Richards, Beverly; And Others
This document contains dental assisting competencies and competency-based performance objectives, learning activities, resources, and evaluation procedures for each competency that was adapted and developed by instructors of dental assisting to suit the needs and legal parameters of Pennsylvania. The competencies and associated elements are…
Pennsylvania State Univ., University Park.
A secondary education health assistant curriculum procedure manual for six occupational areas is presented. The six areas, the number of procedures described for each area, and an example procedure follow: nursing assistant, forty-six (assist patient to and from a wheelchair); home health assistant, six (baby holds); medical/dental offices…
Bedos, Christophe; Brodeur, Jean-Marc; Levine, Alissa; Richard, Lucie; Boucheron, Laurence; Mereus, Witnisse
We examined rationales for behaviors related to dental care among persons receiving public assistance in Montreal, Quebec. Fifty-seven persons receiving public assistance participated in 8 focus groups conducted in 2002. Sessions were recorded on audiotape and transcribed; analyses included debriefing sessions and coding and interpreting transcribed data. In the absence of dental pain and any visible cavity, persons receiving public assistance believed they were free of dental illness. However, they knew that dental pain signals a pathological process that progressively leads to tooth decay and, therefore, should be treated by a dentist. However, when in pain, despite recognizing that they needed professional treatment, they preferred to wait and suffer because of a fear of painful dental treatments and a reluctance to undertake certain procedures. Persons receiving public assistance have perceptions about dental health and illness that prevent them from receiving early treatment for tooth decay, which may lead to disagreements with dentists when planning dental treatments.
Thiel, Sandra J.
Compiled to introduce the dental assisting student to various techniques used in the dental office and to present theoretical information essential for the student's professional development, this laboratory guide consists of three units of instruction. The first unit is an introduction to dental assisting and contains five topics of study. The…
Georgia Univ., Athens. Dept. of Vocational Education.
This program guide contains the standard dental assisting curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level dental assistants, and includes job skills in the technical areas of preventive dentistry; four-handed dentistry; chairside assisting with emphasis in diagnostics,…
Hook, S A; Wagner, C F
The purpose of this study was to identify core journals and the databases that provide access to these journals for the field of dental assisting. This study was completed as a part of the Medical Library Association (MLA) Nursing and Allied Health Resources Section's project to map the literature of allied health. There were three original journals selected for analysis using the prescribed methodology, Dental Assistant, the journal of the American Dental Assistants Association; Journal of the CDAA, the journal of the Canadian Dental Assistants' Association; and Dental Teamwork, published by the American Dental Association. Dental Teamwork ceased publication in December 1996; however, it was considered a necessary part of the analysis due to its extensive coverage of dental assisting as well as its numerous scientific articles with references. In Dental Assistant, there were 16 source articles, containing 206 citations. In Dental Teamwork, there were 31 source articles with 308 citations. In Journal of the CDAA, there were only 3 source articles with 14 citations. Bradford's Law of Scattering was applied to the journal citations. Four databases, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, EMBASE/Excerpta Medica, and HEALTH were analyzed for their coverage of these cited journals. This study may encourage the dental assisting profession to take a close look at its existing journals and to consider enhancing the content of these journals or the publication of additional journals in the field. Dental assistants of today need substantive literature that deals with all aspects of their chosen profession in order to meet the challenges of providing dental health care in the future. PMID:10427427
California State Dept. of Education, Sacramento. Bureau of Industrial Education.
A survey of 22 dental assisting programs showed an average of 1,124 hours of instruction in dental assisting for 15 four-semester, 955 for three three-semester, and 1,042 for four two-semester programs. The average instructional hours for the four-semester programs were 48 in introduction to dental assisting, 179 in the life sciences, 221 in the…
... 42 Public Health 1 2013-10-01 2013-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
... 42 Public Health 1 2011-10-01 2011-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
... 42 Public Health 1 2012-10-01 2012-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
... 42 Public Health 1 2014-10-01 2014-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
... 42 Public Health 1 2010-10-01 2010-10-01 false Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography G Appendix G to Part 75 Public Health PUBLIC HEALTH SERVICE...—Standards for Licensing Dental Hygienists and Dental Assistants in Dental Radiography The following section...
Horst, Jeremy A.; Clark, Matthew D.; Lee, Andrew H.
Dentists are self-selected for visual and kinesthetic learning preferences. Watching another practitioner perform treatment can be incredibly didactic, both before and after learning the procedure. This missing part of dental education has the capacity to play a tremendous role in dental education for all levels of practitioner. Dental students in their clinical years begin to realize the meaning of dentistry as a practice, a set of skills that are never perfected. Abundant evidence demonstrates that cycling between observation and practice enhances procedural learning and retention, yet this mechanism is vastly underused in dental education. Collaborative treatment paradigms, wherein the able student assists a more experienced practitioner, can create mentorship. Learning potentially esoteric information or subtle nuances of clinical acumen is facilitated by the contextual framework of the clinical environment and is strengthened by emotional attachments through interpersonal interactions. In this article, we explore the evidence surrounding mentorship and clinical observation both before and after students are given the responsibilities of patient care, which together recapitulate clinical apprenticeship. Finally, we present examples of how apprenticeship can be brought back to dental education, including evaluation of a clinical assisting program that we implemented and explanation of a hypothetical faculty-student practice partnership model. PMID:19648563
Eling, David R.
This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for dental assistant specialists. Covered in the individual volumes are an introduction to dental services (the mission and organization of medical/dental service, career ladder progressions, medical readiness/wartime training, and…
Heid, Theodore H.; Bair, Jeffrey H.
The U.S. Army Dental Corps has implemented a new concept of dental care delivery, formally identified as the Improved Dental Care Delivery System. The concept is based on the conservation of professional manpower resources through the use of dental treatment teams employing expanded duty dental assistants. Dental Therapy Assistant (DTA) is the…
Michigan State Univ., East Lansing. Coll. of Agriculture and Natural Resources Education Inst.
This curriculum guide, developed for use in dental assistant education programs in Michigan, describes a task-based curriculum that can help a teacher to develop a classroom management system where students learn by doing. It is based on task analysis and reflects the skills, knowledge, and attitudes that employers expect entry-level dental…
Text, illustrations, and exercises are utilized in this set of four learning modules to instruct dental assisting students in various office skills. The first module, "Dental Office Telephone Techniques," examines the qualities of a good telephone voice and demeanor and provides guidelines for taking a message and handling various…
Uziel, Nir; Meyerson, Joseph; Birenzweig, Yonatan; Eli, Ilana
Professional burnout and work-related stress are known problems that have been the subject of in-depth examination among dentists. Nevertheless, these issues have not been widely studied among dental assistants. The aims of this study were threefold: to confirm the structure of a Work Stress Inventory (WSI) for Dental Assistants which was originally developed for Jordanian dental assistants (factor analysis); to evaluate work stress and burnout among Israeli dental assistants and to discover the factors predicting Israeli assistants' burnout (regression analyses). The Maslach Burnout Inventory and the WSI were distributed by mail and in person. Varimax factor analysis revealed that the items which contribute to different aspects of work stress are similar among both Jordanian and Israeli populations. Among the 299 Israeli dental assistants who completed the questionnaires, the most stressful work-related factors were income, workload, and work hazards. Eighteen percent of the participants exhibited a high to very high level of burnout. Participants exhibited a moderate level of emotional exhaustion (EE), low level of depersonalization (DP), and high level of personal accomplishment (PA). Most WSI factors were found to correlate positively with EE and DP. Linear stepwise regression analyses revealed that the best predictor of EE was the dentist‒assistant relationship, followed by workload, patient type, and salary. The best predictor of DP was patient suffering followed by dentist‒assistant relationship, years of professional experience, and work hazards. Professional stress and burnout among dental assistants are important factors that can possibly affect the wellbeing of both dental personnel and their patients. Further studies are necessary to better understand these factors in addition to the effects of personal relationships on burnout among dentists and their assistants.
Post, Jennifer J; Stoltenberg, Jill L
In 2003, the Minnesota legislature revised the Dental Practice Act to include restorative procedures in the scope of practice for registered dental assistants (RDAs) and registered dental hygienists (RDHs). The authors examined these practitioners' characteristics and made comparisons on the basis of their use of restorative function (RF) training and their practices' locations. They also examined practice type, models of implementation and perceived outcomes. The authors mailed a survey to all RF-certified RDAs and RDHs in Minnesota (N = 387). They used descriptive statistics to summarize the data and t tests and Fisher exact tests (P <.0001) to make comparisons between groups. The authors received 243 surveys (63 percent). Less than one-half (38 percent) of the RF-certified practitioners performed RFs. Of these, 29 percent were RDHs and 71 percent were RDAs. These practitioners performed RFs most often by working with a dentist or when time allowed. They perceived increased access to dental care and an increase in the number of patients treated to be outcomes of performing RFs. The results of this survey indicated use of restorative procedures varied greatly by practitioner type. The perceptions of those who performed RFs indicated they had a positive effect on dental practice. The addition of RF-certified personnel to the dental team has the potential to increase the number of patients seen in practice and the job satisfaction of team members.
Tuominen, R; Tuominen, M
This study was conducted to develop a relative value method for dental procedures, and to evaluate the differences in values assigned by private and public sector dentists. Samples of 90 general practitioners and 120 clinical specialists were systematically drawn to represent all actively working Finnish dentists. The dentists were asked to assess the required time and know-how for performing various procedures compared to performing a two-surface amalgam filling (AF2). At the end, the dentists were asked to divide the value of 200 between time and know-how for the reference procedure (AF2). These figures were then utilized to calculate the average relative value for each procedure. Private practitioners' weighted relative values were 55.3% higher than the prices, and among public sector dentists they were 27.9% higher. Overall, know-how constituted more of the total value of the procedures than did time. Private practitioners' time assessments correlated well (r = 0.72-0.95) with the recommended prices. However, significant differences were often observed both in time and know-how assessments of individual procedures. Both time and know-how seem to be important factors when determining values for dental services. For evaluation of the value of output in the private sector, the use of prices is justified. However, when the productivity of non-profit dental offices is evaluated, a value system which is not based on market prices is needed.
Qureshi, Arslan; Kellesarian, Sergio Varela; Pikos, Michael A; Javed, Fawad; Romanos, Georgios E
The purpose of the present study was to review indexed literature and provide an update on the effectiveness of high-frequency radio waves (HRW) application in modern general dentistry procedures. Indexed databases were searched to identify articles that assessed the efficacy of radio waves in dental procedures. Radiosurgery is a refined form of electrosurgery that uses waves of electrons at a radiofrequency ranging between 2 and 4 MHz. Radio waves have also been reported to cause much less thermal damage to peripheral tissues compared with electrosurgery or carbon dioxide laser-assisted surgery. Formation of reparative dentin in direct pulp capping procedures is also significantly higher when HRW are used to achieve hemostasis in teeth with minimally exposed dental pulps compared with traditional techniques for achieving hemostasis. A few case reports have reported that radiosurgery is useful for procedures such as gingivectomy and gingivoplasty, stage-two surgery for implant exposure, operculectomy, oral biopsy, and frenectomy. Radiosurgery is a relatively modern therapeutic methodology for the treatment of trigeminal neuralgia; however, its long-term efficacy is unclear. Radio waves can also be used for periodontal procedures, such as gingivectomies, coronal flap advancement, harvesting palatal grafts for periodontal soft tissue grafting, and crown lengthening. Although there are a limited number of studies in indexed literature regarding the efficacy of radio waves in modern dentistry, the available evidence shows that use of radio waves is a modernization in clinical dentistry that might be a contemporary substitute for traditional clinical dental procedures.
Moen, BE; Hollund, BE; Riise, T
Background Dental assistants help the dentist in preparing material for filling teeth. Amalgam was the filling material mostly commonly used in Norway before 1980, and declined to about 5% of all fillings in 2005. Amalgam is usually an alloy of silver, copper, tin and mercury. Copper amalgam, giving particularly high exposure to mercury was used in Norway until 1994. Metallic mercury is neurotoxic. Few studies of the health of dental assistants exist, despite their exposure to mercury. There are questions about the existence of possible chronic neurological symptoms today within this working group, due to this exposure. The aim of this study was to compare the occurrence of neurological symptoms among dental assistants likely to be exposed to mercury from work with dental filling material, compared to similar health personnel with no such exposure. Methods All dental assistants still at work and born before 1970 registered in the archives of a trade union in Hordaland county of Norway were invited to participate (response rate 68%, n = 41), as well as a similar number of randomly selected assistant nurses (response rate 87%, n = 64) in the same age group. The participants completed a self-administered, mailed questionnaire, with questions about demographic variables, life-style factors, musculoskeletal, neurological and psychosomatic symptoms (Euroquest). Results The dental assistants reported significant higher occurrence of neurological symptoms; psychosomatic symptoms, problems with memory, concentration, fatigue and sleep disturbance, but not for mood. This was found by analyses of variance, adjusting for age, education, alcohol consumption, smoking and personality traits. For each specific neurological symptom, adjusted logistic regression analyses were performed, showing that these symptoms were mainly from arms, hands, legs and balance organs. Conclusion There is a possibility that the higher occurrence of neurological symptoms among the dental assistants
Moen, Be; Hollund, Be; Riise, T
Dental assistants help the dentist in preparing material for filling teeth. Amalgam was the filling material mostly commonly used in Norway before 1980, and declined to about 5% of all fillings in 2005. Amalgam is usually an alloy of silver, copper, tin and mercury. Copper amalgam, giving particularly high exposure to mercury was used in Norway until 1994. Metallic mercury is neurotoxic. Few studies of the health of dental assistants exist, despite their exposure to mercury. There are questions about the existence of possible chronic neurological symptoms today within this working group, due to this exposure. The aim of this study was to compare the occurrence of neurological symptoms among dental assistants likely to be exposed to mercury from work with dental filling material, compared to similar health personnel with no such exposure. All dental assistants still at work and born before 1970 registered in the archives of a trade union in Hordaland county of Norway were invited to participate (response rate 68%, n = 41), as well as a similar number of randomly selected assistant nurses (response rate 87%, n = 64) in the same age group. The participants completed a self-administered, mailed questionnaire, with questions about demographic variables, life-style factors, musculoskeletal, neurological and psychosomatic symptoms (Euroquest). The dental assistants reported significant higher occurrence of neurological symptoms; psychosomatic symptoms, problems with memory, concentration, fatigue and sleep disturbance, but not for mood. This was found by analyses of variance, adjusting for age, education, alcohol consumption, smoking and personality traits. For each specific neurological symptom, adjusted logistic regression analyses were performed, showing that these symptoms were mainly from arms, hands, legs and balance organs. There is a possibility that the higher occurrence of neurological symptoms among the dental assistants may be related to their previous work
Hempler, Nancy A.
A dental assisting instructor was provided with 250 hours of released time to develop standardized Learning Activity Packets (LAPs) for the Dental Assisting program at the Bellingham (Washington) Vocational Technical Institute. The instructor reviewed unit objectives, gathered input from local dental professionals, reviewed reference materials,…
career ladder assist dental officers in the performance of restorative, endodontic, orthodontic , pedodontic, periodontic, prosthodontic, and dental...representative location for orthodontic , pedodontic, and medi- cal readiness functions Randolph AFB TX Typical USAF Clinic In addition to interviews at the...the 2,230 personnel surveyed and are listed below. The relative time spent by respondents in each duty is pre - sented in Table 3. Selected background
Barsky, Nancy Happel; Londeree, Kathy
Guidelines for first aid procedures for temporary relief of dental emergencies include information on: (1) dental first aid supplies; (2) treatment of oral injuries; (3) orthodontic emergencies; (4) toothaches; and (5) prolonged bleeding due to an extraction. Consulting a dentist as soon as possible is strongly recommended. (JN)
compound , or model- ing plaster instead of the rubber dam retainer Removing the Rubber Dam (figures 4-4 and 4-5). A ligature can also be used After the...roots or split crowns. If a is checked. When directed by the dental officer, ligature, dental compound , or modeling plaster remove the rubber dam...34clean" and 1 " dirty " JOB STEPS 1. Wash hands. 2. Recor! patient’s name. 3. Explain procedure to patient. 4. Tell patient to lie in bed or be seated
Gaudin, Robert A; Remenschneider, Aaron K; Phillips, Katie; Knipfer, Christian; Smeets, Ralf; Heiland, Max; Hadlock, Tessa A
Herpes labialis viral reactivation has been reported following dental procedures, but the incidence, characteristics and outcomes of delayed peripheral facial nerve palsy following dental work is poorly understood. Herein we describe the unique features of delayed facial paresis following dental procedures. An institutional retrospective review was performed to identify patients diagnosed with delayed facial nerve palsy within 30 days of dental manipulation. Demographics, prodromal signs and symptoms, initial medical treatment and outcomes were assessed. Of 2471 patients with facial palsy, 16 (0.7%) had delayed facial paresis following ipsilateral dental procedures. Average age at presentation was 44 yrs and 56% (9/16) were female. Clinical evaluation was consistent with Bell's palsy in 14 (88%) and Ramsay-Hunt syndrome in 2 patients (12%). Patients developed facial paresis an average of 3.9 days after the dental procedure, with all individuals developing a flaccid paralysis (House Brackmann (HB) grade VI) during the acute stage. 50% of patients developed persistent facial palsy in the form of non-flaccid facial paralysis (HBIII-IV). Facial palsy, like herpes labialis, can occur in the days following dental procedures and may also be related to viral reactivation. In this small cohort, long-term facial outcomes appear worse than for spontaneous Bell's palsy. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
This curriculum is comprised of 31 instructional units divided into eight subject areas: orientation (6 units), anatomy and physiology (6 units), dental histology (1 unit), microbiology and bacteriology (2 units), pharmacology (2 units), chairside assistance (9 units), roentgenology (2 units), and practice administration (3 units). Each…
Bhagavatula, Pradeep; Xiang, Qun; Szabo, Aniko; Eichmiller, Fredrick; Okunseri, Christopher
Few studies have directly compared dental procedures provided in public and private insurance plans for enrollees living in dental health professional shortage areas (DHPSAs). We examined the rates for the different types of dental procedures received by 0-18-year-old children living in DHPSAs and non-DHPSAs who were enrolled in Medicaid and those enrolled under Delta Dental of Wisconsin (DDW) for years 2002 to 2008. Medicaid and DDW dental claims data for 2002 to 2008 was analyzed. Enrollees were divided into DDW-DHPSA and non-DHPSA and Medicaid-DHPSA and non-DHPSA groups. Descriptive and multivariable analyses using over-dispersed Poisson regression were performed to examine the effect of living in DHPSAs and insurance type in relation to the number of procedures received. Approximately 49 and 65 percent of children living in non-DHPSAs that were enrolled in Medicaid and DDW received at least one preventive dental procedure annually, respectively. Children in DDW non-DHPSA group had 1.79 times as many preventive, 0.27 times fewer complex restorative and 0.51 times fewer endodontic procedures respectively, compared to those in Medicaid non-DHPSA group. Children enrolled in DDW-DHPSA group had 1.53 times as many preventive and 0.25 times fewer complex restorative procedures, compared to children in Medicaid-DHPSA group. DDW enrollees had significantly higher utilization rates for preventive procedures than children in Medicaid. There were significant differences across Medicaid and DDW between non-DHPSA and DHPSA for most dental procedures received by enrollees. © 2016 American Association of Public Health Dentistry.
Chen, Pei-Chun; Tung, Ying-Chang; Wu, Patricia W.; Wu, Lung-Sheng; Lin, Yu-Sheng; Chang, Chee-Jen; Kung, Suefang; Chu, Pao-Hsien
Abstract Infective endocarditis (IE) is an uncommon but potentially devastating disease. Recently published data have revealed a significant increase in the incidence of IE following the restriction on indications for antibiotic prophylaxis as recommended by the revised guidelines. This study aims to reexamine the basic assumption behind the rationale of prophylaxis that dental procedures increase the risk of IE. Using the Longitudinal Health Insurance Database of Taiwan, we retrospectively analyzed a total of 739 patients hospitalized for IE between 1999 and 2012. A case-crossover design was conducted to compare the odds of exposure to dental procedures within 3 months preceding hospitalization with that during matched control periods when no IE developed. In the unadjusted model, the odds ratio (OR) was 0.93 for tooth extraction (95% confidence interval [CI] 0.54–1.59), 1.64 for surgery (95% CI 0.61–4.42), 0.92 for dental scaling (95% CI 0.59–1.42), 1.69 for periodontal treatment (95% CI 0.88–3.21), and 1.29 for endodontic treatment (95% CI 0.72–2.31). The association between dental procedures and the risk of IE remained insignificant after adjustment for antibiotic use, indicating that dental procedures did not increase the risk of IE. Therefore, this result may argue against the conventional assumption on which the recommended prophylaxis for IE is based. PMID:26512586
Mutters, Nico T.; Hägele, Ulrike; Hagenfeld, Daniel; Hellwig, Elmar; Frank, Uwe
Aim: Compliance with infection control practices is the key to quality care and excellence in dentistry. Infection control remains one of the most cost-beneficial interventions available. However, implementing control procedures requires full compliance of the whole dental team. The aim of our study was to measure the compliance in daily clinical practice. Methods: The compliance with infection control practices in dentistry by dental health care personnel (DHCP) in a German university dental clinic was observed during clinical work. In addition, a survey was conducted to assess the individual knowledge about infection control procedures. Contamination of the workplace during invasive dental procedures was tested, as well. Results: A total of 58 invasive dental treatments implying close contacts between HCWs and patients were scrutinized. All HCWs (100%) wore gloves during dental work, but in some cases (female dentists: 14.3%; dental assistants: 28.6%) gloves were neither changed nor hands were disinfected between different activities or patient contacts (female dentists: 68.6%; male dentists: 60.9%; dental assistants: 93%). Only 31.4% of female and 39.1% of male dentists carried out adequate hygienic hand disinfection after removing gloves. Male dentists wore significantly more often (100%) protective eyewear compared to 77.1% of female dentists (p<0.05). In addition, most of female dentists (62.9%) and dental assistants (80.7%) wore jewelry during dental procedures. Conclusion: Despite the knowledge of distinct hygiene procedures only a small percentage of dental staff performs hygiene practices according to recommended guidelines. Strict audit is clearly needed in the dental setting to ensure compliance with infection control guidelines to prevent transmission of pathogens. Our results provide insights for the development of a targeted education and training strategy to enhance compliance of dental staff especially of dental assistants with infection control
Mutters, Nico T; Hägele, Ulrike; Hagenfeld, Daniel; Hellwig, Elmar; Frank, Uwe
Compliance with infection control practices is the key to quality care and excellence in dentistry. Infection control remains one of the most cost-beneficial interventions available. However, implementing control procedures requires full compliance of the whole dental team. The aim of our study was to measure the compliance in daily clinical practice. The compliance with infection control practices in dentistry by dental health care personnel (DHCP) in a German university dental clinic was observed during clinical work. In addition, a survey was conducted to assess the individual knowledge about infection control procedures. Contamination of the workplace during invasive dental procedures was tested, as well. A total of 58 invasive dental treatments implying close contacts between HCWs and patients were scrutinized. All HCWs (100%) wore gloves during dental work, but in some cases (female dentists: 14.3%; dental assistants: 28.6%) gloves were neither changed nor hands were disinfected between different activities or patient contacts (female dentists: 68.6%; male dentists: 60.9%; dental assistants: 93%). Only 31.4% of female and 39.1% of male dentists carried out adequate hygienic hand disinfection after removing gloves. Male dentists wore significantly more often (100%) protective eyewear compared to 77.1% of female dentists (p<0.05). In addition, most of female dentists (62.9%) and dental assistants (80.7%) wore jewelry during dental procedures. Despite the knowledge of distinct hygiene procedures only a small percentage of dental staff performs hygiene practices according to recommended guidelines. Strict audit is clearly needed in the dental setting to ensure compliance with infection control guidelines to prevent transmission of pathogens. Our results provide insights for the development of a targeted education and training strategy to enhance compliance of dental staff especially of dental assistants with infection control procedures.
These six modules provide information, illustrations, and exercises to teach dental assisting students a variety of office skills. The first module, "Patients' Records," stresses the importance of patient records to the dental health team, covers all of the items on a patient record, and teaches how to complete patient information cards…
Boiano, James M; Steege, Andrea L; Sweeney, Marie H
Engineering, administrative, and work practice controls have been recommended for many years to minimize exposure to nitrous oxide during dental procedures. To better understand the extent to which these exposure controls are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted among members of professional practice organizations representing dentists, dental hygienists and dental assistants. The anonymous, modular, web-based survey was completed by 284 dental professionals in private practice who administered nitrous oxide to adult and/or pediatric patients in the seven days prior to the survey. Use of primary engineering controls (i.e., nasal scavenging mask and/or local exhaust ventilation (LEV) near the patient's mouth) was nearly universal, reported by 93% and 96% of respondents who administered to adult (A) and pediatric (P) patients, respectively. However, adherence to other recommended precautionary practices were lacking to varying degrees, and were essentially no different among those administering nitrous oxide to adult or pediatric patients. Examples of work practices which increase exposure risk, expressed as percent of respondents, included: not checking nitrous oxide equipment for leaks (41% A; 48% P); starting nitrous oxide gas flow before delivery mask or airway mask was applied to patient (13% A; 12% P); and not turning off nitrous oxide gas flow before turning off oxygen flow to the patient (8% A; 7% P). Absence of standard procedures to minimize worker exposure to nitrous oxide (13% of all respondents) and not being trained on safe handling and administration of nitrous oxide (3%) were examples of breaches of administrative controls which may also increase exposure risk. Successful management of nitrous oxide emissions should include properly fitted nasal scavenging masks, supplemental LEV (when nitrous oxide levels cannot be adequately controlled using nasal masks alone), adequate general ventilation, regular
Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.
This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the course sequences in the dental assisting technology program. Presented in the introductory section are a description of the program and suggested course sequence. Section I lists baseline competencies. Section II…
Ohio State Univ., Columbus. Vocational Instructional Materials Lab.
Developed through a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives in Ohio, this document is a comprehensive and verified employer competency profile for dental assistants. The list contains units (with and without subunits), competencies, and competency builders that…
Bhagavatula, Pradeep; Xiang, Qun; Eichmiller, Fredrick; Szabo, Aniko; Okunseri, Christopher
Most studies on the provision of dental procedures have focused on Medicaid enrollees known to have inadequate access to dental care. Little information on private insurance enrollees exists. This study documents the rates of preventive, restorative, endodontic, and surgical dental procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI) in Milwaukee. We analyzed DDWI claims data for Milwaukee children aged 0-18 years between 2002 and 2008. We linked the ZIP codes of enrollees to the 2000 U.S. Census information to derive racial/ethnic estimates in the different ZIP codes. We estimated the rates of preventive, restorative, endodontic, and surgical procedures provided to children in different racial/ethnic groups based on the population estimates derived from the U.S. Census data. Descriptive and multivariable analysis was done using Poisson regression modeling on dental procedures per year. In 7 years, a total of 266,380 enrollees were covered in 46 ZIP codes in the database. Approximately, 64 percent, 44 percent, and 49 percent of White, African American, and Hispanic children had at least one dental visit during the study period, respectively. The rates of preventive procedures increased up to the age of 9 years and decreased thereafter among children in all three racial groups included in the analysis. African American and Hispanic children received half as many preventive procedures as White children. Our study shows that substantial racial disparities may exist in the types of dental procedures that were received by children. © 2012 American Association of Public Health Dentistry.
Barber, Thomas K.; Sokolow, Sonya
A developmental project created and field tested a computer-assisted instructional (CAI) unit in dental diagnosis. The main objectives were to determine 1) if, after having received CAI, the dental student could determine whether a patient had a clinical need for space management and 2) if the dental student's attitude toward CAI and space…
Sheridan, C; Gorman, T; Claffey, N
The aim of this paper is to explore the profile of dental nursing students in the National Dental Nurse Training Programme of Ireland and their adjustment to a technology-assisted learning environment. Evaluation by students of the course and their reactions to the course were analysed. Dental nurses must possess the skills and knowledge to proficiently function in the modern day dental surgery. The implementation of a dental nurse programme that is heavily reliant on technology has started to create a group of dental nurses equipped with basic skills to access and retrieve information over a lifetime. However, the transition to a technology-assisted learning environment including online learning activities requires adaptation and expertise by educators and students alike. Careful evaluation and stakeholder feedback is imperative in the creation and maintaining of a quality programme. In conclusion, the students in this study responded well to the transition to a technology-based learning environment. Furthermore, the findings of this study suggest that the use of an online environment is an effective and stimulating learning environment for the students of a dental nurse programme; however, familiarity skills and knowledge of information technology is a prerequisite for success.
Stephan, Christine A
Using a descriptive correlational design, this study surveyed periodontal assessment procedures currently performed by Indiana dental hygienists in general dentistry practices to reveal if deficiencies in assessment exist. Members (n = 354) of the Indiana Dental Hygienists' Association (IDHA) were invited to participate in the survey. A 22 multiple choice question survey, using Likert scales for responses, was open to participants for three weeks. Descriptive and non-parametric inferential statistics analyzed questions related to demographics and assessment procedures practiced. In addition, an evaluation of the awareness of periodontal assessment procedures recommended by the American Academy of Periodontology (AAP) was examined. Of the 354 Indiana dental hygienists surveyed, a 31.9% response rate was achieved. Participants were asked to identify the recommended AAP periodontal assessment procedures they perform. The majority of respondents indicated either frequently or always performing the listed assessment procedures. Additionally, significant relationships were found between demographic factors and participants' awareness and performance of recommended AAP assessment procedures. While information gathered from this study is valuable to the body of literature regarding periodontal disease assessment, continued research with larger survey studies should be conducted to obtain a more accurate national representation of what is being practiced by dental hygienists.
Beazoglou, Tryfon J; Chen, Lei; Lazar, Vickie F; Brown, L Jackson; Ray, Subhash C; Heffley, Dennis R; Berg, Rob; Bailit, Howard L
This study examined the impact of expanded function allied dental personnel on the productivity and efficiency of general dental practices. Detailed practice financial and clinical data were obtained from a convenience sample of 154 general dental practices in Colorado. In this state, expanded function dental assistants can provide a wide range of reversible dental services/procedures, and dental hygienists can give local anesthesia. The survey identified practices that currently use expanded function allied dental personnel and the specific services/procedures delegated. Practice productivity was measured using patient visits, gross billings, and net income. Practice efficiency was assessed using a multivariate linear program, Data Envelopment Analysis. Sixty-four percent of the practices were found to use expanded function allied dental personnel, and on average they delegated 31.4 percent of delegatable services/procedures. Practices that used expanded function allied dental personnel treated more patients and had higher gross billings and net incomes than those practices that did not; the more services they delegated, the higher was the practice's productivity and efficiency. The effective use of expanded function allied dental personnel has the potential to substantially expand the capacity of general dental practices to treat more patients and to generate higher incomes for dental practices.
... 42 Public Health 4 2012-10-01 2012-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
... 42 Public Health 4 2011-10-01 2011-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
... 42 Public Health 4 2010-10-01 2010-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
... 42 Public Health 4 2013-10-01 2013-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
... 42 Public Health 4 2014-10-01 2014-10-01 false Dental services. 440.100 Section 440.100 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.100 Dental services. (a) “Dental services” means diagnostic, preventive, or corrective procedures provided by or under the...
Bourgeois, Denis; Dussart, Claude; Saliasi, Ina; Laforest, Laurent; Tramini, Paul; Carrouel, Florence
Effective sterilization of reusable instruments contaminated by Creutzfeldt–Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental practices was selected in the French Rhône-Alpes region. Data were collected by a self-questionnaire in 2016. Sterilization procedures (n = 33) were classified into 4 groups: (1) Pre-sterilization cleaning of reusable instruments; (2) Biological verification of sterilization cycles—Monitoring steam sterilization procedures; (3) Autoclave performance and practitioner knowledge of autoclave use; (4) Monitoring and documentation of sterilization procedures—Tracking and tracing the instrumentation. Answers were provided per procedure, along with the global implementation of procedures within a group (over 80% correctly performed). Then it was verified how adherence to procedure groups varied with the size of the dental practice and the proportion of dental assistants within the team. Among the 179 questionnaires available for the analyses, adherence to the recommended procedures of sterilization noticeably varied between practices, from 20.7% to 82.6%. The median percentages of procedures correctly implemented per practice were 58.1%, 50.9%, 69.2% and 58.2%, in Groups 1, 2, 3 and 4, respectively (corresponding percentages for performing over 80% of the procedures in the group: 23.4%, 6.6%, 46.6% and 38.6%). Dental practices ≥ 3 dental units performed significantly better (>80%) procedures of Groups 2 and 4 (p = 0.01 and p = 0.002, respectively), while no other significant associations emerged. As a rule, practices complied poorly with the recommended procedures, despite partially improved results in bigger practices. Specific training regarding sterilization procedures and a better understanding of the reasons leading to their non
Ludwick, William E.; And Others
Following specialized training in which naval dental assistants were taught to insert restorations in cavities prepared by dental officers, clinical tests were applied to determine how much more a dental officer can accomplish when he delegates certain procedures to specially trained assistants, to evaluate the quality of the restorations, and to…
Illinois Occupational Skill Standards and Credentialing Council, Carbondale.
These Illinois skill standards for dental assistant are intended to serve as a guide to workforce preparation program providers as they define content for their programs and to employers as the establish the skills and standards necessary for job acquisition. They could also serve as a mechanism for communication among education, business,…
Thygesen, Lau Caspar; Flachs, Esben Meulengracht; Hanehøj, Kirsten; Kjuus, Helge; Juel, Knud
For many years an amalgam containing metallic mercury, which has been associated with neurological and renal diseases, has been used in dentistry. In this nationwide study we compared hospital admissions due to neurological and renal diseases among dentists and dental assistants to admissions in controls. This register-based cohort study included all Danish workers employed in dental clinics, general practitioners' clinics or lawyers' offices between 1964 and 2006. We compared dentists with general practitioners and lawyers, and dental assistants with medical secretaries, nurses and legal secretaries. We also compared dentists and dental assistants employed during periods with high occupational mercury exposure with dentists and dental assistants employed during periods with less mercury exposure. We followed all subjects in a nationwide register of hospital admissions. We analysed risk of neurological diseases, Parkinson's disease and renal diseases using a Cox regression model. The cohort consisted of 122,481 workers including 5371 dentists and 33,858 dental assistants. For neurological diseases, no association was observed for dental assistants, while for dentists an increasing risk for periods with less mercury exposure was observed. Among dental assistants, a negative association between employment length and risk of neurological disease was observed. Admissions for renal disease among dental assistants were increased during periods with less mercury exposure compared with controls. For dentists a non-significant increased risk was observed between employment length and renal disease risk. Our nationwide study does not indicate that occupational exposure to mercury increases the risk of hospital admissions for neurological, Parkinson's or renal diseases.
Gilbert, Gregg H; Gordan, Valeria V; Korelitz, James J; Fellows, Jeffrey L; Meyerowitz, Cyril; Oates, Thomas W; Rindal, D Brad; Gregory, Randall J
Objectives were to: (1) determine whether and how often general dentists (GDs) provide specific dental procedures; and (2) test the hypothesis that provision is associated with key dentist, practice, and patient characteristics. GDs (n = 2,367) in the United States National Dental Practice-Based Research Network completed an Enrollment Questionnaire that included: (1) dentist; (2) practice; and (3) patient characteristics, and how commonly they provide each of 10 dental procedures. We determined how commonly procedures were provided and tested the hypothesis that provision was substantively related to the three sets of characteristics. Two procedure categories were classified as "uncommon" (orthodontics, periodontal surgery), three were "common" (molar endodontics; implants; non-surgical periodontics), and five were "very common" (restorative; esthetic procedures; extractions; removable prosthetics; non-molar endodontics). Dentist, practice, and patient characteristics were substantively related to procedure provision; several characteristics seemed to have pervasive effects, such as dentist gender, training after dental school, full-time/part-time status, private practice vs. institutional practice, presence of a specialist in the same practice, and insurance status of patients. As a group, GDs provide a comprehensive range of procedures. However, provision by individual dentists is substantively related to certain dentist, practice, and patient characteristics. A large number and broad range of factors seem to influence which procedures GDs provide. This may have implications for how GDs respond to the ever-changing landscape of dental care utilization, patient population demography, scope of practice, delivery models and GDs' evolving role in primary care.
Quinn, Robert H; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S
The American Academy of Orthopaedic Surgeons, in collaboration with the American Dental Association, has developed Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Patients with Orthopaedic Implants Undergoing Dental Procedures AUC clinical patient scenarios were derived from indications of patients with orthopaedic implants presenting for dental procedures, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the use of prophylactic antibiotics. The 64 patient scenarios and 1 treatment were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).
... areas: radiation physics; radiation biology; radiation health, safety, and protection; X-ray films and... 42 Public Health 1 2010-10-01 2010-10-01 false Standards for Accreditation of Dental Radiography Training for Dental Assistants C Appendix C to Part 75 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF...
Singhal, Sonica; Mamdani, Muhammad; Mitchell, Andrew; Tenenbaum, Howard; Lebovic, Gerald; Quiñonez, Carlos
Policy advocates continue to argue for the expansion of dental care services for people on social assistance in order to meet their health needs and to promote the move from welfare-to-work. However, there is little to no evidence to support the idea that receiving dental care ultimately improves employment outcomes. A retrospective cohort study was designed using administrative data from five Ontario regions and from the province's social assistance ministry. Employment outcomes among treatment and no-treatment cohorts were assessed at three, six and 12 months from baseline. Multivariable regression modeling was performed. We received data for 8742 people (2742 treatment, 6000 no-treatment). At one year, employment outcomes were not significantly different between the two groups (adjusted odds ratio=0.93; 95% CI: 0.83-1.03). Post-hoc analysis show that the change in proportion of individuals leaving social assistance for employment over time was significantly higher (p=0.0014) among those receiving treatment (13-29%; 124% increase) than those not receiving treatment (18-33%; 83% increase). At one year, dental treatment alone does not appear to be significantly associated with leaving assistance for employment in this population. However, this study suggests that people who received dental treatment may have been particularly disadvantaged and dental treatment may help to level them up in terms of employment outcomes over time. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Aslaner, Mehmet Ali; Kasap, Gül Nihal; Demir, Cihat; Akkaş, Meltem; Aksu, Nalan M
The occurrence of pneumomediastinum and massive subcutaneous emphysema due to dental procedures is quite rare. We present a case of pneumomediastinum and massive subcutaneous emphysema that occurred during third molar tooth extraction with air-turbine handpiece.
Baumgarten, Alexandre; Hugo, Fernando Neves; Bulgarelli, Alexandre Fávero; Hilgert, Juliana Balbinot
To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services. A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals. A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently. A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent
Skaar, Daniel; O'Connor, Heidi; Lunos, Scott; Luepker, Russell; Michalowicz, Bryan S
Practice guidelines historically have recommended postponing dental care after ischemic vascular events. The authors examined an administrative data set to determine whether dental procedures increased patients' risk of experiencing a second vascular event. The authors examined a data set of 50,329 participants in the Medicare Current Beneficiary Survey to identify those who had had a vascular event (n = 2,035) and a second event (n = 445) while in the survey. They used Cox proportional hazards regression to study associations between dental procedures performed within 30, 60, 90 or 180 days after a first event and the risk of experiencing a second vascular event. Dental procedures of any kind, and invasive procedures considered separately, were not associated with patients' risk of experiencing second vascular events across all periods examined. Most hazard ratios associated with dental procedures were less than 1.0, although none differed significantly from 1.0. The authors found that community-dwelling Medicare beneficiaries who underwent dental procedures within 30 to 180 days after an ischemic vascular event, including those that produce a bacteremia consistently, were not at an increased risk of experiencing a second event. The results of this study suggest that clinicians should reassess historical recommendations that dental care in this population be postponed for as long as six months after an ischemic vascular event.
Idaho State Dept. of Education, Boise. Div. of Vocational Education.
This Technical Committee Report prepared by industry representatives in Idaho lists the skills currently necessary for an employee in that state to obtain a job in dental assisting, retain a job once hired, and advance in that occupational field. (Task lists are grouped according to duty areas generally used in industry settings, and are used as…
Hough, Sharon L.; And Others
The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the dental assistant occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Six duties are broken down into a number of…
After the demise of the Industrial Age, we currently live in an 'Information Age' fuelled mainly by the Internet, with an ever-increasing medically and dentally literate population. The media has played its role by reporting scientific advances, as well as securitising medical and dental practices. Reality television such as 'Extreme makeovers' has also raised public awareness of body enhancements, with a greater number of people seeking such procedures. To satiate this growing demand, the dental industry has flourished by introducing novel cosmetic products such as bleaching kits, tooth coloured filling materials and a variety of dental ceramics. In addition, one only has to browse through a dental journal to notice innumerable courses and lectures on techniques for providing cosmetic dentistry. The incessant public interest, combined with unrelenting marketing by companies is gradually shifting the balance of dental care from a healing to an enhancement profession. The purpose of this article is to endeavour to answer questions such as, What is aesthetic or cosmetic dentistry? Why do patients seek cosmetic dentistry? Are enhancement procedures a part of dental practice? What, if any, ethical guidelines and constraints apply to elective enhancement procedures? What is the role of the dentist in providing or encouraging this type of 'therapy'? What treatment modalities are available for aesthetic dental treatment?
Ludwick, William E.; And Others
This report of one phase of a study concerned with seeking means of extending the success of dental officers through delegation of certain treatment procedures to auxiliary personnel focuses upon determining the amount of training dental assistants (termed dental technicians by the Navy) require in order to perform the treatment procedure…
Al Jazairy, Yousra H; Halawany, Hassan Suliman; Hussainan, Nawaf Al; Maflehi, Nassr Al; Abraham, Nimmi Biju; Jacob, Vimal
A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs.
JAZAIRY, Yousra H. AL; HALAWANY, Hassan Suliman; HUSSAINAN, Nawaf AL; MAFLEHI, Nassr AL; ABRAHAM, Nimmi Biju; JACOB, Vimal
A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs. PMID:24747371
Vancouver Community Coll., British Columbia.
These course outlines are intended to assist instructors in the development of curricula for college programs to train medical-dental health clerical support staff. The course outlines consist of a combined profile and four occupational profiles--dental receptionist, hospital clerical worker, medical office assistant, and medical stenographer.…
Summerfelt, Fred F
The 2010 U.S. Patient Protection and Affordable Care Act (PPACA) calls for training programs to develop mid-level dental health care providers to work in areas with underserved populations. In 2004, legislation was passed in Arizona allowing qualified dental hygienists to enter into an affiliated practice relationship with a dentist to provide oral health care services for underserved populations without general or direct supervision in public health settings. In response, the Northern Arizona University (NAU) Dental Hygiene Department developed a teledentistry-assisted, affiliated practice dental hygiene model that places a dental hygienist in the role of the mid-level practitioner as part of a digitally linked oral health care team. Utilizing current technologies, affiliated practice dental hygienists can digitally acquire and transmit diagnostic data to a distant dentist for triage, diagnosis, and patient referral in addition to providing preventive services permitted within the dental hygiene scope of practice. This article provides information about the PPACA and the Arizona affiliated practice dental hygiene model, defines teledentistry, identifies the digital equipment used in NAU's teledentistry model, give an overview of NAU's teledentistry training, describes NAU's first teledentistry clinical experience, presents statistical analyses and evaluation of NAU students' ability to acquire diagnostically efficacious digital data from remote locations, and summarizes details of remote applications of teledentistry-assisted, affiliated practice dental hygiene workforce model successes.
Bhola, Rahul; Malhotra, Reema
Objectives The study aims to determine the degree of anxiety pertaining to dental procedures and various oral hygiene practices among college teenagers. Methods Corah's Modified Dental Anxiety Scale was administered on a randomly chosen sample of 100 Indian college students (50 males and 50 females) of Delhi University, belonging to the age group of 17–20 years. Results Descriptive statistical computations revealed 12.14 years as the mean age of first dental visit, with moderately high levels of anxiety (60.75%) for various dental procedures among the Indian teenagers and 5% lying in the “phobic or extremely anxious” category. With merely 4.16% people going for regular consultations, general check-ups evoked 78.3% anxiety and having an injection or a tooth removed was perceived as the most threatening. The sample subgroup not using mouthwash and mouthspray, smokers, and alcohol drinkers with improper oral hygiene practices experienced much higher anxiety towards routine dental procedures. Conclusion The majority of the Indian youngsters had an evasive attitude of delaying dental treatment. The core problems lay in deficient health care knowledge, lack of patient-sensitive pedagogy to train dental professionals, inaccessibility of services, and a dismissive attitude towards medical help. The feelings of fear and anxiety prevalent among the Indian youth offer significant insights into causes and preventive measures for future research and practice. Methods of education and motivation could be developed to dissipate the anxiety amongst Indian teenagers that prevent routine dental visits and maintenance of adequate oral hygiene. PMID:25379373
Ye, Hong-qiang; Liu, Yu-shu; Liu, Yun-song; Ning, Jing; Zhao, Yi-jiao; Zhou, Yong-sheng
digital dental model with better color simulation can be constructed assisted by 3D dental scanning system and digital photography. In clinical practice, the communication between dentist and patients could be improved assisted by the better visual perception since the colorized 3D digital dental models with better color simulation effect.
Middletown Public Schools, CT.
This volume outlines the requirements and content of a second-year course in allied health occupations education that is designed to provide students with a practical understanding of the work done by dentists, dental hygienists, dental laboratory technicians, and dental assistants and also to help students acquire some basic dental assistant…
Wisconsin Univ., Madison.
Policies and procedures covering graduate teaching assistants (TAs) at the University of Wisconsin-Madison are presented. A TA's duties may include classroom teaching under the direction of a faculty member, assisting in teaching classes, discussion groups, problem-solving sessions or laboratories, assisting in planning courses and developing…
Gilbert, Maud R., Ed.; Fiedler, Belle, Ed.
This manual is for administrator and teacher use in planning a program and individual courses for adults in dental assisting in vocational, technical, and adult programs. The manual was developed by a supervisor, a teacher-coordinator, teachers, and dentists at the local level and tested in the local school. The objectives are to prepare…
Duval, Xavier; Millot, Sarah; Chirouze, Catherine; Selton-Suty, Christine; Moby, Vanessa; Tattevin, Pierre; Strady, Christophe; Euvrard, Edouard; Agrinier, Nelly; Thomas, Daniel; Hoen, Bruno; Alla, François
We aimed to compare oral hygiene habits, orodental status, and dental procedures in patients with infective endocarditis (IE) according to whether the IE-causing microorganism originated in the oral cavity. We conducted an assessor-blinded case-control study in 6 French tertiary-care hospitals. Oral hygiene habits were recorded using a self-administered questionnaire. Orodental status was analyzed by trained dental practitioners blinded to the microorganism, using standardized clinical examination and dental panoramic tomography. History of dental procedures was obtained through patient and dentist interviews. Microorganisms were categorized as oral streptococci or nonoral pathogens using an expert-validated list kept confidential during the course of the study. Cases and controls had definite IE caused either by oral streptococci or nonoral pathogens, respectively. Participants were enrolled between May 2008 and January 2013. Cases (n = 73) were more likely than controls (n = 192) to be aged <65 years (odds ratio [OR], 2.85; 95% CI, 1.41-5.76), to be female (OR, 2.62; 95% CI, 1.20-5.74), to have native valve disease (OR, 2.44; 95% CI, 1.16-5.13), to use toothpicks, dental water jet, interdental brush, and/or dental floss (OR, 3.48; 95% CI, 1.30-9.32), and to have had dental procedures during the prior 3 months (OR, 3.31; 95% CI, 1.18-9.29), whereas they were less likely to brush teeth after meals. The presence of gingival inflammation, calculus, and infectious dental diseases did not significantly differ between groups. Patients with IE caused by oral streptococci differ from patients with IE caused by nonoral pathogens regarding background characteristics, oral hygiene habits, and recent dental procedures, but not current orodental status. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: email@example.com
Angelo, Zavattini; Polyvios, Charalambous
Managing pain and anxiety in patients has always been an essential part of dentistry. To prevent pain, dentists administer local anaesthesia (LA) via a needle injection. Unfortunately, anxiety and fear that arise prior to and/or during injection remains a barrier for many children and adults from receiving dental treatment. There is a constant search for techniques to alleviate the invasive and painful nature of the needle injection. In recent years, researchers have developed alternative methods which enable dental anaesthesia to be less invasive and more patient-friendly. The aim of this review is to highlight the procedures and devices available which may replace the conventional needle-administered local anaesthesia. The most known alternative methods in providing anaesthesia in dentistry are: topical anaesthesia, electronic dental anaesthesia, jet-injectors, iontophoresis, and computerized control local anaesthesia delivery systems. Even though these procedures are well accepted by patients to date, it is the authors' opinion that the effectiveness practicality of such techniques in general dentistry is not without limitations.
Tolidis, K; Crawford, P; Stephens, C; Papadogiannis, Y; Plakias, C
The development of computer-assisted learning software packages is a relatively new field of computer application. The progress made in personal computer technology toward more user-friendly operating systems has stimulated the academic community to develop computer-assisted learning for pre- and postgraduate students. The ability of computers to combine audio and visual data in an interactive form provides a powerful educational tool. The purpose of this study was to develop and evaluate a computer-assisted learning package on dental traumatology. This program contains background information on the diagnosis, classification, and management of dental injuries in both the permanent and the deciduous dentitions. It is structured into chapters according to the nature of the injury and whether injury has occurred in the primary or permanent dentition. At the end of each chapter there is a self-assessment questionnaire as well as references to relevant literature. Extensive use of pictures and video provides a comprehensive overview of the subject.
Maggio, Margrit P; Villegas, Hilda; Blatz, Markus B
optical magnifying devices such as magnification loupes are increasingly used in clinical practice and educational settings. However, scientific evidence to validate their benefits is limited. This study assessed the effect of dental magnification loupes on psychomotor skill acquisition during a preclinical operative dentistry course. the performance of first-year dental students was assessed during an Advanced Simulation Course (AS) using virtual reality-based technology (VRBT) training. The test group consisted of 116 dental students using magnification loupes (+MAG), while students not using them (-MAG, n = 116) served as the control. The following parameters were evaluated: number of successfully passing preparation procedures per course rotation, amount of time per tooth preparation, number of times students needed computer assistance and evaluation, and amount of time spent in the computer assistance and evaluation mode per procedure. Data were collected on each student through VRBT during the preparation procedure and stored on a closed network server computer. Unpaired t tests were used to analyze mean differences between the groups. In addition, student acceptance of magnification loupes was measured and evaluated through survey interpretation. +MAG students completed more preparations, worked faster per procedure, and used the computer-assisted evaluation less frequently and for shorter periods, therefore displaying greater overall performance. The survey revealed a high degree of student acceptance of using magnification. dental magnification loupes significantly enhanced student performance during preclinical dental education and were considered an effective adjunct by the students who used them.
Rademacher, Willem M H; Walenkamp, Geert H I M; Moojen, Dirk Jan F; Hendriks, Johannes G E; Goedendorp, Theo A; Rozema, Frederik R
Background and purpose - To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question: can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015. Studies were included if they involved patients with joint implants undergoing dental procedures, and either considered HPJI as an outcome measure or described a correlation between HPJI and prophylactic antibiotics. A guideline was formulated using the GRADE method and AGREE II guidelines. Results - 9 studies were included in this systematic review. All were rated "very low quality of evidence". Additional literature was therefore consulted to address clinical questions that provide further insight into pathophysiology and risk factors. The 9 studies did not provide evidence that use of antibiotic prophylaxis reduces the incidence of dental HPJI, and the additional literature supported the conclusion that antibiotic prophylaxis should be discouraged in dental procedures. Interpretation - Prophylactic antibiotics in order to prevent dental HPJI should not be prescribed to patients with a normal or an impaired immune system function. Patients are recommended to maintain good oral hygiene and visit the dentist regularly.
Sell, Janet A.
This study was designed to investigate an accredited dental assisting educational program at a Midwest community college. The Bureau of Labor of Statistics (2015) claimed the profession of dental assisting is one of the fastest growing occupation, along with ongoing research that good oral health is linked to overall general health, thereby…
Managing pain and anxiety in patients has always been an essential part of dentistry. To prevent pain, dentists administer local anaesthesia (LA) via a needle injection. Unfortunately, anxiety and fear that arise prior to and/or during injection remains a barrier for many children and adults from receiving dental treatment. There is a constant search for techniques to alleviate the invasive and painful nature of the needle injection. In recent years, researchers have developed alternative methods which enable dental anaesthesia to be less invasive and more patient-friendly. The aim of this review is to highlight the procedures and devices available which may replace the conventional needle-administered local anaesthesia. The most known alternative methods in providing anaesthesia in dentistry are: topical anaesthesia, electronic dental anaesthesia, jet-injectors, iontophoresis, and computerized control local anaesthesia delivery systems. Even though these procedures are well accepted by patients to date, it is the authors' opinion that the effectiveness practicality of such techniques in general dentistry is not without limitations. PMID:29744382
Maulina, Tantry; Djustiana, Nina; Shahib, M Nurhalim
In order to minimize the possibility of unsuccessful dental extraction procedure due to dental anxiety, there are several approaches that can be used, including music intervention. The objective of this research was to investigate the effectiveness of classical and religious Islamic music on reducing dental anxiety. Two hundred and twenty-five muslim participants (105 males, 120 females) were recruited for this study and randomly assigned to three groups: classical music group, religious Islamic music group, and the group with no music intervention, equally in numbers. Participant's blood pressure (BP) and blood sample were taken prior to and after dental extraction to evaluate systolic and diastolic BP as well as nor-adrenaline plasma (NAP) level. All data were then analyzed by using t-test, ANOVA test, Mann-Whitney and Kruskawallis test. There was a decrease in NAP level in the religious music group (0.110 ng/mL) and the control group (0.013 ng/mL) when initial NAP level was compared to post extraction NAP level, whilst the classical music group showed an increase of 0.053 ng/mL. There were significant differences found between the religious Islamic music group and the classical music group ( p = 0.041) as well as the control group ( p = 0.028) for the difference between pre and post NAP level, of which the NAP level of the religious Islamic group participants were lower. Religious Islamic music was proven to be effective in reducing dental anxiety in Muslim participants compared to classical music. Despite, further evaluation in a more heterogenous population with various religious and cultural background is needed.
