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Gibson BJ, Baker SR, Broomhead T, El-Dhuwaib B, Martin N, McKenna G, Alavi A. 'It's like being in a tunnel': Understanding the patient journey from tooth loss to life with removable dentures. J Dent 2024; 145:104964. [PMID: 38574848 DOI: 10.1016/j.jdent.2024.104964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION The aim of this study was to conceptualise the key stages of the patient journey in the provision of a new denture and examine the factors leading to successful patient-related outcomes. METHODS Two partially dentate patient samples were included: (i) Denture wearers - patients who had a denture fitted within the previous five years and (ii) New dentures - patients receiving treatment for a new or replacement denture. The methods involved direct targeted participant observations of the denture fitting process, debriefing interviews and a follow-up focus group exploring the patient journey. Data were analysed through the use of phenomenology and grounded theory. RESULTS Interviews were completed with twenty participants of the denture-wearing sample (11 males and nine females, age range 22 to 86 years). Thirteen participants were included in the treatment journey sample in two primary care settings (six males and seven females, age range 55 to 101 years). Tooth loss and recovery was described as being in an 'emotional tunnel' resulting from 'bodyphonic processes' associated with tooth loss. 'Bodyphonia' subsequently became the context for 'taking control' and 'managing disclosure' when living with a removable denture. Different courses through this process can be readily observed, moderated by different variables (i.e., previous experience, working knowledge, a good fit, the treatment alliance, negotiated compromises and bounded responsibility). CONCLUSIONS An'integrating framework' that seeks to describe the patient journey from the experience of tooth loss to recovery with a denture is proposed. This framework could be used to aid development of a clinical pathway to guide treatment options. CLINICAL SIGNIFICANCE This paper conceptualises the patient journey. It stresses the importance of understanding the stages patients go through and highlights that for the dental team, the try-in stage is perhaps the best stage to give information about the denture and plans for continued care.
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Affiliation(s)
- Barry John Gibson
- School of Clinical Dentistry and The Healthy Life Span Institute, University of Sheffield, UK.
| | - Sarah R Baker
- School of Clinical Dentistry and The Healthy Life Span Institute, University of Sheffield, UK
| | - Tom Broomhead
- School of Clinical Dentistry and The Healthy Life Span Institute, University of Sheffield, UK
| | | | - Nicolas Martin
- School of Clinical Dentistry, University of Sheffield, UK
| | - Gerry McKenna
- Centre for Public Health, Queen's University Belfast, UK
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Broomhead T, Baker SR, Martin N, McKenna G, El-Dhuwaib B, Alavi A, Gibson B. Exploring experiences of living with removable dentures-A scoping review of qualitative literature. Gerodontology 2024. [PMID: 38247018 DOI: 10.1111/ger.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Examine the literature on the experiences of living with removable dentures (complete or partial) to identify any gaps and provide a map for future research. BACKGROUND Increasing proportions of society are living partially dentate with some form of restoration, including removable dentures. Previous studies have reported on the location, materials and usage of these prostheses, along with effects on oral-health-related quality of life (OHRQoL). However, less is known about experiences with removable dentures from a patient-centred perspective. METHODS A scoping review of the qualitative literature was undertaken using the framework of Arksey and O'Malley, updated by Levac et al. Literature searches were carried out using Medline and Web of Science. Papers were screened by title and abstract using inclusion and exclusion criteria. Remaining papers were read in full and excluded if they did not meet the required criteria. Nine papers were included in the final review. FINDINGS Key themes from these papers were: impact of tooth loss and living without teeth, and its impacts in relation to social position, appearance, confidence and function (chewing and speaking); social norms and tooth loss, including attitudes to tooth retention and treatment costs, and changes in intergenerational norms towards dentures; expectations of treatment, including patients being more involved in decision making, viewing the denture as a "gift" and dentures helping to achieve "an ideal"; living with a removable denture (complete or partial), including patient preparedness for a denture, adaptation and impacts on activities and participation; and the dentist-patient relationship, including issues with information and communication, and differing priorities between patients and dentists. CONCLUSION Little qualitative research exists on experiences of living with a removable denture. Existing literature demonstrates the importance of dispersed activities in differing social, spatial and temporal contexts when wearing removable dentures. Focusing on processes of positive adaptation to dentures and OHRQoL, rather than deficits, is also required to fully understand patients' experiences. Additionally, more complex technological advances may not always be in the best interest of every patient.
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Affiliation(s)
- T Broomhead
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - S R Baker
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - N Martin
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - G McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - B El-Dhuwaib
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - A Alavi
- Haleon (formerly GSK Consumer Healthcare), Weybridge, UK
| | - B Gibson
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Cortez GFP, Barbosa GZ, Tôrres LHDN, Unfer B. Reasons for and consequences of tooth loss in adults and elderly people in Brazil: a qualitative metasynthesis. CIENCIA & SAUDE COLETIVA 2023; 28:1413-1424. [PMID: 37194875 DOI: 10.1590/1413-81232023285.01632022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/18/2022] [Indexed: 05/18/2023] Open
Abstract
The objective was to analyze and systematize evidence reported in qualitative studies on the reasons and consequences of tooth loss in adults and elderly people in Brazil. A systematic review of the literature on qualitative research methods and a meta synthesis of the results were performed. The study population consisted of adults over 18 years of age and elderly people in Brazil. Searches were performed in the BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO and SciELO databases. The thematic synthesis identified 8 analytical themes regarding reasons for tooth loss and 3 analytical themes regarding consequences of tooth loss. Dental pain, care model, financial situation and desire for prosthetic rehabilitation were determining factors for extractions. There was recognition of negligence in oral care, and the naturalness of tooth loss was linked to old age. Missing teeth caused psychological and physiological impacts. It is imperative to verify whether the factors that cause tooth loss persist, and how much those factors influence decisions to extract teeth among current young and adult populations. It is necessary to change the care model through the inclusion and qualification of oral health care for the young and elderly adult populations; otherwise, the model of dental mutilation and the culture of edentulism will persist.
