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Alessandri-Bonetti A, Sangalli L, Gallenzi P. Impact of Concurrent Use of N95 and Surgical Masks on Peripheral Oxygen Saturation and Heart Rate Frequency-A Prospective Study during the COVID-19 Outbreak. Medicina (Kaunas) 2024; 60:276. [PMID: 38399563 PMCID: PMC10890314 DOI: 10.3390/medicina60020276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: The COVID-19 outbreak has necessitated the prolonged use of N95 facemasks in addition to traditional surgical facemasks by healthcare workers. The aim of this study was to investigate the effect of wearing N95 facemasks in addition to surgical facemasks on peripheral oxygen saturation (SpO2) and heart rate (HR) among dental professionals during routine care. Materials and Methods: This prospective study compared SpO2 and HR between dental providers wearing N95 + surgical facemasks vs. wearing a surgical facemask only. SpO2 and HR were recorded using a portable pulse oximeter before wearing the facemask (T0); at 30 min (T1); at 1 h (T2); and at the end of clinical activity (T3). Inter-group and intra-group differences were assessed with independent t tests and repeated measures ANOVA, respectively. Results: A total of 88 participants (57 wearing N95 + surgical facemasks, and 31 wearing a surgical facemask only) completed the study. The two groups did not statistically differ in SpO2 at different timepoints nor showed any intra-group differences. The participants wearing N95 + surgical facemasks exhibited a statistically higher HR at T0 (p = 0.007), T2 (p = 0.010), and T3 (p = 0.014) compared to those wearing a surgical facemask only. A statistically significant decrease was observed in HR between T0 and T3 in those wearing N95 + surgical facemasks (p = 0.012). No intra-group differences were seen in HR over time in those wearing a surgical facemask only. Conclusions: The continuous use of an N95 in addition to a surgical facemask did not show any significant effects in SpO2 during routine care; however, the concurrent use of an N95 and a surgical facemask seemed to be accompanied by a decrease in HR, although the values remained within the normal range.
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Affiliation(s)
- Anna Alessandri-Bonetti
- Department of Dental Clinic and Maxillofacial Surgery, A. Gemelli University Policlinic IRCCS, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy; (A.A.-B.); (P.G.)
| | - Linda Sangalli
- College of Dental Medicine—Illinois, Midwestern University, 555 31st Street, Downers Grove, IL 60515, USA
| | - Patrizia Gallenzi
- Department of Dental Clinic and Maxillofacial Surgery, A. Gemelli University Policlinic IRCCS, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy; (A.A.-B.); (P.G.)
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Nadella S, Asi A, Sheridan O, Wolff M, Panchal N. Strategies for managing dental care for refugee patients. Spec Care Dentist 2023; 43:824-828. [PMID: 36310108 DOI: 10.1111/scd.12794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
AIMS To outline key factors that contribute to oral health issues of refugees and asylum seekers and provide management strategies for dental providers to teach desensitization and fear reduction for this special population. METHODS AND RESULTS We researched published literature in the PubMed database and incorporated lessons gained from treating refugee and asylee patients at a Vulnerable Populations Clinic (VPC) at an urban academic dental school. Refugees and asylees are at high risk for oral conditions due to a tendency to not seek routine dental treatment, psychological stressors, and various systemic factors. Oral health providers can teach patients desensitization and fear reduction by working to gain patients' trust by having effective communication and prioritizing comfort in the dental operatory. Providers should also utilize translation, psychological, and/or multicultural support services during their management of care. CONCLUSION By having a stronger understanding of the key causes of oral health issues among refugees and asylees in the United States, dental providers can better approach managing care for this vulnerable patient population. The concepts of teaching desensitization and fear reduction utilized for this special population can be applied to managing care for the wider special needs patient community.