De Benedictis, Alessandro; Trezza, Andrea; Carai, Andrea; Genovese, Elisabetta; Procaccini, Emidio; Messina, Raffaella; Randi, Franco; Cossu, Silvia; Esposito, Giacomo; Palma, Paolo; Amante, Paolina; Rizzi, Michele; Marras, Carlo Efisio
OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population. METHODS Between 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging. RESULTS The authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications. CONCLUSIONS To the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical
Karibe, Hiroyuki; Aoyagi-Naka, Kyoko; Koda, Arisa
The purpose of this study was to assess the levels of dental fear, state anxiety, and physiological distress in children and their mothers during pediatric dental procedures and to investigate the associations between these variables. Forty children and their mothers who visited six pediatric dental clinics in Tokyo, Japan, participated in this study. Dental fear was assessed using the dental subscale of the Children's Fear Survey Schedule (CFSS-DS) and the Dental Fear Survey. Children completed the pre- and post-treatment State-Trait Anxiety Inventory for Children-State (STAIC-S), and mothers completed the State-Trait Anxiety Inventory-State (STAI-S). Pre- and post-treatment salivary alpha amylase (sAA) levels were measured to assess physiological distress. Paired t tests and Pearson's correlation coefficients were used for statistical analyses. State anxiety scores and sAA levels significantly differed between pre- and post-treatment in mothers (P=.007 and P<.02, respectively) but not in children. Pretreatment STAI-S scores in mothers were correlated with CFSS-DS scores in children (r=.348, P<.03), but pretreatment STAI-S and STAIC-S scores were not. Maternal anxiety before children's dental treatment was significantly associated with children's dental fear.
Won, Ki-Bum; Lee, Seung-Hyun; Chang, Hyuk-Jae; Shim, Chi-Young; Hong, Gue-Ru; Ha, Jong-Won; Chung, Namsik
Bridge anticoagulation therapy is mostly utilized in patients with mechanical heart valves (MHV) receiving warfarin therapy during invasive dental procedures because of the risk of excessive bleeding related to highly vascular supporting dental structures. Bridge therapy using low molecular weight heparin may be an attractive option for invasive dental procedures; however, its safety and cost-effectiveness compared with unfractionated heparin (UFH) is uncertain. This study investigated the safety and cost-effectiveness of enoxaparin in comparison to UFH for bridge therapy in 165 consecutive patients (57±11 years, 35% men) with MHV who underwent invasive dental procedures. This study included 75 patients treated with UFH-based bridge therapy (45%) and 90 patients treated with enoxaparin-based bridge therapy (55%). The bleeding risk of dental procedures and the incidence of clinical adverse outcomes were not significantly different between the UFH group and the enoxaparin group. However, total medical costs were significantly lower in the enoxaparin group than in the UFH group (p<0.001). After multivariate adjustment, old age (≥65 years) was significantly associated with an increased risk of total bleeding independent of bridging methods (odds ratio, 2.51; 95% confidence interval, 1.15-5.48; p=0.022). Enoxaparin-based bridge therapy (β=-0.694, p<0.001) and major bleeding (β=0.296, p=0.045) were significantly associated with the medical costs within 30 days after dental procedures. Considering the benefit of enoxaparin in cost-effectiveness, enoxaparin may be more efficient than UFH for bridge therapy in patients with MHV who required invasive dental procedures.
Conyers, Carole; Miltenberger, Raymond G.; Peterson, Blake; Gubin, Amber; Jurgens, Mandy; Selders, Andrew; Dickinson, Jessica; Barenz, Rebecca
Fear of dental procedures deters many individuals with mental retardation from accepting dental treatment. This study was conducted to assess the effectiveness of two procedures, in vivo desensitization and video modeling, for increasing compliance with dental procedures in participants with severe or profound mental retardation. Desensitization…
Silay, E; Candirli, C; Taskesen, F; Coskuner, I; Ceyhanli, K T; Yildiz, H
The aim of our study was to evaluate the likelihood that conscious sedation (CS) with intravenous midazolam could become an alternative modality to general anesthesia (GA) for dental procedures. In our study, 58 and 47 American Society of Anesthesiologists (ASA)-1 pediatric patients, aged 2-12 (mean 6) years, underwent dental procedures and minor oral surgical procedures under GA and CS with intravenous midazolam, respectively. The two groups were evaluated in terms of vital signs, duration of the treatment procedure, patient behavior, and the treatment comfort experienced by the physicians. The oxygen saturation level was significantly lower (GA: 99.0 ± 0.30, CS: 98.4 ± 1.02; P < 0.001) and the duration of the treatment procedure was significantly shorter (P < 0.001) in the sedation group compared with the GA group. The physicians encountered various difficulties during implementation of the treatment strategy in cases where they used CS. Minor oral surgical procedures and tooth extraction processes requiring no saline irrigation, however, could be performed successfully under CS. In cases requiring multiple dental management issues, the sedation method was not found to be a useful alternative to GA.
Sluder, R. S.; Luder, Linda C.
Notes that children with special needs often require specific considerations with regard to dental care. Discusses some of the physical disabilities and how they interfere with dental hygiene, and how child caregivers can modify daily routines and assist disabled children with areas of hygiene the children may find difficult. (HTH)
Journal of Dental Education, 1987
Guidelines for structuring an oral pathology curriculum for dental assistants include: a definition of oral pathology; the scope of instruction and relationships with other fields; recommendations for prerequisites; core content in various subfields; specific behavioral objectives; and suggestions for sequencing, faculty, and facilities. (MSE)
Lipscomb, J; Scheffler, R M
Data from an experimental dental program are used to develop a linear programming model of dental care delivery that the authors use to examine the economic implications of introducing expanded-duty dental assistants (EDDA's) in three types of dental practices. The authors examine the changes in productivity and profitability that result from hiring one or more EDDAs and conclude that a dentist in solo practice can more than double his net revenue by hiring one EDDA but will not increase his productivity further by hiring additional EDDAs. Two- and three-dentist groups also can increase revenue by hiring EDDAs, but, beyond a certain point, an inverse relationship exists between the number of auxiliaries hired and net revenue generated. PMID:812848
Henschel, Heather; Patel, Ursula; Fitzpatrick, Margaret A; Evans, Charlesnika T
Abstract Background Guidelines for antibiotics prior to dental procedures for patients with specific cardiac conditions and prosthetic joints have changed, reducing indications for antibiotic prophylaxis. In addition to guidelines focused on patient comorbidities, systematic reviews specific to dental extractions and implants support preprocedure antibiotics for all patients. However, data on dentist adherence to these recommendations are scarce. Methods This was a cross-sectional study of veterans undergoing tooth extractions, dental implants, and periodontal procedures. Patients receiving antibiotics for oral or nonoral infections were excluded. Data were collected through manual review of the health record. Results Of 183 veterans (mean age, 62 years; 94.5% male) undergoing the included procedures, 82.5% received antibiotic prophylaxis (mean duration, 7.1 ± 1.6 days). Amoxicillin (71.3% of antibiotics) and clindamycin (23.8%) were prescribed most frequently; 44.7% of patients prescribed clindamycin were not labeled as penicillin allergic. Of those who received prophylaxis, 92.1% received postprocedure antibiotics only, 2.6% received preprocedural antibiotics only, and 5.3% received pre- and postprocedure antibiotics. When prophylaxis was indicated, 87.3% of patients received an antibiotic. However, 84.9% received postprocedure antibiotics when preprocedure administration was indicated. While the majority of antibiotics were indicated, only 8.2% of patients received antibiotics appropriately. The primary reason was secondary to prolonged duration. Three months postprocedure, there were no occurrences of Clostridium difficile infection, infective endocarditis, prosthetic joint infections, or postprocedure oral infections. Conclusion The majority of patients undergoing a dental procedure received antibiotic prophylaxis as indicated. Although patients for whom antibiotic prophylaxis was indicated should have received a single preprocedure dose, most antibiotics
Conyers, Carole; Miltenberger, Raymond G; Peterson, Blake; Gubin, Amber; Jurgens, Mandy; Selders, Andrew; Dickinson, Jessica; Barenz, Rebecca
Fear of dental procedures deters many individuals with mental retardation from accepting dental treatment. This study was conducted to assess the effectiveness of two procedures, in vivo desensitization and video modeling, for increasing compliance with dental procedures in participants with severe or profound mental retardation. Desensitization increased compliance for all 5 participants, whereas video modeling increased compliance for only 1 of 3 participants.
Ramar, Kavitha; Hariharavel, V P; Sinnaduri, Gayathri; Sambath, Gayathri; Zohni, Fathima; Alagu, Palani J
To evaluate the effect of audioanalgesia in 6- to 12-year-old children during dental treatment procedure. A total of 40 children were selected and divided into two groups, study group - with audioanalgesia and control group - without audioanalgesia. The value of their pain was evaluated using Venham's pain rating scale. Data were compared using one-sample t-test using Statistical Package for the Social Sciences (SPSS) (Inc.; Chicago, IL, USA), version 17.0. The difference in the control group and study group was statistically significant (p < 0.05). The method of distraction using audioanalgesia instills better positive dental attitude in children and decreases their pain perception. Playing or hearing music during dental procedure significantly alters the perception of pain in 6- to 12-year-old children.
Halawany, Hassan Suliman; AlJazairy, Yousra Hussain; Alhussainan, Nawaf Sulaiman; AlMaflehi, Nassr; Jacob, Vimal; Abraham, Nimmi Biju
Studies evaluating dental assistants' knowledge about tooth avulsion and its management are rare. The purpose of this study was to evaluate the level of knowledge about tooth avulsion and its management among dental assistants in Riyadh, Saudi Arabia and to assess its relationship with their educational background. A convenience sampling methodology was employed for sample selection. Over a period of four months starting in February, 2013, 691 pretested 17-item questionnaires were distributed. A total of 498 questionnaires were returned for an overall response rate of 72.1%. Six questions were related to knowledge about permanent tooth avulsion and one question was related to knowledge about primary tooth avulsion. Correct answers to these questions were assigned one point each, and based on this scoring system, an overall knowledge score was calculated. An analysis of covariance was used to test the association between the level of knowledge (total score) and the educational qualifications of the respondents (dental degree and others). A P-value of 0.05 was considered the threshold for statistical significance. The majority of the respondents (n = 387; 77.7%) were non-Saudis (377 were from the Philippines), and 79.1% (n = 306) of the Filipinos had a dental degree. The question about recommendations for an avulsed tooth that is dirty elicited the highest number of correct responses (n = 444; 89.2%), whereas the question about the best storage media elicited the lowest number of correct responses (n = 192; 38.6%). The overall mean score for knowledge about tooth avulsion was 6.27 ± 1.74. The mean knowledge score among the respondents with a dental degree was 6.63 ± 1.37, whereas that among the respondents with other qualifications was 5.71 ± 2.08. The educational qualifications of the surveyed dental assistants were strongly correlated with the level of knowledge about tooth avulsion and its management.
Conyers, Carole; Miltenberger, Raymond G; Peterson, Blake; Gubin, Amber; Jurgens, Mandy; Selders, Andrew; Dickinson, Jessica; Barenz, Rebecca
Fear of dental procedures deters many individuals with mental retardation from accepting dental treatment. This study was conducted to assess the effectiveness of two procedures, in vivo desensitization and video modeling, for increasing compliance with dental procedures in participants with severe or profound mental retardation. Desensitization increased compliance for all 5 participants, whereas video modeling increased compliance for only 1 of 3 participants. PMID:15293644
Faggion, Clovis Mariano
Every day a large number and variety of dental procedures are performed in clinical dental practice. There is, however, no information on the overall quality of evidence supporting these procedures. The objective of this study was to assess whether several common dental procedures are based on sound evidence. All Cochrane systematic reviews (CSR) published in dentistry were surveyed. The authors' conclusions about the quality of evidence supporting a specific clinical treatment were used as the measure of outcome. The evidence was considered adequate if the authors did not clearly state the evidence was weak in the conclusions while also suggesting some evidence of the effectiveness of the therapy. Of 120 CSRs assessed, in only 26 (22.0% of the reviews) was the quality of evidence regarded as adequate for supporting clinical decisions, although some methodological limitations were identified in the full text of these reviews. Moreover, the authors of most reviews reported weak or unavailable evidence. On the basis of CSRs, the overall quality of evidence can be regarded as low or nonexistent for most of the dental procedures assessed. The information reported may guide future research. Copyright © 2012 Elsevier Inc. All rights reserved.
Ohio State Dept. of Education, Columbus. Div. of Career-Technical and Adult Education.
This document contains an introduction to the Ohio Integrated Technical and Academic Competency (ITAC) and Specialization ITAC; an overview of the dental assistant occupation; a list acknowledging professionals who helped develop the competency list; and the comprehensive list of the professional or occupational competencies deemed essential for…
Idaho State Dept. of Education, Boise. Div. of Vocational Education.
Under the Idaho state system for curriculum development in vocational education, Technical Committees made up solely of industry personnel are responsible for drawing up task lists for each program. Accordingly, a task list for dental assistants was drawn up and used as a basis for revising the curriculum guide for fundamentals of dental assisting…
... EXAMINATIONS DISASTER ASSISTANCE FOR CRISIS COUNSELING AND TRAINING § 38.3 Assistance; procedures, limitations... disaster victims who may need professional mental health crisis counseling services and of the number of... of providing professional mental health crisis counseling to disaster victims or training of disaster...
... EXAMINATIONS DISASTER ASSISTANCE FOR CRISIS COUNSELING AND TRAINING § 38.3 Assistance; procedures, limitations... disaster victims who may need professional mental health crisis counseling services and of the number of... of providing professional mental health crisis counseling to disaster victims or training of disaster...
... EXAMINATIONS DISASTER ASSISTANCE FOR CRISIS COUNSELING AND TRAINING § 38.3 Assistance; procedures, limitations... disaster victims who may need professional mental health crisis counseling services and of the number of... of providing professional mental health crisis counseling to disaster victims or training of disaster...
This review discusses the basic pharmacology of new oral anticoagulants that are used for prevention of thromboembolism in patients with atrial fibrillation. It presents available evidence, and provides recommendations for the management of patients requiring invasive procedures in dental practice. PMID:26835072
Parsons, Kimberly M.
Electronic textbook usage is increasing within higher education while use of traditional textbooks is declining. While some research concerning student preference for textbook type provides insight into student choices, there is a gap in the literature regarding use of electronic textbooks within dental assisting programs. The purpose of this…
Blue, Christine M; Kaylor, Mary Beth
A chronic shortage of dentists, the importance of oral health, and the lack of access to care led to the introduction of a new oral health practitioner in Minnesota, the dental therapist. Dental therapy graduates from the University of Minnesota have been in practice since 2012. To date, there has been no formal study of how they have been incorporated into dental practice. The purpose of this study was to obtain baseline knowledge of dental therapists' practice patterns in Minnesota and determine if dentists' patterns of work changed after a dental therapist was employed. Four dental practices were sampled purposefully to obtain various practice types and geographic locations within Minnesota. Secondary data were collected from practice management software databases in each practice between January-March, 2015. Data were used to describe the work undertaken by dental therapists, the types of patients seen and payer mix. Additionally, data from 6 months before and after employment of the dental therapist were collected to determine whether dentists' practice patterns changed after a dental therapist was employed. Dental therapists were employed full-time, seeing an average of 6.8 patients per day. No distinct pattern emerged with regard to ages of patients seen by dental therapists. Dental therapists saw up to 90% of uninsured patients or patients on public assistance. Restorative services across practices comprised an average of 68% of work undertaken by dental therapists. Dentists delegated a full range of procedures within the dental therapy scope of practice indicating trust and acceptance of dental therapists. Dentists in two practices began to take on more complex dental procedures after a dental therapist joined the practice. Dental therapists are treating a high number of uninsured and underinsured patients, suggesting that they are expanding access to dental care in rural and metropolitan areas of Minnesota. Dentists appear to have an adequate workload for
Carter, Jennifer E; Motsinger-Reif, Alison A; Krug, William V; Keene, Bruce W
Dental procedures are a common reason for general anesthesia, and there is widespread concern among veterinarians that heart disease increases the occurrence of anesthetic complications. Anxiety about anesthetizing dogs with heart disease is a common cause of referral to specialty centers. To begin to address the potential effect of heart disease on anesthetic complications in dogs undergoing anesthesia for routine dental procedures, we compared anesthetic complications in 100 dogs with heart disease severe enough to trigger referral to a specialty center (cases) to those found in 100 dogs without cardiac disease (controls) that underwent similar procedures at the same teaching hospital. Medical records were reviewed to evaluate the occurrence of anesthetic complications. No dogs died in either group, and no significant differences were found between the groups in any of the anesthetic complications evaluated, although dogs in the heart disease group were significantly older with higher American Society of Anesthesiologists scores. Midazolam and etomidate were used more frequently, and alpha-2 agonists used less frequently, in the heart disease group compared to controls. This study suggests dogs with heart disease, when anesthetized by trained personnel and carefully monitored during routine dental procedures, are not at significantly increased risk for anesthetic complications.
Gordon, Chad R; Murphy, Ryan J; Coon, Devin; Basafa, Ehsan; Otake, Yoshito; Al Rakan, Mohammed; Rada, Erin; Susarla, Srinivas; Susarla, Sriniras; Swanson, Edward; Fishman, Elliot; Santiago, Gabriel; Brandacher, Gerald; Liacouras, Peter; Grant, Gerald; Armand, Mehran
Facial transplantation represents one of the most complicated scenarios in craniofacial surgery because of skeletal, aesthetic, and dental discrepancies between donor and recipient. However, standard off-the-shelf vendor computer-assisted surgery systems may not provide custom features to mitigate the increased complexity of this particular procedure. We propose to develop a computer-assisted surgery solution customized for preoperative planning, intraoperative navigation including cutting guides, and dynamic, instantaneous feedback of cephalometric measurements/angles as needed for facial transplantation and other related craniomaxillofacial procedures. We developed the Computer-Assisted Planning and Execution (CAPE) workstation to assist with planning and execution of facial transplantation. Preoperative maxillofacial computed tomography (CT) scans were obtained on 4 size-mismatched miniature swine encompassing 2 live face-jaw-teeth transplants. The system was tested in a laboratory setting using plastic models of mismatched swine, after which the system was used in 2 live swine transplants. Postoperative CT imaging was obtained and compared with the preoperative plan and intraoperative measures from the CAPE workstation for both transplants. Plastic model tests familiarized the team with the CAPE workstation and identified several defects in the workflow. Live swine surgeries demonstrated utility of the CAPE system in the operating room, showing submillimeter registration error of 0.6 ± 0.24 mm and promising qualitative comparisons between intraoperative data and postoperative CT imaging. The initial development of the CAPE workstation demonstrated that integration of computer planning and intraoperative navigation for facial transplantation are possible with submillimeter accuracy. This approach can potentially improve preoperative planning, allowing ideal donor-recipient matching despite significant size mismatch, and accurate surgical execution for numerous
Pezzoli, J. A.; Johnson, Nancy
This document describes the curriculum and objectives of the Certificate of Completion in Dental Assisting at Maui Community College, Hawaii. Hawaii is below the national average in oral health care, with as many as 40% of Maui residents being underserved. Dental disease among the uninsured and underinsured in Hawaii is three times the national…
Edmunds, S; Brown, G
The purpose of this paper is to assist dental researchers to develop their expertise in qualitative research. It sketches the key characteristics of qualitative research; summarises theoretical perspectives; outlines the core skills of qualitative data collection and the procedures which underlie three methods of qualitative research: interviewing, focus groups and concept maps. The paper offers some guidance on writing qualitative research and provides examples of qualitative research drawn from dentistry and dental education. © 2012 John Wiley & Sons A/S.
Sepet, Elif; Aren, Gamze; Dogan Onur, Ozen; Pinar Erdem, Arzu; Kuru, Sinem; Tolgay, Ceren Guney; Unal, Sinasi
The aim of this study was to evaluate the knowledge of sports participants regarding emergency management of dental trauma and the awareness about mouthguards. A specific questionnaire regarding knowledge, experiences and behaviours after dental trauma and the use of mouthguard was distributed to 359 sports participants up to 18 years of age. The sports involved were basketball, swimming, volleyball, soccer, tennis, badminton, handball, athleticism, golf, gymnastics, water polo and karate. The questions were focused on personal experience, awareness of first aid and dental emergency procedures and knowledge about mouthguards. The results showed that 10.9% had experienced a kind of dental trauma, and 12.5% would look for a dentist for treatment in emergency. 34.5% would re-implant the avulsed tooth, 33.4% would maintain the avulsed tooth in handkerchief and 25.3% would maintain it in saline solution. 41.1% were aware of the possibility of oral injuries during sports practice, and 55.4% knew about mouthguards, but only 11.2% of the participants reported to use them. There was a statistically significant difference between the experienced participants (>5 years) and less-experienced group (<5 years) in knowledge about dental emergency procedures and mouthguards. Reasons given for not wearing mouthguards include 'lack of aesthetic' was significantly high in experienced participants. The less-experienced participants significantly stated that they had never heard about mouthguards before. Our results showed a lack of knowledge of sports participants about management and prevention of traumatic dental injuries. Educational programs should be organized to give information about emergency treatment and promote the use of mouthguards to sport participants. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Zubieta-O'Farrill, Gregorio; Ramírez-Ramírez, Moisés; Villanueva-Sáenz, Eduardo
Rectal prolapse is defined as the protrusion of the rectal wall through the anal canal; with a prevalence of less than 0.5%. The most frequent symptoms include pain, incomplete defecation sensation with blood and mucus, fecal incontinence and/or constipation. The surgical approach can be perineal or abdominal with the tendency for minimal invasion. Robot-assisted procedures are a novel option that offer technique advantages over open or laparoscopic approaches. 67 year-old female, who presented with rectal prolapse, posterior to an episode of constipation, that required manual reduction, associated with transanal hemorrhage during defecation and occasional fecal incontinence. A RMI defecography was performed that reported complete rectal and uterine prolapse, and cystocele. A robotic assisted Frykman-Goldberg procedure wass performed. There are more than 100 surgical procedures for rectal prolapse treatment. We report the first robot assisted procedure in Mexico. Robotic assisted surgery has the same safety rate as laparoscopic surgery, with the advantages of better instrument mobility, no human hand tremor, better vision, and access to complicated and narrow areas. Robotic surgery as the surgical treatment is a feasible, safe and effective option, there is no difference in recurrence and function compared with laparoscopy. It facilitates the technique, improves nerve preservation and bleeding. Further clinical, prospective and randomized studies to compare the different minimal invasive approaches, their functional and long term results for this pathology are needed. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.
Blotière, Pierre-Olivier; Hoen, Bruno; Lesclous, Philippe; Millot, Sarah; Rudant, Jérémie; Weill, Alain; Coste, Joel; Alla, François; Duval, Xavier
Objective To assess the relation between invasive dental procedures and infective endocarditis associated with oral streptococci among people with prosthetic heart valves. Design Nationwide population based cohort and a case crossover study. Setting French national health insurance administrative data linked with the national hospital discharge database. Participants All adults aged more than 18 years, living in France, with medical procedure codes for positioning or replacement of prosthetic heart valves between July 2008 and July 2014. Main outcome measures Oral streptococcal infective endocarditis was identified using primary discharge diagnosis codes. In the cohort study, Poisson regression models were performed to estimate the rate of oral streptococcal infective endocarditis during the three month period after invasive dental procedures compared with non-exposure periods. In the case crossover study, conditional logistic regression models calculated the odds ratio and 95% confidence intervals comparing exposure to invasive dental procedures during the three month period preceding oral streptococcal infective endocarditis (case period) with three earlier control periods. Results The cohort included 138 876 adults with prosthetic heart valves (285 034 person years); 69 303 (49.9%) underwent at least one dental procedure. Among the 396 615 dental procedures performed, 103 463 (26.0%) were invasive and therefore presented an indication for antibiotic prophylaxis, which was performed in 52 280 (50.1%). With a median follow-up of 1.7 years, 267 people developed infective endocarditis associated with oral streptococci (incidence rate 93.7 per 100 000 person years, 95% confidence interval 82.4 to 104.9). Compared with non-exposure periods, no statistically significant increased rate of oral streptococcal infective endocarditis was observed during the three months after an invasive dental procedure (relative rate 1.25, 95% confidence interval 0
Heckman, Karen; Noirfalise, Pat
The first component of this three-part package is a student manual designed to be used independently in secondary health occupations programs or on-the-job training programs for dental assistants. The manual contains seven units that cover the following topics: introduction to dentistry; basic office procedures; infection control and occupational…
... Products and Medical Procedures Dental Devices Dental Amalgam Dental Amalgam Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Dental amalgam is a dental filling material which is ...
The purpose of this study is to evaluate the effect of dental supervision on registered dental hygienists' salaries in the 50 states and District of Columbia by comparing the average dental hygiene salaries from the largest metropolitan city within each state from May 2011, the most recent valid data, in relation to the required level of dental supervision. A retrospective contrasted-group quasi-experimental design analysis was conducted using the most current mean dental hygiene salaries for the largest metropolitan city within each state and the District of Columbia which was matched to the appropriate dental supervision level. In addition, a dental assisting salary control group was utilized and correlated to the appropriate dental hygienist salary in the same metropolitan city and state. Samples were obtained from the U.S. Department of Labor. A multivariate analysis of variance (MANOVA) statistical analysis was utilized to assess the relationship of the 5 levels of dentist supervision, with the registered dental hygienist salaries. The MANOVA analysis was also utilized to assess the control group, dental assistant salaries. No statistically significant results were found among the dental supervision levels on the measures of dental hygiene salaries and dental assistant salaries. Wilks's Λ=0.81, F (8, 90)=1.29, p=0.26. Analyses of variances (ANOVA) on the dependent variables were also conducted as follow-up tests to the MANOVA. Study results suggest dental hygienists who are required to have a dentist on the premises to complete any dental treatment obtain similar salaries to those dental hygienists who are allowed to work in some settings unsupervised by a dentist. Therefore, dental supervision does not seem to have an impact on dental hygienists' salaries. Copyright © 2014 The American Dental Hygienists’ Association.
Veterans Administration Medical Center, Washington, DC.
This dental training films catalog is organized into two sections. Section I is a category listing of the films by number and title, indexed according to generalized headings; categories are as follow: anatomy, articulator systems, complete dentures, dental assisting, dental laboratory technology, dental materials, dental office emergencies,…
Huang, Chia-Chang; Hsu, Hui-Chi; Yang, Ling-Yu; Chen, Chen-Huan; Yang, Ying-Ying; Chang, Ching-Chih; Chuang, Chiao-Lin; Lee, Wei-Shin; Lee, Fa-Yauh; Hwang, Shinn-Jang
Failure to transfer procedural skills learned in a laboratory to the bedside is commonly due to a lack of peer support/stimulation. A digital platform (Facebook) allows new clinical clerks to share experiences and tips that help augment their procedural skills in a peer-assisted learning/teaching method. This study aims to investigate the effectiveness of the innovation of using the digital platform to support the transfer of laboratory-trained procedural skills in the clinical units. Volunteer clinical clerks (n = 44) were enrolled into the peer-assisted learning (PAL) group, which was characterized by the peer-assisted learning of procedural skills during their final 3-month clinical clerkship block. Other clerks (n = 51) did not join the procedural skills-specific Facebook group and served as the self-directed learning regular group. The participants in both the PAL and regular groups completed pre- and post-intervention self-assessments for general self-assessed efficiency ratings (GSER) and skills specific self-assessed efficiency ratings (SSSER) for performing vein puncture, intravenous (IV) catheter and nasogastric (NG) tube insertion. Finally, all clerks received the post-intervention 3-station Objective Structured Clinical Skills Examination (OSCE) to test their proficiency for the abovementioned three procedural skills. Higher cumulative numbers of vein punctures, IV catheter insertions and NG tube insertions at the bedside were carried out by the PAL group than the regular group. A greater improvement in GSERs and SSSERs for medical procedures was found in the PAL group than in the regular group. The PAL group obtained higher procedural skills scores in the post-intervention OSCEs than the regular group. Our study suggested that the implementation of a procedural skill-specific digital platform effectively helps clerks to transfer laboratory-trained procedural skills into the clinical units. In comparison with the regular self-directed learning
Leong, Nancy; Laughter, Lory; Rowe, Dorothy J
The aim of this study was to identify the challenges encountered by dental assisting students, especially those from underrepresented racial and ethnic groups (UREG), that affected their achieving academic success. In 2016, directors of the nine northern California dental assisting programs were contacted via email to explain the study and request an opportunity to administer the 26-item survey to their currently enrolled students. Student responses were entered into a survey research program, which tabulated the data and calculated the frequency of responses to each item. All nine programs participated, and the overall student response rate was 98%. Most (71%) of the 215 respondents agreed that they had experienced challenges in achieving academic success. Respondents reported the following challenges that made it difficult to perform well at school: financial responsibilities (41%), family responsibilities (33%), and language challenges (21%). These challenges, as well as difficulty understanding the language and vocabulary of instructional materials and cost of tuition and supplies, were statistically related to respondents' perceptions of their challenges to academic success. Most (83%) of the respondents perceived that faculty members supported their academic success. One-third of the respondents were from UREG: Hispanic, African American, and Native American. Higher percentages of UREG than non-UREG participants worked more hours/week (p=0.03) and tended to perceive financial (52%/32%) and family (42%/28%) responsibilities as challenges. Since both UREG and non-UREG respondents experienced these challenges, all students should be informed of institutional and programmatic resources that can assist them in achieving academic success.
Background Studies evaluating dental assistants’ knowledge about tooth avulsion and its management are rare. The purpose of this study was to evaluate the level of knowledge about tooth avulsion and its management among dental assistants in Riyadh, Saudi Arabia and to assess its relationship with their educational background. Methods A convenience sampling methodology was employed for sample selection. Over a period of four months starting in February, 2013, 691 pretested 17-item questionnaires were distributed. A total of 498 questionnaires were returned for an overall response rate of 72.1%. Six questions were related to knowledge about permanent tooth avulsion and one question was related to knowledge about primary tooth avulsion. Correct answers to these questions were assigned one point each, and based on this scoring system, an overall knowledge score was calculated. An analysis of covariance was used to test the association between the level of knowledge (total score) and the educational qualifications of the respondents (dental degree and others). A P-value of 0.05 was considered the threshold for statistical significance. Results The majority of the respondents (n = 387; 77.7%) were non-Saudis (377 were from the Philippines), and 79.1% (n = 306) of the Filipinos had a dental degree. The question about recommendations for an avulsed tooth that is dirty elicited the highest number of correct responses (n = 444; 89.2%), whereas the question about the best storage media elicited the lowest number of correct responses (n = 192; 38.6%). The overall mean score for knowledge about tooth avulsion was 6.27 ± 1.74. The mean knowledge score among the respondents with a dental degree was 6.63 ± 1.37, whereas that among the respondents with other qualifications was 5.71 ± 2.08. Conclusions The educational qualifications of the surveyed dental assistants were strongly correlated with the level of knowledge about tooth avulsion and its
Wang, Guihua; Gao, Xiaoli; Lo, Edward C M
Dental implants have become a popular option for treating partially dentate or edentulous patients. Information on dental implants is widely available in the public domain and is disseminated through industries and dental practitioners at various levels/disciplines. This qualitative study aimed to evaluate the public's information acquisition and their perceptions of dental implants and the effects of these on their care-seeking and decision making. A purposive sample of 28 adults were recruited to join six focus groups. To be eligible, one must be 35-64 years of age, had never been engaged in dentally related jobs, had at least one missing tooth, and had heard about dental implant but never received dental implant or entered into any dental consultation regarding dental implants. All of the focus groups discussions were transcribed verbatim and subjected to thematic content analysis following a grounded theory approach. Participants acquired information on dental implants through various means, such as patient information boards, printed advertisements, social media, and personal connections. They expected dental implants to restore the patients' appearance, functions, and quality of life to absolute normality. They regarded dental implants as a panacea for all cases of missing teeth, overestimated their functions and longevity, and underestimated the expertise needed to carry out the clinical procedures. They were deterred from seeking dental implant treatment by the high price, invasive procedures, risks, and complications. Members of the public were exposed to information of varying quality and had some unrealistic expectations regarding dental implants. Such perceptions may shape their care-seeking behaviours and decision-making processes in one way or another. The views and experiences gathered in this qualitative study could assist clinicians to better understand the public's perspectives, facilitate constructive patient-dentist communication, and contribute
Lynch, Christopher D; Blum, Igor R; Frazier, Kevin B; Haisch, Larry D; Wilson, Nairn H F
Opportunities exist to promote minimally invasive dentistry by repairing rather than replacing defective and failing direct resin-based composite restorations. The authors conducted a study to investigate the current teaching of such techniques in U.S. and Canadian dental schools. In late 2010, the authors, with the assistance of the Consortium of Operative Dentistry Educators, invited 67 U.S. and Canadian dental schools to participate in an Internet-based survey. The response rate was 72 percent. Eighty-eight percent of the dental schools taught repair of defective direct resin-based composite restorations. Of these schools, 79 percent reported providing both didactic and clinical teaching. Although teaching repair of defective resin-based composite restorations was included in the didactic curricula of most schools, students in some schools did not gain experience in minimally invasive management of defective resin-based composite restorations by means of performing repair procedures. The American Dental Association's Code on Dental Procedures and Nomenclature does not have a procedure code for resin-based composite restoration repairs, which may limit patients' access to this dental treatment. Teaching dental students minimally invasive dentistry procedures, including restoration repair, extends the longevity of dental restorations and reduces detrimental effects on teeth induced by invasive procedures, thereby serving the interests of patients.
Dounis, Georgia; Ditmyer, Marcia M; McCants, Robert; Lee, Yoonah; Mobley, Connie
Oral health is an integral component of general health, and quality of life. The purpose of this study was to determine the perceptions of oral health status and acces\\s to dental care by Southern Nevada Assisted Living Facilities Residents. A cross-sectional questionnaire study design was used to survey residents between 34 and 99 years old residing in Assisted Living Facilities. Seventy respondents (42 males and 28 females) completed a survey that included personal oral hygiene, access to care, and demographic information. Data analyses included descriptive statistics and chi-square. Mean age was 75.78 years, and the majority had a college education (n = 41). Four currently smoked cigarettes. Twenty-nine (males = 14; females = 15) reported having dental insurance. Eleven respondents had seen a dentist twice a year, while 33 reported a visit less than 6 months. Forty-one reported the facility did not provide oral health care with majority (n = 64) indicating that accessing oral health care was difficult. Self-rated response to oral hygiene, a majority (n = 64) reported their oral hygiene as fair and five reported their oral hygiene as poor. Assisted living residents in Southern Nevada reported difficulty accessing dental services within and outside of the facility. Oral care models to address this unique population should be explored. © 2010 The Gerodontology Society and John Wiley & Sons A/S.
Polk, Deborah E; Nolan, Beth A D; Shah, Nilesh H; Weyant, Robert J
The aim of this study was to determine the degree to which dental schools in the United States have policies and procedures in place that facilitate the implementation of evidence-based clinical guidelines. The authors sent surveys to all 65 U.S. dental schools in 2014; responses were obtained from 38 (58%). The results showed that, of the nine policies and procedures examined, only two were fully implemented by 50% or more of the responding schools: guidelines supported through clinical faculty education or available chairside (50%), and students informed of guidelines in both the classroom and clinic (65.8%). Although 92% of the respondents reported having an electronic health record, 80% of those were not using it to track compliance with guidelines. Five schools reported implementing more policies than the rest of the schools. The study found that the approach to implementing guidelines at most of the responding schools did not follow best practices although five schools had an exemplary set of policies and procedures to support guideline implementation. These results suggest that most dental schools are currently not implementing guidelines effectively and efficiently, but that the goal of schools' having a comprehensive implementation program for clinical guidelines is achievable since some are doing so. Future studies should determine whether interventions to improve implementation in dental schools are needed.
To maximize office productivity, dentists should focus on performing tasks that only they can perform and not spend office hours performing tasks that can be delegated to non-dentist personnel. An important element of maximizing productivity is to arrange the schedule so that multiple patients are seated simultaneously in different operatories. Doing so allows the dentist to work on one patient in one operatory without needing to wait for local anesthetic to take effect on another patient in another operatory, or for assistants to perform tasks (such as cleaning up, taking radiographs, performing prophylaxis, or transporting and preparing equipment and supplies) in other operatories. Another way to improve productivity is to structure procedures so that fewer steps are needed to set up and implement them. In addition, during procedures, four-handed dental passing methods can be used to provide the dentist with supplies or equipment when needed. This article reviews basic principles of maximizing dental office productivity, based on the author's observations of business logistics used by various dental offices.
Makade, Chetana Sachin; Shenoi, Pratima R; Gunwal, Mohit K
Introduction: Intraoral local anesthesia is essential for delivering dental care. Needless devices have been developed to provide anesthesia without injections. Little controlled research is available on its use in dental restorative procedures in adult patients. The aims of this study were to compare adult patients acceptability and preference for needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Materials and Methods: Twenty non fearful adults with no previous experience of dental anesthesia were studied using split-mouth design. The first procedure was performed with classical needle infiltration anesthesia. The same amount of anesthetic solution was administered using MADA jet needleless device in a second session one week later, during which a second dental restorative procedure was performed. Patients acceptance was assessed using Universal pain assessment tool while effectiveness was recorded using soft tissue anesthesia and pulpal anesthesia. Patients reported their preference for the anesthetic method at the third visit. The data was evaluated using chi square test and student's t-test. Results: Pressure anesthesia was more accepted and preferred by 70% of the patients than traditional needle anesthesia (20%). Both needle and pressure anesthesia was equally effective for carrying out the dental procedures. Conclusion: Patients experienced significantly less pain and fear (p<0.01) during anesthetic procedure with pressure anesthesia. However, for more invasive procedures needle anesthesia will be more effective. PMID:24778516
Ozkalayci, Ozlem; Araz, Coskun; Cehreli, Sevi Burcak; Tirali, Resmiye Ebru; Kayhan, Zeynep
The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients. Prospective, randomized, and controlled study. Tertiary, university hospital. In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment. Patients were categorized into 3 groups: music, isolation, and control. During the procedures, the patients in the music group listened to Vivaldi's The Four Seasons violin concertos by sound-isolating headphones, whereas the patients in the isolation group wore the headphones but did not listen to music. All patients were sedated by 0.1 mg/kg midazolam and 1 mg/kg propofol. During the procedure, an additional 0.5 mg/kg propofol was administered as required. Bispectral index was used for quantifying the depth of sedation, and total dosage of the propofol was used for sedative requirements. The patients' heart rates, oxygen saturations, and Observer's Assessment of Alertness and Sedation Scale and bispectral index scores, which were monitored during the operation, were similar among the groups. In terms of the amount of propofol used, the groups were similar. Prolonged postoperative recovery cases were found to be significantly frequent in the control group, according to the recovery duration measurements (P = .004). Listening to music or providing sound isolation during pediatric dental interventions did not alter the sedation level, amount of medication, and hemodynamic variables significantly. This result might be due to the deep sedation levels reached during the procedures. However, listening to music and providing sound isolation might have contributed in shortening the postoperative recovery duration of the patients. Copyright © 2016 Elsevier Inc. All rights reserved.
Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh
Background In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. Methods This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Results Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5–8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Conclusions Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia. PMID:28884154
Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh; Kim, Jongbin
In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.
Wang, Yi-Chia; Lin, I-Hua; Huang, Chi-Hsiang; Fan, Shou-Zen
To offer individualized dental treatment to certain patients who cannot tolerate dental treatment, sedation or general anesthesia is required. The needs could be either medical, mental, or psychological. The most common indications for sedation or general anesthesia are lack of cooperation, multiple morbidities, and pediatric autism. In adults, cognitive impairment and multiple morbidities are most commonly encountered indications. Because of suboptimal home care, incomplete medical history, poor preoperative management, lack of cooperation, and developmental abnormalities, it is a challenge to prepare anesthesia for patients with special needs. The American Society of Anesthesiology (ASA) has proposed guidelines for office-based anesthesia for ambulatory surgery. In patients with ASA physical status IV and V, sedation or general anesthesia for treatment in the dental office is not recommended. The distinction between sedation levels and general anesthesia is not clear. If intravenous general anesthesia without tracheal intubation is chosen for dental procedures, full cooperation between the dentist, dental assistant, and anesthesiologist is needed. Teamwork between the dentist and healthcare provider is key to achieve safe and successful dental treatment under sedation or general anesthesia in the patient with special needs. Copyright © 2012. Published by Elsevier B.V.
... and Medical Procedures Dental Devices Dental Amalgam About Dental Amalgam Fillings Share Tweet Linkedin Pin it More ... should I have my fillings removed? What is dental amalgam? Dental amalgam is a dental filling material ...
Kwon, So Ran; Hernández, Marcela; Blanchette, Derek R; Lam, Matthew T; Gratton, David G; Aquilino, Steven A
The aim of this study was to evaluate the impact of computer-assisted learning on first-year dental students' waxing abilities and self-evaluation skills. Additionally, this study sought to determine how well digital evaluation software performed compared to faculty grading with respect to students' technical scores on a practical competency examination. First-year students at one U.S. dental school were assigned to one of three groups: control (n=40), E4D Compare (n=20), and Sirona prepCheck (n=19). Students in the control group were taught by traditional teaching methodologies, and the technology-assisted groups received both traditional training and supplementary feedback from the corresponding digital system. Five outcomes were measured: visual assessment score, self-evaluation score, and digital assessment scores at 0.25 mm, 0.30 mm, and 0.35 mm tolerance. The scores from visual assessment and self-evaluation were examined for differences among groups using the Kruskal-Wallis test. Correlation between the visual assessment and digital scores was measured using Pearson and Spearman rank correlation coefficients. At completion of the course, students were asked to complete a survey on the use of these digital technologies. All 79 students in the first-year class participated in the study, for a 100% response rate. The results showed that the visual assessment and self-evaluation scores did not differ among groups (p>0.05). Overall correlations between visual and digital assessment scores were modest though statistically significant (5% level of significance). Analysis of survey responses completed by students in the technology groups showed that profiles for the two groups were similar and not favorable towards digital technology. The study concluded that technology-assisted training did not affect these students' waxing performance or self-evaluation skills and that visual scores given by faculty and digital assessment scores correlated moderately.
Reddington, Amanda R; Egli, Amy J; Schmuck, Heather M
Health professions students are often unaware of other health care providers' roles or professional expertise due to most education taking place within their single profession. This pattern may be even more prevalent for baccalaureate and associate degree programs since most interprofessional education (IPE) occurs in predoctoral programs and, when IPE is incorporated into allied health professions education, it often utilizes simulation instead of live patient experiences. The aim of this study was to determine if radiologic technology and dental assisting students' perceptions changed regarding interprofessional practice and teamwork after an IPE activity with actual patients. The participants were students in the University of Southern Indiana (USI) radiologic technology and dental assisting programs. This mixed-methods pilot study conducted in 2017 collected quantitative and qualitative data from pre and post surveys, the researchers' observations of student interactions during live patient assessment and acquisition of panoramic images, and large-group discussion. Twenty-five of the 26 students who participated in the IPE program completed both pre and post surveys, for a 96% response rate. The results showed significant differences in the participants' perceptions from the pre to post surveys on a wide variety of survey items. Most notable were the positive changes in perceptions related to trust in judgment of others within their profession (p=0.001), relationships with other professions (p=0.002), and thinking highly of other professions (p=0.002). Overall, this study found that incorporating the IPE activity with a live patient into these radiologic technology and dental assisting programs improved the students' perceptions of other allied health professionals. Future research should include more participants to increase sample size and add quantitative data collection.
Hallier, C; Williams, D W; Potts, A J C; Lewis, M A O
Bioaerosols are defined as airborne particles of liquid or volatile compounds that contain living organisms or have been released from living organisms. The creation of bioaerosols is a recognized consequence of certain types of dental treatment and represents a potential mechanism for the spread of infection. The aims of the present study were to assess the bioaerosols generated by certain dental procedures and to evaluate the efficiency of a commercially available Air Cleaning System (ACS) designed to reduce bioaerosol levels. Bioaerosol sampling was undertaken in the absence of clinical activity (baseline) and also during treatment procedures (cavity preparation using an air rotor, history and oral examination, ultrasonic scaling and tooth extraction under local anaesthesia). For each treatment, bioaerosols were measured for two patient episodes (with and without ACS operation) and between five and nine bioaerosol samples were collected. For baseline measurements, 15 bioaerosol samples were obtained. For bioaerosol sampling, environmental air was drawn on to blood agar plates using a bioaerosol sampling pump placed in a standard position 20 cm from the dental chair. Plates were incubated aerobically at 37°C for 48 hours and resulting growth quantified as colony forming units (cfu/m³). Distinct colony types were identified using standard methods. Results were analysed statistically using SPSS 12 and Wilcoxon signed rank tests. The ACS resulted in a significant reduction (p = 0.001) in the mean bioaerosols (cfu/m³) of all three clinics compared with baseline measurements. The mean level of bioaerosols recorded during the procedures, with or without the ACS activated respectively, was 23.9 cfu/m³ and 105.1 cfu/m³ (p = 0.02) for cavity preparation, 23.9 cfu/m³ and 62.2 cfu/m³ (p = 0.04) for history and oral examination; 41.9 cfu/m³ and 70.9 cfu/m³ (p = 0.01) for ultrasonic scaling and 9.1 cfu/m³ and 66.1 cfu/m³ (p = 0.01) for extraction. The predominant
Buchanan, Judith A
This article reports on extensive experience with advanced simulation at the University of Pennsylvania, School of Dental Medicine (UPSDM). Virtual reality-based technology (VRBT) or advanced simulation is currently available for the instruction of dental students in preclinical restorative procedures. UPSDM was one of the first schools in the world to have extensive experience with VRBT technology using an advanced simulation unit (DentSim) from DenX, Ltd. UPSDM's experience consists of several years of research using control and experimental groups, employing students to participate in an investigative project, and using the units for remediation and a supplement to the preclinical laboratory. Currently, all first-year students (Class of 2007 and Class of 2008) are receiving most of their preparative operative training on the VRBT units. UPSDM started with one (beta) version unit in 1998, which was later updated and expanded first to four units and recently to fifteen units. This communication is presenting the studies that were of fundamental importance in making the decision to acquire fifteen units in 2003. The areas of main interest to the SDM concerning this technology were its use in teaching, refreshing, and remediating students in restorative procedures and its effectiveness as a teaching methodology in relation to time, efficiency, and faculty. Several studies with varying parameters were performed at various time points. The limited statistical analysis conducted was not conclusive for all measures, and in some cases the data only suggest areas of possible significance. This is due to the low number of students who could access the limited number of available units and the change of protocols in response to student and faculty input. Overall, the results do suggest, however, that students learn faster, arrive at the same level of performance, accomplish more practice procedures per hour, and request more evaluations per procedure or per hour than in our
Magrin, Gabriel Leonardo; Sigua-Rodriguez, Eder Alberto; Goulart, Douglas Rangel; Asprino, Luciana
The piezosurgery has been used with increasing frequency and applicability by health professionals, especially those who deal with dental implants. The concept of piezoelectricity has emerged in the nineteenth century, but it was applied in oral surgery from 1988 by Tomaso Vercellotti. It consists of an ultrasonic device able to cut mineralized bone tissue, without injuring the adjacent soft tissue. It also has several advantages when compared to conventional techniques with drills and saws, such as the production of a precise, clean and low bleed bone cut that shows positive biological results. In dental implants surgery, it has been used for maxillary sinus lifting, removal of bone blocks, distraction osteogenesis, lateralization of the inferior alveolar nerve, split crest of alveolar ridge and even for dental implants placement. The purpose of this paper is to discuss the use of piezosurgery in bone augmentation procedures used previously to dental implants placement. PMID:26966469
Kiran Kumar Krishanappa, Salian; Prashanti, Eachempati; Sumanth, Kumbargere N; Naresh, Shetty; Moe, Soe; Aggarwal, Himanshi; Mathew, Rebecca J
An oro-antral communication is an unnatural opening between the oral cavity and maxillary sinus. When it fails to close spontaneously, it remains patent and is epithelialized to develop into an oro-antral fistula. Various surgical and non-surgical techniques have been used for treating the condition. Surgical procedures include flaps, grafts and other techniques like re-implantation of third molars. Non-surgical techniques include allogenic materials and xenografts. To assess the effectiveness and safety of various interventions for the treatment of oro-antral communications and fistulae due to dental procedures. We searched the Cochrane Oral Health Group's Trials Register (whole database, to 3 July 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 6), MEDLINE via OVID (1946 to 3 July 2015), EMBASE via OVID (1980 to 3 July 2015), US National Institutes of Health Trials Registry (http://clinicaltrials.gov) (whole database, to 3 July 2015) and the World Health Organization (WHO) International Clinical Trials Registry Platform (http://www.who.int/ictrp/en/) (whole database, to 3 July 2015). We also searched the reference lists of included and excluded trials for any randomised controlled trials (RCTs). We included RCTs evaluating any intervention for treating oro-antral communications or oro-antral fistulae due to dental procedures. We excluded quasi-RCTs and cross-over trials. We excluded studies on participants who had oro-antral communications, fistulae or both related to Caldwell-Luc procedure or surgical excision of tumours. Two review authors independently selected trials. Two review authors assessed trial risk of bias and extracted data independently. We estimated risk ratios (RR) for dichotomous data, with 95% confidence intervals (CI). We assessed the overall quality of the evidence using the GRADE approach. We included only one study in this review, which compared two surgical interventions: pedicled
Fotos, Pete G.; And Others
Results of a study with dental assistants and hygienists, clinic clerks, supply and sterilization personnel, receptionists, and housekeeping and secretarial staff (n=80) suggest that inservice training programs on infection control and clinical asepsis procedures may be better accomplished by practical demonstration than by lecture or seminar.…
Innovative Programming Systems, Minneapolis, Minn.
These checklists are designed for use during the dental assistant student's extramural clinical experience assignment. Checklists test students on their knowledge of terminology, equipment, procedures, and patient relations. Objectives are listed outline style with columns to check progress during a first and a second evaluation. Areas included…
Neumann, Laura M
Educational programs play an important role in preparing a qualified dental work force. This article reviews the current status and trends in dental, advanced dental and allied dental education programs in the United States and examines their impact on the dental work force. This analysis focuses on survey data collected by the American Dental Association during the past 10 to 15 years and compares recent patterns in applications, enrollment and graduation with previous trends. The numbers of educational programs, applicants, enrollees and graduates have increased in dentistry, dental hygiene and dental assisting, while dental laboratory technology has declined in all measures. The proportion of women in dentistry has increased, while the ethnic profile of dental and allied personnel has shown little change. Both the cost of dental education and student debt continue to increase. Despite increases in the number of educational programs and overall numbers of graduates from dental and allied dental education programs, the proportion of underrepresented groups still lags behind their representation in the overall population, and the number of allied personnel falls short of practice needs. Patterns in applications, enrollment and graduation are important determinants of the dental and allied dental work force. The cost and funding of education significantly affect the attractiveness of dental careers and the sustainability of educational programs and should be monitored carefully by the profession.
Schwei, Kelsey M; Cooper, Ryan; Mahnke, Andrea N.; Ye, Zhan
Summary Background A workflow is defined as a predefined set of work steps and partial ordering of these steps in any environment to achieve the expected outcome. Few studies have investigated the workflow of providers in a dental office. It is important to understand the interaction of dental providers with the existing technologies at point of care to assess breakdown in the workflow which could contribute to better technology designs. Objective The study objective was to assess electronic dental record (EDR) workflows using time and motion methodology in order to identify breakdowns and opportunities for process improvement. Methods A time and motion methodology was used to study the human-computer interaction and workflow of dental providers with an EDR in four dental centers at a large healthcare organization. A data collection tool was developed to capture the workflow of dental providers and staff while they interacted with an EDR during initial, planned, and emergency patient visits, and at the front desk. Qualitative and quantitative analysis was conducted on the observational data. Results Breakdowns in workflow were identified while posting charges, viewing radiographs, e-prescribing, and interacting with patient scheduler. EDR interaction time was significantly different between dentists and dental assistants (6:20 min vs. 10:57 min, p = 0.013) and between dentists and dental hygienists (6:20 min vs. 9:36 min, p = 0.003). Conclusions On average, a dentist spent far less time than dental assistants and dental hygienists in data recording within the EDR. PMID:27437058
Morse, Tim; Bruneau, Heather; Michalak-Turcotte, Claudia; Sanders, Martha; Warren, Nicholas; Dussetschleger, Jeff; Diva, Ulysses; Croteau, Marc; Cherniack, Martin
Dental hygienists have been found to have high rates of neck and shoulder disorders, but there is very limited information on risk factors associated with those disorders, the level of risk for students, and the relationship of prior work as dental assistants for dental hygiene students. This study examines self-reported and physician-diagnosed neck and shoulder pain. A cohort consisting of 27 dental hygiene students with no prior dental occupation experience (mean age 24, 6.2 SD), and 39 dental hygiene students with prior experience as dental assistants (mean age 28, 6.0) and 94 experienced dental hygienists (mean age 46, 8.8) completed a questionnaire on risk factors and self reported pain, and were examined by a physician in reference to upper extremity findings and diagnoses. Analysis included tabular, trend, and logistic regression analysis. There were significant differences for risks, symptoms, and physician findings. Risk factors had a stepwise progression for students, student/assistants, and experienced dental hygienists, including working with a bent neck often or very often (79%, 89%, 96%, respectively, p<.001), static posture (39%, 50%, 63%, p<.001), precise motions (58%, 67%, 90%, p<.001), and repetition (79%, 86%, 98%, p<.001). Neck symptoms were reported by 37%, 43%, and 72%, respectively (p<.001), and 11%, 20%, and 35% for shoulder symptoms (p<.05). Similar patterns were demonstrated in physician findings, particularly for neck disorders (18%, 36%, 50%, p<.01). In regressions, self-reported shoulder pain was significantly associated with working above shoulder height (OR=1.5, CI 1.0-2.4), and neck symptoms with working with a bent neck (OR=2.1, CI 1.3-3.4), with a protective effect from high supervisor support (OR=0.5, CI 0.2-1.0). Risk factors and both self-reported and physician-diagnosed neck and shoulder symptoms increase in frequency from students to experienced hygienists, and students have higher prevalence if they are also dental assistants.
