1
|
Iriti M, Spallino G, Franchini R, Rigoni M, Muti P, Lodi G, Sardella A, Varoni EM. Survey on patients' attitude towards the nutritional counselling in the dental setting. BDJ Open 2024; 10:47. [PMID: 38862495 PMCID: PMC11166955 DOI: 10.1038/s41405-024-00229-0] [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: 03/29/2024] [Revised: 05/01/2024] [Accepted: 05/14/2024] [Indexed: 06/13/2024] Open
Abstract
AIM A healthy diet could help to prevent both oral and systemic diseases, with dentists and nutritionists supplementing their skills. The dental setting, where patients periodically refer to seeking oral health care, represents a powerful opportunity for nutritional counselling. To the best of our knowledge, no study is available on patients' attitudes towards dietary counselling in the dental setting. This cross-sectional study investigates patients' attitude towards receiving nutritional support within the dental setting and it elucidates whether a transdisciplinary approach would be well accepted. MATERIALS AND METHODS A questionnaire was administered to patients attending three different clinics: a private clinic, a hospital dental clinic of the national healthcare system and the private dental practice within the same hospital. RESULTS Three hundred thirteen questionnaires were collected. Most dental patients acknowledged receiving nutritional advice from both dentists and nutritionists. The nutritionist within the dental setting was positively perceived, providing useful advice to prevent oral and systemic diseases and also drawing up a diet with periodic follow-ups. DISCUSSION AND CONCLUSION These findings support the positive attitude of patients towards receiving nutritional counselling within the dental setting. The dental clinics can be pivotal in oral and systemic disease screening and prevention and a multidisciplinary approach is highly encouraged.
Collapse
Affiliation(s)
- M Iriti
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Milan, Italy
| | - G Spallino
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Milan, Italy
| | - R Franchini
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Milan, Italy
- Odontostomatologia, ASST Santi Paolo e Carlo - Presidio Ospedaliero San Paolo, Milan, Italy
| | - M Rigoni
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Muti
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Milan, Italy
- Odontostomatologia, ASST Santi Paolo e Carlo - Presidio Ospedaliero San Paolo, Milan, Italy
| | - A Sardella
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Milan, Italy
- Odontostomatologia, ASST Santi Paolo e Carlo - Presidio Ospedaliero San Paolo, Milan, Italy
| | - E M Varoni
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, University of Milan, Milan, Italy.
- Odontostomatologia, ASST Santi Paolo e Carlo - Presidio Ospedaliero San Paolo, Milan, Italy.
| |
Collapse
|
2
|
Large JF, Madigan C, Graham H, Biddle GJH, Sanders J, Daley AJ. Public and dental teams' views about weight management interventions in dental health settings: Systematic review and meta-analysis. Obes Rev 2024; 25:e13726. [PMID: 38343102 DOI: 10.1111/obr.13726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 12/05/2023] [Accepted: 01/18/2024] [Indexed: 05/14/2024]
Abstract
Collaborative approaches across healthcare to address obesity are needed but intervention in dental settings is not widely implemented. Here we systematically synthesized the views of both the public and dental teams about delivering weight management interventions in dental settings and identified potential barriers to implementation. A systematic review of five databases from inception to April 3, 2023 was completed. Proportional meta-analyses were performed with quantitative data and thematic analysis of qualitative data. A total of 7851 studies were screened and 33 included in the review. The prevalence of height and weight screening in dental settings varied (4%-87%) with an average of 29% undertaking screening (p = <0.01; 95% CI: 14%-46%). A significant proportion of the public were supportive of weight screening in dental settings (83%; p = <0.01; 95% CI:76%-88%). Significant barriers to providing weight screening and/or intervention included fear of offending patients (57%; 95% CI: 45%-68%) and a lack of time (48%; 95% CI: 30%-66%). Qualitative data revealed further barriers including stigmatizing views of dental teams toward people living with overweight/obesity. Enablers of weight discussion included associating weight with oral health. Overall, whilst some barriers were identified, there is potential for weight management interventions to be used more routinely in dental settings.
Collapse
Affiliation(s)
- Jessica F Large
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Claire Madigan
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Henrietta Graham
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Gregory J H Biddle
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - James Sanders
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Amanda J Daley
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| |
Collapse
|
3
|
Berryhill MB, Culmer N, Smith T, Kopycka-Kedzierawski D, Gurganus R, Curry G. Perceptions of mental health screening and referral to treatment in National Dental-Practice Based Research Network practices: A qualitative study. J Public Health Dent 2024; 84:124-135. [PMID: 38561327 PMCID: PMC11168878 DOI: 10.1111/jphd.12607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 11/27/2023] [Accepted: 01/05/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Dental practices can have additional positive impacts on public health by implementing mental health screening and referral to treatment in dental care workflows. In this study, we examined how dental practices identify and address adult patient mental health concerns, attitudes about implementing mental health screening and referral, and potential barriers and facilitators to treatment. METHODS We conducted semi-structured focus groups with 17 dentists, 10 dental hygienists, and 5 dental assistants/office staff in the South-Central region of the National Dental Practice-Based Research Network. Transcribed interviews were analyzed using thematic analysis. RESULTS We identified five main themes from dental practitioners and office staff responses. Practitioners and office staff: (1) discover patient mental health concerns through record review, patient/caregiver disclosure, and patient observation; (2) respond to patients' mental health concerns by making the patient more comfortable, documenting the concern in the patient's chart, and directly addressing the mental health concern; (3) want a systematic process for mental health screening and referral to treatment in their dental office; (4) recognize potential barriers in implementing health screening and referral to treatment processes; (5) desire training on mental health matters. An overarching theme emerged: developing a trusting relationship with patients. CONCLUSIONS Participants noted the importance of implementing systematic procedures for mental health screening and referral to services into dental practices, while also recognizing the potential barriers for integrating such processes. They also expressed a desire for quality training and resources that can support better care for patients with mental health concerns.
Collapse
Affiliation(s)
| | | | - Todd Smith
- The University of Alabama, Tuscaloosa, Alabama, USA
| | | | - Ria Gurganus
- The University of Alabama, Tuscaloosa, Alabama, USA
| | | |
Collapse
|
4
|
Doughty J, Tran C, Santella AJ, Fitzgerald R, Burns F, Porter S, Watt RG. Point of care HIV testing in dental settings in high-income countries: A mixed-methods systematic review. Community Dent Oral Epidemiol 2024. [PMID: 38822596 DOI: 10.1111/cdoe.12963] [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] [Received: 11/08/2023] [Revised: 03/27/2024] [Accepted: 04/12/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES Expanding HIV testing beyond specialized services has been a key strategic approach to eliminating the transmission of HIV. In recent years, dental settings have been identified as offering an opportunity for delivering point of care HIV testing (POCT) interventions. Intervention components and implementation strategies have varied across studies and there is uncertainty about the prevalence of undiagnosed HIV in the dental patient population. Therefore, this systematic review aimed to synthesize the HIV testing outcomes of intervention studies, identify the core components of POCT interventions implemented in dental settings; and understand the barriers and facilitators to intervention implementation. METHODS A mixed-methods systematic review was undertaken. Two authors reviewed abstracts and full papers for inclusion and appraised the studies using the Mixed Methods Appraisal Tool. A convergent integrated mixed methods study design underpinned the synthesis. Outcomes were presented using descriptive statistics. Intervention components were mapped to the Template for Intervention Description and Replication (TIDieR) checklist. Barriers and facilitators were described using a narrative thematic analysis. RESULTS POCT was offered to 22 146 dental patients, 62.5% accepted POCT. Intervention studies that reported higher uptake of testing utilized a dedicated dental or researcher staff member to provide testing, integrated testing and provided results within the routine dental appointment and adopted a provider-initiated universal approach to offering testing. Six themes emerged that were pertinent to the barriers and facilitators to HIV testing in dental setting. CONCLUSIONS POCT uptake in dental settings was comparable with other non-specialized health settings. Key to the operationalization of the intervention were perceptions about its value and relevance to the dental patient population, attitudes toward the intervention, logistical barriers to its implementation, the risk of HIV testing stigma to the patient-practitioner relationship and maximising the fit of the intervention within the constraints of the dental setting.
Collapse
Affiliation(s)
- J Doughty
- Department of Epidemiology & Public Health, Faculty of Pop Health Sciences, University College London, London, UK
- School of Dentistry, University of Liverpool
| | - C Tran
- Oral and Maxillofacial Surgery department, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - A J Santella
- Marion Peckham Egan School of Nursing & Health Studies, Fairfield University, Fairfield, Connecticut, USA
| | - R Fitzgerald
- Department of Special Care Dentistry, Surrey and Sussex Healthcare Trust
| | - F Burns
- Institute for Global Health, University College London, London, UK
| | - Stephen Porter
- Eastman Dental Institute, Faculty of Medical Sciences, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology & Public Health, Faculty of Pop Health Sciences, University College London, London, UK
| |
Collapse
|
5
|
Malik Z. Developmental disability and obesity: Oral health implications across the lifespan. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38699803 DOI: 10.1111/scd.13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Zanab Malik
- South Western Sydney Local Health District, Oral Health Services, NSW Health, Australia
- The University of Newcastle, School of Health Sciences (Oral Health), College of Health, Medicine and Wellbeing, NSW, Australia
| |
Collapse
|
6
|
Pérez-Jardón A, López-Durán A, Somoza-Martín M, Barba-Montero C, Blanco-Carrión A, Chamorro-Petronacci C, Pérez-Sayáns M. Drug use, risk perceptions and attitudes towards drug use amongst medical and dentistry students. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:918-927. [PMID: 36484264 DOI: 10.1111/eje.12882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 04/08/2022] [Accepted: 10/28/2022] [Indexed: 06/17/2023]
Abstract
AIMS To analyse the use of psychoactive substances and the risk perceptions amongst odontology and medical students. To study their perceptions, attitudes and knowledge, and to evaluate their motivation when helping their patients to stop using these substances. METHODS A cross-sectional study was conducted amongst 962 students in Spain, using validated questionnaires on an anonymous basis. RESULTS Amongst these students, drug use varies and increases with age as assessed by the DAST and CAST tests, with more problematic use being observed as the academic cycle progresses (p < .001). Participants in the 2nd cycle presented higher consumption than those in the 1st cycle, in the univariate model (OR = 1.77, IC 95% 1.27-2.48, p = .001) and in the adjusted model (OR = 1.86, IC 95% 1.32-2.62, p < .001). Regarding CAST, non-problematic use in the 1st cycle versus the 3rd cycle presented an OR = 8.69 (IC 95% 4.50-16.78, p < .001) and for low risk use it presented an OR = 15.18 (IC 95% 1.83-14.68). Only 46.7% considered using marijuana on a regular basis as a high risk, whilst 60.5% stated that smoking a pack of cigarettes represents a high risk. Alcohol was the substance for which the risk perception was lowest. 66.2% are in the maintenance stage "I provide my regular drug-using patients help to give up," with women being more likely to be in this stage (p = .012). CONCLUSIONS High risk of drug use increases after the 1st cycle in Dentistry and in Medicine. Training programmes should be implemented in both degrees, focusing on the 1st years in order to simultaneously prevent drug use amongst students.
Collapse
Affiliation(s)
- Alba Pérez-Jardón
- Oral Medicine, Oral Surgery and Implantology, Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- ORALRES group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Ana López-Durán
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Manuel Somoza-Martín
- Oral Medicine, Oral Surgery and Implantology, Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- ORALRES group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Catalina Barba-Montero
- Oral Medicine, Oral Surgery and Implantology, Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery and Implantology, Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- ORALRES group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | | | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology, Unit (MedOralRes). Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- ORALRES group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| |
Collapse
|
7
|
Özcan A, Nijland N, Gerdes VEA, Bruers JJM, Loos BG. Willingness for Medical Screening in a Dental Setting-A Pilot Questionnaire Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6969. [PMID: 37947527 PMCID: PMC10650185 DOI: 10.3390/ijerph20216969] [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: 07/26/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023]
Abstract
An important way to manage noncommunicable diseases (NCDs) is to focus on prevention, early detection, and reducing associated risk factors. Risk factors can be detected with simple general health checks, which can also be performed in dental clinics. The purpose of this study was to investigate participants' willingness to participate in general health checks at the dentist, in particular the difference in opinion between medical patients and random healthy dental attendees. A total of 100 medical patients from an outpatient internal medicine clinic and 100 dental clinic attendees were included (total of 200 participants). The participants were asked for their opinion using six closed-ended questions. Overall, 91.0% of participants were receptive to information about the risk of diabetes mellitus (DM) and cardiovascular diseases (CVD). The majority (80-90%) was receptive to screening for DM and CVD risk, such as weight and height measurements, blood pressure measurement, saliva testing for CVD and to measure glucose and cholesterol via finger stick. No significant differences were found in the frequencies of the responses between the different groups based on health status, age, sex, or cultural background. This study shows that most participants are willing to undergo medical screening at the dentist for early detection and/or prevention of common NCDs.
