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da Mata C, Allen PF. Providing Oral Healthcare to Older Patients-Do We Have What It Takes? Int J Environ Res Public Health 2023; 20:6234. [PMID: 37444082 PMCID: PMC10341455 DOI: 10.3390/ijerph20136234] [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: 05/15/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023]
Abstract
Over the past decades, there has been an increase in the number of natural teeth that are maintained into older age, and this has represented an increase in the need for more complex dental treatment for this population. A trained workforce is needed in order to provide dental care to the different groups of elderly. Currently, the undergraduate training in gerodontology offered by dental schools seems to be limited, with great variation among dental schools worldwide. Given the heterogeneity of elderly groups, it is unlikely that new graduates from dental schools can be deemed competent to deal with the different groups of elderly. In this article, barriers to oral healthcare's provision to older adults are discussed, including the lack of appropriately trained dental professionals. Training pathways are discussed, including the preparation of undergraduate education to provide a suitable foundation to be developed further in postgraduate education. It is also proposed that older adults are classified according to their dependency level and each level is managed by properly trained dental professionals. In order to upskill general dental practitioners to care for these patients, postgraduate certification programmes could be structured to provide additional training. Furthermore, the development of geriatric oral health educational programmes for non-dental healthcare workers is recommended.
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Affiliation(s)
- Cristiane da Mata
- Department of Restorative Dentistry, Cork Dental School and Hospital, University College Cork, T12 E8YV Cork, Ireland
| | - Patrick Finbarr Allen
- Oral Health Services Research Centre, University College Cork, T12 E8YV Cork, Ireland;
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Al Khalaf K, O'Dowling Keane S, da Mata C, McGillycuddy CT, Chadwick BL, Lynch CD. Response rates to questionnaire-based studies in the contemporary dental literature: A systematic review. J Dent 2022; 126:104284. [PMID: 36089221 DOI: 10.1016/j.jdent.2022.104284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This systematic review aimed to investigate what is a reasonable response rate for dental questionnaire-based studies in recent literature and to assess the factors that affect the response rates. METHODS We used MEDLINE/PubMed to search the dental literature of 2021 (January-October). Two reviewers independently assessed studies eligibility and extracted data using standardized electronic extraction form. RESULTS One hundred and seventy-two studies were eligible, of these a total of 149 response rates were reported from 133 studies, whereas the remaining 39 studies were excluded as they did not report response rates. The median response rate across the included studies was 77% (mean = 70.8%). We found significant negative correlation between the response rate and the actual number of distributed questionnaires (sample size) (r = -0.4127; P < 0.001). We also found an association between the response rate and the area of distribution, e.g., national or international (P = 0.0012). However, a wide variation was observed in the quality of information reported within this review and we did not find clear evidence of association between the response rate and other variables such as questionnaire piloting, number of questions in the questionnaire and the journal impact factor. CONCLUSIONS The findings of this systematic review confirm the association between the response rate and the sample size, where the response rate increases when the sample size less than 300 participants. In addition, a higher response rate could be achieved when the study conducted within the same institution (e.g., university). SIGNIFICANCE Questionnaire-based research can provide answers to several questions that could not be answered by other types of research related to the field of dentistry, dental health practitioners and students' attitudes and behaviours and more. Questionnaire-based publications can effectively contribute to dental research; thus, dental journals should consider development of a minimum set of guidelines in the reporting of questionnaire-based manuscripts.
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Affiliation(s)
- Khaleel Al Khalaf
- Restorative Dentistry Department, University Dental School & Hospital, University College Cork, Wilton, Co. Cork, Ireland; Prosthodontics Department, Dammam Specialist Dental Centre, Dammam Medical Complex, Dammam, Saudi Arabia.
| | - Shane O'Dowling Keane
- Restorative Dentistry Department, University Dental School & Hospital, University College Cork, Wilton, Co. Cork, Ireland
| | - Cristiane da Mata
- Restorative Dentistry Department, University Dental School & Hospital, University College Cork, Wilton, Co. Cork, Ireland
| | | | - Barbara L Chadwick
- School of Dentistry, Cardiff University, Heath Park, Cardiff, United Kingdom
| | - Christopher D Lynch
- Restorative Dentistry Department, University Dental School & Hospital, University College Cork, Wilton, Co. Cork, Ireland
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da Mata C, McKenna G, Hayes M. Knowledge transfer on the use of Atraumatic Restorative Treatment: A mixed-methods study: Knowledge transfer on the use of ART. J Dent 2022; 118:103944. [PMID: 34999141 DOI: 10.1016/j.jdent.2022.103944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/02/2022] [Accepted: 01/05/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Cristiane da Mata
- Cork University Dental School and Hospital, University College Cork, Ireland.
| | - Gerry McKenna
- Centre for Public Health, Queens University Belfast, Northern Ireland.
| | - Martina Hayes
- Cork University Dental School and Hospital, University College Cork, Ireland.