Hirano, Hirokazu; Masaki, Noritaka; Hayasaka, Takahiro; Watanabe, Yoshiko; Masumoto, Kazuma; Nagata, Tetsuji; Katou, Fuminori; Setou, Mitsutoshi
Periodontal disease is a serious dental problem because it does not heal naturally and leads to tooth loss. In periodontal disease, inflammation at periodontal tissue is thought as predominant, and its effect against tooth itself remains unclear. In this study, we applied matrix-assisted laser desorption/ionization imaging mass spectrometry (IMS) to teeth for the first time. By comparing anatomical structure of tooth affected with periodontal disease with normal ones, we analyzed traces of the disease on tooth. We found signals characteristic of enamel, dentin, and dental pulp, respectively, in mass spectra obtained from normal teeth. Ion images reconstructed using these signals showed anatomical structures of the tooth clearly. Next, we performed IMS upon teeth of periodontal disease. Overall characteristic of the mass spectrum appeared similar to normal ones. However, ion images reconstructed using signals from the tooth of periodontal disease revealed loss of periodontal ligament visualized together with dental pulp in normal teeth. Moreover, ion image clearly depicted an accumulation of signal at m/z 496.3 at root surface. Such an accumulation that cannot be examined only from mass spectrum was revealed by utilization of IMS. Recent studies about inflammation revealed that the signal at m/z 496.3 reflects lyso-phosphatidylcholine (LPC). Infiltration of the signal is statistically significant, and its intensity profile exhibited the influence has reached deeply into the tooth. This suggests that influence of periodontal disease is not only inflammation of periodontal tissue but also infiltration of LPC to root surface, and therefore, anti-inflammatory treatment is required besides conventional treatments.
Lazea, Andreea; Todea, Carmen
Objectives: To evaluate the dental anxiety level and the degree of acceptance of laser assisted pedodontic treatments from the children part. Also, we want to underline the advantages of laser use in pediatric dentistry, to make this technology widely used in treating dental problems of our children patients. Methods: Thirty pediatric dental patients presented in the Department of Pedodontics, University of Medicine and Pharmacy "Victor Babeş", Timişoara were evaluated using the Wong-Baker pain rating scale, wich was administered postoperatory to all patients, to assess their level of laser therapy acceptance. Results: Wong-Baker faces pain rating scale (WBFPS) has good validity and high specificity; generally it's easy for children to use, easy to compare and has good feasibility. Laser treatment has been accepted and tolerated by pediatric patients for its ability to reduce or eliminate pain. Around 70% of the total sample showed an excellent acceptance of laser dental treatment. Conclusions: Laser technology is useful and effective in many clinical situations encountered in pediatric dentistry and a good level of pacient acceptance is reported during all laser procedures on hard and soft tissues.
Gao, Wen; Hu, Fu-lian; Wang, Xiao-min
To observe the effect of furazolidone quadruple regimen plus dental plaque removal procedures as rescue treatment of refractory H. pylori infection. A total of 104 patients with H. pylori positive [(13)C-urea breath test (UBT) or rapid urease test positive] failing in previous treatment two or more were enrolled and divided into 2 groups. One group (n = 64) were given quadruple regimen [proton pump inhibitor (PPI) + bismuth + amoxicillin + furazolidone, 10 days] treatment and dental plaque removal treatment. And the others (n = 40) received only quadruple regimen treatment. The status of H. pylori was detected by (13)C-UBT at 4 weeks post-therapy and the eradication rates of two groups were compared. The eradication rate of quadruple regimen + dental treatment group was 85.9% (55/64) while that of the other group 72.5% (29/40) (P = 0.091). The PPI + bismuth quadruple regimen plus dental plaque removal procedures as rescue treatment may boost the eradication rate of refractory H. pylori infection patients. And the furazolidone quadruple therapy can be chosen for the treatment of refractory H. pylori infection. Oral H. pylori infection may play a role in the failure of H. pylori infection treatment.
Soni, Anuj; Mishra, D R; Polymeris, G S; Bhatt, B C; Kulkarni, M S
Dental enamel was studied for its thermoluminescence (TL) and optically stimulated luminescence (OSL) defects. The TL studies showed a wide glow curve with multiple peaks. The thermally assisted OSL (TA-OSL) studies showed that the integrated TA-OSL and thus OSL signal increases with readout temperature between 100 and 250 °C, due to the temperature dependence of OSL. The thermally assisted energy E A associated with this increase is found to be 0.21 ± 0.015 eV. On the other hand, the signal intensity decreases with temperature between 260 and 450 °C. This decrease could be due to depletion of OSL active traps or possible thermal quenching. The increase of the OSL signal at increased temperature can be used to enhance the sensitivity of dental enamel for ex vivo measurements in retrospective dosimetry. The emission and excitation spectra of its luminescence centers were studied by photoluminescence and were found to be at 412 and 324 nm, respectively. It was found to possess multiple OSL active traps having closely lying photoionization cross sections characterized by continuous wave OSL and nonlinear OSL methods. The investigated dental enamel samples showed a linear OSL dose response up to 500 Gy. The dose threshold was found to be 100 mGy using a highly sensitive compact OSL reader with blue LED (470 nm) stimulation.
Partido, Brian B
Dental and dental hygiene clinical faculty members often do not provide consistent instruction, especially since most procedures involve clinical judgment. Although instructional variations frequently translate into variations in student performance, the effect of inconsistent instruction is unknown, especially related to ergonomics. The aim of this study was to determine whether photography-assisted calibration training would improve interrater reliability among dental hygiene faculty members in ergonomics evaluation. The photography-assisted ergonomics calibration program incorporated features to improve accessibility and optimize the quality of the training. The study used a two-group repeated measures design with a convenience sample of 11 dental hygiene faculty members (eight full-time and three part-time) during the autumn 2016 term at one U.S. dental school. At weeks one and seven, all participants evaluated imaged postures of five dental students using a modified-dental operator posture assessment instrument. During weeks three and five, training group participants completed calibration training using independent and group review of imaged postures. All pre-training and post-training evaluations were evaluated for interrater reliability. Two-way random effects intraclass coefficient (ICC) values were calculated to measure the effects of the training on interrater reliability. The average measure of ICC of the training group improved from 0.694 with a 95% confidence interval (CI) of 0.001 to 0.965 (F(4,8)=3.465, p>0.05) to 0.766 with a 95% CI of 0.098 to 0.972 (F(4,8)=7.913, p<0.01). The average measure of ICC of the control group improved from 0.821 with a 95% CI of 0.480 to 0.978 (F(4,28)=7.702, p<0.01) to 0.846 with a 95% CI of 0.542 to 0.981 (F(4,28)=8.561, p<0.01). These results showed that the photography-assisted calibration training with the opportunity to reconcile different opinions resulted in improved agreement among these faculty members.
Cameron, D A; Binnie, V I; Sherriff, A; Bissell, V
This study describes a pilot project in which peer assisted learning (PAL) is used to teach dental clinical skills. A cluster randomised controlled trial compared opinions of Bachelor of Dental Surgery (BDS) students from peer-led groups versus staff-led groups in a clinical (impression taking) and a pre-clinical (handpiece skills) task. BDS5 (peer tutors) in their final year delivered teaching to BDS1 (tutees) for each task. Quantitative data from tutees and the peer tutors was gathered from questionnaires, along with open written comments. PAL was well received by both tutees and peer tutors. BDS1 tutees rated BDS5 peer tutors highly for delivery of information, and level of feedback. The tutees considered peer tutors more approachable and less intimidating than staff. Peer tutors reported their own knowledge had increased as a result of teaching. In a summative OSCE (objective structured clinical examination) four months following the teaching, no statistical significant difference between the performance of peer-led and staff-led groups was found at stations related to the subject matter in question. It is argued that PAL, as well as being a useful method of delivering subject-specific teaching, is able to contribute to the development of graduate attributes.
Woodward, Tony M
Dental radiology is the core diagnostic modality of veterinary dentistry. Dental radiographs assist in detecting hidden painful pathology, estimating the severity of dental conditions, assessing treatment options, providing intraoperative guidance, and also serve to monitor success of prior treatments. Unfortunately, most professional veterinary training programs provide little or no training in veterinary dentistry in general or dental radiology in particular. Although a technical learning curve does exist, the techniques required for producing diagnostic films are not difficult to master. Regular use of dental x-rays will increase the amount of pathology detected, leading to healthier patients and happier clients who notice a difference in how their pet feels. This article covers equipment and materials needed to produce diagnostic intraoral dental films. A simplified guide for positioning will be presented, including a positioning "cheat sheet" to be placed next to the dental x-ray machine in the operatory. Additionally, digital dental radiograph systems will be described and trends for their future discussed.
El Batawi, H Y
To investigate the possible effect of intraoperative analgesia, namely diclofenac sodium compared to acetaminophen on post-recovery pain perception in children undergoing painful dental procedures under general anaesthesia. A double-blind randomised clinical trial. A sample of 180 consecutive cases of children undergoing full dental rehabilitation under general anaesthesia in a private hospital in Saudi Arabia during 2013 was divided into three groups (60 children each) according to the analgesic used prior to extubation. Group A, children had diclofenac sodium suppository. Group B, children received acetaminophen suppository and Group C, the control group. Using an authenticated Arabic version of the Wong and Baker faces Pain assessment Scale, patients were asked to choose the face that suits best the pain he/she is suffering. Data were collected and recorded for statistical analysis. Student's t test was used for comparison of sample means. A preliminary F test to compare sample variances was carried out to determine the appropriate t test variant to be used. A "p" value less than 0.05 was considered significant. More than 93% of children had post-operative pain in varying degrees. High statistical significance was observed between children in groups A and B compared to control group C with the later scoring high pain perception. Diclofenac showed higher potency in multiple painful procedures, while the statistical difference was not significant in children with three or less painful dental procedures. Diclophenac sodium is more potent than acetaminophen, especially for multiple pain-provoking or traumatic procedures. A timely use of NSAID analgesia just before extubation helps provide adequate coverage during recovery. Peri-operative analgesia is to be recommended as an essential treatment adjunct for child dental rehabilitation under general anaesthesia.
... FEMA-2010-0036] RIN-1660-AA72 Procedural Changes to the Fire Management Assistance Declaration Process... Federal Emergency Management Agency (FEMA) is updating its Fire Management Assistance Grant Program regulations to reflect a change in the internal delegation of authority for fire management assistance...
Rowland, A S; Baird, D D; Weinberg, C R; Shore, D L; Shy, C M; Wilcox, A J
Exposure to mercury vapour or inorganic mercury compounds can impair fertility in laboratory animals. To study the effects of mercury vapour on fertility in women, eligibility questionnaires were sent to 7000 registered dental assistants in California. The final eligible sample of 418 women, who had become pregnant during the previous four years, were interviewed by telephone. Detailed information was collected on mercury handling practices and the number of menstrual cycles without contraception it had taken them to become pregnant. Dental assistants not working with amalgam served as unexposed controls. Women with high occupational exposure to mercury were less fertile than unexposed controls. The fecundability (probability of conception each menstrual cycle) of women who prepared 30 or more amalgams per week and who had five or more poor mercury hygiene factors was only 63% of that for unexposed women (95% CI 42%-96%) after controlling for covariates. Women with low exposure were more fertile, however, than unexposed controls. Possible explanations for the U shaped dose response and limitations of the exposure measure are discussed. Further investigation is needed that uses biological measures of mercury exposure. PMID:8124459
Pauchet, D; Pigot, J-L; Chabolle, F; Bach, C-A
Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned. Virtual surgery and computer-assisted design and prefabrication techniques are used to plan the reconstruction and then reproduce this planning by means of tailored fibula and mandible cutting guides, thereby ensuring correct positioning of fibular bone fragments and implants. The prefabricated fibula free flap technique requires two surgical procedures (prefabrication and flap transfer) and precise preoperative planning. Prefabricated fibula free flap with dental implants, by improving the quality of osseointegration of the implants before flap transfer, extends the possibilities of prosthetic rehabilitation in complex secondary mandibular reconstructions. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Neenan, M. Elaine; And Others
A study describes the characteristics of the current primary dental care workforce (dentists, hygienists, assistants), its distribution, and its delivery system in private and public sectors. Graduate dental school enrollments, trends in patient visits, employment patterns, state dental activities, and workforce issues related to health care…
EMG studies). Data Management and Analysis Descriptive statistics for subject demographics and nerve conduction study variables were calculated using...military N/A Family history of CTS; previous work history as electrician, guitar player 49 (R) None N/A Dental assistant; waiter NCS indicates
Schuler, Patrick J; Hoffmann, Thomas K; Veit, Johannes A; Rotter, Nicole; Friedrich, Daniel T; Greve, Jens; Scheithauer, Marc O
Total laryngectomy is a standard procedure in head-and-neck surgery for the treatment of cancer patients. Recent clinical experiences have indicated a clinical benefit for patients undergoing transoral robot-assisted total laryngectomy (TORS-TL) with commercially available systems. Here, a new hybrid procedure for total laryngectomy is presented. TORS-TL was performed in human cadavers (n = 3) using a transoral-transcervical hybrid procedure. The transoral approach was performed with a robotic flexible robot-assisted surgical system (Flex®) and compatible flexible instruments. Transoral access and visualization of anatomical landmarks were studied in detail. Total laryngectomy is feasible with a combined transoral-transcervical approach using the flexible robot-assisted surgical system. Transoral visualization of all anatomical structures is sufficient. The flexible design of the robot is advantageous for transoral surgery of the laryngeal structures. Transoral robot assisted surgery has the potential to reduce morbidity, hospital time and fistula rates in a selected group of patients. Initial clinical studies and further development of supplemental tools are in progress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Eskandarian, T; Arabzade Moghadam, S; Reza Ghaemi, S; Bayani, M
For many children medical and dental procedures, unfamiliar dental staff and treatment places are disturbing and stressful. Stress in children often makes them uncooperative. General anaesthesia is indicated for anxious uncooperative children or those who are disabled, immature or too young to undergo dental treatment by other means. Moreover parents' separation while entering the operative room is a traumatic experience for children. Thus premedication such as midazolam is recommended to decrease child's stress. In these situations the increased recovery time was considered as one of the midazolam side effects. There is no study that evaluated the effect of midazolam both in parents-child separation and recovery time in long dental procedure. The purpose of this study was to evaluate the effect of nasal midazolam premedication with placebo on parents-child separation and recovery times in uncooperative paediatric patients undergoing long-lasting general anaesthesia for dental procedures. This randomised, double-blind study was done on 60 uncooperative patients (ASA physical status I or II) aged 2-4 years who were scheduled for general anaesthesia for dental treatment. Group A received 0.2 mg/kg intranasal midazolam as premedication, and group B received the same volume of intranasal placebo 20 minutes before entering the operating room for general anaesthesia. General anaesthesia was done with the same method for all patients, then parent-child separation and recovery times were compared between the two groups. Statical significance was set at P≤0.05. Statically analysis was performed using SPSS version17.Chi-squared and student t-tests were applied to analyse the data. We found significant differences in parents- child separation assessment between two groups. Nasal midazolam premedication had a positive effect on parents-child separation; but there was no significant difference between the two groups in terms of recovery time. Premedication of nasal midazolam
Feldstein, P J; Roehrig, C S
The Econometric Model of the the Dental Sector forecasts a broad range of dental sector variables, including dental care prices; the amount of care produced and consumed; employment of hygienists, dental assistants, and clericals; hours worked by dentists; dental incomes; and number of dentists. These forecasts are based upon values specified by the user for the various factors which help determine the supply an demand for dental care, such as the size of the population, per capita income, the proportion of the population covered by private dental insurance, the cost of hiring clericals and dental assistants, and relevant government policies. In a test of its reliability, the model forecast dental sector behavior quite accurately for the period 1971 through 1977. PMID:7461974
Polyzois, Ioannis; Claffey, Noel; McDonald, Albhe; Hussey, David; Quinn, Frank
The purpose of this study was to examine the effectiveness of conventional pre-clinical training in dentistry and to determine if evaluation of a dental procedure at the beginning of dental training can be a predictor for future performance. A group of second year dental students with no previous experience in operative dentistry were asked to prepare a conventional class I cavity on a lower first molar typodont. Their first preparation was carried out after an introductory lecture and a demonstration and their second at the end of conventional training. The prepared typodonts were coded and blindly scored for the traditional assessment criteria of outline form, retention form, smoothness, cavity depth and cavity margin angulation. Once the codes were broken, a paired t-test was used to compare the difference between the means of before and after scores (P<0.0001) and a Pearson's linear correlation to test the association (r=0.4). From the results of this study, we could conclude that conventional preclinical training results in a significant improvement in the manual skills of the dental students and that the dental procedure used had only a limited predictive value for later performance at the preclinical level. © 2011 John Wiley & Sons A/S.
Peretz, B; Mann, J
The aims of the present study were (a) to evaluate students' estimation of their parents' dental anxiety; (b) to measure students' dental anxiety and to study their ranking of the most fear provoking stimuli in the dental situation during their pre-clinical and clinical years; (c) to investigate gender differences among students with regard to dental anxiety. 30 3rd-year students (15 male and 15 female) who completed a 4-section questionnaire which requested sociodemographic information, evaluation of parents' dental anxiety, dental anxiety scale (DAS) and dental fear scale (DFS), completed the DAS and DFS in their 5th and 6th years. Both male and female students estimated their mothers' dental anxiety as significantly higher than their fathers'. Female students ranked their parents higher than males. DAS scores were significantly higher among female students than among males in the 3rd year. However, DAS scores were reduced from the 3rd to the 6th year among the total class and significantly among females, while males' levels of anxiety remained within close range throughout the years. The dental anxiety scores of all students who experienced a dental procedure in the past were higher than the scores of the students who did not. The most fearful stimulus was 'feeling the needle'. Our findings may suggest that the change in the reported dental anxiety of the students during the years of dental studies in the present study may be explained by the increased professional education and clinical experience that the students acquire throughout their studies in the dental school. Being exposed to basic trivial dental procedures (such as local anaesthetic injection) may help students either to be habituated or to use rational coping strategies when dealing with personal dental experience.
Muroga, R; Tsuruta, J; Morio, I
In Japan, there continues to be a shortage of active dental hygienists. The scope of dental hygienists' practice is also considered to be unclear. One of the reasons for this is that dental hygienists find the working conditions during dental hygiene education different from those in reality. The purpose of this study was to clarify the actual working condition of dental hygienists in dental clinics, as well as evaluate the awareness of dental hygiene students and dentists regarding the working condition of dental hygienists. Questionnaires were sent by post to 481 dentists and were distributed to 89 dental hygiene students. The awareness about the working condition of dental hygienists was compared between dentists and dental hygiene students. Two hundred twenty-two dentists and 89 dental hygiene students responded to questionnaires. Dental hygiene students considered the team of 'dental hygienist, dental technician and clerk' to be more effective in providing dental care than dentists (P < 0.001). Among the dentists, 37.1% did not find any clear distinction between hygienists and assistants in their clinics. However, 97.4% of dental hygiene students answered that dental team members should clearly inform patients of the distinction between hygienists and assistants. This study indicated that there was disparity between dentists' and dental hygiene students' perception of dental hygienists' working conditions, and dental team work was not always effective. For training high quality dental hygienists, all educational institutions related to dentistry must educate students regarding the more realistic dental hygienists' working condition, as well as benefits. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Asserts that parent education is vital to good dental hygiene for the whole family. Discusses what Head Start staffers can do to ensure that children's dental needs are being met, particularly in assisting parents with taking responsibility for children's dental hygiene. Covers dental care tips for parents, questions and answers about dental…
Weaver, Trudy Karlene; Apfel, Maura
This manual is part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. This student manual contains four units covering the following topics: dental anatomical terminology; tooth numbering systems;…
To gain an overview of knowledge of local analgesia, pulpal therapy and restorative procedures in the primary dentition amongst dental undergraduate students (DS), dental therapy students (DTS), recently-qualified dentists (QD) and dental therapists (DT), working within a Dental Hospital setting. A survey undertaken at Dundee Dental Hospital and School, NHS Tayside, United Kingdom to determine current knowledge regarding the use of local analgesia, pulp anatomy and pulp therapy techniques in addition to restoration of primary teeth. Data were available for 24 individuals (DS: 5; QD: 6; DTS: 8; DT: 5). Deficiencies in knowledge regarding the maximum safe dose for local analgesia, pulp canal anatomy, pulp therapy medicaments and the preparation required prior to placement of a pre-formed metal crown were noted in both student and staff groups. The knowledge of basic dental procedures for children amongst a group of dental students, student dental therapists and recently qualified dentists and dental therapists, was found to be imperfect. These findings indicate that more research is needed on the educational procedures used in the transfer of such knowledge and skills. Deficiencies in knowledge were identified in all areas assessed. Courses should be designed at both the pre- and postgraduate level to address and avoid such gaps in knowledge.
... 42 Public Health 5 2014-10-01 2014-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
... 42 Public Health 5 2010-10-01 2010-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
... 42 Public Health 5 2012-10-01 2012-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
... 42 Public Health 5 2013-10-01 2013-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
... 42 Public Health 5 2011-10-01 2011-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...
Alimoglu, Orhan; Sagiroglu, Julide; Atak, Ibrahim; Kilic, Ali; Eren, Tunc; Caliskan, Mujgan; Bas, Gurhan
Robotics was introduced in clinical practice more than two decades ago, and it has gained remarkable popularity for a wide variety of laparoscopic procedures. We report our results of robot-assisted laparoscopic surgery (RALS) in the most commonly applied general surgical procedures. Ninety seven patients underwent RALS from 2009 to 2012. Indications for RALS were cholelithiasis, gastric carcinoma, splenic tumors, colorectal carcinoma, benign colorectal diseases, non-toxic nodular goiter and incisional hernia. Records of patients were analyzed for demographic features, intraoperative and postoperative complications and conversion to open surgery. Forty six female and 51 male patients were operated and mean age was 58,4 (range: 25-88). Ninety three out of 97 procedures (96%) were completed robotically, 4 were converted to open surgery and there were 15 postoperative complications. There was no mortality. Wide variety of procedures of general surgery can be managed safely and effectively by RALS. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Byloff, Friedrich K; Mossaz, Claude F
The purpose of this study was to analyse the changes produced by surgically assisted rapid palatal expansion (SARPE) longitudinally on 14 patients aged between 18 and 41 years. A pre-fabricated Hyrax appliance was cemented prior to the surgical intervention, which consisted of a maxillary buccal corticotomy with pterygoid separation. Models and postero-anterior (PA) headfilms were taken before expansion (T1), at the end of expansion (T2), at the end of retention (T3) and at least 1 year post-surgery (T4). Overall expansion and relapse were measured directly on the casts. Transverse distances increased more at the first molars (8.7 mm) and premolars (8.1 and 8.3 mm) than in the canine (5.2 mm) and second molar (5.5 mm) region. Minimal relapse occurred during the retention phase. The arch width decreased more during the post-retention period, with more pronounced reduction at the teeth used as anchorage during the expansion procedure (-2.0 mm for the first premolars and -2.6 mm for the first molars). The mean total dental relapse was 28 per cent. PA radiographic analysis for angular changes showed 9.6 degrees of lateral tipping per side during expansion. One-third of this movement relapsed during the retention period (-3.3 degrees) and this trend (-6.0 degrees) continued during the post-retention phase to reach practically the original value at T1. Skeletal changes monitored on the PA headfilms were minimal with great individual variation. The mean expansion measured in the proximity of the osteotomy site was only 1.3 mm. From this amount, 0.4 mm was lost during the retention and post-retention periods. Based on these findings, it appears that maxillary skeletal expansion by SARPE is mainly a lateral rotation of the two maxillary halves with only minimal horizontal translation.
Capa, Nuray; Malkondu, Ozlem; Kazazoglu, Ender; Calikkocaoglu, Senih
The authors conducted a study to evaluate the influence of dentists' and nondentists' experience, age, sex, eye color and use of eyeglasses or contact lenses on tooth shade-matching ability. The authors included 120 participants in this study conducted in Istanbul (periodontists, oral and maxillofacial surgeons, orthodontists, endodontists, pediatric dentists, prosthodontists, restorative dentists, general dentists in private practice, dental technicians, dental assistants, dental assistant students and laypeople). The authors assigned participants to one of three groups: group 1 was composed of prosthodontists, restorative dentists and dental technicians; group 2 consisted of other dental specialists and general dentists; and group 3 included dental assistants, dental assistant students and laypeople. The authors asked participants to match the shades of three artificial maxillary right central incisors (Vitapan acrylic teeth [shades 2L1.5, 1M2, 2R1.5], Vita Zahnfabrik, Bad Säckingen, Germany) by using a shade guide system (Vita Toothguide 3D-Master, Vita Zahnfabrik). They calculated shade matching for the three color components (value, hue, chroma) and analyzed the results by using a chi(2) test. The rate of success in matching the shade for IM2 was 53.3 percent for participants in group 1, 30 percent for participants in group 2 and 20 percent for participants in group 3 (P = .017). However, there were no significant differences between the three groups for shades 2L1.5 and 2R1.5. Professional experience (P = .003) and age (P = .027) were associated with shade-matching success for tooth shade 2L1.5 only. The results showed no statistically significant differences with respect to sex, eye color or use of eyeglasses or contact lenses. Dental care professionals who routinely performed restorative procedures matched the shades better than did participants in other groups. Professional experience was associated positively with the outcome, while sex, eye color and
Abdulla, A M; Hegde, A M
The aim of the study was to estimate the diurnal variations of salivary cortisol in children with autism and healthy children and it's implication on behavior during non-invasive dental procedures. 50 children with autism and 50 healthy children in the age group between 6 to 12 years of both genders with the need for dental treatment were included in the study. Whole unstimulated saliva was collected from them during early hours of the day and during evenings for 2 consecutive days . The collected saliva was then subjected to electrochemiluminescence assay . Minimum invasive dental procedures like hand scaling, pit and fissure sealants and glass ionomer cement restorations were performed for the participants each time after the saliva sample collection and their behavior during the procedures was rated using Frankl's Behavior Rating Scale. Significant correlation was seen between cortisol levels and behavior in children with autism. As cortisol levels increased in children with autism, behavior worsened and as the cortisol levels decreased they showed positive behaviour. Cortisol acts as a stress marker and studying the diurnal variations of salivary cortisol can help us in attaining better knowledge about the behavior pattern and thereby assist us in modifying the behavior modification procedures and treatment planning in this group of special children.
... OPERATIONS Farm Credit System Financial Assistance Corporation Securities § 615.5560 Book-entry Procedure for Farm Credit System Financial Assistance Corporation Securities. (a) The Farm Credit System Financial... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Book-entry Procedure for Farm Credit System...
Ambrosano, Gláucia Maria Bovi; Reis, André Figueiredo; Giannini, Marcelo; Pereira, Antônio Carlos
A descriptive survey was performed in order to assess the statistical content and quality of Brazilian and international dental journals, and compare their evolution throughout the last decades. The authors identified the reporting and accuracy of statistical techniques in 1000 papers published from 1970 to 2000 in seven dental journals: three Brazilian (Brazilian Dental Journal, Revista de Odontologia da Universidade de Sao Paulo and Revista de Odontologia da UNESP) and four international journals (Journal of the American Dental Association, Journal of Dental Research, Caries Research and Journal of Periodontology). Papers were divided into two time periods: from 1970 to 1989, and from 1990 to 2000. A slight increase in the number of articles that presented some form of statistical technique was noticed for Brazilian journals (from 61.0 to 66.7%), whereas for international journals, a significant increase was observed (65.8 to 92.6%). In addition, a decrease in the number of statistical errors was verified. The most commonly used statistical tests as well as the most frequent errors found in dental journals were assessed. Hopefully, this investigation will encourage dental educators to better plan the teaching of biostatistics, and to improve the statistical quality of submitted manuscripts.
Spiritoso, Stephen; Gross, Erin; Bean, Canise Y; Casamassimo, Paul S; Levings, Kevin; Lloyd, Patrick
The aim of this study was to investigate the contribution of a tiered predoctoral pediatric dentistry clinical education model to competency achievement by dental students over a two-year clinical education. Retrospective data were obtained for academic years 2012-13 and 2013-14 from three sources: a campus-based, dental school-housed clinic; division-directed clinics in community-based pediatric and special needs clinics (DDC); and clinics affiliated with the dental college's community-based dental education (CBDE) program, the OHIO Project (OP). A fourth dataset was obtained for the same two-year period from a biannual clinic event held at the college in conjunction with Give Kids a Smile Day (GKAS). Procedures considered essential to the care of children were sorted by 12 dental codes from all services for patients 18 years of age and younger. The dental school clinic provided 11,060 procedures; the DDC, 28,462; the OP, 17,863; and GKAS, 2,028. The two-year total was 59,433 procedures. Numbers of diagnostic and preventive procedures were 19,441, restorative procedures were 13,958, and pulp and surgical procedures were 7,392. Site contribution ranged from 52.2 to 144.9 procedures per attending student, with the DDC yielding the highest per student average for each year (126.4 and 144.9) and the dental school clinic the lowest (52.2 and 53.1). This study found that a combination of school-based, community-based, and philanthropic pediatric dental experiences offered a large number of essential pediatric dentistry experiences for predoctoral dental students, with CBDE opportunities offering the largest contribution.
Muhic, Edin; Plancak, Darije; Lajnert, Vlatka; Muhic, Asja
Working in a healthy work environment is the ultimate goal of every employee. Dentistry is a stressful career, and the reasons for dissatisfaction are numerous. The aim of this study was to determine the factors of work satisfaction in dental professionals of the Bosnia and Herzegovina Federation. A total of 134 dental professionals selected randomly from the Registry of Dental Chamber of Bosnia and Herzegovina Federation were included in the study. All of them filled out the Demographic Questionnaire and Job Satisfaction Scale (JSS). An increase in the influence of work on the quality of life as well as an increase in its frequency results in leaving the job and significantly reducing the overall job satisfaction. General dental practitioners are significantly more satisfied as compared with specialists. Significant predictors of the job satisfaction are employment status, type of the practice, and availability of dental assistants. General dental practitioners with a dental assistant employed at a private practice are more likely to be satisfied with their jobs. Employment status, practice type and availability of dental assistants are significant predictors of job satisfaction. General dental practitioners working in a private practice with a dental assistant are most likely to be satisfied.
Includes three articles: "Lending a Hand for Good Dental Health,""A Promising Career Path," and "Dental Laboratory Technicians." Describes careers related to the dental field and the dental programs at various career centers, community colleges, and universities. (JOW)
Bhagavatula, Pradeep; Xiang, Qun; Szabo, Aniko; Eichmiller, Fredrick; Kuthy, Raymond A; Okunseri, Christopher E
Studies on rural-urban differences in dental care have primarily focused on differences in utilization rates and preventive dental services. Little is known about rural-urban differences in the use of wider range of dental procedures. This study examined patterns of preventive, restorative, endodontic, and extraction procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI). We analyzed DDWI enrollment and claims data for children aged 0-18 years from 2002 to 2008. We modified and used a rural and urban classification based on ZIP codes developed by the Wisconsin Area Health Education Center (AHEC). We categorized the ZIP codes into 6 AHEC categories (3 rural and 3 urban). Descriptive and multivariable analysis using generalized linear mixed models (GLMM) were used to examine the patterns of dental procedures provided to children. Tukey-Kramer adjustment was used to control for multiple comparisons. Approximately, 50%, 67% and 68% of enrollees in inner-city Milwaukee, Rural 1 (less than 2500 people), and suburban-Milwaukee had at least one annual dental visit, respectively. Children in inner city-Milwaukee had the lowest utilization rates for all procedures examined, except for endodontic procedures. Compared to children from inner-city Milwaukee, children in other locations had significantly more preventive procedures. Children in Rural 1-ZIP codes had more restorative, endodontic and extraction procedures, compared to children from all other regions. We found significant geographic variation in dental procedures received by children enrolled in DDWI.
This document provides updated coding information for services related to assisted reproductive technology procedures. This document replaces the 2012 ASRM document of the same name. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Daneshkazemi, Alireza; Abrisham, Seyyed Mohammad; Daneshkazemi, Pedram; Davoudi, Amin
Dental pain management is one of the most critical aspects of modern dentistry which might affect patient's quality of life. Several methods are suggested to provide a painless situation for patients. Desensitization of the oral site using topical anesthetics is one of those methods. The improvements of topical anesthetic agents are probably one of the most important advances in dental science in the past 100 years. Most of them are safe and can be applied on oral mucosa with minimal irritation and allergic reactions. At present, these agents are various with different potent and indications. Eutectic mixture of local anesthetics (EMLA) (lidocaine + prilocaine) is a commercial anesthetic agent which has got acceptance among dental clinicians. This article provides a brief review about the efficacy of EMLA as a topical anesthetic agent when used during dental procedures. PMID:27746520
Daneshkazemi, Alireza; Abrisham, Seyyed Mohammad; Daneshkazemi, Pedram; Davoudi, Amin
Dental pain management is one of the most critical aspects of modern dentistry which might affect patient's quality of life. Several methods are suggested to provide a painless situation for patients. Desensitization of the oral site using topical anesthetics is one of those methods. The improvements of topical anesthetic agents are probably one of the most important advances in dental science in the past 100 years. Most of them are safe and can be applied on oral mucosa with minimal irritation and allergic reactions. At present, these agents are various with different potent and indications. Eutectic mixture of local anesthetics (EMLA) (lidocaine + prilocaine) is a commercial anesthetic agent which has got acceptance among dental clinicians. This article provides a brief review about the efficacy of EMLA as a topical anesthetic agent when used during dental procedures.
Muhic, Edin; Plancak, Darije; Muhic, Asja
Introduction Working in a healthy work environment is the ultimate goal of every employee. Dentistry is a stressful career, and the reasons for dissatisfaction are numerous. Aim The aim of this study was to determine the factors of work satisfaction in dental professionals of the Bosnia and Herzegovina Federation. Materials and methods A total of 134 dental professionals selected randomly from the Registry of Dental Chamber of Bosnia and Herzegovina Federation were included in the study. All of them filled out the Demographic Questionnaire and Job Satisfaction Scale (JSS). Results An increase in the influence of work on the quality of life as well as an increase in its frequency results in leaving the job and significantly reducing the overall job satisfaction. General dental practitioners are significantly more satisfied as compared with specialists. Significant predictors of the job satisfaction are employment status, type of the practice, and availability of dental assistants. General dental practitioners with a dental assistant employed at a private practice are more likely to be satisfied with their jobs. Conclusions Employment status, practice type and availability of dental assistants are significant predictors of job satisfaction. General dental practitioners working in a private practice with a dental assistant are most likely to be satisfied. PMID:27847395
Apfel, Maura; Weaver, Trudy Karlene
This manual is part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. This student manual contains four units covering the following topics: local anesthesia; dental office emergencies; oral hygiene;…
Kaimook, Wandee; Tantisarasart, Ratchada; Sooksamear, Puwanai; Chayaphum, Satith; Kongkamol, Chanon; Srisintorn, Wisarut; Phakthongsuk, Pitchaya
Objectives This cross-sectional study was performed in the Dental School of Prince of Songkla University to ascertain noise exposure of dentists, dental assistants, and laboratory technicians. A noise spectral analysis was taken to illustrate the spectra of dental devices. Methods A noise evaluation was performed to measure the noise level at dental clinics and one dental laboratory from May to December 2010. Noise spectral data of dental devices were taken during dental practices at the dental services clinic and at the dental laboratory. A noise dosimeter was set following the Occupational Safety and Health Administration criteria and then attached to the subjects' collar to record personal noise dose exposure during working periods. Results The peaks of the noise spectrum of dental instruments were at 1,000, 4,000, and 8,000 Hz which depended on the type of instrument. The differences in working areas and job positions had an influence on the level of noise exposure (p < 0.01). Noise measurement in the personal hearing zone found that the laboratory technicians were exposed to the highest impulsive noise levels (137.1 dBC). The dentists and dental assistants who worked at a pedodontic clinic had the highest percent noise dose (4.60 ± 3.59%). In the working areas, the 8-hour time-weighted average of noise levels ranged between 49.7-58.1 dBA while the noisiest working area was the dental laboratory. Conclusion Dental personnel are exposed to noise intensities lower than occupational exposure limits. Therefore, these dental personnel may not experience a noise-induced hearing loss. PMID:22953219
Choosong, Thitiworn; Kaimook, Wandee; Tantisarasart, Ratchada; Sooksamear, Puwanai; Chayaphum, Satith; Kongkamol, Chanon; Srisintorn, Wisarut; Phakthongsuk, Pitchaya
This cross-sectional study was performed in the Dental School of Prince of Songkla University to ascertain noise exposure of dentists, dental assistants, and laboratory technicians. A noise spectral analysis was taken to illustrate the spectra of dental devices. A noise evaluation was performed to measure the noise level at dental clinics and one dental laboratory from May to December 2010. Noise spectral data of dental devices were taken during dental practices at the dental services clinic and at the dental laboratory. A noise dosimeter was set following the Occupational Safety and Health Administration criteria and then attached to the subjects' collar to record personal noise dose exposure during working periods. The peaks of the noise spectrum of dental instruments were at 1,000, 4,000, and 8,000 Hz which depended on the type of instrument. The differences in working areas and job positions had an influence on the level of noise exposure (p < 0.01). Noise measurement in the personal hearing zone found that the laboratory technicians were exposed to the highest impulsive noise levels (137.1 dBC). The dentists and dental assistants who worked at a pedodontic clinic had the highest percent noise dose (4.60 ± 3.59%). In the working areas, the 8-hour time-weighted average of noise levels ranged between 49.7-58.1 dBA while the noisiest working area was the dental laboratory. Dental personnel are exposed to noise intensities lower than occupational exposure limits. Therefore, these dental personnel may not experience a noise-induced hearing loss.
... 7 Agriculture 6 2013-01-01 2013-01-01 false USDA assistance with Federal agencies' reviews of... PROTECTION POLICY ACT § 658.7 USDA assistance with Federal agencies' reviews of policies and procedures. (a... the purpose and policy of the Act. (c) USDA will provide certain assistance to other Federal agencies...
... 7 Agriculture 6 2011-01-01 2011-01-01 false USDA assistance with Federal agencies' reviews of... PROTECTION POLICY ACT § 658.7 USDA assistance with Federal agencies' reviews of policies and procedures. (a... the purpose and policy of the Act. (c) USDA will provide certain assistance to other Federal agencies...
... 7 Agriculture 6 2012-01-01 2012-01-01 false USDA assistance with Federal agencies' reviews of... PROTECTION POLICY ACT § 658.7 USDA assistance with Federal agencies' reviews of policies and procedures. (a... the purpose and policy of the Act. (c) USDA will provide certain assistance to other Federal agencies...
... 7 Agriculture 6 2010-01-01 2010-01-01 false USDA assistance with Federal agencies' reviews of... PROTECTION POLICY ACT § 658.7 USDA assistance with Federal agencies' reviews of policies and procedures. (a... the purpose and policy of the Act. (c) USDA will provide certain assistance to other Federal agencies...
... 7 Agriculture 6 2014-01-01 2014-01-01 false USDA assistance with Federal agencies' reviews of... PROTECTION POLICY ACT § 658.7 USDA assistance with Federal agencies' reviews of policies and procedures. (a... the purpose and policy of the Act. (c) USDA will provide certain assistance to other Federal agencies...
Kaz, M E; Schuchman, L
This study compares the oral health attitudes of nursing assistants employed in facilities served by mobile dental units, with attitudes of nursing assistants employed in facilities that are not served by mobile dental units. Seventy-seven nursing assistants were selected from seven long-term care facilities. Mobile dental service was available in four of the seven facilities. Certified nursing assistants completed a three part questionnaire that included demographics, personal oral health care habits, and an attitudinal section based on Kegeles' health belief model, measured by a Likert-type scale. Demographically, a majority of assistants in each group were female, worked the first shift, and had worked at their respective facilities from 6-12 months. On the average, assistants who worked at facilities that were not served by a mobile dental unit had more years of postsecondary education. Both groups had similar in-service dental histories for the previous year. A greater number of nursing assistants at facilities that were not served by a mobile dental unit reported having dental checkups within the past year. The majority of assistants in each group brushed their teeth twice per day, used a medium or hard toothbrush, and did not floss. Attitudinal mean scores were similar in all the areas of the health belief model, with the exception that assistants who were not served by a dental unit showed a greater mean score for the area of susceptibility. Through use of the t-test, the area of susceptibility was found to be statistically significant (P = .05) between the two groups. Results suggest nursing assistants' exposure to mobile dental services may not strongly influence oral health attitudes.
Donaldson, Mark; Goodchild, Jason H
Although dental board regulations for the provision of in-office enteral conscious (oral) sedation vary widely with respect to training and pharmacologic strategies, they agree on the use of drugs that are inherently safe, the use of pulse oximetry and the availability of emergency equipment, including pharmacologic antagonists. Patient safety is of greatest concern and is best addressed by appropriate selection of patients, adequate training of personnel and appropriate monitoring of patients. Readings from bispectral index system (BIS) monitors, which use electroencephalographic signals, correlate accurately with depth of sedation during nondissociative general anesthesia of adults and children in the operating room setting. The usefulness of such monitoring as an adjunct to other forms of monitoring of in-office enteral sedation in the dental setting may represent the next important application of this tool, adding a further level of safety for the patient and another level of predictability for the practitioner. This paper reviews the current evidence supporting this new technique, presenting data from 20 procedures in which BIS monitoring during in-office enteral sedation was employed in a community dental practice.
Sammon, Jesse D; Karakiewicz, Pierre I; Sun, Maxine; Sukumar, Shyam; Ravi, Praful; Ghani, Khurshid R; Bianchi, Marco; Peabody, James O; Shariat, Shahrokh F; Perrotte, Paul; Hu, Jim C; Menon, Mani; Trinh, Quoc-Dien
The use of robot-assisted radical prostatectomy has increased rapidly despite the absence of randomized, controlled trials showing the superiority of this approach. While recent studies suggest an advantage for perioperative complication rates, they fail to account for the volume-outcome relationship. We compared perioperative outcomes after robot-assisted and open radical prostatectomy, while considering the impact of this established relationship. Using the NIS (Nationwide Inpatient Sample), we abstracted data on patients treated with radical prostatectomy in 2009. Univariable and multivariable logistic regression analyses were done to compare the rates of blood transfusion, intraoperative and postoperative complications, prolonged length of stay, increased hospital charges and mortality between robot-assisted and open radical prostatectomy overall and across volume quartiles. An estimated 77,616 men underwent radical prostatectomy, including a robot-assisted and an open procedure in 63.9% and 36.1%, respectively. Low volume centers averaged 26.2 robot-assisted and 5.2 open cases, while very high volume centers averaged 578.8 robot-assisted and 150.2 open cases. Overall, patients treated with the robot-assisted procedure experienced a lower rate of adverse outcomes than those treated with the open procedure for all measured categories. Across equivalent volume quartiles robot-assisted radical prostatectomy outcomes were generally favorable. However, the open procedure at high volume centers resulted in a lower postoperative complication rate (OR 0.59, 95% CI 0.46-0.75), elevated hospital charges (OR 0.75, 95% CI 0.64-0.87) and a comparable blood transfusion rate (OR 1.38, 95% CI 0.93-2.02) relative to the robot-assisted procedure at low volume centers. Regionalization has occurred to a greater extent for robot-assisted than for open radical prostatectomy with an associated benefit in overall outcomes. Nonetheless, low volume institutions experienced inferior
Conway, Susan E; Smith, Winter J; Truong, Teresa H; Shadid, Jill
Interprofessional learning is a key component of today's health sciences education. Within a two-course series in dental pharmacology and therapeutics, a dental curriculum was revised to provide an interprofessional activity to expose dental students to a community pharmacy setting. The objectives of this activity were to augment students' learning about drug laws and prescription writing, as well as to foster interprofessional relationships and collaboration between pharmacists and dentists. Dental students were scheduled for one-hour observations at community pharmacies on campus. Learning objectives to guide this activity focused on demonstrating community pharmacy operating procedures, identifying ways to minimize prescribing and dosing errors, and understanding how pharmacists can assist dentists in prescribing. Following the observation, students were required to submit a written assignment, which accounted for 14 percent of their course grade. All 119 dental students (100 percent) enrolled in the course for the summers of 2012 and 2013 completed the activity. The average grade on the written assignment was 96.2 out of 100. At the end of the course, students were asked to participate in an online course evaluation survey, for which response rates were 37 percent and 43 percent for 2012 and 2013, respectively. The students rated the pharmacy observation activity favorably on this course evaluation. The pharmacy observation activity provided a successful interprofessional component to the didactic pharmacy course and was well received by the dental students as well as the community pharmacists.
Asan, Onur; Ye, Zhan; Acharya, Amit
The use of electronic health records (EHRs) in dental care and their effect on dental care provider-patient interaction have not been studied sufficiently. The authors conducted a study to explore dental care providers' interactions with EHRs during patient visits, how these interactions influence dental care provider-patient communication, and the providers' and patients' perception of EHR use in the dental clinic setting during patient visits. The authors collected survey and interview data from patients and providers at three dental clinics in a health care system. The authors used qualitative and quantitative methods to analyze data obtained from patients and dental care providers. The provider survey results showed significant differences in perceptions of EHR use in patient visits across dental care provider groups (dentists, dental hygienists and dental assistants). Patient survey results indicated that some patients experienced a certain level of frustration and distraction because of providers' use of EHRs during the visit. The provider survey results indicated that there are different perceptions across provider groups about EHRs and the effect of computer use on communication with patients. Dental assistants generally reported more negative effects on communication with patients owing to computer use. Interview results also indicated that dental care providers may not feel comfortable interacting with the EHR without having any verbal or eye contact with patients during the patient's dental visit. A new design for dental operatories and locations of computer screens within the operatories should be undertaken to prevent negative nonverbal communication such as loss of eye contact or forcing the provider and patient to sit back to back, as well as to enhance patient education and information sharing.
Masuda, K; Ohta, M; Ohsuka, S; Matsuyama, M; Ashoori, M; Usami, T; Ito, M; Ueda, M; Kaneda, T
An autoclavable air turbine handpiece, Air Flushing Clean System (AFCS) (Osada Electric Co., Ltd., Tokyo, Japan) was developed for use in dentistry with the objective of reducing cross-contamination. Its potential for bacterial contamination was investigated in vitro using two bacterial strains (Streptococcus mutants ATCC 25175 and Staphylococcus aureus FDA 209 P). In theory, this device should prevent cross-contamination of the internal water and air lines of the handpiece, by maintaining an internal positive pressure even after the turbine is stopped. In the present study, this AFCS device was found to reduce the bacterial contamination within the air turbine handpiece more effectively than the conventional handpiece used according to accepted protocol. The reduction of such contamination by the AFCS is in keeping with the recent objective of the American Dental Association to reduce cross-contamination during dental procedures.
McKinnon, Monette; Luke, Gina; Bresch, Jack; Moss, Myla; Valachovic, Richard W
The U.S. surgeon general defined the national oral health care crisis in 2001 in Oral Health in America: A Report of the Surgeon General. The report concluded that the public infrastructure for oral health is not sufficient to meet the needs of disadvantaged groups and is disproportionately available depending upon certain racial, ethnic, and socioeconomic factors within the U.S. population. Now, several new workforce models are emerging that attempt to address shortcomings in the oral health care workforce. Access to oral health care is the most critical issue driving these new workforce models. Currently, three midlevel dental workforce models dominate the debate. The purpose of this report is to describe these models and their stage of development to assist the dental education community in preparing for the education of these new providers. The models are 1) the advanced dental hygiene practitioner; 2) the community dental health coordinator; and 3) the dental health aide therapist.
Luscre, Deanna M.; Center, David B.
This study of the outcomes of treatment of three children with autism, to reduce fear of dental examinations, found that the children could be trained through a combined desensitization, symbolic modeling, and reinforcement treatment package to undergo a dental exam in an analog setting, and the training could generalize somewhat to a clinical…
McLane, Sara; Waesche, Betty
Specific circulation desk procedures and policies which student assistants helped to create and for which they are responsible are listed. A checklist for students to use in assessing their skills and knowledge of procedures and locations is provided, as well as a list of 30 questions frequently asked by library patrons; answers are included.…
Chaari, N; Kerkeni, A; Saadeddine, S; Neffati, F; Khalfallah, T; Akrout, M
The property of mercury to amalgamate with other metals is used to create a material for filling teeth. This material remains the cheapest and most efficient in tooth restoration. Mercurial toxicity has been documented since Antiquity but the metal remains widely used in some countries. This study compared mercury impregnation in dentists and dental assistants in Monastir (Tunisia) to another population not exposed professionally. A cross-sectional study was made on 52 dentists and dental assistants working in private offices and in the stomatology unit of the Monastir teaching hospital, with a control group of 52 physicians and nurses working in the Monastir Fattouma Bourguiba hospital. The groups were paired according to age and gender. The study lasted three months. A questionnaire investigated the socioprofessional features of the study population, non professional mercury exposure, work environment, the various amalgam handling and preparation techniques, and preventive hygiene measures. Urinary and salivary sampling was performed so as to prevent any accidental mercurial contamination. Mercury level was assessed by atomic absorption spectroscopy in an automatic sampler, urine creatinine with Jaffé's colorimetric reaction. The results of mercury level assessment were expressed in microg/g of creatinine, salivary mercury in mug/l. The statistical analysis was made with the Epi.info 6 software. Khi(2) and Fisher tests were used to compare qualitative variables. The ANOVA test was used to compare averages with a statistic significance threshold at 0.05. Sixty-one percent of individuals with risk exposure worked in a dental clinic. Bruxism and onychophagia were more important in the control group with a significant statistical difference (respectively, p=0.01 and p<0.0001). The urinary and salivary mercury levels were significantly increased in the exposed group, with respective values of 20.4+/-42.4microg/g of creatinine and 10.6+/-13.02microg/l versus 0
Sayed, Abrar; Ranna, Vinisha; Padawe, Dimple; Takate, Vilas
Adapting a child to the alien settings of a dental operatory is a major challenge to the dentist. Fear of the unknown and preconceived notions of dental pain causes anxiety in the pediatric patient. This often leads to disruptive and uncooperative behavior in the dental operatory. Many methods of behavior management have been described, of which the Tell-Show-Do (TSD) is an established and time-tested technique of behavior management. To determine if a live visual output of the dental operating microscope (DOM) could be used as an adjunct to the TSD technique, to involve the child more completely in the procedure and reduce the fear of the unknown. The study was a randomized, controlled, crossover, and cross-sectional clinical trial. Data were obtained from two visits. 90 children having carious lesions on both lower first molars, in the 7-9 years age group were selected and divided randomly into two groups. Restorative procedures were performed on one tooth per visit, with visits 1 week apart. Live display of the procedure was shown to the patient using video output of the DOM displayed on a 72 inch LCD monitor, angled for best visibility of the child. Anxiety levels were evaluated using Venhams picture selection test and pulse oximetry. Student's t-test was used to compare the anxiety scores obtained from the two groups. The results showed there was a decrease in the anxiety from the first visit to the second visit. (P = 0.05 for Group A and P = 0.003 for Group B). The patients preferred the visit in which the DOM was used. The operator reported an increased patient compliance and reduced patient movement in the visits in which the DOM was used. There is a reduction in anxiety from the first visit to the second visit for restorative treatment when the DOM is used.
De Santis, Roberto; Gloria, Antonio; Maietta, Saverio; Martorelli, Massimo; De Luca, Alessandro; Spagnuolo, Gianrico; Riccitiello, Francesco; Rengo, Sandro
Over the last three decades, it has been frequently reported that the properties of dental restorative composites cured with argon laser are similar or superior to those achieved with conventional halogen and light emitting diode (LED) curing units. Whereas laser curing is not dependent on the distance between the curing unit and the material, such distance represents a drawback for conventional curing units. However, a widespread clinical application of this kind of laser remains difficult due to cost, heavy weight, and bulky size. Recently, with regard to the radiation in the blue region of the spectrum, powerful solid-state lasers have been commercialized. In the current research, CAD (computer-aided design)/CAM (computer-aided manufacturing) assisted solid-state lasers were employed for curing of different dental restorative composites consisting of micro- and nanoparticle-reinforced materials based on acrylic resins. Commercial LED curing units were used as a control. Temperature rise during the photopolymerisation process and bending properties were measured. By providing similar light energy dose, no significant difference in temperature rise was observed when the two light sources provided similar intensity. In addition, after 7 days since curing, bending properties of composites cured with laser and LED were similar. The results suggested that this kind of laser would be suitable for curing dental composites, and the curing process does not suffer from the tip-to-tooth distance. PMID:29584683
Pogrel, M A; Kaban, L B; Vargervik, K; Baumrind, S
Twelve adults with maxillary width discrepancy of greater than 5 mm were treated by surgically assisted rapid maxillary expansion. The procedure consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne orthopedic device postoperatively. Mean palatal expansion of 7.5 mm (range of 6 to 13 mm), measured in the first molar region, was achieved within 3 weeks in all patients. Expansion remained stable during the 12-month study period, with a mean relapse for the entire group of 0.88 +/- 0.48 mm. Morbidity was limited to mild postoperative discomfort. The results of this preliminary study indicated that surgically assisted rapid maxillary expansion is a safe, simple, and reliable procedure for achieving a permanent increase in skeletal maxillary width in adults. Further study is necessary to document the three-dimensional movements of the maxillary segments and long-term stability of the skeletal and dental changes.
Morris, Alvin L.
Dental health needs of the country cannot be met through education of more dentists. Rather, we must educate auxiliaries to perform many of the intraoral procedures now regarded the sole responsibility of dentists. (SB)
Wriedt, S; Kunkel, M; Zentner, A; Wahlmann, U W
This study aimed to evaluate the effect of surgically assisted rapid palatal expansion on the skeletal structures of the midface. Ten patients (mean age 28.5 years) were investigated by means of acoustic rhinometry, study model analysis and sonography before and after the procedure of surgically assisted rapid palatal expansion. The measurements revealed that surgically assisted rapid palatal expansion not only resulted in transverse expansion of the maxilla, providing dental arch space for lining up the teeth; the procedure also caused a substantial enlargement of the maxillary apical base and of the palatal vault, providing space for the tongue for correct swallowing and thus preventing relapse. There was a distinct subjective improvement in nasal breathing associated with enlargement of the nasal valve towards normal values and with an increase of nasal volume in all compartments. The measurements showed a marked influence of surgically assisted rapid palatal expansion on the skeletal structures of the midface. The significant widening can be demonstrated by non-invasive examination. Success of the osteotomy procedure can be readily monitored by sonographic examination of the expansion and the subsequent ossification, which allows individually adjusted retention periods and avoids frequent radiation exposure.
