Prospects and ways of development of accessible stomatology in Ukraine

The article presents the basic principles of functioning of the system of providing medical dental care to the population for 1991, the changes that have taken place in recent years. The state of providing medical dental care to children, rural and privileged categories of the population, prevention of major dental diseases and work on preventive dental programs are analyzed. The vision of further development of affordable dentistry in Ukraine is presented.

Evaluation of Dental Students' Awareness and Attitude About Preventive Dental Treatments: Survey Research

Aim: Determination of dental students' approaches to fissure sealant applications; the widespread use and evaluation of their effectiveness of protective dental practices is extremely important. This research aims to evaluate the level of understanding and clinical attitudes of 3rd, 4th and 5th grade students of Necmettin Erbakan University Faculty of Dentistry on preventive dental treatments. Methods: The first part of the questionnaire consists of 10 questions aimed at assessing the students' technical levels of knowledge with data on age, gender and educational level. In the second section analyzing students' clinical behaviors, 11 questions were asked for answers to multiple choices (always, often, sometimes, never). This questionnaire was used on the internet in an anonymous way. Results: The questionnaire was received by 68 3rd grade, 67 4th grade and 75 5th grade students who were previously educated on fissure sealant applications. The vast majority (96.2 percent) of the students involved in the study indicated that the effectiveness of fissure sealants in preventing the development of tooth decay was confirmed by strong scientific evidence. Again, 99.5 percent of the students participating in the study indicated that the justification of the application procedures for the fissure sealant was identified and understood. With the assumption that only new teeth can be applied to fissure sealants, a statistically significant difference between the classes was observed (p<0.05); 3rd graders responded "yes" mainly. Conclusion: Although dental students have sufficient knowledge of protective dental practices and fissure sealants, variations in understanding and implementing clinical practice procedures may be found between classes. Standardization should be provided and education / lectures on preventive dental practices should be increased to obtain the equivalent of theoretical education at the clinical level.

A retrospective study on the incidence of medication-related osteonecrosis of the jaws (MRONJ) associated with different preventive dental care modalities

Purpose To assess the efficacy of different preventive dental visits and treatments in reducing the risk of medication-related osteonecrosis of the jaws (MRONJ). Methods In this retrospective study, patients diagnosed with MRONJ were divided into 5 groups based on available data: no preventive dental visits (group 0); dental visits and compliance with recommended treatments, at the university hospital’s dental clinic (group 1) or maxillofacial surgery unit (group 2), or at a private dentist’s (group 3); dental visits at one of the above and noncompliance with proposed treatments (group 4); patients judged eligible by the oncologist on panoramic radiography (group 5). Patients were classified on severity of MRONJ according to the Italian SIPMO/SICMF 2.0 staging system. A descriptive analysis was performed on the results. Fisher’s exact test was applied (p < 0.05). Results Ninety-three patients diagnosed with MRONJ were considered for the study, but 22 were excluded due to a lack of data, leaving a sample of 71 cases. MRONJ staging was only 0 for some patients (26.92%) in group 0. In all groups, the majority of patients had stage 2 MRONJ. The proportions of cases in stage 3 were 7.69% in group 0, 18.18% in group 3, and 43.48% in group 5. Groups 0 and 3 were somewhat similar as regard MRONJ staging. Most patients in group 5 had MRONJ stage 2 or 3. No statistically significant differences emerged between the groups. Conclusions Preventive dental care can reduce the risk of MRONJ providing patients comply with the specialist’s recommendations.

Forecasting Preventive Dental Quality Measures

Dental quality measures objectively measure the efficiency and performance of dental providers and organizations. While these measures in conjunction with established benchmarks are used routinely for self-assessment, forecasting them ahead of time in a data-driven and evidence-based manner has the potential to assist in assessing future dental treatment needs, oral disease burden, care utilization patterns, and strategic decision making for sustained performance improvement complementing traditional descriptive visualization dashboards. The present study modeled the temporal trends of four key preventive dental quality measures related to caries prevention (Adult New Caries, Sealants (6-9yrs.), Sealants (12-15yrs.), Fluoride Varnish) sampled monthly from (Dec. 2010 to July 2017) averaged across ten Family Health Center Dental Centers (FQHC), Wisconsin, using auto-regressive integrated moving average time series models. Five-month ahead forecasts along with their 95% confidence levels and mean absolute percentage error were determined across the four measures (Adult New Caries: 1.8%, Sealants (6-9yrs.): 0.90%, Sealants (12-15yrs.): 0.30%, Fluoride Varnish: 0.15%). Model diagnostics revealed auto-regressive integrated moving average models to sufficiently capture the temporal patterns of these measures and the forecast estimates of Adult New Caries and Sealants (12-15yrs.) revealed the need for increased efforts for improved preventive care utilization. Forecasting preventive dental quality measures can provide insights into expected treatment needs ahead of time and can assist in optimal resource and staff allocation with potential to prescribe suitable interventions to shift the trajectory from predicted outcomes to desired outcomes in a targeted manner. While the present study investigated organization level preventive dental quality measures, the time series approach presented is as such generic and expected to translate across similar settings.