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Klaassen H, Ashida S, Comnick CL, Xie XJ, Smith BM, Tabrizi M, Arsenault K, Capin OR, Scully AC, da Mata C, Soto AP, Dias Ribeiro AP, Prince D, Christensen A, Giner-Tarrida L, Satorres Nieto M, León S, Gambetta-Tessini K, Santos MBF, Dias da Silva MA, Pereira AC, Dias do Carmo E, Aurora Stabile Gonnelli F, Carvalho FG, Collares K, Bervian J, Sarkis-Onofre R, Jerfeson Dos Santos Gonçalves F, Bueno-Silva B, Estela Haddad A, Gurgel BCDV, Alves PM, Shigli K, Nayak SS, Nayak PP, Murugaboopathy V, Savitha PN, Murthy V, Deshpande S, Marchini L. COVID-19 pandemic and its impact on dental students: A multi-institutional survey. J Dent Educ 2021; 85:1280-1286. [PMID: 33772784 PMCID: PMC8250841 DOI: 10.1002/jdd.12597] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/01/2021] [Accepted: 02/28/2021] [Indexed: 11/07/2022]
Abstract
Purpose/objectives To investigate dental students’ perceptions and concerns regarding the COVID‐19 pandemic, their coping strategies and support resources, and their perceived stress levels. Methods A customized 19‐item survey and the perceived stress scale (PSS) were applied to undergraduate dental students from the US, Spain, Ireland, Chile, India, and Brazil between April 10 and July 5, 2020. Linear modeling and mediation analysis were used to explore the relationships among demographics, stressors, coping mechanisms, social support, and stress Results A total of 4475 students responded to the survey. The majority (72.4%) were women, and 52.3% had no COVID‐19 training at the time of the survey. The students reported that they had to accommodate to changes in patient care (96.6%) and didactic learning (95.2%) activities, while 88.5% of the respondents indicated at least one of their courses moved online. Transition to online courses went “smoothly with some troubles” for 51.8% of the respondents, and 48.3% perceived the faculty as prepared for the online transition; however, 45.9% reported feeling extremely concerned about the impact of COVID‐19 on their education. The average PSS score was 21.9 of 40 (moderate stress). Multivariate models were built for participants with full data (n = 3899). Being male, having completed more dental coursework, and perceiving a smoother transition were associated with lower PSS scores; more concern about academic progress was associated with higher PSS. Faculty support mediated the relationship between a smoothness of transition and concern about academic progress and PSS scores Conclusion Stress caused by the pandemic may be alleviated by smoother transition and good faculty support.
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Affiliation(s)
| | | | | | | | | | - Maryam Tabrizi
- Health Science Center at Houston, University of Texas, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Prajna P Nayak
- Manipal Academy of Higher Education, Manipal College of Dental Sciences, Manipal, India
| | | | | | - Varsha Murthy
- Sri Venkateshwaraa Dental College, Ariyur, Pondicherry, India
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Abstract
The prevalence of caries is set to increase in the coming years as a result of a growing ageing population and a concomitant reduction in levels of edentulousness. Evidence for management of caries in older adults is scarce compared to that for the child population, however, similar principles of risk assessment, prevention and minimal intervention should be applied by dental health professionals. Early identification of high-risk older adults facilitates the implementation of risk reduction strategies, such as topical fluoride regimes. When operative intervention cannot be avoided, Atraumatic Restorative Technique (ART) may allow for conservative cavity preparation and has the advantage of being suitable for the domiciliary setting.
