Safe prescribing in general dental practice – challenges and solutions

All dental practitioners will treat patients who take medicines. An ageing population, combined with improved management of patients with multiple long-term co-morbidities, has seen a rise in complex medication regimens. Healthcare specialization, a widening drug market and better access to medicines has also contributed to more patients taking multiple medicines for conditions, often managed by a variety of specialists. Whether these medicines are prescribed or bought over-the-counter, dental practitioners must understand the implications that these treatment regimens can have on dental care. CPD/Clinical Relevance: Prescribing medicines is a small but essential part of dental practice. This paper describes various aspects of prescribing, the potential implications of dental treatment to a patient's medication regimen, and important considerations to reduce the risk of medication errors and improve patient safety.

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Management of patients on oral anticoagulants in dental practice

Dental Update ◽

10.12968/denu.2020.47.11.912 ◽

2020 ◽

Vol 47 (11) ◽

pp. 912-922

Author(s):

Shrina Nathwani

Keyword(s):

Best Practice ◽

Dental Treatment ◽

Oral Anticoagulants ◽

Quality Care ◽

Current Evidence ◽

Ageing Population ◽

Oral Surgical Procedures ◽

Dental Patients ◽

Dental Practitioners ◽

The Uk

The UK has an increasingly ageing population and, inevitably, the prevalence of anticoagulation among dental patients will grow. This same group of patients are retaining their natural teeth longer and will potentially require dental treatment and oral surgical procedures and so, general dental practitioners will need to be aware of the implications of anticoagulant drugs. Equally, to comply with requirements set by the General Dental Council's ‘Standards for the Dental Team’ it is imperative to ensure that, as clinicians, we put patients' interests first, and provide quality care based on current evidence. CPD/Clinical Relevance: It is important that dentists have knowledge and expertise to consult and treat medically compromised patients for patient safety and to adhere to best practice guidelines.

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Can patients detect hazardous dental practice? A patient complaint study

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa-05-2014-0052 ◽

2015 ◽

Vol 28 (3) ◽

pp. 274-287 ◽

Cited By ~ 5

Author(s):

Nora Hiivala ◽

Helena Mussalo-Rauhamaa ◽

Heikki Murtomaa

Keyword(s):

Dental Treatment ◽

Opportunity To Learn ◽

Risk Indicators ◽

Study Patient ◽

Dental Practice ◽

Care Providers ◽

Content Type ◽

Patient Complaints ◽

Dental Practitioners ◽

Safety Incident

Purpose – The purpose of this paper is to: determine the prevalence and distribution of patient/family-generated, dentistry-related complaints to Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland from 2000 to 2011, study patient/family safety incident experiences and other reasons for complaints, assess complaint validity and evaluate factors associated with disciplinary processes against dentists. Design/methodology/approach – Data included closed cases handled by AVIs and Valvira (2000-2011) against dental practitioners or dental practice units (n=782). The authors analysed the complaints distribution and examined the antecedent factors and circumstances. Findings – This study demonstrated that patients/families can detect many dental treatment hazards, substandard processes and even serious safety risks rather well. The investigation processes revealed some physical harm or potential patient safety (PS) risks in more than half the alleged cases. Many complaints accumulated against certain individuals and statistically significant positive correlations were found between some patient/family complaints, dentist-specific variables and disciplinary actions. Practical implications – Patient/family-generated complaints must be taken seriously and seen as relatively good safety risk indicators. However, more knowledge on how patients might cooperate with dental care providers to prevent errors is needed. Originality/value – This work provides a unique opportunity to learn from several dentistry-related patient complaints. Despite some limitations, patient complaints appear to be useful as a complementary source together with other PS study methods.

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Non-Dental Drugs A Dentist Should Know: A Review

10.20944/preprints202005.0003.v1 ◽

2020 ◽

Author(s):

Khadeeja Saleem ◽

Paras Ahmad ◽

Mohmed Isaqali Karobari ◽

Mohammad Amjad Kamal ◽

Jawaad Ahmed Asif ◽

...

