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This retrospective clinical study compared two different professional maintenance therapy (MT) approaches (with and without periodic removal and decontamination of prosthetic components) on peri-implant inflammatory clinical and biochemical parameters after 5 years of implant function. A retrospective analysis based on patient records was used to assess inflammatory clinical and biochemical parameters around dental implants placed by the same clinician in a private practice. The Plaque Index (PI), peri-implant probing depth (PPD), mucosal recession (REC), bleeding on probing (BOP), and radiographic marginal bone level were determined at baseline and at each follow-up year. Moreover, at the last follow-up visit, the peri-implant intrasulcular levels of active metalloproteinasis 8 (aMMP-8) were also assessed. All participants were under MT with a 6-month recall interval. A total of 92 patients with 132 implants were selected. At the end of the study period, 12 patients with 12 implants were classified as dropouts. The remaining 80 patients and 120 implants were classified into two groups: Group 1 (42 patients, 62 implants) received MT with periodic removal and decontamination of prosthetic components; Group 2 (38 patients, 58 implants) received MT without periodic removal and decontamination of prosthetic components. No statistical differences were found between the groups regarding PI, PPD, and REC. Group 1 presented a statistically significant higher number of sites with BOP (12.4% vs 6.2%). Marginal bone loss was statistically higher in Group 2 than in Group 1 (0.23 ± 0.6 mm vs 0.78 ± 0.3 mm). Intrasulcular levels of aMMP-8 were statistically higher in Group 1 than in Group 2. The supplemental application of periodic removal and decontamination of prosthetic components during MT had a significantly positive effect on the inflammatory status of periimplant tissues. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of air‐abrasion of enamel with three different desensitizing powders on the whitening effect of a bleaching gel containing 40% H2O2, which was used for in‐office tooth bleaching. Materials and Methods: Forty human incisors, extracted and prepared, were acquired for this study and subsequently randomized into four groups (n = 10). The control group specimens underwent no pretreatment prior to the bleaching procedure, whereas the remaining three groups underwent air abrasion using distinct desensitizing powders; (a) Sylc, which contains bioglass 45S5; (b) BioMinF, which contains calcium phospho‐fluoro‐silicate glass; and (c) MI Pearls, which contains nano‐hydroxyapatite, 1 h preceding the Opalescence Boost PF 40% bleaching procedure. Color measurements were conducted using a double‐beam UV–Vis spectrophotometer at four distinct time points (prior to bleaching, 24 h, 15 days, and 30 days post‐bleaching). Results: Tooth color change outcomes revealed that there were no statistically significant results with respect to the interaction of the two criteria (treatments and time) (p = 0.990). Additionally, there were no statistically significant results with respect to the main effects of treatments (p = 0.385), while there were statistically significant effects with respect to the time criterion (p = 0.013). Conclusions: The use of the tested desensitizing powders prior the bleaching procedure did not affect the tooth color change induced by the tested bleaching agent. Clinical Significance: Tooth color change and whiteness are not affected by air‐abrasion desensitizing treatments when applied prior to in‐office bleaching procedures. [ABSTRACT FROM AUTHOR]

Aim: Supportive therapy is key to prevent disease recurrence after peri‐implantitis treatment. The primary objective was to quantify disease recurrence during supportive peri‐implant therapy (SPIT) after peri‐implantitis treatment. A secondary objective was to assess the success/failure of cumulative interceptive supportive therapy (CIST) after peri‐implantitis treatment. Methods: Compliers (whether regular or erratic) with SPIT after peri‐implantitis treatment during ≥12 months were retrospectively evaluated. CIST was prescribed whenever residual pockets ≥6 mm concomitant with profuse bleeding on probing (disease recurrence) were identified. Patient‐ and implant‐related factors were analyzed to explore their associations with disease recurrence and the need for CIST. Results: Disease recurrence was considered in 28 patients (40 implants). Of these, 14 patients (23 implants) further demonstrated radiographic evidence of progressive bone loss (≥1 mm). This represented an overall disease recurrence following peri‐implantitis treatment of ~20% and ~ 10% at patient and implant levels, respectively. Smokers, patients diagnosed at baseline with periodontitis grade C, and males were significantly more prone to exhibit recurrence. Patients undergoing CIST due to instability were not likely to respond favorably (~70% continued to exhibit residual pockets). Conclusion: Disease recurrence during SPIT following peri‐implantitis treatment on selected cases is ~20%. Patients undergoing CIST due to instability are not likely to respond favorably. [ABSTRACT FROM AUTHOR]

Background: Oral health is a critical component of overall well-being. However, students with disabilities (SWDs) face unique challenges in maintaining oral hygiene and accessing dental care. This study aims to explore oral health behaviours, dental care utilisation, and barriers to accessing dental care among SWDs in Al-Ahsa, Saudi Arabia, from the perspectives of their parents. Methods: A descriptive cross-sectional study was conducted among parents of SWDs in Al-Ahsa, Saudi Arabia. Data were collected using a validated questionnaire covering oral health behaviours, dental care utilisation, and barriers to care. The sample size was determined based on the SWDs population in the region. Data were analysed using descriptive and analytical statistics, with significant associations identified at p < 0.05. Results: Findings revealed that 45.7% of SWDs brushed irregularly, with only 16.8% brushing twice a day or more. Dental flossing was reported by just 4.3% of SWDs. Emergency-based dental visits were common (51.9%), and 29.5% of SWDs had never visited a dentist. Significant associations were found between maternal education and tooth brushing frequency (p = 0.004) and between parental education and the frequency of dental visits (p = 0.035). The most reported barriers included fear of treatment (47.1%), difficulty finding willing dentists (45.5%), and long wait times for appointments (44.7%). Conclusions: The study emphasises the pressing need for targeted interventions to improve oral hygiene practices and enhance accessibility to dental services for SWDs. [ABSTRACT FROM AUTHOR]