Collapse
Affiliation(s)
- Asiye Özcan
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands (B.G.L.)
| | - Nina Nijland
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands (B.G.L.)
| | - Victor E. A. Gerdes
- Department of Internal Medicine, Amsterdam University Medical Center (AUMC), University of Amsterdam and Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, 2134 TM Hoofddorp, The Netherlands
| | - Josef J. M. Bruers
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
- Royal Dutch Dental Association (KNMT), 3528 BB Utrecht, The Netherlands
| | - Bruno G. Loos
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands (B.G.L.)
| |
Collapse
|
8
|
Guo Y, Woodard J, Zhang Y, Staras SAS, Gordan VV, Gilbert GH, McEdward DL, Shenkman E. Patients' comfort with and receipt of health risk assessments during routine dental visits: Results from the South Atlantic region of the US National Dental Practice-Based Research Network. Community Dent Oral Epidemiol 2023; 51:854-863. [PMID: 35851866 PMCID: PMC10792993 DOI: 10.1111/cdoe.12773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 06/06/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To understand patients' comfort with health risk assessments (HRAs) and patient and dentist factors associated with the provision of HRAs. METHODS In this cross-sectional study, 857 patients seen by 30 dental practitioners in the United States National Dental Practice-Based Research Network reported their comfort receiving HRA for six risk factors (tobacco use, alcohol use, dietary sugar intake, human immunodeficiency virus risks, human papillomavirus risks and existing medical conditions) and whether they discussed any of the risk factors during their visits. Multi-level logistic models were used to examine the impacts of patient, practitioner, practice characteristics on the (1) number of risk factors patients were comfortable discussing and (2) number of risk factors assessed in the current dental visit. RESULTS Only a small percentage (4%) of patients reported being uncomfortable receiving any HRA during their dental visits. However, over half of the patients (53%) reported that they did not receive any HRAs during the current visit. In the regression analyses, patients who were older, male and from the suburban were more likely to be comfortable with more HRAs. Dentists were more likely to provide HRA if they were younger, not non-Hispanic white, less likely to feel that providing HRAs was beyond their scope of practice, yet more likely to feel occasional discomfort in providing HRA. CONCLUSIONS Interventions should focus on reducing dental practitioner perception that conducting HRAs is beyond their scope of practice and standardizing screening assessments for multiple risk factors.
Collapse
Affiliation(s)
- Yi Guo
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road; Gainesville, FL 32608
| | - Jennifer Woodard
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road; Gainesville, FL 32608
| | - Yahan Zhang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1225 Center Drive, Gainesville, FL, 32610
| | - Stephanie A. S. Staras
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road; Gainesville, FL 32608
| | - Valeria V. Gordan
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, 1395 Center Drive; Gainesville, FL 326010-0415
| | - Gregg H. Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama, 1919 7th Ave S, Birmingham, AL 35294
| | - Deborah L. McEdward
- National Dental Practice-Based Research Network, Restorative Dental Sciences, University of Florida, 1395 Center Drive; Gainesville, FL 326010-0415
| | - Elizabeth Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road; Gainesville, FL 32608
| | | |
Collapse
|
9
|
Balwanth S, Singh S. Caregivers’ knowledge, attitudes, and oral health practices at long-term care facilities in KwaZulu-Natal. Health SA 2023; 28:2147. [PMID: 37064651 PMCID: PMC10091066 DOI: 10.4102/hsag.v28i0.2147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/15/2022] [Indexed: 02/05/2023] Open
Abstract
Background Vulnerable individuals residing at long-term care facilities require special oral health consideration. Examining concepts of oral health and hygiene practices of caregivers becomes essential for understanding the quality of oral health services provided to residents. Aim This study explored the oral health-related knowledge, attitudes and practices (KAP) of caregivers. Setting Long-term care facilities in the eThekwini District, KwaZulu-Natal. Methods A cross-sectional study was conducted at seven long-term care facilities among 188 caregivers who completed a self-administered questionnaire. Data were collated and analysed using the Statistical Package for the Social Sciences (SPSS) version 24. Inferential techniques included an analysis of variance (ANOVA) test. A p-value ≤ 0.05 was considered to be statistically significant. Results Participants reported that dentures do not to be cleaned (n = 139; 73.9%). Participants (n = 70; 37.2%) reported that some medications have oral side effects. Most participants (n = 173; 92%) were optimistic about improving their oral health knowledge and skills. Participants (n = 108; 57.4%) only reported flossing when they had food trapped between their teeth. Few participants (n = 30; 16%) reported visiting the dentist every 6 months. Conclusion Participants had a positive attitude to improve their oral health-related knowledge and practices. However, the study showed that there is a need to scale-up oral health education and training activities for caregivers. Contribution It is envisaged that findings of this study will demonstrate the importance of oral health-related knowledge among caregivers in providing better oral health care through improved attitudes and practices.
Collapse
Affiliation(s)
- Sonam Balwanth
- Discipline of Dentistry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Shenuka Singh
- Discipline of Dentistry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
10
|
The relationship between glycated hemoglobin level and the stage of periodontitis in individuals without diabetes. PLoS One 2023; 18:e0279755. [PMID: 36608039 PMCID: PMC9821507 DOI: 10.1371/journal.pone.0279755] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023] Open
Abstract
Glycemic control appears to have a significant impact on the relationship between periodontitis and diabetes. The current study aimed to investigate the association between the stage of periodontitis and hemoglobin A1c (HbA1c) levels in patients considered to be normoglycemic. A total of 135 patients (100 females and 35 males) with no history of diabetes were included in the study. The mean age of the participants was 38.4 years old. All patients underwent a full-mouth periodontal examination. Periodontal diagnosis was determined according to the 2017 World Workshop on the Classification of Periodontal Disease. The glycemic state of the patients was assessed using a chair-side HbA1c analyzer. Ninety patients were diagnosed with periodontitis. Higher average HbA1c levels were associated with the different stages of periodontitis (p<0.01). Most of the non-periodontitis patients were in the non-diabetes group (67%), while most of the periodontitis patients were in the undiagnosed pre-diabetes group (47% of the stages I and II group, and 44% of the stages III and IV groups) (p<0.001). Periodontitis was found to be significantly associated with elevated glycated hemoglobin levels in patients not previously diagnosed with diabetes, and the elevation in HbA1c levels was more evident in patients with stage III and IV periodontitis.
Collapse
|
11
|
Gordon SC, Riedy CA, Stohler CS, Vujicic M. Trends in Scope of Practice for Oral Health Care: Future Transformative Effects. JDR Clin Trans Res 2022; 7:31S-39S. [PMID: 36121139 DOI: 10.1177/23800844221116845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
KNOWLEDGE TRANSFER STATEMENT The results of this study can help key stakeholders, such as health care facilities, educational and research institutions, insurance companies, and governmental bodies, plan future activities and policies on dental practice and education.
Collapse
Affiliation(s)
- S C Gordon
- School of Dentistry, University of Washington, Seattle, WA, USA
| | - C A Riedy
- Harvard School of Dental Medicine, Boston, MA, USA
| | - C S Stohler
- Columbia University Medical Center, Columbia University College of Dental Medicine, New York, NY, USA
| | - M Vujicic
- American Dental Association Health Policy Institute, Chicago, IL, USA
| |
Collapse
|
12
|
Yonel Z, Kuningas K, Sharma P, Dutton M, Jalal Z, Cockwell P, Webber J, Narendran P, Dietrich T, Chapple ILC. Concordance of three point of care testing devices with clinical chemistry laboratory standard assays and patient-reported outcomes of blood sampling methods. BMC Med Inform Decis Mak 2022; 22:248. [PMID: 36138408 PMCID: PMC9493167 DOI: 10.1186/s12911-022-01999-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Point of care testing (POCT) devices have been developed to facilitate immediate results with the potential to aid screening for new disease and enable patients to self-monitor their disease. Non-communicable diseases (NCDs) are the major cause of mortality globally and are increasing in prevalence as the population ages. Allied health care professionals (AHPs) are skilled in undertaking risk assessment and delivering preventative advice, providing opportunities to access large proportions of the population who may not visit their doctor, within non-traditional community settings. There is evidence of high levels of support from public, patients and health professionals for engaging AHPs in risk-targeted early case detection of certain NCDs. Thus, POCT devices offer a potential alternative to traditional venous blood collection, as novel care pathways for increasing early case detection and access to preventative care. The objectives of this study were to: (i) determine the concordance of the specific POCT devices with laboratory-based standard assays employed within clinical biochemistry laboratories. (ii) compare the sampling experience of both methods via patient-reported experiences. Methods A prospective, two-centre study was undertaken involving 158 participants who provided informed consent. Venous blood was collected for traditional assays of HbA1c, creatinine/ estimated Glomerular-Filtration-Rate (eGFR) and vitamin-D. Capillary blood was collected by finger prick test and also assayed for the same biochemical indices (Nova StatSensor (creatinine/eGFR); Siemens DCA-Vantage (HbA1C); CityAssays (vitamin-D)). All users were provided with device training. Participants reported any discomfort experienced by each simultaneously applied method (randomised in order) via a 100 mm Visual-Analogue-Scale. Results Results for each POCT device and the laboratory standard were analysed by Bland-Altman plots to determine assay concordance. POCT devices demonstrated good concordance with laboratory testing, with at least 95% of all samples being within two standard deviations, for each of the devices tested. The majority of participants reported less discomfort with POCT than venepuncture, with the average reported discomfort being 17/100 mm less for POCT compared to venous blood sample collection on the visual analogue scale. Conclusions The POCT devices demonstrated acceptable concordance with laboratory-based assays, and patients reported lower levels of discomfort compared to traditional means of blood collection. This study demonstrates the potential of using these devices as acceptable methods for opportunistic testing of “at-risk” individuals within non-traditional community care settings.
Collapse
Affiliation(s)
- Z Yonel
- The Periodontal Research Group, School of Dentistry, University of Birmingham, 5 Mill Pool Way, Birmingham, B5 7EG, UK.
| | - K Kuningas
- Department of Renal Medicine, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK
| | - P Sharma
- The Periodontal Research Group, School of Dentistry, University of Birmingham, 5 Mill Pool Way, Birmingham, B5 7EG, UK
| | - M Dutton
- Department of Renal Medicine, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK
| | - Z Jalal
- School of Pharmacy, University of Birmingham, Birmingham, UK
| | - P Cockwell
- Department of Renal Medicine, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK
| | - J Webber
- Diabetes Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK
| | - P Narendran
- Diabetes Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK
| | - T Dietrich
- The Periodontal Research Group, School of Dentistry, University of Birmingham, 5 Mill Pool Way, Birmingham, B5 7EG, UK
| | - I L C Chapple
- The Periodontal Research Group, School of Dentistry, University of Birmingham, 5 Mill Pool Way, Birmingham, B5 7EG, UK
| |
Collapse
|
13
|
Craniofacial Sleep Medicine: The Important Role of Dental Providers in Detecting and Treating Sleep Disordered Breathing in Children. CHILDREN 2022; 9:children9071057. [PMID: 35884041 PMCID: PMC9323037 DOI: 10.3390/children9071057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022]
Abstract
Obstructive sleep apnea (OSA) is a clinical disorder within the spectrum of sleep-related breathing disorders (SRDB) which is used to describe abnormal breathing during sleep resulting in gas exchange abnormalities and/or sleep disruption. OSA is a highly prevalent disorder with associated sequelae across multiple physical domains, overlapping with other chronic diseases, affecting development in children as well as increased health care utilization. More precise and personalized approaches are required to treat the complex constellation of symptoms with its associated comorbidities since not all children are cured by surgery (removal of the adenoids and tonsils). Given that dentists manage the teeth throughout the lifespan and have an important understanding of the anatomy and physiology involved with the airway from a dental perspective, it seems reasonable that better understanding and management from their field will give the opportunity to provide better integrated and optimized outcomes for children affected by OSA. With the emergence of therapies such as mandibular advancement devices and maxillary expansion, etc., dentists can be involved in providing care for OSA along with sleep medicine doctors. Furthermore, the evolving role of myofunctional therapy may also be indicated as adjunctive therapy in the management of children with OSA. The objective of this article is to discuss the important role of dentists and the collaborative approach between dentists, allied dental professionals such as myofunctional therapists, and sleep medicine specialists for identifying and managing children with OSA. Prevention and anticipatory guidance will also be addressed.
