JDR Clinical & Translational Research最新文献

{"title":"Factors Associated with Opioid and Antibiotic Prescribing at US Academic Dental Institutions: 2011 to 2020.","authors":"S Tungare, A-I Yansane, S Gantela, K K Kookal, S McCurdy, T M Krause, S Sharma, M Walji","doi":"10.1177/23800844251320335","DOIUrl":"https://doi.org/10.1177/23800844251320335","url":null,"abstract":"<p><strong>Introduction: </strong>In the United States, dentists are one of the leading prescribers of opioids and antibiotics. Because dental schools are the training grounds for future dentists, it is crucial to understand how prescribing has changed and why these medications are being prescribed in academic settings.</p><p><strong>Objectives: </strong>The objective of this research was to describe the prescribing trends and factors associated with opioid and antibiotic medication prescribing at US academic dental institutions between 2011 and 2020.</p><p><strong>Methods: </strong>Data from electronic dental records collected through the BigMouth data repository from 9 anonymized dental institutions between 2011 and 2020 were used. Prescribing rates were defined as the percentage of patients who received an opioid/antibiotic prescription. The primary outcome was whether at least 1 opioid or antibiotic medication was prescribed at the encounter. Monotonicity and statistical significance of prescribing trends by year were assessed using the Mann-Kendall test, and a statistical analysis using an adjusted multilevel mixed-effects logistic regression model was performed to identify significant patient-, visit-, and dental provider-level factors associated with prescribing of these medications.</p><p><strong>Results: </strong>In total, 5,720,166 patient encounters from 905,426 patients had aggregate opioid and antibiotic prescribing rates of 2.0% and 2.7%, respectively, between 2011 and 2020. For both medications, a downward prescribing trend was observed from 2013, which increased in 2020. Opioid prescribing was most likely for young adults aged 15 to 24 y (odds ratio [OR] = 5.26;95% confidence interval [CI]: 4.99-5.55) and by oral surgeons (OR = 10.03; 95% CI: 8.02-12.55). Antibiotic prescribing had a higher odds for patients aged >65 y (OR = 5.04; 95% CI: 4.62-5.49) and by periodontists/implant specialists (OR = 6.21; 95% CI: 4.96-7.78). Multiple treatments at the same dental visit and pain-associated dental procedures were associated with statistically significantly higher odds of being prescribed both medications.</p><p><strong>Conclusion: </strong>There are significant differences in opioid and antibiotic prescribing by dentist specialty, patient age, whether the dental visit had multiple treatment procedures, and whether 1 or more postoperative dental pain-associated procedures were performed.Knowledge Transfer Statement:This study provides an understanding of patient-, dentist-, and visit-level factors associated with opioid and antibiotic medication prescriptions issued by clinicians at academic dental institutions in the United States. The results can contribute further to predict clinical scenarios related to the prescribing of these medications and the development of specific interventions to reduce inappropriate and excessive opioid and antibiotic medication prescribing.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251320335"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633934","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":"Assessing Teledentistry versus In-Person Examinations to Detect Dental Caries: A Systematic Review and Meta-analysis.","authors":"K Casas, L DiPede, S Toema, C Ogwo","doi":"10.1177/23800844251320974","DOIUrl":"https://doi.org/10.1177/23800844251320974","url":null,"abstract":"<p><strong>Introduction: </strong>There is no recent consensus on the effectiveness of teledentistry versus in-person examination in the diagnosis of dental caries, especially after the COVID-19 pandemic.</p><p><strong>Objective: </strong>To assess the diagnostic accuracy of teledentistry versus in-person examination for dental caries diagnosis (PROSPERO #CRD42023410962).</p><p><strong>Methods: </strong>This systematic review and meta-analysis compared the effectiveness of teledentistry versus in-person examination for dental caries diagnosis. The eligibility criteria were peer-reviewed studies published in English between January 2013 and December 2021 that reported diagnostic parameters (specificity and sensitivity) for caries detection in primary and permanent dentition. Articles were extracted using search strategies from PubMed and CINAHL databases and screened using PRISMA-DTA guidelines, following a review for quality assessment and risk of bias using the QUADAS-2 and JBI Critical Appraisal Checklists. Meta-analysis was conducted in R using the MADA package. A descriptive analysis of the sensitivity, specificity, diagnostic odds ratio, and confidence intervals was performed with respective forest plots. Heterogeneity was assessed using Cochrane <u>Q</u> and Higgins's <u>I</u>² tests. Univariate measures of diagnostic accuracy were performed based on the DerSimonian-Laird random effect and reported summary diagnostic odds ratios.