The scope of practice for dental hygienists includes the care of implants and peri-implant tissues. Hygienists in primary care settings must therefore be competent and confident in assessing, managing, and treating implant restorations and their peri-implant health. Dental hygienists also play a key role in the education of patients on oral health as part of their daily practice, a recognised and valued aspect of their clinical care responsibilities. Dental hygienists and therapists therefore have a pivotal role as adjunct support in a patient's implant journey where they can offer essential support throughout their treatment period and can provide guidance and education at regular intervals. Using current guidelines, dental hygienists and therapists can create and implement practice protocols to help deliver the necessary clinical care during pre-implant, peri-implant, and post-implant phases of care. This article discusses the processes required to achieve a healthy implant patient, how the dental team can support the patient, and how clinicians can work together to achieve the best possible clinical outcome. This article will explore current evidence-based guidance and how to implement guidance in a practice setting, with protocols for all members of the dental team, with the final goal of a dentally healthy, motivated patient. [ABSTRACT FROM AUTHOR]

Background: Local anesthesia (LA) during routine dental treatment in children fails in 5%–35% of first attempts. No data, however, are available on the success rates of subsequent attempts. Aim: To evaluate the effectiveness of primary, secondary, and tertiary LA attempts (P‐LA, S‐LA, and T‐LA, respectively) for anesthetizing molars during routine dental treatments in children. Design: We retrospectively analyzed dental records of all children (2–18 years) who had been administered LA for the treatment of primary or permanent molars by a single paediatric dentist, between 2011 and 2022. All LAs were delivered using a computer‐controlled local anesthetic delivery (CCLAD) system. Results: The failure rate of P‐LA in 1312 molars was 13% and correlated with age (p <.001), type of tooth (p <.001), type of treatment (p <.001), and treated arch (p <.001). The effectiveness of S‐LA for buccal infiltration, intrasulcular, inferior alveolar nerve block, greater palatine nerve block (GPNB), posterior superior alveolar nerve block (PSANB), or a combination of the last two was 50%, 87.2%, 66.7%, 63.6%, 33.3%, and 100%, respectively, and was not significantly associated with age or the type of tooth, treatment, or P‐LA. Conclusion: The optimal choice of S‐LA for anesthetizing maxillary molars was a combination of PSANB and GPNB, whereas for mandibular molars, it was IS‐CCLAD system. [ABSTRACT FROM AUTHOR]

Background: Poor oral health is associated with adverse health, social and economic consequences for pregnant women. While dental professionals promote good oral health within the dental practice context, more broadly, women in the antenatal period face poor oral health outcomes. Therefore, this study explored dental professionals' perceptions of their role in managing the oral health of pregnant women and identified the barriers and facilitators to improving maternal oral health. Methods: This study employed a descriptive qualitative method utilizing semi‐structured interviews. Convenience and snowball sampling were used to recruit 13 dental professionals from Tasmania, Australia, comprising dentists (n = 10), oral health therapists (n = 2) and dental therapist (n = 1). Interviews were audio‐recorded, transcribed verbatim and analysed using inductive thematic analysis. Results: Three major themes were constructed from the interviews: (1) dental professionals' oral health care of women during pregnancy; (2) perceived challenges to maternal oral health; and (3) proposed strategies to improve maternal oral health. Conclusions: Findings suggest dental professionals' competence in maternal oral health, but that several barriers, such as dental care access and maternal factors, hinder oral health outcomes. To address these barriers, oral health policies that support interprofessional collaboration, professional training and evaluation of existing community oral health programmes are needed. © 2024 Australian Dental Association. [ABSTRACT FROM AUTHOR]

The objective of this research was to evaluate the practice trends, clinical services and job satisfaction of dental therapists in Canada. Licenced Canadian dental therapists were recruited to participate in this cross-sectional study. A total of 124 dental therapists completed the survey (~68% response rate), with 57.3% of respondents being over the age of 50. Most respondents were actively engaged in full-time clinical practice in private dental offices. Indigenous dental therapists were significantly more likely to work outside of private dental offices providing care for Indigenous communities. Just over half of respondents were compensated by an annual salary, with the highest proportion of full-time practitioners earning between $75,000 and $99,000 per year. Dental therapists who were active in clinical practice performed a wide range of preventive, diagnostic, and treatment services consistent with their scope of practice. This research demonstrates that Canadian dental therapists are highly engaged and satisfied with their profession. Dental therapists can facilitate improved access to oral health care in less accessible areas of Canada; however, compensation packages and incentives to work in these less accessible areas must be addressed, as well as legal and regulatory requirements to ensure that dental therapists are licenced providers throughout Canada. [ABSTRACT FROM AUTHOR]