Collapse
|
14
|
Parish CL, Pereyra MR, Yanez IG, Vidot DC, Metsch LR. Patient acceptance of HIV rapid testing in the dental care setting. AIDS Care 2022; 35:745-752. [PMID: 35603879 DOI: 10.1080/09540121.2022.2073326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Dental settings are untapped venues to identify patients with undiagnosed HIV who may otherwise lack testing opportunities. Perceived lack of patient acceptance has been a significant barrier limiting dentists' willingness to offer HIV testing. This study implemented rapid HIV testing in dental settings located in an HIV prevalent region to evaluate patient acceptance. Two South Florida community health centers implemented routine oral rapid HIV testing as part of clinical practice, followed by exit interviews with patients immediately after to determine patient acceptance. The binary primary outcome was patient's acceptance of the rapid HIV test. Multivariable logistic regression assessed associations between patient characteristics and acceptance. Overall acceptance by dental patients (N = 600) was 84.5%. Patients who were more likely to participate in other medical screenings in dental settings were more than twice as likely to accept the test compared to those who were neutral/less likely (OR: 2.373; 95% CI: 1.406-4.004). Study findings highlight the high patient acceptance of HIV testing in dental settings. Widespread implementation of such testing will require an expanded societal view of the traditional role of the dentist that will embrace the potentially valuable role of dentistry in preventive health screenings and population health.
Collapse
Affiliation(s)
- Carrigan L. Parish
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | | | - Iveth G. Yanez
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | - Denise C. Vidot
- School of Nursing and Health Sciences, University of Miami, Miami, FL, USA
| | - Lisa R. Metsch
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| |
Collapse
|
15
|
Lobbezoo F, Aarab G. Medicine and Dentistry Working Side by Side to Improve Global Health Equity. J Dent Res 2022; 101:1133-1134. [PMID: 35331053 PMCID: PMC9397386 DOI: 10.1177/00220345221088237] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- F Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
16
|
Giddon DB, Lamster IB. The dilemma of different dental degrees: DDS and DMD. J Dent Educ 2022; 86:998-1005. [PMID: 35285951 DOI: 10.1002/jdd.12921] [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: 10/15/2021] [Revised: 12/21/2021] [Accepted: 02/25/2022] [Indexed: 11/08/2022]
Abstract
Although the Doctor of Dental Surgery (DDS) evolved from the surgical and the Doctor of Medicine in Dentistry (DMD) from the medical (DMD) roots of the dental profession, dental schools in the US currently award both degrees, verified as equivalent by finding no differences between them in standards of admissions, accreditation, or state licensure requirements while continuing to be subjectively perceived as different enough to create professional and public confusion. In contrast, Doctors of Osteopathy (DOs) and Doctors of Medicine (MDs) are both objectively and subjectively perceived as different in philosophy and healthcare training while objectively passing similar examinations to be licensed as physicians. Following from the history of both dental degrees and their implications for training and dental practice, the objective of this manuscript is to update the scientific, socio-political, and professional reasons for awarding only the DMD for future graduates while continuing to recognize the contributions of DDS graduates to oral healthcare. Working with the American Dental Association (ADA), American Dental Education Association (ADEA), and dental school librarians, a historical review was undertaken of the establishment of two doctoral degrees for dentists in the United States, including beliefs and attitudes of faculty and local dentists at the times of initiation or change in degrees awarded. Among the current 68 dental schools in the United States, there are approximately equal numbers of DDS- and DMD-granting schools. Except for some Harvard physicians, some of whom practiced dentistry, who wanted dentistry to be a specialty of medicine and the unexpected, serendipitous substitution of "medicine" for "surgery" which could not be translated into required Latin in 1867, all dental schools would have awarded only the DDS degree. Now, with the ongoing reorganization of the healthcare workforce in the United States, a single degree with broader healthcare connotations of the DMD will facilitate the integration of dentistry with overall healthcare, without changing the fundamental oral healthcare responsibilities of both DDS and DMD graduates.
Collapse
Affiliation(s)
- Donald B Giddon
- Department of Developmental Biology, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA.,NYU College of Dentistry, New York City, New York, USA.,Department of Community Dentistry and Behavioral Science, University of Florida School of Dentistry, Gainesville, Florida, USA
| | - Ira B Lamster
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA.,Columbia University College of Dental Medicine, New York City, New York, USA
| |
Collapse
|
17
|
Dentists' Attitudes toward Diabetes Mellitus Screening in Thai Dental Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063341. [PMID: 35329025 PMCID: PMC8955522 DOI: 10.3390/ijerph19063341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023]
Abstract
Diabetes mellitus (DM), especially type 2 DM, has become a common problem worldwide. Previous studies have demonstrated that chairside screening can effectively identify undetected type 2 DM patients. This study was conducted to determine dentists' attitudes toward DM screening in dental clinics. A total of 632 currently active dentists with more than 1 year of working experience participated. The six-part (importance, barriers, willingness, readiness, knowledge, and routine management) anonymous, self-administered questionnaire of five-point response scales was then distributed. The results illustrated that most dentists (86.3%) realized the importance of DM screening and that patients' willingness was the main potential barrier (86.4%). Of the respondents, 98.1% and 82.4% were willing to measure blood pressure and weight and height for their patients, whereas only 45.4% and 38.8% were willing to collect blood from the fingertip or oral fluids for salivary diagnostics, respectively. Moreover, 73.7% of respondents were ready to refer patients to physicians, and 59.5% could explain the relationship between DM and oral diseases. However, only 44.3% and 27.9% were prepared to provide education about DM awareness or were able to perform screening, respectively. In addition, 67.2% and 65.8% knew the screening criteria and risk factors of DM, respectively, but only 45.1% knew what to do. The result of our study provided essential knowledge with respect to dentists' attitudes in the screening for DM in Thai dental clinics.
Collapse
|
18
|
MacNeil RLM, Hilario H, Gordon SM, Degollado C, Malmrose M, Lepowsky SM. Implementation and analysis of an enhanced screening and testing protocol for prediabetes in a dental school patient population. J Public Health Dent 2022; 82:262-270. [PMID: 35199346 DOI: 10.1111/jphd.12506] [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: 05/28/2021] [Revised: 10/18/2021] [Accepted: 02/04/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This project aimed to enhance the identification of patients at-risk for prediabetes or diabetes within a dental school patient population by introduction of a modified screening tool and related training of dental residents and students. METHODS The American Diabetes Association Risk Tool (ADART) was modified by addition of three diabetes-linked oral health questions. Of the 1477 dental patients screened, 551 (37.3%) indicated an at-risk status using the modified tool. A subset of 138 patients received follow-up chairside HbA1c blood testing conducted by dental residents and students. Data was analysed to determine a) the influence of the modifications on the tool's discrimination strength and b) change in the tool's predictive value. RESULTS The addition of the 3 oral health questions to the 7-item ADART resulted in a 9.4% increase in identification of patients at-risk for pre-diabetes/diabetes. The predictive value of the tool remained stable. Residents and students successfully incorporated the new screening activities within their assigned clinics. CONCLUSIONS This project demonstrates that screening for risk for prediabetes/diabetes is both prudent and practical in the dental setting. Dental personnel, including trainees, can successfully incorporate enhanced screening methods within their traditional activities. Further, screening tools used in the dental setting might be enhanced by inclusion of certain oral health variables associated with diabetes. These findings add to emerging knowledge on the importance of screening for prediabetes/diabetes in dental settings and have particular relevance and application to institutional practice.
Collapse
Affiliation(s)
- Roderick L Monty MacNeil
- Division of General Dentistry, School of Dental Medicine, UConn Health, Farmington, Connecticut, USA
| | - Helena Hilario
- School of Dental Medicine, UConn Health, Farmington, Connecticut, USA
| | - Sharon M Gordon
- College of Dental Medicine, Kansas City University, Joplin, Missouri, USA
| | - Carlos Degollado
- Division of General Dentistry, School of Dental Medicine, UConn Health, Farmington, Connecticut, USA
| | - Michael Malmrose
- Connecticut Department of Energy and Environmental Protection, New Britain, Connecticut, USA
| | - Steven M Lepowsky
- School of Dental Medicine, UConn Health, Farmingtonz, Connecticut, USA
| |
Collapse
|
19
|
Daley AJ. Time to get our teeth into reducing obesity: should dentists screen and deliver interventions to reduce obesity in the population? Br Dent J 2022; 232:78-79. [PMID: 35091605 PMCID: PMC8796197 DOI: 10.1038/s41415-022-3872-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/28/2021] [Indexed: 11/08/2022]
Abstract
Little attention has been devoted to how dentists and dental teams may be able to contribute to reducing obesity, by screening for obesity in the population and offering weight management interventions to those who might benefit. Drawing on the NHS Making Every Contact Count campaign, this paper presents a case as to why dentists have an instrumental role in contributing to the global public heath effort to reduce obesity in both adults and children. This paper suggests how dentists might learn lessons from GPs and practice nurses about how to best address and raise the topic of weight management within patient consultations. Lastly, this report offers some tangible plans of action for further research on this question.
Collapse
Affiliation(s)
- Amanda J Daley
- Professor of Behavioural Medicine, The Centre for Lifestyle Medicine and Behaviour (CLiMB), Loughborough University, Loughborough, UK.
| |
Collapse
|
20
|
Gordon SC, Kaste LM, Mouradian WE, Beemsterboer PL, Berg JH, Murdoch-Kinch CA. Dentists as Primary Care Providers: Expert Opinion on Predoctoral Competencies. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.703958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dentistry and medicine traditionally practice as separate professions despite sharing goals for optimal patient health. Many US residents experience both poor oral and general health, with difficulty accessing care. More efficient collaboration between these professions could enhance health. The COVID-19 pandemic disclosed further disparities while underscoring concerns that physician supply is inadequate for population needs. Hence, enhancing healthcare provider education to better meet the public's health needs is critical. The proposed titles “Oral Physician” or “Oral Health Primary Care Provider” (OP-PCP) acknowledge dentist's capacity to diagnose and manage diseases of the orofacial complex and provide some basic primary healthcare. The US Surgeon General's National Prevention Council and others recommend such models. Medical and dental education already overlap considerably, thus it is plausible that dental graduates could be trained as OP-PCPs to provide primary healthcare such as basic screening and preventive services within existing dental education standards. In 2018, 23 dental and medical educators participated in an expert-opinion elicitation process to review educational competencies for this model. They demonstrated consensus on educational expansion and agreed that the proposed OP-PCP model could work within existing US Commission on Dental Accreditation (CODA) standards for predoctoral education. However, there were broader opinions on scope of practice details. Existing CODA standards could allow interested dental programs to educate OP-PCPs as a highly-skilled workforce assisting with care of medically-complex patients and to helping to reduce health disparities. Next steps include broader stakeholder discussion of OC-PCP competencies and applied studies including patient outcome assessments.
