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  Subjects -> MEDICAL SCIENCES (Total: 6925 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (178 journals)
    - ANAESTHESIOLOGY (78 journals)
    - CARDIOVASCULAR DISEASES (275 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (19 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (188 journals)
    - DENTISTRY (230 journals)
    - DERMATOLOGY AND VENEREOLOGY (132 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (82 journals)
    - ENDOCRINOLOGY (128 journals)
    - EXPERIMENTAL MEDICINE, LABORATORY TECHNIQUE (80 journals)
    - FORENSIC SCIENCES (30 journals)
    - GASTROENTEROLOGY (149 journals)
    - GERONTOLOGY AND GERIATRICS (114 journals)
    - HEMATOLOGY (132 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (117 journals)
    - MEDICAL GENETICS (58 journals)
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    - OBSTETRICS AND GYNECOLOGY (164 journals)
    - ONCOLOGY (323 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (114 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (116 journals)
    - OTORHINOLARYNGOLOGY (60 journals)
    - PATHOLOGY (95 journals)
    - PEDIATRICS (224 journals)
    - PHYSICAL MEDICINE AND REHABILITATION (122 journals)
    - PSYCHIATRY AND NEUROLOGY (689 journals)
    - RADIOLOGY AND NUCLEAR MEDICINE (164 journals)
    - RESPIRATORY DISEASES (82 journals)
    - RHEUMATOLOGY (58 journals)
    - SPORTS MEDICINE (66 journals)
    - SURGERY (308 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (127 journals)

