JDR Clinical & Translational Research最新文献

{"title":"Benefits of Dental Scaling and Polishing in Adults: A Rapid Review and Evidence Synthesis.","authors":"D C Matthews, H Al-Waeli","doi":"10.1177/23800844241271684","DOIUrl":"https://doi.org/10.1177/23800844241271684","url":null,"abstract":"<p><strong>Background: </strong>This rapid review assessed evidence to inform policy on the clinical effectiveness and optimal frequency of dental scaling and polishing (S&P) for adults, including those with low incomes eligible for the Canadian Dental Care Plan.</p><p><strong>Methods: </strong>A rapid review was conducted according to Cochrane Recommendations for Rapid Reviews. Populations included all adults, adults with periodontitis, and those with inequitable access to dental care. Primary outcomes included gingival inflammation, probing depths, and tooth loss. Secondary outcomes included oral health-related quality of life and economic impact. Four databases were searched for randomized clinical trials, systematic reviews, cohort studies, and practice guidelines. Risk of bias was evaluated using Cochrane Risk of Bias, Newcastle-Ottawa, ROBIS, and AGREE II tools. A qualitative synthesis was planned.</p><p><strong>Results: </strong>In total, 3,181 references were retrieved: 4 applied to \"all adults\" and 4 to those with periodontitis. All reports had low risk of bias. One systematic review and one multicenter trial of adults with regular dental care found no clinical benefit regardless of S&P interval; however, patients valued and were willing to pay for regular scaling. One claims-based study reported regular S&P reduced tooth loss, and 2 clinical practice guidelines found a reduced risk of future attachment and tooth loss, lower overall health care costs for diabetes, and reduced costs for and incidence of acute myocardial infarction in those with regular S&P. There were no studies of underserved populations.</p><p><strong>Conclusions: </strong>For adults with no or early periodontal disease and regular access to dental care, routine S&P may have little clinical benefit but reduces tooth loss and some health care expenses. In patients with periodontitis, scaling intervals tailored to individual risk profile and periodontal status can maintain health. There is no evidence on the impact of routine S&P on patients with barriers accessing care.</p><p><strong>Knowledge transfer statement: </strong>In terms of the benefits of routine scaling and polishing in adults, this rapid review found mixed evidence with a high level of certainty due to minimal risk of bias in the appraised studies for \"regular dental attenders\" and those with a diagnosis of periodontal diseases. Tailored intervals for dental scaling are beneficial for those diagnosed with periodontitis but may not provide the clinical benefits previously expected for adults at low risk. There is no evidence that dental polishing is effective. No evidence was found to support recommendations about the clinical effectiveness of scaling or the most appropriate recall intervals for scaling for low-income Canadians eligible for dental services under the new Canadian Dental Care Plan.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241271684"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered Surrogate Markers of Inflammation in Perinatal HIV-Exposed Children with Caries.","authors":"N L Idemudia, E Osagie, P Akhigbe, O Obuekwe, A Omoigberale, V Richards, M O Coker","doi":"10.1177/23800844241280729","DOIUrl":"https://doi.org/10.1177/23800844241280729","url":null,"abstract":"<p><strong>Objective: </strong>Dental caries is associated with immunologic response, yet its association with hematologic parameters and inflammatory markers is unclear. This study aimed to examine the relationship between some surrogate markers of inflammation and dental caries in the context of perinatal exposure to human immunodeficiency virus (HIV).</p><p><strong>Methods: </strong>This cross-sectional study involved 2 groups of children aged 4 to 11 y who were (1) HIV exposed but uninfected (HEU) and (2) HIV unexposed/uninfected (HUU) and recruited from HIV pediatric and child outpatient clinics, respectively, at a tertiary health facility in Nigeria. Medical records were reviewed, and trained dentists conducted oral and dental examinations. Five milliliters of EDTA blood was obtained and used for CD4 and CD8 and complete blood analysis, from which other inflammatory markers such as the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic inflammatory index (SII), CD4/CD8 ratio were calculated using referenced formulas.