Poorterman, J H G; Dikkes, B T; Brand, H S
Many students have paid employment while studying. In the Netherlands, the Individual Health Care Professions Act (IHCP Act) allows dental hygiene students to work under certain conditions in a dental practice. The aim of the study was to determine how many dental hygiene students have part-time job employment in dental practice and which professional tasks they carry out. We also asked the dental hygiene students their opinion of the IHCP Act. All the enrolled dental hygiene students (n = 341) at a School of Health in the Netherlands received a questionnaire by email. The response was 52% (176 students). Of the responding students, 75% had paid employment in addition to their study. A proportion of the students (35%) worked in a dental practice. The median number of hours worked per week was eight. Study year, age and prior education were positively related to working part-time in dental practice. Activities frequently performed were giving oral hygiene instruction, fluoride applications, scaling and root planning, providing chair side assistance and giving local anaesthesia. Although the self-reported knowledge about the IHCP Act was high, almost half of the students expressed the need for more detailed legal information. Many dental hygiene students work in a dental practice, taking over a number of tasks usually performed by the dentist. More information in the dental hygiene curriculum about the requirements of the IHCP Act seems desirable.
Holländer, Sebastian W; Klingen, Hans Joachim; Fritz, Marliese; Djalali, Peter; Birk, Dieter
Despite advances in instruments and techniques in laparoscopic surgery, one thing remains uncomfortable: the camera assistance. The aim of this study was to investigate the benefit of a joystick-guided camera holder (SoloAssist®, Aktormed, Barbing, Germany) for laparoscopic surgery and to compare the robotic assistance to human assistance. 1033 consecutive laparoscopic procedures were performed assisted by the SoloAssist®. Failures and aborts were documented and nine surgeons were interviewed by questionnaire regarding their experiences. In 71 of 1033 procedures, robotic assistance was aborted and the procedure was continued manually, mostly because of frequent changes of position, narrow spaces, and adverse angular degrees. One case of short circuit was reported. Emergency stop was necessary in three cases due to uncontrolled movement into the abdominal cavity. Eight of nine surgeons prefer robotic to human assistance, mostly because of a steady image and self-control. The SoloAssist® robot is a reliable system for laparoscopic procedures. Emergency shutdown was necessary in only three cases. Some minor weak spots could have been identified. Most surgeons prefer robotic assistance to human assistance. We feel that the SoloAssist® makes standard laparoscopic surgery more comfortable and further development is desirable, but it cannot fully replace a human assistant.
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Dental protector. 868.5820 Section 868.5820 Food... DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5820 Dental protector. (a) Identification. A dental protector is a device intended to protect a patient's teeth during manipulative procedures within...
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Dental protector. 868.5820 Section 868.5820 Food... DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5820 Dental protector. (a) Identification. A dental protector is a device intended to protect a patient's teeth during manipulative procedures within...
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Dental protector. 868.5820 Section 868.5820 Food... DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5820 Dental protector. (a) Identification. A dental protector is a device intended to protect a patient's teeth during manipulative procedures within...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental protector. 868.5820 Section 868.5820 Food... DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5820 Dental protector. (a) Identification. A dental protector is a device intended to protect a patient's teeth during manipulative procedures within...
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Dental protector. 868.5820 Section 868.5820 Food... DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5820 Dental protector. (a) Identification. A dental protector is a device intended to protect a patient's teeth during manipulative procedures within...
Poorterman, J H G; Dikkes, B T; Brand, H S
In the Netherlands, the Individual Health Care Professions Act (IHCP Act) allows dental students, amongst other non-qualified individuals, to work under certain conditions in a dental practice. The aim of the study was to determine how many dental students have part-time employment in dental practice and which professional tasks they carry out. We also asked the dental students their opinion about the IHCP Act. All the enrolled dental students at the Academic Centre for Dentistry Amsterdam (ACTA) in the Netherlands received a questionnaire by e-mail. Within 1 month, two reminders were sent. The response was 44% (427 students). Of the responding students, 71% had paid employment in addition to their study. Twenty-five per cent of all students worked in a dental practice, usually 8 h a week. Study year and age were positively related to working part-time in dental practice. Activities frequently performed were providing chair side assistance, giving oral hygiene instruction, fluoride applications, scaling and root planning. The self-reported knowledge about the IHCP Act was positively related to study year and working in a dental practice. Hardly any information about the requirements of the IHCP Act with regard to delegation of tasks was provided by the employer. Many Dutch dental students work in a dental practice, taking over a variety of tasks. Although the self-reported knowledge about the IHCP Act was relatively high, many dental students expressed the need for more detailed information about the legal aspects of their tasks.
Connor, Joseph P; Troendle, Karen
This article applies two well-known management and leadership models-Theory X and Theory Y, and Situational Leadership-to dental education. Theory X and Theory Y explain how assumptions may shape the behaviors of dental educators and lead to the development of "cop" and "coach" teaching styles. The Situational Leadership Model helps the educator to identify the teaching behaviors that are appropriate in a given situation to assist students as they move from beginner to advanced status. Together, these models provide a conceptual reference to assist in the understanding of the behaviors of both students and faculty and remind us to apply discretion in the education of our students. The implications of these models for assessing and enhancing the educational environment in dental school are discussed.
handpiece . Inlets to this system are required throughout the dental facility for all disciplines of patient treatment where coolant and irrigation liquids...speed air turbine dental handpiece is used and for practically all other procedures in the practice of modern dentistry. Performance and reliability...AD-AI16 653 SCHOOL OF AEROSPACE MEDICINE BROOKS AFR TX F/G 6/5 CENTRAL DENTAL EVACUATION SYSTEMS.(U) MAY 52 J M POWELL, J M YOUNG UNCLASSIFIED SAM-TR
Hach, M; Aaberg, K B; Lempert, S M; Danielsen, B
Recent legislation in Denmark has made it possible for dentists to delegate their tasks to dental hygienists. Previous studies have shown that Danish dental hygienists primarily were performing assignments within their own work field. These assignments include prophylaxis or instructing patients in oral health care. However, studies have also shown that Danish dental hygienists performed dental nurse assignments such as chair-side assistance, unit cleaning and disinfection of instruments. The objectives of this study were to investigate (i) the range of work assignments performed by Danish dental hygienists, (ii) the types of dentist tasks performed by Danish dental hygienists and (iii) job satisfaction among Danish dental hygienists. Dental hygienists graduating in 2004-2007 were invited to participate in this study. Participants answered an email-distributed questionnaire. The questionnaire consisted of questions regarding job satisfaction, assignments performed, postgraduate course attendance, receiving assistance from a dental nurse and which work assignments Danish dental hygienists wish to perform in the future. The results of this study showed that 90% of Danish dental hygienists were satisfied with their job and 52% were performing dentists' tasks. Among dentists' tasks performed by Danish dental hygienists, invasive caries therapy was the most frequently performed task. The type of assignments performed by Danish dental hygienists today appears to be changing compared to previous studies. From initially performing prophylaxis and chair-side assistance for the dentist, Danish dental hygienists today are performing a wider range of tasks which includes dentists' tasks. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
El Batawi, H Y
Dental rehabilitation under general anaesthesia is gaining more popularity among parents as a result of increasing safety margins of new anaesthetic drugs and the adoption of strict policies and procedures that target patient safety and comfort. Harmony between members of the anaesthesia team and the dental team is a must to produce full dental service with least discomfort to our child patients. To investigate the possible effect of using local analgesia (lidocaine) during general anaesthesia sessions on stabilising heart rate, respiratory rate and tidal CO2 levels during painful dental procedures. Eighty ASA class I children undergoing full dental rehabilitation under general anaesthesia were divided into two groups of 40 each. Group A had the dental procedures carried out without lidocaine local analgesia, and group B had the procedures done with lidocaine local analgesia prior to painful dental procedures. Patient monitor readings were recorded by a group-allocation blinded anaesthesia technician and the two groups were compared statistically. Group A showed a statistically significant increase in heart rates and respiratory rates during dentine cutting, dental extractions and pulpotomies. No significant difference was observed between the two groups for changes in CO2 end-tidal volume during cavity preparations. During dental extractions and pulpotomies, Group A showed significantly lower carbon dioxide end-tidal volume. Use of local analgesia prior to performing pain-provoking dental procedures under general anaesthesia seems to help patient's homeostasis and stabilises vital signs. This may help in providing a safer anaesthesia environment for medically compromised children undergoing the same procedures under general anaesthesia.
Edmunds, L M; Rawlinson, A
Blood contamination of 16 surfaces in the dental surgery was investigated using the Kastle-Meyer test for haemoglobin, after three types of periodontal procedures had been performed on a total of 30 patients. The effect of cleaning surfaces contaminated by blood was investigated using the same test. Cleaning materials used in the dental surgery were tested to rule out the possibility of false positive outcomes and the sensitivity of the test was determined prior to the study. The results show a marked variation in the degree of contamination and efficacy of cleaning following treatment. Overall, root planing was associated with the most widespread and frequent blood contamination and gingival surgery the least. The surgery work surface, edge of the spittoon, aspirator tube and ultrasonic scaler handpiece into which the ultrasonic insert fits, were the most frequently contaminated surfaces. The work surface, dentist's pen, light switch and handle were cleaned most effectively. The least effectively cleaned surfaces were the water dispenser switch, aspirator tube, bracket table and ultrasonic scaler handpiece. Methods for reducing this potential source of cross-infection are discussed.
X-Ray Equipment and Protective Devices of Dental Assistant Programs in Pennsylvania Vocational Technical Schools. Vocational-Technical Education Research Report, Health Occupations, Monograph No. 7, Vol. 16, No. 1.
Hominsky, Dolores J.; Hole, F. Marvin
Objectives of a Pennsylvania study were (1) to investigate the ways in which the vocational technical schools of the state have met the recommendations of the Pennsylvania Department of Environmental Resources for classroom structural design and dental x-ray machines in dental assistant training programs and (2) to collect data on the methods by…
Hu, Jian; Yu, Hao; Shao, Jun; Li, Zhiyong; Wang, Jiawei; Wang, Yining
Background: Computer-assisted tools are rarely adopted for dental education in China. In China, 3D digital technology, such as Virtual Reality Systems, are often rejected in the dental field due to prohibitive pricing. There is also a reluctance to move away from traditional patterns of dental education. Objective: The current study is one of a…
Rey, Rosalia; Nimmo, Susan; Childs, Gail S; Behar-Horenstein, Linda S
Dental clinicians have an expanding range of biomaterial choices for restoring tooth structure. Scientific developments in cariology, advances in dental biomaterials, and patients' esthetic concerns have led to a reduction in amalgam restorations and an increase in composite restorations. The aim of this study was to compare teaching time with students' clinical procedures in amalgam and composite posterior restorations in dental schools across the United States. Academic deans in 60 schools were invited to complete a survey that asked for the amount of instructional time for amalgam and composite posterior restorations and the number of clinical restorations performed by their Classes of 2009, 2010, and 2011. Of these 60, 12 returned surveys with complete data, for a 20% response rate. Responses from these schools showed little change in lecture and preclinical laboratory instruction from 2009 to 2011. There was a slight increase in two-surface restorations for both amalgam and composites; however, the total number of reported composite and amalgam restorations remained the same. Of 204,864 restorations reported, 53% were composite, and 47% were amalgam. There were twice as many multisurface large or complex amalgam restorations as composites. One-surface composite restorations exceeded amalgams. Among the participating schools, there was little to no change between curriculum time and clinical procedures. Findings from this preliminary study reflect a modest increase in two-surface resin-based restorations placed by dental students from 2009 to 2011 and little change in curricular time devoted to teaching amalgam restorations. The total number of posterior composite restorations placed by students in these schools was slightly higher than amalgams.
Armfield, Jason M; Ketting, Manon
It has been proposed that avoidance of dental visits might be the main determinant of poor oral health outcomes in people with high dental anxiety (HDA). This study aimed to determine the predictors of dental avoidance among people with HDA and also whether these predictors differed from those found in people with lower dental anxiety (LDA). Study participants (n = 596; response rate = 41.1%) comprised a random cross-sectional sample of the Australian adult population who completed a mailed self-complete questionnaire containing items relating to the use and accessibility of dental services, trust in dental professionals, dental anxiety, dental experiences, self-perceived oral health, vulnerability-related perceptions of visiting the dentist, and psychological health. Multiple imputation was used to replace missing values and statistically significant variables in bivariate analyses were entered into a multivariable logistic generalized linear model. More than two-thirds of participants with HDA were currently avoiding or delaying a dental visit. Among people with HDA, dental avoidance was independently and significantly predicted by difficulty paying a $300 dental bill, having no or only little trust in the last-visited dentist, perceived treatment need and dental anxiety. Among people with LDA, only perceived treatment need and dental anxiety predicted avoidance. In addition to their high anxiety, a number of additional barriers to dental visiting were found for people with HDA. These barriers, especially cost and communication issues with dentists, need to be addressed to assist people with HDA obtain necessary, regular dental care. (c) 2015 APA, all rights reserved).
Hadizadeh-Talasaz, Fatemeh; Roudsari, Robab Latifnejad; Simbar, Masoumeh
Controversy surrounding disclosure among the recipients of assisted reproductive donation procedures is escalating worldwide, but little research has been conducted in this topic. The purpose of this qualitative study was to explore the experiences of infertile couples undergoing assisted reproductive donation procedures. In this exploratory qualitative study, 32 patients (nine couples and 14 women) who were candidates to use donor eggs, donor embryos or surrogacy, and 5 members of infertility treatment team including gynaecologists, midwives and psychologist (total 37) were purposively selected from the Montaserieh Infertility Research Centre at Mashhad, Iran in 2012 and interviewed using a semi-structured in-depth method. Data were analysed using conventional qualitative content analysis with MAXqda software. One overarching theme, entitled 'experiencing uncertainty surrounding the disclosure to others' was identified from the data. This theme contained two subthemes including 'Couples' decisions to not disclose to others' and 'Couples' decisions to disclose to others'. Five categories formed the first subtheme, and the second subtheme emerged from four categories which are discussed in this paper. The main reason for secrecy was concern over societal negative views about assisted reproductive donation procedures. This worry deprived the couples from support from family and friends and as a result requires them to tolerate psychological pressure when using such procedures.
Eshghi, Alireza; Mohammadpour, Mehrnaz; Kaviani, Nasser; Tahririan, Dana; Akhlaghi, Najmeh
Background: Proper analgesic agents should be used in combination with sedative agents. Remifentanil is a synthetic narcotic/analgesic agent with a short duration effect and decreases the risk of apnea during recovery. Bispectral index system (BIS) is a new noninvasive technique for the evaluation of the depth of sedation. The aim of present clinical trial was to evaluate and compare the efficacy of intravenous sedation with propofol/midazolam/remifentanil (PMR) in comparison to propofol/midazolam/ketamine (PMK) for dental procedures in children 3-7 years of age. Materials and Methods: In this clinical trial, 32 healthy uncooperative children who were candidates for dental treatments under sedation were randomly divided into two groups. Intravenous sedation was induced with PMR in one group and with PMK in the other group. After injection and during procedure BIS index, heart rate and respiratory rate, blood pressure, and oxygen saturation was evaluated every 5 min. After the procedure, recovery time was measured. Data were analyzed with ANOVA, Friedman, Wilcoxon, and t-test. Results: The BIS value was significantly low in ketamin group (P = 0.003) but respiratory rates and heart rates were same in both groups with no statistical difference (P = 0.884, P = 0.775). The recovery time was significantly shorter in remifentanil group (P = 0.008 and P = 0.003). Conclusion: It can be concluded that intravenous sedation technique with PMR combination induces effective and safe sedation, with less pain and more forgetfulness and a shorter recovery time for children 3-7 years of age during dental procedures. PMID:26962308
... service representative, existing landowner management plans such as Tree Farm management plans, Forest... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Cost-share assistance application and payment procedures. 230.42 Section 230.42 Parks, Forests, and Public Property FOREST SERVICE...
... service representative, existing landowner management plans such as Tree Farm management plans, Forest... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Cost-share assistance application and payment procedures. 230.42 Section 230.42 Parks, Forests, and Public Property FOREST SERVICE...
... service representative, existing landowner management plans such as Tree Farm management plans, Forest... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Cost-share assistance application and payment procedures. 230.42 Section 230.42 Parks, Forests, and Public Property FOREST SERVICE...
... service representative, existing landowner management plans such as Tree Farm management plans, Forest... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Cost-share assistance application and payment procedures. 230.42 Section 230.42 Parks, Forests, and Public Property FOREST SERVICE...
Manguno, Christine; Murray, Peter E; Howard, Cameron; Madras, Jonathan; Mangan, Stephen; Namerow, Kenneth N
The objective was to survey a group of dental residents regarding their expectations for using regenerative endodontic procedures as part of future dental treatments. After institutional review board approval, the opinions of 32 dentists who were having postgraduate residency training to become specialists in a dental school were surveyed. The survey had 40 questions about professional status, ethical beliefs, judgment, and clinical practice. It was found that 83.9% of dentists had no continuing education or training in stem cells or regenerative endodontic procedures. Results showed that 96.8% of dentists are willing to receive training to be able to provide regenerative endodontic procedures for their patients. Of the total group, 49.1% of dentists already use membranes, scaffolds, or bioactive materials to provide dental treatment. It was determined that 47.3% of dentists agree that the costs of regenerative procedures should be comparable with current treatments. It was also found that 55.1% of dentists were unsure whether regenerative procedures would be successful. Dentists are supportive of using regenerative endodontic procedures in their dental practice, and they are willing to undergo extra training and to buy new technology to provide new procedures. Nevertheless, dentists also need more evidence for the effectiveness and safety of regenerative treatments before they will be recommended for most patients. Copyright © 2012. Published by Elsevier Inc.
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN99 VA Dental Insurance Program AGENCY... its regulations to establish rules and procedures for the VA Dental Insurance Program (VADIP), a pilot program that offers premium-based dental insurance to enrolled veterans and certain survivors and...
Goble, J. C.
The integration of the Lixiscope into dental procedures was studied and compared with conventional dental radiographic techniques. It was found that through the use of intraoral sealed sources in conjunction with microchannel plate technology, the Lixiscope gives increased diagnostic information with decreased radiation dosage.
Aselmann, H; Egberts, J-H; Hinz, S; Jünemann, K-P; Becker, T
The surgical treatment of pancreatic head tumours is one of the most complex procedures in general surgery. In contrast to colorectal surgery, minimally-invasive techniques are not very commonly applied in pancreatic surgery. Both the delicate dissection along peri- and retropancreatic vessels and the extrahepatic bile ducts and subsequent reconstruction are very demanding with rigid standard laparoscopic instruments. The 4-arm robotic surgery system with angled instruments, unidirectional movement of instruments with adjustable transmission, tremor elimination and a stable, surgeon-controlled 3D-HD view is a promising platform to overcome the limitations of standard laparoscopic surgery regarding precise dissection and reconstruction in pancreatic surgery. Pancreatic head resection for mixed-type IPMN of the pancreatic head. Robot-assisted, minimally-invasive pylorus-preserving pancreaticoduodenectomy (Kausch-Whipple procedure). The robotic approach is particularly suited for complex procedures such as pylorus-preserving pancreatic head resections. The fully robotic Kausch-Whipple procedure is technically feasible and safe. The advantages of the robotic system are apparent in the delicate dissection near vascular structures, in lymph node dissection, the precise dissection of the uncinate process and, especially, bile duct and pancreatic anastomosis. Georg Thieme Verlag KG Stuttgart · New York.
... (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.84 Procedures for... operational direction to State or local law enforcement officers assisting in a Federal response pursuant to... local law enforcement officers to exercise Federal immigration enforcement authority under the...
... (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.84 Procedures for... operational direction to State or local law enforcement officers assisting in a Federal response pursuant to... local law enforcement officers to exercise Federal immigration enforcement authority under the...
... (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.84 Procedures for... operational direction to State or local law enforcement officers assisting in a Federal response pursuant to... local law enforcement officers to exercise Federal immigration enforcement authority under the...
Young, John; Gosbee, John; Billica, Roger
The objectives were to test the effectiveness of the Health Maintenance Facility (HMF) dental suction/particle containment system, which controls fluids and debris generated during simulated dental treatment, in microgravity; to test the effectiveness of fiber optic intraoral lighting systems in microgravity, while simulating dental treatment; and to evaluate the operation and function of off-the-shelf dental handheld instruments, namely a portable dental hand drill and temporary filling material, in microgravity. A description of test procedures, including test set-up, flight equipment, and the data acquisition system, is given.
White, Joel M.; Kalenderian, Elsbeth; Stark, Paul C.; Ramoni, Rachel L.; Vaderhobli, Ram; Walji, Muhammad F.
Standardized treatment procedure codes and terms are routinely used in dentistry. Utilization of a diagnostic terminology is common in medicine, but there is not a satisfactory or commonly standardized dental diagnostic terminology available at this time. Recent advances in dental informatics have provided an opportunity for inclusion of diagnostic codes and terms as part of treatment planning and documentation in the patient treatment history. This article reports the results of the use of a diagnostic coding system in a large dental school’s predoctoral clinical practice. A list of diagnostic codes and terms, called Z codes, was developed by dental faculty members. The diagnostic codes and terms were implemented into an electronic health record (EHR) for use in a predoctoral dental clinic. The utilization of diagnostic terms was quantified. The validity of Z code entry was evaluated by comparing the diagnostic term entered to the procedure performed, where valid diagnosis-procedure associations were determined by consensus among three calibrated academically based dentists. A total of 115,004 dental procedures were entered into the EHR during the year sampled. Of those, 43,053 were excluded from this analysis because they represent diagnosis or other procedures unrelated to treatments. Among the 71,951 treatment procedures, 27,973 had diagnoses assigned to them with an overall utilization of 38.9 percent. Of the 147 available Z codes, ninety-three were used (63.3 percent). There were 335 unique procedures provided and 2,127 procedure/diagnosis pairs captured in the EHR. Overall, 76.7 percent of the diagnoses entered were valid. We conclude that dental diagnostic terminology can be incorporated within an electronic health record and utilized in an academic clinical environment. Challenges remain in the development of terms and implementation and ease of use that, if resolved, would improve the utilization. PMID:21546594
Silberman, P; Wicker, D A; Smith, S H; DeFriese, G H
Following publication of the Task Force's recommendations for improving dental care access among low-income populations, North Carolina has taken several steps forward. The Division of Medical Assistance and the NC Dental Society are forming an advisory committee (comprising Medicaid patients, providers, and representatives from all elements of organized dentistry in the state) to review dental coverage and reimbursement rates. Using existing state funds, the NC Office of Research, Demonstrations and Rural Health Development has recruited 15 additional dentists and 1 dental hygienist to practice in community facilities serving low-income and uninsured patients. In 1999, the NC General Assembly revised the NC Dental Practice Act. Now, under the general direction of a licensed public health dentist, specially trained public health dental hygienists can perform oral health screenings and preventive and educational services outside the public school setting. The NC Institute of Medicine has begun exploring how to use dental hygienists to expand preventive dental services to underserved populations in federally-funded community or migrant health centers, state-funded health clinics, and the not-for-profit clinics that serve predominantly Medicaid, low-income or uninsured populations. A report is to be sent to the Governor and the Joint Legislative Commission on Governmental Operations no later than May 1, 2000. In 1999, the General Assembly directed the NC State Board of Dental Examiners to establish a procedure for streamlined licensing of dentists and dental hygienists who have been practicing in other states. This should increase the number of qualified dental practitioners in the state. The proposed rules governing the new licensing pathway are to be prepared by May 15, 2000. The Board of Dental Examiners will determine which new procedures will be needed to allow less burdensome and more timely entry of qualified out-of-state licensed applicants, while still
Witte, K., E-mail: firstname.lastname@example.org; Bodnar, W.; Schell, N.
A functional gradient material with eleven layers composed of a dental ceramics and titanium was successfully consolidated using field assisted sintering technique in a two-step sintering process. High energy X-ray diffraction studies on the gradient were performed at High Energy Material Science beamline at Desy in Hamburg. Phase composition, crystal unit edges and lattice mismatch along the gradient were determined applying Rietveld refinement procedure. Phase analysis revealed that the main crystalline phase present in the gradient is α-Ti. Crystallinity increases stepwisely along the gradient with a decreasing increment between every next layer, following rather the weight fraction of titanium. Themore » crystal unit edge a of titanium remains approximately constant with a value of 2.9686(1) Å, while c is reduced with increasing amount of titanium. In the layer with pure titanium the crystal unit edge c is constant with a value of 4.7174(2) Å. The lattice mismatch leading to an internal stress was calculated over the whole gradient. It was found that the maximal internal stress in titanium embedded in the studied gradient is significantly smaller than its yield strength, which implies that the structure of titanium along the whole gradient is mechanically stable. - Highlights: • High energy XRD studies of dental ceramics–Ti gradient material consolidated by FAST. • Phase composition, crystallinity and lattice parameters are determined. • Crystallinity increases stepwisely along the gradient following weight fraction of Ti. • Lattice mismatch leading to internal stress is calculated over the whole gradient. • Internal stress in α-Ti embedded in the gradient is smaller than its yield strength.« less
Reddy, S S; Rakesh, N; Chauhan, Pallavi; Clint, Joseph Ben; Sharma, Shivani
Today, dentists have a wide range of imaging modalities to choose from, the film based techniques, digital techniques, and the recent introduction of 3D volumetric or cone beam computed tomography (CBCT). The inherent design features of the new generation dental x-ray equipment has significantly improved over the years with no evidence of substandard x-ray units in operation. In dental facilities radiological workload is comparatively low, newer radiation equipments and accessories follow safety guidelines and employ better radiation protection measures for the patient and the operator. Dentists' knowledge and expertise in radiation protection measures is good, enabling them to carry out riskfree radiation procedures in their practice. Therefore, the present study is aimed at assessing the need for dosimeters in current dental scenario. 'Is there currently a significant risk from dental radiography to merit the use of personal dosimetery in dental practice. 'Dental health professionals (Oral radiologists) and radiographic assistants of fourteen dental colleges in Karnataka state participated in this questionnaire study. The questionnaire consisted of the following questions--the make, type, year of manufacture of radiographic machines used in their setup, number of radiographs made per day in the institution, type of receptors used, number of personnel at risk for radiation exposure, radiation protection measures used, regular monitoring by personal dosimeters, equivalent dosage readings for the past 12 months and whether the reading of thermoluminescent dosimeters (TLD) for any personnel had exceeded the recommended exposure value in the last 3 years. Dosimetry records of the radiology staff in the last three years shows doses no more than 1.50 mSv per year. The various institutions' dose (person mSv) was in the range of 3.70 mSv-3.90 mSv. Personal monitoring for Dentists can be omitted in the dental colleges since the estimated dose of oral radiologists
The author examined fad diet practices associated with oral health status and the role of the dental practitioner in addressing relevant issues. The author reviewed the literature regarding overweight and obesity in the United States to interpret issues that might arise in reviewing fad diet practices among dental patients. The author provides suggestions for assisting patients in choosing dietary and lifestyle behaviors that are based on current public health evidence in support of achieving and maintaining a healthy body weight. Dental professionals are well-positioned to guide patients toward dietary choices that support dental health and the attainment of a healthy weight associated with a decreased risk of developing chronic diseases.
Bruce, Harry W.; And Others
Intended for adaptation to local situations, the handbook was prepared to assist interested groups to determine whether a dental hygiene educational program is needed and feasible, and to supply basic guidelines for planning. The introduction deals with dental hygiene in preventive dentistry and the historical development of educational programs.…
Friedman, Jay W; Nash, David A; Mathu-Muju, Kavita R
The Virtual Dental Home is a concept of the Pacific Center for Special Care of the Arthur A. Dugoni School of Dentistry in San Francisco. It is designed to improve access to dental care for underserved populations, specifically children and institutionalized adults. This article describes the development and implementation of the Virtual Dental Home, subsequently critiquing the concept. The criteria for a dental home are not met by the program. It is the equivalent of a traditional public oral health prevention and screening program, with the additional dimension of allowing dental hygienists and assistants to place interim glass ionomer restorations in dental cavities. The critique questions the need to insert a "cloud" dentist into the process. The routine utilization of radiographs is also challenged. The VDH not only lacks the attributes of a dental home, it has not been shown to be as efficient and effective as traditional programs staffed by dental hygienists and dental therapists. The article concludes by describing how programs utilizing dental therapists could address the deficiencies of the Virtual Dental Home, effectively improving access to oral health care for underserved populations. © 2017 American Association of Public Health Dentistry.
Skaar, Daniel D; O'Connor, Heidi
This study of the Medicare Current Beneficiary Survey (MCBS) updates trends in utilization of dental services between 1998 and 2006 for community-dwelling U.S. adults of age 65 years and older. Bivariate comparisons were made between dependent variables (annual dental visits and types of dental procedures) and independent variables (age, gender, race, income, education, population density, marital status, U.S. Census Bureau regions, and self-reported health). The estimated percentage of community-dwelling Medicare beneficiaries with a dental visit for the years studied increased from 45.0% in 1998 to 46.3% in 2006. The age group of respondents who were 85 years and older had the greatest percentage increase in dental visits. Those reporting visits with preventive procedures increased from 87.8% to 91.2% whereas those reporting visits with nonpreventive procedures declined from 63.9% to 58.4%. The prevalence of dental visits continues to trend upward for this population of older adults. Increasing delivery of preventive services will likely impact the future mix of dental services as U.S. adults live longer. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.
Rekow, E.D.; Silva, N.R.F.A.; Coelho, P.G.; Zhang, Y.; Guess, P.; Thompson, V.P.
The clinical success of modern dental ceramics depends on an array of factors, ranging from initial physical properties of the material itself, to the fabrication and clinical procedures that inevitably damage these brittle materials, and the oral environment. Understanding the influence of these factors on clinical performance has engaged the dental, ceramics, and engineering communities alike. The objective of this review is to first summarize clinical, experimental, and analytic results reported in the recent literature. Additionally, it seeks to address how this new information adds insight into predictive test procedures and reveals challenges for future improvements. PMID:21224408
Welk, A; Rosin, M; Seyer, D; Splieth, C; Siemer, M; Meyer, G
Compared with its potential, computer technology use is still lacking in medical/dental education. To investigate the primary advantages of computer-assisted learning (CAL) systems in German dental education, as well as the reasons for their relatively low degree of use correlated with personal and professional profiles of respondents. A questionnaire was mailed to heads in the departments of conservative dentistry and prosthetic dentistry in all dental schools in Germany. Besides investigating the advantages and barriers to the use of computer technology, the questionnaire also contained questions regarding each respondent's gender, age, academic rank, experience in academia and computer skills. The response rate to the questionnaire was 90% (112 of 125). The results indicated a distinct discrepancy between the desire for and actual occurrence of lectures, seminars, etc. to instruct students in ways to search for and acquire knowledge, especially using computer technology. The highest-ranked advantages of CAL systems in order, as seen by respondents, were the possibilities for individual learning, increased motivation, and both objective theoretical tests and practical tests. The highest-ranked reasons for the low degree of usage of CAL systems in order were the inability to finance, followed equally by a lack of studies of CAL and poor cost-advantage ratio, and too much effort required to integrate CAL into the curriculum. Moreover, the higher the computer skills of the respondents, the more they noted insufficient quality of CAL systems (r = 0.200, P = 0.035) and content differences from their own dental faculty's expert opinions (r = 0.228, P = 0.016) as reasons for low use. The correlations of the attitudes towards CAL with the personal and professional profiles showed not only statistical significant reinforcements of, but also interesting deviations from, the average responses.
Castaldi, C. R.
Sports-related dental injuries are common but first aid is usually performed by non-dental personnel. This article describes basic procedures to be followed in order to diagnose the type and severity of the injury and to determine whether emergency treatment is required. Prevention of dental injuries is addressed. (Author/MT)
Park, Shin-Young; Kim, Kyoung-Hwa; Shin, Seung-Yun; Koo, Ki-Tae; Lee, Yong-Moo; Chung, Chong-Pyoung; Seol, Yang-Jo
This study evaluated decontamination methods using a dental water jet and dental floss on microthreaded implants for regenerative periimplantitis therapy. In 6 beagle dogs, experimental periimplantitis was induced, and decontamination procedures, including manual saline irrigation (control group), saline irrigation using a dental water jet (group 1) and saline irrigation using a dental water jet with dental flossing (group 2), were performed. After in situ decontamination procedures, some of the implant fixtures (n = 4 per group) were retrieved for analysis by SEM, whereas other fixtures (n = 4 per group) underwent regenerative therapy. After 3 months of healing, the animals were killed. The SEM examination indicated that decontamination of the implant surfaces was the most effective in group 2, with no changes in implant surface morphology. The histological examination also revealed that group 2 achieved significantly greater amounts of newly formed bone (6.75 ± 2.19 mm; P = 0.018), reosseointegration (1.88 ± 1.79 mm; P = 0.038), and vertical bone fill (26.69 ± 18.42%; P = 0.039). Decontamination using a dental water jet and dental floss on microthreaded implants showed positive mechanical debridement effects and positive bone regeneration effects.
Forsyth, Anna R.; Seminario, Ana Lucia; Scott, JoAnna; Berg, Joel; Ivanova, Iskra; Lee, Helen
Purpose The purpose of this study was to describe the use of operating room (OR) time for pediatric dental procedures performed under general anesthesia (GA) at a regional children’s hospital over a 2-year period. Methods A cross-sectional review of a pediatric dental GA records was performed at Seattle Children’s Hospital. Data were collected for 709 0- to 21-year-old patients from January 2008 to December 2009. Demographic data, dental and anesthesia operator types, and procedures were recorded. Utilization of OR time was analyzed. Results The mean age of patients was 7.1 years (±4.2 SD), and 58% were male. Distribution by American Society of Anesthesiology (ASA) classifications were: ASA I 226 (32%); ASA II 316 (45%); ASA III 167 (24%). Cases finished earlier than the scheduled time by an average of 14 minutes (±28). Overrun time was significantly associated with: patient age (P=.01); ASA classification (P=.006); treatment type (P<.001); number of teeth treated (P<.001); and dentist operator type (P=.005). Conclusions Overall, 73% of dental procedures under GA finished early or on time. Significant variables included patient age, medical status, treatment type and extent, and dentist operator type. Assessing factors that impact the time needed in GA may enhance efficiency for pediatric dental procedures. PMID:23211897
..., and Statistics Procedures Relating to the Implementation of the National Environmental Policy Act D... Assistance, Research, and Statistics Procedures Relating to the Implementation of the National Environmental... Statistics (OJARS) assists State and local units of government in strengthening and improving law enforcement...
..., and Statistics Procedures Relating to the Implementation of the National Environmental Policy Act D... Assistance, Research, and Statistics Procedures Relating to the Implementation of the National Environmental... Statistics (OJARS) assists State and local units of government in strengthening and improving law enforcement...
Smith, A; Creanor, S; Hurrell, D; Bagg, J; McCowan, M
This was an observational study in which the management policies and procedures associated with infection control and instrument decontamination were examined in 179 dental surgeries by a team of trained surveyors. Information relating to the management of a wide range of infection control procedures, in particular the decontamination of dental instruments, was collected by interview and by examination of practice documentation. This study found that although the majority of surgeries (70%) claimed to have a management policy on infection control, only 50% of these were documented. For infection control policies, 79% of surgeries had access to the British Dental Association Advice Sheet A12. Infection control policies were claimed to be present in 89% of surgeries, of which 62% were documented. Seventy-seven per cent of staff claimed to have received specific infection control training, but for instrument decontamination this was provided mainly by demonstration (97%) or observed practice (88%). Many dental nurses (74%) and dental practitioners (57%) did not recognise the symbol used to designate a single-use device. Audit of infection control or decontamination activities was undertaken in 11% of surgeries. The majority of surgeries have policies and procedures for the management of infection control in dental practice, but in many instances these are not documented. The training of staff in infection control and its documentation is poorly managed and consideration should be given to development of quality management systems for use in dental practice.
Höhne, S; Schumann, R R
This article describes the development and application of new didactic methods for use in computer-assisted teaching and learning systems for training doctors and dentists. Taking the Meducase project as an example, didactic models and their technological implementation are explained, together with the limitations of imparting knowledge with the "new media". In addition, legal concepts for a progressive, pragmatic, and innovative distribution of knowledge to undergraduate students are presented. In conclusion, potential and visions for the wide use of electronic learning in the German and European universities in the future are discussed. Self-directed learning (SDL) is a key component in both undergraduate education and lifelong learning for medical practitioners. E-learning can already be used to promote SDL at undergraduate level. The Meducase project uses self-directed, constructive, case- and problem-oriented learning within a learning platform for medical and dental students. In the long run, e-learning programs can only be successful in education if there is consistent analysis and implementation of value-added factors and the development and use of media-didactic concepts matched to electronic learning. The use of innovative forms of licensing - open source licenses for software and similar licenses for content - facilitates continuous, free access to these programs for all students and teachers. These legal concepts offer the possibility of innovative knowledge distribution, quality assurance and standardization across specializations, university departments, and possibly even national borders.
Gujjar, Kumar Raghav; Sharma, Ratika; Jongh, Ad De
popularity as an effective treatment for anxiety disorders. The purpose of this article is to determine the applicability of VRET in the treatment of dental phobia of two patients. Two case examples of female dental patients, aged 56 and 24 years, who met the criteria for dental phobia according to the Phobia Checklist, illustrate the use of VRET in the dental setting. VRET that is used as a psychological treatment for dental fear and dental phobia can potentially be given by a non-specialist (for example dental assistant), thereby making it a cost-effective therapy for the treatment of dental phobia. Clinical relevance: This article is the first of its kind to demonstrate Virtual Reality Exposure Therapy (VRET) in the treatment of dental anxiety.
Woofter, Dennis D; Peters, Andrew; Kvaska, Greg; Turner, Carol I; Peters, Robert J; Shaffer, Richard G; Sobocinski, Andre B
The Navy Dental Corps is responsible for ensuring the readiness of America's sailors and marines and optimizing their oral health. This article traces the history from the 1912 Act of Congress authorizing thirty "assistant dental surgeons" as the first Navy Dental Corps through service around the world. Navy dentists have seen service in every war and action in the past ninety years, reaching a peak of seven thousand officers and eleven thousand technicians in World War II. The Navy Dental Corps has served in the Korean and Vietnam Wars, Beirut, Somalia, Haiti, 9/11, Desert Storm, Desert Shield, and Operation Iraqi Freedom.
Howerton, W Bruce; Enrique, Platin R T; Ludlow, John B; Tyndall, Donald A
The purpose of this study was to compare computer-assisted instruction (CAI) with lecture format using recent hardware and software advances. A pre- and post-test was used to determine student performance and instructional preference. In addition, a post-instruction survey was used to determine student learning preferences. Seventy-five first-year University of North Carolina (UNC) dental students who were registered for the introductory radiology course were asked to participate. All agreed and were randomly placed in one of three groups: interactive CD only, interactive CD and lecture, and lecture only. The content of the multimedia instruction focused on intraoral radiography. A pre- and post-test was administered to determine if there was a significant difference between interactive CD and lecture formats, and an evaluation instrument was used to determine if there was a student learning preference between CAI and lecture format. Analysis of covariance and the sign test were used to determine significance (p<.05). There was no significant difference between pre- and post-test outcomes, indicating that similar learning took place using the interactive CD and/or lecture format. However, students preferred CAI to lecture format.
Tessitore, Adele; Vita, Maria Letizia; Cusumano, Giacomo; Congedo, Maria Teresa; Filotico, Mariella; Meacci, Elisa; Porziella, Venanzio; Margaritora, Stefano; Granone, Pierluigi
We describe the technique, the benefits and the drawbacks of an original video-assisted thymectomy (VAT), performed through an inframammary cosmetic incision and median sternotomy in myasthenia gravis (MG) patients. This procedure is clinically valuable and cosmetically satisfactory so as to be very well accepted by patients, especially by young women. Minimal-access thymectomy has become increasingly popular as surgical treatment for patients with nonthymomatous myasthenia gravis because of its comparable efficacy, safety, and lesser degree of tissue trauma with conventional open surgery. We report a review/interview of 180 MG patients treated between 1993 and 2005. According to Myasthenia Gravis Foundation of America (MGFA), complete stable remission (CSR) and pharmacologic remission (PR) were calculated at the end of a minimal period of 12 months. A clinical remission was obtained in 41.1% (CR 27.8%, PR 13.3%), who had been followed for at least 12 months from surgery. 95% of these patients judged their cosmetic results to be excellent or good. Thymectomy in MG video-assisted infra-mammary cosmetic incision has shown to be a useful surgical approach as demonstrated by the good functional and very good aesthetic results, associated with a very low morbidity and no mortality.
Kobayashi, Takashi; Miura, Kohei; Ishikawa, Hirosuke; Soma, Daiki; Zhang, Zhengkun; Ando, Takuya; Yuza, Kizuki; Hirose, Yuki; Katada, Tomohiro; Takizawa, Kazuyasu; Nagahashi, Masayuki; Sakata, Jun; Kameyama, Hitoshi; Wakai, Toshifumi
Laparoscopic surgery for patients with portal hypertension is considered to be contraindicated because of the high risk of massive intraoperative hemorrhaging. However, recent reports have shown hand-assisted laparoscopic surgery for devascularization and splenectomy to be a safe and effective method of treating esophagogastric varices with portal hypertension. The aim of this study is to evaluate the efficacy of hand-assisted laparoscopic devascularization and splenectomy (HALS Hassab's procedure) for the treatment of esophagogastric varices with portal hypertension. From 2009 to 2016, seven patients with esophagogastric varices with portal hypertension were treated with hand-assisted laparoscopic devascularization and splenectomy in our institute. Four men and three women with a median age of 61 years (range 35-71) were enrolled in this series. We retrospectively reviewed the medical records for the perioperative variables, postoperative mortality and morbidity, and postoperative outcomes of esophagogastric varices. The median operative time was 455 (range 310-671) min. The median intraoperative blood loss was 695 (range 15-2395) ml. The median weight of removed spleen was 507 (range 242-1835) g. The conversion rate to open surgery was 0%. The median postoperative hospital stay was 21 (range 13-81) days. During a median 21 (range 3-43) months of follow-up, the mortality rate was 0%. Four postoperative complications (massive ascites, enteritis, intra-abdominal abscess, and intestinal ulcer) were observed in two patients. Those complications were treated successfully without re-operation. Esophagogastric varices in all patients disappeared or improved. Bleeding from esophagogastric varices was not observed during the follow-up period. Although our data are preliminary, hand-assisted laparoscopic devascularization and splenectomy proved an effective procedure for treating esophagogastric varices in patients with portal hypertension.
This manual contains information concerning the policies and procedures of the Southern Illinois University-Carbondale Dental Hygiene Clinic. The manual is presented in a question/answer format for the information and convenience of dental hygiene students in the program, and is intended to answer their questions concerning clinical policies and…
Mitsunaga, S; Iwai, T; Kitajima, H; Yajima, Y; Ohya, T; Hirota, M; Mitsudo, K; Aoki, N; Yamashita, Y; Omura, S; Tohnai, I
Cervicofacial subcutaneous emphysema is a rare complication of dental procedures. Although most cases of emphysema occur incidentally with the use of a high-speed air turbine handpiece, there have been some reports over the past decade of cases caused by dental laser treatment. Emphysema as a complication caused by the air cooling spray of a dental laser is not well known, even though dental lasers utilize compressed air just as air turbines and syringes do. In this study, we comprehensively reviewed cases of emphysema attributed to dental laser treatment that appeared in the literature between January 2001 and September 2012, and we included three such cases referred to us. Among 13 cases identified in total, nine had cervicofacial subcutaneous and mediastinal emphysema. Compared with past reviews, the incidence of mediastinal emphysema caused by dental laser treatment was higher than emphysema caused by dental procedure without dental laser use. Eight patients underwent CO2 laser treatment and two underwent Er:YAG laser treatment. Nine patients had emphysema following laser irradiation for soft tissue incision. Dentists and oral surgeons should be cognizant of the potential risk for iatrogenic emphysema caused by the air cooling spray during dental laser treatment and ensure proper usage of lasers. © 2013 Australian Dental Association.
Heaton, L.J.; Leroux, B.G.; Ruff, P.A.; Coldwell, S.E.
One in four adults reports a clinically significant fear of dental injections, leading many to avoid dental care. While systematic desensitization is the most common therapeutic method for treating specific phobias such as fear of dental injections, lack of access to trained therapists, as well as dentists’ lack of training and time in providing such a therapy, means that most fearful individuals are not able to receive the therapy needed to be able to receive necessary dental treatment. Computer Assisted Relaxation Learning (CARL) is a self-paced computerized treatment based on systematic desensitization for dental injection fear. This multicenter, block-randomized, dentist-blind, parallel-group study conducted in 8 sites in the United States compared CARL with an informational pamphlet in reducing fear of dental injections. Participants completing CARL reported significantly greater reduction in self-reported general and injection-specific dental anxiety measures compared with control individuals (p < .001). Twice as many CARL participants (35.3%) as controls (17.6%) opted to receive a dental injection after the intervention, although this was not statistically significant. CARL, therefore, led to significant changes in self-reported fear in study participants, but no significant differences in the proportion of participants having a dental injection (ClinicalTrials.gov, NCT00609648). PMID:23690352
Collado, Valérie; Faulks, Denise; Nicolas, Emmanuel; Hennequin, Martine
The use of midazolam for dental care in patients with intellectual disability is poorly documented. This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID) compared to dentally anxious patients (DA). Ninety-eight patients with ID and 44 patients with DA programmed for intravenous midazolam participated in the study over 187 and 133 sessions, respectively. Evaluation criteria were success of dental treatment, cooperation level (modified Venham scale), and occurrence of adverse effects. The mean intravenous dose administered was 8.8±4.9 mg and 9.8±4.1 mg in ID and DA sessions respectively (t-test, NS). 50% N2O/O2 was administered during cannulation in 51% of ID sessions and 61% of DA sessions (NS, Fisher exact test). Oral or rectal midazolam premedication was administered for cannulation in 31% of ID sessions and 3% of DA sessions (p<0,001, Fisher exact test). Dental treatment was successful in 9 out of 10 sessions for both groups. Minor adverse effects occurred in 16.6% and 6.8% of ID and DA sessions respectively (p = 0.01, Fisher exact test). Patients with ID were more often very disturbed during cannulation (25.4% ID vs. 3.9% DA sessions) and were less often relaxed after induction (58.9% ID vs. 90.3% DA) and during dental treatment (39.5% ID vs. 59.7% DA) (p<0.001, Fisher exact test) than patients with DA. When midazolam sedation was repeated, cooperation improved for both groups. Conscious sedation procedures using intravenous midazolam, with or without premedication and/or inhalation sedation (50% N2O/O2), were shown to be safe and effective in patients with intellectual disability when administered by dentists. PMID:23940729
... 32 National Defense 5 2011-07-01 2011-07-01 false Appeal procedures. 732.24 Section 732.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.24 Appeal procedures. When a claim for...
... 32 National Defense 5 2013-07-01 2013-07-01 false Appeal procedures. 732.24 Section 732.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.24 Appeal procedures. When a claim for...
... 32 National Defense 5 2014-07-01 2014-07-01 false Appeal procedures. 732.24 Section 732.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.24 Appeal procedures. When a claim for...
... 32 National Defense 5 2010-07-01 2010-07-01 false Appeal procedures. 732.24 Section 732.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.24 Appeal procedures. When a claim for...
... 32 National Defense 5 2012-07-01 2012-07-01 false Appeal procedures. 732.24 Section 732.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NONNAVAL MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.24 Appeal procedures. When a claim for...
Hu, Yu-Hsuan; Tsai, Aileen; Ou-Yang, Li-Wei; Chuang, Li-Chuan; Chang, Pei-Ching
General anesthesia has been widely used in pediatric dentistry in recent years. However, there remain concerns about potential postoperative dental morbidity. The goal of this study was to identify the frequency of postoperative dental morbidity and factors associated with such morbidity in children. From March 2012 to February 2013, physically and mentally healthy children receiving dental treatment under general anesthesia at the Department of Pediatric Dentistry of the Chang Gung Memorial Hospital in Taiwan were recruited. This was a prospective and observational study with different time evaluations based on structured questionnaires and interviews. Information on the patient demographics, anesthesia and dental treatment performed, and postoperative dental morbidity was collected and analyzed. Correlations between the study variables and postoperative morbidity were analyzed based on the Pearson's chi-square test. Correlations between the study variables and the scale of postoperative dental pain were analyzed using the Mann-Whitney U test. Fifty-six pediatric patients participated in this study, with an average age of 3.34 ± 1.66 years (ranging from 1 to 8 years). Eighty-two percent of study participants reported postoperative dental pain, and 23% experienced postoperative dental bleeding. Both dental pain and bleeding subsided 3 days after the surgery. Dental pain was significantly associated with the total number of teeth treated, while dental bleeding, with the presence of teeth extracted. Patients' gender, age, preoperative dental pain, ASA classification, anesthesia time, and duration of the operation were not associated with postoperative dental morbidity. Dental pain was a more common postoperative dental morbidity than bleeding. The periods when parents reported more pain in their children were the day of the operation (immediately after the procedure) followed by 1 day and 3 days after the treatment.
... wheelchairs, other mobility aids, and other assistive devices must be stowed in the cargo compartment? 382.125... Wheelchairs, Other Mobility Aids, and Other Assistive Devices § 382.125 What procedures do carriers follow when wheelchairs, other mobility aids, and other assistive devices must be stowed in the cargo...
... wheelchairs, other mobility aids, and other assistive devices must be stowed in the cargo compartment? 382.125... Wheelchairs, Other Mobility Aids, and Other Assistive Devices § 382.125 What procedures do carriers follow when wheelchairs, other mobility aids, and other assistive devices must be stowed in the cargo...
... wheelchairs, other mobility aids, and other assistive devices must be stowed in the cargo compartment? 382.125... Wheelchairs, Other Mobility Aids, and Other Assistive Devices § 382.125 What procedures do carriers follow when wheelchairs, other mobility aids, and other assistive devices must be stowed in the cargo...
Hellstern, F; Geibel, M-A
To evaluate the implementation of quality assurance requirements for digital dental radiography in routine clinical practice. The results should be discussed by radiation protection authorities in the context of the relevant legal requirements and current debates on radiation protection. Two hundred digital dental radiographs were randomly selected from the digital database of the Department of Dentistry's Dental and Maxillofacial Surgery Clinic, Ulm University, and evaluated for various aspects of image quality and compliance with radiographic documentation requirements. The dental films were prepared by different radiology assistants (RAs) using one of two digital intraoral radiographic systems: Sirona Heliodent DS, 60 kV, focal spot size: 0.7 mm (group A) or KaVo Gendex 765 DC, 65 kV, focal spot size: 0.4 mm (group B). Radiographic justification was documented in 70.5% of cases, and the radiographic findings in 76.5%. Both variables were documented in the patient records as well as in the software in 14% of cases. Clinical documentation of the required information (name of the responsible dentist and radiology assistant, date, patient name, department, tube voltage, tube current, exposure time, type of radiograph, film size, department and serial number of the dental radiograph) was 100% complete in all cases. Moreover, the department certified according to DIN ISO 9001:2008 specifications demonstrated complete clinical documentation of radiographic justifications and radiographic findings. The entire dentition was visible on 83% of the digital films. The visible area corresponded to the target region on 85.7% of the digital dental radiographs. Seven to 8.5% of the images were classified as "hypometric" or "hypermetric". This study indicates that improvements in radiology training and continuing education fordentists and dental staff performing x-ray examinations are needed to ensure consistent high quality of digital dental radiography. Implementation of
Farivar, Behzad S; Flannagan, Molly; Leitman, I Michael
With the continued expansion of robotically assisted procedures, general surgery residents continue to receive more exposure to this new technology as part of their training. There are currently no guidelines or standardized training requirements for robot-assisted procedures during general surgical residency. The aim of this study was to assess the effect of this new technology on general surgery training from the residents' perspective. An anonymous, national, web-based survey was conducted on residents enrolled in general surgery training in 2013. The survey was sent to 240 Accreditation Council for Graduate Medical Education-approved general surgery training programs. Overall, 64% of the responding residents were men and had an average age of 29 years. Half of the responses were from postgraduate year 1 (PGY1) and PGY2 residents, and the remainder was from the PGY3 level and above. Overall, 50% of the responses were from university training programs, 32% from university-affiliated programs, and 18% from community-based programs. More than 96% of residents noted the availability of the surgical robot system at their training institution. Overall, 63% of residents indicated that they had participated in robotic surgical cases. Most responded that they had assisted in 10 or fewer robotic cases with the most frequent activities being assisting with robotic trocar placement and docking and undocking the robot. Only 18% reported experience with operating the robotic console. More senior residents (PGY3 and above) were involved in robotic cases compared with junior residents (78% vs 48%, p < 0.001). Overall, 60% of residents indicated that they received no prior education or training before their first robotic case. Approximately 64% of residents reported that formal training in robotic surgery was important in residency training and 46% of residents indicated that robotic-assisted cases interfered with resident learning. Only 11% felt that robotic-assisted cases
Lang, Andreja; Ovsenik, Maja; Verdenik, Ivan; Remškar, Maja; Oblak, Čedomir
During material treatment in dentistry particles of different size are released in the air. To examine the degree of particle exposure, air scanning to dental employees was performed by the Scanning Mobility Particle Sizer. The size, shape and chemical composition of particles collected with a low-pressure impactor were determined by scanning electronic microscopy and X-ray dispersive analysis. The average concentrations of nanoparticles during working periods in a clean dental laboratory (45,000-56,000 particles/cm 3 ), in an unclean dental laboratory (28,000-74,000 particles/cm 3 ), and in a dental office (21,000-50,000 particles/cm 3 ), were significantly higher compared to average concentrations during nonworking periods in the clean dental laboratory (11,000-24,000 particles/cm 3 ), unclean laboratory (14,000-40,000 particles/cm 3 ), and dental office (13,000-26,000 particles/cm 3 ). Peak concentration of nanoparticles in work-intensive periods were found significantly higher (up to 773,000 particles/cm 3 ), compared to the non-working periods (147,000 particles/cm 3 ) and work-less intensive periods (365,000 particles/cm 3 ). The highest mass concentration value ranged from 0.055-0.166 mg/m 3 . X-ray dispersive analysis confirmed the presence of carbon, potassium, oxygen, iron, aluminum, zinc, silicon, and phosphorus as integral elements of dental restorative materials in form of nanoparticle clusters, all smaller than 100 nm. We concluded that dental employees are exposed to nanoparticles in their working environment and are therefore potentially at risk for certain respiratory and systematic diseases.
Irvin, Donald E.; Galey, Stephen B.
