scholarly journals Dental Care of Patients With Dementia: A Survey on Practice Equipment, Training, and Dental Treatment

2021 ◽  
Vol 2 ◽  
Author(s):  
Sophie Schaper ◽  
Sinja Meyer-Rötz ◽  
Claudia Bartels ◽  
Jens Wiltfang ◽  
Tina Rödig ◽  
...  

For patients with dementia, dental care can pose a considerable challenge due to cognitive impairment, behavioral, and psychological symptoms, and (often subsequently) limited autonomous oral care. In this study, we aimed to assess the proficiency of dentists in general practice in the outpatient dental care of these patients. A total of 119 dentists from private practices in Lower Saxony, Germany, participated in this study. Concerning treatment of patients with dementia, they provided details about (1) practice equipment/consultation, (2) training/expertise, and (3) special circumstances of dental treatment. Participating dentists predominantly reported to use medical aids (e.g., positioning cushions) to improve the treatment situation for patients with dementia. Over two thirds (68.6%) offered consultations in nursing homes, and at the patients' homes (47.0%). The training rate was remarkably low in the field of gerodontology for dentists and their practice staff (<10%), however, 54.5% expressed interest in such training. The majority of dentists reportedly adapted their treatment strategy to the needs of patients with dementia (e.g., communication, inclusion of caregivers, time management). Furthermore, most participants adapted dental treatment adequately (e.g., strict indication for tooth extraction, simple design of dental prostheses). In summary, even though training in the field of gerodontology must be considered insufficient, most dentists in this study showed an adequate adaptation of their treatment strategy as well as consideration of dental characteristics in patients with dementia, along with interest in trainings. We conclude that dementia-specific training should be expanded in the field of dentistry, preferably already at university level.

2021 ◽  
Author(s):  
Sophie Schaper ◽  
Sinja Meyer-Rötz ◽  
Claudia Bartels ◽  
Jens Wiltfang ◽  
Tina Rödig ◽  
...  

AbstractFor patients with dementia, dental care can pose a considerable challenge due to cognitive impairment, behavioral, and psychological symptoms, and (often subsequently) limited autonomous oral care. In this study, we aimed to assess the proficiency of dentists in general practice in the outpatient dental care of these patients. A total of 119 dentists from private practices in Lower Saxony, Germany, participated in this study. Concerning treatment of patients with dementia, they provided details about (1) practice equipment/consultation, (2) training/ expertise, and (3) special circumstances of dental treatment.Participating dentists predominantly reported to use medical aids (e.g., positioning cushions) to improve the treatment situation for patients with dementia. Over two thirds (68.6%) offered consultations in nursing homes, and at the patients’ homes (47.0%). The training rate was remarkably low in the field of gerodontology for dentists and their practice staff (< 10%), however, 54.5% expressed interest in such training. The majority of dentists reportedly adapted their treatment strategy to the needs of patients with dementia (e.g., communication, inclusion of caregivers, time management). Furthermore, most participants adapted dental treatment adequately (e.g., strict indication for tooth extraction, simple design of dental prostheses).In summary, even though training in the field of gerodontology must be considered insufficient, most dentists in this study showed an adequate adaptation of their treatment strategy as well as consideration of dental characteristics in patients with dementia, along with interest in trainings. We conclude that dementia-specific training should be expanded in the field of dentistry, preferably already at university level.


2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Juliana Bertoldi Franco ◽  
Priscila Fernandes Ribas ◽  
Luiz Alberto Soares Valente Júnior ◽  
Diogo Toledo Matias ◽  
Bruna Luiza Roim Varotto ◽  
...  

Introduction: The COVID19 pandemic brought a new panorama for the realization of dental treatment for the general population due to the risk of cross infection in the dental office -  aerosol formation and insertion of new personal protective equipment. Emergency and emergency dental criteria were defined to limit the flow of patients in the office in order to improve biosafety conditions among patients. Objective: to describe the dental procedures pertinent to outpatient special care or during hospitalization in the VOCID19 pandemic -  changes in care and implement biosecurity criteria. Basic procedures: The dental care of the special patient suffers changes -  mainly referring to the difficulty of access to the offices -  interruption of the conditioning process and difficulty to perform outpatient sedation and sedation with nitrous oxide. Dental care during hospitalization is essential in this patient due to prolonged time of tracheal oro intubation -  traumatic oral lesions -  preparation of specific oral care protocols -  removal of mouth infectious and installation of mouth protectors. Conclusion: Change of care -  inclusion of individual protection equipment and new knowledge about the COVID19 allows us to safely assist the patient with special needs both in the dental office and in hospital environment -  providing quality of life -  oral comfort and reducing oral infections during and after the pandemic. KEYWORDSDental care; Hospitals - Special; Needs assessment; Dental service - Hospital; Intensive care units; Pandemics. 