</p><p><strong>Results: </strong>In total, 245 (125 HEU and 120 HUU) children with a mean (standard deviation) age of 7 (2) y were included in this study. No differences in caries experience were observed in both groups of children (38 children [16%] were caries affected; 19 [16%] and 19 [15%] from the HEU and HUU groups, respectively). Examining the relationship between studied inflammatory markers and caries showed that leucocyte counts were slightly lower in caries-affected children compared with their caries-free counterparts (<i>P</i> = 0.05). Lower levels of neutrophils (<i>P</i> = 0.04) and higher levels of lymphocytes (<i>P</i> = 0.02) were associated with caries prevalence. Although not significant, NLR, PLR, and SII were lower in caries-affected children.</p><p><strong>Conclusion: </strong>Caries is associated with leucocytes and some of its subsets in both groups of children and independent of perinatal HIV exposure, highlighting the potential of evaluating inflammatory markers in caries prevention, treatment, and research.</p><p><strong>Knowledge transfer statement: </strong>This study provides evidence that a relationship exists between dental caries, HIV exposure, and inflammation using affordable methods and advocates the inclusion of these markers in caries care in resource-limited settings.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241280729"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Electrical Stimulation of Lingual Nerve on Xerostomia: A Randomized Controlled Trial.","authors":"K Xu, S Ma, S Jia, L Chen, J Wei, Q Liu, M Tian, Z Ji, Y Dong, X Wang, F R Tay, T Zhang, K Jiao, L Niu","doi":"10.1177/23800844241277099","DOIUrl":"https://doi.org/10.1177/23800844241277099","url":null,"abstract":"<p><strong>Introduction: </strong>Xerostomia is a subjective sensation of dry mouth affecting millions of people worldwide. Current management has limitations, often causing side effects. This study aims to investigate whether electrical stimulation of the lingual nerve could offer effective relief for xerostomia sufferers.</p><p><strong>Methods: </strong>Eligible participants were randomly assigned (1:1) to either the experimental or sham group, receiving electrical stimulation of the lingual nerve (<u>n</u> = 24) or sham stimulation (<u>n</u> = 23) for 12 wk. The primary outcome is the changes in xerostomia score using a 100-mm visual analog scale throughout the therapy. Participants assessed their dryness and assigned corresponding scores, with lower scores indicating more severe dry mouth. Secondary outcomes included remission rate in dry mouth frequency, changes in stimulated/unstimulated salivary flow rate (SSFR/USFR), and changes in Oral Health Impact Profile-14 (OHIP-14) questionnaire scores, where higher scores indicate greater impact on oral quality of life.</p><p><strong>Results: </strong>At week 12, the electrical stimulation group showed greater improvement in xerostomia score compared to the sham group, with a mean between-group difference of 13.8 (95% confidence interval [CI], 10.0-17.6). The therapeutic effect of electrical stimulation was also confirmed by secondary outcomes. The remission rate of dry mouth was higher at 12 wk in the electrical stimulation group (61.9% [95% CI, 40.9%-79.3%] vs. 28.6% [95% CI, 13.8%-50.0%]). Participants in the electrical stimulation group also experienced a greater increase in USFR, with a mean difference of 14.5 (6.1-23.0) μL/min. Moreover, they exhibited significant improvement in OHIP-14 score after 12 wk of therapy, with a mean between-group difference of -10.0 (-13.9 to -6.2). No significant difference was observed between the 2 groups for SSFR (<u>P</u> = 0.702).</p><p><strong>Conclusions: </strong>Electric stimulation offers promise as a noninvasive, nonpharmacological strategy for the management of xerostomia. Further research is needed to understand its long-term effectiveness, optimal parameters, and underlying mechanisms.</p><p><strong>Knowledge transfer statement: </strong>The study confirmed that electrical stimulation of the lingual nerve is a promising noninvasive and nonpharmacological modality for relief of xerostomia.