Communicating With Parents and Preschool Children: A Qualitative Exploration of Dental Professional-Parent-Child Interactions During Paediatric Dental Consultations to Prevent Early Childhood Caries

The aim of this study was to explore communication interactions and identify phases adopted by dental professionals with parents and their young children and to examine the hypothesis that successful social talking between the actors together with the containment of worries allows the formation of a triadic treatment alliance, which leads to achieving preventive dental treatment goals. Conversation analysis of the transcribed data from video recordings of dental professionals, parents and preschool children when attending for preventive dental care was conducted. The transcriptions were read, examined and analysed independently to ensure the trustworthiness of the analysis. The transcriptions were explored for interactive patterns and sequences of interaction. Forty-four individual consultations between dental professionals, parents, and preschool children were recorded. The number of communication behaviours was 7,299, with appointment length ranging from 2 min 10 s to 29 min 18 s. Two patterns of communication were identified as dyadic (between two people) and triadic (between three people) interactions within a continuous shifting cycle. The three phases of communication were social talking, containing worries and task-focusing. Social talking was characterised by shifts between dyadic and triadic communication interactions and a symmetry of communication turns and containing worries. This typified the cyclical nature of the triadic and dyadic communication interactions, the adoption of talk-turn pairs, and triadic treatment alliance formation. Task-focusing pattern and structure were different for dentists and extended-duty dental nurses. For dentists, task-focusing was characterised by a dyadic interaction and as an asymmetrical communication pattern: for extended-duty dental nurses, task-focusing was typified by symmetrical and asymmetrical communication patterns within dyadic and triadic interactions. Empathy and understanding of the young child's emotional needs during containing worries allowed the formation of the triadic treatment alliance and with this treatment alliance, the acceptance of interventions to prevent early childhood caries during “task-focusing.” This qualitative exploration suggests that dyadic and triadic communication interactions are of a dynamic and cyclical quality and were exhibited during paediatric dental consultations. The communication phases of social talking, containing worries and task-focusing were evident. Successful social talking signalled the entry to containing worries and triadic treatment alliance formation which permitted the preventive goals of the consultation to be achieved (task-focusing). Future work should generate additional data to support the hypotheses created here namely that, social talking and containing worries triggers an integral pathway to task-focusing and the achievement of preventive dental goals.

Bacterial contamination of the surgical mask and forehead in aerosol-producing conservative-preventive dental treatment

Background Microbial contamination of dental professionals’ facial protective equipment and skin from aerosols and droplets generated during dental treatment has not been studied in all aspects so far. Our aim was therefore to investigate and compare treatment-related bacterial contamination of the forehead skin and surgical mask of dental practitioners. Methods We analyzed samples from 67 consecutive aerosol-producing conservative-preventive dental treatments. Sterile nylon swabs were used to collect samples from the forehead skin before and after performing treatment. Contact samples were obtained from the used surgical face masks. Samples were cultivated on agar under aerobic and anaerobic conditions. Bacteria were classified by MALDI-TOF mass spectrometry. The frequency of detection of obligate and facultative oral bacteria, as well as an increase in bacterial abundance, were examined (bacterial scoring: 0: no growth on agar; 1: <102 colonies; 2: >102 colonies; 3: dense bacterial growth). Results Bacteria were detected in 95% of the skin swabs and 76% of mask samples. Median bacterial scores were 2 for the forehead skin samples before and after treatment, and 1 for samples obtained from masks. Obligate and facultative oral bacteria were more frequent (6% and 30%) in samples from forehead skin after treatment. Samples taken from the forehead skin after treatment showed increased scores for these bacteria (28%). Five percent of samples were positive for methicillin-sensitive Staphylococcus aureus (MSSA). Obligate anaerobes were present in 3% of samples. Conclusions Although exposed during treatment, the forehead skin was significantly less contaminated with obligate oral bacteria than expected based on the surgical face mask findings. Forehead skin samples showed an increase in bacteria in the after treatment, which can be attributed to aerosol-producing procedures. We hypothesize that the forehead’s physiological skin flora may offer some protection against contamination with other microorganisms.