Collapse
|
21
|
Shimpi N, Panny A, Glurich I, Chyou PH, Acharya A. Knowledgeability, Attitude and Practice Behaviors of Dental Providers Toward Provisions of Integrated Care Delivery for Patients With Prediabetes/Diabetes: Wisconsin Statewide Survey. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.674178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: To conduct a statewide survey among Wisconsin-based dental providers evaluating current knowledgeability, attitudes and practice behaviors surrounding management of patients with diabetes/prediabetes in the dental setting. The study explored perceptions on feasibility, value, barriers, and current status of integrated care model (ICM) adoption by dental practicesMaterials and Methods: A 32-question paper-based survey was mailed to all licensed dentists and dental hygienists practicing in Wisconsin. The study was conducted over a 4 week period in 2019. The survey instrument was adapted from a previous validated survey and was expanded to include questions on ICM adoption. Content and validity analyses and beta testing were conducted prior to dissemination of the survey. Descriptive statistics and chi-square tests were applied for data analyses. Thematic analyses was performed on open-ended questions.Results: Survey response rate was 12% (N = 854/7,356) representing 41% dentists and 59% dental hygienists. While 68% reported educating patients on oral health-diabetes association, only 18% reported medical consultations to inform dental treatment, and “frequent” (22%) or “occasional” (40%), medical triage. Knowledge-based questions were correctly answered by >70% of participants. While 50% valued chair-side glycemic screening and 85% supported non-invasive chair-side screening to identify at-risk patients,>88% relied on patient-reported diabetic status. Barriers to ICM adoption included time investment (70%), patient activation/cooperation (62%), cost (50%), insurance coverage (50%), infrequent interdisciplinary communication (46%), lack of equipment (33%) and provider (31%).Conclusion: Low rates of ICM adoption, chair-side testing, medical consultation and triage, and need for educational curricula reform were identified.
Collapse
|
22
|
Laniado N, Cloidt M, Altonen B, Badner V. Interprofessional Oral Health Collaboration: A Survey of Knowledge and Practice Behaviors of Hospital-Based Primary Care Medical Providers in New York City. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:1211-1218. [PMID: 34675748 PMCID: PMC8523314 DOI: 10.2147/amep.s332797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The siloed delivery of oral and medical health care in the United States has contributed to a lack of awareness of the consequences of poor oral health and has hampered effective interprofessional education and collaboration. The aim of this study was to assess the knowledge and practice behaviors of primary care medical providers in an urban safety-net hospital regarding collaboration with dentists and integration of oral health into overall health-care delivery. METHODS A 36-item survey was designed in a web-based platform (Survey Monkey®) and electronically distributed in September 2020 to 181 primary care medical providers (physicians, nurses, physician assistants) within a municipal hospital in the Bronx, New York. The questionnaire included sections on demographics, current practices, oral health knowledge, and opinions regarding interprofessional collaboration. Descriptive statistics and bivariate analyses using the chi-square and Fisher's exact test were performed with a significance level of 0.05. RESULTS The response rate was 66% (119 respondents). The vast majority (80%) reported little or no training in oral health and 85% reported no team experience with oral health professionals. Medical providers' confidence in examining the oral cavity was positively associated with previous additional training (p = 0.001) and with team experience (p = 0.005). The two most commonly reported barriers to willingness to collaborate were lack of formal relationships with dental providers (74%) and competing priorities (69%). CONCLUSION Overall, there is very limited awareness and integration of oral health into the clinical practice of medical providers at this safety-net hospital. However, those providers with previous training and team experience had greater oral health confidence. Given the critical importance of oral health to overall health, increased efforts should be directed to further educate and train medical providers and address barriers to interprofessional care.
Collapse
Affiliation(s)
- Nadia Laniado
- Department of Dentistry, Health+Hospitals/Jacobi Medical Center Bronx, New York, NY, 10461, USA
| | - Megan Cloidt
- Department of Dentistry, Health+Hospitals/Jacobi Medical Center Bronx, New York, NY, 10461, USA
| | - Brian Altonen
- Department of Research Administration, Health+Hospitals/Central Office, New York, NY, 10013, USA
| | - Victor Badner
- Department of Dentistry, Health+Hospitals/Jacobi Medical Center Bronx, New York, NY, 10461, USA
| |
Collapse
|
23
|
Santilli M, Manciocchi E, D’Addazio G, Di Maria E, D’Attilio M, Femminella B, Sinjari B. Prevalence of Obstructive Sleep Apnea Syndrome: A Single-Center Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910277. [PMID: 34639577 PMCID: PMC8508429 DOI: 10.3390/ijerph181910277] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/13/2021] [Accepted: 09/26/2021] [Indexed: 12/15/2022]
Abstract
Obstructive sleep apnea syndrome (OSAS) is a sleep breathing disorder that often remains undiagnosed and untreated. OSAS prevalence is increasing exponentially. Starting on the dentist's role as an epidemiological and diagnostic "sentinel", the purpose of this study was to assess the prevalence of OSAS. The clinical diaries of 4659 patients were reviewed through a single-center retrospective analytic study. Descriptive statistical analysis was performed. Only 0.26% of patients reported to suffer from sleep apnea and were then diagnosed with OSAS. It was found that, out of 4487 patients, 678 suffered from hypertension (14.80%), 188 from gastro-esophageal-reflux-disease (GERD = 4.10%) and 484 from gastritis (10.78%). These results could be related to a difficult diagnosis of OSAS and to the absence of a dedicated section on sleep disorders in medical records. Therefore, the introduction of a question dedicated to sleep disorders, the administration of questionnaires (such as the STOP-BANG questionnaire) for early diagnosis, a multidisciplinary approach and pneumological examination could support the dentist in identifying patients at risk of OSAS.
Collapse
Affiliation(s)
- Manlio Santilli
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (E.M.); (G.D.); (B.F.)
| | - Eugenio Manciocchi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (E.M.); (G.D.); (B.F.)
| | - Gianmaria D’Addazio
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (E.M.); (G.D.); (B.F.)
| | - Erica Di Maria
- Unit of Orthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (E.D.M.); (M.D.)
| | - Michele D’Attilio
- Unit of Orthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (E.D.M.); (M.D.)
| | - Beatrice Femminella
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (E.M.); (G.D.); (B.F.)
| | - Bruna Sinjari
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (E.M.); (G.D.); (B.F.)
- Correspondence: ; Tel.: +39-392-27471479; Fax: +39-0871-3554070
| |
Collapse
|
24
|
Borgnakke WS, Poudel P. Diabetes and Oral Health: Summary of Current Scientific Evidence for Why Transdisciplinary Collaboration Is Needed. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.709831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This Perspective provides a brief summary of the scientific evidence for the often two-way links between hyperglycemia, including manifest diabetes mellitus (DM), and oral health. It delivers in a nutshell examples of current scientific evidence for the following oral manifestations of hyperglycemia, along with any available evidence for effect in the opposite direction: periodontal diseases, caries/periapical periodontitis, tooth loss, peri-implantitis, dry mouth (xerostomia/hyposalivation), dysbiosis in the oral microbiome, candidiasis, taste disturbances, burning mouth syndrome, cancer, traumatic ulcers, infections of oral wounds, delayed wound healing, melanin pigmentation, fissured tongue, benign migratory glossitis (geographic tongue), temporomandibular disorders, and osteonecrosis of the jaw. Evidence for effects on quality of life will also be reported. This condensed overview delivers the rationale and sets the stage for the urgent need for delivery of oral and general health care in patient-centered transdisciplinary collaboration for early detection and management of both hyperglycemia and oral diseases to improve quality of life.
Collapse
|
25
|
Bin Mubayrik A, Al Dosary S, Alshawaf R, Alduweesh R, Alfurayh S, Alojaymi T, Tuwaym M, Alsuhaibani D, Aldaghri E. Public Attitudes Toward Chairside Screening for Medical Conditions in Dental Settings. Patient Prefer Adherence 2021; 15:187-195. [PMID: 33564229 PMCID: PMC7866954 DOI: 10.2147/ppa.s297882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 01/14/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The aim of this study is to investigate the public's attitudes and knowledge toward chairside dental screening and laboratory investigations based on demographic data. METHODS A self-administered structured questionnaire regarding chairside screening was designed employing a 5-point Likert-type scale. The questionnaire was distributed to among sample of adults. Data were collected and statistically analyzed using descriptive statistics, t-tests, ANOVA, and P values. RESULTS A total of 573 questionnaires were completed. Most respondents were willing to have a dentist conduct screening for diseases, in particular blood measurement (89%), hypertension (85.7%) and lab result discussion (83.1%), having medical condition did not affect the willingness. The lowest reported willingness was to undergo biopsy (54%) and hepatitis screening (67.6%) Age, education, hospital, and prior chairside screening were found to be significant factors for willingness. CONCLUSION The population's willingness to undergo chairside medical screenings in the dental office is crucial for the implementation of this strategy and to deliver a holistic approach to treating patients' medical conditions.
Collapse
Affiliation(s)
- Azizah Bin Mubayrik
- Oral Medicine and Diagnostic Science Department, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Azizah Bin Mubayrik Oral Medicine and Diagnostic Science, Department, College of Dentistry, King Saud University, 3680 King Saud University Unit No. 3ar, Riyadh12372 −7453, Kingdom of Saudi Arabia Email
| | - Sara Al Dosary
- Oral Medicine and Diagnostic Science Department, King Saud University, Riyadh, Saudi Arabia
| | - Reema Alshawaf
- Oral Medicine and Diagnostic Science Department, King Saud University, Riyadh, Saudi Arabia
| | - Reem Alduweesh
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Shada Alfurayh
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tagreed Alojaymi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Malath Tuwaym
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Ebtihal Aldaghri
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
26
|
Montero E, Matesanz P, Nobili A, Luis Herrera-Pombo J, Sanz M, Guerrero A, Bujaldón A, Herrera D. Screening of undiagnosed hyperglycaemia in the dental setting: The DiabetRisk study. A field trial. J Clin Periodontol 2020; 48:378-388. [PMID: 33263197 DOI: 10.1111/jcpe.13408] [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] [Received: 07/19/2020] [Revised: 10/05/2020] [Accepted: 11/22/2020] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the efficacy of different screening protocols for undiagnosed hyperglycaemia in a Research Network of Dental Clinics coordinated by the Spanish Society of Periodontology (SEPA). MATERIAL AND METHODS A total of 1143 patients were included in the study. Participants filled a questionnaire considering diabetes risk factors (FINDRISC) and received a periodontal screening examination. Patients with a slightly elevated score according to the Findrisc (≥7), received a point-of-care HbA1c and were eventually referred to their physician for confirmatory diagnosis. Receiver Operating Characteristic (ROC) curves were used to assess the performance of various predictive models with confirmed hyperglycaemia as outcome. RESULTS From this population, 97 (8.5%) were finally diagnosed of diabetes (n = 28; 2.5%) or prediabetes (n = 69; 6.0%). When only including the results from the FINDRISC questionnaire, the model reported an area under the curve (AUC) of 0.866 (95% confidence interval - CI [0.833; 0.900]). This model significantly improved when a basic periodontal examination (EPB Code; AUC = 0.876; 95% CI [0.845: 0.906]; p = .042) or a point-of-care HbA1c were added (AUC = 0.961; 95% CI [0.941; 0.980]; p < .001). CONCLUSIONS The tested protocol, combining the FINDRISC questionnaire and a point-of-care HbA1c, showed to be feasible when carried out in a dental clinic setting and was efficient to identify subjects with undiagnosed diabetes or prediabetes.
Collapse
Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.,Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.,Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - Antonio Nobili
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - José Luis Herrera-Pombo
- Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Madrid, Spain.,Endocrinology and Nutrition Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.,Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - Adrián Guerrero
- Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - Antonio Bujaldón
- Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.,Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Madrid, Spain.,Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | | |
Collapse
|
27
|
Heji ES, Bukhari AA, Bahammam MA, Homeida LA, Aboalshamat KT, Aldahlawi SA. Periodontal Disease as a Predictor of Undiagnosed Diabetes or Prediabetes in Dental Patients. Eur J Dent 2020; 15:216-221. [PMID: 33285572 PMCID: PMC8184281 DOI: 10.1055/s-0040-1719208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The study investigates whether periodontal parameters can identify subjects with undiagnosed diabetes mellitus (DM) or pre-DM in patients seeking dental treatment at a university dental hospital. MATERIALS AND METHODS Adults older than 35 years, not being diagnosed with DM before and have at least one of the risk factors of DM were included in the study. All subjects received a complete periodontal examination, filled a medical history survey, and a fasting blood glucose measurement was obtained. A multiple logistic regression test using a backward elimination method to assess factors that predict if the participant is healthy, prediabetic or diabetic was done. A p-value of <0.05 was considered significant. RESULTS A total of 61 subjects were enrolled with an average age of 42.9 ± 9.4 years. Having a family member diagnosed with DM was reported by 64.5% of the subjects; 59% were diagnosed with advanced periodontal disease. The final logistic regression model included smoking, hypertension, family history of DM, and percentage of clinical attachment loss >3 mm was statistically significant (P < 0.001). The model explained 47.7% of the diabetes condition and correctly classified 69.4% of cases. Participants with a family history of diabetes are 4.98 times more likely to exhibit prediabetic or diabetic status. Each unit increase in the percentage of clinical attachment loss increases the likelihood of participant to be prediabetic or diabetic by 1.104 times. CONCLUSION Dental patients presenting with severe clinical attachment loss and family history of DM have increased likelihood of undiagnosed DM or pre-DM and would benefit from screening at the dental office.
