Wheelchair transfer techniques for the dental office

Dental offices must be made more accessible to individuals who are physically challenged. Transfer techniques for safely moving patients between wheelchairs and dental chairs, sliding transfers, one- and two-person transfers, and methods of accommodating patients in a dental operatory who cannot be transferred from wheelchairs are presented.     

The state of bariatric dental care in Australia: a silent disability crisis?

In the absence of dental related guidelines available in Australia specific to obesity and minimal awareness of the clinical implications on local dental practice, bariatric dental care can be perceived as a 'silent disability crisis'. This opinion piece and brief clinical note aims to question and raise awareness amongst dental professionals surrounding the current limited availability of bariatric dental chairs, difficulties in access, the safety of dental care delivery and ethical considerations for the dental management of people with obesity.     

Tobacco use quitline enrollment through dental practices: a pilot study

BACKGROUND: Time and resource constraints limit the ability of oral health care professionals to help patients quit smoking. Opportunities exist for dental providers to help patients who smoke by enrolling them in tobacco use quitlines. The authors conducted a pilot study to investigate whether such referrals were feasible and effective. METHODS: The authors randomly assigned eight general dental practices to provide either brief counseling regarding smoking cessation or brief counseling along with referrals to a tobacco use quitline for patients receiving routine dental hygiene care who reported that they were currently smoking cigarettes. RESULTS: The authors enrolled 82 patients (60 in the tobacco use quitline group, 22 in the brief counseling group). At six months, the self-reported, seven-day point prevalence tobacco use abstinence rates were 25.0 percent (15 of 60 patients) in the tobacco use quitline group and 27.3 percent (six of 22 patients) in the brief-counseling group (P approximately 1.0). Twenty-eight (47 percent) of 60 subjects in the tobacco use quitline group completed the initial tobacco use quitline consultation. Abstinence rates among subjects in the quitline group were higher if they completed more telephone consultations. CONCLUSIONS: Referral to a tobacco use quitline by dental practices is a feasible strategy for helping patients quit smoking if efficient links between the dental practice and the tobacco use quitline can be established. Research is needed to evaluate whether it is more effective than standard clinical interventions for tobacco use cessation. CLINICAL IMPLICATIONS: Dental practitioners with limited time and other resources can assist patients who smoke by referring them to a tobacco use quitline.     

Prosthodontic management of older severe hypodontia patients in general dental practice: A case series

Although a detailed understanding of the etiology of hypodontia is lacking, there is a need for awareness among dental professionals of the social and psychological consequences of severe hypodontia, as well as knowledge of those affected by hypodontia have ongoing dental treatment needs. Although, there may be a need for immediate referral of children to different specialists for optimal multidisciplinary treatment planning, most older patients with severe hypodontia can be treated by general practitioners. Practitioners therefore need to be aware of the ramifications of the condition and be capable of providing adequate oral health care for these patients and referring them for additional services when necessary. A case-report series is used to illustrate routine prosthodontic treatments that can be offered to older patients in general dental practice.     

Postextraction hemostasis in patients on anticoagulant therapy: the use of a fibrin sealant.

A simple and safe method of achieving hemostasis after tooth extraction in patients on anticoagulant therapy is described. The use of a tissue sealant turns a complicated, difficult, and risky dental procedure into a simple one, suitable for any dental clinic. Sixty-one teeth were extracted in 23 sessions. Only four cases of very slight postsurgical bleeding were reported. Dental treatment of the majority of these medically compromised people can be performed by private practitioners, without referring the patients to specialty care centers.     

Changes in dental care use patterns due to COVID-19 among insured patients in the United States

BackgroundDemand for dental services has been known to be linked closely to dental insurance and disposable income. Widespread economic uncertainty and health systems changes due to COVID-19 thus may have a significant impact on dental care use.MethodsUsing deidentified dental practice management data from 2019 and 2020, the authors observed variations in dental care use among insured patients since the COVID-19 outbreak (during the period of practice closure and after the reopening) by patient age, procedure type, insurance type, practice size, geographic area, and reopening status. The authors examined whether the rebound in procedure volumes at dental practices can be explained by county-level characteristics using hierarchical regression models.ResultsAlthough dental care use among privately insured patients fully rebounded by August 2020, use still remained lower than the prepandemic level by 7.54% among the publicly insured population. Demand for teledentistry increased 60-fold during practice closure. Geographic characteristics—such as median household income, percentages of rural or Black populations, and dental care professional shortage designations—were associated significantly with the number of procedures performed at dental practices.ConclusionsAs a result of COVID-19, dental practices experienced substantial decreases in procedure volume, particularly among patients covered by public insurance or residing in underserved areas.Practical ImplicationsDuring economic downturns, state health officials should be encouraged to adopt policies to expand access to oral health care for vulnerable populations via oral health promotion strategies and increasing the supply of dentists or midlevel dental care providers in underserved areas.     