Objective: Oral healthcare professionals encounter considerable challenges while providing services to curb the oral disease burden. The aim of this study was to explore the challenges faced by oral health practitioners providing oral health services in Nyarugenge, Rwanda and to appraise the availability and adequacy of oral hygiene equipment, instruments, and materials. Methods: This was a cross-sectional concurrent mixed methods study. The quantitative and qualitative parts were independent during data collection and analyses and merged during the interpretation phase. All seven public health facilities and 14 dental professionals working in Nyarugenge were included in the study. Data were collected using an audit checklist and an in-depth interview guide. Descriptive statistics were used to analyze the quantitative data. The interviews were analyzed using thematic content analysis. Results: Most of the dental health professionals were dental therapists (n = 11), women (n = 9), aged 31–40 years (n = 7), and with 11–20 years' experience as oral health practitioners (n = 6). There were five health centers and two hospitals that were audited for equipment, instruments, and materials. The audit of the facilities revealed that most facilities have dental equipment and instruments, but none have adequate preventive dental instruments and materials. Four broad themes emerged from the interviews with the oral health practitioners, namely human resources, supply chain management, patients' oral health awareness and service rendering, and strategic management and administration. The most significant challenges oral health practitioners faced included high dental practitioner/patient ratios, lack of adequate and appropriate equipment and materials, patients' lack of oral health awareness, and a lack of administrative support. Conclusions: Well-established community preventive interventions, such as a mobile oral health App, could reduce the patient/provider ratio by increasing population awareness of oral health and encouraging healthy behaviours. The management of the health facilities should address the human resource challenges and equipment supply chain issues. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mercury (Hg) is a toxic heavy metal with multiple uses in various medical devices. Hg is used in dentistry as a restorative material. Such use creates significant exposure to dental practitioners. Hence, it is important to assess the risk created by Hg use in healthcare. OBJECTIVE: To quantify airborne Hg vapour exposure and Hg levels in dental healthcare workers, and determine the association of various symptoms and diseases to Hg exposure. METHODS: Air monitoring of Hg vapours were conducted in dental clinics and amalgam rooms. Urine samples were collected from occupationally exposed dental healthcare workers and urine Hg levels were measured. A cross-sectional health survey was conducted in 23 healthcare units of Delhi to determine an association between Hg exposure and various health effects. RESULTS: Hg vapour concentration ranged from 0.96μg/m3 to 15μg/m3, the highest concentration was recorded in the amalgam room (15μg/m3). Urine Hg levels in healthcare workers (0.51±0.17μg/L) were higher than the control (0.29±0.05μg/L). A cross-sectional health survey revealed a significant prevalence of confusion, forgetfulness, muscle spasm, and tremors by the respondents. CONCLUSION: Hg concentration in dental clinics may hover above the prescribed safe levels posing a definitive health risk to healthcare workers. Urinary Hg measurements did not reveal an excess of body burden except in one case. Since Hg bio accumulates, it is probable as these workers grow older, they may end up with a higher body burden of Hg that may lead to a variety of adverse health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The mandibular nerve and the mental foramen have occasionally shown variations in its anatomy. This report aims to present a case of lingual mental foramen recognised on three-dimensional cone beam computed tomographic imaging (CBCT). Case Report: Routine Orthopantomogram (OPG) and CBCT images were evaluated to assess the status of impact third molars in a 31-year-old female who had visited the dental clinics in our institution. The OPG image failed to reveal any anatomic variation in the position of the mental foramen. On tracing the course of the mandibular canal in CBCT images, two foramina were traced at the region of premolar. One opened towards the buccal cortical plate at the normal position of the mental foramen and an accessory lingual mental foramen had an opening on the lingual cortical bone at the same level as the mental foramen. Conclusion: Understanding variations of the mental foramen is extremely essential in dentistry to carry out successful anaesthetic or surgical interventions and to avoid complications such as nerve damage or excessive bleeding. [ABSTRACT FROM AUTHOR]

Purpose: Awake extubation and deep extubation are commonly used anesthesia techniques. In this study, the safety of propofol-assisted deep extubation in the dental treatment of children was assessed. Materials and methods: Children with severe caries who received dental treatment under general anesthesia and deep extubation between January 2017 and June 2023 were included in this study. Data were collected on the following variables: details and time of anesthesia, perioperative vital signs, and incidence of postoperative complications. The incidence of laryngeal spasm (LS) was considered to be the primary observation indicator. Results: The perioperative data obtained from 195 children undergoing dental treatment was reviewed. The median age was 4.2 years (range: 2.3 to 9.6 years), and the average duration of anesthesia was 2.56 h (range 1 to 4.5 h). During intubation with a videoscope, purulent mucus was found in the pharyngeal cavity of seven children (3.6%); LS occurred in five of them (2.6%), and one child developed a fever (T = 37.8 °C) after discharge. Five children (2.6%) experienced emergence agitation (EA) in the recovery room. Also, 13 children (6.7%) experienced epistaxis; 10 had a mild experience and three had a moderate experience. No cases of airway obstruction (AO) and hypoxemia were recorded. The time to open eyes (TOE) was 16.3 ± 7.2 min. The incidence rate of complications was 23/195 (11.8%). Emergency tracheal reintubation was not required. Patients with mild upper respiratory tract infections showed a significantly higher incidence of complications (P < 0.001). Conclusions: Propofol-assisted deep extubation is a suitable technique that can be used for pediatric patients who exhibited non-cooperation in the outpatient setting. Epistaxis represents the most frequently encountered complication. Preoperative upper respiratory tract infection significantly increases the risk of complications. The occurrence of EA was notably lower than reported in other studies. [ABSTRACT FROM AUTHOR]

Objective: The aim of this review was to compare various types of restorations used in children and young adults affected with amelogenesis imperfecta (AI) to determine the most effective restorative treatment. Methods: This systematic review included randomized controlled trials, retrospective and prospective cohorts conducted on children and young adults diagnosed with amelogenesis imperfecta and written in French or English. A systematic search was conducted using four databases, namely Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, Science Direct and Scopus, using a selection of MeSH terms: "Amelogenesis Imperfecta," "Therapeutics," "Treatment Outcome," "Adult, young," "Child," "Dental Restoration, Permanent," "Dental Restoration, Temporary," and "Esthetics, Dental." Results: Out of 138 articles identified in the initial search, four articles met all the inclusion criteria. The results showed that ceramic restorations had better quality scores and longevity compared to other restorations. Conclusion: Ceramic restorations could be considered the restorative treatment modality of choice for AI‐affected children and young adults. However, more high‐quality clinical trials involving young patients affected with AI are required to evaluate and compare the outcomes of different restorative approaches. Clinical Significance: Young patients affected with amelogenesis imperfecta usually suffer from low self‐esteem, psychological problems and social avoidance, caused by the alteration of teeth such as discoloration, sensitivity, fractures and reduced size. For the dentist, selecting the appropriate restorative treatment for AI in young patients could be a veritable challenge. Therefore, it is important to have an evidence‐based modality. For this reason, in this review, the different restorative approaches used in AI‐affected young patients were compared to recommend the most effective treatment. [ABSTRACT FROM AUTHOR]

