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Background: Cognitively impaired patients often present poor oral health status that may be explained by ethical tensions in oral healthcare management. This participatory study explored such tensions among adults with intellectual disabilities and with caregivers. The second objective was to specify, with caregivers, the points that should be developed in a future study among dentists. Materials and Methods: Three focus groups involving adults with intellectual disabilities, family caregivers and professional caregivers were organized in France in 2013. Results: The thematic content analysis identified discrepancies between experiences and expectations, which were particularly marked for the dentist's competence and attitudes, the dentist's role in decisions, the dental care management and the French socio-political context. Conclusions: These discrepancies could partly explain multiple attempts to find the "right" dentist or the fact that care was abandoned, and could at least contribute to oral health needs being unmet.

Objective: The aim of this study was to provide a reliable instrument to assess evidence-based practice (EBP) dimensions in French-speaking dental students. To do so, a transcultural adaptation into French of the self-administered KACE questionnaire (Knowledge, Attitude, Access and Confidence Evaluation) and the evaluation of its psychometric properties in a sample of French dental students and teachers were performed. The effects of individual and academic factors on student performance in the KACE were also investigated. Method: Teachers and fourth-year students completed once the translated KACE and fifth-year students completed twice the questionnaire before and after an epidemiology course. Cronbach's alpha coefficient analysis, Kruskal-Wallis and post hoc Dunn's tests, paired samples Wilcoxon tests and a generalised linear mixed model were performed to assess the psychometric properties (reliability, internal consistency, discriminant validity and responsiveness) of the questionnaire and to identify the factors associated with KACE scores, respectively. Results: 186 participants completed the survey. Cronbach's alpha ranged from 0.06 to 0.48 for Knowledge, 0.21 to 0.59 for Attitude, 0.42 to 0.76 for Access and 0.82 to 0.93 for Confidence. The discriminant value and sensitivity of the French KACE revealed significant differences amongst students and teachers and accurately identified the effect the training course had on the students who had completed it. Preparing for a residency programme or having received add-on modules in science improved the students' performance in the test. Being female negatively impacted the KACE Confidence score. Conclusion: This version of the KACE is appropriate to assess EBP dimensions in French dental students. Academic background and gender may affect test performance. [ABSTRACT FROM AUTHOR]

Background: Given that advances in research continuously raise new ethical issues, a multidisciplinary working group of investigators involved in biomedical research has gathered to discuss and compare ethical viewpoints in their daily practice.Methods: The working group has drafted a Charter for Ethics in Biomedical Research that encompasses all the steps in the research process, i.e. from the initial idea to analysis and publication of the results.Results: Based on key principles for ethically responsible research, the Charter may serve as a tool for performing research, discussing research issues and training researchers.Conclusions: The Charter should stimulate researchers to think about their responsibility for research in a progressive, caring society. [ABSTRACT FROM AUTHOR]

The exponential development of chronic noncommunicable diseases requires a rethinking of health systems, which are commonly focused on the curative management of diseases. There is a need to reinvent them to involve lifelong health promotion. For patients, it is no longer just a matter of surviving an acute disease, but also of avoiding its occurrence, and even more often, learning to live and age with it. This is where therapeutic patient education (TPE) plays a role. Supporting this paradigm shift in practice requires a commitment through initial training to help the student— future dentist—to acquire the knowledge, skills, and attitudes relevant and easily applicable to the field of oral medicine, even in independent practice. Integrating TPE teaching into the curriculum is undeniably a challenge, but also a chance for students to develop a different stance and become conscious, competent, and committed professionals.

Background: Observational studies and clinical trials are increasingly highlighting significant associations between periodontitis (chronic, infectious, inflammatory disease affecting tooth supporting tissues) and rheumatoid arthritis (chronic systemic autoimmune disease)., Objective: The aim of the study was to describe the dental, periodontal and oral prosthetic status of outpatients with Rheumatoid Arthritis (RA)., Material and Methods: The study was conducted from June 2010 to March 2011 in the Rheumatology Day Care Department of the University Teaching Hospital, Toulouse. Activity of the RA was defined according to disease activity score 28 (DAS28). 74 subjects with RA were included. Periodontal status was determined using measurements of pocket depth, bleeding on probing and attachment loss. Periodontal Epithelial Surface Area (PESA) and Periodontal Inflamed Surface Area (PISA) were calculated., Results: The study population was 60.3 ± 11.9 years old with 75.7% women. 48.6% of the subjects had moderate RA (3.2 < DAS28 ≤ 5.1) and 22.2% high RA activity (DAS28 > 5.1); 93.2% were treated by biotherapy. The mean number of natural teeth was 18.9 ± 9.7. The mean number of teeth replaced by removable prostheses was 7.1 ± 10.5. The mean PISA was 291.9 mm(2) ± 348.7 and the PISA:PESA ratio was 33.2% ± 24.2. 94% of patients had periodontitis, which was moderate in 48% and severe in 46%., Conclusion: This study highlights the need for prevention and for adequate dental care to improve global and oral quality of life of subjects with rheumatoid arthritis. Given the frequency of periodontitis and some physiopathological hypotheses, clinical trials are needed to assess if periodontal treatment could improve RA biological and clinical parameters.

Background: Few data are available concerning the dental health of adults in France. This study was designed to describe dental status, oral health behaviour and factors associated with caries among workers followed by an occupational health service in Northern France., Methods: A representative sample of workers was selected between May and July 2006. Data were collected by occupational health physicians using a questionnaire completed during a face-to-face interview and a dental examination. After descriptive analysis of the variables, two groups were defined according to the degree of caries as assessed by the Significant Caries Index. Factors associated with the degree of caries were investigated using logistic regression adjusted to age., Results: 420 workers with a mean age of 34.6(±10.4) years were included. The mean DMFT (Decayed Missing Filled Teeth) score and the mean number of decayed teeth were 8.9 (± 6.5) and 1.3 (±2.8), respectively. Three independent factors associated with high caries rates were identified: level of education less than Baccalaureate (ORa = 1.85; p < 0.05), regular consumption of sweet snacks and/or sweet drinks (ORa = 2.01; p < 0.05) and a last dental visit motivated by pain or a reason other than preventive care (ORa = 1.89; p < 0.05)., Conclusion: This study showed a high need for care and oral health education in this population of workers. More oral health education programmes should be set up in the adult working population by occupational health services.