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Affiliation(s)
| | | | | | - Beatriz Unfer
- Universidade Federal de Santa Maria. Santa Maria RS Brasil
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"If I have teeth, I can smile." Experiences with tooth loss and the use of a removable dental prosthesis among people who are partially and completely edentulous in Karnataka, India. BDJ Open 2021; 7:34. [PMID: 34518522 PMCID: PMC8438032 DOI: 10.1038/s41405-021-00088-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives Tooth loss is a phenomenon associated with structural and functional changes, with a negative influence on the oral and general health of an individual. Removable dental prosthesis is commonly fabricated as treatment for tooth loss. However, the perceptions and experiences of individuals during the transition from a dentate to a partially or completely edentulous state and their acceptance of the denture are largely ignored. The objective of this study was to explore the perceptions and experiences during the transition from a dentate state to being partially or completely edentulous in the Indian population. Methods Fifteen individuals wearing partial or complete denture prosthesis were interviewed in depth using open-ended questions. These interviews were recorded using a voice-recording device. They were then transcribed, and a coding process was applied using the thematic framework approach to qualitative analysis. Findings Five themes emerged, namely: (i) Transition from dentulous to partially or completely edentulous state; (ii) Varying experiences with the use of dentures; (iii) Convenience and duration of wearing dentures; (iv) Attitude of dentists towards patients’ complaints; (v) Knowledge and preference of available treatment modalities. Conclusions The loss of natural teeth seemed to affect the psychological, functional, and social well-being of participants. Tooth loss was believed to be a natural aging process. Costs of treatment deterred the uptake of fixed denture treatment options. However, some participants preferred removable dentures to fixed prosthesis.
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Jayachandran S, Hill K, Walmsley AD. A critical review of qualitative research publications in dental implants from 2006 to 2020. Clin Oral Implants Res 2021; 32:659-671. [PMID: 33715249 DOI: 10.1111/clr.13743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/01/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This critical review is aimed to investigate the current status of qualitative research in dental implant research and to explore the quality of available information. MATERIAL AND METHODS A systematic search was done on the journal databases to identify dental implant research articles that used qualitative methodology during 2006 and 2020. The resulting articles were appraised against the checklist offered by the Critical Appraisal Skills programme (CASP) tool. Also, the theories evolved from the research were reviewed to understand the value of this methodology in dental implant research. RESULTS Twenty-five (25) articles out of the 8,421 original results were identified as using qualitative methodology. The researchers have sought to identify the views of patients about tooth loss, dental implants, and the information they receive from dental professionals, and views of the dentists about dental implant practice. The review found that there were few inconsistencies in the quality of such research especially the qualitative data analysis. CONCLUSIONS The quantity of qualitative research in dental implants remains low; however, the quality has improved in the past two decades. Despite these improvements, there is still a lack of research in understanding both patients' and dentists' views on dental implant procedures and management.
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Affiliation(s)
| | - Kirsty Hill
- The School of Dentistry, University of Birmingham, Birmingham, United Kingdom
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Kaiser L, Hübscher M, Rissling O, Schulz S, Langer G, Meerpohl J, Schwingshackl L. [GRADE Guidelines: 19. Assessing the certainty of evidence in the importance of outcomes or values and preferences: Risk of bias and indirectness]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2021; 160:78-88. [PMID: 33461905 DOI: 10.1016/j.zefq.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group defines patient values and preferences as the relative importance patients place on the main health outcomes. We provide GRADE guidance for assessing the risk of bias and indirectness domains for certainty of evidence about the relative importance of outcomes. STUDY DESIGN AND SETTING We applied the GRADE domains to rate the certainty of evidence in the importance of outcomes to several systematic reviews, iteratively reviewed draft guidance and consulted GRADE members and other stakeholders for feedback. RESULTS This is the first of two articles. A body of evidence addressing the importance of outcomes starts at "high certainty"; concerns with risk of bias, indirectness, inconsistency, imprecision, and publication bias lead to downgrading to moderate, low, or very low certainty. We propose the following subdomains of risk of bias: selection of the study population, missing data, the type of measurement instrument, and confounding; we have developed items for each subdomain. The population, intervention, comparison, and outcome elements associated with the evidence determine the degree of indirectness. CONCLUSION This article provides guidance and examples for rating the risk of bias and indirectness for a body of evidence summarizing the importance of outcomes.
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Affiliation(s)
- Laura Kaiser
- Abteilung Fachberatung Medizin, Gemeinsamer Bundesausschuss, Berlin, Deutschland; Universität Witten/Herdecke, Deutschland.