Purpose: To investigate caretakers' understanding of midlevel providers and determine if there is theoretical acceptance of midlevel dental therapist (DT) integration into the dental workforce. Methods: Validated DT integration surveys were disseminated to caregivers of pediatric medical patients in an urban teaching hospital. Subjects completed a questionnaire regarding previous care received by a midlevel medical provider and were questioned on the acceptance of a midlevel dental provider (i.e., DTs) into the dental workforce. Results: Two hundred two questionnaires were evaluated for recalled previous medical midlevel care (ML; 71.2 percent) and those who were unaware of ML care being provided to their child (UML; 28.7 percent). MLs were significantly in agreement with DTs performing primary tooth restorations (P<0.001), permanent tooth restorations (P=0.001), primary tooth extractions (P=0.022), and emergency treatment (P<0.001). UMLs and MLs significantly agreed that procedures be completed with the supervision of a dentist (P<0.001). Conclusions: Caregivers of pediatric medical patients are receptive to the concept of DTs and largely agree with them performing dental procedures. However, the dissemination of information on DTs to the public is necessary to increase awareness of their education, scope of practice and integration into the dental field. [ABSTRACT FROM AUTHOR]

This article focuses on the latest S3-level clinical practice guidelines, which allow for an evidence-based and patient-centred decision-making process for managing periodontitis patients who require orthodontics as part of their interdisciplinary care. Orthodontic management, including types of appliances, movement, use of adjuncts and timing are discussed. Management of periodontitis relapse, as well as the importance of successful maintenance and retention, are also highlighted. CPD/Clinical Relevance: Severe periodontitis can result in pathological migration of teeth that may benefit from orthodontic therapy. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the development and implementation of a co-designed value-based healthcare (VBHC) framework within the public dental sector in Victoria. Methods: A mixed-method study was employed. Explorative qualitative design was used to examine patient, workforce and stakeholder perspectives of implementing VBHC. Participatory action research was used to bring together qualitative narrative-based research and service design methods. An experience-based co-design approach was used to enable staff and patients to co-design services. Quantitative data was sourced from Titanium (online patient management system). Results: Building a case for VBHC implementation required intensive work. It included co-designing, collaborating, planning and designing services based on patient needs. Evidence reviews, value-stream mapping and development of patient reported outcomes (PROMs) and patient reported experience measures (PREMs) were fundamental to VBHC implementation. Following VBHC implementation, a 44% lower failure to attend rate and 60% increase in preventive interventions was reported. A higher proportion of clinicians worked across their top scope of practice within a multi-disciplinary team. Approximately 80% of services previously provided by dentists were shifted to oral health therapists and dental assistants, thereby releasing the capacity of dentists to undertake complex treatments. Patients completed baseline International Consortium for Health Outcomes Measurement PROMs (n = 44,408), which have been used for social/clinical triaging, determining urgency of care based on risk, segmentation and tracking health outcomes. Following their care, patients completed a PREMs questionnaire (n = 15,402). Patients agreed or strongly agreed that: the care they received met their needs (87%); they received clear answers to their questions (93%); they left their visit knowing what is next (91%); they felt taken care of during their visit (94%); and they felt involved in their treatment and care (94%). Conclusion: The potential for health system transformation through implementation of VBHC is significant, however, its implementation needs to extend beyond organisational approaches and focus on sustaining the principles of VBHC across healthcare systems, policy and practice. What is known about the topic? Value-based healthcare (VBHC) has gained significant momentum within the healthcare sector and is seen as a driver for improving patient outcomes and equitable use of resources. What does this paper add? The paper describes firsthand experience and lessons learnt from implementing VBHC within a Victorian public healthcare system; the learnings are applicable to other organisations wanting to implement VBHC. What are the implications for practitioners? In implementing a co-designed VBHC framework, we ensured that its principles are applicable at both patient and population levels, centres on equity of access to care, achieves the best possible health outcomes and sustainable use of resources. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

This research aims to develop a model instrument for implementing family oral health care services with a holistic approach. The study employs a qualitative approach with an explorative qualitative design. The research sample consists of 14 participants, including academic dental and oral therapists, namely dentists, dental therapists, and public health experts. Sample selection is done using purposive sampling technique. Data is collected through Focus Group Discussion (FGD) using a pre-designed set of questions. FGD is conducted in two sessions, each with 7 participants. The FGD results are recorded, transcribed, and analyzed using thematic analysis. An initial draft of the family oral health care service implementation instrument model is formulated based on the FGD results. Subsequently, this draft is validated by an expert panel consisting of academic dental professionals, dentists, dental therapists, and public health experts through a Zoom meeting. The research findings indicate that developing a model instrument for implementing family oral health care services with a holistic approach is a crucial step in enhancing the quality of dental health services. The instrument model should encompass aspects of prevention, treatment, and dental health education, illustrating the interaction among family members, dental health practitioners, and environmental factors influencing family dental health. The implementation of the family oral health care service instrument model with a holistic approach is expected to enhance the knowledge and skills of dental therapists in providing effective and optimal care to patients and their families, especially in a home environment. Commitment is required to ensure strict adherence to these guidelines, providing consistent and high-quality care to every family. [ABSTRACT FROM AUTHOR]

Aims: Increased awareness of oral health disparities in the United States has highlighted the need to expand the workforce and access to both primary and preventive dental care. Achieving the goal of oral health equity will require dental team members with appropriate clinical skills dedicated to reaching historically marginalized populations through intra‐ and interprofessional practice. Materials and Methods: Collective efforts by healthcare advocates in Minnesota led to legislation that created a dental hygiene‐based workforce model inspired by the vision and foresight of the American Dental Hygienists' Association's 'Advanced Dental Hygiene Practitioner'. Results: In July 2023, there were 141 licensed dental therapists and 99 certified advanced dental therapists, the majority dually licensed as dental hygienists/dental therapists, providing primary care services in a variety of settings throughout the state. Current data confirm the contributions of this workforce model to increasing access to primary oral health care for Minnesotans across the lifespan. Conclusions: While challenges remain, new opportunities are emerging for dual‐licensed dental hygienists/dental therapists to reach intended populations. Minnesota's challenges and successes with the authorization and implementation of a dental hygiene‐based workforce model can serve to assist others in developing their own intra‐ and interprofessional oral health care practitioners. [ABSTRACT FROM AUTHOR]