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241277099"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Disease and Atherosclerosis May Be Associated with Overlapping Metabolic Pathways.","authors":"M Bezamat, A Saeed, C McKennan, J Duan, R Zhou, D J Baxter, L Liu, L de Las Fuentes, B Foxman, J R Shaffer, D W McNeil, M L Marazita, S E Reis","doi":"10.1177/23800844241280383","DOIUrl":"10.1177/23800844241280383","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Dental caries and periodontitis are among the most prevalent chronic diseases worldwide and have been associated with atherosclerotic cardiovascular diseases (ASCVD). This study aimed to determine (1) the independent associations between subclinical ASCVD markers (carotid intima media thickness [CIMT] and coronary artery calcification [CAC]) and quantitative indices of oral disease including the decayed, missing, and filled teeth (DMFT) index, gingivitis parameters, periodontal status, and number of teeth lost and (2) the extent to which metabolites altered in individuals with oral disease overlapped with those altered in individuals with ASCVD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used data from 552 participants recruited through the Dental Strategies Concentrating on Risk Evaluation project. Oral examinations were conducted, and CIMT and CAC were measured. Multiple linear regression models were constructed with CIMT and CAC as dependent variables in the epidemiologic analysis. In the metabolomic analysis, logistic or linear regression was used to test 1,228 metabolites for association with each phenotype adjusted for age, sex, race, blood pressure, smoking, diabetes, cholesterol, high-sensitivity C-reactive protein, and interleukin-6.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;None of the oral disease markers were significant predictors of ASCVD markers in the fully adjusted models. However, critical lipid and lipid-signaling pathway metabolites were significantly associated with gingivitis, periodontitis, and DMFT: the lysophospholipid pathway (odds ratio [OR] = 2.29, false discovery rate [FDR]-adjusted &lt;i&gt;P&lt;/i&gt; = 0.038) and arachidonate with gingivitis (OR = 2.35, FDR-adjusted &lt;i&gt;P&lt;/i&gt; = 0.015), the sphingolipid metabolism pathway with periodontitis (OR = 2.09, FDR-adjusted &lt;i&gt;P&lt;/i&gt; = 0.029), and borderline associations between plasmalogen and lysophospholipid pathways and DMFT (P = 0.055). Further, the same metabolite from the sphingolipid metabolism pathway, sphingomyelin (d17:1/14:0, d16:1/15:0), was inversely associated with both CIMT (β = -0.14, FDR-adjusted P = 0.014) and gingivitis (OR = 0.04, FDR-adjusted &lt;i&gt;P&lt;/i&gt; = 0.033).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The discovery of a common sphingomyelin metabolite in both disease processes is a novel finding suggesting that gingivitis and periodontitis may be associated with some overlapping metabolic pathways associated with ASCVD and indicating potential shared mechanisms among these diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Knowledge transfer statement: &lt;/strong&gt;The same metabolites may be altered in atherosclerosis and oral disease. Specifically, a common sphingomyelin metabolite was inversely associated with gingivitis and carotid intima media thickness, a subclinical marker of atherosclerotic cardiovascular disease. These findings can provide valuable insights for future mechanistic studies to establish potential causal relationships, with the hope of influencing disease prevention ","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241280383"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontitis and Metabolic Control of Adults with Type 1 Diabetes.","authors":"A Jeftha, A Suliman, M Conradie-Smit, F Kimmie-Dhansay","doi":"10.1177/23800844241273858","DOIUrl":"10.1177/23800844241273858","url":null,"abstract":"<p><strong>Introduction: </strong>Periodontitis has been reported with increased incidence and prevalence in patients with diabetes mellitus (DM). Noncommunicable diseases burden the South African public health system, and there are no data reporting on this relationship in this population. This is required to inform management protocols in type 1 diabetes mellitus (T1DM), which currently exclude the importance of periodontal treatment.</p><p><strong>Objectives: </strong>The aim of this study was to determine whether there was an association between periodontitis and the glycemic control of adult patients with T1DM at a tertiary institution in South Africa.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on adults diagnosed with T1DM. Bleeding on probing, periodontal pocket depth, and radiographical bone loss were assessed and the periodontal status of the patient was compared to their glycemic control, measured by HbA1c. An HbA1c level of ≤7% was considered to indicate adequate glycemic control.