| | - Markus Hübscher
- Abteilung Fachberatung Medizin, Gemeinsamer Bundesausschuss, Berlin, Deutschland
| | - Olesja Rissling
- Abteilung Fachberatung Medizin, Gemeinsamer Bundesausschuss, Berlin, Deutschland
| | - Sandra Schulz
- Abteilung Fachberatung Medizin, Gemeinsamer Bundesausschuss, Berlin, Deutschland
| | - Gero Langer
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Jörg Meerpohl
- Institut für Evidenz in der Medizin, Universitätsklinikum und Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland; Cochrane Deutschland, Cochrane Deutschland Stiftung, Freiburg, Deutschland
| | - Lukas Schwingshackl
- Institut für Evidenz in der Medizin, Universitätsklinikum und Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland
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Benecke M, Kasper J, Heesen C, Schäffler N, Reissmann DR. Patient autonomy in dentistry: demonstrating the role for shared decision making. BMC Med Inform Decis Mak 2020; 20:318. [PMID: 33267847 PMCID: PMC7709219 DOI: 10.1186/s12911-020-01317-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 11/05/2020] [Indexed: 11/21/2022] Open
Abstract
Background Evidence-based practice, decision aids, patient preferences and autonomy preferences (AP) play an important role in making decisions with the patient. They are crucial in the process of a shared decision making (SDM) and can be incorporated into quality criteria for patient involvement in health care. However, there are few studies on SDM and AP in the field of dentistry. This study explored patients’ autonomy preferences in dentistry in comparison to other medical domains, comparing them with patient preferences in two other cohorts of patients with different conditions and in different health care settings. Methods A sample of 100 dental patients attending 16 dentists was consecutively recruited in a university-based prosthodontic clinic. Patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions were compared using the Control Preference Scale (CPS). This was followed by cross sectional surveys to study autonomy preferences in three additional cohorts recruited from general practices (n = 100), a multiple sclerosis clinic (n = 109), and a university-based prosthodontic clinic (n = 100). A questionnaire with combined items from the Autonomy Preference Index (API) to assess general and the CPS to assess specific preferences was used in the additional cohorts. Results Dentists were less willing to give patients control than patients were willing to enact autonomy. However, decisions about management of tooth loss were considered relevant for a shared decision making by both parties. When comparing cohorts from different samples, the highest AP was expressed by people with multiple sclerosis and the lowest by patients in dentistry (means: dentistry 2.5, multiple sclerosis 2.1, general practice 2.4, p = .035). There were considerable intra-individual differences in autonomy preferences referring to different decision types (p < .001). In general, more autonomy was desired for treatment decisions in comparison to diagnostic decisions, for trivial compared to severe conditions, and for dental care compared to general practice (all: p < .001). Conclusion There is an important role of patient participation in decision making in dentistry. Furthermore, PA should be considered with respect to specific medical decisions instead of assessing autonomy preferences in general implying a need for communication skills training of health care professionals.
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Affiliation(s)
- Mareike Benecke
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Kasper
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Christoph Heesen
- Institute of Neuroimmunology and Clinical MS Research (INiMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nina Schäffler
- Institute of Neuroimmunology and Clinical MS Research (INiMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel R Reissmann
- Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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van de Rijt LJM, Stoop CC, Weijenberg RAF, de Vries R, Feast AR, Sampson EL, Lobbezoo F. The Influence of Oral Health Factors on the Quality of Life in Older People: A Systematic Review. THE GERONTOLOGIST 2020; 60:e378-e394. [PMID: 31729525 DOI: 10.1093/geront/gnz105] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The number of people aged 65 years or older is growing substantially. As a result of increased health burden and tooth retention, more oral health problems are expected in this age group. A poor oral health-related quality of life (OHQoL) can compromise a person's psychological state, social relationships, personal beliefs, and physical health. The aim of this systematic review was to identify oral health factors associated with OHQoL in people aged 65 years or older and to give a comprehensive overview of the body of literature for each oral health factor separately. RESEARCH DESIGN AND METHODS A comprehensive search was performed in five databases. The following terms were used as index terms or free-text words: "Oral Health," "Quality of Life," "Older People." Two researchers independently assessed studies for eligibility based on predefined criteria. RESULTS Of 3,702 references retrieved from the databases, 68 studies were eligible and included (9 randomized clinical trials, 6 cohort studies, and 53 cross-sectional studies). All results were reported descriptively. OHQoL in people aged 65 years or older is positively associated with higher number of teeth, higher number of occluding pairs, implant-retained overdentures, and the shortened dental arch concept and negatively associated with xerostomia, orofacial pain, and poor chewing ability. In the current literature, there is no consensus on the association between edentulism, caries, and periodontal conditions and OHQoL. DISCUSSION AND IMPLICATIONS Having a functional dentition (either natural or prosthetic) is important for a good OHQoL, whereas painful or functional complaints are associated with impaired OHQoL.
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Affiliation(s)
- Liza J M van de Rijt
- Faculty of Dentistry, Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Celine C Stoop
- Faculty of Dentistry, Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Roxane A F Weijenberg
- Faculty of Dentistry, Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit Amsterdam, The Netherlands
| | - Alexandra R Feast
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College Londen, UK
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College Londen, UK.,Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, London, UK
| | - Frank Lobbezoo
- Faculty of Dentistry, Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
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Moore D, Keat R. Does dental appearance impact on employability in adults? A scoping review of quantitative and qualitative evidence. Br Dent J 2020:10.1038/s41415-020-2025-5. [PMID: 33082523 DOI: 10.1038/s41415-020-2025-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/14/2020] [Indexed: 11/09/2022]
Abstract
Background The importance of physical appearance in social and professional situations has been well studied. It has been suggested that improving dental appearance may increase employment prospects. This scoping review aims to map the current literature regarding the impact of dental appearance on employability.Methods A scoping review was carried out in accordance with guidance from the Joanna Briggs Institute. Inclusion and exclusion criteria were developed iteratively, databases were searched and decisions on inclusion made in duplicate. Data were charted in Excel and synthesised using a visual map, study summary table and narrative description.Results We identified 16 relevant articles: ten experimental simulation studies, two qualitative studies, one cross-sectional survey, one pre-/post-dental treatment survey, one retrospective cohort study and one narrative systematic review. Experimental simulations support the notion that visible dental conditions can negatively impact appraisals of employment-related personal characteristics. Negative impacts on job-seeking self-efficacy and willingness to apply for jobs have also been documented.Conclusions The applicability of this evidence base to the UK health system context is uncertain and demonstration of real-life impact on employment is lacking. Further research is needed before programmes to improve dental appearance could be justified on the basis of improving employment outcomes.
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Affiliation(s)
- Deborah Moore
- University of Manchester, Division of Dentistry, Dental Health Unit, Williams House, Lloyd Street North, Manchester, M15 6SE, UK.
| | - Ross Keat
- University of Manchester, Division of Dentistry, Dental Health Unit, Williams House, Lloyd Street North, Manchester, M15 6SE, UK
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McKenna G, Tsakos G, Burke F, Brocklehurst P. Managing an Ageing Population: Challenging Oral Epidemiology. Prim Dent J 2020; 9:14-17. [PMID: 32940594 DOI: 10.1177/2050168420943063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Global population projections indicate that the proportion of older people is increasing and will continue to do so for the foreseeable future. Many countries are already experiencing the challenges of managing an ageing population, including increased pension contributions from workers, rises to national retirement ages, and spiralling healthcare costs. In oral health terms, in addition to simply an ageing population, epidemiological studies have demonstrated significant changes in the oral health of older adults in recent years. As the numbers of edentulous older adults has declined, there has been a significant increase in the number of partially dentate elderly. Changing attitudes, improved access to dental care and more effective preventative programmes have meant that large numbers of patients are now retaining natural teeth into old age. However, as older patients retain natural teeth for longer, the dental profession is charged with controlling chronic dental diseases in an increasingly challenging oral environment.