Background: Dental therapy is a category of mid-level oral health professional that was introduced to address inequities in oral health service provision in South Africa within a constrained human resource for health context. However, low numbers of registered dental therapists and attrition threaten this strategy. Aim: This study explored reasons for this attrition, building on the Hertzberg Two-Factor Theory. Methods: Through a qualitative exploratory study design, in-depth interviews were conducted with former dental therapists to explore their reasons for leaving the profession. They were recruited using snowball sampling. All interviews were audio recorded, transcribed verbatim, and coded in NVIVO12. A team of researchers applied thematic analysis to agree on themes and sub-themes, guided by Hertzberg's ideas of intrinsic and extrinsic factors. Findings: All 14 former dental therapists interviewed expressed their passion for the profession, even though their motivations to join the profession varied. Many of their reasons for leaving aligned with extrinsic and intrinsic factors defined in Hertzberg's Two-Factor Theory. However, they also spoke about a desire for a professional identity that was recognized and respected within the oral health profession, health system, and communities. This is a novel study contribution. Conclusion: Dental therapist attrition in South Africa is mainly caused by job dissatisfaction and motivation issues resulting from health system level factors. While the Hertzberg Two-Factor Theory helped identify extrinsic and intrinsic factors at an individual level, we used the Human Resources for Health System Development Analytical Framework to identify solutions for dental therapist production, deployment, and retention. Addressing these issues will enhance retention and accessibility to oral health services in the country. [ABSTRACT FROM AUTHOR]

Digital tools and apps are revolutionizing healthcare and provide creative answers to urgent problems. Through teamwork and the incorporation of digital technologies, dentistry has experienced a remarkable revolution. A large body of scholarly research backs up this trend. The context, trends, and content of digital health technology in oral and dental health are examined in our bibliometric analysis. Using targeted keywords and synonyms, an organized searching technique was used in the Scopus database, yielding 1942 articles that were extracted into a CSV file. To acquire insights into the content, trends, and context, visualization using VOSviewer 1.6.18 and a variety of analyses—including coauthorship, citation, cooccurrence of author keywords, bibliographic coupling, and cocitation—were executed. The analysis revealed that the USA and the UK contributed to a significant quantity of the literature, with newer contributions coming from nations like India. Cone Beam Computed Tomography, Dental Caries, and Artificial Intelligence were prominent keywords. It is important to note that BMC Oral Health was associated with a sizable number of the papers. This bibliometric analysis provides insightful information about the context, content, and trends of digital health in the field of oral and dental health. By implementing the right technology, policymakers can use this information to increase oral health, encourage dental literacy, and improve access to dental treatment. It is vital to take into account the wide variety of technologies and their classifications based on dental services and contextual variables. [ABSTRACT FROM AUTHOR]

Purpose: Oral health disparities related to access persist for American Indian/Alaska Native (AI/AN) communities compared to the general population, especially in rural areas of the United States. The objective of this study was to better understand community perspectives of oral health, how rurality impacts access to care, and attitudes towards the implementation of dental therapists in Oklahoma, particularly among the AI/AN population. Methods: A descriptive, observational study design was utilized. An exploratory survey was conducted online and comprised of qualitative and quantitative data. The total frequencies and percentages were evaluated for the quantitative questions. The qualitative data was analyzed using thematic analysis. Utilizing descriptive and qualitative research methods, the focus was to describe the experiences of the respondents and their characteristics related to oral health in Oklahoma. Results: A total of 201 responses were obtained, where 65% (n = 131) identified as an enrolled member or employee of a tribe represented in Oklahoma. Key qualitative themes included community access to care, community concerns, and community motivated solutions. Conclusions: AI/AN communities are an underserved group in healthcare. Although communities in rural areas face major barriers to oral health services, evidence-based solutions can be implemented. [ABSTRACT FROM AUTHOR]

Among the patients seeking dental treatment, some may present with symptoms that cannot be resolved by dental treatment alone. Patients with orofacial symptoms associated with malignant diseases, which require medical treatment, often visit dental clinics for their initial consultation. Delays in making a definitive diagnosis worsen the patient's prognosis. Therefore, dental clinicians should also be aware of the signs and symptoms associated with malignant diseases. The chief complaints of these patients include numb chin syndrome (NCS), painless swelling of the palate and neck, trismus and temporomandibular disorders, and an enlarged tongue. This article aimed to review these orofacial symptoms and related diseases and describe representative cases of these diseases to obtain a definitive diagnosis via imaging. Panoramic radiograph is widely used in general dentistry, and this article reaffirmed the importance of panoramic radiograph anatomical landmarks in diagnosing the cases presented in this paper. [ABSTRACT FROM AUTHOR]

To increase the detection of unknown atrial fibrillation (AF), general practitioners have started screening their patients using small hand-held devices. It is thought that dental settings could be utilized for screening as they have regular access to patients. The aim of this study was to explore the perceptions of dental staff of screening for AF using a hand-held electronic device in primary dental care. The research took place in one large mixed NHS and private general dental practice. Views from staff including dentists, dental therapists, dental nurses, and managers were elicited via semi-structured interviews conducted face-to-face, audio recorded, and transcribed verbatim. Interviews continued until there were no new themes or patterns emerging from the data, and thematic saturation had been achieved. Eleven participants were interviewed. The main themes generated were methodology for screening, acceptability for screening within the practice, attitudes to screening, and implementation of screening. Overall, participants were positive about implementing AF screening in a dental practice but expressed concerns about time and remuneration. Staff also gave encouraging feedback regarding the simplicity of the portable screening device. Participants felt that AF screening in primary care dental practices was a good concept but may be challenging to implement in NHS Dentistry, especially due to the pandemic. [ABSTRACT FROM AUTHOR]