DENTISTRY (230 journals)                  1 2     

Showing 1 - 0 of 0 Journals sorted alphabetically
Ação Odonto     Open Access  
Acta Biomaterialia Odontologica Scandinavica     Open Access  
Acta Odontológica Colombiana     Open Access  
Acta Odontologica Scandinavica     Hybrid Journal   (Followers: 3)
Acta Odontologica Turcica     Open Access  
Actas Odontológicas     Open Access  
Actualités Odonto-Stomatologiques     Open Access   (Followers: 3)
Advances in Dental Research     Hybrid Journal  
Angle Orthodontist     Open Access   (Followers: 3)
Annals of Periodontology     Full-text available via subscription   (Followers: 2)
Annals of the Royal Australasian College of Dental Surgeons     Full-text available via subscription   (Followers: 3)
APOS Trends in Orthodontics     Open Access  
Australian Dental Journal     Hybrid Journal   (Followers: 3)
Australian Endodontic Journal     Hybrid Journal   (Followers: 2)
Avances en Odontoestomatologia     Open Access  
Avances en Periodoncia e Implantología Oral     Open Access   (Followers: 1)
Avicenna Journal of Dental Research     Open Access  
Bangladesh Journal of Dental Research & Education     Open Access  
Bangladesh Journal of Orthodontics and Dentofacial Orthopedics     Open Access   (Followers: 1)
Brazilian Dental Journal     Open Access   (Followers: 2)
Brazilian Dental Science     Open Access  
Brazilian Journal of Oral Sciences     Open Access   (Followers: 1)
Brazilian Oral Research     Open Access  
British Dental Journal     Hybrid Journal   (Followers: 13)
Bulletin du Groupement International pour la Recherche Scientifique en Stomatologie et Odontologie     Open Access  
Canadian Journal of Dental Hygiene     Full-text available via subscription  
Caries Research     Full-text available via subscription   (Followers: 1)
Case Reports in Dentistry     Open Access   (Followers: 3)
City Dental College Journal     Open Access   (Followers: 1)
Cleft Palate-Craniofacial Journal     Hybrid Journal   (Followers: 7)
Clínica e Pesquisa em Odontologia - UNITAU     Open Access  
Clinical Advances in Periodontics     Full-text available via subscription   (Followers: 4)
Clinical and Experimental Dental Research     Open Access  
Clinical and Laboratorial Research in Dentistry     Open Access   (Followers: 1)
Clinical Implant Dentistry and Related Research     Hybrid Journal   (Followers: 7)
Clinical Oral Implants Research     Hybrid Journal   (Followers: 5)
Clinical Oral Investigations     Hybrid Journal   (Followers: 1)
Clinical, Cosmetic and Investigational Dentistry     Open Access   (Followers: 4)
Community Dentistry and Oral Epidemiology     Hybrid Journal   (Followers: 2)
Contemporary Clinical Dentistry     Open Access   (Followers: 3)
Critical Reviews in Oral Biology Medicine     Hybrid Journal   (Followers: 1)
Current Oral Health Reports     Hybrid Journal  
Current Research in Dentistry     Open Access   (Followers: 6)
Dental Abstracts     Full-text available via subscription   (Followers: 2)
Dental Cadmos     Partially Free   (Followers: 1)
Dental Clinics of North America     Full-text available via subscription   (Followers: 4)
Dental Forum     Open Access  
Dental Hypotheses     Open Access   (Followers: 3)
Dental Materials     Full-text available via subscription   (Followers: 7)
Dental Press Journal of Orthodontics     Open Access   (Followers: 2)
Dental Protection Annual Review     Full-text available via subscription   (Followers: 1)
Dental Research Journal     Open Access   (Followers: 6)
Dental Traumatology     Hybrid Journal   (Followers: 4)
Dentistry     Open Access  
Dentistry 3000     Open Access  
Dentistry and Medical Research     Open Access  
Dentistry Journal     Open Access   (Followers: 3)
Dentomaxillofacial Radiology     Full-text available via subscription   (Followers: 3)
Der Freie Zahnarzt     Hybrid Journal  
der junge zahnarzt     Hybrid Journal  
Die Quintessenz     Full-text available via subscription  
Disease-a-Month     Full-text available via subscription   (Followers: 5)
Droit et Médecine Bucco-Dentaire     Full-text available via subscription   (Followers: 1)
ENDO     Full-text available via subscription   (Followers: 6)
Endodontic Topics     Hybrid Journal   (Followers: 2)
Endodontie     Full-text available via subscription  
European Archives of Paediatric Dentistry     Hybrid Journal   (Followers: 1)
European Journal of Dental Education     Hybrid Journal   (Followers: 1)
European Journal of Dentistry     Full-text available via subscription   (Followers: 2)
European Journal of Dentistry and Medicine     Open Access   (Followers: 2)
European Journal of Esthetic Dentistry     Full-text available via subscription   (Followers: 4)
European Journal of General Dentistry     Open Access   (Followers: 1)
European Journal of Oral Implantology     Full-text available via subscription   (Followers: 8)
European Journal of Oral Sciences     Hybrid Journal   (Followers: 1)
European Journal of Orthodontics     Hybrid Journal   (Followers: 4)
European Journal of Prosthodontics     Open Access  
Evidence Based Summaries in Dentistry     Full-text available via subscription   (Followers: 1)
Evidence-Based Dentistry     Full-text available via subscription   (Followers: 4)
Faculty Dental Journal     Full-text available via subscription   (Followers: 1)
Implant Dentistry     Full-text available via subscription   (Followers: 5)
Implantologie     Full-text available via subscription   (Followers: 3)
Indian Journal of Dental Research     Open Access   (Followers: 4)
Indian Journal of Dentistry     Open Access   (Followers: 1)
Indian Journal of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian Journal of Oral Health and Research     Open Access  
Indian Journal of Oral Sciences     Open Access   (Followers: 1)
Informationen aus Orthodontie & Kieferorthopädie     Hybrid Journal  
International Dental Journal     Hybrid Journal   (Followers: 1)
International Endodontic Journal     Hybrid Journal   (Followers: 1)
International Journal of Computerized Dentistry     Full-text available via subscription   (Followers: 3)
International Journal of Dental Hygiene     Hybrid Journal   (Followers: 2)
International Journal of Dental Research     Open Access   (Followers: 2)
International Journal of Dental Science and Research     Full-text available via subscription  
International Journal of Dental Sciences and Research     Open Access   (Followers: 1)
International Journal of Dentistry     Open Access   (Followers: 6)
International Journal of Implant Dentistry     Open Access  
International Journal of Odontostomatology     Open Access   (Followers: 1)
International Journal of Oral & Maxillofacial Implants     Full-text available via subscription   (Followers: 9)
International Journal of Oral & Maxillofacial Pathology     Open Access   (Followers: 5)
International Journal of Oral Health Sciences     Open Access  
International Journal of Oral Science     Open Access   (Followers: 1)
International Journal of Paediatric Dentistry     Hybrid Journal   (Followers: 2)
International Journal of Periodontics & Restorative Dentistry     Full-text available via subscription   (Followers: 9)
International Journal of Prosthodontics     Full-text available via subscription   (Followers: 3)
International Journal of Stomatological Research     Open Access  
International Orthodontics     Full-text available via subscription   (Followers: 3)
Japanese Dental Science Review     Full-text available via subscription  
Journal of Adhesive Dentistry     Full-text available via subscription   (Followers: 3)
Journal of Applied Oral Science     Open Access  
Journal of Clinical Periodontology     Hybrid Journal   (Followers: 3)
Journal of Conservative Dentistry     Open Access   (Followers: 4)
Journal of Craniomandibular Function     Full-text available via subscription  
Journal of Dental and Allied Sciences     Open Access  
Journal of Dental Biomaterials     Open Access  
Journal of Dental Education     Full-text available via subscription   (Followers: 1)
Journal of Dental Implants     Open Access   (Followers: 7)
Journal of Dental Lasers     Open Access   (Followers: 2)
Journal of Dental Medicine     Open Access   (Followers: 1)
Journal of Dental Research     Hybrid Journal   (Followers: 4)
Journal of Dental Research and Review     Open Access   (Followers: 1)
Journal of Dental Sciences     Full-text available via subscription  
Journal of Dental, Oral and Craniofacial Epidemiology     Open Access   (Followers: 1)
Journal of Dentistry     Hybrid Journal   (Followers: 2)
Journal of Dentistry and Oral Hygiene     Open Access   (Followers: 1)
Journal of Dentistry for Children     Full-text available via subscription   (Followers: 2)
Journal of Dentistry Indonesia     Open Access  
Journal of Dentofacial Anomalies and Orthodontics     Full-text available via subscription   (Followers: 2)
Journal of Education and Ethics in Dentistry     Open Access   (Followers: 5)
Journal of Endodontics     Full-text available via subscription   (Followers: 2)
Journal of Esthetic and Restorative Dentistry     Hybrid Journal   (Followers: 3)
Journal of Evidence Based Dental Practice     Full-text available via subscription   (Followers: 2)
Journal of Forensic Dental Sciences     Open Access   (Followers: 4)
Journal of Indian Academy of Dental Specialist Researchers     Open Access  
Journal of Indian Academy of Oral Medicine and Radiology     Open Access  
Journal of Indian Association of Public Health Dentistry     Open Access   (Followers: 1)
Journal of Indian Orthodontic Society     Open Access   (Followers: 1)
Journal of Indian Prosthodontic Society     Open Access  
Journal of Indian Society of Periodontology     Open Access  
Journal of Interdisciplinary Dentistry     Open Access   (Followers: 5)
Journal of International Society of Preventive and Community Dentistry     Open Access   (Followers: 2)
Journal of Investigative and Clinical Dentistry     Hybrid Journal   (Followers: 2)
Journal of Isfahan Dental School     Open Access  
Journal of Istanbul University Faculty of Dentistry     Open Access  
Journal of Minimum Intervention in Dentistry     Full-text available via subscription  
Journal of Oral & Facial Pain and Headache     Full-text available via subscription   (Followers: 1)
Journal of Oral and Maxillofacial Radiology     Open Access  
Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology     Full-text available via subscription   (Followers: 4)
Journal of Oral Biosciences     Hybrid Journal   (Followers: 3)
Journal of Oral Health and Oral Epidemiology     Open Access  
Journal of Oral Hygiene & Health     Open Access   (Followers: 1)
Journal of Oral Implantology     Hybrid Journal   (Followers: 3)
Journal of Oral Microbiology     Open Access   (Followers: 1)
Journal of Oral Research     Open Access  
Journal of Oral Research and Review     Open Access  
Journal of Orthodontic Research     Open Access   (Followers: 2)
Journal of Orthodontic Science     Open Access   (Followers: 2)
Journal of Orthodontics     Hybrid Journal   (Followers: 3)
Journal of Pediatric Dentistry     Open Access  
Journal of Periodontology     Full-text available via subscription   (Followers: 4)
Journal of Pierre Fauchard Academy (India Section)     Full-text available via subscription  
Journal of Public Health Dentistry     Hybrid Journal   (Followers: 1)
Journal of Research in Dentistry     Open Access   (Followers: 1)
Journal of Research in Medical and Dental Science     Open Access   (Followers: 1)
Journal of Restorative Dentistry     Open Access   (Followers: 2)
Journal of the American Dental Association     Full-text available via subscription   (Followers: 4)
Journal of the Canadian Dental Association     Full-text available via subscription   (Followers: 3)
Journal of the International Clinical Dental Research Organization     Open Access  
Journal of Theory and Practice of Dental Public Health     Open Access  
Kieferorthopädie     Full-text available via subscription  
King Saud University Journal of Dental Sciences     Open Access  
L'Orthodontie Française     Full-text available via subscription   (Followers: 2)
Médecine Buccale Chirurgie Buccale     Open Access   (Followers: 1)
Medicina Oral, patología oral y cirugía bucal     Open Access  
Nigerian Dental Journal     Full-text available via subscription   (Followers: 1)
Odontoestomatología     Open Access  
Odontología     Open Access  
Odontology     Hybrid Journal  
Odovtos - International Journal of Dental Sciences     Open Access   (Followers: 1)
Open Journal of Dentistry and Oral Medicine     Open Access  
Open Journal of Implant Dentistry     Open Access   (Followers: 3)
Operative Dentistry     Hybrid Journal   (Followers: 4)
Oral Biology and Dentistry     Open Access   (Followers: 2)
Oral Diseases     Hybrid Journal   (Followers: 3)
Oral Health & Preventive Dentistry     Full-text available via subscription   (Followers: 2)
Orthodontic Journal of Nepal     Open Access  
Orthodontic Waves     Full-text available via subscription   (Followers: 2)
Orthodontics & Craniofacial Research     Hybrid Journal   (Followers: 3)
Parodontologie     Full-text available via subscription   (Followers: 1)
Pediatric Dental Journal     Full-text available via subscription  
Pediatric Dentistry     Full-text available via subscription   (Followers: 1)
Periodontology 2000     Hybrid Journal   (Followers: 3)
Pesquisa Brasileira em Odontopediatria e Clinica Integrada     Open Access  
Pesquisa Odontológica Brasileira     Open Access  
Prevenzione & Assistenza Dentale     Full-text available via subscription  
Primary Dental Care     Full-text available via subscription   (Followers: 1)
Primary Dental Journal     Full-text available via subscription  
Progress in Orthodontics     Open Access   (Followers: 2)
Regenerative Dentistry and Implant Therapy     Open Access   (Followers: 3)
Research & Reviews : A Journal of Dentistry     Full-text available via subscription   (Followers: 1)
Revista Bahiana de Odontologia     Open Access  

        1 2     

Journal Cover Journal of Evidence Based Dental Practice
  [2 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 1532-3382
   Published by Elsevier Homepage  [2805 journals]
  • Longevity of Self-Etch Dentin Bonding Adhesives compared to Etch-and-Rinse
           Dentin Bonding Adhesives: A Systematic Review
    • Abstract: Publication date: Available online 29 March 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Nader Masarwa, Ahmed Mohamed, Iyad Abou-Rabii, Rawan Abu Zaghlan, Liviu Steier
      Objectives A systematic review and meta-analysis were performed to compare longevity of Self-Etch Dentine Bonding Adhesives to Etch-and-Rinse Dentin Bonding Adhesives. Material and methods The following databases were searched for PubMed, MEDLINE, Web of Science, CINAHL, the Cochrane Library complemented by a manual search of the Journal of Adhesive Dentistry. The MESH keywords used were: “etch and rinse”, “total etch”, “self-etch”, “dentine bonding agent”, “bond durability”, and “bond degradation”. Included were in-vitro experimental studies performed on human dental tissues of sound tooth structure origin. The examined Self-Etch Bonds were of two subtypes; Two Steps and One Step Self-Etch Bonds, while Etch-and-Rinse Bonds were of two subtypes; Two Steps and Three Steps. The included studies measured micro tensile bond strength (μTBs) to evaluate bond strength and possible longevity of both types of dental adhesives at different times. The selected studies depended on water storage as the aging technique. Statistical analysis was performed for outcome measurements compared at 24 hours, 3 months, 6 months and 12 months of water storage. Results After 24 hours (p-value = 0.051), 3months (p-value = 0.756), 6 months (p-value = 0.785) and 12 months of water storage self-etch adhesives showed lower μTBs when compared to the etch-and-rinse adhesives, but the comparisons were statistically insignificant. Conclusion In this study, longevity of Dentine Bonds was related to the measured μTBs. Although Etch-and-Rinse bonds showed higher values at all times, the meta-analysis found no difference in longevity of the two types of bonds at the examined aging times.