This manual represents an attempt to develop a model and procedures for implementing career planning and placement assistance services in Minnesota high schools. The procedures described were developed for and tested in four participating high schools of different sizes, administrative structures, and geographic locations. Divided into seven…
van der Stelt, P F
The first computer applications in the dental office were based upon standard accountancy procedures. Recently, more and more computer applications have become available to meet the specific requirements of dental practice. This implies not only business procedures, but also facilities to store patient records in the system and retrieve them easily. Another development concerns the automatic calculation of diagnostic data such as those provided in cephalometric analysis. Furthermore, growth and surgical results in the craniofacial area can be predicted by computerized extrapolation. Computers have been useful in obtaining the patient's anamnestic data objectively and for the making of decisions based on such data. Computer-aided instruction systems have been developed for undergraduate students to bridge the gap between textbook and patient interaction without the risks inherent in the latter. Radiology will undergo substantial changes as a result of the application of electronic imaging devices instead of the conventional radiographic films. Computer-assisted electronic imaging will enable image processing, image enhancement, pattern recognition and data transmission for consultation and storage purposes. Image processing techniques will increase image quality whilst still allowing low-dose systems. Standardization of software and system configuration and the development of 'user friendly' programs is the major concern for the near future.
National Association of Dental Labs., Inc., Washington, DC.
The dental technician performs completely one or more specialized areas of the dental laboratory procedures required in the creation of a dental appliance. Policies of the 8000 hour apprenticeship program are explained in terms of qualifications, apprenticeship terms and agreement, ratio of apprentices to technicians, probationary period, credit…
Yavner, S B
The success of any dental practice depends, among other factors, on the critical role of staff employees. In order to encourage desired staff behaviors, incentive systems can be designed for employee dentists, assistants/hygienists and managers. A survey of dental franchises was conducted in 1987 for the purpose of examining their incentive control systems. The specific incentives employed by these dental franchises for their employees are analyzed. The implications of these incentive systems used by dental franchise organizations for all dental practices are then discussed.
Taghavi, Sharven; Jayarajan, Senthil N; Ambur, Vishnu; Mangi, Abeel A; Chan, Elaine; Dauer, Elizabeth; Sjoholm, Lars O; Pathak, Abhijit; Santora, Thomas A; Goldberg, Amy J; Rappold, Joseph F
As left ventricular assist devices (LVADs) are increasingly used for patients with end-stage heart failure, the need for noncardiac surgical procedures (NCSs) in these patients will continue to rise. We examined the various types of NCS required and its outcomes in LVAD patients requiring NCS. The National Inpatient Sample Database was examined for all patients implanted with an LVAD from 2007 to 2010. Patients requiring NCS after LVAD implantation were compared to all other patients receiving an LVAD. There were 1,397 patients undergoing LVAD implantation. Of these, 298 (21.3%) required 459 NCS after LVAD implantation. There were 153 (33.3%) general surgery procedures, with abdominal/bowel procedures (n = 76, 16.6%) being most common. Thoracic (n = 141, 30.7%) and vascular (n = 140, 30.5%) procedures were also common. Patients requiring NCS developed more wound infections (9.1 vs. 4.6%, p = 0.004), greater bleeding complications (44.0 vs. 24.8%, p < 0.001) and were more likely to develop any complication (87.2 vs. 82.0%, p = 0.001). On multivariate analysis, the requirement of NCSs (odds ratio: 1.45, 95% confidence interval: 0.95-2.20, p = 0.08) was not associated with mortality. Noncardiac surgical procedures are commonly required after LVAD implantation, and the incidence of complications after NCS is high. This suggests that patients undergoing even low-risk NCS should be cared at centers with treating surgeons and LVAD specialists.
Partido, Brian B; Jones, Archie A; English, Dana L; Nguyen, Carol A; Jacks, Mary E
Dental and dental hygiene faculty members often do not provide consistent instruction in the clinical environment, especially in tasks requiring clinical judgment. From previous efforts to calibrate faculty members in calculus detection using typodonts, researchers have suggested using human subjects and emerging technology to improve consistency in clinical instruction. The purpose of this pilot study was to determine if a dental endoscopy-assisted training program would improve intra- and interrater reliability of dental hygiene faculty members in calculus detection. Training included an ODU 11/12 explorer, typodonts, and dental endoscopy. A convenience sample of six participants was recruited from the dental hygiene faculty at a California community college, and a two-group randomized experimental design was utilized. Intra- and interrater reliability was measured before and after calibration training. Pretest and posttest Kappa averages of all participants were compared using repeated measures (split-plot) ANOVA to determine the effectiveness of the calibration training on intra- and interrater reliability. The results showed that both kinds of reliability significantly improved for all participants and the training group improved significantly in interrater reliability from pretest to posttest. Calibration training was beneficial to these dental hygiene faculty members, especially those beginning with less than full agreement. This study suggests that calculus detection calibration training utilizing dental endoscopy can effectively improve interrater reliability of dental and dental hygiene clinical educators. Future studies should include human subjects, involve more participants at multiple locations, and determine whether improved rater reliability can be sustained over time.
Scannapieco, Frank A; Ho, Alex W; DiTolla, Maris; Chen, Casey; Dentino, Andrew R
To determine if the prevalence of respiratory disease among dental students and dental residents varies with their exposure to the clinical dental environment. A detailed questionnaire was administered to 817 students at 3 dental schools. The questionnaire sought information concerning demographic characteristics, school year, exposure to the dental environment and dental procedures, and history of respiratory disease. The data obtained were subjected to bivariate and multiple logistic regression analysis. Respondents reported experiencing the following respiratory conditions during the previous year: asthma (26 cases), bronchitis (11 cases), chronic lung disease (6 cases), pneumonia (5 cases) and streptococcal pharyngitis (50 cases). Bivariate statistical analyses indicated no significant associations between the prevalence of any of the respiratory conditions and year in dental school, except for asthma, for which there was a significantly higher prevalence at 1 school compared to the other 2 schools. When all cases of respiratory disease were combined as a composite variable and subjected to multivariate logistic regression analysis controlling for age, sex, race, dental school, smoking history and alcohol consumption, no statistically significant association was observed between respiratory condition and year in dental school or exposure to the dental environment as a dental patient. No association was found between the prevalence of respiratory disease and a student's year in dental school or previous exposure to the dental environment as a patient. These results suggest that exposure to the dental environment does not increase the risk for respiratory infection in healthy dental health care workers.
The Australian Defence Health Service uses a disease-risk management strategy to achieve two goals: first, to identify Australian Defence Force (ADF) members who are at high risk of developing an adverse health event, and second, to deliver intervention strategies efficiently so that maximum benefits for health within the ADF are achieved with the least cost. The present dental classification system utilized by the ADF, while an excellent dental triage tool, has been found not to be predictive of an ADF member having an adverse dental event in the following 12-month period. Clearly, there is a need for further research to establish a predictive risk-based dental classification system. This risk assessment must be sensitive enough to accurately estimate the probability that an ADF member will experience dental pain, dysfunction, or other adverse dental events within a forthcoming period, typically 12 months. Furthermore, there needs to be better epidemiological data collected in the field to assist in the research.
Pretty, Iain A; Maupomé, Gerardo
Dentists are involved in diagnosing disease in every aspect of their clinical practice. A range of tests, systems, guides and equipment--which can be generally referred to as diagnostic procedures--are available to aid in diagnostic decision making. In this era of evidence-based dentistry, and given the increasing demand for diagnostic accuracy and properly targeted health care, it is important to assess the value of such diagnostic procedures. Doing so allows dentists to weight appropriately the information these procedures supply, to purchase new equipment if it proves more reliable than existing equipment or even to discard a commonly used procedure if it is shown to be unreliable. This article, the first in a 6-part series, defines several concepts used to express the usefulness of diagnostic procedures, including reliability and validity, and describes some of their operating characteristics (statistical measures of performance), in particular, specificity and sensitivity. Subsequent articles in the series will discuss the value of diagnostic procedures used in daily dental practice and will compare today's most innovative procedures with established methods.
Er, Nilay; Alkan, Alper; Ilday, Serim; Bengu, Erman
The dental implant drilling procedure is an essential step for implant surgery, and frictional heat in bone during drilling is a key factor affecting the success of an implant. The aim of this study was to increase the dental implant drill lifetime and performance by using heat- and wear-resistant protective coatings to decrease the alveolar bone temperature caused by the dental implant drilling procedure. Commercially obtained stainless steel drills were coated with titanium aluminum nitride, diamond-like carbon, titanium boron nitride, and boron nitride coatings via magnetron-sputter deposition. Drilling was performed on bovine femoral cortical bone under the conditions mimicking clinical practice. Tests were performed under water-assisted cooling and under the conditions when no cooling was applied. Coated drill performances and durabilities were compared with those of three commonly used commercial drills with surfaces made from zirconia, black diamond. and stainless steel. Protective coatings with boron nitride, titanium boron nitride, and diamond-like carbon have significantly improved drill performance and durability. In particular, boron nitride-coated drills have performed within safe bone temperature limits for 50 drillings even when no cooling is applied. Titanium aluminium nitride coated drills did not show any improvement over commercially obtained stainless steel drills. Surface modification using heat- and wear-resistant coatings is an easy and highly effective way to improve implant drill performance and durability, which can improve the surgical procedure and the postsurgical healing period. The noteworthy success of different types of coatings is novel and likely to be applicable to various other medical systems.
Lindahl, Roy L.; Young, Wesley O.
This guide has been developed to assist administrators, providers of dental care, and others involved in carrying out the dental care provisions of the EPSDT program (Early and Periodic Screening, Diagnosis, and Treatment Program). It is intended to assist in the development of programs concerned with the unique characteristics of dental diseases…
Stuart, Jackie; Hoang, Ha; Crocombe, Len; Barnett, Tony
Collaboration between dental practitioners and non-dental primary care providers has the potential to improve oral health care for people in rural and remote communities, where access to oral health services is limited. However, there is limited research on collaboration between these professional disciplines. The purpose of this paper was to explore the relationships between dental practitioners and non-dental primary care providers from rural and remote areas of Queensland and to identify strategies that could improve collaboration between these disciplines from the perspective of dental participants. Semi-structured interviews were conducted between 2013 and 2015 with visiting, local and regional dental practitioners (n = 12) who had provided dental services to patients from eight rural and remote Queensland communities that did not have a resident dentist. Participants were purposely recruited through a snow ball sampling technique. Interview data were analysed using thematic analysis with the assistance of QSR Nvivo v.10. Four major themes emerged from the data: (1) Communication between dental practitioners and rural primary care providers; (2) Relationships between dental and primary care providers; (3) Maintenance of professional dualism; (4) Strategies to improve interprofessional relationships (with subthemes: face to face meetings; utilisation of technology; oral health training for primary care providers; and having a community based oral health contact person). Participants observed that there was a lack of communication between the dental providers who saw patients from these rural communities and the primary care providers who worked in each community. This was attributed to poor communication, the high turnover of staff and the siloed behaviours of some practitioners. Visiting dental practitioners were likely to have stronger professional relationships with hospital nursing, administrative and allied health care staff who were often long term
GRP588, N=37) E. Prosthodontic Assistants (GRP453, N=35) F. Preventive Dentistry-Operative Assistants (GRP486, N=15) G. Orthodontic Assistants (GRP477, N...basic functions. Their assistance to the dentist involved preparing materials and instruments to be used in treating the patient, performing patient pre ...Mix surgical packs or periodontal dressings Don or doff surgical caps, gowns, gloves, shoes, or covers Disassemble or assemble prophylaxis hand pieces
Reed, Michael J; Corry, Ann Marie; Liu, Ying W
The purpose of this study was to analyze data collected by the American Dental Association and the American Dental Education Association over the past two decades relating to changes in the number of women active in dental education and dental practice. The concept of a pipeline of women in dentistry was explored by analyzing predoctoral, postdoctoral, dental practice, and dental education domains for the inclusion of women. Statistical analyses show that there has been a consistent and progressive increase in the number of women in all stages of the pipeline. Over the past two decades, the number of female students attending and graduating from dental school has steadily increased. In 1984-85, 23.7 percent of all predoctoral students were women; in 2009-10, 45.1 percent were women. Similarly, in 1999, the graduating class was 35.3 percent women; in 2009, it was 46.1 percent women. In the postdoctoral domain, in 1996, 29.9 percent of all residents were women; in 2010, this had increased to 39.0 percent. In dental practice, the number of actively licensed women dentists in 1999 was 15.3 percent of the workforce; in 2010, this percentage had grown to 24.0 percent. In dental education, the number of women clinical faculty members has gradually increased from 669 in 1997-98 to 902 in 2007-08. Until 2000, there had been only two women deans and very few associate/assistant deans, with only sixteen in 1990. In 2000, major changes began with three women deans and seventy-two women associate/assistant deans. In 2009-10, there were 111 associate/assistant women deans and twelve women deans. These data show a progressive increase in the presence of women in all domains of dentistry, especially in leadership positions in dental education.
Hamedi-Sangsari, Adrien; Chinipardaz, Zahra; Carrasco, Lee
The aim of this study was to compare outcome measurements of skeletal and dental expansion with bone-borne (BB) versus tooth-borne (TB) appliances after surgically assisted rapid palatal expansion (SARPE). This study was performed to provide quantitative measurements that will help the oral surgeon and orthodontist in selecting the appliance with, on average, the greatest amount of skeletal expansion and the least amount of dental expansion. A computerized database search was performed using PubMed, EBSCO, Cochrane, Scopus, Web of Science, and Google Scholar on publications in reputable oral surgery and orthodontic journals. A systematic review and meta-analysis was completed with the predictor variable of expansion appliance (TB vs BB) and outcome measurement of expansion (in millimeters). Of 487 articles retrieved from the 6 databases, 5 articles were included, 4 with cone-beam computed tomographic (CBCT) data and 1 with non-CBCT 3-dimensional cast data. There was a significant difference in skeletal expansion (standardized mean difference [SMD], 0.92; 95% confidence interval [CI], 0.54-1.30; P < .001) in favor of BB rather than TB appliances. However, there was no significant difference in dental expansion (SMD, 0.05; 95% CI, -0.24 to 0.34; P = .03). According to the literature, to achieve more effective skeletal expansion and minimize dental expansion after SARPE, a BB appliance should be favored. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Al-Shayyab, Mohammad H; Ryalat, Soukaina; Dar-odeh, Najla; Alsoleihat, Firas
Purpose The study reported here aimed to identify current sedation practice among general dental practitioners (GDPs) and specialist dental practitioners (SDPs) in Jordan in 2010. Methods Questionnaires were sent by email to 1683 GDPs and SDPs who were working in Jordan at the time of the study. The contact details of these dental practitioners were obtained from a Jordan Dental Association list. Details on personal status, use of, and training in, conscious sedation techniques were sought by the questionnaires. Results A total of 1003 (60%) questionnaires were returned, with 748 (86.9%) GDPs and 113 (13.1%) SDPs responding. Only ten (1.3%) GDPs and 63 (55.8%) SDPs provided information on the different types of treatments related to their specialties undertaken under some form of sedation performed by specialist and/or assistant anesthetists. Approximately 0.075% of the Jordanian population received some form of sedation during the year 2010, with approximately 0.054% having been treated by oral and maxillofacial surgeons. The main reason for the majority of GDPs (55.0%) and many SDPs (40%) not to perform sedation was lack of training in this field. While some SDPs (26.0%) indicated they did not use sedation because of the inadequacy of sedative facilities. Conclusion Within the limitations of the present study, it can be concluded that the provision of conscious sedation services in general and specialist dental practices in Jordan is inconsistent and inadequate. This stresses the great need to train practitioners and dental assistants in Jordan to enable them to safely and effectively perform all forms of sedation. PMID:23700369
Al-Shayyab, Mohammad H; Ryalat, Soukaina; Dar-Odeh, Najla; Alsoleihat, Firas
The study reported here aimed to identify current sedation practice among general dental practitioners (GDPs) and specialist dental practitioners (SDPs) in Jordan in 2010. Questionnaires were sent by email to 1683 GDPs and SDPs who were working in Jordan at the time of the study. The contact details of these dental practitioners were obtained from a Jordan Dental Association list. Details on personal status, use of, and training in, conscious sedation techniques were sought by the questionnaires. A total of 1003 (60%) questionnaires were returned, with 748 (86.9%) GDPs and 113 (13.1%) SDPs responding. Only ten (1.3%) GDPs and 63 (55.8%) SDPs provided information on the different types of treatments related to their specialties undertaken under some form of sedation performed by specialist and/or assistant anesthetists. Approximately 0.075% of the Jordanian population received some form of sedation during the year 2010, with approximately 0.054% having been treated by oral and maxillofacial surgeons. The main reason for the majority of GDPs (55.0%) and many SDPs (40%) not to perform sedation was lack of training in this field. While some SDPs (26.0%) indicated they did not use sedation because of the inadequacy of sedative facilities. Within the limitations of the present study, it can be concluded that the provision of conscious sedation services in general and specialist dental practices in Jordan is inconsistent and inadequate. This stresses the great need to train practitioners and dental assistants in Jordan to enable them to safely and effectively perform all forms of sedation.
Sleeper, Joshua; Lotan, Yair
New technologies such as robotic-assisted surgery are constantly introduced clinically without a complete understanding of benefits and costs. This article will discuss general concepts of health economics and apply them to the application of robotic-assisted surgery to urologic procedures. Utilization of robotic surgery has increased dramatically in recent years. This has been most dramatic in the treatment of prostate cancer. The robot adds significant costs from acquisition, maintenance and recurrent instrument costs. These added costs, thus far, have not been associated with significant improvement in outcomes over 'pure' laparoscopy or open procedures. In order for the robot to be cost effective, there needs to be an improvement in efficacy over alternative approaches, and a decrease in costs of the robot or instrumentation. Robotic surgery has not been found to be cost effective in urology. Future studies may yet reveal indirect benefits that are not yet obvious.
NAVAL MEDICAL RESEARCH UNIT SAN ANTONIO TESTING OF DENTST AT™ AND COMPETING DENTAL MATERIALS Y OON HWANG PHD, JONATHAN STAHL DDS PHD, WAYNE M. D...LtCOL Wen Lien of the US Air Force Dental Evaluation and Consultation Service for assistance with the strength testing. 1 Reviewed and Approved by...direct dental repair materials. They are made of calcium or strontium aluminofluoro-silicate glass powder (base) combined with a water-soluble polymer
Vaderhobli, Ram M
The use of materials to rehabilitate tooth structures is constantly changing. Over the past decade, newer material processing techniques and technologies have significantly improved the dependability and predictability of dental material for clinicians. The greatest obstacle, however, is in choosing the right combination for continued success. Finding predictable approaches for successful restorative procedures has been the goal of clinical and material scientists. This article provides a broad perspective on the advances made in various classes of dental restorative materials in terms of their functionality with respect to pit and fissure sealants, glass ionomers, and dental composites. Copyright © 2011 Elsevier Inc. All rights reserved.
Leadership opportunities for dental students have opened dramatically in recent decades because of the humanistic approach to education that shares responsibility for learning between students and faculty and that values mutual respect. Technology has also had an effect because it creates instant access and global communities. This new student leadership is most apparent in the American Student Dental Association (ASDA), which recently developed a White Paper on ethics, assisted in the establishment of Student Professionalism and Ethics Clubs at schools, and is developing a policy on unsupervised dental care. Students are also demonstrating leadership in research; in dual degrees that enhance teaching and policy; and in community service and outreach.
Hernandez, Purnima; Ikkanda, Zachary
There are a limited number of studies addressing behavior management techniques and procedural modifications that dentists can use to treat people with an autism spectrum disorder (ASD). The authors conducted a search of the dental and behavioral analytic literature to identify management techniques that address problem behaviors exhibited by children with ASDs in dental and other health-related environments. Applied behavior analysis (ABA) is a science in which procedures are based on the principles of behavior through systematic experimentation. Clinicians have used ABA procedures successfully to modify socially significant behaviors of people with ASD. Basic behavior management techniques currently used in dentistry may not encourage people with cognitive and behavioral disabilities, such as ASD, to tolerate simple in-office dental procedures consistently. Instead, dental care providers often are required to use advanced behavior management techniques to complete simple in-office procedures such as prophylaxis, sealant placement and obtaining radiographs. ABA procedures can be integrated in the dental environment to manage problem behaviors often exhibited by children with an ASD. The authors found no evidence-based procedural modifications that address the behavioral characteristics and problematic behaviors of children with an ASD in a dental environment. Further research in this area should be conducted. Knowledge and in-depth understanding of behavioral principles is essential when a dentist is concerned with modifying behaviors. Using ABA procedures can help dentists manage problem behaviors effectively and systematically when performing routine dental treatment. Being knowledgeable about each patient's behavioral characteristics and the parents' level of involvement is important in the successful integration of the procedures and reduction of in-office time.
Cilingir, Altug; Geckili, Onur; Parlar, Zeynep; Gencel, Burc; Bozdag, Ergun; Temiz, Vedat
This study investigated the possible detrimental effects of steam treatment on the surface of type III dental stone, which is a common laboratory material used for the construction of removable dentures. Forty dental stone specimens were prepared and divided into four groups (A, B, C and D), and group A was used as the control group. The other groups were treated with steam from a standard distance for varying durations (30, 60 and 120 s). The duration of steam cleaning significantly increased Ra values (F = 63.150, p = 0.000). Similarly, the duration of steam application was directly correlated with the weight changes (F = 17.721, p = 0.000). A significant amount of dental stone can be removed from the surface while treating with steam. These studies demonstrated that expanded periods of steam cleaning cause weight loss and abrade the surface of type III dental stones; therefore, these devices should be used with caution during denture fabrication procedures. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.
Pebley, H C
The dental health care requirements of Navy and Marine Corps personnel exceed the treatment capabilities of the Navy Dental Corps. Through the effective training and efficient utilization of the various categories of auxiliaries, members of the naval service have all essential care completed. The staff of the Dental Technicians School has developed a task-based/self-paced curriculum for the basic dental assisting course. In the task-based curriculum instruction is limited to the psychomotor domain. Background knowledge from the cognitive domain is included only to the extent that the information is needed to perform designated tasks. There are 229 tasks in the inventory of the 12 week basic dental assisting course. These are organized into 17 instructional modules covering all aspects of chairside dental assisting. Student evaluation is based on demonstrated performance of the tasks and is graded on a pass/fail standard. The new curriculum is believed to be unique in dental auxiliary education. Because of the highly successful results in improving the quality of graduates, the positive student enthusiasm and acceptance of task-based instruction and the overall revitalization of every dimension of the basic dental assistant training program, development teams have begun to convert the other three courses of instruction conducted at the Dental Technicians School to the task-based curriculum format.
Taghizadeh, Farhan; Reiley, Carol; Mohr, Catherine; Paul, Malcolm
We are evaluating the technical feasibility of robotic-assisted laparoscopic vertical-intermediate platysmaplasty in conjunction with an open rhytidectomy. In a cadaveric study, the da Vinci Surgical System was used to access certain angles in the lower neck that are difficult for traditional short incision, short flap procedures. Ergonomics, approach, and technical challenges were noted. To date, there are no published reports of robotic-assisted neck lifts, motivating us to assess its potential in this field of plastic surgery. Standard open technique short flap rhytidectomies with concurrent experimental robotic-assisted platysmaplasties (neck lifts) were performed on six cadavers with the da Vinci Si Surgical System(®) (Intuitive Surgical, Sunnyvale, CA, USA). The surgical procedures were performed on a diverse cadaver population from June 2011 to January 2012. The procedures included (1) submental incision and laser-assisted liposuction, (2) open rhytidectomy, and (3) robotic-assisted platysmaplasty using knot-free sutures. A variety of sutures and fat extraction techniques, coupled with 0° and 30° three-dimensional endoscopes, were utilized to optimize visualization of the platysma. An unaltered da Vinci Si Surgical System with currently available instruments was easily adaptable to neck lift surgery. Mid-neck platysma exposure was excellent, tissue handling was delicate and precise, and suturing was easily performed. Robotic-assisted surgery has the potential to improve outcomes in neck lifts by offering the ability to manipulate instruments with increased freedom of movement, scaled motion, tremor reduction, and stereoscopic three-dimensional visualization in the deep neck. Future clinical studies on live human patients can better assess subject and surgeon benefits arising from the use of the da Vinci system for neck lifts. Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in
Zitzmann, Nicola U; Kovaltschuk, Irina; Lenherr, Patrik; Dedem, Philipp; Joda, Tim
The aim of this randomized controlled trial was to analyze inexperienced dental students' perceptions of the difficulty and applicability of digital and conventional implant impressions and their preferences including performance. Fifty undergraduate dental students at a dental school in Switzerland were randomly divided into two groups (2×25). Group A first took digital impressions in a standardized phantom model and then conventional impressions, while the procedures were reversed for Group B. Participants were asked to complete a VAS questionnaire (0-100) on the level of difficulty and applicability (user/patient-friendliness) of both techniques. They were asked which technique they preferred and perceived to be more efficient. A quotient of "effective scan time per software-recorded time" (TRIOS) was calculated as an objective quality indicator for intraoral optical scanning (IOS). The majority of students perceived IOS as easier than the conventional technique. Most (72%) preferred the digital approach using IOS to take the implant impression to the conventional method (12%) or had no preference (12%). Although total work was similar for males and females, the TRIOS quotient indicated that male students tended to use their time more efficiently. In this study, dental students with no clinical experience were very capable of acquiring digital tools, indicating that digital impression techniques can be included early in the dental curriculum to help them catch up with ongoing development in computer-assisted technologies used in oral rehabilitation.
MIND has finished two years of operation as a regional center for continuing dental education. The responses from viewing cards, and the number of credit hours given, indicate that approximately 20% of the potential audience participated in the course offerings. Previous experience from a two-year study in South Dakota has shown that there are three major factors that are essential for effective use of television as a dissemination medium. These are as follows: 1) the program should establish effective use of the communication system to maintain an audience; 2) the quality of thr programming material that is televised must be high; 3) the program should be televised on a regular basis to develop viewer habits or expectations. With a potential audience of 11,000 persons, MIND has had to depend heavily on a bulk-rate mailing system to communicate with members of the dental profession. This has caused problems such as reminders not being received on time, or being lost in the mail, or not being read, so that the individual is unaware that the courses are being telecast. Another problem of mailing system is maintaining an up-to-date list of addresses. The names and addresses of the dental assistants are impossible to keep up to date. We use the lists of licensed dentists and dental hygienists issued each July and a list of the certified dental assistants, which, of course, does not include all the dental assistants in our five-state area. A system providing more direct contact with the individual needs to be developed. Quality of televised courses is determined by the clinician's style of presentation as well as by the content and organization of the course material. The selection of dental information aimed toward the dentist in general practice results in loss of some members of the viewing audience, particularly specialists and generalpractitioners who have confined their practice to a particular area of dentistry. Quality is also judged by the technical aspects
Meiller, T F; Kelley, J I; Baqui, A A; DePaola, L G
Dental unit waterline biofilm has been recognized as a potential point of contamination and a risk to patients with any level of immunocompromise. Biofilm in dental unit waterlines, once established, has proven formidable to efforts in disinfection/disruption. This project compared standardized evaluation techniques by assessing the efficacy of a variety of agents that have been reported or suggested as useful in surface disinfection and/or antiseptic protocols. The zones of inhibition, minimum inhibitory/bactericidal concentrations and use-dilution with stainless steel carrier replicates tests assessed the disinfection of planktonic organisms using standardized microbial testing procedures. The disruption and/or disinfection of planktonic and biofilm organisms within naturally occurring dental unit waterlines were evaluated by culture and scanning electron microscopy. The six commercially available antimicrobial agents used to assess the techniques were bleach (sodium hypochlorite), Cavicide, glutaraldehyde, Listerine Antiseptic, Peridex and Sterilex Ultra. Comparisons between the results for each technique evaluated were determined for each product. All six agents demonstrated antimicrobial efficacy at the working concentrations designated by the manufacturers. Biofilm matrix elimination evaluated by scanning electron microscopy found virtually 0% elimination by glutaraldehyde to an estimated 90% elimination by Sterilex Ultra and bleach after one treatment. Treatment with Cavicide, Listerine Antiseptic and Peridex resulted in negligible elimination of the biofilm matrix. For comparability, the use of standardized testing techniques to evaluate a disinfection agent's efficacy against dental unit waterline contamination is essential. This project demonstrates a model system for evaluating disinfection agents potentially useful in the management of dental unit waterline biofilm, and should assist in educating the dental clinician in the appraisal of existing and
VT, Hemalatha; T, Manigandan; T, Sarumathi; Nisha V, Aarthi; A, Amudhan
Pregnancy is a dynamic physiological state which is evidenced by several transient changes. These can develop as various physical signs and symptoms that can affect the patients health, perceptions and interactions with others in the environment. The patients may not always understand the relevance of the adaptations of their bodies to the health of their foetuses. A gestational woman requires various levels of support throughout this time, such as medical monitoring or intervention, preventive care and physical and emotional assistance. The dental management of pregnant patients requires special attention. Dentists, for example, may delay certain elective procedures so that they coincide with the periods of pregnancy which are devoted to maturation versus organogenesis. At other times, the dental care professionals need to alter their normal pharmacological armamentarium to address the patients’ needs versus the foetal demands. Applying the basics of preventive dentistry at the primary level will broaden the scope of the prenatal care. Dentists should encourage all the patients of the childbearing ages to seek oral health counseling and examinations as soon as they learn that they are pregnant. This article has reviewed some of the physiologic changes and the oral pathologies which are associated with pregnancy, and how these alterations can affect the dental care of the patient. PMID:23814753
Vt, Hemalatha; T, Manigandan; T, Sarumathi; Nisha V, Aarthi; A, Amudhan
Pregnancy is a dynamic physiological state which is evidenced by several transient changes. These can develop as various physical signs and symptoms that can affect the patients health, perceptions and interactions with others in the environment. The patients may not always understand the relevance of the adaptations of their bodies to the health of their foetuses. A gestational woman requires various levels of support throughout this time, such as medical monitoring or intervention, preventive care and physical and emotional assistance. The dental management of pregnant patients requires special attention. Dentists, for example, may delay certain elective procedures so that they coincide with the periods of pregnancy which are devoted to maturation versus organogenesis. At other times, the dental care professionals need to alter their normal pharmacological armamentarium to address the patients' needs versus the foetal demands. Applying the basics of preventive dentistry at the primary level will broaden the scope of the prenatal care. Dentists should encourage all the patients of the childbearing ages to seek oral health counseling and examinations as soon as they learn that they are pregnant. This article has reviewed some of the physiologic changes and the oral pathologies which are associated with pregnancy, and how these alterations can affect the dental care of the patient.
McDermott, R E; Fuglerud, K P
The debt level of graduating dental students is increasing annually. Six of Canada's 10 dental schools responded to a survey designed to ascertain the level of student debt on entering and graduating from dental school. For the academic year 1993-94, the average starting debt for students was $2,013.89 and the average graduating debt was $25,671.30. On average, dental students accumulated more than $23,600 in debt while pursuing their dental education. Of those students who completed the survey, 57.89 per cent relied on their parents for assistance, and 76.69 per cent received student/government loans. The level of student debt was independent of age, gender and parents' income.
Behar-Horenstein, Linda S; Morris, Dustin R
A lack of curriculum time devoted to teaching dental students about the needs of lesbian, gay, bisexual, and transgendered (LGBT) health care patient needs and biases against LGBT students and faculty have been reported. Understanding dental school administrators' attitudes about LGBT students' needs might provide further insight into these long-standing issues. The aims of this study were to develop a survey to assess dental administrators' attitudes regarding the support services they believe LGBT-identified students need, to identify dental schools' current diversity inclusion policies, and to determine what types of support dental schools currently provide to LGBT students. A survey developed with the aid of a focus group, cognitive interviewing, and pilot testing was sent to 136 assistant and associate deans and deans of the 65 U.S. and Canadian dental schools. A total of 54 responses from 43 (66%) schools were received from 13 deans, 29 associate deans, and 11 assistant deans (one participant did not report a position), for a 40% response rate. The findings suggest there is a considerable lack of knowledge or acknowledgment of LGBT dental students' needs. Future studies are needed to show the importance of creating awareness about meeting the needs of all dental student groups, perhaps through awareness campaigns initiated by LGBT students.
Hernández-Alfaro, Federico; Guijarro-Martínez, Raquel
The dental community has expressed low acceptance of traditional corticotomy techniques for corticotomy-facilitated orthodontics. These procedures are time consuming, entail substantial postoperative morbidity and periodontal risks, and are often perceived as highly invasive. A total of 114 interdental sites were treated in nine consecutive patients. Under local anesthesia, a tunnel approach requiring one to three vertical incisions per arch (depending on the targeted teeth) was used. Piezosurgical corticotomies and elective bone augmentation procedures were performed under endoscopic assistance. Postoperative cone-beam computerized tomography evaluation was used to confirm adequate corticotomy depth. Procedures were completed in a mean time of 26 minutes. Follow-up evaluations revealed no loss of tooth vitality, no changes in periodontal probing depth, good preservation of the papillae, and no gingival recession. No evidence of crestal bone height reduction or apical root resorption was detected. The tunnel approach minimizes soft-tissue debridement and permits effective cortical cuts. The combination of piezosurgery technique with endoscopic assistance provides a quick, reliable means to design and perform these corticotomies while maximizing root integrity preservation. Moreover, the sites needing bone augmentation are selected under direct vision. Compared to traditional corticotomies, this procedure has manifest advantages in surgical time, technical complexity, patient morbidity, and periodontium preservation.
McCabe, C. Aberdeen E.
In a national disaster, the medical profession would lose physicians and auxiliary personnel and would need assistance. Canada's 22,000 physicians and 85,000 nurses are located for the most part in potential target areas. Survivors among Canada's 6396 dentists could supply 30% reinforcement. The dentist's training, his manual dexterity and experience acquired in the management of hemorrhage, shock, débridement, suturing, reduction and immobilization of fractures, and control of pain and infection would be valuable. Additional functions he could perform would be first-aid, including but not limited to artificial respiration, early management of chest wounds, preparation of casualties for movement, and assistance in general surgical procedures. Dentists with special training in anesthesia, oral surgery or public health could be of particular value in relieving anesthetists, surgeons, radiologists and public health officers of some of their duties. Joint training of physicians and dentists in mass casualty care could increase the efficiency of the team work in disaster and is being considered by many medical and dental faculties. PMID:6015739
Chirillo, Fabio; Faggiano, Pompilio; Cecconi, Moreno; Moreo, Antonella; Squeri, Angelo; Gaddi, Oscar; Cecchi, Enrico
Efficacy and safety of antibiotic prophylaxis (AP) for prevention of infective endocarditis (IE) in patients with predisposing cardiac condition (PCC) undergoing invasive procedures is still debated. We sought to assess the prevalence of PCC, the type of interventional procedures preceding the onset of symptoms, and the usefulness of AP in a large cohort of consecutive patients with definite IE. We examined 677 (median age 65.34 years; male 492 [73%]) consecutive patients with IE enrolled from July 2007 through 2010 into the Italian Registry of Infective Endocarditis. Predisposing cardiac condition was present in 341 patients (50%).Thirty-two patients (4.7%) underwent dental procedures. Of 20 patients with PCC undergoing dental procedure, 13 had assumed AP. Viridans group streptococci were isolated from blood cultures in 8 of 20 patients with PCC and prior dental procedure. Nondental procedures preceded IE in 139 patients (21%). They were significantly older and had more comordibities compared with patients undergoing dental procedures. Predisposing cardiac condition was identified in 91 patients. Perioperative antimicrobial prophylaxis was administered to 67 patients. Staphylococcus aureus was the most frequent causative agent. Cardiac surgery was necessary in 85 patients (20 with prior dental and 65 with nondental procedure). Surgical mortality (12% vs 0%, P = .03) and hospital mortality (23% vs 3%, P = .001) were significantly larger among patients with nondental procedures. In a large unselected cohort of patients with IE, the incidence of preceding dental procedures was minimal. The number of cases potentially preventable by means of AP was negligible. Nondental procedures were more frequent than dental procedures and were correlated with poorer prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.
Wahl, Michael J
Continuous anticoagulation therapy is used to prevent heart attacks, strokes, and other embolic complications. When patients receiving anticoagulation therapy undergo dental surgery, a decision must be made about whether to continue anticoagulation therapy and risk bleeding complications or briefly interrupt anticoagulation therapy and increase the risk of developing embolic complications. Results from decades of studies of thousands of dental patients receiving anticoagulation therapy reveal that bleeding complications requiring more than local measures for hemostasis have been rare and never fatal. However, embolic complications (some of which were fatal and others possibly permanently debilitating) sometimes have occurred in patients whose anticoagulation therapy was interrupted for dental procedures. Although there is now virtually universal consensus among national medical and dental groups and other experts that anticoagulation therapy should not be interrupted for most dental surgery, there are still some arguments made supporting anticoagulation therapy interruption. An analysis of these arguments shows them to be based on a collection of myths and half-truths rather than on logical scientific conclusions. The time has come to stop anticoagulation therapy interruption for dental procedures. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.
Zhang, Shinan; Lo, Edward C M; Chu, Chun-Hung
Medical-dental collaboration is essential for improving resource efficiency and standards of care. However, few studies have been conducted on it. This study aimed to investigate the attitude and awareness of medical and dental students about collaboration between medical and dental practices in Hong Kong. All medical and dental students in Hong Kong were invited to complete a questionnaire survey at their universities, hospitals and residential halls. It contained 8 questions designed to elicit their attitudes about the collaboration between medical and dental practice. Students were also asked about their awareness of the collaboration between dentistry and medicine. The questionnaires were directly distributed to medical and dental students. The finished questionnaires were immediately collected by research assistants on site. A total of 1,857 questionnaires were distributed and 809 (44%) were returned. Their mean attitude score (SD) towards medical-dental collaboration was 6.37 (1.44). Most students (77%) were aware of the collaboration between medical and dental practice in Hong Kong. They considered that Ear, Nose & Throat, General Surgery and Family Medicine were the 3 most common medical disciplines which entailed collaboration between medical and dental practice. In this study, the medical and dental students in general demonstrated a good attitude and awareness of the collaboration between medical and dental practice in Hong Kong. This established an essential foundation for fostering medical-dental collaboration, which is vital to improving resource efficiency and standards of care.
Tan, Peng Hui; Chew, Bertrand; Wee, Wee Chee; Tan, Bernard
In 2007, the Singapore Armed Forces deployed a Dental Project Team (DPT) to the capital city of the Bamiyan Province in Afghanistan. The team set up the province's first modern dental facility. Besides providing primary dental care to the 60,000 population there, the Singaporeans also trained and prepared a team of Afghan dentist and dental assistants. The Afghan dental team took over the dental clinic and continued to provide care when it was time for the DPT to depart for home. Braving challenging security and austere living conditions, the DPT completed its mission successfully. Copyright © 2011 Elsevier. Published by Elsevier B.V. All rights reserved.
Ní Ríordáin, R; McCreary, C
To determine the use of the Internet by patients attending a range of dental clinics to search for information regarding dental procedures, and also to investigate their interest in online dental consultations and 'dental tourism'. A questionnaire was designed and randomly distributed to 520 patients attending the restorative dentistry, dental surgery and oral medicine clinics of Cork University Dental School and Hospital. Of the 520 questionnaires distributed, 500 were completed leading to a response rate of 96.2%. The majority of patients were familiar with using the Internet on a daily basis, with only 163 (32.6%) patients not using the Internet in their everyday lives. One hundred and seventy-seven (34.5%) patients either researched their presenting dental/oral condition or had a family or friend research their condition on their behalf. One hundred and eighty-five (37%) patients would consult with a dental practitioner online regarding an oral problem and a similar number (n=186) of patients surveyed would consider using the Internet to plan trips abroad for dental treatment. Practitioner-led direction for patients regarding quality information sources online is important. With the increased interest in travelling abroad for dental treatment, guidance for patients and practitioners regarding the legal and ethical issues pertaining to dental tourism is critical.
Skylab 2 Commander Charles Conrad is seen undergoing a dental examination by the Medical Officer, Joseph Kerwin in the Skylab Medical Facility. In the absence of an examination chair, Conrad simply rotated his body to an upside down position to facilitate the procedure.
Calvasina, Paola; Muntaner, Carles; Quiñonez, Carlos
This study examines predictors of transnational dental care utilization, or the use of dental care across national borders, over a 4-year period among immigrants to Canada. Data from the Longitudinal Survey of Immigrants to Canada (LSIC, 2001-2005) were used. Sampling and bootstrap weights were applied to make the data nationally representative. Bivariate and multiple logistic regression analyses were applied to identify factors associated with immigrants' transnational dental care utilization. Approximately 13% of immigrants received dental care outside Canada over a period of 4 years. Immigrants lacking dental insurance (OR = 2.05; 95% CI: 1.55-2.70), those reporting dental problems (OR = 1.45; 95% CI: 1.12-1.88), who were female (OR = 1.59; 95% CI: 1.22-2.08), aged ≥ 50 years (OR = 2.30; 95% CI: 1.45-3.64), and who were always unemployed (OR = 1.70; 95% CI: 1.20-2.39) were more likely to report transnational dental care utilization. History of social assistance was inversely correlated with the use of dental services outside Canada (OR = 0.48; 95% CI: 0.30-0.83). It is estimated that roughly 11 500 immigrants have used dental care outside Canada over a 4-year period. Although transnational dental care utilization may serve as an individual solution for immigrants' initial barriers to accessing dental care, it demonstrates weaknesses to in-country efforts at providing publicly funded dental care to socially marginalized groups. Policy reforms should be enacted to expand dental care coverage among adult immigrants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Mahoney, G D; Coombs, M
The ability to determine dental casualty rates for the Australian Defence Force in a given situation is vital for military planners. This article reviews the literature and the available Australian Defence Force data on the subject to give some guide to planners. The review found the studies to be fairly consistent in that a well-prepared dentally fit force can expect 150 to 200 dental casualties per 1,000 soldiers per year. If the force were less prepared, as in the case of a reserve call out, this figure would be likely to increase; in the extreme case of an ill-prepared force or a force assisting in humanitarian aid, the emergency rate could be five times that figure. The literature also indicates a change in the nature of dental casualties. Although maxillofacial cases have remained steady at 25%, dental disease has decreased and endodontic cases have had a corresponding increase.
Costa Filho, Luiz Cesar da; Duncan, Bruce Bartholow; Polanczyk, Carisi Anne; Sória, Marina Lara; Habekost, Ana Paula; Costa, Carolina Covolo da
The present study evaluated the dental care plan offered to 4,000 employees of a private hospital and their respective families. The analysis covered three stages: (1) baseline (control), when dental care was provided by an outsourced company with a network of dentists paid for services, (2) a renegotiation of costs with the original dental care provider, and (3) provision of dental care by the hospital itself, through directly hired dentists on regular salaries. Monthly economic and clinical data were collected for this research. The dental plan renegotiation reduced costs by 37% in relation to baseline, and the hospital's own dental service reduced costs by 50%. Renegotiation led to a 31% reduction in clinical procedures, without altering the dental care profile; the hospital's own dental service did not reduce the total number of clinical procedures, but modified the profile of dental care, since procedures related to the causes of diseases increased and surgical/restorative procedures decreased.
Huchun, Wan; Zheng, Yang; Hongkun, Wu; Jianguo, Liu; Jin, Zhao; Xiaoping, Ji; Lin, Zhu; Deqin, Yang; Xuedong, Zhou
The number of disabled persons increases in the course of human life and in the aging population. The high prevalence, low treatment rate, long therapy period, and sophisticated procedures prevent most of disabled individuals from availing dental services. Moreover, special dental institutions for the disabled are insufficient, and a certain treatment standard is commonly not complied. This study performed analysis and evaluation, including treatment features, pretreatment procedures, patient communication, treatment factors, and treatment standards to provide a targeted solution for the special requirements of the oral therapy for disabled patients.
Demko, Catherine A; Victoroff, Kristin Zakariasen; Wotman, Stephen
The commonly used methods of chart review, billing data summaries and practitioner self-reporting have not been examined for their ability to validly and reliably represent time use and service delivery in routine dental practice. A more thorough investigation of these data sources would provide insight into the appropriateness of each approach for measuring various clinical behaviors. The aim of this study was to assess the validity of commonly used methods such as dental chart review, billing data, or practitioner self-report compared with a 'gold standard' of information derived from direct observation of routine dental visits. A team of trained dental hygienists directly observed 3751 patient visits in 120 dental practices and recorded the behaviors and procedures performed by dentists and hygienists during patient contact time. Following each visit, charts and billing records were reviewed for the performed and billed procedures. Dental providers characterized their frequency of preventive service delivery through self-administered surveys. We standardized the observation and abstraction methods to obtain optimal measures from each of the multiple data sources. Multi-rater kappa coefficients were computed to monitor standardization, while sensitivity, specificity, and kappa coefficients were calculated to compare the various data sources with direct observation. Chart audits were more sensitive than billing data for all observed procedures and demonstrated higher agreement with directly observed data. Chart and billing records were not sensitive for several prevention-related tasks (oral cancer screening and oral hygiene instruction). Provider self-reports of preventive behaviors were always over-estimated compared with direct observation. Inter-method reliability kappa coefficients for 13 procedures ranged from 0.197 to 0.952. These concordance findings suggest that strengths and weaknesses of data collection sources should be considered when investigating
We report the case of an elderly female patient who presented with dangerous space emphysema occurring after a dental procedure. This case presented a diagnostic and management dilemma because of the development of an unusual complication of dental disease. In our review of the medical literature, we were unable to find any cases with similar manifestations and clinical courses. PMID:20835314
O'Callaghan, Michael G
"Human trafficking" is a term for a modern form of slavery. It is a criminal human rights violation and a significant health issue. Dental professionals can assist in recognizing victims of trafficking. The author conducted a PubMed search of the English-language literature through May 2011, which yielded no articles meeting the search criteria "dentistry" and "human trafficking prostitution." Given these results, the author reviewed articles published in medical journals, reports from both governmental and nongovernmental agencies and lay literature. The author examines the present state of human trafficking and provides information--including specific questions to ask--to help dentists identify victims. In addition, the author suggests means of notifying authorities and assisting trafficking victims. He also examines the health care needs of these patients. Human trafficking is a global problem, with thousands of victims in the United States, including many women and children. Dentists have a responsibility to act for the benefit of others, which includes detecting signs of abuse and neglect. Dental professionals are on the front lines with respect to encountering and identifying potential victims who seek dental treatment. Dentists can combat human trafficking by becoming informed and by maintaining vigilance in their practices.
New York State Education Dept., Albany. Office of the Professions.
The laws, rules and regulations of the New York State Education Department governing dentistry and dental hygiene practice in the state are presented. In addition, the requirements and procedures for obtaining licensure and first registration as a dentist and dental hygienist in New York are discussed. The following chapters are provided: (1)…
Ali, Dena A
This study aimed to (1) measure the degree of patient satisfaction among the clinical and nonclinical dental services offered at specialty dental centers and (2) investigate the factors associated with the degree of overall satisfaction. Four hundred and ninety-seven participants from five dental centers were recruited for this study. Each participant completed a self-administered questionnaire to measure patient satisfaction with clinical and nonclinical dental services. Analysis of variance, t-tests, a general linear model, and stepwise regression analysis was applied. The respondents were generally satisfied, but internal differences were observed. The exhibited highest satisfaction with the dentists' performance, followed by the dental assistants' services, and the lowest satisfaction with the center's physical appearance and accessibility. Females, participants with less than a bachelor's degree, and younger individuals were more satisfied with the clinical and nonclinical dental services. The stepwise regression analysis revealed that the coefficient of determination (R (2)) was 40.4%. The patient satisfaction with the performance of the dentists explained 42.6% of the overall satisfaction, whereas their satisfaction with the clinical setting explained 31.5% of the overall satisfaction. Additional improvements with regard to the accessibility and physical appearance of the dental centers are needed. In addition, interventions regarding accessibility, particularly when booking an appointment, are required.
Silva, M; Hopcraft, M; Morgan, M
The poor oral health of nursing home residents is the cause of substantial morbidity and has major implications relating to health care policy. The aim of this study was to measure dental caries experience in Australians living in nursing homes, and investigate associations with resident characteristics. Clinical dental examinations were conducted on 243 residents from 19 nursing homes in Melbourne. Resident characteristics were obtained from nursing home records and interviews with residents, family and nursing home staff. Two dental examiners assessed coronal and root dental caries using standard ICDAS-II criteria. Residents were elderly, medically compromised and functionally impaired. Most required assistance with oral hygiene and professional dental care was rarely utilized. Residents had high rates of coronal and root caries, with a mean 2.8 teeth with untreated coronal caries and 5.0 root surfaces with untreated root caries. Functional impairment and irregular professional dental care were associated with higher rates of untreated tooth decay. There were no significant associations with medical conditions or the number of medications taken. Nursing home residents have high levels of untreated coronal and root caries, particularly those with high needs due to functional impairment but poor access to professional services. © 2014 Australian Dental Association.
El-Housseiny, Azza A; Alamoudi, Najlaa M; Farsi, Najat M; El Derwi, Douaa A
Dental fear has not only been linked to poor dental health in children but also persists across the lifespan, if unaddressed, and can continue to affect oral, systemic, and psychological health. The aim of this study was to assess the factor structure of the Arabic version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and to assess the difference in factor structure between boys and girls. Participants were 220 consecutive paediatric dental patients 6-12 years old seeking dental care at the Faculty of Dentistry, King Abdulaziz University, Saudi Arabia. Participants completed the 15-item Arabic version of the CFSS-DS questionnaire at the end of the visit. Internal consistency was assessed using Cronbach's alpha. Factor analysis (principal components, varimax rotation) was employed to assess the factor structure of the scale. The Cronbach's alpha was 0.86. Four factors with eigenvalues above 1.00 were identified, which collectively explained 64.45% of the variance. These factors were as follows: Factor 1, 'fear of usual dental procedures' consisted of 8 items such as 'drilling' and 'having to open the mouth', Factor 2, 'fear of health care personnel and injections' consisted of three items, Factor 3, 'fear of strangers', consisted of 2 items. Factor 4, 'fear of general medical aspects of treatment', consisted of 2 items. Notably, four factors of dental fear were found in girls, while five were found in boys. Four factors of different strength pertaining to dental fear were identified in Arabic-speaking children, indicating a simple structure. Most items loaded high on the factor related to fear of usual dental procedures. The fear-provoking aspects of dental procedures differed in boys and girls. Use of the scale may enable dentists to determine the item/s of dental treatment that a given child finds most fear-provoking and guide the child's behaviour accordingly.
Jones, Vickie E; Karydis, Anastasios; Hottel, Timothy L
Interprofessional and intraprofessional education (when students from two or more professions or within the same profession, respectively, learn about, from, and/or with each other) is crucial for effective interdisciplinary collaboration. The aims of this study were to assess the effectiveness of a clinical intraprofessional education program for dental and dental hygiene students, based on students' expectations and satisfaction with the program and patients' satisfaction with the team-based care. The pilot program was developed at the University of Tennessee Health Science Center College of Dentistry, where dental hygiene students were paired randomly with dental students scheduled for prophylaxis, scaling and root planing, or periodontal maintenance. Surveys with questions about the students' expectations and satisfaction were distributed to 89 senior dental students and 27 senior dental hygiene students before and after team-based procedures. Another survey was distributed to 17 patients asking about their satisfaction with the team-based care. All 27 dental hygiene students (100% response rate), 51 dental students (57.3% response rate), and all 17 patients (100% response rate) participated in the surveys. The results showed that both the dental and dental hygiene students had high expectations and were overall satisfied with the intraprofessional education. The students' expectations and perceived educational gap (difference between expectations and satisfaction) differed for the dental and dental hygiene students (p<0.001). The male dental students were also more satisfied than the female dental students (p<0.01). Overall, the program met or exceeded the students' expectations, and the patients were overwhelmingly satisfied with the team-based care. These results suggest that this intraprofessional practice model provided an effective educational experience for both dental and dental hygiene students and patients. The differences between the dental hygiene
Beazoglou, Tryfon; Heffley, Dennis; Lepowsky, Steven; Douglass, Joanna; Lopez, Monica; Bailit, Howard
Many poor, medically disabled and geographically isolated populations have difficulty accessing private-sector dental care and are considered underserved. To address this problem, public- and voluntary-sector organizations have established clinics and provide care to the underserved. Collectively, these clinics are known as "the dental safety net." The authors describe the dental safety net in Connecticut and examine the capacity and efficiency of this system to provide care to the noninstitutionalized underserved population of the state. The authors describe Connecticut's dental safety net in terms of dentists, allied health staff members, operatories, patient visits and patients treated per dentist per year. The authors compare the productivity of safety-net dentists with that of private practitioners. They also estimate the capacity of the safety net to treat people enrolled in Medicaid and the State Children's Health Insurance Program. The safety net is made up of dental clinics in community health centers, hospitals, the dental school and public schools. One hundred eleven dentists, 38 hygienists and 95 dental assistants staff the clinics. Safety-net dentists have fewer patient visits and patients than do private practitioners. The Connecticut safety-net system has the capacity to treat about 28.2 percent of publicly insured patients. The dental safety net is an important community resource, and greater use of allied dental personnel could substantially improve the capacity of the system to care for the poor and other underserved populations.
Hubálková, Hana; Hora, Karel; Seidl, Zdenek; Krásenský, Jan
The objective of this investigation was to evaluate the reaction of selected dental materials in the magnetic field of a magnetic resonance imaging device to determine a possible health risk. The following dental materials were tested in vitro during magnetic resonance imaging: 15 dental alloys, four dental implants, one surgical splint and two wires for fixation of maxillofacial fractures. Possible artefacts (corresponding with magnetic properties), heating and force effects were tested. Results concerning movement and heating were in agreement with the literature. The artefacts seen were significant: for the surgical splint, a spherical artefact with a diameter of 55 mm; for the wires, up to 22 mm; and for the dental blade implant, an artefact of 28 x 20 mm. The results of our tests of selected dental appliances indicate that their presence in the human organism is safe for patients undergoing magnetic resonance imaging procedures. The presence of artefacts can substantially influence the magnetic resonance imaging results.
Djustiana, Nina; Greviana, Nadia; Faza, Yanwar; Sunarso
During the last few decades, the increasing demands in esthetic dentistry have led to the development of dental composites material that provide similar appearance to the natural teeth. Recently, esthetic trend was an issue which increase the demand for teeth restorations that is similar with the origin. The esthetics of dental composite are more superior compared to amalgam, since its color look similar with natural teeth. Various dental composites have been developed using many type of fillers such as amorphous silica, quartz), borosilicate, Li-Sr-Ba-Al glass and oxide: zirconia and alumina. Researchers in Faculty of Dentistry University of Padjadjaran have prepared dental composites using zirconia-alumina-silica (ZAS) system as the filler. The aim is to improve the mechanical properties and the esthetic of the dental composites. The ZAS was obtained from chemical grade purity chemicals and Indonesia's natural sand as precursors its characterization were also presented. This novel method covers the procedure to synthesis and characterize dental composites in Padjadjaran University and some review about dental composites in global research.
