北京市1～4岁儿童龋流行情况调查及其危险因素的初步研究

目的 调查婴幼儿龋流行情况及其相关因素的分析以利于早期防治。方法 对北京市海淀、丰台8所幼儿园408名1～4岁儿童，女195名，男213名，通过口腔检查龋齿及详细问卷调查，最后分别作统计分析及Logistic回归分析。结果 本研究婴幼儿龋患病率为40．19％，男性45．07％，女性34．87％，两性间有显著差异。各年龄组间患病率也有显著性差异。婴幼儿龋和乳磨牙龋的发生密切相关，Logistic回归分析结果显示，婴幼儿龋发生的危险因素依次为睡前哺乳，年龄，母亲受教育的程度，每天吃甜食及含糖饮料的次数，哺乳持续时间，刷牙的频率，均有相关性。针对婴幼儿龋的危险因素予以早期防治。结论 强调对双亲早期教育，尽早地去看口腔医生及局部用氟极为重要。     

A pilot study of the use and perceived utility of a scale to assess clinical dental teaching within a UK dental school restorative department

Introduction:  Feedback on individual teaching performance gives an important contribution and support to the reflective practices of educators. Unfortunately, feedback is an infrequent exercise provided to dental teachers about their teaching practices. The Effective Clinical Dental Teaching (ECDT) scale has been used previously to assess clinical teachers, but has not been used within the UK.
Methods:  This study looks at the use of the ECDT scale in the setting of a UK dental school, as a method of feedback collection and delivery in seven domains of clinical teaching. The ECDT was used to evaluate the teaching of 16 clinical teachers by dental undergraduates, and to investigate the opinions of these clinical teachers and clinical dental students about the utility of this scale.
Results:  The study identified that there was a disparity between self and student perception of teaching. The total ECDT scores ranged from a minimum of 55% 66.6/125 to a maximum of 90% 113.8/125, with a mean group score of 73% 91.6/125. Most clinicians evaluated by students scored above 3/5 for all teaching domains, although there appeared to be significant differences between the four teacher groups. The majority of staff and students were in favour of the use of such a scale to support the progression and development of teaching styles.
Conclusion:  The ECDT scale is a useful tool for highlighting the areas of strength and deficiency within clinical dental teaching. Its use may complement peer review for individual teachers and identify future topics for staff development sessions. Further research is recommended to identify the individual strengths and weaknesses that different types of teacher may bring to curriculum teaching.     

Development and validation of an instrument to assess oral health literacy in Norwegian adult dental patients

Abstract

Objective. To develop and validate an interview instrument to assess oral health literacy in Norwegian adult dental patients. Materials and methods. The instrument, Adult Health Literacy Instrument for Dentistry (AHLID), was based on an OECD instrument used to assess general literacy in adults. One hundred and thirty Norwegian adults (mean age = 48 years; 57% women) participated. AHLID included a selection of oral health-related printed texts that ranged from 1–5 with respect to difficulty. A questionnaire regarding socio-demographic variables and knowledge of risk factors for oral disease was used. DMFT, stimulated salivary flow rate and streptococcus mutans and lactobacillus in saliva was also examined. Results. The Cronbach’s alpha values of AHLID were 0.98 for internal consistency reliability (p < 0.01) and 0.81 for test–re-test reliability (p < 0.05). AHLID score 3 was most frequent while very few fulfilled the criteria for score 1 and 5. Linear multiple regression analysis showed that lactobacillus in saliva and knowledge of risk factors for periodontitis and caries were predictor variables of AHLID score. Conclusions. AHLID appears to be reliable and valid to assess oral health literacy in Norwegian adults and suggests a method for country-specific health literacy instruments.     

In search of a universal and objective method to assess facial aging: The new face objective photo-numerical assessment scale

Most patients who undergo cosmetic rejuvenation treatment hope to appear younger and healthier. Although a number of scales have been put forward to assess facial aging, to date none has focused on predicting patients’ age. The purpose of our study was to validate a more complete version of the face - Objective assessment scale previously developed by the authors. Since patients with a photo-damaged skin can look older than others we created a new sub-scale: the facial photo-aging scale, in order to provide a more comprehensive method for the overall assessment of facial aging.The Rasch model was used as part of the validation process. We assigned a score to each patient based on the scales we have developed. The correlation between a patient's actual age and the obtained scores was analyzed; we also analyzed the inter-rater reliability and test-retest reliability. All the scales exceeded criteria for acceptability, reliability and validity.The facial aging scale we have developed may prove to be a valuable tool to assess patients before and after facial rejuvenation treatment or surgery, as well as for clinical research in the field of facial skin regeneration.     

Dental caries prevalence among Type 1 diabetes mellitus (T1DM) 6- to 12-year-old children in Riyadh,Kingdom of Saudi Arabia compared to non-diabetic children

ObjectiveThe aim of this study was to compare the prevalence of dental caries among groups of 6–12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters.MethodsThe study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant.ResultsThe mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5–5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04).ConclusionThe difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of “critical” pH values (pH = 4.5–5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.     