      PubDate: 2016-04-02T04:36:04Z
       
  • Clinical trials in dentistry: A cross-sectional analysis of World Health
           Organization-International Clinical Trial Registry Platform
    • Abstract: Publication date: Available online 26 March 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Gowri Sivaramakrishnan., Kannan Sridharan.
      Introduction Clinical trials are the back bone for evidence-based practice (EBP) and recently EBP has been considered the best source of treatment strategies available. Clinical trial registries serve as databases of clinical trials. As regards to dentistry in specific data on the number of clinical trials and their quality is lacking. Hence, the present study was envisaged. Method Clinical trials registered in WHO-ICTRP (http://apps.who.int/trialsearch/AdvSearch.aspx) in dental specialties were considered. The details assessed from the collected trials include: Type of sponsors; Health condition; Recruitment status; Study design; randomization, method of randomization and allocation concealment; Single or multi-centric; Retrospective or prospective registration; and Publication status in case of completed studies. Results A total of 197 trials were identified. Maximum trials were from United States (n=30) and United Kingdom (n=38). Seventy six trials were registered in Clinical Trials.gov, 54 from International Standards of Reporting Clinical Trials, 13 each from Australia and New Zealand Trial Register and Iranian Registry of Clinical Trials, 10 from German Clinical Trial Registry, eight each from Brazilian Clinical Trial Registry and Nederland’s Trial Register, seven from Japan Clinical Trial Registry, six from Clinical Trial Registry of India and two from Hong Kong Clinical Trial Registry. A total of 78.7% studies were investigator-initiated and 64% were completed while 3% were terminated. Nearly four-fifths of the registered trials (81.7%) were interventional studies of which randomized were the large majority (94.4%) with 63.2% being open-label, 20.4% using single blinding technique and 16.4% were doubled blinded. Conclusion The number, methodology and the characteristics of clinical trials in dentistry have been noted to be poor especially in terms of being conducted multi-centrically, employing blinding and the method for randomization and allocation concealment. More emphasis has to be laid down on the quality of trials being conducted in order to provide justice in the name of EBP.


      PubDate: 2016-03-28T23:56:05Z
       
  • Periodontal Management by Risk Assessment: A pragmatic approach
    • Abstract: Publication date: Available online 21 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Joanna M. Mullins, Joshua B. Even, Joel M. White
      Declarative Title An evidence-based periodontal disease risk assessment and diagnosis system has been developed and combined with a clinical decision support and management program to improve treatment and measure outcomes for patients. Background There is little agreement on a universally accepted periodontal risk assessment, periodontal diagnosis and treatment management tool and their incorporation into dental practice to improve patient care. This article highlights the development and use of a practical periodontal management and risk assessment program that can be implemented in dental settings. Methods The approach taken by Willamette Dental Group (WDG) to develop a periodontal disease risk assessment, periodontal diagnosis and treatment management tool is described using evidence-based best practices. With goals of standardized treatment interventions while maintaining personalized care and improved communication, this process is described to facilitate its incorporation into other dental settings. Conclusions Current electronic health records (EHRs) can be leveraged to enhance patient-centered care through the use of risk assessments and standardized guidelines to more effectively assess, diagnose, and treat patients to improve outcomes. Dental hygienists, and other committed providers, with their emphasis on prevention of periodontal disease can be principal drivers in creation and implementation of periodontal risk assessments and personalized treatment planning. WDG believes that such evidence-based tools can advance dentistry to new diagnostic and treatment standards.


      PubDate: 2016-02-25T01:56:07Z
       
  • Preventing Advanced Carious Lesions with Caries Atraumatic Restorative
           Technique (ART)
    • Abstract: Publication date: Available online 21 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Tammi O. Byrd
      Declarative Title An alternative approach to controlling dental caries and preventing the associated pain, called atraumatic restorative technique (ART), is described for populations in need, where dental hygienists restore decayed teeth with glass ionomer restorations without prior removal of all decayed tooth structure. Background and Purpose There are populations whose decay needs are not adequately being met within the current oral healthcare delivery system. These include those in poverty conditions, vulnerable children, and the elderly who are often in long-term care facilities without adequate resources or opportunities for traditional dentistry. ART provides a viable option for controlling caries and relieving the pain of untreated decay. The purpose of this article is to suggest that the evidence surrounding ART be viewed objectively in order to support dental hygienists, who with additional education in this approach, can contribute to relieving the pain of untreated dental decay. Conclusion Evidence suggests that teeth can be effectively restored with ART. Dental hygienists represent an appropriate workforce to provide ART with their current background and education combined plus a brief training program; it is suggested that current dental hygiene educational programs include ART within the curriculum. Along with dental sealants and fluoride varnish application, ART can be an important component of a comprehensive preventive program to address the unmet needs of vulnerable populations.


      PubDate: 2016-02-25T01:56:07Z
       
  • Practical Implementation of Evidence-Based Dentistry into Daily Dental
           Practice Through a Short time Dependent Searching Method
    • Abstract: Publication date: Available online 23 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Eunice Carrilho, Simona Dianiskova, Guliz N. Guncu, Secil Karakoca Nemli, Paulo Melo, Nermin Yamalik
      Introduction Despite the fact that the benefits of implementation of Evidence-Based Dentistry (EBD) into clinical practice is increasingly being highlighted, there are still clear limitations in its implementation into daily dental practice. One potentially important barrier to effective implementation into practice is the perception of EBD as a time-consuming process. The aim of the present study is to increase the familiarity of dental practitioners with the benefits of different time-dependent ‘practical’ search strategies important to EBD using a clinical question from the field of dental implantology as an example. Materials and Methods The PICO (population, intervention, comparison, outcome) question used in this study was: "In young adults with anterior single-tooth implant what is the effect of immediate or delayed loading on success'" A bibliographic search according to the Haynes 5S pyramid, together with 3 different time-dependent strategies ( 5-min, 30-min and more than 60-min), were applied. Results Both the Haynes 5S Pyramid and time-dependent search strategies revealed promising results for enhancing decision-making for determining the feasibility of immediate or conventional loading of anterior single dental implants. Results clearly showed that selection of the loading protocol would be case (patient)-specific and also indicated high primary implant stability and bone quality as the most important prerequisites for a successful immediate/early loading. From among the 3 different time-dependent strategies (5 min, 30 min and more than 60 min), the 60+ min search results were quite comparable with the Haynes pyramid search results. Conclusion It is likely that the different time-dependent search strategies may have the potential to support the clinical decision making process and may improve the implementation of EBD into daily dental practice. Increased time spent searching naturally seems to increase the extent of this support. However, even with short time-dependent searches, busy dental clinicians may get an improved idea/opinion regarding a clinical question.


      PubDate: 2016-02-25T01:56:07Z
       
  • Complexities of Providing Dental Hygiene Services in Community Care
           Settings
    • Abstract: Publication date: Available online 17 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Pamela Zarkowski, Mert N. Aksu
      Declarative Title Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory and ethical considerations create complexities and limits. Background and Purpose Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care ‘beyond the operatory’. Methods An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice.