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Affiliation(s)
- Gerry McKenna
- Senior Lecturer/Consultant in Restorative Dentistry, Centre for Public Health, Queen's University Belfast
| | - George Tsakos
- Professor of Dental Public Health, Faculty of Population Health Sciences, University College London
| | - Francis Burke
- Vice-Dean, College of Medicine and Health, University College Cork
| | - Paul Brocklehurst
- Professor in Health Services Research, School of Health Sciences, Bangor University
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McKenna G, Tada S, McLister C, DaMata C, Hayes M, Cronin M, Moore C, Allen F. Tooth replacement options for partially dentate older adults: a survival analysis. J Dent 2020; 103:103468. [PMID: 32911009 DOI: 10.1016/j.jdent.2020.103468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/07/2020] [Accepted: 09/02/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To compare the success of two different tooth replacement strategies for partially dentate older adults; namely resin bonded bridgework (RBB) provided to restore patients according to the principles of the shortened dental arch concept (SDA) and conventional full-arch rehabilitation with removable dental prostheses (RDPs). METHODS A randomised controlled clinical trial (RCT) was conducted with partially dentate adults aged 65 years or older. Each patient from the RDP group had all missing natural teeth replaced with cobalt-chromium framework RDPs. Each patient from the SDA group was restored to 10 occluding pairs of natural and replacement teeth using RBB. Patients were followed-up at 6, 12, 24, 36 months. Success rates were generated according to defined success criteria. Log-rank tests and Cox's proportional hazard models were used to compare the success of the two treatment strategies. RESULTS After 36 months, 89 patients completed the RCT; n = 45 in the RDP group and n = 44 in the SDA group. The overall success rate of the SDA treatment was 90.4% compared to 73.0% for RDPs (p = 0.005). In the upper arch SDA treatment was 100% successful compared to 86.4% for RDPs (p = 0.019). In the lower arch, lower success rates were reported for both the SDA treatment (80.0%) and RDPs (60.0%) (p = 0.054). Further analyses with cox's proportional hazard models demonstrated that SDA treatment was significantly more successful than RDPs (Hazard Ratio: 2.47, p = 0.04). CONCLUSIONS After 36 months SDA treatment using RBB was significantly more successful than RDPs used for conventional full-arch rehabilitation in partially dentate older adults. CLINICAL SIGNIFICANCE Functionally orientated treatment according to the principles of the SDA is a feasible alternative to RDPs for partially dentate older patients. SDA treatment using RBB can achieve higher success rates compared to RDPs in this patient group.
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Affiliation(s)
- Gerald McKenna
- Centre for Public Health, Queen's University, Belfast, United Kingdom.
| | - Sayaka Tada
- Faculty of Dentistry, National University of Singapore, Singapore.
| | - Conor McLister
- School of Dentistry, Belfast Health and Social Care Trust, Royal Victoria Hospital, Belfast, United Kingdom.
| | - Cristiane DaMata
- Cork University Dental School and Hospital, University College Cork, Ireland.
| | - Martina Hayes
- Cork University Dental School and Hospital, University College Cork, Ireland.
| | - Michael Cronin
- School of Mathematical Sciences, University College Cork, Ireland.
| | - Ciaran Moore
- Centre for Public Health, Queen's University, Belfast, United Kingdom.
| | - Finbarr Allen
- Faculty of Dentistry, National University of Singapore, Singapore.
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The patient experience of dental implant surgery: a literature review of pertinent qualitative studies. Ir J Med Sci 2020; 190:835-842. [PMID: 32720197 DOI: 10.1007/s11845-020-02327-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
This review aims to identify and summarise the findings of published qualitative studies relating to patients' experiences of dental implant surgery, by means of textual narrative synthesis. A comprehensive two-stage electronic and manual search of the literature identified relevant qualitative studies up to January 2020. Included primary studies (n = 15) used qualitative research methods including interviews and focus groups to investigate patients' experiences of dental implant treatment. They looked at the experience of tooth loss, the decision making process, the pre-implant experience, motivating factors and barriers for treatment and the post-implant experience with the prosthesis. There is a deficiency in the exploration of the patients' intraoperative dental surgical experience and the adjunctive effects of conscious sedation. The included studies give considerable insight into patients' experiences of the dental implant journey, which in the main, had overall positive consensus. The limited information available regarding patients' experience of the intra operative dental implant surgery with or without conscious sedation warrants further investigation. This information is a fundamental step to understanding the patients' preferences, needs and values and ultimately enhancing the quality of patient care.
