What Factors Influence Dental Faculty's Willingness to Treat Pregnant Women?
BACKGROUND/UNASSIGNED:Despite evidence-based guidelines advocating for the provision of oral health care throughout pregnancy, dentists remain hesitant to provide dental treatment for pregnant women. However, little is known about attitudes toward treating pregnant women among dental school faculty, who may transmit their attitudes and treatment preferences to their students. METHODS/UNASSIGNED:We collected cross-sectional survey data at the New York University College of Dentistry, which produces 10% of all US dentists and is the largest US dental school, to understand faculty attitudes and knowledge regarding providing dental treatment to pregnant women. This study was part of an educational effort to improve dental care access by pregnant women and to examine what factors influence willingness to treat pregnant patients among dental faculty members. RESULTS/UNASSIGNED:We found that concerns about professional liability outweighed inadequate knowledge regarding treatment of pregnant patients in determining dental faculty's willingness to treat pregnant women. CONCLUSIONS/UNASSIGNED:Educational interventions delivered to dental faculty regarding current dental treatment guidelines for pregnant women may not be sufficient to increase faculty's provision of dental care to women during pregnancy. Future work to design effective interventions to increase dental treatment of pregnant women among dental faculty should address liability concerns. KNOWLEDGE TRANSFER STATEMENT/UNASSIGNED:Interventions addressing dental clinician and faculty knowledge about dental treatment for pregnant women may be insufficient to increase dental treatment among pregnant women. Instead, policy makers should consider designing, implementing, and evaluating interventions addressing malpractice and liability concerns.
Periodontitis, edentulism and glycemic control in patients with type 2 diabetes: a cross-sectional study
Objectives/UNASSIGNED:To compare the glycemic control in non-smoking patients with type 2 diabetes according to their periodontal and dental status. Research design and methods/UNASSIGNED:This cross-sectional study investigated patients previously diagnosed with type 2 diabetes and under antidiabetic medication. Clinical data and fasting blood glucose (FBG) levels were collected from medical and dental records. Patients were divided into three groups according to dental and periodontal diagnosis: no or mild periodontitis (NO/MILD, n=96), moderate or severe periodontitis (MOD/SEV, n=74) and edentulous (n=141). FBG levels were compared between groups. Logistic regression was also applied to estimate the OR of presenting hyperglycemia. Results/UNASSIGNED:Edentulous patients had significantly higher FBG levels of 155.7Â±70.9 (meanÂ±SDâ€‰mg/dL) than those in the MOD/SEV (136.6Â±33.8) and the NO/MILD (123.1Â±36.7) groups. Differences between the latter two groups were also significant. Edentulous patients had adjusted ORs of 4.53, 4.27 and 3.95 of having FBGâ‰¥126, â‰¥150 and â‰¥180â€‰mg/dL, respectively, in comparison with NO/MILD group. The MOD/SEV group also presented significant odds of having FBGâ‰¥126â€‰mg/dL (OR=2.66) and â‰¥150â€‰mg/dL (OR=2.45) than the NO/MILD group. Conclusions/UNASSIGNED:Patients in the MOD/SEV group had worse glycemic control than the ones in the NO/MILD group. However, edentulous patients presented higher glycemic levels than both dentate groups, and also presented with higher odds of having hyperglycemia.
Four or More Amalgam Fillings Correlate With Higher Blood Mercury Levels in Pregnant Women but Not High Enough to be of Health Concern
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Dental associations with blood mercury in pregnant women. Golding J, Steer CD, Gregory S, Lowery T, Hibbeln JR, Taylor CM. Community Dent Oral Epidemiol 2016; 44: 216-22. SOURCE OF FUNDING: This study was funded by a combination of government (UK Medical Research Council), foundation/nonprofit (the Welcome Trust) and university (University of Bristol, UK) grants. TYPE OF STUDY/DESIGN: Cross-sectional.
Addressing Health Disparities via Coordination of Care and Interprofessional Education: Lesbian, Gay, Bisexual, and Transgender Health and Oral Health Care
Lesbian, gay, bisexual, and transgender (LGBT) persons are a diverse group, but they share a common need for competent, accessible health care, dispensed without intolerance and with an understanding of their unique health needs. Dental practitioners need to understanding that LGBT persons have distinctive health (and oral health) needs. This article reviews the literature on oral and overall health of LGBT persons in the United States, and discusses ways in which dentists can improve the health care they provide to this vulnerable population, including how interprofessional education and collaborative practice may help to reduce oral health disparities within this group.