      PubDate: 2016-02-20T22:32:07Z
       
  • Improving Outcomes for Transplant Patients: Contribution of a Dental
           Hygienist
    • Abstract: Publication date: Available online 4 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): C. Michele E. Lloid
      Declarative Statement A dental hygienist member of an interdisciplinary medical team can contribute to improved outcomes when cancer and transplant patients experience oral sequelae. Background and Purpose: Cancer and transplant patients benefit from care provided by an interdisciplinary team comprised of general and oral healthcare providers. Diagnostic and supportive care including assessment and stabilization of oral health as well as management of treatment and disease sequelae are essential treatment planning components. This article provides support for a dental hygienist team member contributing toward optimal care for this patient population at high risk for infection and other serious complications. Methods A dental hygienist manager of an oral medicine service that provides clinical care for transplant patients describes how her position within a cancer research center has evolved. Using case scenarios, the impact of an interdisciplinary medical transplant team on patient care is discussed. Conclusions A dental hygienist, interested in working with oncology or transplant patients, as part of an interdisciplinary medical team, can contribute toward the well-being of patients and experience a challenging and rewarding career that combines aspects of medicine and dentistry.


      PubDate: 2016-02-12T18:40:26Z
       
  • Minnesota Extends Oral Healthcare Delivery to Impact Population Health
    • Abstract: Publication date: Available online 4 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Colleen M. Brickle, Suzanne M. Beatty, Merry Jo Thoele
      Declarative Title Collaborative leadership and stakeholder engagement have created the concept of dental therapist intraprofessional dental team members who are expanding and extending the reach of oral healthcare to help meet the public need in Minnesota. Background and Purpose: Partially due to inadequate access to affordable oral healthcare, health disparities exist within Minnesota’s population with significant numbers of residents lacking access to basic oral healthcare. Policymakers, advocacy organizations and dental professionals recommended action to address these issues. In 2009, Minnesota became the first state government in the U.S. to license two levels of practitioners, the Dental Therapist and the Advanced Dental Therapist to primarily treat underserved patients. The purpose of this article is to explain the evolution of the dental therapist and guide other constituencies toward innovative dental hygiene-based workforce models. Methods The evolution and educational preparation of the dental therapist and advanced dental therapist is explained in the context of a unique working relationship between educators, legislators, educational institutions and the Minnesota Department of Health. Pivotal societal, public health and legislative issues are described from the initial stages in 2005 until 2014 when early data is emerging regarding the impact of dental therapists. Conclusions Dental therapist oral healthcare providers are working in a variety of settings in Minnesota including community clinics, hospitals and private practices. As of early February 2014, there were 32 licensed dental therapists six of whom also held certifications as advanced dental therapists. Initial public health impacts are positive; research regarding the benefits to the public is in its infancy. Further evaluation of outcomes will ascertain the viability of this new professional.


      PubDate: 2016-02-12T18:40:26Z
       
  • The oral healthcare manager in a patient-centered health facility
    • Abstract: Publication date: Available online 4 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Cheryl Westphal Theile, Shiela Strauss, Mary Evelyn Northridge, Shirley Birenz
      Declarative Title The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral healthcare manager Background and Purpose Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral healthcare manager who can facilitate integration of oral and primary care in a variety of healthcare settings. Methods Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral healthcare manager who would address both oral healthcare and a patient’s related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral healthcare manager. Conclusion A healthcare provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive healthcare. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral healthcare manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care.


      PubDate: 2016-02-12T18:40:26Z
       
  • The Baccalaureate Educated Dental Hygienist
    • Abstract: Publication date: Available online 5 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Rebecca L. Stolberg, Terri Tilliss
      Declarative Title The baccalaureate degree as entry level education will prepare dental hygienists to meet the basic challenges of evolving patient oral healthcare needs. Background The nature of healthcare is changing due to economic and societal developments. For example, the Affordable Care Act is allowing more individuals the opportunity to seek care. People are living longer with chronic disorders. Technological advances allow for treatment of disease to ultimately improve or extend lives. States are legislating broader scopes of practice for dental hygienists and other types of healthcare providers. Trends such as non-traditional work settings and patients exhibiting chronic diseases with co-morbidities, suggest that dental hygienists have at least a baccalaureate education to be prepared to embrace expanded interprofessional roles, technological advances, and effective care for diverse populations. Advanced degrees beyond the baccalaureate level will be indicated for dental hygienist researchers and scholars who will lead theory and policy development to improve population health. Methods The importance of a baccalaureate education for dental hygienists is illustrated with insights from dental hygiene and dental education organizations, the American Association of Colleges and Universities, and current literature. Conclusions A baccalaureate education will equip dental hygienists to help provide basic oral care for a diverse population in a variety of healthcare settings. Healthcare providers with a broad range of knowledge and skills, flexibility and decision-making capacity and a commitment to personal and social responsibility will be valued in the marketplace. More research is needed documenting the public health benefits of a baccalaureate-educated dental hygienist and further advanced degrees in dental hygiene.


      PubDate: 2016-02-12T18:40:26Z
       
  • Dental Hygienist Providers in Long-Term Care: Meeting the Need
    • Abstract: Publication date: Available online 5 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Elizabeth J. Brown
      Declarative Title Dental hygienists with expertise in the policies, protocols, and practices of long-term care settings can provide oral healthcare services that complement the health complexities of residents. Background Adults in the U.S. are living longer and retaining more teeth, creating an increased demand for oral healthcare within long-term care facilities. Oral health has, in the past, been perceived as less important than other aspects of daily care and focused more on comfort than control of potential pathogens of oral origin. 1 The concept in medicine of a care continuum from cradle to grave has not generally included provisions for oral health since historically few private dental practices have had provisions for continuation of care once an individual is unable to access the private office. This article supports the inclusion of dental hygienist care team members in long-term care settings. Methods The author has provided oral healthcare services in long-term care for many years, modeling this important career path for dental hygienists. Examples of the personal contributions of the dental hygienist author in helping to meet the extreme needs of this population illustrate this viable career option for dental hygienists. Resources utilized include federal and state healthcare publications, data from the American Dental Hygienists’ Association and selected state dental hygiene associations, published literature, and interviews with dental hygiene business owners, as well as the author’s years of expertise. Conclusion Oral health is a significant health concern for elders and others in long-term care settings. Daily oral care practices and optimal oral health are related to the well-being and quality of life that long-term care residents deserve.2 Pathways to providing preventive oral health services will gain momentum as dental hygienists become an integral part of the long-term care setting healthcare team.


      PubDate: 2016-02-12T18:40:26Z
       
  • Oral Healthcare Delivery Within the Accountable Care Organization
    • Abstract: Publication date: Available online 8 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Christine Blue, Sheila Riggs
      Declarative Statement The accountable care organization (ACO), provides an opportunity to strategically design a comprehensive health system in which oral health works within primary care. A dental hygienist/therapist within the ACO represents value-based healthcare in action. Background Inspired by healthcare reform efforts in Minnesota, a vision of an accountable care organization that integrates oral health into primary health care was developed. Dental hygienists and dental therapists can help accelerate the integration of oral health into primary care, particularly in light of the compelling evidence confirming the cost-effectiveness of care delivered by an allied workforce. Methods A dental insurance CEO and a dental hygiene educator utilized their unique perspectives and experience to describe the potential of an interdisciplinary team-based approach to individual and population health, including oral health, via an accountable care community. Conclusions The principles of the patient-centered medical home and the vision for accountable care communities present a paradigm shift from a curative system of care to a prevention-based system that encompasses the behavioral, social, nutritional, economic, and environmental factors that impact health and well-being. Oral health measures embedded in the spectrum of general healthcare have the potential to ensure a truly comprehensive health care system.