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Risk predictors of dental root caries: A systematic review. J Dent 2019; 89:103166. [DOI: 10.1016/j.jdent.2019.07.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 11/22/2022] Open
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Zhang Y, Alonso-Coello P, Guyatt GH, Yepes-Nuñez JJ, Akl EA, Hazlewood G, Pardo-Hernandez H, Etxeandia-Ikobaltzeta I, Qaseem A, Williams JW, Tugwell P, Flottorp S, Chang Y, Zhang Y, Mustafa RA, Rojas MX, Schünemann HJ. GRADE Guidelines: 19. Assessing the certainty of evidence in the importance of outcomes or values and preferences—Risk of bias and indirectness. J Clin Epidemiol 2019; 111:94-104. [DOI: 10.1016/j.jclinepi.2018.01.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/14/2017] [Accepted: 01/11/2018] [Indexed: 12/23/2022]
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Alzahrani AAH, Gibson BJ. Scoping Review of the Role of Shared Decision Making in Dental Implant Consultations. JDR Clin Trans Res 2019; 3:130-140. [PMID: 30931770 DOI: 10.1177/2380084418761340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To what extent does dental research on implant consultations focus on the use of shared decision making? There has been an explosion in the use of implant therapies in dentistry, but very little is known about the decision-making processes involved in the provision of dental implants. The use of shared decision making (SDM) has been found to reduce undesirable outcomes and increase patient and clinician satisfaction in other health care fields. This scoping review reports on the current status of SDM in research on implant therapies. A scoping review methodology was used. Web of Knowledge, MEDLINE via OvidSP, MEDLINE via PubMed, Embase, Scopus, Cochrane, DARE, and CINAHL databases were reviewed between 1900 and December 1, 2017. The search strategy resulted in 2,289 eligible articles; 1,892 duplicated articles were deleted, resulting in a hand search of 397 titles and abstracts. These were subsequently evaluated while applying the inclusion and exclusion criteria, resulting in 48 articles for full-text evaluation. After full-text evaluation of these 48 studies, a further 27 were eliminated as not being relevant, leading to the inclusion of 21 studies for the review. No studies to date have examined how patients and dentists engage in decisions to place dental implants. Aspects that were discussed in the literature related to the decision-making process included a discussion about patients' values and discussing possible treatment options. How patients and dentists interacted during implant consultations was poorly explored. Shared decision making has been shown to improve health care quality and increase clinician and patient satisfaction. Further research concerning dental implant decisions is warranted with emphasis on evaluating patients' contributions to treatment, which is currently poorly understood. Exploring existed methods for examining the SDM process in implant consultations should facilitate improve care and consent. Knowledge Transfer Statement: The findings of this scoping review can be used by all dentists when deciding which decision-making model they wish to use when planning implant therapy. The article places special emphasis on the role of shared decision making in improving health care quality and increasing patients' and clinicians' satisfaction.
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Affiliation(s)
- A A H Alzahrani
- 1 Dental Health Department, School of Applied Medical Sciences, Al Baha University, Al Baha, Saudi Arabia
| | - B J Gibson
- 2 Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, The University of Sheffield, Claremont Crescent, Sheffield, UK
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16
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Reissmann DR, Bellows JC, Kasper J. Patient Preferred and Perceived Control in Dental Care Decision Making. JDR Clin Trans Res 2018; 4:151-159. [PMID: 30931704 DOI: 10.1177/2380084418811321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Shared decision making is increasingly considered the most desirable model for making decisions in medical and dental settings. It supports patients by empowering them to play an active role in the decision-making process. However, dental patients' involvement needs and perceptions have not yet been sufficiently assessed. OBJECTIVES The aim of this study was to assess patients' preferred roles in decision making for a range of dental treatments and whether patients' preferences are being met. METHODS Based on a cross-sectional study design, dental patients' autonomy preferences and actual perceived roles were surveyed in the context of existing dental appointments in a consecutive sample of 101 adult dental patients (aged 20 to 79 y). The questionnaire for the assessment of patient preferred and perceived roles in dental decision making consisted of 14 items, each representing a decision in the broad spectrum of preventive and restorative dental treatment planning, and was administered before the dental appointment and immediately afterward. Responses for each item were indicated on an ordinal 5-point scale, which was adapted from the Control Preference Scale. Differences in overall levels of control and responses for each decision were tested for statistical significance per the Wilcoxon matched-pairs signed-rank test. Furthermore, a multilevel mixed effects linear regression model was computed. RESULTS Patients rated their preferred role in decision making more active and involved than their perceived role. This effect was observed and statistically significant ( P < 0.05) for 11 of 14 treatment decisions. Perceived roles (follow-up) matched the preferred roles (baseline) for less than half of patients. None of the sociodemographic characteristics had a substantial statistical effect on whether perceived roles matched the preferred roles. CONCLUSION Dental patients' perceived roles in decision making do not meet their preferences. Dentists should allow and encourage their patients to be more active in decision making. KNOWLEDGE TRANSFER STATEMENT Since dental patients' perceived roles in decision making do not meet their preferences, clinicians should encourage and enable their dental patients to fulfill the role in decision making that they prefer. This may help in the future to not only fulfill the right of patients to be informed but also empower them to play an active role in the decision-making process and reduce the risk of decisional conflicts.
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Affiliation(s)
- D R Reissmann
- 1 Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J C Bellows
- 1 Department of Prosthetic Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Kasper
- 2 Division of Internal Medicine, University Hospital of Northern Norway, Tromsø, Norway.,3 Department of Health and Caring Sciences, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway
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17
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Walsh LJ. Minimal intervention management of the older patient. Br Dent J 2017; 223:151-161. [DOI: 10.1038/sj.bdj.2017.660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 01/08/2023]
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18
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Haag D, Peres K, Balasubramanian M, Brennan D. Oral Conditions and Health-Related Quality of Life: A Systematic Review. J Dent Res 2017; 96:864-874. [DOI: 10.1177/0022034517709737] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to verify whether oral conditions (tooth loss, periodontal disease, dental caries) are negatively associated with health-related quality of life (HRQoL) in adults. A search was carried out on PubMed, EMBASE, Web of Science, Scopus, SciELO, and LILACS databases until the end of July 2016 with no date restrictions. Quantitative observational studies written in English were included and data extraction was performed independently by 2 reviewers. HRQoL was investigated as the outcome, and tooth loss, periodontal diseases, and dental caries were exposures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used and the quality of the selected studies was assessed by using the Joanna Briggs Institute Meta-Analysis of Statistics assessment and review instrument (JBI-MAStARI). Twenty-one studies were included. The sample sizes ranged from 88 to 15,501 subjects; 20 studies were cross-sectional designs, while 1 was a case-control study. Case definitions of the exposures were different across the studies, mainly for tooth loss, which was defined according to 11 different criteria. Fifteen studies were of “high” and 6 of “medium” quality. Eight HRQoL instruments were identified, and the most frequent was the EuroQol ( n = 8). Ten of 16 studies reported a negative impact of tooth loss on HRQoL. Four of 7 studies reported that periodontal disease impairs HRQoL, and 1 study showed that periodontal disease is positively associated with HRQoL. All studies that assessed dental caries reported a negative association between this condition and HRQoL. Despite the different definitions and measures of tooth loss and dental caries, the majority of the available evidence reported a negative impact of these conditions on HRQoL. Mixed and inconclusive findings were observed for the association between periodontal disease and HRQoL. Longitudinal prospective studies are suggested to improve the strength of the findings.