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria and were reviewed and included in the meta-analysis. The diagnostic parameters ranged from 45.6% to 88.3% for sensitivity, 55.2% to 98.3% for specificity, 79% to 92% for positive predictive value, 48% to 97% for negative predictive value, and 70% to 96% for accuracy. The κ scores ranged from 0.46 to 0.89 for teledentistry modalities. Tests for equality of sensitivities and specificities were significant (<u>P</u> < 0.001). The studies were not heterogeneous with Cochran's <u>Q</u>: 14.502 (<u>P</u> = 0.206) and Higgins's <u>I</u>² of 24%. The multivariable analysis showed a diagnostic odds ratio based on the DerSimonian-Laird random effect of 35.14, which indicates that the odds of caries detection via teledentistry is 35 times more true positive (i.e., correctly identifying a positive condition) than false positive.</p><p><strong>Conclusions: </strong>Diagnosis of caries via teledentistry is effective and comparable to in-person diagnosis. Remote assessments are consistent in diagnostic accuracy for caries.Knowledge Transfer Statement:This systematic review and meta-analysis added to the evidence about using teledentistry assessment as a diagnostically accurate tool to detect dental caries. Using teledentistry dental practices could promote greater access to dental and oral health care in the absence of in-person assessment.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251320974"},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615479","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":"Bisphenol A Biomonitoring after Sealant Placement: A Prospective Cohort Study in Schoolchildren.","authors":"V Supornsilchai, L Sutthirat, I Kaewkamnerdpong, C Jantarat, N Sakorn, W Nosoongnoen, T Chaiboonyarak, L Samaranayake, S Wacharasindhu, T Porntaveetus","doi":"10.1177/23800844251320009","DOIUrl":"https://doi.org/10.1177/23800844251320009","url":null,"abstract":"<p><strong>Introduction: </strong>Bisphenol A (BPA), known for its endocrine-disrupting properties, is a concern when leaching from dental sealants. This study investigates the systemic BPA exposure following the placement of Bis-GMA-based dental sealants in Thai primary school students.</p><p><strong>Objectives: </strong>The main objective was to evaluate the changes in urinary BPA concentrations after the application of Bis-GMA dental sealants in a cohort of Thai students.</p><p><strong>Methods: </strong>In a prospective cohort of Thai primary school students participating in a voluntary sealant placement program, urinary BPA concentrations were measured at 4 time points: immediately before and on days 1, 7, and 14 after sealant application. BPA levels were measured using high-performance liquid chromatography. Repeated-measures analysis using generalized estimating equations was performed to determine the correlation between BPA concentration and time. Beta coefficient was used to estimate the mean change in BPA concentration following sealant placement. The associated cofactors were evaluated by calculating the incidence rate ratio.</p><p><strong>Results: </strong>Sixty-seven children (50.7% boys) with a mean age of 9.9 ± 1.3 years and a body mass index of 17.7 ± 4.4 kg/m² participated. On average, students had 2.9 ± 1.9 (range, 1-11) teeth with filled sealants. The median adjusted BPA levels before sealant placement and on days 1, 7, and 14 were 0.01, 0.03, 0.19, and 0.23 µg/g creatinine, respectively. The analysis showed a significant association between the number of sealed teeth and increased BPA levels at all visits.</p><p><strong>Conclusion: </strong>The application of Bis-GMA-based dental sealants in children results in low-level systemic BPA exposure due to chemical leaching. Despite such a low level of BPA exposure, approved by international health authorities, it could be considered a silent, chronic, and persistent systemic event, the long-term implications of which are yet to be deciphered.Knowledge Transfer Statement:This research shows that Bis-GMA dental sealants cause minimal bisphenol A (BPA) exposure in children, within safe international limits. However, the long-term effects are unknown. This information should inform dental care practices and guide policymakers in assessing the chronic impacts of BPA exposure from dental materials.