</p><p><strong>Results: </strong>There were 120 adult participants, of whom 61.7% (74) were female and 38.3% (46) were male. The majority were nonsmokers and younger than 44 y. There were 78 (65%) participants with uncontrolled blood glucose and 42 (35%) with good control (HbA1c ≤ 7%). The median HbA1c level was 8.75 (range, 6.1 to 12.2). Most participants (94%) had periodontitis, and 97% of them had uncontrolled blood glucose.</p><p><strong>Conclusion: </strong>There was an association between percentage bleeding score (P < 0.001) and metabolic control in adults with T1DM treated at a tertiary hospital in Cape Town, South Africa. Periodontitis severity as described by staging was not associated with T1DM in this sample. The high prevalence of periodontitis in this sample (94%) highlights the need for periodontal management to form a part of holistic patient care in patients with T1DM in this setting.</p><p><strong>Knowledge transfer statement: </strong>The study results highlight the role of periodontitis severity and gingival bleeding scores on the metabolic control of adults with T1DM and thus emphasizes the importance of periodontal care in whole-person health in this patient population.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":"9 1_suppl","pages":"6S-12S"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward a Comprehensive Model of Medical-Dental-Behavioral Integration.","authors":"D W McNeil, D B Pereira, O S Ensz, K Lukose, G Harrell, D B Feller","doi":"10.1177/23800844241273836","DOIUrl":"10.1177/23800844241273836","url":null,"abstract":"<p><strong>Introduction: </strong>Existing models of medical-dental integration, as well as those from behavioral health care integrated with primary medical treatment, provide a basis for a truly synthesized and expanded model incorporating medical, dental, and behavioral components. Such a comprehensive model allows for collaborative health care serving patients seamlessly without disciplinary silos, promoting optimal whole-person health. This innovative approach is consistent with recent developments in the behavioral and social oral health sciences that include an imperative for their full inclusion in dental health care, research, and education.</p><p><strong>Methods: </strong>Existing models of medical-dental integration are described, along with current models from integrated primary medical and behavioral health care. Using these existing approaches as a basis, a new multilevel model is proposed to include social and cultural determinants of health.</p><p><strong>Results: </strong>Contemporary approaches to providing health care across disciplines include referral to a geographically separate entity, co-location of services, and integrated, side-by-side care. Integration of electronic health records and interoperability are necessary (but not sufficient) factors that affect transdisciplinary health care. Effective communication among health care providers and the need for interprofessional education, comprehensive training, and ongoing cross-disciplinary consultation also are noted as crucial factors in truly collaborative care. Evidence for existing models varies greatly depending on the target population and type of services provided.</p><p><strong>Conclusions: </strong>A fully integrated, transdisciplinary model of health care is possible, theoretically and practically. Combining aspects of extant integrated models and extending them provides opportunity for a greater focus on systemic factors and more emphasis on prevention. Consistent with this new model, medical and dental home concepts can be expanded to that of a person-centered health care home that includes interprofessional practice. This transdisciplinary approach contributes to greater health equity given the multilevel approach. Multidirectional integration of diverse disciplines representing the various realms of medicine, dentistry, and behavioral health care is essential for optimal health of all.</p><p><strong>Knowledge transfer statement: </strong>This article can be used by clinicians, scientists, administrators, and policy makers in developing and implementing integrated systems of care that provide for patients' medical, dental, and behavioral health needs.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":"9 1_suppl","pages":"23S-31S"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes toward Adolescent Mental Health Screening in a Dental Setting: A Mixed-Methods Study.","authors":"S Ticku, S Nath, N Ramesh, C A Riedy","doi":"10.1177/23800844241273775","DOIUrl":"10.1177/23800844241273775","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents have experienced increasing levels of anxiety (AD) and depressive disorders (DD) in recent years. This study assessed the current attitudes of pediatric dentists and orthodontists on incorporating screenings for mental health disorders for their adolescent patients.