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Affiliation(s)
- Srighana Nadella
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Abdalla Asi
- Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Olivia Sheridan
- Clinical Restorative Dentistry, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Mark Wolff
- Morton Amsterdam Dean, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Neeraj Panchal
- Philadelphia Veterans Affairs Medical Center, Penn Presbyterian Medical Center, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
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Gruß I, Papajorgji-Taylor D, Tommasi NP, Pihlstrom DJ, Hendrickson BP, Ikeda J, Manning W, Madden T, Fellows JL. Dental providers' perceptions of the feasibility and acceptability of implementing vaccine administration programs in dental settings: A qualitative study. J Public Health Dent 2022; 82:330-337. [PMID: 35869664 PMCID: PMC10757238 DOI: 10.1111/jphd.12540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/25/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Involving dental offices in routine vaccinations could have a positive impact on public health. In this study, we assessed dental providers' attitudes and perceptions regarding implementing vaccination in dental settings. METHODS We performed semi-structured interviews with 31 dental providers (25 dentists and 6 dental hygienists) enrolled in the Western region of the National Dental Practice-Based Research Network as of June 28, 2021. Interviews were recorded and transcribed. We analyzed transcripts using deductive and inductive coding approaches. RESULTS We identified three main themes that captured the perceptions of dental practitioners regarding the feasibility of implementing vaccine administration in a dental setting: (1) dental practitioners perceive contributing to the public health mission of disease prevention as having high value, (2) dental practitioners face considerable complexity when deciding whether to implement vaccine administration, and (3) dental practitioners do not understand current laws and associated reimbursement models related to vaccine administration. CONCLUSIONS To make vaccination commonplace in dental practices, legal changes to allow dental practitioners to administer vaccines should be followed by concrete guidance and relevant trainings to help interested dental practitioners successfully implement vaccination programs in their clinical settings.
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Affiliation(s)
- Inga Gruß
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate, Portland, OR, 97227
| | - Dea Papajorgji-Taylor
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate, Portland, OR, 97227
| | - Natalia P. Tommasi
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate, Portland, OR, 97227
| | | | | | | | | | | | - Jeffrey L. Fellows
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate, Portland, OR, 97227
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Daley EM, Thompson EL, Beckstead J, Driscoll A, Vamos C, Piepenbrink RP, Desch J, Merrell L, Richardson Cayama MB, Owens H, Lovett SM. Discussing HPV and oropharyngeal cancer in dental settings: gender and provider-type matter. Hum Vaccin Immunother 2021; 17:5454-5459. [PMID: 34890526 DOI: 10.1080/21645515.2021.1996809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and the leading cause of oropharyngeal cancer (OPC), an oral cancer most often identified by dental providers. Given the rise in HPV-associated OPC and recent Food and Drug Administration (FDA) approval of the HPV vaccine to prevent OPC, dental providers have a unique role in HPV prevention. This study assessed US adults' comfort levels discussing HPV and OPC with dental providers. An online survey platform was used to recruit a nationally representative sample of US adults (n = 300). The questionnaire assessed participants' knowledge, acceptability, and comfort discussing HPV-related topics with dental providers. SPSS 24 was utilized for data analyses. In general, participants reported feeling comfortable discussing HPV and OPC with dental providers. Participants reported feeling more comfortable with dentists than dental hygienists when discussing (t = 2.85, p < .01) and receiving recommendations about the HPV vaccine (t = 2.09, p < .05). Participants were less comfortable discussing HPV as a risk factor for OPC compared to non-HPV related risk factors (t = 2.94, p < .01). Female participants preferred female providers, whereas male participants had no preference. Previous research has indicated dental providers recognize their role in HPV prevention, but research is needed to understand patients' perceptions of dental providers' role in HPV prevention. Findings demonstrate that US adults are comfortable discussing HPV and OPC with dental providers, which may be key to OPC-HPV prevention. Future research is needed to facilitate HPV communication between patients and dental providers.