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251320009"},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615491","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":"How Artificial Intelligence Can Revolutionize Evidence-Based Health Care: A Critical Commentary.","authors":"F Tamimi, K Jasim","doi":"10.1177/23800844251321839","DOIUrl":"https://doi.org/10.1177/23800844251321839","url":null,"abstract":"<p><p>Evidence-based medicine (EBM) enhances clinical decision-making but faces implementation challenges, particularly in dentistry, where patient-specific complexities limit its effectiveness. This article examines EBM through the lens of Aristotelian logic, exploring its use of deductive and inductive reasoning and its limitations in addressing real-world variability. We then discuss how artificial intelligence (AI) can enhance EBM by synthesizing data, automating evidence appraisal, and generating personalized treatment insights. While AI offers a promising solution, it also presents challenges related to ethics, transparency, and reliability. Integrating AI into EBM requires careful consideration to ensure precise, adaptive, and patient-centered decision-making.Knowledge Transfer Statement:This commentary provides a critical discourse on the challenges of evidence-based medicine and how artificial intelligence could help address these shortcomings.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251321839"},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604843","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":"Prenatal Dental Visits, Perceived Benefits of Oral Health, and Preterm Birth Outcome, 2009-2021.","authors":"H Lee, N Hong, T Janevic","doi":"10.1177/23800844251318698","DOIUrl":"https://doi.org/10.1177/23800844251318698","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated a significant association between maternal oral health and pregnancy complications, including preterm birth (<37 wk). However, research on the impact of dental care utilization during pregnancy on these outcomes has produced both positive and negative results.</p><p><strong>Objective: </strong>The current study investigated the association between preterm birth and dental care utilization, focusing on dental visits for cleaning during pregnancy as well as the perceived benefits of oral health during pregnancy.</p><p><strong>Methods: </strong>This secondary data analysis cross-sectional study used data from the Pregnancy Risk Assessment Monitoring System in the United States from 2009 to 2021. Descriptive and multivariate logistic regression analyses were performed to examine the association between dental variables and preterm birth.</p><p><strong>Results: </strong>The study included 399,847 women with a recent single live birth, representing 21,218,114 women across 48 states and New York City. After adjusting for factors such as race and ethnicity, age, marital status, medical insurance type, education level, adequacy of prenatal care, and other medical variables associated with preterm birth, women who had dental visits for cleaning during pregnancy had a lower odds of preterm birth (adjusted odds ratio [aOR] = 0.90, 95% confidence interval [CI] [0.86, 0.93], <i>P</i> < 0.001) compared with those who did not. A significant association between prenatal dental cleaning and reduced preterm birth was observed only among women who perceived the benefits of oral health during pregnancy (aOR = 0.93, 95% CI [0.88, 0.97], <i>P</i> = 0.002) and among non-Hispanic White women (aOR = 0.88, 95% CI [0.83, 0.93], <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This study revealed an inverse relationship between dental cleaning visits during pregnancy and preterm birth outcomes, notably among women who recognized the benefits of oral health and among non-Hispanic White women. The results emphasize the significance of dental visits and the perception of oral health benefits during pregnancy.</p><p><strong>Knowledge transfer statement: </strong>The study demonstrated an inverse association between dental visits for cleaning during pregnancy and preterm birth outcomes, with this relationship being significant among women who perceived the benefits of oral health during pregnancy and among non-Hispanic White women. These findings suggest that both the dental visits and the perception of oral health benefits may be important factors linked to preterm birth outcomes, with potential racial and ethnic variations. Policy makers and clinicians could integrate oral health care and prenatal oral health education into prenatal care as essential components of primary health care to improve both oral and overall health outcomes for women.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251318698"},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515757","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":"Dietary Factors and Dental Caries among Adolescents: Eight-Year Follow-up Study.","authors":"M Methuen, V F Kukkonen, V Anttonen, S Mikkonen, J Väistö, S Soininen, M Närhi, T A Lakka, A L Suominen, A-M Eloranta","doi":"10.1177/23800844251314856","DOIUrl":"https://doi.org/10.1177/23800844251314856","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to conduct a longitudinal investigation of the associations between changes in dietary factors and changes in caries experience among Finnish children and adolescents participating in the Physical Activity and Nutrition in Children (PANIC) study.