Consensus Report of the XI Congress of the Spanish Society of Odontology for the Handicapped and Special Patients

This article summarizes the findings of consensus of the XI congress of the SEOEME. All of these conclusions are referring to the review articles responsible to the general rapporteurs in order to bringing up to date knowledge with regard to the use of implants in patients medically compromised and with special needs and, in the dental management of autism and cerebral palsy, in the dental treatment of patients with genetic and adquired haematological disorders, the dental implications of cardiovascular disease and hospital dentistry. Key words:Autism, cardiovascular diseases, cerebral palsy, dental implants, disabled patients, haematological disorders, hospital dentistry.     

数码相机在口腔X线牙片管理中的应用

目的：探讨传统口腔X线牙片长期保存和椅旁迅速调用的数字化管理方法。方法：使用数码相机将传统X线牙片的模拟图象转换为数字图象，然后将数字图像输入计算机系统，通过图像处理软件对其进行加工，整理，保存在特定目录下，使用图象浏览软件在牙科治疗椅旁迅速调用患者牙片。结果：通过数码相机摄影后输入电脑的图像其图片效果较好，操作方便，快捷，保证了图片信息的准确采集和长久保存。结论；该方法对基层口腔医疗机构保存和利用普通牙片进行了探索，给医疗，教学，科研及学术交流等带来很大的方便。     

Dental fear and avoidance: a comparison of two modes of treatment

Ninety-nine individuals, all of whom had long avoided dental treatment due to severe dental fear, received therapy according to one of two treatment modalities--behavioral therapy from a psychologist (BT) and treatment under general anesthesia (GA)--both of which were followed by clinical training and dental test treatments. These treatment programs were followed by referring the individuals to community dental clinics for complete oral rehabilitation. Among BT patients, significantly more (92%) completed the treatment program, compared with the GA patients (69%). Complete oral rehabilitation in community dental clinics was achieved by 78 and 53%, respectively. BT patients also had a significantly lower frequency of cancellations. The reduction in dental anxiety according to the Corah Dental Anxiety Scale was substantial in both groups, but the anxiety was significantly more reduced for BT patients, who reached a level equivalent to that of average dental patients. Patients' self-reported tension and the dentists' ratings of patient behavior during treatment were also significantly more positive for the BT groups.     

Value gaps in dental practice: understanding how differences in core values can adversely affect the practice

BACKGROUND: The authors explore the importance of human values in dental practice, an area often overlooked as we struggle to deal with the everyday demands of treating patients and managing staff members. Such values are, however, fundamental to the success of any practice; therefore, it is important to understand their significance. CONCLUSIONS: Problems arise in dental practices when gaps develop between the values held by the various players involved (that is, between the entire dental team and patients, the dentist/owner's personal values and business goals, the dentist/owner and staff members, and the dental practice and any third-party funding organizations). PRACTICE IMPLICATIONS: By understanding the potentially damaging consequences of value gaps for practice viability, dental practice owners and managers can take steps to create a more harmonious workplace in which all parties strive to reach common goals.     

Tobacco use cessation provided by dental hygienists

Abstract:  Second to regular mechanical plaque control, tobacco use cessation has become the most important measure for the treatment of periodontal diseases. In contrast to general medical professionals, dental hygienists are seeing their patients regularly and are therefore available for supporting their patients to quit tobacco use. Tobacco use disease consists of both a physical addiction and a psychological dependence. Therefore, the combination of behaviour change support with pharmacotherapy is recommended for tobacco use cessation counselling. The use of brief motivational interviewing for tobacco use short interventions in the dental practice appears to be suitable. In addition to behavioural support, the use for nicotine replacement therapy is the treatment of choice for the dental practice. Following a critical review of the literature on this topic, a step by step approach for tobacco use cessation is presented for the dental hygienists to be implemented in their daily practice routine.     

The Use of Fissure Sealants in Public Health Programs: A Reactor''s Comments

The papers presented a thorough, up-to-the-minute look at fissure sealants and their possible use in dental public health programs. The papers demonstrated that sealant technology has progressed to the point that where properly used, retention rates and caries-prevention effectiveness are, even over a five-year period, satisfactory. As a reactor to the papers, I attempted to underline three points: First, with respect to the sealant-amalgam comparison, the point must be made forcefully that sealants are not an alternative to amalgams. Rather, they represent a highly effective and technically practical procedure that, if correctly employed in a preventive program, would significantly reduce the cutting of teeth and the placement of amalgams. This is particularly relevant to the use of sealants in private practice. Second, in formal public health programs, the use of sealants should probably be concentrated on the more highly caries-susceptible children in the population who would require a full range of chairside preventive procedures. Third, for the immediate future there is a pressing need for a limited number of well-defined studies to further investigate the cost and price determinants associated with the fissure-sealant procedure. These points were all explicitly or implicitly made in the papers presented and I appreciate having had the opportunity to reemphasize them.     

