An Initial Visit in a Patient with a History of Tuberculosis

As public health stewards, dental providers must be mindful of actual of potential infectious disease risks. Tuberculosis (TB) is a leading cause of death in adults worldwide and is spread via aerosolized droplets. Individuals at the greatest risk of contracting TB are those with impaired immunity or those who have a higher risk of being exposed to an infection due to environmental factors. Dental providers must be aware of the clinical and public health implications of treating people with active versus latent TB infections.

Development and evaluation of an individualised dental habituation programme for children with autism spectrum disorder living in Rogaland, Norway

PURPOSE

To develop and evaluate an individualised habituation programme for children with autism spectrum disorder (ASD) to enhance their cooperation during a routine dental examination.

METHODS

In collaboration with school personnel, we developed and evaluated a research-based habituation programme comprising a toolbox with aids (pictures, videos, appliances, social stories) for preparations and gradual exposure to a 10-step dental examination. The habituation programme was subjected to a small-scale evaluation involving 17 children with ASD living in Rogaland, Norway. Changes in cooperation were registered using Frankl behaviour rating scale. Further, school personnel were interviewed using semi-structured interviews, and the data obtained were analysed through content analysis.

RESULTS

Fourteen children (82%) completed the dental examination. Compared to previous accomplishments reported by the caregivers, an increased number of children completed the examination with a mirror and probe and were able to take an X-ray with good compliance following the habituation programme. The registration of cooperation (Frankl score) during each session indicated varying progression rates. Further, changing the dentist did not influence compliance, and most children showed a similar level of cooperation towards the dental examination one year later. Further, school personnel highlighted the need for preparations that could facilitate control and the importance of catering to individual needs.

CONCLUSION

An individualised approach combining preparations and behavioural methods in close collaboration with school personnel can increase cooperation during a dental examination in children with ASD.

Oral health status of pregnant women in the Republic of Kiribati

Prenatal dental examinations were performed from June 2012 to May 2013 in the Republic of Kiribati as a Japan International Cooperation Agency support program. We analyzed the examination data and compared it with Japanese data retrospectively to clarify the oral health condition of pregnant women in the Republic of Kiribati. We recorded the DMF index, gingival status, and calculus attachment, analyzed data of 512 pregnant women. We also compared the city and the rural group data. The average number of present teeth, decayed teeth, missing teeth and filled teeth was 26.9, 2.5, 1.1, 0.2, respectively. Pregnant Kiribati women had significantly more decayed teeth and fewer filled teeth, more severe periodontal condition, more calculus deposition, and more severe gingival swelling than pregnant Japanese women. No significant difference was found in missing and filled teeth, but pregnant women in the city group had significantly more decayed teeth and tooth stumps than those in the rural group. Our findings indicate that pregnant women in Kiribati have more decayed teeth, more missing teeth, fewer filled teeth, and more severe periodontal problems than their counterparts in Japan. Additionally, the oral health status of pregnant women in Kiribati could be subject to regional variations. J. Med. Invest. 70 : 110-114, February, 2023.

The price of private dental services: results from a national representative survey of Ireland

Introduction

Dental services in Ireland are delivered in a mixed public–private system but the majority of dental care is paid for out-of-pocket by individuals. Ireland is not unusual in the global context where public subsidisation for oral healthcare is limited in many countries. This is despite the fact that oral health plays an important role in well-being and despite international evidence on the negative impact of user fees on utilisation of beneficial healthcare. However, there has been little up-to-date assessment of the prices faced by individuals for a range of non-acute care services in Ireland, including dental care. This paper presents an up-to-date assessment of private dental prices in Ireland for a range of preventive, primary, and complex services based on a nationally representative survey.

Methods

The total sample size for the desk-based survey was 103, accounting for 6% of private dentists in Ireland, weighted to reflect the geographic distribution of dentists. Dentists were selected at random from the publicly available list of dentists participating in the Dental Treatment Benefit Scheme. The adult price of 10 different services covering core preventive, primary, and complex procedures were identified from public websites for the selected dental practices.

Results

Results showed that in addition to there being an uneven supply of dentists across the country, dental prices also vary with some notable variations by region and type of service. In particular, dental practices located in border counties, and those in rural areas typically show lower mean prices relative to non-border counties and urban areas. These factors need to be considered when planning how to reduce inequalities in access to oral health services in Ireland.

Attitudes of EAPD members toward using the "knee-to-knee" position

AIM

This survey assessed the attitude of paediatric dental EAPD members toward using "knee-to-knee" positioning for dental examinations and minor procedures in infants and toddlers.

METHODS

An anonymous electronic online questionnaire was distributed among EAPD members. The survey consisted of 12 questions and assessed demographic characteristics, professional experience and attitudes toward the use of the "knee-to-knee" position.

RESULTS

Of the 162 respondents, 148 (91%) reported using "knee-to-knee" positioning for dental examination. In addition, 97 (63%) reported performing other procedures in the "knee-to-knee" position. Fluoride application and oral hygiene instructions were the most common procedures performed in the "knee-to-knee" position.

CONCLUSIONS

Most of the paediatric dentists who responded to this survey reported performing dental examinations in toddlers up to 2 years old using the "knee-to-knee" position. Majority of respondents also used this position to instruct parents regarding oral hygiene and to apply fluoride varnish.

Training children with autism spectrum disorder to undergo oral assessment using a digital iPad® application

AIM

To present a training programme for teaching children and adolescents with autism spectrum disorder (ASD), to be compliant with a dental examination.

METHODS

Fifty-two children and adolescents with ASD (age range 3-19 years) with a parent-signed consent form were enrolled. Dental examinations were performed once a month in education centres by a paediatric dentist using a visual activity schedule on an iPad^® that was created with a digital application, çATED. Achievement and anxiety were evaluated using scales and grids every 2 months for 8 months.

RESULTS

Showed an improvement in oral assessment; the children became compliant and less anxious. The percentage of individuals who underwent the entire dental exam process increased over time; it was 25% at the beginning of the study and 65.4% after 8 months. Only 7.7% of the sample was not anxious at the beginning, while 59.6% of the sample was not anxious after 8 months. Wilcoxon analysis also showed significant improvement in the studied variables.

CONCLUSIONS

Training children and adolescents with ASD to undergo dental examination was efficient. The use of the iPad^® is attractive and easy for practitioners and people with ASD.