</p><p><strong>Methods: </strong>Among 487 children included at baseline at the age of 6 to 8 y, 406 were reexamined at 2-y follow-up and 202 at 8-y follow-up. Food consumption, nutrient intake, and eating frequency were assessed using 4-d food records; diet quality was assessed using the Baltic Sea Diet Score; and eating behavior was evaluated using the Children's and Adult's Eating Behaviour Questionnaires. At baseline and 2-y follow-up, caries findings were recorded using the World Health Organization guidelines and at 8-y follow-up using the International Caries Detection and Assessment System criteria. Generalized linear mixed-effects regression analyses were used.</p><p><strong>Results: </strong>Over 8 y from childhood to adolescence, improved diet quality (β = -0.017, P = 0.046) and increased consumption of butter and butter-oil mixtures (β = -0.009, P = 0.044) were associated with decreased caries experience. Increased number of snacks (β = 0.072, P = 0.032), increased consumption of sour milk products (β = 0.001, P = 0.039) and salty snacks (β = 0.006, P = 0.010), and increased calcium intake (β = 2.41 × 10^-4, P = 0.022) were associated with increased caries experience. However, the latter association was explained by the consumption of sour milk products (β = 1.88 × 10^-4, P = 0.090). Increased enjoyment of food was associated with decreased caries experience (β = -0.121, P = 0.046), and increased slowness in eating (β = 0.113, P = 0.051) and food fussiness (β = 0.140, P = 0.009) were associated with increased caries experience.</p><p><strong>Conclusions: </strong>A healthy diet is vital for oral health among children and adolescents. Dietary behaviors developing from childhood to adolescence seem to be associated with caries experience in adolescence. Dietary counseling aimed at improving dental health from childhood to adolescence should include avoiding frequent snacking, strengthening healthy eating behavior, and composing good overall diet quality.</p><p><strong>Knowledge transfer statement: </strong>Results of this longitudinal study showed how crucial a healthy diet is for oral health among growing children. Eating behaviors and enjoyment of food play also a role in maintaining good oral health. Research results can be used when planning dietary recommendations and health education for children and adolescents.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844251314856"},"PeriodicalIF":2.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483257","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":"Quality Improvement in General Dental Practice: Situational Analysis for the United Kingdom and Germany.","authors":"C Lin, V Fehrer, L O'Malley, W Thompson, S Listl, M Lorenz, M Byrne","doi":"10.1177/23800844241306734","DOIUrl":"https://doi.org/10.1177/23800844241306734","url":null,"abstract":"<p><strong>Introduction: </strong>Quality improvement (QI) is important in ensuring standards in oral health care. Despite the growing literature on quality indicators, audit, and feedback, the perceptions and expectations of oral health professionals toward QI remain unclear. Understanding these perspectives, barriers, and facilitators is important to effectively encourage and maintain QI activities in dental practices. This is the first of 6 publications in a series titled \"Situational Analysis of QI in Oral Health Care in Europe.\"</p><p><strong>Aim: </strong>This study aimed to investigate how QI was conducted and perceived in dental practices in the United Kingdom and Germany.</p><p><strong>Methods: </strong>A situational analysis, comprising desk research and semistructured interviews, was conducted. Data collection was conducted from May to October 2023. Purposive and snowball sampling techniques were used to recruit dental practice participants in the United Kingdom and Germany. Interviews and key texts were thematically analyzed to synthesize 3 maps: a situational map, a social world map, and a positional map.</p><p><strong>Results: </strong>Eighteen participants were interviewed, comprising dentists, dental hygienists, dental therapists, dental nurses, and practice managers. The participants described 6 competing positions surrounding QI: QI activities were expressed as being worthwhile or box-ticking exercises to satisfy regulators. Some felt that QI detracted from service delivery and should not be the role of the dentist, whereas others stressed the need for a whole-team approach. Some felt that patients were important to judge quality, whereas others felt quality in dentistry required understanding of technical processes beyond the reach of patients.