The article discusses the advancements and developments in implant dentistry over the past 24 years. The author emphasizes the importance of implant therapy being predominantly provided in primary care and highlights how it can positively impact patients' quality of life. The article also emphasizes the need for sound case selection, care planning, and a team approach to ensure successful implant outcomes. The author encourages readers to share the article with colleagues and to consider implant dentistry as a valuable opportunity to contribute to patient well-being. [Extracted from the article]

Claire Frisby discusses the current calls for a DCP wellbeing community with dental therapist Victoria Wilson. [ABSTRACT FROM AUTHOR]

In September 2017, Hurricane Irma struck several Caribbean islands, which suffered catastrophic damage. Anguilla, the most northerly of the Caribbean's Leeward Islands, a developing nation, experienced devastating damage to its social, physical, political, and economic infrastructures. Anguilla's longstanding Dental Unit, a public sector health care facility, was among the services that suffered irreparable destruction. Hurricane Irma's debilitating impact on a developing nation and its citizens' livelihoods exacerbated existing challenges in dental care, and created barriers to access. As part of the rehabilitation process, it was essential to promote access to dental care. This commentary shares examples of some practical and economical approaches that were employed: providing direct access to dental therapists, offering dedicated emergency and routine care appointments, delivering oral health campaigns, partaking in community health fairs, and social media engagement. The commentary also considers future approaches that could be beneficial. [ABSTRACT FROM AUTHOR]

The expanding role of endodontics into different phases of dental treatment is illustrated by the awareness of its relationship with orthodontics. Orthodontic treatment is done for gaining esthetic appearance for the patient and for the establishment of proper occlusion. However, there is a paucity of information on the concise relationship between endodontics and orthodontics during treatment planning decisions. This paper presents the part of relationship that includes the effects on the pulp and its viability hence, requiring some preventive measures to be undertaken during orthodontic treatment. [ABSTRACT FROM AUTHOR]

Background: Dental anxiety is associated with untreated dental caries. Understanding which childhood behaviours or experiences have the strongest association with later dental anxiety may help focus preventive strategies, subsequently limiting the burden of dental caries and anxiety. Aim: The aim of this study was to explore whether behaviours and experiences during childhood were associated with adolescent dental anxiety. Design: Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). Multivariable logistic regression was used to explore associations between adolescent dental anxiety and childhood behaviours and experiences. 1791 participants answered questions about oral health behaviours and experiences at 8 years of age and dental anxiety questions aged 17 years. Results: Children with experience of invasive dental treatment were more likely to have dental anxiety at 17 years of age than those who had not experienced dental treatment (OR 1.63; 95% CI: 1.12, 2.37; p =.011). Irregular dental attenders in childhood had over three times the odds of dental anxiety by adolescence, compared with regular attenders (OR 3.67 95% CI: 1.52, 8.88; p =.004). Conclusions: Adolescent dental anxiety is associated with invasive treatment and irregular dental attendance in childhood. A history of irregular attendance or invasive treatment may serve as a useful predictor when considering dental anxiety in young adult patients. Early preventive care supports good attendance and oral health. These actions may have secondary effects of reducing future dental anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Dental therapists are mid‐level oral healthcare providers introduced in 1977 to the South African health system to improve access to oral health services. There has, however, been anecdotal evidence of their unusually high rate of attrition that is cause for concern. Aim and Objectives: This study aimed to determine the demographic profile and attrition rate among members of the South African Dental Therapy profession. Methods: A retrospective time series review of records of all dental therapists who were previously registered and who are still registered with the Health Professions Council of South Africa (HPCSA) between 1977 and 2019 was conducted. Results: A total of 1232 dental therapists were registered from 1977 to 2019. The majority (64%) were Africans. Most practicing dental therapists were based in KwaZulu‐Natal (44%) and Gauteng (27%), which are the provinces where dental therapists are trained. The overall attrition rate between 1977 and 2019 was 40%, with a figure of 9% for the last 10 years of the study (2010 to 2019). Conclusion: This study has provided the first evidence of the high attrition rate of dental therapists in South Africa. The high attrition warrants further investigation to address the loss of valuable human resources from an already overburdened and under‐resourced public oral health sector. [ABSTRACT FROM AUTHOR]

Dental therapists have a vital role to play in the provision of dentistry in the UK. This article examines the role of dental therapists in carrying out aesthetic dentistry in the UK dental practice setting. Patient access through collaborative working, especially through a shared care model, referral, and direct access will be discussed. In addition, two clinical cases are presented to demonstrate the provision of aesthetic anterior dental restorations by dental therapists. [ABSTRACT FROM AUTHOR]

Objectives: This qualitative study explored the enablers and barriers of career satisfaction among Australian oral health therapists (OHTs) and the reasons behind career changes. Methods: Participants were recruited in 2 ways: 1) recruitment posts were made on the Facebook pages of two professional groups; and 2) an email was sent to the Doctor of Dental Medicine students of the University of Sydney School of Dentistry, inviting those with OHT qualifications to participate. Each participant completed a semi‐structured interview which was guided by open‐ended questions. The average interview length was 45 min. All interviews were recorded, transcribed verbatim and manually coded. Thematic analysis of the qualitative data was completed using an inductive approach. Results: Twenty‐one OHTs participated in this study. The enablers of OHT career satisfaction include clinical practice, job variety, career flexibility, being in a supportive team environment and the opportunity for constant learning and growth. The barriers to career satisfaction include musculoskeletal problems, restrictions on the scope of practice use, psychological stress and lack of recognition from others. OHTs remain in the profession due to stable income and employment opportunities. The main reasons for retirement were burnout and pursuing dentistry. OHTs pursue dentistry to expand their scope of practice. Conclusion: This study revealed the enablers and barriers of OHT career satisfaction in an Australian context. OHTs are an important component of modern dental workforces, and reasons for attrition within the workforce are essential for maintaining responsiveness to community oral health needs. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Health History is the property of University of Toronto Press 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.)