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Affiliation(s)
- D.G. Haag
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia
| | - K.G. Peres
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia
| | - M. Balasubramanian
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia
| | - D.S. Brennan
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia
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19
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Zhang Y, Coello PA, Brożek J, Wiercioch W, Etxeandia-Ikobaltzeta I, Akl EA, Meerpohl JJ, Alhazzani W, Carrasco-Labra A, Morgan RL, Mustafa RA, Riva JJ, Moore A, Yepes-Nuñez JJ, Cuello-Garcia C, AlRayees Z, Manja V, Falavigna M, Neumann I, Brignardello-Petersen R, Santesso N, Rochwerg B, Darzi A, Rojas MX, Adi Y, Bollig C, Waziry R, Schünemann HJ. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach. Health Qual Life Outcomes 2017; 15:52. [PMID: 28460638 PMCID: PMC5412036 DOI: 10.1186/s12955-017-0621-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 03/02/2017] [Indexed: 12/15/2022] Open
Abstract
Background There are diverse opinions and confusion about defining and including patient values and preferences (i.e. the importance people place on the health outcomes) in the guideline development processes. This article aims to provide an overview of a process for systematically incorporating values and preferences in guideline development. Methods In 2013 and 2014, we followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to adopt, adapt and develop 226 recommendations in 22 guidelines for the Ministry of Health of the Kingdom of Saudi Arabia. To collect context-specific values and preferences for each recommendation, we performed systematic reviews, asked clinical experts to provide feedback according to their clinical experience, and consulted patient representatives. Results We found several types of studies addressing the importance of outcomes, including those reporting utilities, non-utility measures of health states based on structured questionnaires or scales, and qualitative studies. Guideline panels used the relative importance of outcomes based on values and preferences to weigh the balance of desirable and undesirable consequences of alternative intervention options. However, we found few studies addressing local values and preferences. Conclusions Currently there are different but no firmly established processes for integrating patient values and preferences in healthcare decision-making of practice guideline development. With GRADE Evidence-to-Decision (EtD) frameworks, we provide an empirical strategy to find and incorporate values and preferences in guidelines by performing systematic reviews and eliciting information from guideline panel members and patient representatives. However, more research and practical guidance are needed on how to search for relevant studies and grey literature, assess the certainty of this evidence, and best summarize and present the findings. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0621-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuan Zhang
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Pablo Alonso Coello
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Iberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, Spain
| | - Jan Brożek
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Department of Medicine, McMaster University, Hamilton, Canada
| | - Wojtek Wiercioch
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Itziar Etxeandia-Ikobaltzeta
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Department of Internal Medicine, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Joerg J Meerpohl
- Cochrane Germany, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité - U1153, Inserm/Université Paris Descartes, Cochrane France, Hôpital Hôtel-Dieu, 1 place du Parvis Notre Dame, 75181, Paris, Cedex 04, France
| | - Waleed Alhazzani
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Department of Medicine, McMaster University, Hamilton, Canada
| | - Alonso Carrasco-Labra
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Reem A Mustafa
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Departments of Internal Medicine/Nephrology and Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO, USA
| | - John J Riva
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 6th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Ainsley Moore
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, 100 Main Street West, 6th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Juan José Yepes-Nuñez
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,School of Medicine, University of Antioquia, Medellín, Colombia
| | - Carlos Cuello-Garcia
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Tecnologico de Monterrey School of Medicine, Monterrey, Mexico
| | | | - Veena Manja
- Division of Cardiology, Department of Medicine, Veterans Affairs Medical Center, Buffalo, NY, USA.,Department of Internal Medicine, University at Buffalo, the State University of New York, Buffalo, NY, USA
| | - Maicon Falavigna
- Hospital Moinhos de Vento, Porto Alegre, Brazil.,National Institute of Science and Technology for Health Technology Assessment, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ignacio Neumann
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Romina Brignardello-Petersen
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Nancy Santesso
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Bram Rochwerg
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.,Department of Medicine, McMaster University, Hamilton, Canada
| | - Andrea Darzi
- Department of Internal Medicine, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Maria Ximena Rojas
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Yaser Adi
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Claudia Bollig
- Cochrane Germany, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Reem Waziry
- Department of Internal Medicine, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.,The Kirby Institute, University of New South Wales, New South Wales, Australia
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada. .,Department of Medicine, McMaster University, Hamilton, Canada.
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20
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Gassem AB, Foxton R, Bister D, Newton T. Development of a measure of hypodontia patients’ expectations of the process and outcome of combined orthodontic and restorative treatment. J Dent 2016; 55:114-120. [DOI: 10.1016/j.jdent.2016.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 10/10/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022] Open
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21
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Øzhayat EB, Åkerman S, Lundegren N, Öwall B. Patients' experience of partial tooth loss and expectations to treatment: a qualitative study in Danish and Swedish patients. J Oral Rehabil 2015; 43:180-9. [PMID: 26426127 DOI: 10.1111/joor.12355] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2015] [Indexed: 11/30/2022]
Abstract
Knowledge of impairments, wishes and expectations is essential to make correct decisions regarding oral rehabilitation. The purpose of this study was to investigate discomforts, wishes and expectations in patients' with partial edentulism before entering oral rehabilitation. In Copenhagen, Denmark, and Malmö, Sweden, respectively, 20 patients with partial edentulism seeking rehabilitation were interviewed in a semistructured qualitative manner. The interviews were transcribed and analysed yielding overall domains. Six themes appeared as overall domains: (i) experienced impairments, (ii) experienced social awareness, (iii) expectation to treatment, (iv) expectation to durability/survival, (v) coping strategies dealing with the tooth loss including explanations of the tooth loss and (vi) modifications to experienced impairment. The impairments were mostly experienced as problems in social settings. Most participants expressed a simple wish to function normally; a fixed solution was preferred. Many Danish participants accepted a removable solution whereas only few Swedish participants did so. The domains 'coping strategies' and 'modifications' were not part of the chosen topics of interest, indicating a high wish of the participants to explain their tooth loss and how they coped with it. In conclusion, a large degree of social impairment was found in the patient group along with several coping strategies. The impairments were modified by a number of factors indicating that highly individualised care and treatment is needed. A state of normality was described as the primary treatment wish with a higher acceptance of removable solutions in Denmark than in Sweden. For final decision-making, surrounding factors seemed to influence the patients' choices.