</p><p><strong>Conclusion: </strong>This study provided insights into how QI activities were carried out in dental practices in the United Kingdom and Germany and how it is was perceived by those working in this environment. This study offers key observations into the situations, social worlds and arenas, and positions that influence QI in dental practices.</p><p><strong>Knowledge transfer statement: </strong>The findings from this study highlight several contextual barriers and facilitators to quality improvement in general dental practice. Understanding these determinants of quality improvement is relevant for oral health teams and dental practice managers who aim to develop and implement quality improvement strategies in dental practice.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241306734"},"PeriodicalIF":2.2,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483258","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 Becoming Unemployed on Affordability of Oral Health Care among Australian Adults.","authors":"G Kaur, G Tsakos, T Yap, A Karahalios, Z Chen, A Singh","doi":"10.1177/23800844241311843","DOIUrl":"https://doi.org/10.1177/23800844241311843","url":null,"abstract":"<p><strong>Introduction: </strong>Oral health care impacts of unemployment are not well understood. This is particularly important as many people, even in high-income countries, lack publicly funded oral health care, creating a financial burden for working-age individuals. This study aims to investigate the short-term effect of becoming unemployed on affordability of oral health care among working-age Australian adults.</p><p><strong>Methods: </strong>Longitudinal data from the Household, Income and Labour Dynamics in Australia Survey facilitated analysis of those employed in 2016 and examined the effect of becoming unemployed in 2017 on affordability of oral health care in 2018, adjusted for confounding with inverse probability weighting.</p><p><strong>Results: </strong>Individuals who became unemployed were 2.95 (95% CI, 1.88 to 4.63) times more likely to not receive dental treatment when needed due to a lack of affordability as compared with individuals who remained employed (<u><i>N</i></u> = 6,529). On an absolute scale, the aforementioned difference in probability was 9% (95% CI, 3% to 15%).</p><p><strong>Discussion: </strong>Becoming unemployed had a considerable and immediate negative impact on the affordability of oral health care among working-age Australian adults. Adequate welfare support services are needed to address the immediate financial hardship and consequences that may result due to unemployment.</p><p><strong>Knowledge transfer statement: </strong>Using large population-based cohort data, we established that becoming unemployed hampers the ability to afford oral health care. Our study showed that this impact occurs within a year of unemployment, highlighting how quickly unemployment can create ripple effects for oral health care utilization, cascading into a potential lack of timely treatment or preventive therapies. Our findings highlight the need for adequate welfare support policies to address the immediate financial hardship and consequences that may result due to unemployment.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241311843"},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468167","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":"Medical Practitioners' Views on Barriers in Collaboration with Dentists in Long-Term Care Settings.","authors":"S Tada, S M Y Koh, G K Y Lee, M L Wong","doi":"10.1177/23800844241305015","DOIUrl":"10.1177/23800844241305015","url":null,"abstract":"<p><strong>Introduction: </strong>In long-term care settings (LTCs), oral health care often remains fragmented from other geriatric care services. Medical practitioners (MPs) typically take the lead in addressing medical aspects of geriatric care plans, making it essential for them to understand the importance of oral health and to collaborate with dental professionals. However, little is known about MPs' perceptions toward oral health management in LTCs. This qualitative study aimed to gain an in-depth understanding of MPs' views on oral health management in LTCs and explore challenges in collaborating with dental professionals in Singapore.</p><p><strong>Methods: </strong>Participants were recruited using a purposive sampling strategy, initially through targeted outreach to those with experience in LTCs, followed by snowball sampling to identify additional participants until data saturation was achieved. One-to-one interviews with participants were conducted via teleconferencing using a semi-structured interview guide. The transcripts were analyzed using a hybrid (inductive and deductive) thematic analysis supported by NVivo data management software.