Dental general anesthesia (GA) is a day-stay procedure and is a suitable choice for complicated cases. It is undertaken in a controlled hospital setting that ensures the quality, safety, efficacy, and efficiency of dental treatment. The purpose of this study is to determine the prevalence, severity, duration, and factors related to the occurrence of postoperative discomfort in young children following GA in a general hospital. This study includes a minimum sample size of 23 children that were undergoing GA over a 1-month period. Informed consent was obtained from the parent prior to the treatment. A preoperative questionnaire via the Survey Monkey program was used for the purposes of recording the responses of the survey population. All data related to the immediate postoperative period while the child was in the post-anesthetic recovery room (PAR) was collected and assessed by one of the investigators using the Face, Legs, Activity, Cry, and Consolability (FLACC) pain assessment scale. Postoperative data was gathered using the Dental Discomfort Questionnaire (DDQ-8) and was performed by phone 3 days after the GA procedure. The participating 23 children ranged from 4 to 9 years old (mean 5.43 ± 1.53). A total of 65.2% were girls and 34.8% were boys, with 30.4% experiencing a recent history of pain. [ABSTRACT FROM AUTHOR]

Purpose Chronic kidney disease is highly prevalent in the general population and can progress to end-stage renal disease (ESRD). The purpose of this pilot study was to assess dental hygiene and dental therapy students' knowledge, attitudes, and perceptions towards ESRD and evaluate the feasibility of a larger scale study. Methods A convenience sample (n=59) of dental hygiene (DH) and dual degree DH/dental therapy students were invited to participate in an electronic survey for the pilot study. The investigator designed survey consisted of a total of 37 items: demographics (4), perceived knowledge, confidence, importance and attitudes (14), knowledge of chronic kidney disease (18). The knowledge questions were adapted from the Chronic Kidney Disease Self-Management Knowledge Tool (CKD-SMKT) with permission. Descriptive statistics and the non-parametric two-sample Wilcoxon rank sum test were used to analyze the data. Results Twenty-five participants completed the survey for a 42% response rate. Fewer than half (36%) perceived having some knowledge regarding ESRD, its oral manifestations (28%) and mental health implications (12%). The importance of managing oral health for ESRD was rated by most respondents as "very important" or "extremely important" (76%). Respondent attitudes indicated high interest (68%) regarding employment in hospital settings to care for individuals with ESRD. Knowledge scores from the CKD-SMKT were low in the categories of general knowledge of ESRD and dental hygiene care modifications for individuals with ESRD. Conclusion Results of this pilot study indicate that using a validated instrument on a national sample is feasible to determine the knowledge, attitudes and perceptions of dental hygiene students regarding ESRD. Future research should include knowledge and awareness of hypertension, diabetes, and the role that management of chronic kidney disease plays in the prevention of ESRD. [ABSTRACT FROM AUTHOR]

Background: New graduate dental practitioners with a dental/oral health therapy (OHT) qualification have varied experiences when they begin their careers. The aim of this narrative review is to investigate the concept of clinical coaching and whether the literature supports this relationship as an important transition from university into dental practice. Methods: A review of the literature was initiated by searching key words relating to coaching, clinical coaching, coaching dental/oral health therapy and coaching in dentistry. As publications relating directly to the dental field were not found, a broader search of the literature was undertaken, and key literature identified in other professional groups. Results: The literature reviewed demonstrated that studies investigating the importance of coaching within teaching, nursing and business had been undertaken for several decades. These studies provide conclusive evidence that coaching is an important part of transitioning into a chosen profession. The findings in these studies also suggest that careful approaches and techniques in coaching, must be considered in order to ensure the new graduate is enabled to develop their own individual growth and at their own pace. Within a structured and supportive background, new graduates can explore safe approaches as they develop professional independence that best suits them. The studies within the nursing profession are most comparable to dental/oral health therapy. Conclusion: Clinical coaches are fundamental for dental/oral health therapy new graduates as they transition from university into clinical practice. Powerful coaching allows for coaching that is individual, ensures safety but encourages self-exploration, is flexible and transitional into independent practice. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la ALAD is the property of Publicidad Permanyer SLU 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 goal of the study was to identify secular trends in dental service delivery between dental therapists and dentists in the Yukon-Kuskokwim Delta region of Southwest Alaska, the first area of the United States to authorize dental therapy practice. Electronic health record transactions from the Yukon-Kuskokwim Health Corporation from 2006 through 2015 (n = 27,459) were analyzed. Five types of dental services were identified using Current Dental Terminology procedure codes: diagnostic, preventive, restorative, endodontic, and oral surgery. Main outcomes were percentages of services provided by dental therapists compared with dentists and population-level preventive oral health care. The overall number of diagnostic, preventive, and restorative services in the Yukon-Kuskokwim Delta increased. For diagnostic services, there was a 3.5% annual decrease observed for dentists and a 4.1% annual increase for dental therapists (P <.001). Similar trends were observed for restorative services. For preventive services, there was no change for dentists (P =.89) and a 4.8% annual increase for dental therapists (P <.001). Dental therapists were more likely than dentists to provide preventive care at the population level. Dental therapists have made substantial contributions to the delivery of dental services in Alaska Native communities, particularly for population-based preventive care. The study's findings indicate that there is a role for dental therapy practice in addressing poor access to oral health care in underserved communities. [ABSTRACT FROM AUTHOR]

A report of the National Dental Council, and the subsequent the Ministry of Public Health Call to Action to Promote Oral Health, contributed significantly to raising awareness regarding the lack of access to oral health care by many Cameroonians, especially minority and low-income populations, with resulting disparities in oral health. The problem is particularly acute among the rural and poor communities. The current dental workforce in Cameroon is inadequate to meet the oral health care needs for the population. It is inadequate in terms of numbers of dentists, as well as their geographic distribution, ethnicity, education, and practice orientation. Dental therapists, paraprofessionals trained in a 3 to 4 academic-years program of postsecondary education, have been employed internationally to improve access to oral health care for population. Research has documented that utilizing dental therapists is a cost-effective method of providing quality oral health care in the community. Dental therapists have recently been introduced in Cameroon by the Ministry of Higher Education through Private institutions as St Louis University of Health and Biomedical Sciences, Bamenda. Dental therapists could potentially care for children and adult in dental offices, public health clinics, and school systems, as well as in the domain of Sport activities and NGOs. Adding dental therapists to the health care team would be a significant strategy for improving access to care for communities and reducing oral health inequities.