Views of Dental Providers on Primary Care Coordination at Chairside: A Pilot Study
PURPOSE/OBJECTIVE:There is a need for research to facilitate the widespread implementation, dissemination and sustained utilization of evidence-based primary care screening, monitoring and care coordination guidelines, thereby increasing the impact of dental hygienists' actions on patients' oral and general health. The aims of this formative study are to explore dental hygienists' and dentists' perspectives regarding the integration of primary care activities into routine dental care, and assess the needs of dental hygienists and dentists regarding primary care coordination activities and use of information technology to obtain clinical information at chairside. METHODS:This qualitative study recruited 10 dental hygienists and 6 dentists from 10 New York City area dental offices with diverse patient mixes and volumes. A New York University faculty dental hygienist conducted semi-structured, in-depth interviews, which were digitally recorded and transcribed verbatim. Data analysis consisted of multilevel coding based on the Consolidated Framework for Implementation Research, resulting in emergent themes with accompanying categories. RESULTS:The dental hygienists and dentists interviewed as part of this study do not use evidence-based guidelines to screen their patients for primary care sensitive conditions. Overwhelmingly, dental providers believe that tobacco use and poor diet contribute to oral disease, and report using electronic devices at chairside to obtain web-based health information. CONCLUSION/CONCLUSIONS:Dental hygienists are well positioned to help facilitate greater integration of oral and general health care. Challenges include lack of evidence-based knowledge, coordination between dental hygienists and dentists, and systems-level support, with opportunities for improvement based upon a theory-driven framework.
Oral health knowledge and dental care utilization in pregnant women
[S.l. : NYU College of Dentistry], 2016
Toward Implementing Primary Care at Chairside: Developing a Clinical Decision Support System for Dental Hygienists
INTRODUCTION: The goal of this project was to use the Consolidated Framework for Implementation Research (CFIR) as the theoretical foundation for developing a web-based clinical decision support system (CDSS) for primary care screening and care coordination by dental hygienists at chairside. METHODS: First, we appraised New York State education and scope of practice requirements for dental hygienists with input from health experts who constituted a Senior Advisory Board for the project, and reviewed current professional guidelines and best practices for tobacco use, hypertension and diabetes screening, and nutrition counseling at chairside. Second, we created algorithms for these four health issues (tobacco, hypertension, diabetes, and nutrition) using evidence-based guidelines endorsed by authoritative professional bodies. Third, an information technology specialist incorporated the algorithms into a tool using an iterative process to refine the CDSS, with input from dental hygienists, dentists, Senior Advisory Board members and research staff. RESULTS: An evidence-based CDSS for use by dental hygienists at chairside for tobacco use, hypertension and diabetes screening, and nutrition counseling was developed with the active participation of the individuals involved in the implementation process. CONCLUSIONS: CDSS technology may potentially be leveraged to enhance primary care screening and coordination by dental hygienists at chairside, leading to improved patient care. Using the CFIR as a pragmatic structure for implementing this intervention across multiple settings, the developed CDSS is available for downloading and adaptation to diverse dental settings and other primary care sensitive conditions.
Views Of Dental Providers On Primary Care Coordination
[New York NY : NYU College of Dentistry. NYU Academy of Distinguished Educators], 2015
Interprofessional Education and Practice : A Concept Whose Time Has Come [Editorial]
Pregnancy is associated with various degrees of increased gingival inflammation in healthy women
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review. Figuero E, Carrillo-de-Albornoz A, Martin C, Tobias A, Herrera D. J Clin Periodontol 2013;40(5):457-73. REVIEWER: Stefanie L. Russell, DDS, MPH, PhD PURPOSE/QUESTION: How large an effect does pregnancy have on gingival inflammation in healthy pregnant women? SOURCE OF FUNDING: This work was supported by a non-profit group: the Spanish Society on Periodontology (SEPA), a member group of the European Federation of Periodontology, one of the largest dental organizations in Europe TYPE OF STUDY/DESIGN: Systematic review with meta-analysis LEVEL OF EVIDENCE: Level 1: Good-quality, patient-oriented evidence STRENGTH OF RECOMMENDATION GRADE: Grade B: Inconsistent or limited-quality patient-oriented evidence.