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Affiliation(s)
- Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Jason Beckstead
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Annelise Driscoll
- Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Cheryl Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | | | - Jill Desch
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Laura Merrell
- Department of Health Sciences, James Madison University, Harrisonburg, VA, USA
| | | | - Heather Owens
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Sharonda M Lovett
- College of Public Health, University of South Florida, Tampa, FL, USA
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Tseng W, Pleasants E, Ivey SL, Sokal-Gutierrez K, Kumar J, Hoeft KS, Horowitz AM, Ramos-Gomez F, Sodhi M, Liu J, Neuhauser L. Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication among Dental Providers in California. Int J Environ Res Public Health 2020; 18:ijerph18010216. [PMID: 33396682 PMCID: PMC7795206 DOI: 10.3390/ijerph18010216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 11/16/2022]
Abstract
Studies demonstrate that dental providers value effective provider-patient communication but use few recommended communication techniques. This study explored perspectives of California dental providers and oral health literacy experts in the United States on use of communication techniques. We conducted a qualitative key informant interview study with 50 participants between November 2019 and March 2020, including 44 dental providers (dentists, hygienists, and assistants) in public or private practice in California and 6 oral health literacy (OHL) experts. We undertook thematic analysis of interview transcripts and descriptive statistics about interviewees from pre-surveys. Dental providers reported frequently speaking slowly, and using simple language and models/radiographs to communicate with patients, while infrequently using interpretation/translation, illustrations, teach-back, or motivational interviewing. Providers reported using only 6 of the 18 American Medical Association's (AMA) recommended communication techniques and only 3 of the 7 AMA's basic communication techniques. A majority of providers indicated using one of five oral health assessment and educational strategies. Key barriers to effective communication included limited time, financial incentives promoting treatment over prevention, lack of OHL training, limited plain-language patient education materials, and patients with low OHL knowledge. Dental organizations should prioritize supporting dental providers in effective patient communication practices. Standardizing OHL continuing education, creating an evidence-based OHL toolkit for dental teams, ensuring accessible interpretation/translation services, and incentivizing dental providers to deliver education could improve oral health literacy and outcomes.
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Affiliation(s)
- Winston Tseng
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
- Correspondence: ; Tel.: +1-925-699-4016
| | - Elizabeth Pleasants
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
| | - Susan L. Ivey
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
| | - Karen Sokal-Gutierrez
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
| | - Jayanth Kumar
- Office of Oral Health, California Department of Public Health, Sacramento, CA 95899, USA;
| | - Kristin S. Hoeft
- Department of Preventive & Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, CA 94143, USA;
| | - Alice M. Horowitz
- Department of Behavioral Health & Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Francisco Ramos-Gomez
- Division of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, CA 90095, USA;
| | - Miku Sodhi
- Shasta Cascade Health Centers, McCloud, CA 96057, USA;
| | - Jessica Liu
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
| | - Linda Neuhauser
- Health Research for Action, School of Public Health, University of California, Berkeley, CA 94720, USA; (E.P.); (S.L.I.); (K.S.-G.); (J.L.); (L.N.)
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Fingar KR, Smith MW, Davies S, McDonald KM, Stocks C, Raven MC. Medicaid dental coverage alone may not lower rates of dental emergency department visits. Health Aff (Millwood) 2017; 34:1349-57. [PMID: 26240249 DOI: 10.1377/hlthaff.2015.0223] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Medicaid was expanded to millions of individuals under the Affordable Care Act, but many states do not provide dental coverage for adults under their Medicaid programs. In the absence of dental coverage, patients may resort to costly emergency department (ED) visits for dental conditions. Medicaid coverage of dental benefits could help ease the burden on the ED, but ED use for dental conditions might remain a problem in areas with a scarcity of dentists. We examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. Higher density of dental providers was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. County-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for. Providing dental coverage alone might not reduce Medicaid-funded dental ED visits if patients do not have access to dental providers.
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Affiliation(s)
- Kathryn R Fingar
- Kathryn R. Fingar is a research leader at Truven Health Analytics in Sacramento, California
| | - Mark W Smith
- Mark W. Smith is a director in the Federal Government Division of Truven Health Analytics in Bethesda, Maryland
| | - Sheryl Davies
- Sheryl Davies is a research associate in the Center for Health Policy and the Center for Primary Care and Outcomes Research at Stanford University, in California
| | - Kathryn M McDonald
- Kathryn M. McDonald is executive director of and a senior scholar at the Center for Health Policy and the Center for Primary Care and Outcomes Research at Stanford University
| | - Carol Stocks
- Carol Stocks is a senior research analyst in the Center for Delivery, Organization, and Markets at the Agency for Healthcare Research and Quality, in Rockville, Maryland
| | - Maria C Raven
- Maria C. Raven is an associate professor of emergency medicine at the University of California, San Francisco
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