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Affiliation(s)
- E B Øzhayat
- Department of Odontology, Section of Oral Rehabilitation, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - S Åkerman
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - N Lundegren
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - B Öwall
- Department of Odontology, Section of Oral Rehabilitation, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
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22
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Kashbour W, Rousseau N, Ellis J, Thomason J. Patients’ experiences of dental implant treatment: A literature review of key qualitative studies. J Dent 2015; 43:789-97. [DOI: 10.1016/j.jdent.2015.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 04/15/2015] [Accepted: 04/17/2015] [Indexed: 10/23/2022] Open
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23
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Zeng XT, Luo W, Huang W, Wang Q, Guo Y, Leng WD. Tooth loss and head and neck cancer: a meta-analysis of observational studies. PLoS One 2013; 8:e79074. [PMID: 24260154 PMCID: PMC3829962 DOI: 10.1371/journal.pone.0079074] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 09/26/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND [corrected] Epidemiological studies have shown that tooth loss is associated with risk of head and neck cancer (HNC); however, the results were inconsistent. Therefore, we conducted a meta-analysis to ascertain the relationship between tooth loss and HNC. METHODS We searched for relevant observational studies that tested the association between tooth loss and risk of HNC from PubMed and were conducted up to January 30, 2013. Data from the eligible studies were independently extracted by two authors. The meta-analysis was performed using the Comprehensive Meta-Analysis 2.2 software. Sensitivity and subgroup analyses were conducted to evaluate the influence of various inclusions. Publication bias was also detected. RESULTS Ten articles involving one cohort and ten case-control studies were yielded. Based on random-effects meta-analysis, an association between tooth loss and HNC risk was identified [increased risk of 29% for 1 to 6 teeth loss (OR = 1.29, 95% CI = 0.52-3.20, p = 0.59), 58% for 6 to 15 teeth loss (OR = 1.58, 95% CI = 1.08-2.32, p = 0.02), 63% for 11+ teeth loss (OR = 1.63, 95% CI = 1.23-2.14, p<0.001), 72% for 15+ teeth loss (OR = 1.72, 95% CI = 1.26-2.36, p<0.001), and 89% for 20+ teeth loss (OR = 1.89, 95% CI = 1.27-2.80, p<0.001)]. The sensitivity analysis shows that the result was robust, and publication bias was not detected. CONCLUSIONS Based on the current evidence, tooth loss is probably a significant and dependent risk factor of HNC, which may have a dose-response effect. People who lost six or more teeth should pay attention to symptoms of HNC, and losing 11 teeth or 15 teeth may be the threshold.
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Affiliation(s)
- Xian-Tao Zeng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Wei Luo
- Institute of Stomatology, General Hospital of Chinese People’s Liberation Army, Beijing, People’s Republic of China
| | - Wei Huang
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Quan Wang
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Yi Guo
- Department of Epidemilogy, School of Public Health, Wuhan University, Wuhan, People’s Republic of China
| | - Wei-Dong Leng
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- * E-mail:
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24
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Dhima M, Paulusova V, Lohse C, Salinas TJ, Carr AB. Practice-Based Evidence from 29-Year Outcome Analysis of Management of the Edentulous Jaw Using Osseointegrated Dental Implants. J Prosthodont 2013; 23:173-81. [DOI: 10.1111/jopr.12084] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2013] [Indexed: 11/27/2022] Open
Affiliation(s)
- Matilda Dhima
- Assistant Professor, Mayo Clinic College of Medicine and Chief Resident, Prosthodontics and Maxillofacial Prosthetics, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry; Mayo Clinic; Rochester MN
| | - Vladimira Paulusova
- Assistant Professor, Department of Dentistry, Faculty of Medicine and University Hospital in Hradec Králové; Charles University; Prague Czech Republic
| | - Christine Lohse
- Statistician, Department of Biostatistics; Mayo Clinic; Rochester MN
| | - Thomas J. Salinas
- Professor, Mayo Clinic College of Medicine and Consultant, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry; Mayo Clinic; Rochester MN
| | - Alan B. Carr
- Professor, Mayo Clinic College of Medicine and Consultant, Chair, Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry; Mayo Clinic; Rochester MN
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25
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Nordenram G, Davidson T, Gynther G, Helgesson G, Hultin M, Jemt T, Lekholm U, Nilner K, Norlund A, Rohlin M, Sunnegårdh-Grönberg K, Tranæus S. Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: a systematic review with meta-synthesis. Acta Odontol Scand 2013; 71:937-51. [PMID: 23101439 DOI: 10.3109/00016357.2012.734421] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation. BACKGROUND Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function. MATERIALS AND METHODS The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded. RESULTS The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation. CONCLUSIONS In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth.
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Affiliation(s)
- Gunilla Nordenram
- Karolinska Institutet, Department of Dental Medicine, Huddinge, Sweden
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26
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Preshaw PM, Walls AWG, Jakubovics NS, Moynihan PJ, Jepson NJA, Loewy Z. Association of removable partial denture use with oral and systemic health. J Dent 2011; 39:711-9. [PMID: 21924317 DOI: 10.1016/j.jdent.2011.08.018] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 08/26/2011] [Accepted: 08/30/2011] [Indexed: 11/20/2022] Open
Affiliation(s)
- P M Preshaw
- School of Dental Sciences, Newcastle University, UK.
