68%, respectively). Fewer dentists were satisfied with their skills in terms of some specific procedures (50%) and clinical professional areas (33%). By far, the majority (85%) were satisfied with the educational skills of their teachers. The majority (70%) felt that their education fitted in well with their professional practice. Nevertheless, 60% thought a year's trainee work experience would be a good idea. The overall evaluation of dentists who have their own practices was less positive than those who do not. Conclusion: Knowledge and skills relating to managing a practice were not sufficiently addressed in the programme. The introduction of a practical internship would be desirable, preferably during the education. But when they look back, the majority of recently graduated dentists in the Netherlands are generally positive about the education they received. [ABSTRACT FROM AUTHOR]

The use of dental handpieces and ultrasonic instruments expose dental professionals to high-frequency vibration, precise gripping, high pinch force, and repetitive bending movements of wrist during restorative procedures involving cutting dental material, periodontal scaling, and root planning. There is clear evidence of an association between the dentistry profession and work-related musculoskeletal disorders in the neck, upper back and upper extremities; however, the influence of high-frequency vibration on hand and fingers from dental handpieces is not well known. The objectives of the current paper are to present the results of a survey on hand-arm vibration syndrome (HAVS) among members of a professional dental society and to present a literature review on dental handpieces and ultrasonic scalers exposure assessment and occurrence of hand-arm vibration syndrome among dental professionals. There seems to be limited awareness of the occupational risk associated with hand-arm vibration from handpieces and ultrasonic devices. This study highlights the occurrence of vascular and neurological disorders of HAVS among dental professionals, as well as wrist/hand pain, osteoarthritis, diminished hand grip, and carpal tunnel syndrome. The assessment of high-frequency vibration and ultra-vibration from these vibrating tools and vibration-related injuries deserve special attention for future preventive measures. [ABSTRACT FROM AUTHOR]

Introduction: the need for age assessment remains relevant due to unregistered births or lack of identification documents as a result of political and socioeconomic conflicts. Dentists play a significant role in age assessment. In order to establish the need for capacity building and collaboration, the study set out to determine the proportion of dental patients referred for age assessment and their sources of referral. Methods: a cross-sectional study, based on 5-year records (2014-2018) of dental patients and a selected sample of 316 patients who visited for age assessment in 2019- 2020 in the same hospitals. The study centers were 8 county hospitals. Variables included gender, dental visits, health facility, and sources of referral. One-way Analysis of Variance (ANOVA) and Fisher's Exact test were used to identify a significant association between variables. Results: from the records, 12,738 (5.7%) patients sought age assessment services. Females 6,410 (50.3%) and males 6,328 (49.7%) were nearly equal. There was a statistically significant difference in the average number of patients who required age assessment services from different facilities, p=0.000. The selected sample comprised of 186 (58.9%) and 130 (41.1%) males and females respectively. Sources of referral included; court of law (267, 84.5%), prior to acquiring identification documents (47, 14.9%), and others (2, 0.6%). Conclusion: an average of 5% of dental patients seek age assessment services signifying the need for sustained capacity building so as to ensure competent service delivery. The majority of the sampled patients were referrals from the court of law. Further research on how the dental fraternity can collaborate with the Judiciary to ensure justice in age disputes is recommended. [ABSTRACT FROM AUTHOR]