</p><p><strong>Results: </strong>Participants (n = 13) felt that oral health care was currently not well-integrated into the existing LTC system. They frequently encountered oral health issues but arranged for dental appointments only when their patients complained of acute symptoms. Key barriers identified were (1) a cultural misconception within the eldercare community that poor oral health was an inevitable part of aging, (2) systemic barriers related to the inadequate geriatric oral health care services and infrastructure, and (3) knowledge gaps in geriatric oral health management among MPs. These factors collectively hindered effective collaboration with dental professionals in LTCs.</p><p><strong>Conclusion: </strong>Participants emphasized the lack of oral health care integration in LTCs, identifying cultural, systemic, and internal barriers. Strengthening collaboration with dental professionals in LTCs, implementing oral health education for the eldercare community, and introducing domiciliary services could address these challenges and support more effective geriatric care, with insights for similar systems globally.</p><p><strong>Knowledge transfer statement: </strong>This qualitative study highlighted a critical gap in oral health care integration within eldercare described by the MPs in this study in Singapore's long-term care settings. Although findings are context specific, they may offer insights for aging nations facing similar challenges. Overcoming misconceptions about aging and oral health, improving systems, and educating MPs are key to fostering interdisciplinary collaboration and enhancing eldercare. Addressing these barriers could improve the overall well-being of care-dependent older adults.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241305015"},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391040","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 Microbiome and Dental Caries in Kenyan Children and Adolescents Living with HIV.","authors":"Y Wang, O Matangkasombut, A M Kemoli, G John-Stewart, S Benki-Nugent, J Slyker, G M Aldrovandi, A L Seminario","doi":"10.1177/23800844241311862","DOIUrl":"10.1177/23800844241311862","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study evaluates the association between the oral microbiome and the presence of untreated dental caries among Kenyan children and adolescents living with HIV (CALHIV).</p><p><strong>Methods: </strong>We collected 83 oral swab samples from CALHIV receiving medical care at Kenyatta National Hospital. We used the 16S rRNA sequencing technique on oral swab samples to profile bacterial composition. Only CALHIV with results of oral microbiome and dental examinations simultaneously were included in the further analysis. We compared the alpha and beta diversity of the oral microbiome between individuals with and without dental caries. Log-ratio LASSO regression with 2-stage estimation, 10-fold cross-validation, and adjustment for the false discovery rate was applied to select the best features that can predict caries status at the phylum level.</p><p><strong>Results: </strong>Of the 70 participants with both oral health data and oral microbiome data available, 66% had dental caries. The group with dental caries had higher Chao 1 alpha diversity (P = 0.046) but not beta diversity. Log-ratio LASSO regression had a higher ratio of paired features proteobacteria/SR1 (P = 0.0067), Euryarchaeota/SR1 (P = 0.0074), Acidobacteria/SR1 (P = 0.0079), and Fusobacteria/SR1 (P = 0.0125) at the phylum level and was significantly associated with a lower prevalence of untreated dental caries. A higher abundance of SR1 together with certain bacteria was associated with a higher prevalence of untreated dental caries.</p><p><strong>Conclusions: </strong>This is the first study to analyze the oral microbiome of CALHIV and untreated dental caries in a cohort that had received medical care since their first years of life. While this study provides information about the paired feature selection for dental caries in CALHIV on ART using cross-validation, SR1 may interact with other bacteria to increase the prevalence of untreated dental caries. Longitudinal microbiome data and samples from multiple sites in the oral cavity will be essential for understanding and confirming these findings.</p><p><strong>Knowledge transfer statement: </strong>The results of this study can help clinicians understand how SR1 interacts with other bacteria that may increase the prevalence of untreated dental caries in children and adolescents living with HIV and on long-term antiretroviral therapy. Furthermore, these findings may provide valuable insights for future research, informing longitudinal microbiome data and sampling from various sites in the oral cavity.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844241311862"},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364902","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}