Keyword(s):

Geriatric Patients ◽

Dental Treatment ◽

Vitamin K Antagonists ◽

Oral Anticoagulants ◽

Herbal Medicines ◽

Health Conditions ◽

Dental Practice ◽

Over The Counter ◽

Dental Procedures ◽

The Us

More than 15,000 prescriptions and over the counter drugs are available according to the US Food and Drug Administration website. Moreover, several herbal medicines and dietary supplements are readily available to add to the list of possible drugs, which can potentially cause adverse drug interactions. These are a pressing concern for all as they can interfere with many dental procedures. Additionally, the number of geriatric patients seen in routine dental practice has increased over time. This implies that there are more patients with multiple diseases and health conditions like hypertension, diabetes, problems associated with the cardiovascular, renal and gastrointestinal systems, arthritis, osteoporosis, etc. All these require patients to be on certain medications. Furthermore, advancement in the dental field has led to more complex dental procedures (implants, grafts) being carried out in a general dental practice. These advanced and slightly more invasive treatments require the use of certain drugs before, during and after the treatment like local anesthetics, vasoconstrictors, anxiolytics, analgesics and antibiotics. All of these can possibly interact with medications a patient is already taking and can also interfere with the current dental treatment and create complications. This article aims to provide necessary information about commonly encountered systemic diseases and associated treating medications, their mechanism of action, possible complications and their management. The classes of drugs discussed include anti-platelet agents, vitamin K antagonists, novel oral anticoagulants, bisphosphonates, disease-modifying anti-rheumatic drugs and oral contraceptives.

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Cross infection control in private dental practice in Karachi, Sindh.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.08.17 ◽

2019 ◽

Vol 26 (08) ◽

pp. 1354-1358

Author(s):

Gotam Das ◽

Imran Samejo ◽

Shabir Ahmed ◽

Bushra Jabeen ◽

Muhammad Ilyas Shaikh ◽

...

Keyword(s):

Infection Control ◽

Dental Treatment ◽

Cross Sectional Study ◽

Cross Infection ◽

Dental Practice ◽

Sectional Study ◽

Cross Sectional ◽

Dental Practitioners ◽

Detailed Medical History ◽

Hand Piece

The Aim of this study was to assess that what measures were taken routinely by private dental practitioners regarding cross infection control. Study Design: Cross sectional study. Setting: Private dental practitioners in Karachi. Period: 01-04-2018 to 30-09-2018. Materials and Methods: A questionnaire comprised of 10 questions was prepared regarding measures taken for infection control in private dental practice. The questionnaire was distributed randomly among 130 private dental practitioners by hand to carry out a cross sectional study on cross Infection control among the private dental practitioners in Karachi. The each question had two options (YES OR NO), and the respondents had to select one of the two. Results: The questionnaire was sent to 130 private dental practitioners, out of which 111 dentists responded and returned the questionnaire. The response rate was 85%. Following are the results obtained. 85% of participants asked detailed medical history. Majority of dentists (78%) were immunized against hepatitis B. 95 % of the participants stated that they wore gloves during dental treatment and change on each patient. Mask was worn and changed on each patient by 67% of dentists during treatment. Protective eyeglasses and protective face shield were worn by 20% and 2 % of respondents respectively during dental treatment. Majority of dentists (84%) used autoclave to sterilize the hand piece and 16% dentists used sterilized hand piece on each patient. 100% participants changed instruments such as extraction instruments, saliva ejector, hand piece, impression trays on each patient. Only 3% of participant disinfected the impression before sending to laboratory. Only 17 % participants used special container to disposal off sharp objects. Conclusion: Cross infection control measures need to be improved in private dental practice.

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The preventive measures adopted during dental practice by the dentists in a low-income country to prevent the transmission of COVID-19: A questionnaire-based survey

Indian Journal of Medical Sciences ◽

10.25259/ijms_231_2020 ◽

2020 ◽

Vol 0 ◽

pp. 1-7

Author(s):

Safaa Shihabi ◽

Salma Al Nesser ◽

Omar Hamadah

Keyword(s):

Low Income ◽

Preventive Measures ◽

Dental Treatment ◽

High Vacuum ◽

Dental Practice ◽

Waiting Room ◽

Low Income Country ◽

Dental Practitioners ◽

Before And After ◽

Novel Coronavirus

Objectives: A novel coronavirus was first proclaimed in Hubei province, China, 213 countries worldwide also became an epicenter of the virus until June 17, 2020. The dental team has a high risk of infection as a result of the specificity of their procedures. The aim of this questionnaire was to estimate the preventive measures and the awareness methods that may be adopted by the dentists to prevent or reduce the transmission of COIVD-19. Material and Methods: The questionnaire was an electronic survey contained 23 questions, which were designed based on the instruction given for dental setting by CDC during COVID-19 pandemic; the respondents in this study were dental practitioners in Syria. Results: A total of 1013 dentists have responded to this survey 61% of the participants treated only the emergent treatment, 84% of them wear facial masks, while the prevalence for other protective equipment was low. The majority of the participants schedule the appointments as there is only one patient in the waiting room. More than half of the dentists sterilize the patients’ hands before and after the dental treatment, and 59% of them choose 70% ethyl alcohol as a disinfectant. Most of the respondents use dental mouthwashes before the initiation of the treatment. Almost three-quarters of the dentists use high vacuum. Only 15% of dentists sterilize the dental handpieces in the autoclaves after each patient. Most of dentists educate their patients about preventive methods. Conclusion: Based on these results, the Syrian dentists should take more strict measures during dental practice.