Author(s):  
A. A. Skakodub ◽  
O. I. Admakin ◽  
Ad. A. Mamedov ◽  
P. A. Nikulin ◽  
A. S. Vatyan

Relevance. Rheumatic diseases strongly influence the condition of the oral cavity, salivary glands and the temporomandibular joint, that, along with poor oral hygiene in children and active growth, increases the risk of oral disease development. The growing number of rheumatic diseases in children requires evaluation of the oral cavity condition and assessment of the provided dental services; enhancement of the professional oral care in children with rheumatic diseases through the comprehensive evaluation of the quality of the performed dental procedures and development of caries prevention measures based on the analysis of the epidemiological survey results.Materials and methods. 316 children with rheumatic pathology aged 1 to 18 years were examined. The children were divided into three age groups: group I – 1-5 years, group II – 6-12 years, group III – 13-17 years. The Oral hygiene and past dental experience questionnaire was developed for each group. Hard dental tissue condition and caries intensity level (df – in group I, df+DMF – in group II, DMF – in group III) were assessed, the oral hygiene index was calculated by the child age. On dental examination, past caries treatment and its complications were considered, the level of dental care (LDC) according to Leus was assessed.Results. The received data on caries intensity in all age groups and all medical conditions were analyzed. The values corresponded to the high and very high intensity (4.2 to 13); the values were 1.89 – 3 times higher than the values received during the epidemiological survey in children of the same age groups in Russia. Multiple primary and secondary (as a complication after the previous dental treatment) caries, associated with poor oral hygiene, was detected. The data revealed that the dental care level in children with rheumatic diseases was ‘poor’ and ‘insufficient’ The interview of the children and their parents showed that 91% of children had never had preventive treatment and 89% of children visited the dentist less than twice a year. The examination revealed that secondary caries, that had developed in 50% of children after the treatment of caries and its complications, and bad fillings, that had to be replaced.Conclusions. Thus, indirect influence of the main disease on the hard dental tissues in children was revealed – motivation for dental treatment and good oral hygiene was decreased for the lack of knowledge. The analysis of dental treatment quality in such children was insufficient. Only emergency dental visits as well as inappropriate materials and methods used for the treatment of caries and its complications result in secondary caries. So, customized treatment approach and prevention programs should be developed and introduced for the oral care in children with rheumatic diseases according to the main disease course, administered background therapy and the level of dental health education.


2021 ◽  
Vol 9 (7) ◽  
pp. 80
Author(s):  
Hidenobu Senpuku ◽  
Masahiko Fukumoto ◽  
Toshikazu Uchiyama ◽  
Chieko Taguchi ◽  
Itaru Suzuki ◽  
...  

Dental professionals are at increased risk of being infected with airborne pathogens such as SARS-CoV-2 because they are often exposed to droplets/aerosols production during dental treatment. To scientifically clear the effects of extraoral and oral suctions on the droplets and aerosols produced by dental treatments using an ultrasonic scaler was analyzed. The adenosine triphosphate and bacteria in droplets and aerosols produced during simulated scaling were quantitatively observed by reactions with luciferin/luciferase and incubation in culture plates to grow bacteria, respectively. The protection against spreading droplets and aerosols by oral and extraoral suctions was recognized, and the areas were limited to the left and posterior sides of the dental chair head when a right-handed dentist and dental hygienist performed scaling. Extraoral suction is a very useful tool for reducing the infection risk of COVID-19 in dental care, but the effective area is limited depending on physical characteristics of dentist and dental hygienist.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yuji Sato ◽  
Shigeto Koyama ◽  
Chikahiro Ohkubo ◽  
Shin Ogura ◽  
Ryutaro Kamijo ◽  
...  

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masaki Kobayashi ◽  
Mio Ito ◽  
Yasuyuki Iwasa ◽  
Yoshiko Motohashi ◽  
Ayako Edahiro ◽  
...  

Abstract Background The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals. Methods This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and 1 month after the training (secondary outcome). Results The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P < 0.05, effect size = 0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training. Conclusions The multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed. Trial registration UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586


Author(s):  
Maximiliane Amelie Schlenz ◽  
Alexander Schmidt ◽  
Bernd Wöstmann ◽  
Andreas May ◽  
Hans-Peter Howaldt ◽  
...  