Development and validation of the Burdens in Oral Surgery Questionnaire (BiOS‐Q)

Patients’ perspective is increasingly re‐cognised as an important outcome measure in oral surgery. However, how patients perceive the surgical treatment cannot be assessed currently. This would be an important indicator for process‐related quality of care. It was the aim to develop and to validate an instrument for the assessment of patient‐based measures of process‐related quality of care in oral surgery. The new Burdens in Oral Surgery Questionnaire (BiOS‐Q) was developed in two steps in patients undergoing oral surgery. First, an item pool was created using semi‐structured interviews in 90 patients. Second, a preliminary version was applied in 297 consecutively recruited patients to assess redundancy, completion rates, face validity, difficulty and distribution. Psychometric properties of the final version of the questionnaire were evaluated. The BiOS‐Q consists of 16 items and showed satisfactory internal consistency (Cronbach's alpha = 0·84) and excellent test–retest reliability (ICC = 0·90). The questionnaire's mean score was significantly correlated with dentists’ burdens (r = 0·44) and patients’ overall satisfaction (r = 0·39) indicating sufficient validity. The BiOS‐Q is a reliable and valid instrument for the assessment of patient‐based process‐related quality of care in oral surgery.     

Development of a patient-reported outcomes and experience measure for Orthognathic surgery: validation of the Northwick Park Orthognathic Questionnaire (NOQ)

Orthognathic surgery aims to correct dentoskeletal and facial discrepancies. The expected benefits are functional, cosmetic, and psychological. In a previous publication, this group assessed the determinants of patient satisfaction to formulate the Northwick Park Orthognathic Questionnaire (NOQ). The aim of the present study was to validate this questionnaire. A total of 118 postoperative patients prospectively completed the NOQ, 30 of whom completed the questionnaire a second time. The mean completion rate was 87.6 ± 10%. Response reproducibility was high: 92% of patients gave identical responses (range 81–100%). The intra-class correlation coefficient (ICC) was 0.96 (0.96 ± 0.072). Average test–retest scores for each domain were as follows (range in parenthesis): reasons for treatment 93% (60–100%), preoperative experience 96% (81–100%), preparation for surgery 95% (81–100%), inpatient experience 89% (55–100%), post-discharge experience 83% (55–100%), benefits of treatment 92% (71–100%), overall patient education 91% (62–100%). Internal validity using Cronbach’s alpha was 0.72 (standard deviation 0.23, range 0.5–1). The results confirm the consistency of responses and the reliability of the information collected with the NOQ. The NOQ is a novel questionnaire and a valid metric to quantify a patient’s perception of their experience. Its adoption may aid in making targeted improvements to patient care.     

The evaluation of a novel method comparing quantitative light-induced fluorescence (QLF) with spectrophotometry to assess staining and bleaching of teeth

This study reports the development and evaluation of a novel method using quantitative light-induced fluorescence (QLF), which enables its use for quantifying and assessing whole tooth surface staining and tooth whitening. The method was compared with a spectrophotometer to assess reliability. Two experimental phases, intrinsic stain formation and tooth whitening, were conducted in vitro on 16 extracted bovine teeth. Intrinsic stains were developed via access through lingual surfaces and root canals of these teeth using tea solution (2 g/100 ml, Marks and Spencer Extra Strong Tea, Marks and Spencer, London, UK) for 6 days. Stains were removed using 33% hydrogen peroxide (VWR Prolab, Leicestershire, UK) in cycles over 150 min. Stain development/whitening was monitored with QLF (Inspektor Research systems, Amsterdam, Netherlands) and spectrophotometry (Easy shade, Vita Zahnfabrik, Bad Säckingen, Germany). Parameters Delta F for QLF and Delta E for the spectrophotometer were obtained. The progression of stain intensity and removal observed by the methods were tested for correlation using Pearson's correlation coefficient. Intra-examiner reliability for each method was tested. QLF showed a high correlation with spectrophotometry for detecting and monitoring intrinsic tooth stain progression (Pearson coefficient r was ?0.987 with correlation significant p < 0.0001). For stain removal, the Pearson coefficient (r) between both methods was ?0.906 with no significance p = 0.094. The use of an external reference material in combination with the inner patch QLF analysis technique had the ability to detect and measure whole tooth surface staining and its removal longitudinally. The reliability of the method shows a potential clinical application.     

Development and evaluation of a questionnaire to evaluate clinical dental teachers (ECDT)

OBJECTIVES: To develop and test the psychometric properties (validity and reliability) of a questionnaire to evaluate clinical dental teachers. METHODS: An item (question) pool was generated with the use of a literature review, feedback from faculty staff, and from focus group discussions with dental students. Following factor analysis the validity and reliability of a revised questionnaire was assessed. This involved 148 dental students and 453 assessments of 29 clinical dental teachers. RESULTS: Effective clinical dental teaching (ECDT) scores were associated with 'global ratings' of the effectiveness of clinical dental teaching (P<0.01), indicating strong criterion validity. In comparison analysis there was strong agreement between students regarding ratings of individual clinical dental teachers, indicating good construct validity. Reliability was assessed by examining internal consistency of sub-scales and overall ECDT scale, and found to be good (Cronbach alpha's > 0.80). CONCLUSION: A valid and reliable measure to evaluate clinical dental teachers has been developed for use in a clinical academia setting, and has potential use as a quality assurance measure.     