Hubar, J S; Gardiner, D M
Infection control guidelines for dental radiography have been modified since 1986, when the American Dental Association and the Centers for Disease Control and Prevention supported the concept of "universal blood and body fluid precautions." With the introduction of computed digital radiography, hardware manufacturers recommend that alternative infection control techniques are necessary to prevent potential damage to the digital x-ray sensors placed inside the patient's mouth. Thirty first-year dental hygiene students were asked to insert and remove a Schick CDR number 2 size intraoral digital x-ray sensor into modified Rinn XCP bitewing bite blocks and a modified Rinn Snap-a-ray five times with each of the recommended infection control covers. Reduced rates of cross contamination are possible if the plastic barrier envelope has an additional latex finger cot stretched over it and the x-ray sensor. Sole usage of a latex finger cot will result in a reduced incidence of contamination, but still not to acceptable levels. However, a plastic barrier envelope placed over the x-ray sensor and over the modified XCP bite block together or a covered sensor in a Snap-a-ray under normal conditions does not result in a perforation and is least likely to result in cross contamination.
Texas Univ., Austin. Center for Occupational Curriculum Development.
These materials are part of a series dealing with skills and information needed by students in dental assisting. The individualized student materials are suitable for classroom, laboratory, or cooperative training programs. These student materials, designed to be used with the Dental Charting Student Manual, consist of learning activities, unit…
Kwasman, R; Handelman, S L; MacIntyre, B; Barrett, G
Using audiovisual tapes of 150 actual dental treatment sessions, five dental teams working with handpieces positioned in the 8-o'clock location were compared with five dental teams working with hand pieces positioned in the 12-o'clock location. Criteria used for analysis were frequency and duration of instrument transfer, critical incidents that interfered with instrument movements, and subjective responses of the dental team members. The data showed that the handpiece transfers were faster and more frequent in the 12-o'clock location where they were done via the assistant. However, the reverse was true for transfers of the three-way syringe. Most critical incidents occurred with equal frequency and were common to both rooms, but some were related to instrument location. The subjective responses indicated that the assistant working with the 12-o'clock instrument location had many more tasks and must be more highly trained.
Tamí-Maury, Irene; Aigner, Carrie J.; Hong, Judy; Strom, Sara; Chambers, Mark S.; Gritz, Ellen R.
Rates of tobacco use are increasing in regions of Latin America and the Caribbean (LAC). Unfortunately, tobacco cessation education is not a standard component of dental curriculum in LAC dental schools. The objective of this study was to identify the perceptions of LAC dental faculty members regarding the tobacco use prevention and cessation (TUPAC) competencies that should be addressed in dental curricula. Dental deans and faculty completed a web-based questionnaire in Spanish, Portuguese, French, or English. The questionnaire contained 32 competencies grouped into the 5A’s (Ask, Advise, Assess, Assist, and Arrange) of tobacco cessation and 6 supplementary questions for identifying barriers to providing TUPAC education to dental students. Respondents indicated the degree to which they believed each competency should be incorporated into dental curricula using a 5-point Likert scale (“1”= strongly disagree to “5”=strongly agree). Responses were obtained from 390 faculty members (66% South America, 18% Mexico/Central America, 16% the Caribbean). Two%, 12%, and 83% of respondents reported that smoking was allowed in clinical environments, other indoor environments, and outdoor environments of their dental schools, respectively. Mean importance ratings for each of the competencies were as follows: Ask (4.71), Advise (4.54), Assess (4.41), Assist (4.07), and Arrange (4.01). Overall, LAC dental educators agree that TUPAC training should be incorporated in dental curricula. Assist and Arrange competencies were rated lower, relative to other competencies. Tobacco use among dental educators and high rates of on-campus smoking could potentially pose barriers to promoting cessation interventions in the LAC dental schools. PMID:24385339
Tamí-Maury, Irene; Aigner, Carrie J; Hong, Judy; Strom, Sara; Chambers, Mark S; Gritz, Ellen R
Rates of tobacco use are increasing in the regions of Latin America and the Caribbean (LAC). Unfortunately, tobacco cessation education is not a standard component of the dental curriculum in LAC dental schools. The objective of this study was to identify the perceptions of LAC dental faculty members regarding the tobacco use prevention and cessation (TUPAC) competencies that should be addressed in the dental curricula. Dental deans and faculty completed a web-based questionnaire in Spanish, Portuguese, French, or English. The questionnaire contained 32 competencies grouped into the five A's (Ask, Advise, Assess, Assist, and Arrange) of tobacco cessation and six supplementary questions for identifying barriers to providing TUPAC education to dental students. Respondents indicated the degree to which they believed each competency should be incorporated into the dental curricula using a five-point Likert scale ("1" = strongly disagree to "5" = strongly agree). Responses were obtained from 390 faculty members (66 % South America, 18 % Mexico/Central America, 16 % the Caribbean). Of the respondents, 2, 12, and 83 % reported that smoking was allowed in clinical environments, other indoor environments, and outdoor environments of their dental schools, respectively. Mean importance ratings for each of the competencies were as follows: Ask (4.71), Advise (4.54), Assess (4.41), Assist (4.07), and Arrange (4.01). Overall, LAC dental educators agree that TUPAC training should be incorporated into the dental curricula. Assist and Arrange competencies were rated lower, relative to other competencies. Tobacco use among dental educators and high rates of on-campus smoking could potentially pose barriers to promoting cessation interventions in the LAC dental schools.
Lam, Raymond; Kruger, Estie; Tennant, Marc
One disadvantage of the remarkable achievements in dentistry is that treatment options have never been more varied or confusing. This has made the concept of Evidenced Based Dentistry more applicable to modern dental practice. Despite merit in the concept whereby clinical decisions are guided by scientific evidence, there are problems with establishing a scientific base. This is no more challenging than in modern dentistry where the gap between rapidly developing products/procedures and its evidence base are widening. Furthermore, the burden of oral disease continues to remain high at the population level. These problems have prompted new approaches to enhancing research. The aim of this paper is to outline how a modified approach to dental coding may benefit clinical and population level research. Using publically assessable data obtained from the Australian Chronic Disease Dental Scheme and item codes contained within the Australian Schedule of Dental Services and Glossary, a suggested approach to dental informatics is illustrated. A selection of item codes have been selected and expanded with the addition of suffixes. These suffixes provided circumstantial information that will assist in assessing clinical outcomes such as success rates and prognosis. The use of item codes in administering the CDDS yielded a large database of item codes. These codes are amenable to dental informatics which has been shown to enhance research at both the clinical and population level. This is a cost effective method to supplement existing research methods. Copyright © 2014 Elsevier Inc. All rights reserved.
Lessard, Eric; Glick, Michael; Ahmed, Sultan; Saric, Muhamed
Heart murmurs, a common finding in dental patients, are of major concern to dental professionals because certain dental procedures occasionally can induce severe cardiovascular complications. Murmurs may indicate existing heart disease that is a risk factor for infective endocarditis following a dental procedure, as well as more severe heart conditions such as congenital heart disease, atrial fibrillation or congestive heart failure. This review article is based on data published in peer-reviewed journals, including practice guidelines published by major dental and medical professional organizations. Echocardiography is the primary means of evaluating heart murmurs, and all dental professionals should become familiar with major aspects of an echocardiogram. Understanding the medical evaluation and assessment of a heart murmur fosters better communication with other health care professionals and results in improved patient care. Beyond the need to administer antibiotic prophylaxis, the dentist also needs to address the underlying causes of a patient's heart murmur. By providing dental care to such patients, oral health care providers become part of the patient's overall health care team.
Blue, Christine M; Rockwood, Todd; Riggs, Sheila
The purpose of this study was to evaluate dentists' attitudes and perceptions toward dental therapists, a new licensed dental provider in Minnesota. This study employed mixed modes to administer a survey using a stratified random sample of 1000 dentists in Minnesota. The response rate was 55% (AAPOR RR1: n=551/999). Results showed a majority of dentists were opposed to dental therapists performing irreversible procedures. In addition, results identified perceived barriers to hiring a dental therapist and found dentists do not believe dental therapists will alleviate oral health disparity in the State. Published by Elsevier Inc.
Fakhruddin, Kausar Sadia; El Batawi, Hisham Yehia
The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder. This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5-9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples t -test was used to assess the significance of changes in pulse and O 2 saturation levels during each visit. International Caries Detection and Assessment System-code 2 was found to be the most prevalent ( n = 58; 52%). A significant difference ( P < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions. Initial desensitization appointment and "tell-show-do" approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental procedures.
Fakhruddin, Kausar Sadia; El Batawi, Hisham Yehia
Background: The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder. Materials and Methods: This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5−9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples t-test was used to assess the significance of changes in pulse and O2 saturation levels during each visit. Results: International Caries Detection and Assessment System-code 2 was found to be the most prevalent (n = 58; 52%). A significant difference (P < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions. Conclusion: Initial desensitization appointment and “tell-show-do” approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental
Estafan, D J
Although needle-administered local anesthesia has been an essential tool of modern dentistry, it has also been responsible for many patients' fears of dental visits. Several new techniques have recently evolved that may offer viable alternatives. Two of these operate via electronic mechanisms that interfere with pain signals, two others involve transmucosal modes of administration, and a fifth technique involves an intraosseous pathway for anesthesia administration. Each of these techniques has different indications for dental procedures, but none is intended to replace needle administration in dentistry. This overview highlights the salient features of these alternative dental anesthesia techniques.
Heaton, Lisa J.; Hyatt, Halee A.; Huggins, Kimberly Hanson; Milgrom, Peter
Dental fear is a barrier to receiving dental care, particularly for those patients who also suffer from mental illnesses. The current study examined United States dental professionals’ perceptions of dental fear experienced by patients with mental illness, and frequency of sedation of patients with and without mental illness. Dentists and dental staff members (n = 187) completed a survey about their experiences in treating patients with mental illness. More participants agreed (79.8%) than disagreed (20.2%) that patients with mental illness have more anxiety regarding dental treatment (p < .001) than dental patients without mental illness. Further, significantly more participants reported mentally ill patients’ anxiety is “possibly” or “definitely” a barrier to both receiving (96.8%; p < .001) and providing (76.9%; p < .01) dental treatment. Despite reporting more fear in these patients, there were no significant differences in frequency of sedation procedures between those with and without mental illness, regardless of type of sedation (p’s > .05). This lack of difference in sedation for mentally ill patients suggests hesitancy on the part of dental providers to sedate patients with mental illness and highlights a lack of clinical guidelines for this population in the US. Suggestions are given for the assessment and clinical management of patients with mental illness. PMID:24876662
Midura, Ronald J; Cali, Valbona; Lauer, Mark E; Calabro, Anthony; Hascall, Vincent C
Hyaluronan (HA) exhibits numerous important roles in physiology and pathologies, and these facts necessitate an ability to accurately and reproducibly measure its quantities in tissues and cell cultures. Our group previously reported a rigorous and analytical procedure to quantify HA (and chondroitin sulfate, CS) using a reductive amination chemistry and separation of the fluorophore-conjugated, unsaturated disaccharides unique to HA and CS on high concentration acrylamide gels. This procedure is known as fluorophore-assisted carbohydrate electrophoresis (FACE) and has been adapted for the detection and quantification of all glycosaminoglycan types. While this previous FACE procedure is relatively straightforward to implement by carbohydrate research investigators, many nonglycoscience laboratories now studying HA biology might have difficulties establishing this prior FACE procedure as a routine assay for HA. To address this need, we have greatly simplified our prior FACE procedure for accurate and reproducible assessment of HA in tissues and cell cultures. This chapter describes in detail this simplified FACE procedure and, because it uses an enzyme that degrades both HA and CS, investigators will also gain additional insight into the quantities of CS in the same samples dedicated for HA analysis. © 2018 Elsevier Inc. All rights reserved.
Lewis, D L; Boe, R K
When a dye solution used to simulate patient material was either injected into high-speed dental handpiece (drill) waterlines or applied to the equipment externally, internal air turbine chambers became contaminated. These chambers served as a reservoir of the material, which was slowly dislodged by air expelled during subsequent handpiece operation and which was diluted by water spray used for cooling the drilling surface. Considering the fact that patient materials could reside in internal parts of the equipment that are not usually disinfected and that the material may be subsequently sprayed into cuts and abrasions in the oral cavity, the common approach to reprocessing handpieces (external wiping in combination with flushing) may pose unacceptably high risks to those individuals treated soon after infected patients. Therefore, unless reliable data on cross-infection frequencies are obtained and prove it unnecessary, heat-treating high-speed handpieces between each patient should be considered an essential component of standard procedures whenever universal precautions are practiced in dentistry. PMID:1537909
Chuenjitwongsa, Supachai; Poolthong, Suchit; Bullock, Alison; Oliver, Richard G
Current policy in Southeast Asian dental education focuses on high-quality dental services from new dental graduates and the free movement of dental practitioners across the region. The Southeast Asian Nations (ASEAN) Dental Councils have proposed the "Common Major Competencies for ASEAN General Dental Practitioners" to harmonize undergraduate dental education. This article discusses how the ASEAN competencies were developed and established to assist the development of general dental practitioners with comparable knowledge, skills, and attitudes across ASEAN. The competencies were developed through four processes: a questionnaire about current national oral health problems, a two-round Delphi process that sought agreement on competencies, a panel discussion by representatives from ASEAN Dental Councils, and data verification by the representatives after the meeting. Key themes of the ASEAN competencies were compared with the competencies from the U.S., Canada, Europe, Australia, and Japan. A total of 33 competency statements, consistent with other regions, were agreed upon and approved. Factors influencing the ASEAN competencies and their implementation include oral health problems in ASEAN, new knowledge and technology in dentistry, limited institutional resources, underregulated dental schools, and uneven distribution of dental practitioners. The ASEAN competencies will serve as the foundation for further developments in ASEAN dental education including policy development, curriculum revision, quality assurance, and staff development. Collaboration amongst stakeholders is essential for successful harmonization of ASEAN dental education.
Radentz, William H.; Caffesse, Raul G.
A survey of 58 dental school periodontics departments revealed the frequency of predoctoral dental students performing surgery, the frequency of specific procedures, the degree of participation or performance of students, incidence of preclinical surgical laboratories in the curricula, and materials and anesthesia used. A wide range in…
Newton, J. T.
Background: Dental disease is more common among people with intellectual disabilities than in the general population. Improvements in oral health require individuals to engage in daily oral hygiene and regular visits to a dental practitioner; both may be challenging for the individual with intellectual impairment. Materials and Methods: A review…
Dickey, Keith Winfield
The article describes a survey of 36 dental education programs to identify educators' reactive policies and procedures in their patient treatment centers to minimize dental contamination and cross-contamination. (Author/CT)
Freitas, Elisângela P; Rahal, Sheila C; Teixeira, Carlos R; Teixeira, Rodrigo H F; Mendes, Guilherme M; Gioso, Marco A
The aims of this study were to develop a dental evaluate any oral cavity disease, develop gypsum models of the dental arches, and to register the occlusions found in coatis (Nasua nasua) in captivity Formulation of the dental chart was assisted by intraoral radiographs from the head of an adult coati cadaver of the same species with the following dental formula.: I 3/3, C 1/1, P 4/3, M 2/2. Seven live coatis of the Nasua nasua species were evaluated. Five of the seven coatis presented with various dental abnormalities as follows: dental plaque (71.4 0%), gingivitis (71.4 %), periodontitis (57.1 %), dental stain (42.9 %), dental abrasion (57.1 %), dental fracture (57.1 %), pulp exposure (42.9 %), malocclusion (57.1 %) and supernumerary teeth (14.2 %).
Chen, Xu; Liu, Yao; Jin, Shi-fu; Zhang, Qian; Jin, Xuan-yu
To determine the age and sex characteristics of the children and type of dental procedures performed under dental general anesthesia (DGA) and to assess the results after six months to one year's follow-up. A sample of 30 patients treated under dental general anesthesia (DGA) during 2006-2007 in the Department of Pediatric Dentistry of China Medical University was reviewed. All the teeth were treated one time. The dental procedures performed included caries restoration, indirect pulp capping, pulpotomy, root canal therapy (RCT) and dental extraction. Oral prophylaxis and topical fluoride applications were performed on all teeth. Pit and fissure sealing was performed on all healthy premolars and molars. SPSS10.0 software package was used for statistical analysis. Chi-square test was used to analyze the difference of the sex distribution in different age group and the difference of dental procedures performed between the primary teeth and the permanent teeth. The age of the patients ranged from 19 months to 14 years. The mental retardation patients accounted for 10% and mental healthy patients accounted for 90% of the sample studied. Males were more than females with the ratio about 2 to 1 in each age group. The dental procedures performed were caries restoration (18.67%), indirect pulp capping (23.26%), pulpotomy (0.77%), RCT (29.16%), dental extractions (2.05%) and fissure sealants (26.09%). The percentage of RCT was higher than that of caries restoration in the primary teeth, whereas the result was opposite as for the permanent teeth as indicated by Chi-square test (X(2)=11.630, P=0.001). New dental caries was not found except 2 patients who suffered from dysnoesia and were not cooperative to have regular examination. Fillings were lost in 3 cases, with 3 anterior teeth and 2 posterior teeth after RCT. All the children could cooperate except two mental retardation patients during the follow-up visit. Caries restoration and RCT are the most frequently performed
Wides, Cynthia D.; Brody, Harvey A.; Alexander, Charles J.; Gansky, Stuart A.; Mertz, Elizabeth A.
The University of California, San Francisco School of Dentistry established the Dental Postbaccalaureate Program in 1998 to provide reapplication assistance to students from economically and/or educationally disadvantaged backgrounds who were previously denied admission to dental school. The goals were to increase diversity in the dental school student population and improve access to dental services for underserved populations. This article assesses the program’s short-, mid-, and long-term outcomes and is the first to examine long-term practice patterns after a dental postbaccalaureate program. Data collected on all participant (n=94) demographics, pre/post-program DAT scores, and post-program dental school admission results were used to assess short- and mid-term outcomes. Long-term outcomes and practice patterns were assessed using results of a census survey administered between 2009 and 2011 to the participants who had completed dental school and been in practice for at least two years (n=57). The survey had a response rate of 93 percent (n=53). Descriptive statistical techniques were used to examine the responses and to compare them to U.S. Census Bureau data and nationally available practice data for new dental graduates. Program participants’ DAT scores improved by an average of two points, and 98 percent were accepted to dental school. All survey respondents were practicing dentistry, and 81 percent reported serving underserved populations. These participants treat more Medicaid recipients than do most dentists, and their patient population is more diverse than the general population. The outcomes demonstrate that the program’s graduates are increasing diversity in the dental student population and that their practices are providing access to care for underserved populations. PMID:23658398
Klorman, Rafael; And Others
This study examines the relationship between children's disruptiveness during dental treatment and their state (comptemporaneous or situational nervousness), trait (general nervousness), and specific dental anxiety. All patients studied were about 8 years old. Sample I (84 pedodontic patients) underwent a variety of dental procedures (extractions,…
Radanović, B; Vučinić, P; Janković, T; Mahmutović, E; Penjašković, D
Musculoskeletal symptoms of the neck and shoulder represent a condition whose basic characteristic is pain. These conditions are very often present in dental health professionals. The aim of the paper was to determine presence of discomforts in areas of head, neck, shoulders, upper back and upper limbs at health professionals in area of dentistry, as well as discomfort localisation and methods of treatment. The research included 45 health professionals (dentists, dental assistants and dental technicians) employed at Dental Clinic of Vojvodina. The information was collected via questionnaire for analysis musculoskeletal disorders. Most of the dentists (75.9%) and the dental assistants (90.9%) as well as nearly half of the dental technicians (40%) experience discomforts in area of the neck, which are occasional, present in all three working positions and this discomforts are a little more frequent at women. The present musculoskeletal disorders are followed by headache, whose presence is statistically more significant compared to the other symptoms. The headache is usually located in the occipital part, it occurs individually or joined with other symptoms. Due to said discomforts the examinees in 59.4% of the cases don't contact the doctor. Medical therapy prevails in opposition to physical therapy. The discomforts deriving from the cervical part of the spine are present at great percentage of our examinees. Considering the fact that the said discomforts affect performing both professional and everyday activities, its prevention is necessary in order to avoid the consequences they carry.
Alhazzazi, Turki Y; Alzebiani, Nouran A; Alotaibi, Samaher K; Bogari, Dania F; Bakalka, Ghaida T; Hazzazi, Loai W; Jan, Ahmed M; McDonald, Neville J
The authors conducted a study aimed to assess the awareness and attitude among dental students and residents at King Abdulaziz University, Faculty of Dentistry (KAUFD) toward using dental magnification. An e-questionnaire was formulated then sent to dental students and residents (n = 651). The questionnaire included questions that assessed both the awareness and attitude toward using dental magnification. Data were analyzed using IBM SPSS version 22. The chi-square test was used to establish relationships between categorical variables. The response rate was 69.7 % (n = 454). Of those, 78.1 % did not use magnification during dental procedures. However, 81.8 % agreed that dental magnification could enhance the accuracy and quality of their dental work. Thus, 91.6 % thought it would be useful in endodontics and 46.3 % voted for surgery. Of the 21.9 % that used magnification, dental loupes were mostly used, 55.9 %. The majority (59.4 %) of the participants believed that using dental magnification should be introduced by faculty beginning in Year I of dental school. Among our respondents, most of the undergraduate students did not use dental magnification nor attended courses in the use of dental magnifications. However, most of the students were aware of its significance in improving the accuracy and quality of their work.
Shroff, Sulabh; Hughes, Cody; Mobley, Connie
To determine if there was an association between the type of dental procedure being performed on children and parental desire to be present in the operatory. Parents (N=339) whose children had dental appointments at a university pediatric dental clinic or affiliated practices in Southern Nevada completed a survey. Parents identified attitudes/preferences associated with five commonly conducted pediatric dental procedural scenarios. Data were analyzed using chi-square tests (P=.05). Most respondents (N=339) were female (N=248) and/or Hispanic (N=204), had a household income of less than $50,000 annually (N=251), and a high school education. The primary reason (78 percent) parents wanted to be present during their child's dental treatment was comfort. Most parents wanted to observe exams/X-rays (70 percent), sedation procedures (69 percent), fillings and crowns (66 percent), extractions (64 percent), and physical restraint (61 percent). Only 38 percent of parents would be content with the dentist unilaterally deciding about their presence in the operatory. Parents in this study expressed a preference to remain with their child during any dental treatment. Practitioners are encouraged to consider their presence customary and establish office policies and protocols that beneficially involve parents in the pediatric patient's care.
Ballouhey, Quentin; Dib, Nabil; Binet, Aurélien; Carcauzon-Couvrat, Véronique; Clermidi, Pauline; Longis, Bernard; Lardy, Hubert; Languepin, Jane; Cros, Jérôme; Fourcade, Laurent
We report the first description of robotic-assisted Heller myotomy in children. The purpose of this study was to improve the safety of Heller myotomy by demonstrating, in two adolescent patients, the contribution of the robot to the different steps of this procedure. Due to the robot's freedom of movement and three-dimensional vision, there was an improvement in the accuracy, a gain in the safety regarding different key-points, decreasing the risk of mucosal perforation associated with this procedure.
Demoli, Nazif; Vučić, Zlatko; Milat, Ognjen; Gladić, Jadranko; Lovrić, Davorin; Pandurić, Vlatko; Marović, Danijela; Moguš-Milanković, Andrea; Ristić, Mira; Čalogović, Marina; Tarle, Zrinka
The purpose of this paper is to present the current activities of a research collaborative program between three institutions from Zagreb (School of Dental Medicine, Institute of Physics, and Institute Ruđer Bo\\vsković). Within the scope of this program, it is planned to investigate and find guidelines for the refinement of the properties of dental biomaterials (DBs) and of procedures in restorative dental medicine. It is also planned to identify and model the dominant mechanisms which control polymerization of DBs. The materials to be investigated include methacrylate based composite resins, new composite materials with amorphous calcium phosphate, silorane based composite resins, glass-ionomer cements, and giomer.
Darbar, Arun A.
This is a clinical presentation on the use of laser therapy in a private dental practice using a 810nm diode. A wide range of conditions involving pain management, treatment and as an adjunct to procedures to enhance patient comfort and experience. This will include cases treated for TMD (Temporo mandibular dysfunction), apthous ulcers, angular chelitis, cold sores, gingival retraction, periodontal treatment and management of failing dental implants. The case presentation will include the protocols used and some long term reviews. The results have been very positive and will be shared to enable this form of treatment to be used more frequently and with confidence within dental practice.
Burton, Karen L O; Morrow, Angela M; Beswick, Brooke V; Khut, George P
The objective of this pilot study was to assess the acceptability and feasibility of using BrightHearts, a biofeedback-assisted relaxation application (app), in children undergoing painful procedures. Thirty children 7 to 18 years of age undergoing a medical procedure (peripheral blood collection, botulinum toxin injection, or intravenous cannula insertion) participated. Participants used BrightHearts, a heart rate-controlled biofeedback-assisted relaxation training app delivered via an iPad with heart rate measured through a pulse oximeter worn on the ear or thumb. Feasibility was assessed through observations and patient, parent/carer, and healthcare professional feedback. Patient, parent/carer, and healthcare professional satisfaction with BrightHearts was rated using investigator-developed surveys. Eighty-three percent of child participants reported that they found BrightHearts helpful during the procedure and that they would use BrightHearts again. All parents and 96% of healthcare professionals indicated they would use BrightHearts again. Sixty-four percent of healthcare providers perceived that BrightHearts assisted with the ease of performing the procedure. Qualitative analyses found 2 themes: (1) BrightHearts calms through providing distraction and biofeedback and (2) the impact of BrightHearts on the procedure. This pilot study demonstrates the feasibility of using biofeedback-assisted relaxation delivered via the BrightHearts app in children undergoing peripheral blood collection and cannulation. Future studies are required to evaluate BrightHearts' efficacy in reducing pain and anxiety during painful procedures and distinguish the effects of a biofeedback-mediated app from distraction. © 2018 World Institute of Pain.
Zhang, Yu; Sailer, Irena; Lawn, Brian R
Objectives Clinical data on survival rates reveal that all-ceramic dental prostheses are susceptible to fracture from repetitive occlusal loading. The objective of this review is to examine the underlying mechanisms of fatigue in current and future dental ceramics. Data/sources The nature of various fatigue modes is elucidated using fracture test data on ceramic layer specimens from the dental and biomechanics literature. Conclusions Failure modes can change over a lifetime, depending on restoration geometry, loading conditions and material properties. Modes that operate in single-cycle loading may be dominated by alternative modes in multi-cycle loading. While post-mortem examination of failed prostheses can determine the sources of certain fractures, the evolution of these fractures en route to failure remains poorly understood. Whereas it is commonly held that loss of load-bearing capacity of dental ceramics in repetitive loading is attributable to chemically-assisted 'slow crack growth' in the presence of water, we demonstrate the existence of more deleterious fatigue mechanisms, mechanical rather than chemical in nature. Neglecting to account for mechanical fatigue can lead to gross overestimates in predicted survival rates. Clinical significance Strategies for prolonging the clinical lifetimes of ceramic restorations are proposed based on a crack-containment philosophy. PMID:24135295
Zhang, Yu; Sailer, Irena; Lawn, Brian R
Clinical data on survival rates reveal that all-ceramic dental prostheses are susceptible to fracture from repetitive occlusal loading. The objective of this review is to examine the underlying mechanisms of fatigue in current and future dental ceramics. The nature of various fatigue modes is elucidated using fracture test data on ceramic layer specimens from the dental and biomechanics literature. Failure modes can change over a lifetime, depending on restoration geometry, loading conditions and material properties. Modes that operate in single-cycle loading may be dominated by alternative modes in multi-cycle loading. While post-mortem examination of failed prostheses can determine the sources of certain fractures, the evolution of these fractures en route to failure remains poorly understood. Whereas it is commonly held that loss of load-bearing capacity of dental ceramics in repetitive loading is attributable to chemically assisted 'slow crack growth' in the presence of water, we demonstrate the existence of more deleterious fatigue mechanisms, mechanical rather than chemical in nature. Neglecting to account for mechanical fatigue can lead to gross overestimates in predicted survival rates. Strategies for prolonging the clinical lifetimes of ceramic restorations are proposed based on a crack-containment philosophy. Copyright © 2013 Elsevier Ltd. All rights reserved.
Meyerhoefer, Chad D; Zuvekas, Samuel H; Manski, Richard
Chronic tooth decay is the most common chronic condition in the United States among children ages 5-17 and also affects a large percentage of adults. Oral health conditions are preventable, but less than half of the US population uses dental services annually. We seek to examine the extent to which limited dental coverage and high out-of-pocket costs reduce dental service use by the nonelderly privately insured and uninsured. Using data from the 2001-2006 Medical Expenditure Panel Survey and an American Dental Association survey of dental procedure prices, we jointly estimate the probability of using preventive and both basic and major restorative services through a correlated random effects specification that controls for endogeneity. We found that dental coverage increased the probability of preventive care use by 19% and the use of restorative services 11% to 16%. Both conditional and unconditional on dental coverage, the use of dental services was not sensitive to out-of-pocket costs. We conclude that dental coverage is an important determinant of preventive dental service use, but other nonprice factors related to consumer preferences, especially education, are equal if not stronger determinants. Copyright © 2013 John Wiley & Sons, Ltd.
Tatham, Elaine L.; And Others
A structured interview procedure was used during the spring of 1975 as a tool in selecting nursing and dental hygiene students at Johnson County Community College. Potential students had two 20-minute interviews: one by a staff member of the program to which application was made, and one by another staff member. Interviewers rated the applicants…
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Quock, Ryan L; Patel, Shalizeh A; Falcao, Felipe A; Barros, Juliana A
Dental caries, a bacterial process that results in the acidic destruction of tooth structure, has historically been managed by the mechanical excavation of diseased tooth structure and then restoration with a synthetic material. The mechanical excavation of the infected site is most commonly achieved by a dental handpiece, or "drill"; this handpiece may induce stress and anxiety in many patients. Alternatively, a drill-less filling will involve the utilization of silver diamine fluoride (38%) to arrest and prevent dental caries, followed by restoration with a bonded filling material to achieve adequate seal at the lesion margins. This is a minimally invasive procedure that addresses both microbial and mechanical issues posed by dental caries. Copyright © 2011 Elsevier Ltd. All rights reserved.
Pervez, Anushey; Kinney, Janet S; Gwozdek, Anne; Farrell, Christine M; Inglehart, Marita R
In 2005, Public Act No. 161 (PA 161) was passed in Michigan, allowing dental hygienists to practice in approved public dental prevention programs to provide services for underserved populations while utilizing a collaborative agreement with a supervising dentist. The aims of this study were to assess how well dental and dental hygiene students and faculty members and practicing dental hygienists have been educated about PA 161, what attitudes and knowledge about the act they have, and how interested they are in additional education about it. University of Michigan dental and dental hygiene students and faculty members, students in other Michigan dental hygiene programs, and dental hygienists in the state were surveyed. Respondents (response rate) were 160 dental students (50%), 63 dental hygiene students (82%), 30 dental faculty members (26%), and 12 dental hygiene faculty members (52%) at the University of Michigan; 143 dental hygiene students in other programs (20%); and 95 members of the Michigan Dental Hygienists' Association (10%). The results showed that the dental students were less educated about PA 161 than the dental hygiene students, and the dental faculty members were less informed than the dental hygiene faculty members and dental hygienists. Responding dental hygiene faculty members and dental hygienists had more positive attitudes about PA 161 than did the students and dental faculty members. Most of the dental hygiene faculty members and dental hygienists knew a person providing services in a PA 161 program. Most dental hygiene students, faculty members, and dental hygienists wanted more education about PA 161. Overall, the better educated about the program the respondents were, the more positive their attitudes, and the more interested they were in learning more.
Peters, Mathilde C; Adu-Ababio, Francis; Jarrett-Ananaba, Nejay P; Johnson, Lynn A
The dearth of dental faculty members is a widely known problem that is exacerbated in countries that are attempting to begin dental education programs. This collaboration between Kwame Nkrumah University of Science and Technology and the University of Michigan investigated if dental students who have just started their clinical dental education can learn the knowledge and skills required for identifying and restoring cavitated caries lesions through compact course delivery. There were three instructional blocks: 1) didactic seminar; 2) seminar, simulated hands-on skills instruction, and clinical observation/assisting with treatment of schoolchildren; and 3) seminar, simulated skills training, and application to schoolchildren. Each dental student completed a questionnaire measuring knowledge and perceptions of knowledge, experience, and confidence at five points in time. The dental students' knowledge increased significantly as well as their perceived knowledge, experience, and confidence (p<0.0001). In general, the students showed proficiency in delivering simple treatments. The project showed that an integrated compact course delivery model may assist emerging dental schools to cope with the challenging shortage of resident faculty members.
Rahman, Betul; Hawas, Nuha; Rahman, Muhammed Mustahsen
The objective of this study was to investigate the opinions of dental students, in one of the dental colleges in the United Arab Emirates (UAE), toward providing tobacco cessation interventions to their patients. Three-hundred-and-fifty students were administered a questionnaire including questions about tobacco cessation interventions (with a response rate of 77%). We generated descriptive statistics for all questions and examined the frequency distribution and percentages of all answers. Data were analysed using cross-tabulations and χ(2) -tests. The statistical significance was set at P < 0.05. While 83.4% of students agreed that dentists should be trained in tobacco cessation, 56% of students disagreed that they are adequately trained to assist the patient in stopping tobacco use. As the year of study increased, the students' 'agree' responses increased to the statements that the dentist should be trained and that the dentist has a role in assisting patients to stop smoking. Non-Arab students were more confident than Emiratis in tobacco cessation counselling. The percentage of female students who felt greatly confident in assisting was double that of male students. There was a significant difference between tobacco-user students and non-users in response to the question about dentist's role in assisting tobacco cessation. A comprehensive tobacco cessation education and training program should be included in dental schools' curriculum in the UAE to further improve student confidence in providing tobacco cessation services to their patients. © 2016 FDI World Dental Federation.
Webb, Bettine C; Whittle, Terry; Schwarz, Eli
To determine the perceptions of dental care held by the residents in aged care facilities (ACFs) in New South Wales (NSW) and to compare these perceptions with clinical observations. No specific data exist relating to NSW residents' perceptions of dental care compared with a clinical examination. Planning for appropriate oral health programs in ACFs necessitate such data. Four Area Health Services of Sydney and 25 low care ACFs were selected from which representative residents were sampled who completed a survey and underwent a basic dental examination. Of the subjects (25 males, 96 females), 76.9% had never received a dental visit as entering the ACF; 14.1% suffered from dental pain; 69.4% wore dentures and of these 18.3% required assistance in cleaning. Dentures were cleaned twice/day in 54.9% of cases. Natural teeth were reported present in 71.9% of residents, and 85.1% did not require assistance in cleaning. Appropriate dental care facilities and dry mouth were most frequent problems highlighted. Clinical examinations showed that 69% were denture wearers; oral hygiene and denture hygiene were considered good in 15.7% of cases. A high level of concordance existed between self-reports and examination. Increased awareness about oral health across leadership, caregivers and residents with appropriate dental health education and dedicated space within facilities would provide a much needed improvement for addressing oral health issues of the ACF residents. This might be the right time to plan for the future challenges that will need to be met by the NSW care system. © 2015 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
[Daily living activities and oral condition among care facility residents with severe intellectual disabilities. Comparative analyses between residents receiving tooth-brushing assistance and those not receiving tooth-brushing assistance].
Chiwata, Kaoru; Takeda, Fumi
To clarify 1) differences in daily living activities and oral condition among care facility residents with severe intellectual disabilities and 2) chronological changes in daily living activities and oral condition for residents receiving tooth-brushing assistance and those never receiving tooth-brushing assistance. Subjects were 44 residents at a care facility for individuals with severe intellectual disabilities, who underwent dental screening in July 1994 and October 2003. At each time point, daily living activities, behavior during oral health guidance, behavior during dental health screening and oral condition were compared between residents receiving tooth-brushing assistance (assistance group) and those not receiving tooth-brushing assistance (independent group). Furthermore, chronological changes were analyzed for residents requiring assistance at both screenings, those requiring assistance only at the second screening, and those not requiring assistance at either screening. 1) In the assistance group, 100% and 36.4% of residents were unable to brush their teeth independently in 1994 and 2003, respectively. Significant differences between the assistance and independent groups were observed in all items of behavior during dental health screening in 1994, but not in 2003. No significant intergroup differences in oral condition were observed in 1994, but differences were seen in 2003; when compared to the assistance group, the number of lost teeth was significantly higher in the independent group, while the number of remaining teeth was lower. 2) Regarding changes over the nine-year period, a significantly greater proportion of residents not requiring assistance at either screening and those requiring assistance only at the second screening finally required assistance in bathing. As for oral condition, no significant changes in healthy teeth were observed in residents requiring assistance at both screening time points, while significant increases in dental
McAndrew, Maureen; Brunson, W David; Kamboj, Karanjit
The faculty shortage in dental education has been reported for many years and is expected to increase. Some dental schools have developed "grow your own" programs that introduce students to academic careers and give them teaching experiences. These programs generally consist of teaching assistant, fellowship, and peer tutoring opportunities. In this study, a nineteen-item survey was sent to fifty-six U.S. dental schools to determine the extent to which such programs were being implemented. Thirty-six out of fifty-six dental schools responded, a response rate of 64 percent. Twenty-five schools or 69 percent of the respondents reported the existence of a formal teaching assistant, fellowship, or peer tutoring program in which students teach in some capacity. The main reasons reported for implementing these programs were to expose students to academia and to address faculty shortages. The respondents reported that positive outcomes for dental student teachers and their students were academic benefits and increased interest in academic life. Among the barriers reported were securing faculty and financial support and problems with scheduling.
Molinari, John; Gray, Carolyn F.
The American Association of Dental Schools' task force on acquired immune deficiency syndrome and dental education recommends that educational strategies stress the necessity for routine infection control procedures in treatment, enhancing the health professionals' knowledge, attitudes, and behaviors concerning all aspects of disease prevention.…
Beil, Heather; Mayer, Michelle; Rozier, R Gary
The authors compared children with special health care needs (CSHCN) and children without special health care needs (SHCN) with respect to the odds, amount and determinants of having any dental care and dental care expenditures. The authors assessed data from the 2004 Medical Expenditures Panel Survey, Agency for Healthcare Research and Quality, to identify a sample of 8,518 children aged 2 to 17 years. The authors used logistic regression to determine the effect of having SHCN on the probability of having any dental care expenditure, for total dental care expenditures and procedure-specific expenditures. They tested the modifying effect between CSHCN and other variables on the probability of having any dental care expenditure. Compared with children without SHCN, CSHCN did not differ in the probability (odds ratio = 0.91, 95 percent confidence interval [CI] = 0.76 to 1.09) or amount (beta = 30.17, 95 percent CI = -162.93 to 223.27) of total dental care expenditures. Likewise, CSHCN did not differ in their likelihood of having undergone a preventive, restorative, diagnostic or other procedure. Known determinants of dental care utilization did not modify the relationships between having SCHN and any dental care expenditure. Despite the reported difficulty in CSHCN's accessing dental care, the authors found that CSHCN had dental care utilization and expenditures that were comparable with those of children without SHCN. Furthermore, the association of CSHCN status and any dental care expenditure was not modified by known determinants of dental care utilization. Future research should focus on characterizing risk for dental disease among CSHCN more accurately and identifying factors that affect dental care utilization in CSHCN, including provider and parent characteristics. The study results highlight low rates of dental care utilization among all young children, including CSHCN. Efforts to increase dental care utilization among children are warranted and need to
Tomita, Ryouichi; Fujisak, Shigeru
Total colectomy with ileorectal anastomosis (IRA) is the most widely adopted procedure. The aim of this study was to introduce a minimally invasive procedure, i.e., minilaparotomy with laparoscopic-assisted procedure, by abdominal wall lifting for IRA in patients with slow transit constipation (STC). Six STC patients (6 women, aged 40-69 years, mean age 56.3 years) underwent minilaparotomy with gasless laparoscopic-assisted approach by abdominal wall lifting for IRA. The present procedure involved a 7-cm lower abdominal median incision made at the beginning of the operation. 12 mm ports were also placed in the right and left upper abdominal quadrant positions. The upper abdominal wall was lifted by a subcutaneous Kirshner wire. The small wound was pulled upward and/or laterally by retractors (abdominal lifting) and conventional surgical instruments were used through the wound. Occasionally laparoscopic assistance was employed. The terminal ileum with total colon was brought out through the small wound and transected, approximately 5 cm from the ileocecal valve. The colon was also resected at the level of promontrium. Then, IRA was performed in the instruments. The total surgical time was 197.7 +/- 33.9 min and the mean estimated blood loss was 176.8 +/- 42.2 ml. There was no surgical mortality. Post-operative hospitalization was 8.1 +/- 2.1 days. Six months after surgery, they defecated 1.8 +/- 2.1 times daily, have no abdominal distension, pain, and incontinence. The patients also take no laxatives. All subjects were satisfied with this procedure. Minilaparotomy with gasless laparoscopic-assisted IRA by abdominal wall lifting could be a safe and efficient technique in the treatment of STC.
De Bruijn-Geraets, Daisy P; Van Eijk-Hustings, Yvonne JL; Vrijhoef, Hubertus JM
Aim The study protocol is designed to evaluate the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Background Recent (temporarily) enacted legislation in Dutch health care authorizes nurse practitioners and physician assistants to indicate and perform specified medical procedures, i.e. catheterization, cardioversion, defibrillation, endoscopy, injection, puncture, prescribing and simple surgical procedures, independently. Formerly, these procedures were exclusively reserved to physicians, dentists and midwives. Design A triangulation mixed method design is used to collect quantitative (surveys) and qualitative (interviews) data. Methods Outcomes are selected from evidence-based frameworks and models for assessing the impact of advanced nursing on quality of health care. Data are collected in various manners. Surveys are structured around the domains: (i) quality of care; (ii) costs; (iii) healthcare resource use; and (iv) patient centredness. Focus group and expert interviews aim to ascertain facilitators and barriers to the implementation process. Data are collected before the amendment of the law, 1 and 2·5 years thereafter. Groups of patients, nurse practitioners, physician assistants, supervising physicians and policy makers all participate in this national study. The study is supported by a grant from the Dutch Ministry of Health, Welfare and Sport in March 2011. Research Ethics Committee approval was obtained in July 2011. Conclusion This study will provide information about the effects of granting independent authorization for medical procedures to nurse practitioners and physician assistants on processes and outcomes of health care. Study findings aim to support policy makers and other stakeholders in making related decisions. The study design enables a cross-national comparative analysis. PMID:24684631
Welk, A; Splieth, Ch; Wierinck, E; Gilpatrick, R O; Meyer, G
Computer technology is increasingly used in practical training at universities. However, in spite of their potential, computer-assisted learning (CAL) and computer-assisted simulation (CAS) systems still appear to be underutilized in dental education. Advantages, challenges, problems, and solutions of computer-assisted learning and simulation in dentistry are discussed by means of MEDLINE, open Internet platform searches, and key results of a study among German dental schools. The advantages of computer-assisted learning are seen for example in self-paced and self-directed learning and increased motivation. It is useful for both objective theoretical and practical tests and for training students to handle complex cases. CAL can lead to more structured learning and can support training in evidence-based decision-making. The reasons for the still relatively rare implementation of CAL/CAS systems in dental education include an inability to finance, lack of studies of CAL/CAS, and too much effort required to integrate CAL/CAS systems into the curriculum. To overcome the reasons for the relative low degree of computer technology use, we should strive for multicenter research and development projects monitored by the appropriate national and international scientific societies, so that the potential of computer technology can be fully realized in graduate, postgraduate, and continuing dental education.
Tanja-Dijkstra, Karin; Pahl, Sabine; P. White, Mathew; Andrade, Jackie; Qian, Cheng; Bruce, Malcolm; May, Jon; Moles, David R.
Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n = 69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people’s previous experiences affect their behaviour for future events. PMID:24621518
Tanja-Dijkstra, Karin; Pahl, Sabine; White, Mathew P; Andrade, Jackie; Qian, Cheng; Bruce, Malcolm; May, Jon; Moles, David R
Dental anxiety creates significant problems for both patients and the dental profession. Some distraction interventions are already used by healthcare professionals to help patients cope with unpleasant procedures. The present study is novel because it a) builds on evidence that natural scenery is beneficial for patients, and b) uses a Virtual Reality (VR) representation of nature to distract participants. Extending previous work that has investigated pain and anxiety during treatment, c) we also consider the longer term effects in terms of more positive memories of the treatment, building on a cognitive theory of memory (Elaborated Intrusions). Participants (n = 69) took part in a simulated dental experience and were randomly assigned to one of three VR conditions (active vs. passive vs. control). In addition, participants were distinguished into high and low dentally anxious according to a median split resulting in a 3×2 between-subjects design. VR distraction in a simulated dental context affected memories a week later. The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants. This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people's previous experiences affect their behaviour for future events.
Ramoni, Rachel; Walji, Muhammad F; Tavares, Anamaria; White, Joel; Tokede, Oluwabunmi; Vaderhobli, Ram; Kalenderian, Elsbeth
Although dentists perform highly technical procedures in complex environments, patient safety has not received the same focus in dentistry as in medicine. Cultivating a robust patient safety culture is foundational to minimizing patient harm, but little is known about how dental teams view patient safety or the patient safety culture within their practice. As a step toward rectifying that omission, the goals of this study were to benchmark the patient safety culture in three U.S. dental schools, identifying areas for improvement. The extensively validated Medical Office Survey on Patient Safety Culture (MOSOPS), developed by the Agency for Healthcare Research and Quality, was administered to dental faculty, dental hygienists, dental students, and staff at the three schools. Forty-seven percent of the 328 invited individuals completed the survey. The "Teamwork" category received the highest marks and "Patient Care Tracking and Follow-Up" and "Leadership Support for Patient Safety" the lowest. Only 48 percent of the respondents rated systems and processes in place to prevent/catch patient problems as good/excellent. All patient safety dimensions received lower marks than in medical practices. These findings and the inherent risk associated with dental procedures lead to the conclusion that dentistry in general, and academic dental clinics in particular, stands to benefit from an increased focus on patient safety. This first published use of the MOSOPS in a dental clinic setting highlights both clinical and educational priorities for improving the safety of care in dental school clinics.
Suenaga, Hideyuki; Taniguchi, Asako; Yonenaga, Kazumichi; Hoshi, Kazuto; Takato, Tsuyoshi
Computer-assisted preoperative simulation surgery is employed to plan and interact with the 3D images during the orthognathic procedure. It is useful for positioning and fixation of maxilla by a plate. We report a case of maxillary retrusion by a bilateral cleft lip and palate, in which a 2-stage orthognathic procedure (maxillary advancement by distraction technique and mandibular setback surgery) was performed following a computer-assisted preoperative simulation planning to achieve the positioning and fixation of the plate. A high accuracy was achieved in the present case. A 21-year-old male patient presented to our department with a complaint of maxillary retrusion following bilateral cleft lip and palate. Computer-assisted preoperative simulation with 2-stage orthognathic procedure using distraction technique and mandibular setback surgery was planned. The preoperative planning of the procedure resulted in good aesthetic outcomes. The error of the maxillary position was less than 1mm. The implementation of the computer-assisted preoperative simulation for the positioning and fixation of plate in 2-stage orthognathic procedure using distraction technique and mandibular setback surgery yielded good results. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Nikzad, Sakineh; Azari, Abbas; Mahgoli, Hosseinali; Akhoundi, Nasrin
Dental students in programs around the world typically pass preclinical courses before entering the clinic and working on actual patients. Since fixed prosthodontics is a preclinical course that requires a great deal of effort, students may experience a substantial amount of stress that may affect their self-confidence and/or clinical performance. In this study, an instructional video CD (VCD) and study guide depicting the step-by-step procedures involved in a metal-ceramic tooth preparation and provisional crown fabrication was prepared. Students at the Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran, were divided randomly into two groups. Group A students trained as usual with live patients, and Group B students were given a copy of the VCD and study guide following a lecture. The students in Group B were encouraged to read the study guide and watch the VCD after live demonstrations. Then, both groups practiced individually on mannequins. At the end of the course, the students completed a sixteen-item questionnaire about their stress level, self-confidence, and knowledge base. The results showed that the students exposed to the extra media performed significantly better on some practical phases, e.g., laboratory procedures. A moderate, insignificant correlation was detected between exposure to media and decreasing the students' stress and self-esteem. We concluded that supplementary teaching aids such as a VCD and study guide may improve the clinical performance of dental students to some extent, but the live demonstration is still preferred by students.
Kroon, J; Prince, E; Denicker, G A
Mobile clinics are a cost-effective method of meeting the dental needs of rural communities in South Africa. Phelophepa, the first primary health care train of its kind world-wide, provides eye care, education, medicine, basic health care and since June 1995 dental treatment to rural communities. All services are rendered by students under supervision of qualified staff. The aim of this study was to analyse and report the data for treatment performed in the dental clinic from June 1995 to May 2000. During its first five years of operation, dental services were provided at 183 towns in all provinces except Gauteng. Of the 42,073 patients treated during this time (an average of 229.9 per town), 67.4% were adults. 71.3% of the 103,283 procedures performed were extractions, 15.7% could be classified as preventive with the remaining 13% as restorative procedures. The average value of the service provided to each patient was R218.53. The exposure of dental, dental therapy and oral hygiene students to rural areas of South Africa serves the important purpose of sensitising students to the realities of oral diseases in these communities.
Sinescu, Cosmin; Negrutiu, Meda; Faur, Nicolae; Negru, Radu; Romînu, Mihai; Cozarov, Dalibor
Scanning, also called digitizing, is the process of gathering the requisite data from an object. Many different technologies are used to collect three dimensional data. They range from mechanical and very slow, to radiation-based and highly-automated. Each technology has its advantages and disadvantages, and their applications and specifications overlap. The aims of this study are represented by establishing a viable method of digitally representing artifacts of dental casts, proposing a suitable scanner and post-processing software and obtaining 3D Models for the dental applications. The method is represented by the scanning procedure made by different scanners as the implicated materials. Scanners are the medium of data capture. 3D scanners aim to measure and record the relative distance between the object's surface and a known point in space. This geometric data is represented in the form of point cloud data. The contact and no contact scanners were presented. The results show that contact scanning procedures uses a touch probe to record the relative position of points on the objects' surface. This procedure is commonly used in Reverse engineering applications. Its merits are represented by efficiency for objects with low geometric surface detail. Disadvantages are represented by time consuming, this procedure being impractical for artifacts digitization. The non contact scanning procedure implies laser scanning (laser triangulation technology) and photogrammetry. As a conclusion it can be drawn that different types of dental structure needs different types of scanning procedures in order to obtain a competitive complex 3D virtual model that can be used in CAD/CAM technologies.
Bham, F; Perrie, H; Scribante, J; Lee, C-A
Procedural sedation and analgesia (PSA) is often required to perform dental procedures in children. Serious adverse outcomes, while rare, are usually preventable. To determine the proportion of dental practitioners making use of paediatric dental chair PSA in Gauteng Province, South Africa, describe their PSA practice, and determine compliance with recommended safety standards. A prospective, contextual, descriptive study design was used, with 222 randomly selected dental practitioners contacted to determine whether they offered paediatric dental chair PSA. Practitioners offering PSA were then asked to complete a web-based questionnaire assessing their practice. Of the 213 dental practitioners contacted, 94 (44.1%; 95% confidence interval 37 - 51) provided PSA to children. Most patients were 1 - 5 years old, although there were practices that offered PSA to infants. While most procedures were performed under minimal to moderate sedation, deep sedation and general anaesthesia were also administered in dental rooms. Midazolam was the most frequently used sedative agent, often in conjunction with inhaled nitrous oxide; 28.1% of PSA providers administered a combination of three or more agents. Presedation patient assessment was documented in 83.0% of cases, and informed consent for sedation was obtained in 75.6%. The survey raised several areas of concern regarding patient safety: 41.3% of dental practices did not use any monitoring equipment during sedation; the operator was responsible for the sedation and monitoring of the patient in 41.3%; 43.2% did not keep any recommended emergency drugs; and 19.6% did not have any emergency or resuscitation equipment available. Most respondents (81.8%) indicated an interest in sedation training. Paediatric dental chair PSA was offered by 44.1% of dental practitioners interviewed in Gauteng. Modalities of PSA provided varied between practices, with a number of safety concerns being raised.
The goal of this document is to assist the regulated community to make proper utilization of the Toxicity Characteristic Leaching Procedure (TCLP) to demonstrate compliance with the Toxicity Characteristic (TC) and Land Ban Regulations.
Newton, J T; Gibbons, D E
To compare the levels of career satisfaction expressed by three professional groups working in dental health: dental therapists, dental hygienists and dental practitioners. Level of career satisfaction was assessed using a ten point scale in three surveys. Postal surveys were conducted of all dental therapists and dental hygienists registered with the General Dental Council. Data for dental practitioners were collected as part of the British Dental Association Omnibus Survey 2000. Data are reported for 227 dental therapists, 2,251 dental hygienists and 970 dental practitioners. Significant differences were found between groups in the level of career satisfaction expressed. Dental practitioners were less likely to express high levels of satisfaction in comparison with the other two professional groups. Within each group characteristics of the respondents were associated with satisfaction levels. Younger dental therapists and dental hygienists expressed lower levels of career satisfaction. The level of career satisfaction expressed by dental practitioners was associated with gender, place of work (North vs South UK), year of qualification, size of practice and system of remuneration. Dental practitioners express lower levels of job satisfaction in comparison to other groups of dental health care professionals. Job dissatisfaction among dental practitioners is related to a number of socio-demographic factors.