Clementine Rees Brown speaks to Leigh Ann Randell about the challenges and rewards of paediatric dentistry. [ABSTRACT FROM AUTHOR]

The article provides a roundup of in-person and virtual training and CPD events offered by the College of General Dentistry and partner organizations. These events include the College Annual Members' meeting, the British Dental Conference and Dentistry Show, a meet-and-greet event in Birmingham, lectures on topics such as record-keeping, managing complaints, safeguarding, and medical emergencies, a Fellows' summer reception in London, a peer review and discussion on endodontics, a study day in Scotland, and webinars on ethical considerations in cosmetic dentistry, managing ectopic teeth, and syncope. The article provides dates, locations, and registration information for each event. [Extracted from the article]

The article provides a roundup of in-person and virtual training and CPD events offered by the College of General Dentistry and partner organizations. The events cover a range of topics, including endodontics, tooth wear, composite dentistry, dental care for people with diabetes, the role of Clinical Dental Technicians, early detection of oral cancer, and time management. The events are open to students, dental therapists, dental hygienists, and dentists, and some are free for CGDent members. The article includes links for more information and registration. [Extracted from the article]

Objective: To assess Malaysian dental therapists' job satisfaction, motivation, turnover intention and perceived future roles, following recent changes in the regulations that allow them to provide dental care within their scope of practice in the private sector. Methods: A self‐administered questionnaire was distributed to public dental therapists who were selected using a stratified random sampling technique. Questions included items on social structure, job satisfaction and motivation (based on the Warr‐Cook‐Wall scale), turnover intention (based on four cognitive processes) and perceived future roles. Multiple logistic regression was used to assess the predictors of dental therapists' turnover intention. Results: Overall, a majority (>90%) of the participants had high job satisfaction and job motivation, with total mean scores of 45.70 ± 6.86 and 21.16 ± 2.63, respectively. A total of 8.3% intended to leave the public sector to work in a different organization. Of those who chose to remain as a dental therapist in the next five years, only 7% considered working in the private sector. The significant predictors for turnover intention were educational attainment, years of working experience, job satisfaction level and future preferred working sector. Conclusion: Although the newly introduced Dental Act allows dental therapists to expand their roles to the private setting, very few intended to do so. This could be related to them having a high level of job satisfaction and job motivation while serving in the public sector. [ABSTRACT FROM AUTHOR]

Like other areas of health, structural racism has a deep impact on oral health and is a key driver of racial inequities in access to care and outcomes. Racism also structures the relationship between oral health and access to economic opportunities. As a result, communities of color, American Indian/Alaska Native (AI/AN) communities, and low‐income populations experience the highest rates of the health, social, and economic costs of dental disease. This is compounded by issues of community‐level dental fear/trauma resulting from receiving itinerate care. Dentistry has long struggled to equitably distribute care and diversify its overwhelmingly white and affluent workforce, resulting in many communities not having access to providers who represent their identity and/or live in their community. While multi‐generational lack of access to dental care is not unique to Alaska, Alaska Native communities are the home to a reimagined, community‐centered care delivery system that is improving health outcomes. For almost two decades, AI/AN leaders have recruited and trained community members to serve as dental therapists—dental team members who offer routine and preventive care responsive to local geographic and cultural/community norms. As members of the communities they serve, dental therapists are fluent in the language and cultural norms of their patients, improving patient‐provider trust, access to care, and oral health outcomes. The communities that dental therapists serve are also now investing money and training in their community members, building educational opportunities, and professional wage jobs and directly countering the economic impact structural racism has on oral health. [ABSTRACT FROM AUTHOR]

Background: The first case of coronavirus disease 2019 (COVID-19) was identified in Wuhan, China in December 2019, as a highly contagious infection transmitted via droplets, and person-to-person contact. Airborne and aerosol transmission have also been implicated. Aerosol generating procedures such as scaling and polishing may increase the risk for developing COVID-19 in dental clinics, and may thus place some psychological strain on dental therapists. This study aimed to determine the psychosocial effect of COVID-19 on dental therapists in Nigeria. Materials and Methods: This cross-sectional study was carried out following ethical approval from the institutional Ethics Committee. Data collection was through self-administered online questionnaires and included socio-demographic characteristics. Psychosocial well-being was assessed using a five-point Likert scale that assessed the level of worry. Scores were summed up to obtain the mean (range 5–25). Statistical significance was set at a level of P ≤ 0.05. Results: The 192 respondents had a mean age of 28.0 ± 7.2 years, 96.9% were aware of COVID-19. Sixteen (8.3%) participants reported at least one medical condition. The mean psychosocial-wellbeing score was 18.4 ± 4.9. Most (90.1%) were worried about the COVID-19 pandemic, while 76% were severely worried about getting infected with COVID-19 in the dental clinic, and 72.9% were severely worried about the availability of personal protective equipment (PPE) in the clinic. Participants with self-reported medical conditions had a slightly higher psychosocial score (18.6 vs. 18.4), but this was not significant (P = 0.902). Conclusion: The psychosocial effect of the COVID-19 pandemic was considerable on the dental therapists. The provision of PPE, training on Infection Prevention and Control, and psychosocial support will reduce the psychosocial effect of COVID-19 on dental therapists in Nigeria as they are willing to ensure patients' safety.