Patient-centred measures in dental practice: 3. Patient satisfaction

This, the final paper in this three-part series, looks at how patients evaluate the dental care they receive and how this translates into either satisfaction, dissatisfaction or something in between. It explains how it might be possible to manage patient expectations so that patients are more likely to be satisfied with all aspects of the care provided and describes a framework for dentists and staff to use when trying to enhance patient experience in everyday dental practice. Clinical Relevance: By better understanding the concept of 'patient satisfaction' dentists can develop strategies that take into account the way patients evaluate the quality of their own dental care.     

PRODUCT GUIDE

The following compilation of products and manufacturers resulted from a survey done by Dr. Darn Rosenberg and Ms. Carolyn Fetter for the ADPD. The purpose is to provide practitioners with a useful resource for those special patients with functional limitations or a disability, who may need unconventional dental aides to maintain their oral health. By no means does this product guide attempt to list all the dental products which our membership has found useful in their practices. This list represents the second edition of what we hope will be a regular review and update of dental products which may be helpful for all members of the Federation or anyone who provides oral care for patients with special needs .
We encourage members to send us suggestions or updates regarding dental products not listed or of specific benefit in your practice. Future editions will include sections on educational products and aides available for inservice use, and likewise, we would appreciate your contributions on materials useful in your practice. We apologize for any inaccuracy. Please contact the National Office for any necessary corrections.     

Management of the dental patient with congestive heart failure

This article presents the basic pathophysiology, clinical findings, medical management, and dental management for patients with congestive heart failure. The emphasis is on the role of the dentist in detecting these patients based on history and clinical findings, referring the patient for medical diagnosis and management, and working closely with the physician to develop a dental management plan that will be effective and safe for the patient.     

Evaluation of cause-related periodontal therapy and compliance with maintenance care recommendations

Abstract An evaluation of the long-term clinical effects of an intense period of cause-related periodontal therapy provided by dental hygiene students, was made in patients with moderately advanced periodontitis. By the evaluation, we also intended to gain information about compliance with given recommendations for periodontal health maintenance. The results after 3 years without supervision by the specialist team showed that achieved beneficial effects on the gingival conditions were maintained despite a significant increase in plaque prevalence. Recommendations as to the daily use of a variety of additional oral hygienic measures besides toothbrushing met with a considerable lack of compliance. Maintenance visits to the referring general practitioner were mostly made once a year and included regular dental care. Despite this, no further deterioration of periodontal status was observed. The results indicate that it may be possible to maintain successful effects of periodontal therapy in this patient category with less personal and professional effort than traditionally recommended.     

Role of the dental hygienist in the prosthodontic practice

Prosthodontic practices can benefit from the inclusion of a dental hygienist on the dental team. The dental hygienist can successfully complete procedures traditionally performed by the dentist. Delegation of these duties permits the dentist to spend time and energy on intricate procedures for which he or she has special expertise. The major modalities of responsibility that can be delegated include diagnostic data collection, educational and preventive services, and corrective therapy. It has been suggested that there is a need for expanding the duties of auxiliaries for prosthodontics in the future. It is our recommendation to use effectively the important auxiliary, the dental hygienist, in prosthodontic practice. For prosthodontic patients, the importance of the dental hygienist can be supported from two perspectives. First, the dental hygienist is formally educated in the oral and basic sciences and is qualified to perform intraoral procedures. Second, the dental hygienist is able to educate patients in regard to diet and oral hygiene habits. The dental hygienist's role in the prosthodontic practice has a potential that must not be overlooked. This opportunity, when provided, can be challenging, successful, and beneficial to the dentist, the patient, and the practice of prosthodontics.     

The use of radiation dose-reduction techniques in the practices of dental faculty members

X-ray exposure to dental patients has been significantly reduced by the introduction of speed group E intraoral film, rectangular beam limitation, long position indicating devices (PIDs), and rare-earth intensifying screens for extraoral radiography. Research indicates that many dentists do not use these techniques. However, schools of dentistry have implemented them to varying degrees for many years, so this investigation was conducted to determine the extent to which dental school faculty members use these materials and techniques in their own practices. Comparisons were made between full- and part-time instructors, those in practice for fifteen years or less and those in practice for more than fifteen years, and those with postgraduate education versus those with no formal education beyond dental school. The significance of differences was measured with chi-square analysis. The results indicate that dentists with faculty appointments utilize dose-reducing techniques to degrees that are comparable to or greater than reported usage by non-dental faculty practitioners. Faculty dentists in practice fifteen years or less are more likely than their older colleagues to use E-speed film (p = 0.001), whereas those in practice more than fifteen years are more likely to use longer PIDs (p = 0.049). Greater acceptance of these practices by faculty may lead to reinforcement of their use in the clinical education of dental students.     

The dental role in smoking cessation advice for patients with mental and behavioural disorders--time for improvement?

The past few years have seen an increasing emphasis upon the role of the dental team in smoking cessation. The recent advances in knowledge of the level and role of tobacco use in patients with mental and behavioural disorders, the biological factors involved and the influences of tobacco on psychiatric medication metabolism and side effects has not been reflected in dental postgraduate education. Perhaps it is time for an evidence based improvement in care standards by referring these patients for specialist cessation advice?