Lee, Helen H; Milgrom, Peter; Starks, Helene; Burke, Wylie
Inadequate access to oral health care places children at risk of caries. Disease severity and inability to cooperate often result in treatment with general anesthesia (GA). Sedation is increasingly popular and viewed as lower risk than GA in community settings. Currently, few data are available to quantify pediatric morbidity and mortality related to dental anesthesia. Summarize dental anesthesia-related pediatric deaths described in media reports. Review of media reports in the Lexis-Nexis Academic database and a private foundation website. Dental offices, ambulatory surgery centers, and hospitals. Patients :US-based children (≤21 years old) who died subsequently receiving anesthesia for a dental procedure between 1980-2011. Most deaths occurred among 2-5 year-olds (n = 21/44), in an office setting (n = 21/44), and with a general/pediatric dentist (n = 25/44) as the anesthesia provider. In this latter group, 17 of 25 deaths were linked with a sedation anesthetic. This series of media reports likely represent only a fraction of the overall morbidity and mortality related to dental anesthesia. These data may indicate an association between mortality and pediatric dental procedures under sedation, particularly in office settings. However, these relationships are difficult to test in the absence of a database that could provide an estimate of incidence and prevalence of morbidity and mortality. With growing numbers of children receiving anesthesia for dental procedures from providers with variable training, it is imperative to be able to track anesthesia-related adverse outcomes. Creating a national database of adverse outcomes will enable future research to advance patient safety and quality. © 2013 John Wiley & Sons Ltd.
Pourat, Nadereh; Choi, Moonkyung Kate; Chen, Xiao
Preventive dental health services are intended to reduce the likelihood of development of tooth decay and the need for more intensive treatment overtime. The evidence on the effectiveness of preventive dental care in reducing treatment services and expenditures is lagging for adults, particularly those with lower incomes and chronic conditions. We assessed the impact of preventive dental services on dental treatment service use and expenditures overall and by category of service. We calculated the annual numbers of preventive (periodic diagnostic and prophylactic procedures) and treatment (restorative, surgery, prosthodontic, endodontic, and periodontic) services per beneficiary using Medicaid enrollment and claims data for beneficiaries with three categories of conditions (diabetes, heart disease, and respiratory disease) from 10 largest California counties. We used Cragg hurdle exponential regression models controlling for past service use, demographics, length of enrollment, and county. We found that using preventive services in 2005-2007 was associated with higher likelihood and number of treatment dental services used, but associated with lower treatment expenditures in 2008. The reduction in expenditures was noted only in restorative, prosthodontics, and periodontic services. The findings provide much needed evidence of the contribution of preventive dental care in maintaining oral health of low-income adults with chronic conditions and potential for savings to the Medicaid program. Providing lower cost preventive dental care to the individuals with chronic conditions would achieve better oral health and lower treatment expenditures. © 2018 American Association of Public Health Dentistry.
Keyes, Paul H; Rams, Thomas E
An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. These observations further document the potential protective effects of dental calculus mineralization against dental caries.
Keyes, Paul H.; Rams, Thomas E.
Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993
Bedos, C; Levine, A; Brodeur, J-M
Oral diseases are highly prevalent among people on social assistance. Despite benefiting from public dental coverage in North America, these people rarely consult the dentist. One possible reason is rooted in their perception of oral health and the means to improve it. To respond to this question, largely unexplored, we conducted qualitative research through 8 focus groups and 15 individual interviews in Montreal (Canada). Thematic analysis revealed that people on social assistance: (a) define oral health in a social manner, placing tremendous value on dental appearance; (b) complain about the decline of their dental appearance and its devastating impact on self-esteem, social interaction, and employability; and (c) feel powerless to improve their oral health and therefore contemplate extractions and complete dentures. Our research demonstrates that perception of oral health strongly influences treatment preference and explains low and selective use of dental services in this disadvantaged population.
Shajahan, Irfana Fathima; Kandaswamy, D; Srikanth, Padma; Narayana, L Lakshmi; Selvarajan, R
Objective: The purpose of the study was to investigate the efficacy of a new disinfectant to disinfect the dental unit waterlines. Materials and Methods: New dental unit waterlines were installed in 13 dental chairs, and biofilm was allowed to grow for 10 days. Disinfection treatment procedure was carried out in the 12 units, and one unit was left untreated. The dental unit waterlines were removed and analyzed using the scanning electron microscope (SEM) (TESCAN VEGA3 SBU). Result: On examination, SEM images showed that there was no slime layer or bacterial cells seen in any of the 12 cut sections obtained from the treated dental waterlines which mean that there was no evident of biofilm formation. Untreated dental unit waterlines showed a microbial colonization with continuous filamentous organic matrix. There was significant biofilm formation in the control tube relative to the samples. Conclusion: The tested disinfectant was found to be effective in the removal of biofilm from the dental unit waterlines. PMID:27563184
Muhamedagic, Belma; Muhamedagic, Lejla; Masic, Izet
CONFLICT OF INTEREST: NONE DECLARED Waste management is one of the key ecological challenges of the modern world. As dental practitioners, we must recognize that some of the materials and procedures we use to provide dental health services may present challenges to the environment. Realizing this, we can begin to take measures to minimize the production of these wastes and their potential environmental effects. Dental office waste typically cause toxic chemicals to enter our streams, sewers, and landfills. This paper identifies some common wastes produced by dental offices (dental amalgam, silver, lead, biomedical and general office waste) and provides practical suggestions for reducing the impact of our profession on the environment. To dispose of dental wastes, if recycling is not an option, proper disposal as hazardous waste is necessary. But, problem is that dental waste is in most cases dumped at uncontrolled disposal sites, and that is public health and ecological risk. PMID:24133379
Referred to as Standard of Care, the legal duty of a dentist requires exercising the degree of skill and care that would be exhibited by other prudent dentists faced with the same patient-care situation. Primarily, the goal of keeping good dental records is to maintain continuity of care. Diligent and complete documentation and charting procedures are essential to fulfilling the Standard of Care. Secondly, because dental records are considered legal documents they help protect the interest of the dentist and/or the patient by establishing the details of the services rendered. Patients today are better educated and more assertive than ever before and dentists must be equipped to protect themselves against malpractice claims. Every record component must be handled as if it could be summoned to a court room and scrutinized by an attorney, judge or jury. Complete, accurate, objective and honest entries in a patient record are the only way to defend against any clinical and/or legal problems that might arise. Most medical and dental malpractice claims arise from an unfavorable interaction with the dentist and not from a poor treatment outcome. By implementing the suggestions mentioned in this course, dental health care professionals can minimize the legal risks associated with the delivery of dental care to promote greater understanding for patients of their rights and privileges to their complete record.
Andersson, P; Westergren, A; Johannsen, A
This study elucidates dental hygienists' experiences of work with tobacco cessation among patients who smoke or use snuff. Data were obtained and categorized by interviewing 12 dental hygienists, who worked actively with tobacco cessation interventions. Qualitative content analysis was used for analysis. The latent content was formulated into the core category 'the invisible oral health promotion work'. The informants thought that they had a responsibility to work with tobacco cessation. They perceived the financial system in which they perform the activity as frustrating, because tobacco cessation has no treatment code in the dental care insurance. This was one of several reasons why they had to integrate it in other treatment procedures. The results identified three categories: 'balance in the meeting', 'possibilities and hindrance' and 'procedures'. In the narratives, both positive and negative aspects were displayed. The financial conditions for tobacco cessation interventions need to be reformed and the activity has to be given a higher priority in the organization of dental care. Practical training in performing tobacco cessation interventions is important during the dental hygiene education; otherwise, tobacco cessation interventions will remain invisible in oral health promotion in the future. © 2011 John Wiley & Sons A/S.
Tut, Ohnmar K; Langidrik, Justina R; Milgrom, Peter M
This case study reports the ongoing progress and results of a manpower development program to expand indigenous dental personnel at four levels in the Republic of the Marshall Islands. The program was designed to: 1) increase the number of Marshallese students who successfully complete dentistry training; 2) recruit and train a group of Marshallese high school graduates in dental assisting for service in new preventive outreach programs within the community; 3) enhance the dental training of health assistants providing primary medical care to outer islands away from the main population centers of Majuro and Ebeye; and 4) provide in-service training on tooth decay prevention for Head Start teachers. The program resulted in the training of one Marshallese dentist and two Marshallese dental therapist, 16 primary care health aides who received oral health training for work in the outer island dispensaries, and 200 Head Start and kindergarten teachers who completed in-service training in oral health. Additional expertise was shared with other United States Affiliated Pacific Islands (USAPI) to enhance the dental workforce throughout the Pacific.
Blau, Soren; Hill, Anthony; Briggs, Christopher A; Cordner, Stephen M
The subject of missing persons is of great concern to the community with numerous associated emotional, financial, and health costs. This paper examines the forensic medical issues raised by the delayed identification of individuals classified as "missing" and highlights the importance of including dental data in the investigation of missing persons. Focusing on Australia, the current approaches employed in missing persons investigations are outlined. Of particular significance is the fact that each of the eight Australian states and territories has its own Missing Persons Unit that operates within distinct state and territory legislation. Consequently, there is a lack of uniformity within Australia about the legal and procedural framework within which investigations of missing persons are conducted, and the interaction of that framework with coronial law procedures. One of the main investigative problems in missing persons investigations is the lack of forensic medical, particularly, odontological input. Forensic odontology has been employed in numerous cases in Australia where identity is unknown or uncertain because of remains being skeletonized, incinerated, or partly burnt. The routine employment of the forensic odontologist to assist in missing person inquiries, has however, been ignored. The failure to routinely employ forensic odontology in missing persons inquiries has resulted in numerous delays in identification. Three Australian cases are presented where the investigation of individuals whose identity was uncertain or unknown was prolonged due to the failure to utilize the appropriate (and available) dental resources. In light of the outcomes of these cases, we suggest that a national missing persons dental records database be established for future missing persons investigations. Such a database could be easily managed between a coronial system and a forensic medical institute. In Australia, a national missing persons dental records database could be
Thevissen, Eric; De Bruyn, Hugo; Colman, Roos; Koole, Sebastiaan
Promoting oral hygiene and stimulating patient's responsibility for his/her personal health remain challenging objectives. The presence of dental hygienists has led to delegation of preventive tasks. However, in some countries, such as Belgium, this profession is not yet legalized. The aim of this exploratory study was to compare the attitude towards oral-hygiene instructions and patient motivational actions by dental hygienists and by general practitioners/periodontists in a context without dental hygienists. A questionnaire on demographics (six items), oral-hygiene instructions (eight items) and patient motivational actions (six items) was distributed to 241 Dutch dental hygienists, 692 general practitioners and 32 periodontists in Flanders/Belgium. Statistical analysis included Fisher's exact-test, Pearson's chi-square test and multiple (multinomial) logistic regression analysis to observe the influence of profession, age, workload, practice area and chair-assistance. Significant variance was found between general practitioners and dental hygienists (in 13 of 14 items), between general practitioners and periodontists (in nine of 14 items) and between dental hygienists and periodontists (in five of 14 items). In addition to qualification, chair-assistance was also identified as affecting the attitude towards preventive oral care. The present study identified divergence in the application of, and experienced barriers and opinions about, oral-hygiene instructions and patient motivational actions between dental hygienists and general practitioners/periodontists in a context without dental hygienists. In response to the barriers reported it is suggested that preventive oriented care may benefit from the deployment of dental hygienists to increase access to qualified preventive oral care. © 2017 FDI World Dental Federation.
Wanyonyi, Kristina L; Radford, David R; Gallagher, Jennifer E
Research suggests that health professionals who have trained together have a better understanding of one another's scope of practice and are thus equipped for teamwork during their professional careers. Dental hygiene-therapists (DHTs) are mid-level providers that can deliver routine care working alongside dentists. This study examines patterns of delegation (selected tasks and patients) by dental students to DHT students training together in an integrated team. A retrospective sample of patient data (n = 2,063) was extracted from a patient management system showing the treatment activities of two student cohorts (dental and DHT) involved in team training in a primary care setting in the South of England over two academic years. The data extracted included key procedures delegated by dental students to DHT students coded by skill-mix of operator (e.g., fissure sealants, restorations, paediatric extractions) and patient demography. χ2 tests were conducted to investigate the relationship between delegation and patient age group, gender, smoking status, payment-exemption status, and social deprivation. A total of 2,063 patients managed during this period received treatments that could be undertaken by either student type; in total, they received 14,996 treatment procedures. The treatments most commonly delegated were fissure sealants (90%) and restorations (51%); whilst the least delegated were paediatric extractions (2%). Over half of these patients (55%) had at least one instance of delegation from a dental to a DHT student. Associations were found between delegation and patient age group and smoking status (P <0.001). Children under 18 years old had a higher level of delegation (86%) compared with adults of working age (50%) and patients aged 65 years and over (56%). A higher proportion of smokers had been delegated compared with non-smokers (45% cf. 26%; P <0.001). The findings suggest that delegation of care to DHT students training as a team with dental
Krüger, Marta S M; Lang, Celina A; Almeida, Luiza H S; Bello-Corrêa, Fernanda O; Romano, Ana R; Pappen, Fernanda G
The present study aimed to determine the prevalence of dental pain during pregnancy and its association with sociodemographic factors and oral health conditions among 315 pregnant women in South Brazil. Participants were interviewed to obtain sociodemographic data, such as age, educational level, employment status, family income, and marital and parity status. Medical and dental histories were also collected, including the occurrence of dental pain and the use of dental services during pregnancy. Clinical examinations were performed to assess the presence of visible plaque and gingival bleeding and to calculate the decayed, missing, and filled teeth index. Means and standard deviations of continuous variables and frequencies and percentages of categorical variables were calculated. Independent variables were included in a multivariate logistic regression analysis. A total of 173 (54.9 %) pregnant women reported dental pain during pregnancy. After adjustment of the analysis, caries activity remained the main determinant of dental pain (odds ratio 3.33, 95 % CI 1.67-6.65). The prevalence of dental pain during pregnancy was high and the presence of caries activity was a determinant of dental pain. Moreover, access to oral health care was low, despite pregnant women's increased need for dental assistance.
..., suspension, or reduction of assistance based on information obtained from a SWICA or Federal agency. 5.236 Section 5.236 Housing and Urban Development Office of the Secretary, Department of Housing and Urban... Obtaining Income Information About Applicants and Participants § 5.236 Procedures for termination, denial...
..., suspension, or reduction of assistance based on information obtained from a SWICA or Federal agency. 5.236 Section 5.236 Housing and Urban Development Office of the Secretary, Department of Housing and Urban... Obtaining Income Information About Applicants and Participants § 5.236 Procedures for termination, denial...
Prasad, Soni; Bansal, Naveen
The aims of this study were to assess 1) differences in perceptions of dental implant training between dental students who received didactic training alone (control group) and those who received didactic plus simulation training (test group); 2) differences in response between students with and without clinical experience in implant dentistry; and 3) the interaction effect of simulation training and clinical experience on students' satisfaction. A survey was distributed to the control group in 2014 and to the test group in 2015; both groups were at the same U.S. dental school. Data were collected on confidence levels with various implant restorative procedures along with overall satisfaction and number of implant restorations performed by each student. The response rate was 78.7% in the control group and 81.3% in the test group. In the control group, 85.7% of students reported being satisfied with implant training compared to 90.8% of students in the test group. The interaction effect of simulation training and clinical experience on overall student satisfaction was OR=1.5 at 95% CI: 0.8, 3.0. The students who had clinical experience with implant restorative procedures had significantly greater satisfaction than those who did not (OR=4.8, 95% CI: 2.1, 11.1, p<0.01). This study found that both the simulation and clinical experience affected these students' confidence and satisfaction levels with implant education: they were almost five times more satisfied with implant training when clinical experience in implant restorative procedures was a part of their implant education.
Freeman, R; Gorter, R; Braam, A
To investigate if women compared with men dentists experience deferential treatment from their female nurses, what workplace strategies women use to manage chair-side assistance and to examine if these were country related. A convenience sample of 22 male and female dentists of different ages working in general dental practice in The Netherlands and Northern Ireland participated. The sample framework was determined by saturation of the concepts. All informants were interviewed in a clinical setting. The data was subjected to rigorous line by line coding in order to identify clusters of codes, themes and concepts. Three themes were identified. These were: experiencing deferential nursing assistance; adopting 'friendly-like' working strategies and adopting business-like, hierarchical working strategies. Gender differences were shown for each of the themes. Women rather than men made friends with their nurses and attempted to reduce status inequalities. This led to workplace strategy inconsistencies. This suggested that it was not the type of strategy adopted but the inconsistency with which it was implemented that caused difficulties between younger women dentists and their nurses. Training dental students and young graduates how to interact appropriately in the clinical situation and to appreciate the nurses' work status will assist in improving working relationships.
Keles, Sultan; Kocaturk, Ozlem
The aim of this study was to detect the effect of 1 μ g/kg of oral dexmedetomidine (DEX) as premedication among children undergoing dental procedures. The study involved 100 children between 2 and 6 years of age, ASA I, who underwent full-mouth dental rehabilitation. The DEX group ( n = 50) received 1 μ g/kg DEX in apple juice, and the control group ( n = 50) received only apple juice. The patients' scores on the Ramsay Sedation Scale (RSS), parental separation anxiety scale, mask acceptance scale, and pediatric anesthesia emergence delirium scale (PAEDS) and hemodynamic parameters were recorded. The data were analyzed using chi-square test, Fisher's exact test, Student's t -test, and analysis of variance in SPSS. RSS scores were significantly higher in the DEX group than group C at 15, 30, and 45 min ( p < 0.05). More children (68% easy separation, 74% satisfactory mask acceptance) in the DEX group showed satisfactory ease of parental separation and mask acceptance behavior ( p < 0.05). There was no significant difference in the PAEDS scores and mean hemodynamic parameters of both groups. Oral DEX administered at 1 μ g/kg provided satisfactory sedation levels, ease of parental separation, and mask acceptance in children but was not effective in preventing emergence delirium. The trial was registered (Protocol Registration Receipt NCT03174678) at clinicaltrials.gov.
Hashemi, Sepehr; Armand, Mehran; Gordon, Chad R
To describe the development and refinement of the computer-assisted planning and execution (CAPE) system for use in face-jaw-teeth transplants (FJTTs). Although successful, some maxillofacial transplants result in suboptimal hybrid occlusion and may require subsequent surgical orthognathic revisions. Unfortunately, the use of traditional dental casts and splints pose several compromising shortcomings in the context of FJTT and hybrid occlusion. Computer-assisted surgery may overcome these challenges. Therefore, the use of computer-assisted orthognathic techniques and functional planning may prevent the need for such revisions and improve facial-skeletal outcomes. A comprehensive CAPE system for use in FJTT was developed through a multicenter collaboration and refined using plastic models, live miniature swine surgery, and human cadaver models. The system marries preoperative surgical planning and intraoperative execution by allowing on-table navigation of the donor fragment relative to recipient cranium, and real-time reporting of patient's cephalometric measurements relative to a desired dental-skeletal outcome. FJTTs using live-animal and cadaveric models demonstrate the CAPE system to be accurate in navigation and beneficial in improving hybrid occlusion and other craniofacial outcomes. Future refinement of the CAPE system includes integration of more commonly performed orthognathic/maxillofacial procedures.
Hicks, Rodney W; Denholm, Bonnie
Perioperative nurses are likely to encounter the use of pneumatic tourniquets in a variety of operative and invasive extremity procedures. Use of a pneumatic tourniquet offers an opportunity to obtain a near-bloodless surgical field; however, the use of tourniquets is not without risk. Unfavorable outcomes include pain, thrombotic events, nerve compression injuries, and disruption of skin integrity. Perioperative nurses should be familiar with the indications, contraindications, and changes in physiology associated with pneumatic tourniquet use. The revised AORN "Recommended practices for care of patients undergoing pneumatic tourniquet-assisted procedures" is focused on the perioperative nurse's role in patient care and provides guidance for developing, implementing, and evaluating practices that promote patient safety and improve the likelihood of positive outcomes. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.
AlRahabi, Mothanna K
This study evaluated the technical quality of root canal treatment (RCT) and detected iatrogenic errors in an undergraduate dental clinic at the College of Dentistry, Taibah University, Saudi Arabia. Dental records of 280 patients who received RCT between 2013 and 2016 undertaken by dental students were investigated by retrospective chart review. Root canal obturation was evaluated on the basis of the length of obturation being ≤2 mm from the radiographic apex, with uniform radiodensity and good adaptation to root canal walls. Inadequate root canal obturation included cases containing procedural errors such as furcal perforation, ledge, canal transportation, strip perforation, root perforation, instrument separation, voids in the obturation, or underfilling or overfilling of the obturation. In 193 (68.9%) teeth, RCT was adequate and without procedural errors. However, in 87 (31.1%) teeth, RCT was inadequate and contained procedural errors. The frequency of procedural errors in the entire sample was 31.1% as follows: underfilling, 49.9%; overfilling, 24.1%; voids, 12.6%; broken instruments, 9.2%; apical perforation, 2.3%; and root canal transportation, 2.3%. There were no significant differences (p > 0.05) in the type or frequency of procedural errors between the fourth- and fifth-year students. Lower molars (43.1%) and upper incisors (19.2%) exhibited the highest and lowest frequencies of procedural errors, respectively. The technical quality of RCT performed by undergraduate dental students was classified as 'adequate' in 68.9% of the cases. There is a need for improvement in the training of students at the preclinical and clinical levels.
Maltz, Marisa; Jardim, Juliana Jobim; Alves, Luana Severo
The central idea of the Brazilian health system is to prevent the establishment of disease or detect it as early as possible. Prevention and treatment of dental caries are related to behavioral factors, including dietary and oral hygiene habits, which are related to many chronic diseases. Dental health promotion therefore should be fully integrated into broadly based health-promoting strategies and actions such as food and health policies, and general hygiene (including oral hygiene), among others. For decades, a linear relationship between sugar consumption and caries has been observed. Recent data has indicated that this relationship is not as strong as it used to be before the widespread use of fluoride. However, diet is still a key factor acting in the carious process. Oral hygiene is a major aspect when it comes to caries, since dental biofilm is its etiological factor. Oral hygiene procedures are effective in controlling dental caries, especially if plaque removal is performed adequately and associated with fluoride. An alternative to a more efficient biofilm control in occlusal areas is the use of dental sealants, which are only indicated for caries-active individuals. If a cavity is formed as a consequence of the metabolic activity of the biofilm, a restorative material or a sealant can be placed to block access of the biofilm to the oral environment in order to prevent caries progress. The prevention of dental caries based on common risk-factor strategies (diet and hygiene) should be supplemented by more disease-specific policies such as rational use of fluoride, and evidence-based dental health care.
Pan, Xiao-Gang; Qian, Yu-Fen; Weng, Si-En; Feng, Qi-Ping; Yu, Quan
To explore a simple method of reverting individual dental arch form template for wire bending. Individual dental arch form was reverted by four-point method. By defining central point of bracket on bilateral lower second premolar and first molar, certain individual dental arch form could be generated. The arch form generating procedure was then be developed to computer software for printing arch form. Four-point method arch form was evaluated by comparing with direct model measurement on linear and angular parameters. The accuracy and reproducibility were assessed by paired t test and concordance correlation coefficient with Medcalc 9.3 software package. The arch form by four-point method was of good accuracy and reproducibility (linear concordance correlation coefficient was 0.9909 and angular concordance correlation coefficient was 0.8419). The dental arch form reverted by four-point method could reproduce the individual dental arch form.
Mauriello, S M; Platin, E
Radiographs are an important adjunct to providing oral health care for the total patient. Historically, radiographic images have been produced using film-based systems. However, in recent years, with the arrival of new technologies, many practitioners have begun to incorporate digital radiographic imaging into their practices. Since dental hygienists are primarily responsible for exposing and processing radiographs in the provision of dental hygiene care, it is imperative that they become knowledgeable on the use and application of digital imaging in patient care and record keeping. The purpose of this course is to provide a comprehensive overview of digital radiography in dentistry. Specific components addressed are technological features, diagnostic software, advantages and disadvantages, technique procedures, and legal implications.
Dolin, Elana; Perlmutter, Leigh D; Segelnick, Stuart L; Weinberg, Mea A; Schoor, Robert
Septic arthritis of the glenohumoral joint is rare following dental procedures, comprising approximately 3% of all joint infections. Septic arthritis following bacteremia from dental procedures is uncommon and generally occurs in prosthetic joints. Predisposing causes may include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. We report a rare case of unilateral glenohumoral joint septic arthritis in a 60-year-old male patient (without a prosthetic joint) secondary to a dental procedure. The insidious nature of the presentation is highlighted. Septic arthritis infections, though rare, require a high level of clinical suspicion. Vague symptoms of shoulder pain may mask the initial diagnosis, as was the case in our patient. Incision and drainage via surgical intervention are often required, followed by parenteral antibiotics.
A course plan is presented for introducing literature searching and critical skills to dental students. Topics include the “life cycle of information,” reference sources available, search procedure, abstracting and indexing, and personal information systems. Teaching is structured around planned seminars and student projects. The course design is compatible with traditional dental curricula and is based on students' interest in dentistry rather than in information/library science. PMID:5024320
Brennan, David S; Do, Loc Giang; Slade, Gary D
In Australia, the majority of dental patients attend the private sector, while those with means tested eligibility for government assistance may attend the public sector. The aims of this study were to compare dental caries among persons who last visited private and public clinics, controlling for age, sex, reason for visit, and income. Data were collected in 2004-06, using a three-stage, stratified clustered sample of Australians aged 15+years, involving a computer-assisted telephone interview (CATI), oral examination, and mailed questionnaire. A total of 14,123 adults responded to the CATI (49 percent response) of whom 5,505 (44 percent of those interviewed) had an oral epidemiological examination. Multivariate regression analysis controlling for age, sex, reason for visit, and showed (P < 0.05) that persons attending public clinics had higher levels of decayed (beta = 0.33) and missing teeth (beta = 0.83), but lower levels of filled teeth (beta = -1.09) compared with the reference category of private clinics. Persons who attend for dental care in the public sector have worse oral health than adults who visit private dental clinics, in addition to an independent effect of socioeconomic disadvantage.
Cher, Tsang-Lie; Lai, Eddie Hsiang-Hua; Huang, Chiung-Shing; Lin, Chun-Pin
In Taiwan, dental manpower in hospitals plays an important role in dental education other than clinical service. Questionnaires, as well as a field survey, were conducted to understand the situation of dental manpower in 2007 and 2008. During the period from 2007 to 2008, questionnaires about dental administration, clinical dental practice, dental education, dental manpower and dental facilities were mailed to the dental departments of 165 hospitals located around Taiwan; 134 completed the questionnaire and mailed it back. The field survey was also carried out by visiting hospitals, to collect and gather information at the local level. There were 102 hospitals within the 134 hospitals which accepted the field survey; the rate was 62.0%. In 2008, the number of dentists working in the hospitals was 1,421, which was approximately 13% of the number of total dentists in Taiwan (9672). Within the 1,421 dentists, 675 were attending staffs and 745 dentists were training residents. Within the 675 attending dentists, 510 (75.6%) had dental specialist certificates and 272 (40.3%) had teaching positions in dental schools. There were 382 dental interns (6(th) year undergraduate students) taking the training programs in hospitals, most of whom were trained in medical centers (342/382, 89.5%). Moreover, there were 888 dental assistants, 338 of whom were nurses and the other 550 were hospital self-trained personnel. Comparing the dental manpower of different types of hospitals in Taiwan, the medical center was the best, followed by the regional hospital and the district hospital was last. When comparing 2008 with 2002, the numbers of both dentists and auxiliary personnel in Taiwan's hospitals increased with years. Although there were still only 13% dentists working in the hospital, they were responsible for teaching young dentists and doing research in hospitals. In other words, the quality of clinical service, teaching, and research in hospitals would influence the development of
Matthew, Ian R; Walton, Joanne N; Dumaresq, Cheryl; Sudmant, Walter
Debt among Canadian university graduates is increasing, while money apportioned to federal and provincial needs-based student assistance programs has been decreasing since the 1990s. Dental students have had to absorb increased tuition fees at both the undergraduate and post-baccalaureate levels. Existing debt and high tuition fees may adversely influence a potential candidate"s decision to enroll in dental school. Likewise, debt incurred during the minimum 2 years of pre-dental education adds to the future debt load of dental graduates. It seems that few dental students can remain debt-free during their dental education, although data are lacking about the extent of debt among dental students and its impact on their career decisions. Government statistics focus primarily on tuition costs for baccalaureate-degree students. Tuition and clinic-related fees constitute a significant proportion of costs for dental students; moreover, university administrations perceive dentistry as an expensive curriculum. This first article of a 4-part series examines debt among dental students, both nationally and internationally.
Blue, Christine M.; Funkhouser, D. Ellen; Riggs, Sheila; Rindal, D. Brad; Worley, Donald; Pihlstrom, Daniel J.; Benjamin, Paul; Gilbert, Gregg H.
Objectives The purpose of this study was to quantify within The National Dental Practice-Based Research Network current utilization of dental hygienists and assistants with expanded functions and quantify network dentists’ attitudes toward a new non-dentist provider model - the dental therapist. Methods Dental practice-based research network practitioner-investigators participated in a single, cross-sectional administration of a questionnaire. Results Current non-dentist providers are not being utilized by network practitioner-investigators to the fullest extent allowed by law. Minnesota practitioners, practitioners in large group practices, and those with prior experience with expanded function non-dentist providers delegate at a higher rate and had more-positive perceptions of the new dental therapist model. Conclusions Expanding scopes of practice for dental hygienists and assistants has not translated to the maximal delegation allowed by law among network practices. This finding may provide insight into dentists’ acceptance of newer non-dentist provider models. PMID:23668892
Barbe, Anna Greta; Kottmann, Hannah Elisa; Hamacher, Stefanie; Derman, Sonja Henny Maria; Noack, Michael Johannes
To determine the impact of general and oral health status of nursing home residents in Germany on efficacy and acceptance of professional dental cleaning performed by a dental nurse. Participants (N = 41; mean age 83 ± 8 years) living in a nursing home were included. Personal and general health, oral health, oral hygiene habits, and needs were investigated. Individual acceptance regarding professional dental cleaning via different devices (scaler, interdental brushes, ultrasonic cleaning) was assessed, as was the efficacy of this method using after-cleaning indices. Oral health among nursing home residents was impaired and independent from dementia status. Most residents (33/41) performed oral hygiene procedures independently and showed better index values than those in need of external help. Residents requiring help with oral hygiene showed increased risk profiles (higher age, more often immobile, demented, more xerostomia). The dental cleaning procedure required a mean time of 37 ± 11 min, was widely accepted (36/41), and achieved clean results (plaque index 0.1 ± 0.5, oral hygiene index 0.2 ± 1.6, Volpe-Manhold index 0.4 ± 1.6); food residues were reduced to 0 independent from cognitive status. Regarding the cleaning methods, scalers were accepted best without difference between demented and non-demented residents. Professional dental cleaning in nursing homes is an accepted and efficacious oral hygiene procedure among nursing home residents. Professional dental cleaning is an efficacious and accepted method as a first step in line with strategies to improve oral health and should be considered in nursing home residents.
Johansen, Raymond J; Michael Bowers, C
Dental identification of unknown human remains continues to be a relevant and reliable adjunct to forensic investigations. The advent of genomic and mitochondrial DNA procedures has not displaced the practical use of dental and related osseous structures remaining after destructive incidents that can render human remains unrecognizable, severely burned, and fragmented. The ability to conclusively identify victims of accident and homicide is based on the availability of antemortem records containing substantial and unambiguous proof of dental and related osseous characteristics. This case report documents the use of digital comparative analysis of antemortem dental models and postmortem dentition, to determine a dental identification. Images of dental models were digitally analyzed using Adobe Photoshop(TM) software. Individual tooth anatomy was compared between the antemortem and postmortem images. Digital superimposition techniques were also used for the comparison. With the absence of antemortem radiographs, this method proved useful to reach a positive identification in this case. © 2012 American Academy of Forensic Sciences.
Kriangcherdsak, Yutthasak; Raucharernporn, Somchart; Chaiyasamut, Teeranut; Wongsirichat, Natthamet
Inferior alveolar nerve block (IANB) of the mandible is commonly used in the oral cavity as an anesthetic technique for dental procedures. This study evaluated the success rate of the first IANB administered by dental practitioners. Volunteer dental practitioners at Mahidol University who had never performed an INAB carried out 106 INAB procedures. The practitioners were divided into 12 groups with their advisors by randomized control trials. We recorded the success rate via pain visual analog scale (VAS) scores. A large percentage of the dental practitioners (85.26%) used the standard method to locate the anatomical landmarks, injecting the local anesthetic at the correct position, with the barrel of the syringe parallel to the occlusal plane of the mandibular teeth. Further, 68.42% of the dental practitioners injected the local anesthetic on the right side by using the left index finger for retraction. The onset time was approximately 0-5 mins for nearly half of the dental practitioners (47.37% for subjective onset and 43.16% for objective onset), while the duration of the IANB was approximately 240-300 minutes (36.84%) after the initiation of numbness. Moreover, the VAS pain scores were 2.5 ± 1.85 and 2.1 ± 1.8 while injecting and delivering local anesthesia, respectively. The only recorded factor that affected the success of the local anesthetic was the administering practitioner. This reinforces the notion that local anesthesia administration is a technique-sensitive procedure.
Moore, Kenneth; Khan, Nickalus R; Michael, L Madison; Arthur, Adam S; Hoit, Daniel
Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method. We review the literature on intravascular foreign bodies, retained dental needles, and endovascular techniques for retrieval of such foreign bodies. 2017 BMJ Publishing Group Ltd.
Hosoki, M.; Satsuma, T.; Nishigawa, K.; Takeuchi, H.; Asaoka, K.
The elemental analysis of intraoral dental restorations provides considerable information for the treatment of dental metal allergy. Elemental analyses require specific instruments and complicated procedures, so this examination is not commonly carried out in private dental clinics. We describe a novel, simple and useful micro-analytical method for dental metal restorations. Micro metal dust was obtained by polishing the surface of restorative metal material with an unused silicone point (SUPER-SNAP). The metal dust on the silicone point was then rubbed onto adhesive tape, and this tape was covered with polyethylene film. The amount of metal dust material was <20 μg. An energy dispersive X-ray fluorescence spectrometer was used to carry out the elementary analysis of the metal dust on the polyethylene film. Three types of dental metal alloy materials of known components were examined. The results of elementary analyses were compared with the specifications provided by the manufacturer. The same procedure was carried out for three dental metal restorations of an adult female volunteer in vivo. The results of elemental analyses for five alloy materials exactly matched the product specification. Three metal samples obtained from intraoral restoration were also available for elemental analyses. The distinct advantage of this method is that it enables sample extraction without an invasive effect for the restoration. The metal sample is in a polyethylene film, so it is easy to mail it for inspection at specialist institutes yet it can be also be used in general dental clinics.
Nakib, Ghassan; Calcaterra, Valeria; Scorletti, Federico; Romano, Piero; Goruppi, Ilaria; Mencherini, Simonetta; Avolio, Luigi; Pelizzo, Gloria
Robotic assisted surgery is not yet widely applied in the pediatric field. We report our initial experience regarding the feasibility, safety, benefits, and limitations of robot-assisted surgery in pediatric gynecological patients. Descriptive, retrospective report of experience with pediatric gynecological patients over a period of 12 months. Department of Pediatric Surgery, IRCCS Policlinico San Matteo Foundation. Children and adolescents, with a surgical diagnosis of ovarian and/or tubal lesions. Robot assembly time and operative time, days of hospitalization, time to cessation of pain medication, complication rate, conversion rate to laparoscopic procedure and trocar insertion strategy. Six children and adolescents (2.4-15 yrs), weighing 12-55 kg, underwent robotic assisted surgery for adnexal pathologies: 2 for ovarian cystectomy, 2 for oophorectomy, 1 for right oophorectomy and left salpingo-oophorectomy for gonadal disgenesis, 1 for exploration for suspected pelvic malformation. Mean operative time was 117.5 ± 34.9 minutes. Conversion to laparatomy was not necessary in any of the cases. No intra- or postoperative complications occurred. Initial results indicate that robotic assisted surgery is safely applicable in the pediatric gynecological population, although it is still premature to conclude that it provides better clinical outcomes than traditional laparoscopic surgery. Randomized, prospective, comparative studies will help characterize the advantages and disadvantages of this new technology in pediatric patients. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Sun, Xiaoyan; McKenzie, Frederic D; Bawab, Sebastian; Li, Jiang; Yoon, Yongki; Huang, Jen-K
One of the most important factors affecting the outcome of dental implantation is the accurate insertion of the implant into the patient's jaw bone, which requires a high degree of anatomical accuracy. With the accuracy and stability of robots, image-guided robotics is expected to provide more reliable and successful outcomes for dental implantation. Here, we proposed the use of a robot for drilling the implant site in preparation for the insertion of the implant. An image-guided robotic system for automated dental implantation is described in this paper. Patient-specific 3D models are reconstructed from preoperative Cone-beam CT images, and implantation planning is performed with these virtual models. A two-step registration procedure is applied to transform the preoperative plan of the implant insertion into intra-operative operations of the robot with the help of a Coordinate Measurement Machine (CMM). Experiments are carried out with a phantom that is generated from the patient-specific 3D model. Fiducial Registration Error (FRE) and Target Registration Error (TRE) values are calculated to evaluate the accuracy of the registration procedure. FRE values are less than 0.30 mm. Final TRE values after the two-step registration are 1.42 ± 0.70 mm (N = 5). The registration results of an automated dental implantation system using image-guided robotics are reported in this paper. Phantom experiments show that the practice of robot in the dental implantation is feasible and the system accuracy is comparable to other similar systems for dental implantation.
An informal survey of individuals and a search of MEDLINE literature sought information on funding sources for computer-assisted instruction projects in dental, medical, and nursing education. General patterns are outlined, and suggestions are made for locating project funding. (MSE)
Maramaldi, Peter; Walji, Muhammad F.; White, Joel; Etoulu, Jini; Kahn, Maria; Vaderhobli, Ram; Kwatra, Japneet; Delattre, Veronique F.; Hebballi, Nutan B.; Stewart, Denice; Kent, Karla; Yansane, Alfa; Ramoni, Rachel B.; Kalenderian, Elsbeth
Background There is increased recognition that patients suffer adverse events (AEs) or harm caused by treatments in dentistry, and little is known about how dental providers describe these events. Understanding how providers view AEs is essential to building a safer environment in dental practice. Methods Dental providers and domain experts were interviewed through focus groups and in-depth interviews and asked to identify the types of AEs that may occur in dental settings. Results The first order listing of the interview and focus group findings yielded 1,514 items that included both causes and AEs. 632 causes were coded into one of the eight categories of the Eindhoven classification. 882 AEs were coded into 12 categories of a newly developed dental AE classification. Inter-rater reliability was moderate among coders. The list was reanalyzed and duplicate items were removed leaving a total of 747 unique AEs and 540 causes. The most frequently identified AE types were “Aspiration/ingestion” at 14% (n=142), “Wrong-site, wrong-procedure, wrong-patient errors” at 13%, “Hard tissue damage” at 13%, and “Soft tissue damage” at 12%. Conclusions Dental providers identified a large and diverse list of AEs. These events ranged from “death due to cardiac arrest” to “jaw fatigue from lengthy procedures”. Practical Implications Identifying threats to patient safety is a key element of improving dental patient safety. An inventory of dental AEs underpins efforts to track, prevent, and mitigate these events. PMID:27269376
Ternovoĭ, S K; Serova, N S; Ivanova, D V
To determine the capacities of radiologic studies in the examination of patients with dental anomalies. One hundred and twenty patients with dental anomalies were examined. Conventional X-ray and high-technology radiology techniques (multislice spiral computed tomography (MSSCT) and cone-beam computed tomography (CBCT)) were used. Orthopantomography is the most common method for radiologic examination of patients with dental anomalies. However, X-ray procedures do not provide complete information on the position and status of an abnormal tooth, which is required to define further patient management tactics. While planning the management, MSSCT and CBCT were performed in 56 (46.7%) and 64 (53.3%) patients, respectively. In addition, 72 (60.0%) patients in whom orthodontic treatment had been recommended at the first stage underwent MSSCT or CBCT following 7 months. CBCT showed that 4 (3.3%) patients had dental ankylosis previously undiagnosed by MSSCT. The high-technology radiology techniques could assess the position of a tooth in relation to its important anatomic structures and identify the comorbidity that keeps from being treated. MSSCT and CBCT can make in full measure the topical diagnosis of abnormal teeth and hence choose an optimal algorithm for comprehensive treatment of patients.
Platt, Larry A.; Bailey, Wilfrid C.
This paper discusses the advantages of using both qualitative and quantitative methodological procedures in investigating attitudinal and perception changes in the population studied. This project is part of a 4-year longitudinal study involving 24 dental students and 29 faculty members of a new southern dental school. The paper reviews some of…
Taylor, Mary Ann
This project was conducted to develop a curriculum for dental auxiliary training in the dental specialty field of oral and maxillofacial surgery. Research was conducted to identify the major functions performed by an oral surgery assistant and then to organize these functions into an educational program that would provide adequate didactic and…
Weems, Richard A.; And Others
A procedure for testing the ability of dental students to detect presence and depth of dental caries was evaluated. Students (n=40) from four experience groups examined radiographs obtained from a model. Results indicated that this method of assessing student competence in radiographic interpretation is valid. (MSE)
Kotlow, L A
Educating the parents of my patients about the techniques and specialized care pediatric dentists provide has always been a challenge. When I began my dental practice in 1974, the materials and audiovisual programs that were available for parental and patient education were of poor quality and often did not reflect my office philosophy. The multimedia material for pediatric dentistry was limited in scope and of little value in conveying to the parents and patients pediatric restorative procedures, causes of dental disease, caries prevention and patient management. Effective communication to the public can be divided into two areas: in-office marketing; and outside advertising. The primary focus of this discussion will be on in-house marketing of your dental practice using Microsoft PowerPoint.
To maximize office production, dentists should continuously perform treatment-related tasks throughout the workday. To this end, the office should logically organize and store dental instruments, disposables, materials, handpieces, and small equipment to optimize accessibility of these items at the moment when the dentist needs them. The office needs multiple copies of these items to prevent their inaccessibility during the workday due to breakdown, inventory depletion, or lack of a sterilized copy of the item when needed. Staff should know where all items are located in the office at all times to minimize the time needed to search for them. This article describes how to organize dental items in an office for optimal accessibility to the dentist during procedures.
Rajavaara, P; Rankinen, S; Laitala, M-L; Vähänikkilä, H; Yli-Urpo, H; Koskinen, S; Anttonen, V
To analyse the occurrence and causes of dental general anaesthesia (DGA) in healthy and medically compromised children, and to investigate if there are differences between those groups considering factors associated with DGA and DGA procedures. The data was collected from medical records of children under 7 years of age treated under DGA in the years 2009 and 2010 at the Oulu University Hospital, Finland. The children were divided into two groups: 0-35-month-olds and ≥36-month olds. Background information (year, age, gender, dental diagnosis, health) and the procedures performed were registered. The procedures were analysed considering the child's age and tooth types. The number of children treated under DGA increased between 2009 (58) and 2010 (82), particularly in the group of healthy children. The two main diagnoses leading to DGA were dental caries and dental fear. Dental caries as the first dental diagnosis leading to DGA was more common among the medically compromised children (61.5%) compared to the healthy children (38.6%). The procedures performed were similar among the two groups. However, they varied between the age groups and tooth types and even between upper and lower teeth. The medically compromised children had been treated more frequently under DGA in the past. The threshold for treating medically compromised children under DGA seems to be lower than for healthy children. However, the occurrence of DGA among healthy children has increased recently. To avoid unnecessary DGA, the control of caries should be carried out according to individual needs and independent of whether the child is healthy or has a chronic disease.
Doughty, J; Lala, R; Marshman, Z
The popularity of cosmetic surgery has seen a rapid increase recently, with the trend mirrored in dentistry. The Department of Health expressed concerns about the potential for biological and psychosocial harm of these cosmetic procedures. Furthermore, the dental public health implications (DPH) of the growing uptake of cosmetic dental procedures have not been explored. Conduct a scoping review to explore the DPH implications of cosmetic dentistry and identify gaps for future research. A fivestage scoping review was conducted of studies identified using the search terms cosmetic AND dentistry. Data from the studies meeting the inclusion criteria were extracted, collated and summarised into themes. Fifty-seven papers met the inclusion criteria (11 cross-sectional studies, 10 literature reviews and 36 opinion pieces). The DPH implications were summarised into five emergent themes: dento-legal and ethical, marketing, psychosocial, biological and workforce. These themes revealed patients' increased expectations, expanding commercialisation of the profession, psychological risks to vulnerable patients, the iatrogenic consequences of invasive cosmetic dental procedures and workforce implications of the current trends. The scoping review found that existing literature on cosmetic dentistry is predominately anecdotal - professional opinions and discussions. Despite this, our findings demonstrated workforce training and governance implications due to increased demand for cosmetic dentistry. Further empirical research is needed to understand the DPH implications of the increasing demand and uptake of cosmetic dental procedures to guide evidence-based policy to safeguard patients and improve the quality of dental services. Copyright© 2016 Dennis Barber Ltd
Hakim, H.; Razak, I. A.
Objective. To assess the prevalence and level of dental fear among health related undergraduates and to identify factors causing such fear using Kleinknecht's Dental Fear Survey (DFS) questionnaire. Methods. Kleinknecht's DFS questionnaire was used to assess dental fear and anxiety among the entire enrollment of the medical and dental undergraduates' of the University of Malaya. Results. Overall response rate was 82.2%. Dental students reported higher prevalence of dental fear (96.0% versus 90.4%). However, most of the fear encountered among dental students was in the low fear category as compared to their medical counterpart (69.2 versus 51.2%). Significantly more medical students cancelled dental appointment due to fear compared to dental students (P = 0.004). “Heart beats faster” and “muscle being tensed” were the top two physiological responses experienced by the respondents. “Drill” and “anesthetic needle” were the most fear provoking objects among respondents of both faculties. Conclusion. Dental fear and anxiety are a common problem encountered among medical and dental undergraduates who represent future health care professionals. Also, high level of dental fear and anxiety leads to the avoidance of the dental services. PMID:25386615
Lee, Donghyun; Park, Sungjo; Kim, Chulhong
Dental implants are common method to replace decayed or broken tooth. As the implant treatment procedures varies according to the patients' jawbone, bone ridge, and sinus structure, appropriate examinations are necessary for successful treatment. Currently, radiographic examinations including periapical radiology, panoramic X-ray, and computed tomography are commonly used for diagnosing and monitoring. However, these radiographic examinations have limitations in that patients and operators are exposed to radioactivity and multiple examinations are performed during the treatment. In this study, we demonstrated photoacoustic (PA) and ultrasound (US) combined imaging of dental implant that can lower the total amount of absorbed radiation dose in dental implant treatment. An acoustic resolution PA macroscopy and a clinical PA/US system was used for dental implant imaging. The acquired dual modal PA/US imaging results support that the proposed photoacoustic imaging strategy can reduce the radiation dose rate during dental implant treatment.
The cutting of dental hard tissue during restorative procedures presents considerable demands on the ability to selectively remove diseased carious tissue, obtain outline and retention form and maintain the integrity of supporting tooth tissue without structural weakening. In addition, the requirement to preserve healthy tissue and prevent further breakdown of the restoration places the choice of instrumentation and clinical technique as prime factors for the dental surgeon. The quest for an alternative treatment modality to the conventional dental turbine has been, essentially, patient-driven and has led to the development of various mechanical and chemical devices. The review of the literature has endorsed the beneficial effects of current laser machines. However utopian, there is additional evidence to support the development of ultra-short (nano- and femto-second) pulsed lasers that are stable in use and commercially viable, to deliver more efficient hard tissue ablation with less risk of collateral thermal damage. This paper explores the interaction of laser energy with dental hard tissues and bone and the integration of current laser wavelengths into restorative and surgical dentistry.
VanCleave, Andrea M; Jones, James E; McGlothlin, James D; Saxen, Mark A; Sanders, Brian J; Walker, LaQuia A
Surgical fires are well-characterized, readily preventable, potentially devastating operating room catastrophes that continue to occur from 20 to 100 times per year or, by one estimate, up to 600 times per year in US operating rooms, sometimes with fatal results. The most significant risk factors for surgical fires involve (a) the use of an ignition source, such as laser or electrocautery equipment, in or around an oxygen-enriched environment in the head, neck, and upper torso area and (b) the concurrent delivery of supplemental oxygen, especially via nasal cannula. Nonetheless, while these 2 conditions occur very commonly in dental surgery, especially in pediatric dental surgery where sedation and anesthesia are regularly indicated, there is a general absence of documented dental surgical fires in the literature. Barring the possibility of underreporting for fear of litigation, this may suggest that there is another mechanism or mechanisms present in dental or pediatric dental surgery that mitigates this worst-case risk of surgical fires. Some possible explanations for this include: greater fire safety awareness by dental practitioners, incidental ventilation of oxygen-enriched environments in patient oral cavities due to breathing, or suction used by dental practitioners during procedures. This review of the literature provides a background to suggest that the practice of using intraoral suction in conjunction with the use of supplemental oxygen during dental procedures may alter the conditions needed for the initiation of intraoral fires. To date, there appear to be no published studies describing the ability of intraoral suctioning devices to alter the ambient oxygen concentration in an intraoral environment. In vivo models that would allow examination of intraoral suction on the ambient oxygen concentration in a simulated intraoral environment may then provide a valuable foundation for evaluating the safety of current clinical dental surgical practices
Palenik, C J
Many dental laboratory procedures increase the chances of serious eye injury. This would include traumatic injuries due to projectiles or through exposure to harsh chemicals or heat and infections from contact with patient body fluids. To help assure a safer working environment, awareness of the need for eye protection must be established and maintained by all laboratory personnel. The purpose of this article are: 1) to list the applicable federal regulations concerning eye safety in dental laboratory workplaces; 2) to describe the various types of appropriate eyewear; and 3) to identify which protective devices best prevent exposure to specific types of hazards. The goal of this article is to help dental laboratories with their employee safety programs, especially concerning the selection of protective eyewear. Such programs must include engineering controls and work practice controls plus appropriate personal protective equipment. Laboratories today must comply with safety mandates in the most effective and efficient manner.
Rai, Reena; Dinakar, Devina; Kurian, Swetha S; Bindoo, Y A
Dental products are widely used by patients and dental personnel alike and may cause problems for both. Dental materials could cause contact allergy with varying manifestations such as burning, pain, stomatitis, cheilitis, ulcers, lichenoid reactions localized to the oral mucosa in patients, and hand dermatitis in dental personnel. Patch testing with the dental series comprising commonly used materials can be used to detect contact allergies to dental materials. This study aimed to identify contact allergy among patients who have oral mucosal lesions after dental treatment and among dental personnel who came in contact with these materials. Twenty patients who had undergone dental procedures with symptoms of oral lichen planus, oral stomatitis, burning mouth, and recurrent aphthosis, were included in the study. Dental personnel with history of hand dermatitis were also included in the study. Patch testing was performed using Chemotechnique Dental Series and results interpreted as recommended by the International Contact Dermatitis Research Group (ICDRG). Out of 13 patients who had undergone dental treatment/with oral symptoms, six patients with stomatitis, lichenoid lesions, and oral ulcers showed positive patch tests to a variety of dental materials, seven patients with ulcers had negative patch tests, seven dental personnel with hand dermatitis showed multiple allergies to various dental materials, and most had multiple positivities. The patch test is a useful, simple, noninvasive method to detect contact allergies among patients and among dental personnel dealing with these products. Long term studies are necessary to establish the relevance of these positive patch tests by eliminating the allergic substances, identifying clinical improvement, and substituting with nonallergenic materials.
Wolff, A; Singer, A; Shlomi, B
Patients unable to tolerate routine dental treatment in an ordinary dental setting may undergo a wide range of dental procedures under general anaesthesia. This report describes a practical protocol for providing comprehensive dental treatment under general anaesthesia. The importance and uniqueness of planning, treating and adopting safety measures is illustrated through the presentation of clinical cases of patients with mouth opening limitation. Complete treatment can thus be achieved in a single visit, thereby eliminating repetition of coping with anxiety associated with repeated treatment sessions.
Jeon, Jin Pyeong; Cho, Young Dae; Rhim, Jong Kook; Park, Jeong Jin; Cho, Won-Sang; Kang, Hyun-Seung; Kim, Jeong Eun; Hwang, Gyojun; Kwon, O-Ki; Han, Moon Hee
Outcomes of stent-assisted coil embolization (SACE) have not been well established in the setting of vertebrobasilar dissecting aneurysms (VBDAs) due to the low percentage of cases that need treatment and the array of available therapeutic options. Herein, we presented clinical and radiographic results of SACE in patients with VBDAs. A total of 47 patients (M:F, 30:17; mean age ± SD, 53.7 ± 12.6 years), with a VBDA who underwent SACE between 2008 and 2014 at two institutions were evaluated retrospectively. Medical records and radiologic data were analyzed to assess the outcome of SACE procedures. Cox proportional hazards regression analysis was conducted to determine the factors that were associated with aneurysmal recanalization after SACE. Stent-assisted coil embolization technically succeeded in all patients. Three cerebellar infarctions occurred on postembolization day 1, week 2, and month 2, but no other procedure-related complications developed. Immediately following SACE, 25 aneurysms (53.2%) showed no contrast filling into the aneurysmal sac. During a mean follow-up of 20.2 months, 37 lesions (78.7%) appeared completely occluded, whereas 10 lesions showed recanalization, 5 of which required additional embolization. Overall recanalization rate was 12.64% per lesion-year, and mean postoperative time to recanalization was 18 months (range, 3-36 months). In multivariable analysis, major branch involvement (hazard ratio [HR]: 7.28; p = 0.013) and the presence of residual sac filling (HR: 8.49, p = 0.044) were identified as statistically significant independent predictors of recanalization. No bleeding was encountered in follow-up monitoring. Stent-assisted coil embolization appears feasible and safe for treatment of VBDAs. Long-term results were acceptable in a majority of patients studied, despite a relatively high rate of incomplete occlusion immediately after SACE. Major branch involvement and coiled aneurysms with residual sac filling may predispose to
Kalghatgi, Shrivardhan; Prasad, Kakarla Veera Venkata; Chhabra, Kumar Gaurav; Deolia, Shravani; Chhabra, Chaya
To assess the knowledge, attitude, and practice of ergonomics among dental professionals of Hubli-Dharwad twin cities, India. Investigator-developed, self-administered, closed-ended questionnaire assessing knowledge, attitude, and practices regarding ergonomics during dental practice was filled in by undergraduates, house surgeons, postgraduates, and faculty members of dental institutions and private practitioners from Hubli-Dharwad twin cities. Data were collected from a total of 250 participants, 50 belonging to each academic group. Overall mean knowledge, attitude, and practice scores were 52%, 75%, and 55%, respectively. Significant correlation was found for age with attitude (χ(2) = 10.734, p = 0.030) and behavior (χ(2) = 12.984, p = 0.011). Marital status was significantly associated with all the three domains; knowledge (χ(2) = 29.369, p = 0.000), attitude (χ(2) = 29.023, p = 0.000), and practices (χ(2) = 13.648, p = 0.009). Participants had considerable awareness and behavior toward ergonomics in dental practice. The high attitude score indicates stronger acceptance of ergonomics principles and guidelines during routine dental procedures. The current study highlights the situation of ergonomics in dental practice in the form of knowledge, attitude, and practices.