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27
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Meaney S, Anweigi L, Ziada H, Allen F. The impact of hypodontia: a qualitative study on the experiences of patients. Eur J Orthod 2011; 34:547-52. [PMID: 21693681 DOI: 10.1093/ejo/cjr061] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Congenital absence of teeth affects 2-6 per cent of the population, but its impact on quality of life (QoL) is not fully understood. The symptoms of hypodontia can vary and therefore also the treatment and management of this condition. Determining and understanding the possible impact of hypodontia on patients could inform and improve the management of such patients. A purposive sample of 10 participants aged 16-25 years (five males and five females) with mild, moderate, or severe hypodontia at various stages of treatment was recruited. The participants had previously completed a 49-item Oral Health Impact Profile (OHIP) questionnaire with summary scores ranging from 24 to 143. All subjects participated in semi-structured interviews, and these were transcribed and analysed using NVivo software. The results show that the role of hypodontia patients in the treatment decision-making process changes significantly as they move from childhood to adulthood. Participants indicated dissatisfaction with the lack of communication with dental services throughout early adolescence as they became more cognizant of their condition which in turn led to concerns with regard to appearance which impacted on their psychosocial well-being. Hypodontia patients expect improved communication with dental practitioners and services as they become more cognizant of their condition and wish to become more actively involved in the decision-making process regarding their current and future treatment.
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Affiliation(s)
- S Meaney
- Department of Restorative Dentistry, University College Cork, Ireland
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28
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Gerritsen AE, Allen PF, Witter DJ, Bronkhorst EM, Creugers NHJ. Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes 2010; 8:126. [PMID: 21050499 PMCID: PMC2992503 DOI: 10.1186/1477-7525-8-126] [Citation(s) in RCA: 540] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 11/05/2010] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most cases being a consequence of oral diseases, affects Oral Health-Related Quality of Life (OHRQoL). The aim of the present study is to systematically review the literature and to analyse the relationship between the number and location of missing teeth and oral health-related quality of life (OHRQoL). It was hypothesized that tooth loss is associated with an impairment of OHRQoL. Secondly, it was hypothesized that location and distribution of remaining teeth play an important role in this. METHODS Relevant databases were searched for papers in English, published from 1990 to July 2009 following a broad search strategy. Relevant papers were selected by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers. Selected studies were grouped on the basis of OHRQoL instruments used and assessed for feasibility for quantitative synthesis. Comparable outcomes were subjected to meta-analysis; remaining outcomes were subjected to a qualitative synthesis only. RESULTS From a total of 924 references, 35 were eligible for synthesis (inter-reader agreement abstracts κ = 0.84 ± 0.03; full-texts: κ = 0.68 ± 0.06). Meta-analysis was feasible for 10 studies reporting on 13 different samples, resulting in 6 separate analyses. All studies showed that tooth loss is associated with unfavourable OHRQoL scores, independent of study location and OHRQoL instrument used. Qualitative synthesis showed that all 9 studies investigating a possible relationship between number of occluding pairs of teeth present and OHRQoL reported significant positive correlations. Five studies presented separate data regarding OHRQoL and location of tooth loss (anterior tooth loss vs. posterior tooth loss). Four of these reported highest impact for anterior tooth loss; one study indicated a similar impact for both locations of tooth loss. CONCLUSIONS This study provides fairly strong evidence that tooth loss is associated with impairment of OHRQoL and location and distribution of tooth loss affect the severity of the impairment. This association seems to be independent from the OHRQoL instrument used and context of the included samples.
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Affiliation(s)
- Anneloes E Gerritsen
- Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Centre, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands.
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Leles CR, Ferreira NP, Vieira AH, Campos ACV, Silva ET. Factors influencing edentulous patients' preferences for prosthodontic treatment. J Oral Rehabil 2010; 38:333-9. [PMID: 21039748 DOI: 10.1111/j.1365-2842.2010.02158.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to identify factors influencing edentulous patients' preferences for treatment using conventional or implant dentures (ID). A consecutive sample of 112 patients was selected in a university facility. All patients responded to a questionnaire concerning preferences about treatment and factors influencing preferences for conventional complete dentures (CD), implant-retained overdentures (IRO) and fixed implant-supported prostheses (FISP). Subsequently, a set of 21 questions was presented, and patients were requested to rate the importance of various potential reasons influencing their choice of treatment. Preference for CD was more prevalent for maxilla (52·7%) and mandible (41·1%). Fixed implant-supported prostheses and IRO were preferred for the mandible (FISP=37·5%; IRO=21·4%) rather than maxilla (FISP=27·7%; IRO=19·6%). The most preferred treatment option among the subjects when evaluating both arches was the implant-supported fixed or removable prosthesis (FISP/IRO). A preference for combined upper and lower CD was also commonly reported (39·3%). Factor analysis identified six components that accounted for 72·2% of the total variance: (i) psychosocial benefits, (ii) functional performance, (iii) technical and financial concerns, (iv) post-insertion complaints, (v) removability and (vi) longevity. Technical and financial concerns (cost, complexity, surgery risks and duration of treatment) were more relevant for those who preferred ID (P<0·001). With the exception of post-insertion complaints, all mean scores of component factor loadings were positive for ID. Conventional complete dentures are associated with lower expected outcomes by patients, and cost-related issues are the major factors associated with the preferences for implant treatment of edentulous patients.
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Affiliation(s)
- C R Leles
- School of Dentistry, Federal University of Goias, Goiania, Goias School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Gregory J, Thomson WM, Broughton JR, Cullinan MP, Seymour GJ, Kieser JA, Donaghy MA, Shearer DM. Experiences and perceptions of oral health and oral health care among a sample of older New Zealanders. Gerodontology 2010; 29:54-63. [DOI: 10.1111/j.1741-2358.2010.00402.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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