</p><p><strong>Methods: </strong>A sequential mixed-methods approach was used. A 35-item survey was sent to 5,538 pediatric dentists and orthodontists that included questions about attitudes and current screening practices for AD and DD. Multivariate logistic regression analysis was performed to examine factors associated with dentists' willingness to incorporate screening and discuss results with patients for AD and DD. Subsequently, we interviewed 16 orthodontists and pediatric dentists, conducted thematic analysis, and identified themes and subthemes.</p><p><strong>Results: </strong>Based on 305 responses, >80% of respondents viewed screening for AD and DD as important, but <15% conducted screenings for them. Moreover, for those not screening, the odds of future screening for AD (odds ratio [OR]: 0.18, confidence interval [CI]: 0.08-0.43) and DD (OR: 0.23; CI: 0.09-0.56) were lower as the perceived importance of screening increased. Their willingness to screen for both AD (OR: 0.26, CI: 0.08-0.82) and DD (OR: 0.18, CI: 0.05-0.71) was also lower if they perceived this to negatively affect their patients' perception of them. The thematic analysis identified 3 main themes: (1) provider attitudes around mental health, (2) barriers to incorporating mental health screening, and (3) opportunities to integrate screening. Barriers included lack of training, access to mental health resources, and provider and patient stigma.</p><p><strong>Conclusions: </strong>Our study showed that while most pediatric dentists and orthodontists understand the importance of screening their adolescent patients for AD and DD, many are unlikely to conduct screenings in the future. Obstacles such as inadequate training and stigma must be addressed for wider adoption. Further research and initiatives are crucial to tackle these challenges.</p><p><strong>Knowledge transfer statement: </strong>The findings of this study offer insights to clinicians and policy makers into the attitudes, barriers, and facilitators among dentists-specifically pediatric dentists and orthodontists-who regularly treat adolescent patients, regarding mental health screenings for these individuals. This information can guide the development of initiatives, policy changes, and future research aimed at creating a more integrated dental care system that emphasizes the overall health of adolescent patients.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":"9 1_suppl","pages":"70S-87S"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Surgical Activity in Hospitals during COVID-19: A Nationwide Observational Cohort Study.","authors":"J Booth, A J Fowler, R Pearse, P Dias, Y I Wan, R Witton, T E F Abbott","doi":"10.1177/23800844231216356","DOIUrl":"10.1177/23800844231216356","url":null,"abstract":"<p><strong>Introduction: </strong>The number of surgical extractions performed in hospitals in England remains unclear. This study reports the volume of surgical extractions conducted in hospitals and change in activity during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We conducted a nationwide observational cohort study using Hospital Episode Statistics (HES) in England for patients undergoing surgical removal of a tooth (defined using OPSC-4 code F09) between April 1, 2015, and December 31, 2020. Procedures were stratified by age, gender, and urgency (elective or nonelective), reported using descriptive statistics, number, and percentage. We conducted post hoc modeling to predict surgical activity to December 2023. In addition, we contrasted this with aggregate national data on simple dental extraction procedures and drainage of dental abscesses in hospital as well as dental activity in general practice.</p><p><strong>Results: </strong>We identified a total of 569,938 episodes for the surgical removal of a tooth (females 57%). Of these, 493,056/569,938 (87%) were for adults and 76,882/569,938 (13%) children ≤18 years. Surgical extractions were most frequent in adult females. Elective cases accounted for 96% (<i>n</i> = 548,805/569,938) of procedures. The median number of procedures carried out per quarter was 27,256, dropping to 12,003 during the COVID-19 pandemic, representing a 56% reduction in activity. This amounted to around 61,058 cancelled procedures. Modeling predicts that this activity has not returned to prepandemic levels.