      PubDate: 2016-02-12T18:40:26Z
       
  • Advocacy for the Provision of Dental Hygiene Services within the Hospital
           Setting: Development of a Dental Hygiene Student Rotation
    • Abstract: Publication date: Available online 8 February 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Jacqueline A. Juhl, Lynn Stedman
      Declarative Title Educational preparation of dental hygiene students for hospital-based practice, along with advocacy efforts promote inclusion of dental hygienists within hospital-based interdisciplinary healthcare teams. Background and Purpose While the value of attending to the oral care needs of patients in critical care units has been recognized, the potential impact of optimal oral healthcare for the general hospital population is now gaining attention. This article describes a hospital-based educational experience for dental hygiene students, and provides advocacy strategies for inclusion of dental hygienists within the hospital interdisciplinary team Methods The dental hygienist authors, both educators committed to evidence-based oral healthcare and the profession of dental hygiene, studied hospital healthcare and recognized a critical void in oral healthcare provision within that setting. They collaboratively developed and implemented a hospital-based rotation within the curriculum of a dental hygiene educational program utilizing advocacy skills to encourage hospital administrators to include a dental hygiene presence within hospital-based care teams. Conclusions Hospital-based dental hygiene practice, as part of interprofessional healthcare delivery, has the potential improve patient well-being, shorten hospital stays, and provide fiscal savings for patients, institutions, and 3rd party payers. Advocacy efforts can promote dental hygienists as members of hospital-based healthcare teams. Further research is needed to document: 1) patient outcomes resulting from optimal oral care provision in hospitals, 2) best ways to prepare dental hygienists for career opportunities within hospitals and other similar health care settings, and 3) most effective advocacy strategies to promote inclusion of dental hygienists within care teams.


      PubDate: 2016-02-12T18:40:26Z
       
  • Estimates of Hospital Based Emergency Department Visits Due to Dental
           Implant Failures in The United States
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Satheesh Elangovan, Veerasathpurush Allareddy
      Objective Objective of the current study is to provide nationally representative estimates of hospital based emergency department (ED) visits attributed to dental implant failures in the United States Methods The Nationwide Emergency Department sample for the years 2008 to 2010 was used. All ED visits with a diagnosis of “dental implant failures” were selected for analysis. Patient demographics were examined. Outcomes of interest included disposition status following the ED visit and ED charges. Results During the study period, a total of 1,200 ED visits were due to dental implant failures. Most ED visits with dental implant failures occurred among those aged <18 years (22.4% of all ED visits) followed by those aged 70 years and above (18.2%). Males comprised 53.7% of all ED visits. Close to 89% did not have any other chronic co-morbid conditions. Osseointegration failure of dental implant occurred in 31.7% of patients while post-osseointegration mechanical failure of dental implant occurred in 30.4% of patients. Following an ED visit, 82.8% were discharged routinely and 13.3% of patients were admitted as in-patients into the same hospital following the ED visit. The mean ED charge per visit was $1,167. Conclusions Highest proportions of these ED visits were comprised of those aged <18 years, those aged 70 years and above, and male patients. The inherent limitations of NEDS database and lack of data elements precluded us from establishing an association between patient related factors and risk of ED visits due to implant failures


      PubDate: 2016-01-30T06:30:28Z
       
  • ADHA Leads Dental Hygienists into 21st Century Workforce Opportunities
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Ann Lynch, Pam Steinbach, Ann Battrell
      Declarative Title With the dental hygiene profession undergoing tremendous transformation as greater and more diverse workplace opportunities present themselves, the American Dental Hygienists’ Association (ADHA) is leading the effort to ensure that dental hygienists are prepared to take advantage of these growing opportunities in today’s constantly evolving health care landscape. Background and Purpose: The ADHA’s vision statement calls for the integration of dental hygienists into the health care delivery system as essential primary care providers to expand access to oral health care. This article discusses changes in dental hygiene curriculum, as well as how changes in the health care environment and legislative outcomes are impacting workplace opportunities for dental hygienists in the 21st century. Method Research from ADHA’s Transforming Dental Hygiene Education and the Profession for the 21 st Century white paper and other oral health-related literature, ADHA policies, and ADHA survey research describe the evolving dental hygiene workplace environment. The article discusses trends in education, health care, legislative and regulatory practice, and societal need that are creating new workforce opportunities for the dental hygiene profession. Conclusion With rapid change in both the oral and overall health care environments, transformation in dental hygiene curriculum and competencies, and more states allowing the public to have direct access to dental hygienists, dental hygiene professionals are expanding their presence into all aspects of the health care system. The ADHA is leading this effort to help dental hygienists provide that care by expanding workforce opportunities and allowing dental hygienists to practice to the full extent of their scope. The dental hygiene profession must be prepared and ready to embrace these opportunities. In doing so, new career pathways will be available for dental hygiene professionals that will also improve the public’s access to oral health care.


      PubDate: 2016-01-30T06:30:28Z
       
  • Buffered lidocaine with sodium bicarbonate did not increase inferior
           alveolar nerve block success rate in patients having symptomatic
           irreversible pulpitis
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Masoud Parirokh
      Article Title and Bibliographic Information Effect of buffered 4% lidocaine on the success of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a prospective, randomized, double-blind study. Schellenberg J, Drum M, Reader A, Nusstein J, Fowler S, Beck M. J Endod 2015;41(6): 791-6. Reviewer Masoud Parirokh, DMD, MS Purpose/Question The aim of the study was to evaluate the effect of 4% buffered lidocaine with 1/100000 epinephrine on the success rate of inferior alveolar nerve block in patients who had symptomatic irreversible pulpitis. Source of Funding The study was supported by Meyers/Reader Graduate Endodontic Support Fund. Type of Study/Design Double blinded randomized controlled trial Level of Evidence Level 1: good quality patient-oriented evidence Strength of Recommendation Grade N/A Not applicable


      PubDate: 2016-01-30T06:30:28Z
       
  • Treponema sp. shown to be important pathogens in primary endodontic
           infections
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Ashraf F. Fouad
      Article Title and Bibliographic Information Prevalence of Treponema species detected in endodontic infections: systematic review and meta-regression analysis. Leite FRM, Nascimento GG, Demarco FF, Gomes BPFA, Pucci CR, Martinho FC. J Endod 2015;41(5): 579-87. Reviewer Ashraf F. Fouad Purpose/Question The purpose of this study was to conduct a systematic review of the literature on the prevalence of different Treponema spp. in endodontic infections. The review also investigated the differences in prevalence of Treponema spp. in primary and persistent cases and in symptomatic and asymptomatic cases, and discussed the different methodologies involved in identifying members of this bacterial genus. Source of Funding The authors declare no conflict of interest. No sources of funding are listed for this study. Type of Study/Design This study was a systematic review and meta-regression analysis. Level of Evidence Level 3: Disease-oriented evidence; inconsistent findings among studies. Strength of Recommendation Grade C: disease-oriented evidence of surrogate endpoints that describe pathogenesis and may affect outcomes.


      PubDate: 2016-01-30T06:30:28Z
       
  • Limited evidence suggests a single implant overdenture as an alternative
           to two-implant−supported mandibular overdentures
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Ahmed Yaseen Alqutaibi
      Article Title and Bibliographic Information Survival in 1- versus 2-implant mandibular overdentures: a systematic review and meta-analysis. Srinivasan M, Makarov NA, Herrmann FR, Müller F. Clin Oral Implants Res. 2016;27(1):63-72 Reviewer Name and Contact Information Ahmed Yaseen Alqutaibi Purpose/Question Do single-implant−retained overdentures have similar outcomes in terms of implant survival when compared with two-implant−supported overdentures in the edentulous mandible? Source of Funding The authors reported no external funding sources. Type of Study/Design Systematic review and meta-analysis Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Grade B: Inconsistent, limited-quality patient-oriented evidence


      PubDate: 2016-01-30T06:30:28Z
       
  • Retention of asymptomatic third molars may be unwise
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): G.R. Ogden
      Article Title and Bibliographic Information What is the risk of future extraction of asymptomatic third molars? A systematic review. Bouloux GF, Busaidy KF, Beirne OR, Chuang S-K, Dodson TB. J Oral Maxillofac Surg 2015;73(5): 806-811. Reviewer Name and Contact Information Professor G.R. Ogden BDS, MDSc,PhD,FDS RCPS,FDS RCS Eng,FHEA,FRSA Purpose/Question Do young adults who retain their asymptomatic third molars, run the risk of removal later in life. Source of Funding No external funding source is identified although all 5 authors appear to be on the American Association of Oral and Maxillofacial Surgery 3rd Molar Task Force. Type of Study/Design Systematic review Level Of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Grade B: Inconsistent or limited-quality patient-oriented evidence