Evans, J; Henderson, A; Johnson, N
Teamwork is essential for the provision of contemporary, high quality oral health care. Teamwork skills need to be taught and learnt and therefore ought to be one of the core competencies in all dental education programmes: dentistry, oral health therapy, dental technology and dental assisting. Currently, lack of opportunities for collaborative learning and practice within educational establishments, and in the practising professions, hamper the development of effective teamwork. For students across oral health care, learning 'together' requires positive action for teamwork skills to be developed. Interprofessional curricula need to be formally developed, based on evidence from the wider education literature that demonstrates how to maximise the engagements needed for teamwork in practice. Rigorous study of interprofessional education within dentistry and oral health is in its infancy. Anecdotal evidence indicates that dental technology students who experience an interprofessional curriculum are better prepared for collaborative practice. Formalised interprofessional education is posited as an effective strategy to improve interactions among oral health professionals leading to improved patient care. This paper reviews the extant literature and describes the approach currently being trialled at Griffith University.
Pritzel, S J; Green, T G
The purpose of this study was to reexamine the working relationship between the dentist and the dental hygienist with regard to delegation and professional interaction. A questionnaire was mailed to Michigan dentists and dental hygienists to acquire data regarding dental hygiene practice, office procedures, and employer/employee interaction. Of the 500 dentists surveyed, 289 (58%) returned questionnaires, and of the 360 hygienists surveyed, 298 (83%) returned questionnaires. The dental hygienists' perception of their practice is significantly different from the dentists' in several major areas. More than half of the dentists reported checking the hygienist's work all of the time, whereas only one third of the hygienists reported always being checked. Assessment of patient needs by a clinical caries examination is perceived differently. Most of the hygienists reported they perform clinical caries examinations all of the time, whereas only two thirds of the dentists reported the hygienist always performs an examination. Delegation of auxiliary procedures is viewed similarly by both dentists and hygienists, but procedures which can be performed are not being delegated. With respect to professional communications, half of the dentists perceive that they provide feedback to the hygienist all of the time, while only one third of the hygienists feel they receive feedback all of the time. In determining the recall interval, most of the dentists reported establishing it in consultation with the hygienist, whereas half of the hygienists reported setting it alone. Data suggest that the dentists' perceptions are inconsistent with the hygienists' in role delineation and patient care.
Monarca, S; Garusi, G; Gigola, P; Spampinato, L; Zani, C; Sapelli, P L
Bacterial contamination of the dental unit water system can become a health problem for patients, particularly if they are immunodepressed. The present study has had the purpose of evaluating the effectiveness of methods of chemical decontamination using different disinfectants (peracetic acid, hydrogen peroxide, silver salts, chloramine T, glutaraldehyde T4) and methods of physical decontamination using synthetic membranes for the filtration of water. A preliminary removal procedure of the biofilm present in the waterline has been followed in a dental unit prepared on purpose for the research; subsequently different 2-week long maintenance procedures were applied using disinfectants injected by a pump and finally the bacterial contamination of the water flowing from the waterline was evaluated. The physical decontamination was performed using 0.22 mm membrane filters, which have been installed also in another dental unit, and the filtered water was analyzed to detect bacterial contamination. The preliminary procedure of biofilm removal succeeded obtaining germ-free water. Among the disinfectants used for the maintenance of the water quality only glutaraldehyde T4 was able to reduce the bacterial contamination under the limit suggested by the ADA. The membrane filter system was not able to purify the water, but when a disinfectant (peracetic acid) was used in the last part of the waterline good results were obtained. At present no decontamination system of dental waterline is available, and glutaraldehyde T4 seems to be the best disinfectant only if integrated with periodic biofilm removal for the maintenance of the water quality.
Hazey, Jeffrey W; Melvin, W Scott
With the initiation of laparoscopic techniques in general surgery, we have seen a significant expansion of minimally invasive techniques in the last 16 years. More recently, robotic-assisted laparoscopy has moved into the general surgeon's armamentarium to address some of the shortcomings of laparoscopic surgery. AESOP (Computer Motion, Goleta, CA) addressed the issue of visualization as a robotic camera holder. With the introduction of the ZEUS robotic surgical system (Computer Motion), the ability to remotely operate laparoscopic instruments became a reality. US Food and Drug Administration approval in July 2000 of the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, CA) further defined the ability of a robotic-assist device to address limitations in laparoscopy. This includes a significant improvement in instrument dexterity, dampening of natural hand tremors, three-dimensional visualization, ergonomics, and camera stability. As experience with robotic technology increased and its applications to advanced laparoscopic procedures have become more understood, more procedures have been performed with robotic assistance. Numerous studies have shown equivalent or improved patient outcomes when robotic-assist devices are used. Initially, robotic-assisted laparoscopic cholecystectomy was deemed safe, and now robotics has been shown to be safe in foregut procedures, including Nissen fundoplication, Heller myotomy, gastric banding procedures, and Roux-en-Y gastric bypass. These techniques have been extrapolated to solid-organ procedures (splenectomy, adrenalectomy, and pancreatic surgery) as well as robotic-assisted laparoscopic colectomy. In this chapter, we review the evolution of robotic technology and its applications in general surgical procedures.
Humphris, G M; Freeman, R; Campbell, J; Tuutti, H; D'Souza, V
To gain further evidence of the psychometric properties of the Modified Dental Anxiety Scale. Dental admission clinics. Consecutive sampling, cross-sectional survey. Patients (n = 800) in four cities (Belfast, Northern Ireland; Helsinki, Finland; Jyväskylä, Finland and Dubai, UAE). Questionnaire booklet handed to patients, attending clinics, for completion following an invitation by the researcher to be included in the study. Modified Dental Anxiety Scale (MDAS), together with further questions concerning dental attendance and nervousness about dental procedures. Overall 9.3 per cent of patients indicated high dental anxiety. MDAS showed high levels of internal consistency, and good construct validity. The relationship of dental anxiety with age was similar to previous reports and showed lowered anxiety levels in older patients. Data from three countries has supported the psychometric properties of this modified and brief dental anxiety scale.
Colvard, Michael D; Hirst, Jeremy L; Vesper, Benjamin J; DeTella, George E; Tsagalis, Mila P; Roberg, Mary J; Peters, David E; Wallace, Jimmy D; James, James J
The reauthorization of the Pandemic and All-Hazards Preparedness Act in 2013 incorporated the dental profession and dental professionals into the federal legislation governing public health response to pandemics and all-hazard situations. Work is now necessary to expand the processes needed to incorporate and train oral health care professionals into pandemic and all-hazard response events. A just-in-time (JIT) training exercise and immunization drill using an ex vivo porcine model system was conducted to demonstrate the rapidity to which dental professionals can respond to a pandemic influenza scenario. Medical history documentation, vaccination procedures, and patient throughput and error rates of 15 dental responders were evaluated by trained nursing staff and emergency response personnel. The average throughput (22.33/hr) and medical error rates (7 of 335; 2.08%) of the dental responders were similar to those found in analogous influenza mass vaccination clinics previously conducted using certified public health nurses. The dental responder immunization drill validated the capacity and capability of dental professionals to function as a valuable immunization resource. The ex vivo porcine model system used for JIT training can serve as a simple and inexpensive training tool to update pandemic responders' immunization techniques and procedures supporting inoculation protocols.
A personnel management problem exists within dental public health that interferes with its mission of improving the nation's oral health. A major cause of this problem may be that many administrators who write position descriptions and hire professional staff are unaware of differences between clinical and public health dental practitioners. A marketing plan has been developed to address this lack of awareness about proper use of dental public health professionals. Its main goal is to establish more appropriate personnel and employment practices within dental public health. The expected outcomes of this plan could assist both recipients of dental public health services and members of the profession. The purpose of this article is to introduce the marketing strategy to dental public health professionals.
Shah, Syed M; Merchant, Anwar T; Dosman, James A
Background Percutaneous exposure incidents facilitate transmission of bloodborne pathogens such as human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV). This study was conducted to identify the circumstances and equipment related to percutaneous injuries among dental professionals. Methods We used workers' compensation claims submitted to the Department of Labor and Industries State Fund during a 7-year period (1995 through 2001) in Washington State for this study. We used the statement submitted by the injured worker on the workers' compensation claim form to determine the circumstances surrounding the injury including the type of activity and device involved. Results Of a total of 4,695 accepted State Fund percutaneous injury claims by health care workers (HCWs), 924 (20%) were submitted by dental professionals. Out of 924 percutaneous injuries reported by dental professionals 894 (97%) were among dental health care workers in non-hospital settings, including dentists (66, 7%), dental hygienists (61, 18%) and dental assistants (667, 75%). The majority of those reporting were females (638, 71%). Most (781, 87%) of the injuries involved syringes, dental instruments (77, 9%), and suture needles (23%). A large proportion (90%) of injuries occurred in offices and clinics of dentists, while remainder occurred in offices of clinics and of doctors of medicine (9%), and a few in specialty outpatient facilities (1%). Of the 894 dental health care workers with percutaneous injuries, there was evidence of HBV in 6 persons, HCV in 30 persons, HIV in 3 persons and both HBV and HVC (n = 2) exposure. Conclusion Out of hospital percutaneous injuries are a substantial risk to dental health professionals in Washington State. Improved work practices and safer devices are needed to address this risk. PMID:17074095
Cuypers, Eva; Flinders, Bryn; Boone, Carolien M; Bosman, Ingrid J; Lusthof, Klaas J; Van Asten, Arian C; Tytgat, Jan; Heeren, Ron M A
Today, hair testing is considered to be the standard method for the detection of chronic drug abuse. Nevertheless, the differentiation between systemic exposure and external contamination remains a major challenge in the forensic interpretation of hair analysis. Nowadays, it is still impossible to directly show the difference between external contamination and use-related incorporation. Although the effects of washing procedures on the distribution of (incorporated) drugs in hair remain unknown, these decontamination procedures prior to hair analysis are considered to be indispensable in order to exclude external contamination. However, insights into the effect of decontamination protocols on levels and distribution of drugs incorporated in hair are essential to draw the correct forensic conclusions from hair analysis; we studied the consequences of these procedures on the spatial distribution of cocaine in hair using imaging mass spectrometry. Additionally, using metal-assisted secondary ion mass spectrometry, we are the first to directly show the difference between cocaine-contaminated and user hair without any prior washing procedure.
Ng, Man Wai; Fida, Zameera
Management of the complex chronic disease of early childhood caries requires a system of coordinated health care interventions which can be led by a dental hygienist and where patient self-care efforts are paramount. Even after receiving costly surgical treatment under general anesthesia in the operating room, many children develop new and recurrent caries after only 6-12 months, a sequela that can be prevented. This article describes the chronic disease management (CDM) of dental caries, a science-based approach that can prevent and control caries. In this article, we (1) introduce the concept of CDM of dental caries, (2) provide evidence that CDM improves oral health outcomes, and (3) propose a dental hygienist-led team-based oral health care approach to CDM. Although we will be describing the CDM approach for early childhood caries, CDM of caries is applicable in children, adolescents, and adults. Early childhood caries disease control requires meaningful engagement of patients and parents by the oral health care team to assist them with making behavioral changes in the unique context of their families and communities. The traditional dentist/hygienist/assistant model needs to evolve to a collaborative partnership between care providers and patients/families. This partnership will be focused on systematic risk assessment and behaviorally based management of the disease itself, with sensitivity toward the familial environment. Early pilot study results demonstrate reductions in the rates of new caries, dental pain, and referral to the operating room compared with baseline rates. Dental hygienists are the appropriate team members to lead this approach because of their expertise in behavior change and prevention. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Mathe, Nathalie; Kedar, Smadar
Procedures are widely used by operators for controlling complex dynamic systems. Currently, most development of such procedures is done manually, consuming a large amount of paper, time, and manpower in the process. While automated knowledge acquisition is an active field of research, not much attention has been paid to the problem of computer-assisted acquisition and refinement of complex procedures for dynamic systems. The Procedure Acquisition for Reactive Control Assistant (PARC), which is designed to assist users in more systematically and automatically encoding and refining complex procedures. PARC is able to elicit knowledge interactively from the user during operation of the dynamic system. We categorize procedure refinement into two stages: diagnosis - diagnose the failure and choose a repair - and repair - plan and perform the repair. The basic approach taken in PARC is to assist the user in all steps of this process by providing increased levels of assistance with layered tools. We illustrate the operation of PARC in refining procedures for the control of a robot arm.
Barnes, Caren M
With the advent of new caries detection devices that allow early detection, dental hygienists can intervene in the demineralization process and work with the patient toward remineralization through patient self-care procedures and the professional application of topical fluorides. The focus of this article is on caries detection devices, caries risk assessment, agents used to prevent dental caries, and the development of self-care plans for patients that include prevention, intervention, and therapeutic components.
Prasant, M C; Thukral, Rishi; Kumar, Sachin; Sadrani, Sannishth M; Baxi, Harsh; Shah, Aditi
Ever since its introduction in 1977, a minimum of few months of period is required for osseointegration to take place after dental implant surgery. With the passage of time and advancements in the fields of dental implant, this healing period is getting smaller and smaller. Immediate loading of dental implants is becoming a very popular procedure in the recent time. Hence, we retrospectively analyzed the various risk factors for the failure of delayed and immediate loaded dental implants. In the present study, retrospective analysis of all the patients was done who underwent dental implant surgeries either by immediate loading procedure or by delayed loading procedures. All the patients were divided broadly into two groups with one group containing patients in which delayed loaded dental implants were placed while other consisted of patients in whom immediate loaded dental implants were placed. All the patients in whom follow-up records were missing and who had past medical history of any systemic diseases were excluded from the present study. Evaluation of associated possible risk factors was done by classifying the predictable factors as primary and secondary factors. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Kaplan-Meier survival analyses and chi-square test were used for assessment of level of significance. In delayed and immediate group of dental implants, mean age of the patients was 54.2 and 54.8 years respectively. Statistically significant results were obtained while comparing the clinical parameters of the dental implants in both the groups while demographic parameters showed nonsignificant correlation. Significant higher risk of dental implant failure is associated with immediate loaded dental implants. Tobacco smoking, shorter implant size, and other risk factors play a significant role in predicting the success and failure of dental implants. Delayed loaded dental implant placement should be preferred
Nevzatoğlu, Sirin; Küçükkeleş, Nazan
The long-term treatment results of surgically-assisted facemask therapy were assessed by a comparison of the immediate protraction effects with those seen at five years review. Nine patients treated with a corticotomy-assisted maxillary protraction protocol were recalled five years following protraction. Cephalometric films taken before treatment (T0), immediately after maxillary protraction (T1) and five years after treatment (T2) were compared. The short-term results of surgically-assisted facemask therapy showed significant skeletal and soft tissue changes. After five years, the profile and dental relationships were well maintained and a cephalometric analysis revealed a stable vertical increase but only partially maintained soft tissue changes with loss of sagittal advancement. There was significant upper incisor proclination providing dental camouflage. Patients who are treated with corticotomy-assisted maxillary advancement should be very carefully selected. Assessment criteria include a low mandibular plane angle Class III patients who have severe maxillary retrognathism unable to be treated by conventional orthopaedic correction alone; patients who have almost completed growth and missed the chance of earlier orthopaedic correction, as well as patients who are not willing to accept bimaxillary orthognathic surgery, may be successfully treated.
The purpose of this SOP is to describe the training sequence of incoming student laboratory assistants. The procedure is designed to provide them with an overview of the project in terms of project goals, structure, and laboratory needs. This overview familiarizes the student l...
The purpose of this SOP is to describe the training sequence for incoming student data assistants (students). The procedure is designed to provide them with an overview of the study in terms of study goals, structure and project data needs. This overview familiarizes the studen...
Rai, Reena; Dinakar, Devina; Kurian, Swetha S.; Bindoo, Y. A.
Background: Dental products are widely used by patients and dental personnel alike and may cause problems for both. Dental materials could cause contact allergy with varying manifestations such as burning, pain, stomatitis, cheilitis, ulcers, lichenoid reactions localized to the oral mucosa in patients, and hand dermatitis in dental personnel. Patch testing with the dental series comprising commonly used materials can be used to detect contact allergies to dental materials. Aim: This study aimed to identify contact allergy among patients who have oral mucosal lesions after dental treatment and among dental personnel who came in contact with these materials. Materials and Methods: Twenty patients who had undergone dental procedures with symptoms of oral lichen planus, oral stomatitis, burning mouth, and recurrent aphthosis, were included in the study. Dental personnel with history of hand dermatitis were also included in the study. Patch testing was performed using Chemotechnique Dental Series and results interpreted as recommended by the International Contact Dermatitis Research Group (ICDRG). Results: Out of 13 patients who had undergone dental treatment/with oral symptoms, six patients with stomatitis, lichenoid lesions, and oral ulcers showed positive patch tests to a variety of dental materials, seven patients with ulcers had negative patch tests, seven dental personnel with hand dermatitis showed multiple allergies to various dental materials, and most had multiple positivities. Conclusion: The patch test is a useful, simple, noninvasive method to detect contact allergies among patients and among dental personnel dealing with these products. Long term studies are necessary to establish the relevance of these positive patch tests by eliminating the allergic substances, identifying clinical improvement, and substituting with nonallergenic materials. PMID:25165644
Brodie, Abby J; Crow, Heidi C; Eber, Robert M; Handysides, Robert; Holexa, Roy; Kiat-amnuay, Sudarat; Spallek, Heiko
Increasingly, U.S. dental schools report pass/fail grades and do not rank students. In addition, the Joint Commission on National Dental Examinations will report National Board Dental Examination (NBDE) scores as pass/fail after January 1, 2012. This article discusses how these changes will force postdoctoral dental program directors to modify how they assess candidates and how noncognitive evaluations might enhance those assessments. The authors propose developing a national qualifying examination for postdoctoral dental programs that will measure knowledge, decision making, and noncognitive traits including empathy, self-confidence, integrity, and emotional intelligence. Without NBDE scores, class rank, and GPA as a basis for decision making, a single national qualifying examination would assist postdoctoral programs in selecting high-quality candidates based on knowledge, critical thinking skills, and noncognitive traits.
Dyer, Tom A; Brocklehurst, Paul; Glenny, Anne-Marie; Davies, Linda; Tickle, Martin; Issac, Ansy; Robinson, Peter G
Poor or inequitable access to oral health care is commonly reported in high-, middle- and low-income countries. Although the severity of these problems varies, a lack of supply of dentists and their uneven distribution are important factors. Delegating care to dental auxiliaries could ease this problem, extend services to where they are unavailable and liberate time for dentists to do more complex work. Before such an approach can be advocated, it is important to know the relative effectiveness of dental auxiliaries and dentists. To assess the effectiveness, costs and cost effectiveness of dental auxiliaries in providing care traditionally provided by dentists. We searched the following electronic databases from their inception dates up to November 2013: the Cochrane Effective Practice and Organisation of Care (EPOC) Group's Specialised Register; Cochrane Oral Health Group's Specialised Register; the Cochrane Central Register of Controlled Trials (Issue 11, 2013); MEDLINE; EMBASE; CINAHL; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effectiveness; five other databases and two trial registries. We also undertook a grey literature search and searched the reference list of included studies and contacted authors of relevant papers. We included randomised controlled trials (RCTs), non-randomised controlled clinical trials (NRCTs), interrupted time series (ITSs) and controlled before and after studies (CBAs) evaluating the effectiveness of dental auxiliaries compared with dentists in undertaking clinical tasks traditionally performed by a dentist. Three review authors independently applied eligibility criteria, extracted data and assessed the risk of bias of each included study and two review authors assessed the quality of the evidence from the included studies, according to The Cochrane Collaboration's procedures. Since meta-analysis was not possible, we gave a narrative description of the results. We identified five studies (one cluster
... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Application procedures. 206.202 Section 206.202 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Administration § 206.202 Application procedures. (a) General. This section describes the policies and procedures...
Koulocheris, P; Metzger, M C; Kesting, M R; Hohlweg-Majert, B
It is highly recommended to conduct a prophylactic check for any dental problems on patients who suffer from leukaemia before chemotherapy begins. Bacteraemia caused by oral microflora may be very dangerous for patients with haematological malignancies. However, it should be noted that the prophylactic process itself might bring about life-threatening complications if there is only a short interval between dental treatment and the beginning of chemotherapy, or if the dental treatment is too aggressive. We present a case where this prophylactic procedure produced life-threatening complications for a patient with acute myeloid leukaemia.
Garrett, Pauline H; Faraone, Karen L; Patzelt, Sebastian B M; Keaser, Michael L
Little is known about self-directed and self-reflective assessment in preclinical dental curricula. The aim of this study was to evaluate a visual dental anatomy teaching tool to train dental students to self-assess their dental anatomy wax carving practical examinations. The students self-assessed two waxing practical examinations (tooth #8 and tooth #19) using high-quality digital images in an assessment tool incorporated into a digital testing program. Student self-assessments were compared to the faculty evaluations and the results of a software-based evaluation tool (E4D Compare). Out of a total 130 first-year dental students at one U.S. dental school, wax-ups from 57 participants were available for this study. The assessment data were submitted to statistical analyses (p<0.05). For tooth #8, the student self-assessments were significantly different from the faculty and software assessments at a 400 micrometer level of tolerance (p=0.036), whereas the faculty assessment was not significantly different from the software assessment at a 300 micrometer level of tolerance (p=0.69). The evaluation of tooth #19 resulted in no significant differences between faculty members (p=0.94) or students (p=0.21) and the software at a level of tolerance of 400 micrometers. This study indicates that students can learn to self-assess their work using self-reflection in conjunction with faculty guidance and that it may be possible to use software-based evaluation tools to assist in faculty calibration and as objective grading tools.
Lind, Patricia; Germano, Catherine
These five learning modules use text interspersed with illustrations and reinforcement exercises to instruct dental aide and dental hygiene students about jaw bones and gums, dental deposits, and dental instruments. The first four modules were prepared by Patricia Lind in both Spanish and English. "The Gum and Bone of Permanent Teeth"…
Petrović, Mateja; Kühl, Sebastian; Šlaj, Martina; Connert, Thomas; Filippi, Andreas
Handball has developed into a much faster and high-impact sport over the past few years because of rule changes. Fast sports with close body contact are especially prone to orofacial trauma. Handball belongs to a category of sports with medium risk for dental trauma. Even so, there is only little literature on this subject. The aim of this study was to examine the prevalence and the type of injuries, especially the occurrence of orofacial trauma, habits of wearing mouthguards, as well as degree of familiarity with the tooth rescue box. For this purpose, 77.1% (n=542/703) of all top athletes and coaches from the two highest Swiss leagues (National League A and National League B), namely 507 professional players and 35 coaches, were personally interviewed using a standardized questionnaire. 19.7% (n=100/507) of the players experienced dental trauma in their handball careers, with 40.8% (n=51/125) crown fractures being the most frequent by far. In spite of the relatively high risk of lip or dental trauma, only 5.7% (n=29/507) of the players wear mouthguards. The results of this study show that dental trauma is common among Swiss handball players. In spite of the high risk of dental trauma, the mouthguard as prevention is not adequately known, and correct procedure following dental trauma is rarely known at all.
Aweid, Osama; Sundararajan, Sabapathy; Teferi, Abraham
Granulicatella adiacens is a Gram-positive bacteria and a normal component of oral flora. It is also found in dental plaques, endodontic abscesses and can rarely cause more serious infections. We describe a prosthetic hip joint infection in an 81-year-old fit and healthy man due to Granulicatella adiacens who underwent a prolonged dental intervention two days earlier without antibiotic prophylaxis. The infection was successfully treated with surgical intervention and a combination of antibiotics. The patient eventually succumbed to severe community-acquired pneumonia two months later. Current guidelines recommend avoidance of antibiotic prophylaxis prior to dental treatment in patients who have no co-morbidities and no prior operation on the index prosthetic joint. This case report indicates that infections of prosthetic joints may be associated with dental procedures even in fit and healthy patients without the recognized risk factors.
Sonneveld, Rutger E; Brands, Wolter G; Bronkhorst, Ewald M; Welie, Jos V M; Truin, Gert-Jan
To explore which organisational aspects are considered most important by patients when assessing a general dental practice, and which patients' characteristics influence their views on these aspects by a paper questionnaire. The questionnaire was handed out to a sample of 5,000 patients in the Netherlands. The response rate was 63%. Six organisational aspects out of a list of 41 aspects were valued as most important by at least 50%. In decreasing order of importance, these were: accessibility by telephone; continuing education for general dental practitioners; Dutch-speaking general dental practitioners; in-office waiting times; information about treatments offered; and waiting lists. For four out of these six aspects, respondents' age and education significantly influenced their preferences. Aspects concerning the infrastructure of a general dental practice were chosen more often than aspects such as working to professional standards, working according to protocols and guidelines, quality assessment and guaranteed treatment outcomes. The findings will enable organisations to increase the transparency of health-care delivery systems to focus on those organisational aspects of dental practices that patients themselves consider most important. These findings can also assist general dental practitioners in adapting their organisational services to the preferences of patients or specific patient groups. © 2013 FDI World Dental Federation.
Kalghatgi, Shrivardhan; Prasad, Kakarla Veera Venkata; Chhabra, Kumar Gaurav; Deolia, Shravani; Chhabra, Chaya
Background To assess the knowledge, attitude, and practice of ergonomics among dental professionals of Hubli–Dharwad twin cities, India. Methods Investigator-developed, self-administered, closed-ended questionnaire assessing knowledge, attitude, and practices regarding ergonomics during dental practice was filled in by undergraduates, house surgeons, postgraduates, and faculty members of dental institutions and private practitioners from Hubli–Dharwad twin cities. Results Data were collected from a total of 250 participants, 50 belonging to each academic group. Overall mean knowledge, attitude, and practice scores were 52%, 75%, and 55%, respectively. Significant correlation was found for age with attitude (χ2 = 10.734, p = 0.030) and behavior (χ2 = 12.984, p = 0.011). Marital status was significantly associated with all the three domains; knowledge (χ2 = 29.369, p = 0.000), attitude (χ2 = 29.023, p = 0.000), and practices (χ2 = 13.648, p = 0.009). Conclusion Participants had considerable awareness and behavior toward ergonomics in dental practice. The high attitude score indicates stronger acceptance of ergonomics principles and guidelines during routine dental procedures. The current study highlights the situation of ergonomics in dental practice in the form of knowledge, attitude, and practices. PMID:25516809
Arnaoutakis, George J; Bittle, Gregory J; Allen, Jeremiah G; Weiss, Eric S; Alejo, Jennifer; Baumgartner, William A; Shah, Ashish S; Wolfgang, Christopher L; Efron, David T; Conte, John V
Left ventricular assist devices (LVADs) have become common as a bridge to heart transplant as well as destination therapy. Acute care surgical (ACS) problems in this population are prevalent but remain ill-defined. Therefore, we reviewed our experience with ACS interventions in LVAD patients. A total of 173 patients who received HeartMate(®) XVE or HeartMate(®) II (HMII) LVADs between December 2001 and March 2010 were studied. Patient demographics, presentation of ACS problem, operative intervention, co-morbidities, transplantation, complications, and survival were analyzed. A total of 47 (27 %) patients underwent 67 ACS procedures at a median of 38 days after device implant (interquartile range 15-110), with a peri-operative mortality rate of 5 % (N = 3). Demographics, device type, and acuity were comparable between the ACS and non-ACS groups. A total of 21 ACS procedures were performed emergently, eight were urgent, and 38 were elective. Of 29 urgent and emergent procedures, 28 were for abdominal pathology. In eight patients, the cause of the ACS problem was related to LVADs or anticoagulation. Cumulative survival estimates revealed no survival differences if patients underwent ACS procedures (p = 0.17). Among HMII patients, transplantation rates were unaffected by an ACS intervention (p = 0.2). ACS problems occur frequently in LVAD patients and are not associated with adverse outcomes in HMII patients. The acute care surgeon is an integral member of a comprehensive approach to effective LVAD management.
Racine, E; Hautvast, G; Binnekamp, D
Purpose: To report on the results of a complete permanent implant brachytherapy procedure assisted by an electromagnetic (EM) hollow needle possessing both 3D tracking and seed drop detection abilities. Methods: End-to-end in-phantom EM-assisted LDR procedures were conducted. The novel system consisted of an EM tracking apparatus (NDI Aurora V2, Planar Field Generator), a 3D US scanner (Philips CX50), a hollow needle prototype allowing 3D tracking and seed drop detection and a specially designed treatment planning software (Philips Healthcare). A tungsten-doped 30 cc spherical agarose prostate immersed in gelatin was used for the treatment. A cylindrical shape of 0.8 cc wasmore » carved along its diameter to mimic the urethra. An initial plan of 26 needles and 47 seeds was established with the system. The plan was delivered with the EM-tracked hollow needle, and individual seed drop locations were recorded on the fly. The phantom was subsequently imaged with a CT scanner from which seed positions and contour definitions were obtained. The DVHs were then independently recomputed and compared with those produced by the planning system, both before and after the treatment. Results: Of the 47 seeds, 45 (96%) were detected by the EM technology embedded in the hollow needle design. The executed plan (from CT analysis) differed from the initial plan by 2%, 14% and 8% respectively in terms of V100, D90 and V150 for the prostate, and by 8%, 7% and 10% respectively in terms of D5, V100 and V120 for the urethra. Conclusion: The average DVH deviations between initial and executed plans were within a 5% tolerance imposed for this proof-of-concept assessment. This relatively good concordance demonstrates the feasibility and potential benefits of combining EM tracking and seed drop detection for real-time dosimetry validation and assistance in permanent implant brachytherapy procedures. This project has been entirely funded by Philips Healthcare.« less
Mehr, Katarzyna; Wyganowska-Swiatkowska, Marzena; Kowalkowska, Iwona; Kurhańska-Flisykowska, Anna; Piotrowski, Paweł
Music is generally recognized as the best and, in parallel, the simplest medium of communication. The music therapy, applied in various spheres linked to a therapeutic process, is particularly valued in rehabilitation, medicine, humanities and social sciences. Present study aimed at determination of usefulness of selected techniques of music therapy in different dental specialties. The studies were conducted on 81 generally healthy patients aging 18 to 62 years. Various planned dental procedures were performed first time or were appraised by the patients as unpleasant ones. On the basis of pilot studies, a stable scheme of the visits was established. At the beginning of the studies, music therapy according to Kierył was conducted. Subsequently, basing on description of Schwabe, a form of regulatory individual music therapy was conducted. Depending on psychoemotional condition of the patient, music programming was based on ISO and LEVEL principles, taking into account musical preferences of the patient and his/her age. After every visit the patients filled questionnaires and appropriate results, together with results of studies performed by the dentist, were subjected to statistical analysis. 1. Results of the studies encourage application of musicotherapeutic techniques in different dental specialties. 2. Dental visit can be made attractive and patient's visits in dental office can be facilitated with no significant financial input or organizational.
Holt, Marianne P
The main purpose of this study was to investigate student retention strategies and practices implemented in associate degree, entry-level dental hygiene programs. Included are student attrition issues, academic standards, re-entry policies, and clinical remediation strategies. A survey consisting of forced choice and open-ended questions was mailed to 31 randomly selected associate degree, entry-level dental hygiene programs. Surveys were analyzed using descriptive statistics and frequency distributions. Open-ended questions were analyzed using the constant comparative qualitative method to identify recurring themes. There was an 80% (n=25) return response to the survey. The findings of this study determined that dental hygiene programs are graduating, on average, a higher percentage (83%) of students when compared to two-year, associate degree programs in general (46%). The primary reasons reported by respondents for student attrition included: academic difficulties (88%), dissatisfaction with career choice (76%), family/personal responsibilities (72%), and clinical skill difficulties (56%). A wide variety of retention strategies were reported. Those most often cited were academic remediation (92%), clinical skill development/remediation (84%), academic advising (84%), financial aid assistance (84%), and tutoring (80%). Participating programs also reported setting high academic and ethical standards. Specific criteria for student re-entry were discussed. The findings of this study suggest that associate degree, entry-level dental hygiene programs are committed to student retention and make considerable efforts to help students succeed. Student retention efforts could be enhanced for those student groups identified as possibly being at high risk for attrition. The findings and recommendations in this investigation may assist associate degree, entry-level dental hygiene programs in their efforts to retain a higher percentage of students.
..., beneficiary pre-authorization and marketing procedures, and care for beneficiaries residing in distant areas... examinations; and (iii) Diagnostic laboratory tests and examinations provided in connection with other dental...) Initial determination. A formal written decision on a TDP claim, a request for TDP benefit pre...
..., beneficiary pre-authorization and marketing procedures, and care for beneficiaries residing in distant areas... examinations; and (iii) Diagnostic laboratory tests and examinations provided in connection with other dental...) Initial determination. A formal written decision on a TDP claim, a request for TDP benefit pre...
Grenoble, D. E.; Knoell, A. C.
The human need for safe and effective dental implants is well-recognized. Although many implant designs have been tested and are in use today, a large number have resulted in clinical failure. These failures appear to be due to biomechanical effects, as well as biocompatibility and surgical factors. A unified approach is proposed using multidisciplinary systems technology, for the study of the biomechanical interactions between dental implants and host tissues. The approach progresses from biomechanical modeling and analysis, supported by experimental investigations, through implant design development, clinical verification, and education of the dental practitioner. The result of the biomechanical modeling, analysis, and experimental phases would be the development of scientific design criteria for implants. Implant designs meeting these criteria would be generated, fabricated, and tested in animals. After design acceptance, these implants would be tested in humans, using efficient and safe surgical and restorative procedures. Finally, educational media and instructional courses would be developed for training dental practitioners in the use of the resulting implants.
Stewart, Stacey; Hanning, Rhona
The National Report Card on Osteoporosis Care (2008) announced the need for comprehensive approaches to risk reduction and improvement in the early diagnosis of osteoporosis. Dental research has suggested that low systemic bone-mineral density also occurs in alveolar bone, and people with osteoporosis may have an increased risk of tooth loss. Whether or not a causal link exists, both conditions share similar modifiable risk factors, including a role for calcium and vitamin D. The purpose of this paper was to critically examine the role calcium and vitamin D play in the relationship between osteoporosis and the risk of tooth loss. Scientific articles were obtained through PubMed, MEDLINE, CINAHL, AgeLine and Web of Science. Publications were restricted to those involving human subjects, and English-language articles on calcium and vitamin D. The search yielded 8 articles relating to osteoporosis and tooth loss that included calcium and vitamin D intake. Despite methodological concerns, the evidence shows a relationship between osteoporosis and tooth loss for people who have an inadequate intake of calcium and vitamin D. Adequate calcium intake positively influences optimal peak bone mass and may also assist in tooth retention in later life. The dental sector can assist with national prevention strategies for osteoporosis care.
.... FDA-2008-N-0163] (formerly Docket No. 2001N-0067) RIN 0910-AG21 Dental Devices: Classification of Dental Amalgam, Reclassification of Dental Mercury, Designation of Special Controls for Dental Amalgam... the Federal Register of August 4, 2009 (74 FR 38686) which classified dental amalgam as a class II...
Munetz, Mark R; Ritter, Christian; Teller, Jennifer L S; Bonfine, Natalie
Mandated community treatment has been proposed as a mechanism to engage people with severe and persistent mental disorders in treatment. Recently, two approaches to mandate treatment through the courts have been highlighted: assisted outpatient treatment (AOT) and mental health court programs. This study examined levels of perceived coercion, procedural justice, and the impact of the program (mental health court or AOT) among participants in a community treatment system. Data were analyzed from interviews with former AOT participants who were no longer under court supervision (N=17) and with graduates of a mental health court program (N=35). The MacArthur Admission Experience Survey, created to measure perceived coercion, procedural justice, and program impact on hospital admission, was modified to include judges and case managers. Mental health court graduates perceived significantly less coercion and more procedural justice in their interactions with the judge than did AOT participants. No significant difference was found between mental health court and AOT participants in perceptions of procedural justice in interactions with their case managers. Mental health court participants felt more respected and had more positive feelings about the program than did AOT participants. Both mental health courts and AOT programs have potentially coercive aspects. Findings suggest that judges and case managers can affect participants' perceptions of these programs by the degree to which they demonstrate procedural justice, a process that may affect the long-term effects of the programs on individuals.
Thompson, Geoffrey A; Luo, Qing; Hefti, Arthur
Previous studies have shown casting methodology to influence the as-cast properties of dental casting alloys. It is important to consider clinically important mechanical properties so that the influence of casting can be clarified. The purpose of this study was to evaluate how torch/centrifugal and inductively cast and vacuum-pressure casting machines may affect the castability, microhardness, chemical composition, and microstructure of 2 high noble, 1 noble, and 1 base metal dental casting alloys. Two commonly used methods for casting were selected for comparison: torch/centrifugal casting and inductively heated/ vacuum-pressure casting. One hundred and twenty castability patterns were fabricated and divided into 8 groups. Four groups were torch/centrifugally cast in Olympia (O), Jelenko O (JO), Genesis II (G), and Liberty (L) alloys. Similarly, 4 groups were cast in O, JO, G, and L by an inductively induction/vacuum-pressure casting machine. Each specimen was evaluated for casting completeness to determine a castability value, while porosity was determined by standard x-ray techniques. Each group was metallographically prepared for further evaluation that included chemical composition, Vickers microhardness, and grain analysis of microstructure. Two-way ANOVA was used to determine significant differences among the main effects. Statistically significant effects were examined further with the Tukey HSD procedure for multiple comparisons. Data obtained from the castability experiments were non-normal and the variances were unequal. They were analyzed statistically with the Kruskal-Wallis rank sum test. Significant results were further investigated statistically with the Steel-Dwass method for multiple comparisons (α=.05). The alloy type had a significant effect on surface microhardness (P<.001). In contrast, the technique used for casting did not affect the microhardness of the test specimen (P=.465). Similarly, the interaction between the alloy and casting
Intravenous fluids are administered in virtually every parenteral sedation and general anesthetic. The purpose of this article is to review the physiology of body-water distribution and fluid dynamics at the vascular endothelium, evaluation of fluid status, calculation of fluid requirements, and the clinical rationale for the use of various crystalloid and colloid solutions. In the setting of elective dental outpatient procedures with minor blood loss, isotonic balanced crystalloid solutions are the fluids of choice. Colloids, on the other hand, have no use in outpatient sedation or general anesthesia for dental or minor oral surgery procedures but may have several desirable properties in long and invasive maxillofacial surgical procedures where advanced hemodynamic monitoring may assess the adequacy of intravascular volume.
Fu, Martin M; Rodriguez, Angel; Chen, Rebecca Y; Fu, Earl; Liao, Shu-Yi; Karimbux, Nadeem Y
The aims of this study were to analyze the administrative trends in U.S. dental schools at the beginning and end of a thirteen-year period and to identify the predictive factors for those changes. Administrative trends were measured by the difference in the number of major administrative positions for 1997 and 2010 reported in American Dental Education Association (ADEA) and American Dental Association (ADA) publications. Secondary measures (program length, student enrollment, and tuition) were also gathered. The mean numbers of administrative positions per school significantly increased over the study period, while the mean number of clinical science departments per school significantly decreased. The change in the number of directors was positively correlated with the change in student enrollment, but inversely correlated with the change in number of vice/associate/assistant deans. The change in the number of clinical science departments was positively correlated with changes in student enrollment and out-of-state tuition, but inversely correlated with the change in in-state tuition. The number of all departments per U.S. dental school significantly decreased in this period. The schools that had consolidation of clinical science departments were less likely to have increases in student enrollment and out-of-state tuition, but more likely to have increases in in-state tuition.
Pereira, Nigel; Hutchinson, Anne P; Lekovich, Jovana P; Hobeika, Elie; Elias, Rony T
The use of assisted reproductive technologies (ART) has increased steadily. There has been a corresponding increase in the number of ART-related procedures such as hysterosalpingography (HSG), saline infusion sonography (SIS), hysteroscopy, laparoscopy, oocyte retrieval, and embryo transfer (ET). While performing these procedures, the abdomen, upper vagina, and endocervix are breached, leading to the possibility of seeding pelvic structures with microorganisms. Antibiotic prophylaxis is therefore important to prevent or treat any procedure-related infections. After careful review of the published literature, it is evident that routine antibiotic prophylaxis is generally not recommended for the majority of ART-related procedures. For transcervical procedures such as HSG, SIS, hysteroscopy, ET, and chromotubation, patients at risk for pelvic infections should be screened and treated prior to the procedure. Patients with a history of pelvic inflammatory disease (PID) or dilated fallopian tubes are at high risk for postprocedural infections and should be given antibiotic prophylaxis during procedures such as HSG, SIS, or chromotubation. Antibiotic prophylaxis is recommended prior to oocyte retrieval in patients with a history of endometriosis, PID, ruptured appendicitis, or multiple prior pelvic surgeries.
Chirilă, Lucian; Rotaru, Cristian; Filipov, Iulian; Săndulescu, Mihai
The sinus lift was first described in 1974 and it has proven to be a predictable procedure ever since. The complications of this surgical procedure are reported in the literature to be low, and can include acute maxillary sinusitis, scattering of the grafting material into the sinus cavity, wound dehiscence and Schneiderian membrane perforations. We aimed to evaluate the rate of acute maxillary sinusitis after sinus lift procedures and the appropriate management strategies. Between 2013 and 2015, 245 dental implants were placed in 116 patients (76 males and 40 females) with concomitant bone augmentation of the maxillary sinus floor. The sinus lifting procedure was bilateral in 35 patients and unilateral in 81 patients (a total of 151 sinuses). Maxillary sinusitis occurred in 5 patients (4.3 %). The clinical signs of infection were: headache, locoregional pain, cacosmia, inflammation of the oral buccal mucosa and rhinorrhea or unilateral nasal discharge. A mucosal fistula was observed during inspection in one patient. The management included only the removal of the grafting material in 3 patients, in 1 patient the grafting material was removed together with all the implants, and in 1 patient only 2 implants and the grafting material were removed, 1 implant being left in place. The sinus cavity was irrigated with metronidazole solution and antibiotic therapy with clindamycin and metronidazole was prescribed for 10 days. Subsequently, all signs of infection disappeared within 5 to 7 days and normal sinus function and drainage were restored. Although sinus lift is regarded as a safe and reliable procedure, acute sinusitis is a possible complication which has to be managed immediately in order to reduce the risk of further complications like pansinusitis, osteomyelitis of the maxillary bone, and spreading of the infection in the infratemporal space or orbital cavity. To minimize risk, caution must be taken with all the steps of the procedure, in order not to
Spera, Allison L.; Saxen, Mark A.; Yepes, Juan F.; Jones, James E.; Sanders, Brian J.
The number of children with caries requiring general anesthesia to achieve comprehensive dental care and the demand for dentist anesthesiologists to provide ambulatory anesthesia for these patients is increasing. No current published studies examine the safety and outcomes of ambulatory anesthesia performed by dentist anesthesiologists for dental procedures in pediatric patients, and there is no national requirement for reporting outcomes of these procedures. In 2010, the Society for Ambulatory Anesthesia Clinical Outcomes Registry was developed. This Web-based database allows providers of ambulatory anesthesia to track patient demographics and various outcomes of procedures. Our study is a secondary analysis of data collected in the registry over a 4-year period, 2010–2014. Of the 7041 cases reviewed, no cases resulted in serious complications, including death, anaphylaxis, aspiration, cardiovascular adverse events, or neurologic adverse events. Of the 7041 cases reviewed, 196 (3.0%) resulted in a predischarge or postdischarge adverse event. The predischarge adverse event occurring with the highest frequency was laryngospasm, occurring in 35 cases (0.50%). The postdischarge adverse event occurring with the highest frequency was nausea, reported by 99 patients (5.0%). This study provides strong clinical outcomes data to support the safety of office-based anesthesia as performed by dentist anesthesiologists in the treatment of pediatric dental patients. PMID:28858554
Spera, Allison L; Saxen, Mark A; Yepes, Juan F; Jones, James E; Sanders, Brian J
The number of children with caries requiring general anesthesia to achieve comprehensive dental care and the demand for dentist anesthesiologists to provide ambulatory anesthesia for these patients is increasing. No current published studies examine the safety and outcomes of ambulatory anesthesia performed by dentist anesthesiologists for dental procedures in pediatric patients, and there is no national requirement for reporting outcomes of these procedures. In 2010, the Society for Ambulatory Anesthesia Clinical Outcomes Registry was developed. This Web-based database allows providers of ambulatory anesthesia to track patient demographics and various outcomes of procedures. Our study is a secondary analysis of data collected in the registry over a 4-year period, 2010-2014. Of the 7041 cases reviewed, no cases resulted in serious complications, including death, anaphylaxis, aspiration, cardiovascular adverse events, or neurologic adverse events. Of the 7041 cases reviewed, 196 (3.0%) resulted in a predischarge or postdischarge adverse event. The predischarge adverse event occurring with the highest frequency was laryngospasm, occurring in 35 cases (0.50%). The postdischarge adverse event occurring with the highest frequency was nausea, reported by 99 patients (5.0%). This study provides strong clinical outcomes data to support the safety of office-based anesthesia as performed by dentist anesthesiologists in the treatment of pediatric dental patients.
Moore, Kenneth; Khan, Nickalus R; Michael, L Madison; Arthur, Adam S; Hoit, Daniel
Intravascular foreign bodies are a known complication of medical and dental procedures. Dental anesthetic needles may be broken off and retained in the oropharynx. These needles have occasionally been reported to migrate through the oral mucosa in to deeper structures. Here we present the case of a 57-year-old man who had a retained dental needle that had migrated into his internal carotid artery. The needle was removed using endovascular techniques. To our knowledge, this is the first report of a retained dental needle being retrieved using this method. We review the literature on intravascular foreign bodies, retained dental needles, and endovascular techniques for retrieval of such foreign bodies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Zheng, Liwei; Yue, Li; Zhou, Min; Yu, Haiyang
Modern dentistry and dental education in China were first introduced from abroad by Dr. Lindsay in 1907. However, advancements in the field of dental laboratory technology did not occur to the same degree in specialties such as prosthodontics and orthodontics. Since the 1990s, orders from abroad demanding dental appliances surged as the image of China as the "world's factory" strengthened. The assembly line model, in which technicians work like simple procedure workers, was rapidly applied to denture production, while the traditional education system and apprenticeship systems demonstrated little progress in these years. The lack of advancement in dental laboratory technology education caused insufficient development in China's dental technology industry. In order to alter the situation, a four-year dental laboratory technology undergraduate educational program was established in 2005 by West China School of Stomatology, Sichuan University (WCSS, SCU). This program was based on SCU's undergraduate education and WCSS's junior college education systems. The program introduced scientific methods in relevant subjects into laboratory technicians' training and made many improvements in the availability of trained faculty, textbooks, laboratory facilities, and curriculum.
Lobb, Douglas; Clarke, Alix; Lai, Hollis
The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences. A total of 76 charts (40 midazolam-first and 36 fentanyl-first administrations), were used in the analysis. Administering midazolam first resulted in an average 4.38 min (52%) decrease in administration times (P < 0.001), and a decrease in procedural recollection immediately following the procedure (P = 0.03), and 24 to 48 hours later (P = 0.009). Administering fentanyl first required an average of 2.43 mg (29%) less midazolam (P < 0.001). No significant differences were found for change in vital signs, minimum oxygen saturation levels, recovery times, and patient satisfaction (P > 0.05). Oxygen saturation levels did not drop below 90% for either group; however, 5 cases in the fentanyl-first group fell to between 90% and 92%, compared with 0 cases in the midazolam-first group. The administration order of fentanyl and midazolam may have different effects on patients and the sedation procedure. Findings from this study should be used to facilitate discussion among dental practitioners and to guide additional research investigating this topic.
Background The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. Methods A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences. Results A total of 76 charts (40 midazolam-first and 36 fentanyl-first administrations), were used in the analysis. Administering midazolam first resulted in an average 4.38 min (52%) decrease in administration times (P < 0.001), and a decrease in procedural recollection immediately following the procedure (P = 0.03), and 24 to 48 hours later (P = 0.009). Administering fentanyl first required an average of 2.43 mg (29%) less midazolam (P < 0.001). No significant differences were found for change in vital signs, minimum oxygen saturation levels, recovery times, and patient satisfaction (P > 0.05). Oxygen saturation levels did not drop below 90% for either group; however, 5 cases in the fentanyl-first group fell to between 90% and 92%, compared with 0 cases in the midazolam-first group. Conclusions The administration order of fentanyl and midazolam may have different effects on patients and the sedation procedure. Findings from this study should be used to facilitate discussion among dental practitioners and to guide additional research investigating this topic. PMID:29556559
Wotman, Stephen; Demko, Catherine A; Victoroff, Kristin; Sudano, Joseph J; Lalumandier, James A
This report defines verbal interactions between practitioners and patients as core activities of dental practice. Trained teams spent four days in 120 Ohio dental practices observing 3751 patient encounters with dentists and hygienists. Direct observation of practice characteristics, procedures performed, and how procedure and nonprocedure time was utilized during patient visits was recorded using a modified Davis Observation Code that classified patient contact time into 24 behavioral categories. Dentist, hygienist, and patient characteristics were gathered by questionnaire. The most common nonprocedure behaviors observed for dentists were chatting, evaluation feedback, history taking, and answering patient questions. Hygienists added preventive counseling. We distinguish between preventive procedures and counseling in actual dental offices that are members of a practice-based research network. Almost a third of the dentist’s and half of the hygienist’s patient contact time is utilized for nonprocedure behaviors during patient encounters. These interactions may be linked to patient and practitioner satisfaction and effectiveness of self-care instruction. PMID:23662080
Blæhr, Tue Lindberg
ABSTRACT Objectives The objective of the present systematic review was to test the hypothesis of no difference in transverse skeletal and dental arch expansion and relapse after segmental Le Fort I osteotomy versus surgically assisted rapid maxillary expansion. Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted by including human studies published in English from January 1, 2000 to June 1, 2016. Results The search provided 130 titles and four studies fulfilled the inclusion criteria. All the included studies were characterized by high risk of bias and meta-analysis was not possible due to considerable variation. Both treatment modalities significantly increase the transverse maxillary skeletal and dental arch width. The transverse dental arch expansion and relapse seems to be substantial higher with tooth-borne surgically assisted rapid maxillary expansion compared to segmental Le Fort I osteotomy. The ratio of dental to skeletal relapse was significantly higher in the posterior maxilla with tooth-borne surgically assisted rapid maxillary expansion. Moreover, a parallel opening without segment tilting was observed after segmental Le Fort I osteotomy. Conclusions Maxillary transverse deficiency in adults can be treated successfully with both treatment modalities, although surgically assisted rapid maxillary expansion seems more effective when large transverse maxillary skeletal and dental arch expansion is required. However, considering the methodological limitations of the included studies, long-term randomized studies assessing transverse skeletal and dental expansion and relapse with the two treatment modalities are needed before definite conclusions can be provided. PMID:28154745
Jones, T; Cumberbatch, K
access and treatment for the deaf can be extended to dentists and to other dental students globally. The vision is that similar courses will be introduced in other health training programmes at the UWI, and conceivably, in other institutions. The small sample size allows for informative, but not definitive, conclusions to be drawn. The mandatory inclusion of sign language and Deaf culture in the dental curricula has not just removed a communication barrier, but has assisted in the empathetic and ethical development of the dental student. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Reinders, Jan J; Krijnen, Wim P; Stegenga, Boudewijn; van der Schans, Cees P
Attitudes of dental students regarding the provision of treatment tend to be dentist-centered; however, facilitating mixed student group formation could change such perceptions. The aim of this study was to investigate the perceived scope of practice of dental and dental hygiene students and whether their perceptions of task distribution between dentists and dental hygienists would change following an educational intervention consisting of feedback, intergroup comparison, and competition between mixed-group teams. The study employed a pretest-posttest single group design. Third-year dental students and second-year dental hygiene students at a university in The Netherlands were randomly assigned to intraprofessional teams (four or five members) and received team-based performance feedback and comparison. The intervention was finalized with an award ceremony for the best intraprofessional team. Before and after the intervention, students completed a questionnaire measuring their perceived distribution of ten tasks between dentists and dental hygienists. A total of 38 dental students and 32 dental hygiene students participated in the intervention-all 70 of those eligible. Questionnaires were completed by a total 88.4% (n=61) of the participants: 34 dental (89.5%) and 27 dental hygiene students (84.4%). Dental and dental hygiene students had similar perceptions regarding teeth cleaning (prophylaxis) (p=0.372, p=0.404) and, after the intervention, preventive tasks (p=0.078). Following the intervention, dental students considered four out of ten tasks as less dentist-centered: radiograph for periodontal diagnosis (p=0.003), local anesthesia (p=0.037), teeth cleaning (p=0.037), and periodontal treatment (p=0.045). Dental hygiene students perceived one task as being less dentist-centered after the intervention: radiograph for cariologic diagnosis (p=0.041). This study found that these dental and dental hygiene students had different opinions regarding the scope of practice
Singh, Divya; Samadi, Firoza; Jaiswal, Jn; Tripathi, Abhay Mani
The purpose of the present study was to evaluate the eff-cacy of 'audio distraction' in anxious pediatric dental patients. Sixty children were randomly selected and equally divided into two groups of thirty each. The first group was control group (group A) and the second group was music group (group B). The dental procedure employed was extraction for both the groups. The children included in music group were allowed to hear audio presentation throughout the treatment procedure. Anxiety was measured by using Venham's picture test, pulse rate, blood pressure and oxygen saturation. 'Audio distraction' was found efficacious in alleviating anxiety of pediatric dental patients. 'Audio distraction' did decrease the anxiety in pediatric patients to a significant extent. How to cite this article: Singh D, Samadi F, Jaiswal JN, Tripathi AM. Stress Reduction through Audio Distraction in Anxious Pediatric Dental Patients: An Adjunctive Clinical Study. Int J Clin Pediatr Dent 2014;7(3):149-152.
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