Teledentistry within oral health care providers' training: A scoping review

INTRODUCTION

Despite teledentistry (TD) ubiquitous utilization, it has yet to be fully adopted by oral health care providers' educational training. This study aimed to explore TD incorporation in the training of oral health care providers.

METHODS

This review included studies on the TD content offered to oral health care providers. The JBI (Joanna Briggs Institute) methodology was used, and two reviewers screened the literature. Studies published between 1989 and 4 June 2022 were searched using "Teledentistry" and "Education" as initial keywords. The searched databases included MEDLINE, Cochrane Library, CINAHL, EPPI, Scopus, Epistemonikos, ERIC, MedEdPORTAL, ProQuest Dissertations and Theses Global, and Google Scholar. All of the relevant literature, regardless of their language, were added. The data were extracted using an extraction table and are presented in tabular and narrative summary formats.

RESULTS

A total of 2180 documents were found, and 1804 documents were screened by the title and abstract after deduplication; 59 were selected for full-text review; and 19 were eligible for data extraction. Of all studies, 63.15% were published after the COVID-19 pandemic. Practicing TD and TD reimbursement were some of the addressed topics. Didactic education and hands-on practice were the most employed training methods. Self/peer evaluations and surveys were among the employed assessment techniques.

CONCLUSION

TD education has been emphasized during the COVID-19 pandemic. There is a variation in the existing TD educational programmes, from addressing topics to assessment techniques. However, the number of educational programmes on this topic is sparse.

A Protocol for Treating Patients with Post-Covid Conditions in Dental Settings

Purpose The relative newness of Post-COVID Conditions (PCC) has revealed a void in assessment protocols and treatment guidelines for dental settings. Providing oral health care practitioners with an assessment and treatment protocol could facilitate the delivery of comprehensive oral health care. The purpose of this study was to test a protocol for assessing and treating patients with PCC in dental practice settings.Methods A qualitative exploratory research design was used to conduct the study. A PCC assessment and treatment protocol (ATP) was developed and was used by dental hygienists in clinical practice in California for a period of 6 weeks. Following the use of the PCC ATP practitioners were invited to participate in individual interviews. Online individual interviews were comprised of 20 dental hygienists recruited via purposive sampling. Participant anonymity was preserved using pseudonyms. A qualitative analysis software program was used to identify codes and themes. Investigator triangulation, member checks, and saturation were used to validate responses.Results Fifty-six participants completed the six-week PCC ATP and twenty participants took part in the interview session. Four themes were identified: awareness, accessibility, resources, and complications. Within the accessibility theme, subthemes of ease of use and guidance emerged. The complications theme yielded three subthemes: time, clinician hesitation, and patient lack of cooperation.Conclusion This study demonstrated that a PCC ATP created awareness of the varied symptoms of PCC and is a useful resource for clinical practitioners. Providing dental hygienists with a treatment protocol supports efforts to provide person-centered evidence-based care.

Teledentistry content in Canadian dental and dental hygiene curricula

OBJECTIVES

To explore the extent to which teledentistry (TD) content is incorporated into Canadian dental and dental hygiene curricula.

METHODS

An anonymous survey was distributed among all 10 dental and 35 dental hygiene programs across Canada in June and July 2022. The survey focused on TD teaching (methods employed, content taught, and barriers to TD education), with descriptive (frequency, maximum, minimum, mean) and inferential (Pearson chi-square for odds ratio test) data analyses using SPSS. A ρ - value < 0.05 was considered statistically significant.

RESULTS

Thirty-four programs responsed to the survey, including all dental (n = 10) and 68% (n = 24) of dental hygiene programs; eighteen reported having TD content, including three dental programs. An average of 9.22 ± 4.86 h was reported for teaching TD, with lecture format as the most employed approach and using TD in dental practice as the most covered topic. While 53% of the dental hygiene programs employed formative and summative assessments, only one dental program reported having assessment for this content. Moreover, programs that dedicated less than 9 h to teaching this content were less likely to address more than seven topics (Odds ratio (OR) = 0.14).

CONCLUSION

The dental and dental hygiene programs in Canada differ in their offering TD education, and 30% of the dental and 62.5% of the surveyed dental hygiene programs addressed TD content. This scarcity emphasizes the necessity for incorporating such content in future curriculum planning to consequently decrease the lack of knowledge, an identified barrier to TD implementation in education and practice, as today's students will be future educators.