      PubDate: 2016-01-30T06:30:28Z
       
  • Although cast post and cores present acceptable survival, patient-related
           factors may influence survival
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Jovito Adiel Skupien, Maximiliano Sérgio Cenci, Tatiana Pereira-Cenci
      Article Title and Bibliographic Information Survival of teeth treated with cast post and cores: A retrospective analysis over an observation period of up to 19.5 years. Raedel M, Fiedler C, Jacoby S, Boening KW. J Prosthet Dent 2015;114(1):40-5. Reviewers Jovito Adiel Skupien, DDS, MSc, PhD, Maximiliano Sérgio Cenci, DDS, MSc, PhD, Tatiana Pereira-Cenci, DDS, MSc, PhD Purpose/Question This retrospective study assessed survival of teeth treated with cast post and cores and clinical factors that could influence survival. Source of Funding None or information not available. Type of Study/Design Retrospective cohort study. Level of Evidence Level 2 Strength of Recommendation Grade N/A


      PubDate: 2016-01-30T06:30:28Z
       
  • Severe periodontitis may result in higher numbers of oral
           polymorphonuclear (oPMN) leukocytes in oral rinse samples
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Bruno G. Loos
      Article Title and Bibliographic Information Quantifying oral inflammatory load: oral neutrophil counts in periodontal health and disease.Landzberg M, Doering H, Aboodi GM, Tenenbaum HC, Glogauer M.J Periodontal Res 2015;50(3):330-6. Reviewer Bruno G. Loos, DDS, MSc, PhD Purpose/Question The aim of the study was to enumerate oPMN leukocytes in oral rinse samples in subjects with periodontal health and in subjects with various degrees of periodontitis, and to investigate whether numbers of oPMN leukocytes could be used as a diagnostic marker for gingivitis, periodontitis, or periodontal health. Source of Funding No sources of funding have been reported, nor were there statements on conflicts of interest. Type of Study/Design Case series. The design of the current report needs to be regarded as a case series. There was no a priori power calculation or pilot data available. The current study is also not a true cross- sectional study, as participants were not consecutively recruited. Inclusion and exclusion criteria have been described rather weakly and do not follow established “case definitions.” Level of Evidence Level 2 Limited-quality, patient-oriented evidence Strength of Recommendation Grade Not applicable


      PubDate: 2016-01-30T06:30:28Z
       
  • Scaling and root planing is recommended in the nonsurgical treatment of
           chronic periodontitis
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): David Herrera
      Article Title and Bibliographic Information Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N. J Am Dent Assoc 2015;146(7): 508-524 e505. Reviewer David Herrera, DDS, PhD Purpose/Question Two questions for systematic review were proposed, in a PICO format: “In patients with chronic periodontitis, does scaling and root planing (SRP, hand or ultrasonic), when compared with no treatment, supragingival scaling and polish (prophylaxis), or debridement, result in greater improvement of clinical attachment level (CAL)?”, and “In patients with chronic periodontitis, does the use of locally delivered antibiotics or antimicrobials, systemic antibiotics, combinations of locally delivered and systemic antibiotics, agents for biomodification or host modulation, or nonsurgical lasers as adjuncts to SRP, compared with SRP alone, result in greater improvement of CAL?” Source of Funding The study was funded by the American Dental Association. Type of Study/Design Systematic review with meta-analysis. Level of Evidence Level 2 Limited-quality, patient-oriented evidence Strength of Recommendation Grade Grade C Consensus, disease-oriented evidence, usual practice, expert opinion, or case series for studies of diagnosis, treatment, prevention, or screening.


      PubDate: 2016-01-30T06:30:28Z
       
  • No clear evidence of the effect of cantilevered implant supported fixed
           restorations on the marginal bone or the prosthetic complications
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Iman Abd-Elwahab Radi
      Article Title and Bibliographic Information Effect of cantilevers for implant-supported prostheses on marginal bone loss and prosthetic complications: systematic review and meta-analysis. Torrecillas-Martinez L, Monje A, Lin G, Suarez F, Ortega-Oller I, Galindo-Moreno P, Wang H. Int J Oral Maxillofac Implants 2014;29:1315–21. Reviewer Iman Abd-Elwahab Radi Purpose or question The PICO question was: In partially edentulous patients restored by implant-supported fixed prostheses with or without cantilever extensions, are there any differences in terms of marginal bone loss (MBL) and prosthetic complications? Study design Systematic review and meta-analysis.


      PubDate: 2016-01-30T06:30:28Z
       
  • Commentary on an Innovative Interprofessional Dental Practice for 2026
    • Abstract: Publication date: Available online 29 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Brad Guyton, Jan LeBeau, Rebecca Sorci, Amy Doneen
      Declarative Title An innovative interprofessional model is described for the delivery of dental care in the year 2026 to optimize efficiency and profitability while enhancing quality of care. Background The dental practice of tomorrow may look different than today. Although not broken, the current system can be improved in efficiency and effectiveness. While traditional private practices will continue to exist and many will thrive over the next few decades, they may not present the optimal model for dental practice. To manage complex patient needs, a more collaborative model of multi-disciplinary, interprofessional clinical teams capable of treating patients comprehensively has been developed by the authors. They explore an alternative model of practice that may be possible in the next 10 years to better serve patients and improve outcomes while honoring the role of practitioners. Methods Landmark publications and reviews are used to examine evidence showing the potential benefits of an innovative interprofessonal approach to the delivery of care in the oral healthcare setting. Conclusions By examining key studies, the authors provide commentary on the potential for enhanced efficiency, profitability, and quality of care in the oral healthcare setting through a collaborative model of multi-disciplinary, interprofessional clinical teams capable of treating patients comprehensively.


      PubDate: 2016-01-30T06:30:28Z
       
  • Dental Hygienist-Led Chronic Disease Management System to Control Early
           Childhood Caries
    • Abstract: Publication date: Available online 29 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Man Wai Ng, Zameera Fida
      Declarative Title Management of the complex chronic disease of early childhood caries (ECC) requires a system of coordinated healthcare interventions which can be led by a dental hygienist and where patient self-care efforts are paramount. Background and Purpose Even after receiving costly surgical treatment under general anesthesia in the operating room, many children develop new and recurrent caries after only 6-12 months, a sequela that can be prevented. This article describes the chronic disease management (CDM) of dental caries, a science-based approach that can prevent and control caries. Methods In this article, we 1) introduce the concept of CDM of dental caries, 2) provide evidence that CDM improves oral health outcomes, and 3) propose a dental hygienist-led team-based oral health care approach to CDM. Although we will be describing the CDM approach for ECC, CDM of caries is applicable in children, adolescents and adults. Conclusions ECC disease control requires meaningful engagement of patients and parents by the oral health care team in order to assist them with making behavioral changes in the unique context of their families and communities. The traditional dentist/hygienist/assistant model needs to evolve to a collaborative partnership between care providers and patients/families. This partnership will be focused on systematic risk assessment and behaviorally-based management of the disease itself, with sensitivity toward the familial environment. Early pilot study results demonstrate reductions in rates of new caries, dental pain and referral to the operating room compared to baseline rates. Dental hygienists are the appropriate team members to lead this approach due to their expertise in behavior change and prevention.