</p><p><strong>Conclusions: </strong>The number of surgical extractions taking place in hospitals during the pandemic fell by 56%. The true impact of this reduction is unknown, but delayed treatment increases the risk of complications, including life-threatening infections.</p><p><strong>Knowledge transfer statement: </strong>The result of this study provides an evidence-based overview of the trends relating to surgical extractions of teeth in England taking place in hospitals. This information can be used to inform service and workforce planning to meet the needs of patients requiring surgical extractions. The data also provide an insight into the oral health needs of the population in England.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"387-397"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139080576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Accessing Primary Dental Care in Adults with Alcohol Dependence: A Qualitative Study.","authors":"C Bowes, M Breckons, R D Holmes, J Durham, B K Bareham","doi":"10.1177/23800844231169642","DOIUrl":"10.1177/23800844231169642","url":null,"abstract":"<p><strong>Background: </strong>People with alcohol dependence (AD) frequently experience oral health problems, but their dental attendance is poor, with limited evidence to the reasons why from their perspective.</p><p><strong>Objective: </strong>To explore perceived barriers, motivators, and facilitators to accessing primary dental care in people with AD.</p><p><strong>Methods: </strong>Qualitative study consisting of remote one-to-one and group semistructured interviews with a convenience sample of adults with lived experience of AD in northern England. Data were audio-recorded, transcribed, and coded. A reflexive thematic analysis method was used; use of COM-B model informed data interpretation.</p><p><strong>Results: </strong>Twenty adults with lived experience of AD participated in 18 one-to-one interviews and 1 group interview (of 3 participants). Barriers to access were fear and physical, social, and environmental factors (physical effects of AD, financial barriers, nonprioritization of oral health). Motivators to access were pain and prioritization of oral health. Facilitators to access were patterns of alcohol use (i.e., sobriety) and dental service provision within recovery services.</p><p><strong>Conclusions: </strong>Fear of \"the dentist\" is a major barrier to accessing dental care, and pain is the primary motivator, among people with AD, although neither are unique to this population. Fear and physical, social, and environmental barriers to access contribute to problem-oriented attendance, which negatively affect oral health outcomes. Opportunity to facilitate attendance increases when a person is in remission from AD through their physical capabilities improving. Increasing capability and opportunity can influence attendance beyond the automatic motivation of pain. Provision of dental care within recovery services could facilitate access to care. Understanding the \"web of causation\" is key to developing any intervention to improve dental access in people with AD. Further research is needed from the perspective of other adult populations with lived experience of AD, as well as of dental professionals, to gain deeper insight into barriers, facilitators, and possible solutions.</p><p><strong>Knowledge transfer statement: </strong>\u0000 <i>The results of this study can help dental professionals understand factors affecting access to primary care in people with alcohol dependence to provide knowledge that may reduce stigma surrounding the disease. Results also demonstrate areas for intervention development for public policy.</i>\u0000 </p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"325-336"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical-Dental-Behavioral Integration: Embracing Whole-Person Health in Research and Practice.","authors":"L J Heaton, T Tiwari, E P Tranby","doi":"10.1177/23800844241273799","DOIUrl":"10.1177/23800844241273799","url":null,"abstract":"<p><strong>Knowledge transfer statement: </strong>The goal of this editorial and following supplement articles is to present different perspectives on the implementation of medical-dental-behavioral integration to provide comprehensive, whole-person care. Through a discussion of barriers to and opportunities that emerge from this type of integrated care, this editorial and supplement provide strong evidence for the importance, feasibility, and necessity of integrated health care and concept of overall health.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":"9 1_suppl","pages":"3S-5S"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}