Collapse
Affiliation(s)
- Esraa S Heji
- Dental Teaching Hospital, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Manal A Bahammam
- Dental Teaching Hospital, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lujain A Homeida
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Khalid T Aboalshamat
- Division of Dental Public Health, Department of Preventative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Salwa A Aldahlawi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| |
Collapse
|
28
|
Kassim S. The impact of protective psychosocial factors on khat chewing among male medical and dental future health-care providers in Yemen. J Dent Sci 2020; 15:451-456. [PMID: 33505616 PMCID: PMC7816017 DOI: 10.1016/j.jds.2019.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 08/15/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND/PURPOSE Khat chewing, a green leaf with amphetamine effects, is a public health concern. Yet, it is prevalent and evident, in the khat belt region, among male students in health faculties. This study aimed to examine whether psychosocial factors have a protective impact on khat chewing among male dental and medical students. MATERIALS AND METHODS A cross-sectional study included all students (1457) in second year and above at a Yemeni university. A self-administered questionnaire was used to obtain sociodemographic data and to assess students' psychosocial characteristics namely, depression, resilience and social support (perceived or received [living with or away from family]). Data analysis included descriptive statistics and multivariable logistic regression modelling. RESULTS The response rate was 61% (male = 334, female = 547) and the responding students' mean ± SD age was 22.95 ± 1.56 years. Of the respondents 185 (21% [95%CI = 18%-24%]) were current khat chewers (7 [4%] females and 178 [96%] males respectively). In the adjusted model, among male students living away from family was significantly associated with khat chewing (adjusted odd ratio [AOR] = 3.15,95%CI = 1.96-5.07, p < 0.001) and perceived social support was inversely significantly related to khat chewing (AOR = 0.98; 95%CI = 0.96-1.00; p = 0.019). CONCLUSION Within the limitation of the study of a single institute, social support whether received (living with family) or perceived appeared to be a protective factor from khat chewing among male medical and dental students. Social support should be enhanced and targeted to discourage khat chewing during the preparation of this future health care force.
Collapse
Affiliation(s)
- Saba Kassim
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Naif Ibn Abdulaziz Road, Al-Madinah Al-Munawwarah, 42353, Saudi Arabia
| |
Collapse
|
29
|
Staras SAS, Guo Y, Gordan VV, Gilbert GH, McEdward DL, Manning D, Woodard J, Shenkman EA. Dental practitioners' use of health risk assessments for a variety of health conditions: Results from the South Atlantic region of The National Dental Practice-Based Research Network. J Am Dent Assoc 2020; 152:36-45. [PMID: 33276954 DOI: 10.1016/j.adaj.2020.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/10/2020] [Accepted: 09/02/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND An important step in integrating dental and medical care is improving understanding of the frequency and characteristics of dental practitioners who conduct health risk assessments (HRAs). METHODS From September 2017 through July 2018, active dentist and hygienist members of the South Atlantic region of The National Dental Practice-Based Research Network (N = 870) were invited to participate in a survey evaluating their HRA practices (screening, measuring, discussing, referring patients) for 6 health conditions (obesity, hypertension, sexual activities, diabetes, alcohol use, tobacco use). For each health condition, the authors used ordinal logistic regression to measure the associations among the practitioner's HRA practices and the practitioner's characteristics, barriers, and practice characteristics. RESULTS Most of the 475 responding practitioners (≥ 72%) reported they at least occasionally complete 1 or more HRA steps for the health conditions except sexual activities. Most practitioners screened (that is, asked about) and gave referral information to affected patients for diabetes (56%) and hypertension (63%). Factors associated with each increased HRA practice for 2 or more outcomes were non-Hispanic white compared with Hispanic practitioner (cumulative odds ratio [COR] obesity, 0.4; 95% confidence interval [CI], 0.2 to 0.8; and COR diabetes, 0.3; 95% CI 0.2 to 0.8), male compared with female practitioner (COR tobacco, 0.3; 95% CI, 0.2 to 0.7; and COR hypertension, 0.4; 95% CI 0.2 to 0.8), and practitioner discomfort (COR, obesity and alcohol use, 0.7; 95% CI, 0.6 to 0.9; and COR, sexual activities 0.6; 95% CI 0.5 to 0.8). CONCLUSIONS AND PRACTICAL IMPLICATIONS Dental practitioners are conducting HRA practices for multiple conditions. Interventions should focus on reducing practitioner discomfort and target non-Hispanic white, male practitioners.
Collapse
|
30
|
Riddle MW. HIV screening in dental settings: Challenges, opportunities, and a call to action. Oral Dis 2020; 26 Suppl 1:9-15. [PMID: 32862545 DOI: 10.1111/odi.13468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/19/2020] [Accepted: 06/09/2020] [Indexed: 01/03/2023]
Abstract
HIV is responsible for tremendous suffering and loss around the world, but many advances in HIV screening, diagnosis, treatment, and prevention provide hope for an end to the HIV epidemic. Global and national campaigns facilitate access to these HIV advances, but some individuals and communities still lack access, particularly in developing countries. To reach those who remain under-served, campaigns encourage greater integration of HIV services with non-HIV services. As members of the healthcare team with a clinical stake in HIV, dental care providers have a unique contribution to make. Much research on the role of dental care providers in HIV has focused on HIV screening in the dental setting, and researchers have identified possible ways forward but also daunting challenges. Approaches for screening, brief intervention, and referral to treatment used in primary care and dental care settings for other health risks may help overcome challenges related to provider scope of practice and need for training. Approaches to managing distress and uncertainty in other clinical contexts may help overcome challenges related to patient acceptability, equipping providers to manage sensitive topics and emotional aspects of HIV screening. While not panaceas, these approaches may be useful to dental care providers interested in answering the global "call to action" for contributing to ending the HIV epidemic.
Collapse
Affiliation(s)
- Melissa Wiseman Riddle
- Division of Extramural Research, Behavioral and Social Sciences Research Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
31
|
Schmalz G, Wolf C, Merle C, Kottmann T, Haak R, Ziebolz D. Evaluation of a questionnaire-based diabetes screening concept in German patients with Stage III or IV periodontitis: A practice-based study. J Periodontol 2020; 92:1163-1170. [PMID: 33155276 DOI: 10.1002/jper.20-0297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/13/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND This practice-based retrospective study evaluated a screening method for diabetes mellitus (DM) in patients with Stage III or IV periodontitis using the FINDRISC questionnaire. METHODS Patients with Stage III or IV periodontitis who received FINDRISC screening in a German private dental practice were recruited. Individuals with positive FINDRISC scores (≥12, FINDRISC+) were referred for diabetological examination. Several general and periodontal findings from the patients' documentation were recorded and analyzed. RESULTS A total of 179 patients (52.65 ± 11.49 years) were included. In DM screening, 24.6% (n = 44) patients were FINDRISC+, including all patients with currently known DM (21 of 21). Of the remaining FINDRISC+ patients, 82.6% (19 of 23) visited their general practitioner, and 63.2% (12 of 19, 7.6% of total cohort) had an HbA1c ≥5.7%. Accordingly, 75% of the FINDRISC+ patients were diabetologically conspicuous (HbA1c ≥ 5.7%), including those with already known DM. Patients with previously unknown DM showed higher mean age, more missing teeth, a higher periodontitis stage (more Stage IV) and more frequently teeth with suppuration compared with the diabetologically inconspicuous individuals (P <0.01). CONCLUSION The FINDRISC questionnaire is appropriate for patients with Stage III or IV periodontitis and can be recommended in dental practice setting.
Collapse
Affiliation(s)
- Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | | | - Cordula Merle
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | | | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| |
Collapse
|
32
|
Fleming E, Singhal A. Chronic Disease Counseling and Screening by Dental Professionals: Results From NHANES, 2011-2016. Prev Chronic Dis 2020; 17:E87. [PMID: 32816664 PMCID: PMC7458110 DOI: 10.5888/pcd17.200152] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Dental visits may provide an opportunity to counsel and screen for chronic disease prevention. However, few studies have used nationally representative data to assess the potential role of dental professionals in chronic disease prevention. We examined the percentage of US adults who reported chronic disease counseling and screening by dental professionals. METHODS We analyzed data from the National Health and Nutrition Examination Survey 2011-2016 for 5,541 participants aged 30 or older who reported seeing a dental professional in the past year and estimated the percentage who reported receiving counseling about selected chronic disease prevention during the visit. We used logistic regressions to examine associations between risk factors and counseling. RESULTS Overall, 4.0% (standard error [SE], 0.3) of adults were told by a dental professional about the benefits of checking blood glucose, 42.4% (SE, 2.9) giving up tobacco (among tobacco users), 26.6% (SE, 1.2) about checking for oral cancer, and 43.0% (SE, 1.8) had an oral cancer examination. Groups with risk factors were more likely to receive health behavior counseling than those without (eg, those previously told they had diabetes risk factors were more likely to receive blood glucose counseling than those without [8.1% vs 3.3%, P < .05]). The pattern for oral cancer counseling and receiving an oral cancer examination was different: adults without oral cancer risk factors (no tobacco use, normal/underweight, and/or excellent/very good health) were more likely to receive oral cancer counseling or screening. Adjusted analyses did not change these associations. CONCLUSION Most adults were not counseled about chronic disease prevention during a visit with a dental professional. Current tobacco users and those with overweight or obesity were more likely to report receiving counseling.
Collapse
Affiliation(s)
- Eleanor Fleming
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782.
- Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts
| | - Astha Singhal
- Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts
| |
Collapse
|
33
|
Alazzam MF, Darwazeh AMG, Hassona YM, Khader YS. Diabetes mellitus risk among Jordanians in a dental setting: a cross-sectional study. Int Dent J 2020; 70:482-488. [PMID: 32705689 DOI: 10.1111/idj.12591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Dental offices can be useful to screen and identify patients at risk of developing diabetes mellitus (DM) using risk prediction tools. The Finnish Diabetes Risk Score (FINDRISC) is a validated, questionnaire-based tool used to predict the 10-year risk of developing type II DM. OBJECTIVES To determine the 10-year DM risk among Jordanians using the FINDRISC questionnaire in a dental setting. MATERIALS AND METHODS Participants attending two university dental teaching centres between March 2017 and February 2018 were interviewed using an Arabic translated version of the FINDRISC questionnaire. Anthropometrics including weight, height, waist circumference (WC) and body mass index (BMI) were recorded. Random capillary blood glucose level was measured for each participant. Statistical analysis was done using Chi-square and independent t-tests. RESULTS A total of 1,247 (436 males and 811 females) participants were included. As defined by BMI, 1,012 (81.2%) participants were either overweight or obese. Abdominal adiposity as determined by WC was seen in 738 (59.2%) participants. The mean (± SD) FINDRISC score for females (11.3 ± 4.3) was significantly higher (P = 0.001) than males (10.4 ± 4.9). After age adjustment, more females were in the high-risk categories (FINDRISC ≥ 15) compared with males. This trend was seen among all age groups, but was statistically significant in the older age groups; 55-64 years (P = 0.037) and ≥ 65 years (P = 0.004). CONCLUSION In a developing Middle Eastern country such as Jordan, almost half of Jordanians attending university dental clinics are at a moderate to high risk of developing type II DM in 10 years. The risk of DM should be considered in dental patients, particularly older females.