      PubDate: 2016-01-30T06:30:28Z
       
  • EDITOR’S NOTES
    • Abstract: Publication date: Available online 29 January 2016
      Source:Journal of Evidence Based Dental Practice




      PubDate: 2016-01-30T06:30:28Z
       
  • Doctoral dental hygiene education would prepare scholars and leaders to
           improve population health through changes in oral health policy and
           delivery
    • Abstract: Publication date: Available online 29 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): JoAnn R. Gurenlian, Ellen J. Rogo, Ann Eshenaur Spolarich
      Background Discussions about doctoral education in dental hygiene have centered on the need to create a cadre of dental hygiene researchers and scholars who will expand the body of knowledge for the profession. It has been proposed that scholars are needed to lead the development of theory and disseminate knowledge unique to the discipline of dental hygiene. Transformation to doctoral education is not a new trend as many other health care disciplines have already implemented curricular models establishing the doctoral degree for entry-level into practice. The Institute of Medicine has called for the exploration of new models for care delivery. Dental hygienists need to be prepared with leadership skills enabling them to participate and lead inter-professional teams and develop policies designed to improve the delivery of oral health care services to enhance population health. Current educational models do not adequately prepare dental hygienists to serve in this capacity. Methods The purpose of this paper is to present two models of doctoral education for dental hygiene that will illustrate how dental hygienists can be better prepared as scholars and leaders for the profession. Conclusion These proposed models of doctoral education in dental hygiene present a paradigm shift in dental hygiene education. As with other disciplines that have evolved, both academically and professionally, dental hygiene will be positioned to achieve the hallmark of professional status with this terminal degree.


      PubDate: 2016-01-30T06:30:28Z
       
  • A Risk of Bias Assessment of Randomized Controlled Trials (RCTs) on
           Periodontal Regeneration Published in 2013
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Satheesh Elangovan, Sivaraman Prakasam, Praveen Gajendrareddy, Veerasathpurush Allareddy
      Objective The objective of this assessment is to evaluate the degree of risk of bias in randomized controlled trials published in 2013 and focusing on periodontal regeneration. Methods Three reviewers searched and selected the trials based on pre-defined inclusion criteria. Predictor variables [number of authors, primary objective of the study, biomaterial employed, follow-up time periods, split mouth study (yes/ no), journal, year of publication, country, scale (single/multi-center) and nature of funding] were extracted and risk of bias assessment using Cochrane risk of bias tool were performed independently by the three reviewers. Results Seventeen RCTs were included in this assessment. The risk of bias in RCTs published in 2013 with a focus in periodontal regeneration varied significantly with only in less than 30% of the included trials, the overall risk of bias was found to be low, while 41% of trials were designated to have a higher degree of bias. Specifically, when looking at the domains assessed, 70 % of the included trials reported an accepted method of sequence generation, blinding (whenever possible), completeness of outcome data or avoided selective outcome reporting. Meanwhile, only 47% of the included trials reported some form of allocation concealment. Conclusion In this assessment, of the included 17 trials, slightly more than 40% of them had a high risk of bias, underscoring the importance of careful appraisal of trials before implementing the study interventions in clinical practice and the need for more detailed analyses.


      PubDate: 2016-01-30T06:30:28Z
       
  • Declarative Title: Canine-guide occlusion and group function occlusion are
           equally acceptable when restoring the dentition
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Rodolfo Miralles
      Article Title and Bibliographic Information Impact of lateral occlusion schemes: A systematic review. Abduo J ,Tennant M. J Prosthet Dent 2015;114:193-204 Reviewer Rodolfo Miralles, DDS Purpose/Question What is the influence of the lateral occlusion scheme on patient comfort, masticatory system physiology, and prosthesis longevity? Source of Funding Not reported. Type of Study/Design Systematic review J Evid Base Dent Pract 2016; Level of Evidence Level 1: Good-quality, patient-oriented evidence Strength of Recommendation Grade Grade A: Consistent, good-quality patient-oriented evidence


      PubDate: 2016-01-30T06:30:28Z
       
  • A New Practice Approach for Oral Health Professionals
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Noreen Myers-Wright, Ira B. Lamster
      Declarative Title A New Practice Approach for Oral Health Professionals The oral healthcare paradigm presented here would broaden oral health services to include primary healthcare activities focusing on risk reduction and chronic disease screening. Background and Purpose Changes in our nation’s healthcare delivery system, shifting patient demographics and availability of new health insurance programs have resulted in exploration of new practice models of healthcare delivery. Chronic diseases require coordinated care efforts over decades of a patient’s life. Oral health professionals will be part of that care. Methods The practice model for this article was developed in the context of an academic medical center that promotes oral healthcare professionals as healthcare providers through interprofessional education. The combined experiences of the authors, including a diabetes predictive model for oral health settings, the efficacy and effectiveness of Human Immunodeficiency Virus screening in a dental setting, the feasibility of using a decision support tool for tobacco cessation, and the effectiveness of integrating oral health education with comprehensive health services for people living with HIV, have contributed to this concept. Conclusions Prevention is increasingly recognized as a cost effective means of reducing chronic disease burdens. To be effective health promotion activities that encourage healthy living and early detection need to occur in a variety of healthcare settings. Oral health professionals represent an underutilized group of healthcare providers that can contribute to improved health of populations living with chronic diseases by broadening their scope of practice to include primary health screenings and tailored health promotion activities.


      PubDate: 2016-01-30T06:30:28Z
       
  • DECLARATIVE TITLE: Consumption of xylitol gummy bears may not provide
           additional caries prevention for school children.
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Jaana Gold
      Article Title And Bibliographic Information The effectiveness of xylitol in a school-based cluster-randomized clinical trial. Lee W, Spiekerman C, Heima M, Eggertsson H, Ferretti G, Milgrom P, Nelson S. Caries Res 2015;49(1): 41-9. Reviewer Name And Contact Information Jaana Gold, DDS, MPH, PhD, CPH, Associate Professor Purpose/Question To assess the caries preventive effect of xylitol gummy bear consumption in the primary and permanent teeth of elementary school children beyond the effects of primary prevention methods. Source Of Funding Government: Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services, grant no. R40MC07838. Type Of Study/Design Double-blind, cluster-randomized controlled trial Level Of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Not applicable


      PubDate: 2016-01-30T06:30:28Z
       
  • A Baccalaureate Education Curriculum To Prepare Dental Hygienists for
           Expanded Public Health Practice
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Lisa J. Rowley, Susan M. Stein
      Declarative Title A baccalaureate dental hygiene education program was intentionally designed and implemented to prepare dental hygienists to work in expanded public health practice. Background Expanded practice dental hygienists (EPDH) in Oregon practice without the supervision of a dentist to provide dental hygiene services for underserved patients with limited access to dental care. Ten competencies were identified for the successful expanded practice dental hygienist and then these competencies were incorporated into the curriculum of a baccalaureate dental hygiene program. Methods When recent graduates of the innovative program were surveyed, results indicated that they felt well prepared for expanded practice, they had a high level of interest in working as an expanded practice dental hygienist, and all were planning to apply for an expanded practice permit, and. Two graduates and their unique contributions to individuals in need are profiled. Conclusions Intentional preparation of dental hygienists for expanded public health roles suggested the need for a baccalaureate curriculum designed specifically for that purpose. Advocacy and collaboration among educators, legislators and administrators in Oregon led to the development and implementation of such an innovative dental hygiene education program at Pacific University. Graduates are likely to pursue opportunities working as expanded practice dental hygienists. Further research will document the viability of this purposefully designed curriculum to prepare dental hygienists to help meet the public need for optimal oral health.


      PubDate: 2016-01-30T06:30:28Z
       
  • DECLARATIVE TITLE: Consumption of xylitol gummy bears may not provide
           additional caries prevention for school children
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Jaana Gold
      Article Title and Bibliographic Information The effectiveness of xylitol in a school-based cluster-randomized clinical trial.Lee W, Spiekerman C, Heima M, Eggertsson H, Ferretti G, Milgrom P, Nelson S.Caries Res 2015;49(1): 41-9. Reviewer Jaana Gold, DDS, MPH, PhD, CPH, Associate Professor Purpose/Question To assess the caries preventive effect of xylitol gummy bear consumption in the primary and permanent teeth of elementary school children beyond the effects of primary prevention methods. Source of Funding Government: Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services, grant no. R40MC07838. Type Of Study/Design Double-blind, cluster-randomized controlled trial Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Not applicable