The purpose of this cross-sectional study was to explore the sources of daily oral hygiene information among urban community-dwelling older adults in Athens, Greece and associate them with their dental and denture care habits. One hundred and fifty-four older adults (aged 71.7 ± 9.2 years) participated in the study, and their dental status, denture use, daily oral care habits according to current gerodontology recommendations, and oral care information sources were investigated. Daily oral hygiene practices were poor, and a small number of individuals recalled having received oral hygiene advice from a dentist. Only 41.7% of the 139 dentate participants performed toothbrushing with fluoride-based toothpaste at least twice a day, and 35.9% completed regular interdental cleaning. Among 54 denture wearers, 68.5% removed their denture(s) at night, and 54% cleaned them at least twice a day. Oral hygiene information sources included dentists (for approximately half of the participants), media, friends/relatives, non-dental health care providers and dental technicians. Dentate participants who had received oral hygiene information from dentists had a greater probability of brushing their teeth with fluoride toothpaste at least twice a day (p = 0.049, OR = 2.15) and performing regular interdental cleaning (p < 0.001, OR = 29.26). Denture wearers who had received instructions about denture hygiene from dentists were more likely to use a brush and mild soap (p = 0.016, OR = 14.67) and remove their denture(s) at night (p = 0.003, OR = 8.75). Dentists should improve their oral health prevention and promotion strategies for their older patients. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the experience of tooth loss and associated factors in older adults and elderly residing in nursing homes. A cross-sectional study was conducted in Mexican older adults and elderly aged ≥60 years living in four nursing homes (two in Mexico City, Mexico: one in Cuernavaca, Morelos, and one in Oaxaca, Oaxaca). The data were collected at the facility (home nursing) by two dentists in 2019. To determine the number of tooth loss and DMFT, a clinical oral examination was performed. In addition, a questionnaire was applied to determine diverse independent variables (demographic, socioeconomic, and behavioral). The analysis was performed using nonparametric tests and negative binomial regression (p < 0.05). 257 subjects were included. The mean age was 81.25 ± 9.02 years, and 60.7% were women. The mean number of lost teeth was 18.78 ± 9.05 (women = 19.43 ± 8.59 and men = 17.77 ± 9.68 ; p > 0.05). In the multivariate negative binomial regression model, it was found that, for each one-year increase in age, the mean tooth loss increased 0.92% (p < 0.05). In current smokers (p < 0.01) and in those who brush their teeth < 2 times a day (p < 0.01), the average of tooth loss increased 22.04% and 61.46%, respectively. The experience of tooth loss in Mexican older adults and elderly was high. Demographic (age) and habit of behavior (tobacco use and less frequent tooth brushing) were associated with increased tooth loss. It is important to promote oral health programs for institutionalized older adults. [ABSTRACT FROM AUTHOR]

Background and aims. Sustainability is the sensitive and responsible way of using the natural resources, its goal being to prevent their depletion and preserving the ecological balance. An essential requirement to achieve this is to practice environmentally conscious behavior. The main objective of the present study was to carry out a survey among dentists about the importance of sustainability, feasibility of an environmentally friendly dental practice and the steps in favor of it. Methods. An online survey with 6 question groups, including a total of 50 questions, was performed. The survey was available online for dentists on different platforms. In total 98 responses were recorded during September - November 2020. Results. Out of the responding dentists, 74.49% liked the idea of an environmentally friendly dental practice and 98.97% would take some steps toward environmental awareness in their practice. A statistically significant (p<0.05) difference between those who prefer an environmentally conscious practice and those who had not yet thought about it was only in the questions related to environmentally conscious lifestyle in their household, the use of environmentally friendly cleaning products, the creation of a 'green wall' and selective waste collection in their practice. Conclusions. Most of the respondents were open to the idea of forming an environmentally conscious dental practice and they would act to achieve it. In order to reach this, it is necessary to provide dentists with feasible solutions for better practice. Some of the guidance issues, which would be easy to implement, are listed at the end of the present study. We intend to provide a guidance regarding sustainable dental practice. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop a diagnostic support tool using pretrained models for classifying panoramic images of the temporomandibular joint (TMJ) into normal and osteoarthritis (OA) cases. Subjects and Methods: A total of 858 panoramic images of the TMJ (395 normal and 463 TMJ‐OA) were obtained from 518 individuals from January 2015 to December 2018. The data were randomly divided into training, validation, and testing sets (6:2:2). We used pretrained Resnet152 and EfficientNet‐B7 as transfer learning models. The accuracy, specificity, sensitivity, area under the curve, and gradient‐weighted class activation mapping (grad‐CAM) of both trained models were evaluated. The performances of the trained models were compared to that of dentists (both TMD specialists and general dentists). Results: The classification accuracies of ResNet‐152 and EfficientNet‐B7 were 0.87 and 0.88, respectively. The trained models exhibited the highest accuracy in OA classification. In the grad‐CAM analysis, the trained models focused on specific areas in osteoarthritis images where erosion or osteophyte were observed. Conclusions: The artificial intelligence model improved the diagnostic power of TMJ‐OA when trained with two‐dimensional panoramic condyle images and can be effectively applied by dentists as a screening diagnostic tool for TMJ‐OA. [ABSTRACT FROM AUTHOR]