Collapse
Affiliation(s)
- Melanie Fawaz Alazzam
- Department of Oral Medicine and Oral Surgery, School of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Azmi Mohammad-Ghaleb Darwazeh
- Department of Oral Medicine and Oral Surgery, School of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Yazan Mansour Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, University of Jordan, Amman, Jordan
| | - Yousef Saleh Khader
- Department of Public Health, School of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
34
|
Chinnasamy A, Moodie M. Diabetes Related Knowledge, Attitudes and Practice - A Survey Among Oral Health Professionals in Victoria, Australia. Clin Cosmet Investig Dent 2020; 12:111-121. [PMID: 32308495 PMCID: PMC7138629 DOI: 10.2147/ccide.s240212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/29/2020] [Indexed: 01/29/2023] Open
Abstract
Purpose Until now, little is known as to how well the evidence supporting the link between periodontal disease and diabetes is incorporated in the dental practice, in Australia. This study aims to explore Oral health Professionals (OHP) knowledge, attitudes, and practice (KAP) towards diabetes screening in the dental setting. Methods The survey questionnaire consisted of sociodemographic, practice characteristics and Likert scaled questions categorised in different domains of KAP and one additional domain as barriers. A Mann–Whitney and Kruskal–Wallis test was performed to determine differences in the OHP response. To predict if practice behavior was influenced by knowledge and attitudes, a multiple linear regression was conducted. Results A total of 197 respondents were included in the analysis of the results. General dentists constituted 64.6% of the response. For chairside screening of diabetes, 58% felt it was essential and 70% felt it was appropriate. More public sector OHP (79%) felt it is important to conduct chairside screening for T2DM. Patient willingness was identified as the most important and insurance coverage as the least important (43%) consideration for T2DM screening. Conclusion Overall, knowledge, attitude and practice towards DM were positive, but a significant proportion of the OHP felt chairside screening may not be appropriate or important.
Collapse
Affiliation(s)
- Alagesan Chinnasamy
- Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia
| | - Marjory Moodie
- Deakin Health Economics, Deakin University, Geelong, VIC, Australia
| |
Collapse
|
35
|
Chung R, Leung SYJ, Abel SN, Hatton MN, Ren Y, Seiver J, Sloane C, Lavigne H, O’Donnell T, O’Shea L. HIV screening in the dental setting in New York State. PLoS One 2020; 15:e0231638. [PMID: 32298336 PMCID: PMC7161960 DOI: 10.1371/journal.pone.0231638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/29/2020] [Indexed: 12/14/2022] Open
Abstract
While primary care providers in New York State (NYS) are mandated to offer all patients a HIV test, still many NYS residents miss the HIV screening opportunity. To fill the gap, and as the CDC recommends, this study aimed to examine the feasibility of implementing HIV screening in dental setting, identify patient characteristics associated with acceptance of HIV rapid testing, and discuss best practices of HIV screening in dental setting. New York State Department of Health (NYSDOH) collaborated with the Northeast/Caribbean AIDS Education and Training Center (NECA AETC) and three dental schools in New York State to offer free HIV screening tests as a component of routine dental care between February 2016 and March 2018. Ten clinics in upstate New York and Long Island participated in the study. HIV screening was performed using the OraQuick™ In-Home HIV Test. 14,887 dental patients were offered HIV screening tests; 9,057 (60.8%) were screened; and one patient (0.011%) was confirmed HIV positive and linked to medical care. Of all dental patients, 33% had never been screened for HIV; and 56% had not had a primary care visit or had not been offered an HIV screening test by primary care providers in the previous 12 months. Multi-level generalized linear modeling analysis indicated that test acceptance was significantly associated with patient's age, race/ethnicity, gender, country of origin, primary payer (or insurance), past primary care visits, past HIV testing experiences, and the poverty level of patient's community. HIV screening is well accepted by dental patients and can be effectively integrated into routine dental care. HIV screening in the dental setting can be a good option for first-time testers, those who have not seen a primary care provider in the last 12 months, and those who have not been offered HIV screening at their last primary care visit.
Collapse
Affiliation(s)
- Rakkoo Chung
- New York State Department of Health, AIDS Institute, Albany, New York, United States of America
- * E-mail:
| | - Shu-Yin John Leung
- New York State Department of Health, AIDS Institute, Albany, New York, United States of America
| | - Stephen N. Abel
- School of Dental Medicine, University at Buffalo, Buffalo, New York, United States of America
| | - Michael N. Hatton
- School of Dental Medicine, University at Buffalo, Buffalo, New York, United States of America
| | - Yanfang Ren
- Eastman Institute for Oral Health, University of Rochester, Rochester, New York, United States of America
| | - Jeffrey Seiver
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Carol Sloane
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Howard Lavigne
- Northeast/Caribbean AIDS Education and Training Center, Syracuse, New York, United States of America
| | - Travis O’Donnell
- New York State Department of Health, AIDS Institute, Albany, New York, United States of America
| | - Laura O’Shea
- New York State Department of Health, AIDS Institute, Albany, New York, United States of America
| |
Collapse
|
36
|
Lasisi TJ, Lawal FB. Preference of saliva over other body fluids as samples for clinical and laboratory investigations among healthcare workers in Ibadan, Nigeria. Pan Afr Med J 2019; 34:191. [PMID: 32180865 PMCID: PMC7060920 DOI: 10.11604/pamj.2019.34.191.18738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 10/24/2019] [Indexed: 01/02/2023] Open
Abstract
Introduction The study aimed to assess the knowledge and practices of clinicians and laboratory scientists on the use of saliva for clinical or laboratory tests. Methods This was a cross-sectional survey of health care workers (100 clinicians and 62 laboratory scientists) closely involved with specimen collection for clinical and laboratory investigation at two health facilities (secondary and tertiary) in Nigeria. Information was obtained from participants using pretested structured questionnaires. Data were analyzed with SPSS and level of significance set at p < 5%. Results The mean age of the study participants was 34.1 (±6.6) years. The majority (95.7%) knew saliva could be used for clinical/laboratory test. A higher proportion of laboratory scientists knew saliva could be used in diagnosing HIV (59.2%), oral diseases (88.7%), oro-facial tumors (64.4%) and genetic testing (94.5%) compared to (41%), (80%), (40%) and (80%), of clinicians respectively (p < 0.05). More clinicians (85%) indicated saliva as a good specimen for diagnosing systemic diseases compared with scientists (63%), p < 0.001. Saliva was the most comfortable/convenient body fluid to obtain from patients with more clinicians (80%) mentioning this than scientists (49.1%), p < 0.001. Twenty-six clinicians had used saliva for disease diagnosis (64%), treatment monitoring (28%) or research purposes (8%). Saliva sampling for research purposes was more prevalent among clinicians (p = 0.004). Conclusion The majority of the health care workers knew the various uses and advantages of saliva as a specimen for clinical and laboratory investigation. However, few indicated previous use for clinical and laboratory investigation especially in the area of research.
Collapse
Affiliation(s)
- Taye Jemilat Lasisi
- Department of Physiology, University of Ibadan, Ibadan, Nigeria.,Department of Oral Pathology, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Folake Barakat Lawal
- Department of Periodontology & Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
| |
Collapse
|
37
|
Goel D, Patthi B, Singla A, Malhi R, Chaudhary PK, Khan A. Assessment of knowledge and attitude regarding management of patients with substance usage in dental clinics in Modinagar- A cross-sectional study. J Family Med Prim Care 2019; 8:3683-3688. [PMID: 31803673 PMCID: PMC6881923 DOI: 10.4103/jfmpc.jfmpc_733_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction The consequences of oral issues among drug users necessitate the implementation of a comprehensive dental care program. Integrated oral health-care services should be programmed for the management of drug addiction as a multi-organ disease needs a multi-disciplinary approach. Aim The aim of the present study was to assess the knowledge and attitude regarding the management of patients with substance usage at a dental clinic. Methodology A cross-sectional study was conducted among 208 dentists working as clinicians. A self-structured 27-item questionnaire consisting of questions related to the management of patients with substance usage at a dental clinic was distributed to them. Data were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 (SPSS Inc., Chicago, IL, USA) and descriptive and analytical tests, including mean, standard deviation, and Chi-square test were used. P < 0.05 was considered statistically significant. Results Majority of the dentist irrespective of qualification were unaware of the modalities regarding the management of the patients with substance usage at the dental clinic. Most dental clinicians were having a positive attitude regarding such patients and agreed that abuser should be identified and managed in dental settings. Conclusion Educating dental graduates and postgraduates about the oral implications of substance usage and making it a part of the dental curriculum may help us deal with the global issues of substance usage. The dental setting is recognized increasingly as an untapped venue for the delivery of medical screenings, given the long-term nature and frequent contacts associated with the patient-dentist relationship.
Collapse
Affiliation(s)
- Divyangi Goel
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Basavaraj Patthi
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Ashish Singla
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Ravneet Malhi
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Pankaj Kumar Chaudhary
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Ambar Khan
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| |
Collapse
|
38
|
Borgnakke WS. IDF Diabetes Atlas: Diabetes and oral health - A two-way relationship of clinical importance. Diabetes Res Clin Pract 2019; 157:107839. [PMID: 31520714 DOI: 10.1016/j.diabres.2019.107839] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/06/2019] [Indexed: 12/22/2022]
Abstract
The current scientific evidence for the bi-directional associations between oral health and diabetes is summarized. The universal biologic mechanisms and demographic and behavioral risk drivers underlying these associations in both directions are also described. Dysglycemia, even slightly elevated blood sugar levels, adversely affects oral health, manifesting itself in several oral diseases and conditions. In the opposite direction, any oral infection with its subsequent local and systemic inflammatory responses adversely affects blood glucose levels. Moreover, painful, mobile, or missing teeth may lead to intake of soft food items representing a sub-optimal diet and hence poor nutrition, and thereby contribute to incident type 2 diabetes or to poorer glucose control in existing diabetes. Treatment of inflammation related oral conditions, such as non-surgical periodontal treatment and extraction of infected teeth, can lead to a clinically significant decrease in blood glucose levels. Attention to infectious oral diseases and referral to dental care professionals for treatment can therefore be an important novel tool for medical care professionals in preventing and managing diabetes mellitus. Dental professionals can detect unrecognized potential dysglycemia and refer for medical examination. Such interprofessional, patient centered care may contribute to improved health, wellbeing, and quality of life in people with diabetes.
Collapse
Affiliation(s)
- Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 North University Avenue Rm# 3060, Ann Arbor, MI 48109-1078, USA.
| |
Collapse
|
39
|
Kassim S, Othman B, AlQahtani S, Kawthar AM, McPherson SM, Greenberg BL. Dentists' attitudes towards chairside medical conditions screening in a dental setting in Saudi Arabia: an exploratory cross-sectional Study. BMC Oral Health 2019; 19:179. [PMID: 31387573 PMCID: PMC6685149 DOI: 10.1186/s12903-019-0870-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 07/29/2019] [Indexed: 01/06/2023] Open
Abstract
Background Screening for medical conditions (MCs) of public health importance is a first step in disease prevention and control. Prior studies in the United States found oral health care providers (OHCPS) embrace screening for increased risk of medical conditions in the dental setting. Our objectives were to assess Saudi Arabian (SA) dentist’s attitudes, willingness and perceived barriers towards implementing screening for MCs into their dental practices. Methods A self-administered, 5-point Likert Scale (1 = very important/willing to 5 = very unimportant/unwilling) questionnaire was given to a convenience sample of 190 practicing dentists. Friedman nonparametric analysis of variance was used to compare responses within each question. Results Of the 143 responding dentists the mean age was 31 years; 102 (71%) were men. The majority felt it was important for a dentist to screen for cardiovascular disease (98.6%), hypertension (97.9%), diabetes (97.9%), human immunodeficiency virus (HIV) (97.9%), and hepatitis C virus (98.6%). Respondents were willing to refer a patient to a physician (97.9%); send samples to an outside laboratory (96.1%); conduct screening that yields immediate results (96.2%); and discuss results immediately with the patient (93.7%). Respondents were willing to measure/collect blood pressure (67.2%); weight and height (63.7%); and finger stick blood (54.6%). The whole responding dentists (100%) reported time as an important barrier. Respondents were significantly more willing to refer a patient for consultation than send samples to an outside laboratory (mean ranks: 2.32, 2.81, P < 0.001); significantly more willing to measure blood pressure than take oral fluids for salivary diagnostics (mean ranks 2.22, 2.75, p = 0.003). Insurance was significantly (P < 0.05) less important barrier than time, cost, patients’ willingness or liability (mean ranks 3.56, 2.63, 3.00, 2.79, 3.02, respectively). Conclusions The majority of dentists in this study reported positive attitudes towards and willingness to perform medical screenings in their practice. Time was an important factor.