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Affiliation(s)
- Martina Hayes
- Senior Lecturer in Restorative Dentistry, University College Cork
| | - Igor R Blum
- Reader in Primary Dental Care and Advanced General Dental Practice & Director of Dental Outreach Training, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK; Consultant in Restorative Dentistry & Head of Primary Dental Care, King's College Hospital, London, UK
| | - Cristiane da Mata
- Lecturer in Restorative Dentistry, Cork University Dental School and Hospital
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Göstemeyer G, da Mata C, McKenna G, Schwendicke F. Atraumatic vs conventional restorative treatment for root caries lesions in older patients: Meta- and trial sequential analysis. Gerodontology 2019; 36:285-293. [PMID: 31125136 DOI: 10.1111/ger.12409] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/07/2019] [Accepted: 03/23/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES We aimed to appraise the comparative clinical efficacy of atraumatic restorative treatment (ART) versus conventional restorative treatment (CT) using a meta-analysis, and assessed the robustness of evidence by trial sequential analysis (TSA). BACKGROUND Due to its simplified clinical approach, ART may be advantageous over CT for restoration of root caries lesions in institutionalised older patients. METHODS Three electronic databases (PubMed, Embase and Cochrane CENTRAL) were screened, and hand searches and cross-referencing performed to identify randomised controlled trials reporting on survival of ART vs CT for restoration of root caries in older patients. Trial selection, data extraction and risk of bias assessment were performed by two independent reviewers. ART and CT were compared using fixed- or random-effects pairwise meta-analysis for per-protocol (PP), intention-to-treat (ITT) and best-case scenarios. TSA was used to control for risk of random errors. RESULTS A total of 235 studies were identified, and three trials involving 130 patients (463 restorations) were included. Risk of bias was high or moderate in all but one trial. ART was associated with a significantly increased risk of failure (OR [95% CI] 2.06 [1.06/4.00]) in PP- but not in ITT analysis (1.36 [0.92/2.02]). Analyses for best-case scenarios found great uncertainty introduced by attrition. No firm evidence was reached according to TSA. CONCLUSIONS For restoration of root caries, there is insufficient data to clearly rule out whether differences between ART and CT exist. Limited available data indicate there might be an increased risk of failure for ART.
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Affiliation(s)
- Gerd Göstemeyer
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Cristiane da Mata
- Cork University Dental School and Hospital, University College Cork, Cork, Ireland
| | - Gerald McKenna
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
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da Mata C, Allen PF, McKenna GJ, Hayes M, Kashan A. The relationship between oral‐health‐related quality of life and general health in an elderly population: A cross‐sectional study. Gerodontology 2018; 36:71-77. [DOI: 10.1111/ger.12384] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Cristiane da Mata
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | | | | | - Martina Hayes
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Ali Kashan
- Epidemiology and Public Health University College Cork Cork Ireland
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da Mata C, Allen PF, McKenna G, Cronin M, O'Mahony D, Woods N. Two-year survival of ART restorations placed in elderly patients: A randomised controlled clinical trial. J Dent 2015; 43:405-11. [PMID: 25597266 DOI: 10.1016/j.jdent.2015.01.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 11/09/2014] [Revised: 01/01/2015] [Accepted: 01/07/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Older dentate adults are a high caries risk group who could potentially benefit from the use of the atraumatic restorative treatment (ART). This study aimed to compare the survival of ART and a conventional restorative technique (CT) using rotary instruments and a resin-modified glass-ionomer for restoring carious lesions as part of a preventive and restorative programme for older adults after 2 years. METHODS In this randomised controlled clinical trial, 99 independently living adults (65-90 years) with carious lesions were randomly allocated to receive either ART or conventional restorations. The survival of restorations was assessed by an independent and blinded examiner 6 months, 1 year and 2 years after restoration placement. RESULTS Ninety-six (67.6%) and 121 (76.6%) restorations were assessed in the ART and CT groups, respectively, after 2 years. The cumulative restoration survival percentages after 2 years were 85.4% in the ART and 90.9% in the CT group. No statistically significant between group differences were detected (p=0.2050, logistic regression analysis). CONCLUSIONS In terms of restoration survival, ART was as effective as a conventional restorative approach to treat older adults after 2 years. This technique could be a useful tool to provide dental care for older adults particularly in the non-clinical setting. ( TRIAL REGISTRATION NUMBER ISRCTN 76299321). CLINICAL SIGNIFICANCE The results of this study show that ART presented survival rates similar to conventional restorations in older adults. ART appears to be a cost-effective way to provide dental care to elderly patients, particularly in out of surgery facilities, such as nursing homes.