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COVID-19 Transmission in Dental Practice: Brief Review of Preventive Measures in Italy

Journal of Dental Research ◽

10.1177/0022034520920580 ◽

2020 ◽

Vol 99 (9) ◽

pp. 1030-1038 ◽

Cited By ~ 71

Author(s):

R. Izzetti ◽

M. Nisi ◽

M. Gabriele ◽

F. Graziani

Keyword(s):

Literature Search ◽

Preventive Measures ◽

Dental Treatment ◽

World Health ◽

Dental Practice ◽

Italian Experience ◽

Dental Practitioners ◽

Health Organization ◽

Restrictive Measures ◽

And Diffusion

The outbreak and diffusion of SARS-CoV-2, responsible for the coronavirus disease (COVID-19), has caused an emergency in the health system worldwide. After a first development in Wuhan, China, the virus spread in other countries, with Italy registering the second highest number of cases in Europe on the 7th of April 2020 (135,586 in total). The World Health Organization declared the pandemic diffusion of COVID-19, and restrictive measures to limit contagion have been taken in several countries. The virus has a predominantly respiratory transmission through aerosol and droplets. The importance of infection control is therefore crucial in limiting the effects of virus diffusion. We aim to discuss the risks related to dental practice and current recommendations for dental practitioners. A literature search was performed to retrieve articles on the management of COVID-19 diffusion in dental practice. The documented clinical experience, the measures of professional prevention, and the actual Italian situation were reported and described. Four articles were retrieved from the literature search. Among the eligible articles, 3 reported measures to contrast COVID-19 diffusion. The infection management protocols suggested were reviewed. Finally, recommendations based on the Italian experience in terms of patient triage, patients’ entrance into the practice, dental treatment, and after-treatment management are reported and discussed. COVID-19 is a major emergency worldwide, which should not be underestimated. Due to the rapidly evolving situation, further assessment of the implications of COVID-19 outbreak in dental practice is needed.

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Epidemiological Investigation of OHCWs with COVID-19

Journal of Dental Research ◽

10.1177/0022034520962087 ◽

2020 ◽

Vol 99 (13) ◽

pp. 1444-1452

Author(s):

L. Meng ◽

B. Ma ◽

Y. Cheng ◽

Z. Bian

Keyword(s):

Health Care ◽

Health Care Workers ◽

Dental Treatment ◽

Psychological Impact ◽

Clinical Work ◽

Study Data ◽

Dental Practice ◽

Care Workers ◽

Dental Practitioners ◽

Epidemiological Characteristics

During the coronavirus disease 2019 (COVID-19) pandemic, there is an important risk of infection in health care workers, including oral health care workers (OHCWs), due to the characteristics of dental practice. In this retrospective study, data pertaining to the 31 OHCWs diagnosed with COVID-19 in Wuhan, Hubei Province, were retrieved and analyzed. Questionnaires were administered to the subjects over the Internet and telephone. Clinical and epidemiological characteristics and information on the use of personal protective equipment (PPE) were collected. There were 22 females and 9 males, with a median age of 39 y. Although the severity of most cases of COVID-19 (93.5%) was mild or moderate, 1 case was severe, and another case was critical, resulting in death. Fever was the main first symptom of COVID-19, followed by fatigue and myalgia. Most of the OHCWs routinely used PPE such as medical masks, gloves, caps, and work clothes while performing clinical work. N95 or KN95 masks were rarely available because of the scarcity of PPE during the outbreak. Nineteen OHCWs reported a contact history, among whom 7 worked in a fever clinic, 5 reported contact with dental patients suspected of having COVID-19, and 7 reported contact with family members with COVID-19–related symptoms at least 1 d earlier. Our findings indicated that there were few clusters of COVID-19 in dental settings. Since the outbreak, the Hospital of Stomatology, Wuhan University, has provided emergency dental treatment, and none of their staff were infected while providing dental service, which indicates that comprehensive measures such as the use of advanced PPE and environmental disinfection can prevent cross-infection in dental practice. The analysis of the procedures followed during the emergency treatments indicated that OHCWs preferred to recommend conservative treatment to patients, suggesting that attention should be paid to the psychological impact of COVID-19 on dental practitioners.