Dental care has been affected by SARS-CoV-2 (COVID-19) worldwide. In contrast to other dental clinics, the Justus-Liebig-University Giessen (Germany) decided not to limit dental treatment to emergencies alone, but to continue dental care for all patients, with increased safety measures. As such, health care professionals may be exposed to additional physical and mental stress. The aim of this study was to assess the perspectives of all persons involved in dental care (dentists, dental assistants, students, and patients) regarding the aspects of safety measures, anxiety about self-infection and infecting others, and other prospects in the period March to December 2020 using a questionnaire. Data collection was performed between 14 December 2020 and 23 January 2021. A total of 35 dentists (response rate of 79.5%), 23 dental assistants (65.7%), 84 students (80%), and 51 patients (21.8%) completed the survey. The patients did not notice any changes in the care received. Dentists and dental assistants reported a higher workload due to additional safety measures. The majority of dentists, students, and patients agreed that normal patient care was maintained. One-third of dental assistants would have preferred emergency treatment alone and expressed significantly higher anxiety about COVID-19 infection than all other groups (p < 0.05). In conclusion, all groups showed a predominantly positive perspective on dental care, and anxiety about self-infection and infecting others was especially low. However, additional measures are time-consuming and compound daily patient care. This concept, based on well-established infection control, might be a viable proposal for current and future pandemics.


2021 ◽  
Vol 12 (46) ◽  
pp. 15-22
Author(s):  
Ana de Lourdes Sá de Lira ◽  
Francisca Janiele de Sousa

This study aimed to review, qualify and summarize the existing evidence on associations and risk factors for Covid-19 during dental treatment and dentists’ knowledge about these risks. After being registered with PROSPERO, the systematic review was carried out in accordance with the PRISMA guidelines, with searches in electronic databases, in specific journals, manual searches and Google Scholar, without language restrictions, from December 2019 to August 2020. Two questions were asked to be investigated: did patients seek dental care in the emergency room and do dentists know the symptoms and the mode of transmission of Covid-19, feeling qualified to attend them? Only 6 articles were included because they met all defined inclusion criteria. It was concluded that endodontic urgencies and emergencies with symptomatic irreversible pulpitis are the most common, consisting of a much higher proportion of dental emergencies during Covid-19 epidemic compared with dental trauma and no-urgent care. Although dentists are aware of the symptoms, mode of transmission, infection controls, and measures in dental clinics, they do not feel confident about the correct measures to be taken to prevent Covid-19 for their staff and patients.


Dental Update ◽  
2021 ◽  
Vol 48 (4) ◽  
pp. 302-306
Author(s):  
Jessica Hamilton ◽  
Mary Gittins ◽  
Andrew Geddis-Regan ◽  
Graham Walton

As the overweight and obese population increases, one must be mindful of the implications on the delivery of dental care to this group. Appropriate facilities must be available, which may warrant structural and equipment adaptations to clinical and non-clinical areas. The complexity of dental treatment planning and delivery may be compounded by medical comorbidities, and careful consideration must be given to the suitability and safety of conscious sedation and general anaesthesia in order to facilitate treatment. This article aims to discuss how safe provision and equitable access to dental care can be achieved for the bariatric population. CPD/Clinical Relevance: This article aims to discuss the challenges posed by the increase in the overweight and obese population and considerations to be taken for provision of safe and equitable bariatric dental care.


2018 ◽  
Vol 9 ◽  
pp. 144
Author(s):  
Margaretha Sovaria ◽  
Eka S Shofiyah ◽  
Mochamad F Rizal ◽  
Sarworini B Budiardjo

Objective: Mothers have very important roles in their children’s development. Their instinctive love develops strong emotional connections with their children, especially when their children have sensory impairments (SI). Feelings experienced by mothers, such as anxiety toward dental treatment, can affect their children’s emotions. Salivary alpha amylase (sAA) has been proposed as a biomarker of stress due to its sensitivity to changes in the body, such as dental anxiety. This study aimed to analyze the relationship between sAA levels in mothers and children with SI before dental treatment.Methods: Measurement of sAA from sixty pairs of children with SI and their mothers was taken together in the waiting room before the children’s dental treatment. Spearman’s analysis was used to find the correlation between their sAA levels.Results: In this study, sAA levels in mothers accompanying their children with SI correlated significantly with their children’s sAA levels (r=0.533; p<0.002).Conclusions: The correlation between dental anxiety in mothers and children with SI before dental treatment was found to be significant.Practical Implications: Anxiety toward dental care is a phenomenon that frequently arises in children. Mothers, the main influencers of their children’s development, are thought to be one cause of high anxiety in children. Children with special needs are at a higher risk for developing dental problems. Therefore, an understanding of these children’s levels of anxiety can be used by pediatric dentists to improve dental care.


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