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Affiliation(s)
- Cristiane da Mata
- Cork University Dental School and Hospital, University College Cork, Ireland.
| | - P Finbarr Allen
- Cork University Dental School and Hospital, University College Cork, Ireland
| | - Gerald McKenna
- Centre for Dentistry, Queens University Belfast, Northern Ireland, United Kingdom
| | - Michael Cronin
- School of Mathematical Sciences, University College Cork, Ireland
| | | | - Noel Woods
- Centre for Policy Studies, University College Cork, Ireland
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Hayes M, Allen E, da Mata C, McKenna G, Burke F. Minimal intervention dentistry and older patients part 2: minimally invasive operative interventions. ACTA ACUST UNITED AC 2014; 41:500-2, 504-5. [PMID: 25195481 DOI: 10.12968/denu.2014.41.6.500] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED As described in the first paper of this two part series, the expansion of our older population and the concomitant reduction in levels of edentulism will result in an increase in the number of patients presenting in general practice with complex restorative challenges. The application of the concepts of minimal intervention dentistry and minimally invasive operative techniques may offer a powerful armamentarium to the general dentist to provide ethical and conservative treatment to older patients. CLINICAL RELEVANCE When it is unavoidable, operative intervention should be as minimally invasive as practicable in older patients to preserve the longevity of their natural dentition.
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Hayes M, Allen E, da Mata C, McKenna G, Burke F. Minimal intervention dentistry and older patients part 1: risk assessment and caries prevention. ACTA ACUST UNITED AC 2014; 41:406-8, 411-2. [DOI: 10.12968/denu.2014.41.5.406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Martina Hayes
- Clinical Research Fellow, Restorative Dentistry, University College Cork
| | - Edith Allen
- Lecturer in Restorative Dentistry, University College Cork, Dental School and Hospital, Wilton, Cork, Ireland
| | - Cristiane da Mata
- Restorative Dentistry, University College Cork, Dental School and Hospital, Wilton, Cork, Ireland
| | - Gerald McKenna
- Lecturer in Prosthodontics and Oral Rehabilitation, Restorative Dentistry, University College Cork, Dental School and Hospital, Wilton, Cork, Ireland
| | - Francis Burke
- Senior Lecturer/Consultant, Restorative Dentistry, University College Cork, Dental School and Hospital, Wilton, Cork, Ireland
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da Mata C, Allen PF, Cronin M, O'Mahony D, McKenna G, Woods N. Cost-effectiveness of ART restorations in elderly adults: a randomized clinical trial. Community Dent Oral Epidemiol 2013; 42:79-87. [PMID: 23952107 DOI: 10.1111/cdoe.12066] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2012] [Accepted: 07/06/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND As the world population ages, the requirement for cost-effective methods of treating chronic disease conditions increases. In terms of oral health, there is a rapidly increasing number of dentate elderly with a high burden of maintenance. Population surveys indicate that older individuals are keeping their teeth for longer and are a higher caries risk group. Atraumatic Restorative Treatment (ART) could be suitable for patients in nursing homes or house-bound elderly, but very little research has been done on its use in adults. OBJECTIVES To compare the cost-effectiveness of ART and a conventional technique (CT) for restoring carious lesions as part of a preventive and restorative programme for older adults. METHODS In this randomized clinical trial, 82 patients with carious lesions were randomly allocated to receive either ART or conventional restorations. Treatment costs were measured based on treatment time, materials and labour. For the ART group, the cost of care provided by a dentist was also compared to the cost of having a hygienist to provide treatment. Effectiveness was measured using percentage of restorations that survived after a year. RESULTS Eighty-two patients received 260 restorations, that is, 128 ART and 132 conventional restorations. 91.1% of the restorations were on one surface only. After a year, 252 restorations were assessed in 80 patients. The average cost for ART and conventional restorations was €16.86 and €28.71 respectively; the restoration survival percentages were 91.1% and 97.7%, respectively. This resulted in a cost-effectiveness ratio of 0.18 (ART) and 0.29 (CT). When the cost of a hygienist to provide ART was inserted in the analysis, the resulting ratio was 0.14. CONCLUSIONS Atraumatic restorative treatment was found to be a more cost-effective alternative to treat older adults after 1 year, compared to conventional restorations, especially in out of surgery facilities and using alternative workforce such as hygienists. Atraumatic restorative treatment can be a useful tool to provide dental care for frail and fearful individuals who might not access dental treatment routinely.
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