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Management of SARS-CoV-2 transmission in emergency dental settings: current knowledge and personal experience

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.483 ◽

2020 ◽

pp. 1-22

Author(s):

M Negucioiu ◽

A Bucur ◽

O Lucaciu ◽

A Soanca ◽

A Roman

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Personal Experience ◽

Preventive Measures ◽

Dental Treatment ◽

Current Knowledge ◽

Rapid Evolution ◽

Dental Practice ◽

Research Guidelines ◽

Dental Office ◽

Dental Practitioners

Abstract The coronavirus disease (COVID-19) has seen a violent and fast spread worldwide. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a predominantly respiratory transmission through droplets and aerosol with serious implications for dental settings. This article is based on recent research, guidelines issued by relevant authorities, as well as on the authors’ experience acquired through their involvement in setting up an emergency dental care hub in Cluj-Napoca, Romania during the COVID-19 lockdown. The present article aims to provide a brief description of COVID-19 implications in dental office and to recommend preventive protocols for dental practitioners to ensure a safe and healthful workplace. The recommendations for infection control presented in this article address the specific risks of exposure to SARS-CoV-2. The article provides a special customized guideline covering patient triage and entrance into the dental practice, personnel protection, dental treatment and after-treatment management. The implementation of strict preventive measures has been found to be efficient in the prevention of SARS-CoV-2 contamination since no infections have been reported among our staff or patients. COVID-19 is a major emergency worldwide marked by a rapid evolution, and warranting a need for further assessment of the implications of COVID-19 outbreak in dental practice.

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Deficiencies in Silicone Impression for Crowns and Bridges

Revista de Chimie ◽

10.37358/rc.17.10.5876 ◽

2017 ◽

Vol 68 (10) ◽

pp. 2317-2319

Author(s):

Claudia Florina Andreescu ◽

Oana Botoaca ◽

Horia Mihail Barbu ◽

Doina Lucia Ghergic ◽

Anamaria Bechir ◽

...

Keyword(s):

Dental Practice ◽

Present Study Deal ◽

Dental Crowns ◽

Impression Materials ◽

Dental Practitioners ◽

Adequate Quality ◽

Dental Impression ◽

Single Crowns

There are many steps in fabrication of dental crowns and bridges at which an error can occur, and a technician can only fabricate a quality restoration if the impression itself is of adequate quality. All dental practitioners should have the ability to evaluate the quality of dental impression before sending to the laboratory. Elastomeric silicones (polysiloxane) are the most utilised impression materials in dental practice. The present study deal with the deficiencies of silicones dental impressions sent to commercial dental laboratories for fabrication of single crowns and bridges.

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Dental implant care and trouble among dependent patients based on the questionnaire survey among Japanese dental practitioners

BMC Oral Health ◽

10.1186/s12903-020-01279-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yuji Sato ◽

Shigeto Koyama ◽

Chikahiro Ohkubo ◽

Shin Ogura ◽

Ryutaro Kamijo ◽

...

Keyword(s):

Elderly People ◽

Dental Care ◽

Questionnaire Survey ◽

Japanese Society ◽

Dental Treatment ◽

Actual State ◽

Treatment Type ◽

Dental Practitioners ◽

Care Problems ◽

Implant Treatment

Abstract Background Self-care and professional care of implants may prove difficult for elderly people who require nursing care. However, the actual state of care and problems remains unknown. In this study, we investigated the actual state of implant problems in elderly people living in their own home or in a nursing home who received visiting dental treatment. Methods We mailed questionnaire survey forms to 2339 representatives or specialists who were members of the Japanese Society of Oral Implantology, the Japanese Society of Gerodontology or the Japan Prosthodontic Society. We narrowed down the respondents to those who provided visiting dental treatment, and analyzed the actual state of implants observed during visiting dental treatment (type, care, problems, countermeasures, etc.). Results Of the 924 dentists who responded to the questionnaire survey, 291 (22%) provided visiting dental treatment. While the majority of implant types encountered in the previous 12 months were root-form implants, there were still a certain number of blade and subperiosteal implants. Daily implant care involved mostly cleaning with a toothbrush + auxiliary tools. The most frequent implant problems encountered in the past were difficulty in cleaning and peri-implantitis. Medication and antiphlogistic treatment were most frequently adopted as countermeasures to implant problems, followed by observation. When we classified the results into those for the dentists who provided implant treatment and those for the dentists who did not, we found that many of the dentists who did not provide implant treatment opted for observation or medication, while those who provided implant treatment also implemented removal of superstructure, retightening of screws, repair and so forth. Conclusions We found that many of the implant troubles encountered by dentists who provided visiting dental care were difficulty in cleaning or peri-implantitis, and that the actions taken against these troubles varied depending on the experience of the dentist performing the implant treatment. Our study also revealed that dentists who provide visiting dental care need to acquire knowledge and skills of implant treatment, to have actions prepared in case they encounter such cases, or to closely coordinate with dentists who specialize in implants.

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