Access to preventive services after the integration of oral health care into early childhood education and medical care

Background

The effect of Early Head Start (EHS) on receipt of preventive oral health services (POHS) from both oral and medical health care providers is not known.

A Study to assess the awareness and use of Silver Diammine Fluoride and Hall Technique among dental professionals and dental students in the Eastern Province

BackgroundA major shift has occured in the trend of dealing with dental caries from primary to secondary prevention, specially after SDF approval off-label by US FDA in recent years and Hall Technique (HT) in the last decade.ObjectivesTo determine the frequency of awareness and use of Silver Diammine Fluoride (SDF) and Hall technique among dental professionals in the Eastern province of Saudi Arabia.MethodsThis cross-sectional study was conducted in a public hospital, metropolitan city of Middle Eastern region between March 15, 2019 & January 31, 2020. Dental practitioners were requested, with their consent, to fill up a digitally designed survey. Chi-square test on SPSS-20.0 was applied to compare frequency of awareness and use of SDF and HALL Technique among the survey participants.ResultsThe awareness of SDF was found to be 73.6% among specialists, 54.9% among graduates and 29.6% among students whereas awareness of HALL technique for stainless steel crown in pediatric dentistry was found statistically similar in all participants groups i.e. 42.7% in students, 55.5% in graduates and 54.9% in specialist group (p = 0.125).ConclusionThe results show potential with regards to awareness of dental specialists & postgraduate residents but inadequate among general dentists and students though all were keen advocates and found committed to its use to help the community. It points towards a further need of the of education for all groups. Those non- invasive techniques are very useful tools in general but specifically during Covid-19 pandemic where they can play a major role in preventing the spread of infection, arresting decay, alleviating pain and anxiety without resorting to aggressive treatment like pulp treatment/extraction. Low response rate may be improved in future through the respondents’ counselling and regular follow up.     

Prevalence of Functional Problems After Oral Cavity Malignancy Treatment at a Tertiary Center: Utilizing PSS HN (Performance Status Scale for Head and Neck) Scale

Background

Oral cancer is the most common type of cancer occurring in India and it is equally important to assess morbidities after treatment for optimal utilization of resources. Utilizing PSS HN we try to identify the patient population who are severely impaired and need aggressive rehabilitation.

Method and Material

The PSSHN questionnaire was administered by the treating physician to 100 consecutive oral cancer patients who completed their index treatment at least 6 months prior to accrual. Functional morbidities with score ≤50 were considered as significant.

Results

Prevalence of functional deficit of eating in public; deficit of understandability of speech and deficit of normalcy of diet were 28, 13 and 38 % respectively.

Conclusion

Type of resection either segmental mandibulectomy or major glossectomy, had most significant impact on concerned functional deficits and surgeries involving these defects should be carefully planned to involve free flap reconstruction and proper postoperative rehabilitation.

     

Management of Obstructive Sleep Apnea with a Mandibular and Tongue Advancement Splint (MTAS) in a Completely Edentulous Patient. A Clinical Report

Treatment of obstructive sleep apnea (OSA) in dentate patients using a mandibular advancement splint (MAS) from mandibular repositioners has been documented in detail. Nevertheless, studies about completely edentulous patients with OSA are sparse. This clinical report describes a clinical and laboratory method for producing a functional splint combining an MAS and a tongue-retaining device with an individualized tongue tip housing and discusses the rationale for using such a device.     

Development and biomechanical testing of a new osteosynthesis plate (TCP) designed to stabilize mandibular condyle fractures.

INTRODUCTION: In this paper, the different steps of development and experimental validation of a new type of three-dimensional (3-D) trapezoidal osteosynthesis plate (Modus TCP 2.0, Medartis, Basel, Switzerland) is described. These plates have been designed to stabilize sub-condylar and condylar neck fractures of the mandible. MATERIAL AND METHODS: In order to apply the principles of functionally stable osteosynthesis to the mandibular condyle, i.e. to put the plate as close as possible to the tensile strain lines occurring during function, two new 4- and 9-hole 3-D trapezoidal plates were designed. Tests were conducted on fresh human mandibles before and after osteosynthesis of a standardised unilateral sub-condylar 'fracture', and a static biting exercise between the ipsilateral first molars was reproduced on a test bench. The resulting condylar fragment displacement in the sagittal plane was measured and the alterations of the condylar tensile strain lines induced by the osteosynthesis were investigated by using photoelastic strain tests. RESULTS: None of the plates broke. No macroscopic condylar displacement was noted when assessing the quality of the primary stabilization. Strain analysis showed the ability of these 3-D plates to transmit physiological strains across the fracture line and the absence of potentially damaging strains around the plate. DISCUSSION: These results were accredited to the 3-D and trapezoidal features of the plates. CONCLUSION: The Modus TCP plates experimentally fulfil the principles of functionally stable osteosynthesis in the condylar region and are able to resist physiological strains.