Collapse
Affiliation(s)
- Saba Kassim
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Al-Madinah Al-Munawwarah, 42353, Saudi Arabia.
| | - Badr Othman
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Al-Madinah Al-Munawwarah, 42353, Saudi Arabia
| | - Sakher AlQahtani
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, 11545, Saudi Arabia
| | - Alemad Mustafa Kawthar
- Pediatric Division AlJouf Specialty Dental Centre, Ministry of Health, AlJouf, Saudi Arabia
| | - Sterling M McPherson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 9921-1495, USA
| | - Barbara L Greenberg
- Touro College of Dental Medicine, New York Medical College, Valhalla, NY, USA
| |
Collapse
|
40
|
Christell H, Gullberg J, Nilsson K, Heidari Olofsson S, Lindh C, Davidson T. Willingness to pay for osteoporosis risk assessment in primary dental care. HEALTH ECONOMICS REVIEW 2019; 9:14. [PMID: 31127454 PMCID: PMC6734228 DOI: 10.1186/s13561-019-0232-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 05/14/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Fragility fracture related to osteoporosis among postmenopausal women is a significant cause of morbidity. The care and aftercare of these fractures are associated with substantial costs to society. A main problem is that many individuals suffer from osteoporosis without knowing it before a fracture happens. Dentists may have an important role in early identification of individuals with osteoporosis by assessment of dental radiographs already included in the dental examination. The aim of this study was therefore to investigate postmenopausal women's preferences for an osteoporosis risk assessment in primary dental care. RESULTS Most respondents (129 of 144 (90%)) were willing to pay for an osteoporosis risk assessment in primary dental care. The overall mean willingness to pay (WTP) including respondents that denoted none or zero WTP was 44.60 € (CI 95% 38.46-50.74 €) (median 34.75 €). A majority (80.6%) of the respondents that denoted WTP also gave a motivation for their answer. The two most common reasons denoted for being willing to pay for osteoporosis risk assessment were the importance of early diagnosis and preventive care to avoid fractures (41.0%) and the importance of knowledge of a risk of osteoporosis (26.4%). A majority of respondents (67.8%) considered it valuable if dental clinics would offer osteoporosis risk assessment. CONCLUSIONS Postmenopausal women seem to find it valuable to be offered osteoporosis risk assessment in primary dental care and are willing to pay for such a risk assessment. From a societal perspective early diagnosis of osteoporosis by risk assessment in primary dental care could prevent osteoporotic related fractures and benefit women's health and quality of life, as well as have a major impact on the health-care budget in terms of cost-savings.
Collapse
Affiliation(s)
- Helena Christell
- Faculty of Odontology, Malmö University, Box 50500, 202 50 Malmö, Sweden
- Department of Radiology, Helsingborg Hospital, 251 87 Helsingborg, Sweden
| | - Joanna Gullberg
- Faculty of Odontology, Malmö University, Box 50500, 202 50 Malmö, Sweden
| | - Kenneth Nilsson
- Faculty of Odontology, Malmö University, Box 50500, 202 50 Malmö, Sweden
| | | | - Christina Lindh
- Faculty of Odontology, Malmö University, Box 50500, 202 50 Malmö, Sweden
| | - Thomas Davidson
- Centre for Medical Technology Assessment, Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Linköping, Sweden
| |
Collapse
|
41
|
Singer RH, Feaster DJ, Stoutenberg M, Hlaing WM, Pereyra M, Abel S, Pollack H, Gellman MD, Schneiderman N, Metsch LR. Dentists' willingness to screen for cardiovascular disease in the dental care setting: Findings from a nationally representative survey. Community Dent Oral Epidemiol 2019; 47:299-308. [PMID: 30908721 DOI: 10.1111/cdoe.12457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Dental clinics offer an untapped health care setting to expand access to screening and early identification of cardiovascular disease (CVD) risk. This study examined the correlates of dentists' willingness to provide CVD screening in the dental care setting. METHODS Private practice and public health general dentists in the U.S. participated in a nationally representative survey from 2010 to 2011. The survey examined dentists' willingness to provide a finger stick test to support CVD screening and agreement that their professional role should include CVD screening. RESULTS Data analysed from 1802 respondents indicated that 46.6% of dentists were willing to provide CVD screening. The adjusted odds ratio (AOR) of dentists' willingness to screen for CVD was associated with currently screening for hypertension (AOR = 1.49, 95% CI 1.01, 2.20), screening for obesity (AOR = 1.66, 95% CI 1.17, 2.36) and agreement that their role as health care professionals includes CVD screening (AOR = 3.03, 95% CI 2.15, 4.29). Dentists' agreement that their role includes CVD screening was associated with self-rated knowledge of CVD (good vs none or limited) and CVD training during their professional education (5 to 8 hours of training vs none or limited), (AOR = 5.75, 95% CI 2.26, 14.62) and (AOR = 3.84, 95% CI 2.17, 6.80), respectively. CONCLUSIONS Our study highlights strategies that may be employed to expand future access to early detection of CVD risk. Including CVD screening instruction and clinical screening experiences in dental school curriculum may serve as catalysts to reshape the future scope of dental practice.
Collapse
Affiliation(s)
- Richard H Singer
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.,College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, Florida
| | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Mark Stoutenberg
- Department of Health & Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee
| | - WayWay M Hlaing
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Margaret Pereyra
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Stephen Abel
- School of Dental Medicine, University at Buffalo, Buffalo, New York
| | - Harold Pollack
- School of Social Service Administration, University of Chicago, Chicago, Illinois
| | - Marc D Gellman
- Department of Psychology, University of Miami, Miami, Florida
| | - Neil Schneiderman
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.,Department of Psychology, University of Miami, Miami, Florida
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| |
Collapse
|
42
|
Salmerón D, Gómez García F, Pons-Fuster E, Pérez-Sayáns M, Lorenzo-Pouso AI, López-Jornet P. Screening for prediabetes and risk of periodontal disease. Diabetes Metab Syndr 2019; 13:1661-1666. [PMID: 31336538 DOI: 10.1016/j.dsx.2019.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 03/05/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Diabetes and periodontitis are non-transmissible chronic disorders that exhibit a mutual relationship. A study was made to evaluate the risk of prediabetes and periodontal disease, and to explore the association between them. METHODS A descriptive cross-sectional study was made of 186 individuals over 18 years of age, without prediabetes or diabetes, or cognitive impairment. Subjects undergoing dental treatment and pregnant women were excluded. Prediabetes risk was assessed based on the Finnish Diabetes Risk Score (FINDRISC), and the individual risk of development and/or progression of periodontal disease was explored with a periodontal disease risk questionnaire. RESULTS A total of 135 gingival risk questionnaires and 142 FINDRISC questionnaires were correctly completed. The proportion of subjects with a low, moderate and high risk of periodontal disease was 60.36%, 38.74% and 0.9%, respectively. With regard to the FINDRISC, the proportion of individuals with low, slightly increased, moderately increased and high risk of prediabetes was 54.4%, 32.8%, 8%, and 4.8%, respectively. A significant linear correlation between the two scores was observed (r = 0.3659, p < 0.0005). The variables associated with a slightly increased risk of prediabetes were age, overweight and smoking, while the variables associated with a moderately increased or high risk were age 40-65 years, tooth loss, overweight and smoking. CONCLUSIONS These questionnaires may be of benefit to patients and can contribute to develop a chronic care model characterized by collaboration among different healthcare professionals.
Collapse
Affiliation(s)
- Diego Salmerón
- Faculty of Medicine, University of Murcia, Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain
| | - Francisco Gómez García
- Research Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Clínica Odontológica Universitaria Hospital Morales Meseguer Adv, Marques de los velez s/n, Murcia, 30008, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Eduardo Pons-Fuster
- Research Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Murcia, Spain; Colaborate Oral Medicine, Clínica Odontológica Universitaria Hospital Morales Meseguer, Adv. Marques de los velez s/n, Murcia, 30008, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Instituto de Investigación Sanitaria de Santiago (IDIS), Entrerríos s/n, Santiago de Compostela, C.P 15782, Spain.
| | - Alejandro I Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Instituto de Investigación Sanitaria de Santiago (IDIS), Entrerríos s/n, Santiago de Compostela, C.P 15782, Spain.
| | - Pia López-Jornet
- Research Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Clínica Odontológica Universitaria Hospital Morales Meseguer Adv, Marques de los velez s/n, Murcia, 30008, Spain; School of Dentistry, Faculty of Medicine, University of Murcia, Murcia, Spain.
| |
Collapse
|
43
|
Suarez-Durall P, Osborne MS, Enciso R, Melrose MD, Mulligan R. Results of offering oral rapid HIV screening within a dental school clinic. SPECIAL CARE IN DENTISTRY 2019; 39:188-200. [PMID: 30719739 DOI: 10.1111/scd.12363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/01/2018] [Accepted: 11/10/2018] [Indexed: 01/05/2023]
Abstract
To broaden the availability of human immunodeficiency virus (HIV) testing, we offered rapid HIV screening tests to 811 patients attending a dental school for routine dental hygiene care. Study design is a prospective cross-sectional study. The 319 (39.3%) agreeing to test, self-identified as: Hispanic (34.4%), White (25.8%), African American (13.1%), Asian (8.3%), Native American/Pacific Islander (0.9%), more than one race/ethnicity (1.1%) or declining to state (16.5%). Over 35% (n = 113) were first time HIV test takers, with another 2.2% (n = 7) unaware of their testing history. Approximately 60% of the decliners choose "just don't want test today" as the reason. Following a strictly structured algorithm, four possible undiagnosed infections were initially identified, with one completing the algorithm to case confirmation. In conclusion, the confirmed incidence rate finding of HIV seropositivity of 0.31% found through initial screening at the dental clinic, compared with the 0.018% incidence rate of HIV with confirmed diagnosis in Los Angeles County, indicates that a rapid HIV screening test offered in a dental school clinic can potentially play an important role in discovering undiagnosed HIV individuals.
Collapse
Affiliation(s)
- Piedad Suarez-Durall
- Division of Dental Public Health and Pediatric Dentistry, Ostrow School of Dentistry, University of Southern California, Los Angeles, California
| | - Maile S Osborne
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California
| | - Reyes Enciso
- Division of Dental Public Health and Pediatric Dentistry, Ostrow School of Dentistry, University of Southern California, Los Angeles, California
| | - M Diane Melrose
- Dental Hygiene Program, Division of Periodontology, Diagnostic Sciences and Dental Hygiene, Herman Ostrow School of Dentistry of USC, Los Angeles, California
| | - Roseann Mulligan
- Division of Dental Public Health and Pediatric Dentistry, Ostrow School of Dentistry, University of Southern California, Los Angeles, California
| |
Collapse
|
44
|
Chandrupatla SG, Ramachandra R, Dantala S, Pushpanjali K, Tavares M. Importance and Potential of Dentists in Identifying Patients at High Risk of Diabetes. Curr Diabetes Rev 2019; 15:67-73. [PMID: 29852874 DOI: 10.2174/1573399814666180531121921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 04/09/2018] [Accepted: 05/25/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The study was conducted to assess the utilization of medical and dental services by dental patients at two dental school hospitals and to approximate the number of patients having no known previous diagnosis of type 2 diabetes but are at high risk of acquiring it. METHODS A cross-sectional study was conducted at two dental school hospitals in India. A 20-item questionnaire was administered as interviews among the dental patients aged 35 to 55 years. Data was collected on past dental and medical visits, medical history, family history relevant to diabetes, cardiovascular health, BMI and waist circumference (measured). RESULTS A total of 413 adult patients (males 61.26%, females 38.74%) participated in the surveys. The mean age was 43.06 years. Results revealed that nearly 50% did not have a medical or a dental visit in the last 1 year, 33% had Cardiovascular Diseases (CVD). Among those who did not have medical visit in last one year 45% had BMI >25 kg, 55% had waist circumference above the normal range and 38% were at high risk of diabetes. CONCLUSION The high number of patients without a medical visit in the past year or more, as well as the high levels of diabetes risk indicators, affirms the need for dentists to perform chair-side screenings for diabetes. These results suggest the need for additional training among dental students to improve early detection and identification of high-risk patients to minimize potential morbidity due to diabetes.