Perceptions about human papillomavirus vaccine and oropharyngeal cancers, and the role of dental care providers in human papillomavirus prevention among US adults

BACKGROUND

The authors examined adults' perceptions about the importance of the human papillomavirus (HPV) vaccine in preventing oropharyngeal cancers and dental care providers' role in HPV prevention and identified associated factors.

METHODS

Adults (≥ 18 years) completed a national survey of consumer and patient attitudes, experiences, and behaviors on oral health. Descriptive and multivariable logistic regression models determined associations between perceptions regarding HPV and attitudes toward dental care providers' role and HPV knowledge, HPV vaccine recommendation, and sociodemographic characteristics.

RESULTS

One in 3 adults (32.8%; n = 5,320) said the HPV vaccine was very important, 1 in 2 said it was somewhat important (48.1%), and 1 in 5 said it was not important (19.1%) in preventing mouth and throat cancers. More than one-half (56.7%) of adults had positive perceptions about dental care providers' role in HPV education and were comfortable discussing the HPV vaccine with a dental care provider (59.4%). Adults with knowledge about HPV and oral health linkage and those who received HPV vaccine recommendation from a dental care provider had 2.0 to 2.5 times higher odds of reporting positively for all 3 outcomes (P < .001).

CONCLUSIONS

Most adults are comfortable discussing HPV and the HPV vaccine with their oral health care provider. Perceptions about the HPV vaccine's importance in preventing oropharyngeal cancers and the role of dental care providers in HPV prevention can be improved by means of increasing adults' knowledge about the relationship between HPV and oral health.

PRACTICAL IMPLICATIONS

Dental care providers' engagement in HPV conversations with patients may increase their knowledge about the HPV and oral health linkage and their understanding of the role of the HPV vaccine in preventing oropharyngeal cancers.

Exploring Young Adult Comfort with Oral Health Care Providers' Discussions Related to HPV: A mixed methods study

Purpose: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the United States and oral healthcare providers (OHPs) have become increasingly focused on preventing oral health outcomes related to HPV through screening for oral cancer and recommending HPV vaccination. The purpose of this study was to explore the comfort of having HPV-related discussions with OHPs among a college-age population.Methods: Students enrolled in an introductory-level, personal health class at a large, public, mid-Atlantic institution were invited to participate in an anonymous survey. Ten items related to participant's perceptions of HPV discussions with an OHP were part of a larger 100 item online survey designed to measure various aspects of college student health. Comfort with an OHPs' discussion of various health issues (including oral cancer, the relationship between oral cancer and HPV, and HPV vaccination) was measured on a 5-point scale with follow up, open-ended questions. Descriptive statistics were used to analyze the data; thematic coding was used to analyze the open-ended items.Results: A total of 3,236 students were invited to participate during the two data collection waves; 2,198 surveys were fully completed, representing a 67.9% response rate. Participants reported having the greatest level of comfort discussing oral health prevention behaviors such as tooth brushing and flossing and the least comfort discussing HPV-related topics with OHPs. Among those expressing low levels of comfort, qualitative responses highlighted participants limited knowledge related to HPV and the HPV vaccination along with the belief that these discussions were better suited for physicians.Conclusions: Results from this study demonstrated that college-age students may be uncomfortable with HPV-related discussions in a dental care setting. However, given the relationship between HPV infection and poor oral health outcomes, it is important that this population be informed about the oral-systemic HPV relationship and of the HPV vaccination as means for primary prevention. These findings highlight the need to address the public's perceptions regarding the role that OHPs play in educating the public about oral-systemic health.

"Trans-forming" dental practice norms: Exploring transgender identity and oral health implications

OBJECTIVE

This narrative review explores current research to broaden understanding and awareness of the transgender experience while identifying oral health needs and proposing strategies of inclusivity to optimize oral health outcomes.

METHODS

A comprehensive electronic literature search was conducted in the following online databases: PubMed, Google Scholar, CINAHL, and Education Source. The search yielded 35 articles with a wide range of study designs and methodologies.

RESULTS & DISCUSSION

Several themes emerged from the literature, including psychosocial oral health implications, barriers to oral health care, inclusive dental practice strategies, and cultural competence of oral health providers.

CONCLUSION

The transgender population experiences many social and health disparities that stem from discrimination. Systemic inequalities, coupled with other barriers to care, have significant oral health implications for this population. Implementing inclusivity strategies and gaining awareness of the transgender experience will contribute to better oral health outcomes in this community.