Collapse
Affiliation(s)
- Siddardha G Chandrupatla
- Department of Oral Epidemiology and Health Policy, Harvard School of Dental Medicine, Boston, MA, United States
| | - Ranadheer Ramachandra
- Department of Public Health Dentistry, M.S. Ramaiah Dental College and Hospital, Bangalore, India
| | - Satyanarayana Dantala
- Department of Public Health Dentistry, Panineeya Dental College and Hospital, Hyderabad, India
| | - Krishnappa Pushpanjali
- Department of Public Health Dentistry, M.S. Ramaiah Dental College and Hospital, Bangalore, India
| | - Mary Tavares
- Department of Oral Epidemiology and Health Policy, Harvard School of Dental Medicine, Boston, MA, United States
| |
Collapse
|
45
|
Wijey T, Blizard B, Louca C, Leung A, Suvan J. Patient perceptions of healthy weight promotion in dental settings. J Dent 2019; 91S:100002. [PMID: 34059278 DOI: 10.1016/j.jjodo.2019.100002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Excess weight is a risk factor for systemic and oral diseases. Since dental professionals are already involved in imparting overall health messages when certain conditions impact oral health, it should make sense that they also deliver related health messages such as promoting the maintenance of healthy weight for patients. OBJECTIVES This study evaluated the perceptions of adult patients attending private dental clinics on healthy weight promotion by dental professionals. METHODS A cross-sectional multicenter survey was designed and set in four private dental clinics (London/Hampshire) between April and July 2015. All eligible patients (≥ 18 years) completed a questionnaire. Body Mass Index (BMI; kg/m2) was calculated from height and weight measurements. Questionnaire content was centred on patient perceptions of 6 domains with the primary domain as to whether patients would accept healthy weight promotion by dental professionals. RESULTS 213 adults (aged 20-85 years) participated in this study and 58.2% were females. Although the overwhelming majority endorsed healthy weight promotion by the dental team, the overweight/obese were significantly more sensitive (BMI screening χ2 trend = 6.840, p = 0.009; healthy weight information χ2 trend = 6.231, p = 0.013). Awareness of risk of periodontitis, carcinoma and overall adverse health outcomes associated with overweight or obesity was low. CONCLUSION The study cohort was well primed for healthy weight advice. Routine healthy weight promotion and BMI screening should be considered in the private dental clinic settings. CLINICAL SIGNIFICANCE This is an opportunity to collaborate with other health care professionals to support overall health monitoring/advice; a common risk factor strategy as recommended by the WHO. Future research is merited for this new initiative particularly perceptions of: dental teams' on healthy weight management, longitudinal interventions, NHS, children/parents and separate obese groups.
Collapse
Affiliation(s)
- T Wijey
- Continuing Professional Development, UCL Eastman Dental Institute, London, UK
| | - B Blizard
- Continuing Professional Development, UCL Eastman Dental Institute, London, UK
| | - C Louca
- University of Portsmouth Dental Academy, Portsmouth, UK
| | - A Leung
- Continuing Professional Development, UCL Eastman Dental Institute, London, UK
| | - J Suvan
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK.
| |
Collapse
|
46
|
Feng I, Brondani M, Chong KL, Donnelly L. Evaluating Point-of-Care HIV Screening in Dental Hygiene Education Settings: Patient, Faculty, and Student Perspectives. J Dent Educ 2018; 82:819-827. [PMID: 30068770 DOI: 10.21815/jde.018.076] [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] [Received: 08/20/2017] [Accepted: 01/08/2018] [Indexed: 11/20/2022]
Abstract
Although HIV screening is needed at a wider range of sites, dentists have shown reluctance to incorporate screening in their practices, but dental hygiene settings may be better suited for such screenings. The aim of this mixed-methods study was to determine the feasibility and acceptability of point-of-care (POC) HIV screening in dental hygiene education community settings from the patient, faculty, and student perspectives. After training, dental hygiene students and faculty at a Canadian dental school offered POC HIV screening to patients as part of routine dental hygiene care over 36 weeks at four sites in 2015-16. Of the 199 patients offered screening, 78 agreed; no positive results were found. Of the 199 patients, 97 completed an 11-item survey (49% response rate), with 80 (82%) agreeing HIV screening was within the scope of practice of a dental professional. Of the 57 patients who were screened, 48 (84%) agreed POC HIV screening should be part of regular dental check-ups, and 52 (91%) perceived dental settings were appropriate sites for screening. The main reasons for patients' agreeing to screening were that it was free and convenient and the results were delivered quickly. Those who refused screening had been tested recently or did not perceive themselves at risk for HIV. In two focus groups with 12 dental hygiene students, one focus group with five faculty members, and individual interviews with five other faculty members, participants agreed on the importance of offering POC HIV screening in the dental setting as a public health service. Faculty members thought students were well prepared and increased in confidence with testing. Students expressed a desire to offer screening throughout their careers and to educate patients about the importance of HIV testing.
Collapse
Affiliation(s)
- Iris Feng
- Iris Feng, BDSc, is a graduate student, Faculty of Dentistry, University of British Columbia; Mario Brondani, DDS, MSc, MPH, PhD, is Associate Professor, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia; Kerri-Lyn Chong, BHSc, is a senior DMD student, Faculty of Dentistry, University of British Columbia; and Leeann Donnelly, BDSc, MSc, PhD, is Assistant Professor, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia
| | - Mario Brondani
- Iris Feng, BDSc, is a graduate student, Faculty of Dentistry, University of British Columbia; Mario Brondani, DDS, MSc, MPH, PhD, is Associate Professor, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia; Kerri-Lyn Chong, BHSc, is a senior DMD student, Faculty of Dentistry, University of British Columbia; and Leeann Donnelly, BDSc, MSc, PhD, is Assistant Professor, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia
| | - Kerri-Lyn Chong
- Iris Feng, BDSc, is a graduate student, Faculty of Dentistry, University of British Columbia; Mario Brondani, DDS, MSc, MPH, PhD, is Associate Professor, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia; Kerri-Lyn Chong, BHSc, is a senior DMD student, Faculty of Dentistry, University of British Columbia; and Leeann Donnelly, BDSc, MSc, PhD, is Assistant Professor, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia
| | - Leeann Donnelly
- Iris Feng, BDSc, is a graduate student, Faculty of Dentistry, University of British Columbia; Mario Brondani, DDS, MSc, MPH, PhD, is Associate Professor, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia; Kerri-Lyn Chong, BHSc, is a senior DMD student, Faculty of Dentistry, University of British Columbia; and Leeann Donnelly, BDSc, MSc, PhD, is Assistant Professor, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia
| |
Collapse
|
47
|
Estrich CG, Araujo MWB, Lipman RD. Prediabetes and Diabetes Screening in Dental Care Settings: NHANES 2013 to 2016. JDR Clin Trans Res 2018; 4:76-85. [PMID: 30596147 PMCID: PMC6299263 DOI: 10.1177/2380084418798818] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction Early recognition of prediabetes may prevent progression to diabetes, yet not all adults are aware of their prediabetes risk. To reach all adults unaware of their risk, additional risk assessment strategies are warranted. Objectives The objective of this study was to evaluate the potential scope of benefit from prediabetes risk assessment in the dental care setting and to identify characteristics of dental patients likely to unknowingly have prediabetes or diabetes. Methods Data from 10,472 adults in the National Health and Nutrition Examination Survey from 2013 to 2014 and 2015 to 2016 were analyzed for associations among prediabetes/diabetes risk factors, health care use, and hemoglobin A1C levels according to chi-square tests and multivariate logistic regression. Results A total of 7.73% of US adults had seen a dentist but not a medical provider in the past 12 mo. The composition of this subpopulation was significantly different from that who saw a medical provider, in ways that might affect their diabetes risk. In addition, 31.27% of this subpopulation would be identified as being at high risk for prediabetes according to the CDC Prediabetes Screening Test (Centers for Disease Control and Prevention), and 15.83% had hemoglobin A1C levels indicative of undiagnosed prediabetes or diabetes. Screening in a dental setting would have the highest odds of identifying someone unaware of his or her diabetes risk among those who were non-White, obese, or ≥45 y old. Conclusion Extrapolation from this analysis indicates that screening for prediabetes at dental visits has the potential to alert an estimated 22.36 million adults of their risk for prediabetes or diabetes. Incorporating prediabetes or diabetes risk assessment into routine dental visits may enable 1) those with prediabetes to take action to decrease their risk of developing diabetes and 2) those with diabetes to engage in treatment to decrease their risk of diabetes-related complications. Knowledge Transfer Statement Screening for prediabetes and diabetes during dental visits has the potential to raise patients' awareness of diabetes risk and prevent prediabetes from progressing to diabetes. For some patients, the dental visit may be the only point of contact with the health care system, which heightens the importance of including diabetes risk assessment for patient well-being.
Collapse
Affiliation(s)
- C G Estrich
- Science Institute, American Dental Association, Chicago, IL, USA
| | - M W B Araujo
- Science Institute, American Dental Association, Chicago, IL, USA
| | - R D Lipman
- Science Institute, American Dental Association, Chicago, IL, USA
| |
Collapse
|
48
|
Abstract
This article describes the evolution of nondental health providers engaging in oral health and the influences that have played a role. This discussion is followed by a review of why oral health is a natural fit for medical care, an examination of the current trends and successes in oral health education and practice in the health professions, and the need for a comprehensive approach. The article concludes by reviewing the impact these efforts are having and defining roles for each profession in the future with thoughts about what will be required to obtain these goals.
Collapse
Affiliation(s)
- Hugh Silk
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Community Healthlink, 40 Spruce Street, Leominster, MA 01453, USA.
| |
Collapse
|
49
|
Greenberg BL, Glick M. Providing Health Screenings in a Dental Setting to Enhance Overall Health Outcomes. Dent Clin North Am 2018; 62:269-278. [PMID: 29478457 DOI: 10.1016/j.cden.2017.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Data suggest that providers and patients have a favorable attitude toward chairside screening in the dental setting and are willing to participate in these activities. Likewise, efficacy studies indicate this strategy can effectively identify patients who are at increased risk of disease or have the presence of disease risk factors and could benefit from medical follow-up. Studies suggest it is feasible to conduct these screenings in the dental setting. Although the American Dental Association has established screening treatment codes, challenges to widespread implementation still exist, including developing a provider reimbursement strategy and the need for adequate provider training.
Collapse
Affiliation(s)
- Barbara L Greenberg
- Department of Epidemiology and Community Health, School of Health Sciences and Practice, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA.
| | - Michael Glick
- The State University of New York, University at Buffalo School of Dental Medicine, 355 Squire Hall, Buffalo, NY 14214, USA
| |
Collapse
|
50
|
Saglam-Aydinatay B, Uysal S, Taner T. Facilitators and barriers to referral compliance among dental patients with increased risk of obstructive sleep apnea. Acta Odontol Scand 2018; 76:86-91. [PMID: 28984173 DOI: 10.1080/00016357.2017.1386797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Our aims were to determine the adherence rate to dentist referrals for sleep apnea evaluation and the barriers and facilitators to referral compliance. MATERIAL AND METHODS A sample of 1099 patients was screened with the STOP-Bang questionnaire. Those with elevated risk were referred for a sleep evaluation. An interview was conducted over the phone to determine compliance to referral and the barriers and facilitators to compliance. RESULTS Of the 1099 patients (mean age: 45.1 ± 10 years) screened, 224 (20.4%) patients were determined to be at-risk for obstructive sleep apnea (OSA). Only 41 (18.3%) patients with increased risk adhered to referral recommendation. Demographic and health characteristics did not show significant differences between the compliant and non-compliant patients. The most common facilitators to compliance were increased awareness about OSA (N = 25, 65%) and dentist recommendation (N = 14, 34.1%), whereas the most common barriers to referral compliance were misconceptions about OSA (N = 69, 37.7%) and work responsibilities (N = 44, 24%). CONCLUSIONS Only a small percentage of patients adhered to the recommendation of their dentist to see a sleep specialist. Increased awareness about OSA and dentist recommendation were the most common factors that facilitated compliance, whereas misconceptions about OSA and work responsibilities were the most common barriers to patient compliance.
Collapse
Affiliation(s)
- Banu Saglam-Aydinatay
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Serdar Uysal
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Tülin Taner
- Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| |
Collapse
|