Dental hygiene shortages and their impact on the Canadian Dental Care Plan

Objective

This narrative review explores current research to broaden the understanding of dental hygienists' experiences and satisfaction in the workplace while suggesting strategies for the retention of dental hygienists and examining how current staffing shortages may impact the forthcoming Canadian Dental Care Plan.

Methods

An electronic literature search was conducted in the following online databases: PubMed, Google Scholar, CINAHL, and Education Source. Only full-text, peer-reviewed articles written in English were selected for review.

Results

The search yielded 18 articles with a wide range of study designs and methodologies.

Discussion

Five key themes emerged from the literature: health impacts, psychosocial environment, strategies for retention, contradictory findings, and implications for the Canadian Dental Care Plan.

Conclusion

Dental hygienists experience many health, environmental, and psychosocial challenges in their day-to-day working life that affect their job satisfaction and overall willingness to remain in the profession. Strategies for retention are essential for maintaining the current dental hygiene workforce and can have a positive impact on the Canadian Dental Care Plan and its success.

Electromyographical Assessments of Recommended Neck and Trunk Positions for Dental Hygienists

Purpose: Dental professionals are recommended to limit neck and trunk flexion to within 20° of a neutral (0°) body posture, however empirical support for the recommendations is lacking. The purpose of this study was to determine whether there are differences in muscle workload between a range of neck and trunk postures in a population of dental hygiene students.Methods: Fifteen first semester senior dental hygiene students with no history of neck and trunk injury volunteered to participate. Surface electromyography was used to record muscle activity from two neck extensors muscles, cervical erector spinae (CES) and upper trapezius (UT), and two trunk extensor muscles, thoracic erector spinae (TES) and iliocostalis lumboruni (IL). Participants performed ten conditions, including five neck flexion angles (0°, 10°, 20°, 30°, 40°) and five trunk flexion angles (0°,10°, 20°, 30°, 40°). For each trial, posture was checked with a goniometer and maintained for 20s. Muscle activity for each muscle was normalized to the individual's maximum voluntary isometric contraction (MVIC).Results: Activity of the CES was significantly lower in the neutral position than all flexed neck positions. Activation of the UT increased with neck flexion but required 30° of flexion to differ significantly from the neutral position. Activity of the TES required 20° of trunk flexion to differ significantly from neutral and IL activity in the neutral position was significantly lower than all other trunk flexion conditions.Conclusion: Even small amounts of neck or trunk flexion (10°), within the recommended range (≤ 20°), can significantly increase the workload for some muscles in an oral health care provider.

Orofacial Manifestations of Lyme Disease: A systematic review

Purpose: Orofacial manifestations of Lyme disease can affect head and neck anatomical structures that are frequently examined by dental professionals. The purpose of this systematic review was to examine the literature for types and frequencies of orofacial manifestations documented in populations in the United States (US) with Lyme disease.Methods: Four electronic databases (Dentistry and Oral Sciences, PubMed, Cinahl Plus, and Medline) were systematically searched during the summer of 2019 using keywords and MeSH terms to identify relevant studies. Search term alterations and synonyms were cross-checked using the US National Library of Medicine Unified Medical Language System Metathesaurus. Full-text, English language studies were included if they reported on US populations with Centers for Disease Control and Prevention confirmed cases of Lyme disease. The review followed guidelines set forth in Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Quality was assessed with a modified version of the Cochrane Data Collection Form for Randomized Control Trials and Non-randomized Control Trials. Extracted data was organized by themes of manifestations and the frequencies were calculated.Results: An initial search extracted 217,381 articles; 43 met the inclusion criteria and were further reviewed for quality. Twelve articles published from 1992-2017 were deemed appropriate for inclusion. All were from non-dental journals and fewer than half (n=6) reported on Lyme disease endemic states. Eight incidences of orofacial manifestations within head/neck regions were documented in Lyme disease patients (n=951) and included: headache (39.5%), facial palsy (42.5%), temporomandibular joint arthralgia (42.0%), altered taste (11.0%), stiff neck (13.6%), sore throat (3.0%), neck pain/arthralgia (7.5%), and erythema migrans rash (5.2%).Conclusion: Eight orofacial manifestations of Lyme disease were revealed by this systematic review. Future research regarding the orofacial manifestations of Lyme disease is needed so this medical condition can be better understood by oral health care providers and result in improved health outcomes for infected patients.