      PubDate: 2016-01-30T06:30:28Z
       
  • Drivers Advancing Oral Health in a Large Group Dental Practice
           Organization
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Kristen Simmons, Stephanie Gibson, Joel White
      Declarative Statement Three change drivers are being implemented to high standards of patient-centric and evidence-based oral healthcare within the context of a large multi-specialty dental group practice organization based upon the commitment of the dental hygienist, who is Chief Operating Officer, and her team. Background and Purpose: A recent environmental scan elucidated 6 change drivers that can impact the provision of oral healthcare. Practitioners who can embrace and maximize aspects of these change drivers will move dentistry forward and create future opportunities. This article explains how 3 of these change drivers are being applied in a privately held, accountable-risk bearing entity that provides individualized treatment programs for over 400,000 members. To facilitate integration of the conceptual changes related to the drivers, a multi-institutional, multi-disciplinary, highly functioning collaborative work group was formed. Methods and Approach The document Dental Hygiene at a Crossroads for Change, 1 inspired the first author, a dental hygienist in a unique position as Chief Operating Officer of a large group practice, to pursue evidence-based organizational change, to impact the quality of patient care. This was accomplished by implementing technological advances including dental diagnosis terminology in the electronic health record (EHR), clinical decision support, standardized treatment guidelines, quality metrics and patient engagement to improve oral health outcomes at the patient and population levels. The systems and processes utilized to implement 3 change drivers into a large multi-practice dental setting is presented to inform and inspire others to implement change drivers with the potential for advancing oral health. Conclusions Technology, implementing best practices and improving patient engagement are excellent drivers to advance oral health and are effective use of oral healthcare dollars. Improved oral health can be leveraged through technological advances to improve clinical practice.


      PubDate: 2016-01-30T06:30:28Z
       
  • “Patients with manifest caries lesions have higher levels of
           salivary matrix metalloproteinase -8 than patients with no caries
           lesions”
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Patricia Nivoloni Tannure, Erika Calvano Kuchler
      Article Title and Bibliographic Information Caries correlates strongly to salivary levels of matrix metalloproteinase-8.Hedenbjörk-Lager A, Bjørndal L, Gustafsson A, Sorsa T, Tjäderhane L, Åkerman S, Ericson D.Caries Res 2015;49(1):1-8. Purpose/Question The main purpose of this study was to evaluate the relationship between the concentration of MMP-8 in saliva and the number of caries lesions. Source of Funding The study was funded by faculty grants and by the Regional Board of Public Dental Health in the county of Skane, Sweden. Type of Study/Design Cross-sectional study Reviewer name and Contact Information Patricia Nivoloni Tannure, DDS, MSD, PhD, Erika Calvano Kuchler, DDS, Ms, PhD Level of Evidence Level 3 Other evidence Strength of Recommendation Grade Not applicable


      PubDate: 2016-01-30T06:30:28Z
       
  • DECLARATIVE TITLE: Pulpotomy with calcium hydroxide may be an effective
           alternative to root canal therapy in vital teeth
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Saeed Asgary, Armin Shirvai
      Article Title and Bibliographic Information Permanent teeth pulpotomy survival analysis: retrospective follow-upKunert GG, Kunert IR, da Costa Filho LC, de Figueiredo JAJ Dent. 2015 Sep;43(9):1125-31. Purpose/Question 1. To analyze the long-term survival of pulpotomy with calcium hydroxide in vital permanent teeth that needed root canal therapy. 2. To evaluate the prognostic factors influencing the success rates of pulpotomy with calcium hydroxide. Source of Funding Information not available Type of Study/Design Historical cohort study Reviewer Names and Contact Information Saeed Asgary, DDS, MS, Armin Shirvai, MD, PhD Level of Evidence Level 2: limited-quality, patient-oriented evidence. Strength of Recommendation Grade Not applicable.


      PubDate: 2016-01-30T06:30:28Z
       
  • DECLARATIVE TITLE: There is a positive long-term effect of the Nexo-method
           on caries prevention.
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Eleanor Fleming
      ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Outcomes 18 years after implementation of a nonoperative caries preventive program--the Nexo-method--on children in Moscow, RussiaKuzmina I, Ekstrand KRCommunity Dent Oral Epidemiol 2015;43(4): 308-16. PURPOSE/QUESTION What are the long-term effects of the Nexo-method on caries prevention in adults? SOURCE OF FUNDING Not available TYPE OF STUDY/DESIGN Randomized controlled trial REVIEWER NAME and CONTACT INFORMATION Eleanor Fleming, PhD, DDS, MPH Strength of Recommendation Grade Not applicable Level of Evidence Level 1: patient-oriented evidence based on clinical experiences


      PubDate: 2016-01-30T06:30:28Z
       
  • Valuing the clinical effectiveness of therapeutics
    • Abstract: Publication date: Available online 12 January 2016
      Source:Journal of Evidence Based Dental Practice
      Author(s): Stefan Listl, Clovis Mariano Faggion
      Objective This second article of a series of four is aimed to inform dental practitioners about the relevance to provide more formal analysis of economic resources when helping patients make clinical decisions. Methods The following methods of health economic evaluation are described: Cost-effectiveness-analysis (CEA), cost-utility-analysis (CUA) and cost-benefit-analysis (CBA). CEA compares the effectiveness of different interventions usually based on specific clinical outcome measures, for example pocket depth reduction. CUA evaluates the effectiveness of therapies by taking into account more generic health outcome measures such as quality-adjusted life-years (QALYs). Cost-benefit-analysis (CBA) is based on measuring patients’ actual willingness to pay. Cost-benefit-analysis (CBA) is based on measuring patients’ actual willingness to pay, and it offers a method of economic evaluation that values all benefits against all costs. In other words, the total costs of a specific intervention are subtracted from the value of benefits related to that intervention. Results This article reported common methods of health economic evaluation that could be taken into account throughout clinical decision making. Decision makers (patients, practitioners, health policy) should be adequately informed about costs and health outcomes associated with the various therapeutic alternatives in order to act responsibly within scenarios of resource scarcity. Economic evaluations can be informative with respect to whether or not the health outcomes outweigh the costs of an intervention, and hence provide a decision-making tool for decision makers considering treatment alternatives. Conclusions The information provided here may help decision makers (patients, practitioners, health policy) to understand economic considerations as an essential component of the decision-making process. Carefulness is advised with regard to interpreting the results from economic evaluation studies.


      PubDate: 2016-01-14T18:10:41Z
       
  • Information for Readers
    • Abstract: Publication date: December 2015
      Source:Journal of Evidence Based Dental Practice, Volume 15, Issue 4




      PubDate: 2015-12-17T13:54:44Z
       
  • Information for Authors
    • Abstract: Publication date: December 2015
      Source:Journal of Evidence Based Dental Practice, Volume 15, Issue 4




      PubDate: 2015-12-17T13:54:44Z
       
  • Statement of Purpose/Levels of Evidence
    • Abstract: Publication date: December 2015
      Source:Journal of Evidence Based Dental Practice, Volume 15, Issue 4




      PubDate: 2015-12-17T13:54:44Z
       
  • Table of Contents
    • Abstract: Publication date: December 2015
      Source:Journal of Evidence Based Dental Practice, Volume 15, Issue 4




      PubDate: 2015-12-17T13:54:44Z
       
  • Matrix JEBDP December 2015
    • Abstract: Publication date: December 2015
      Source:Journal of Evidence Based Dental Practice, Volume 15, Issue 4




      PubDate: 2015-12-17T13:54:44Z
       
  • Editorial Board
    • Abstract: Publication date: December 2015
      Source:Journal of Evidence Based Dental Practice, Volume 15, Issue 4




      PubDate: 2015-12-17T13:54:44Z
       
  • Appropriate recall interval for Periodontal Maintenance: A Systematic
           Review
    • Abstract: Publication date: Available online 19 November 2015
      Source:Journal of Evidence Based Dental Practice
      Author(s): Owais A. Farooqi, Carolyn J. Wehler, Gretchen Gibson, M. Marianne Jurasic, Judith A. Jones
      Objectives A systematic review of the literature was undertaken to assess the evidence to support a specific time interval between periodontal maintenance (PM) visits. Methods Relevant articles were identified through searches in MEDLINE, EMBASE and PubMed using specific search terms, until April, 2014, resulting in 1095 abstracts and/or titles with possible relevance. Critical Appraisal Skills Programme (CASP) guidelines were used to evaluate the strength of studies and synthesize findings. If mean recall interval was not reported for study groups, authors were contacted to attempt to retrieve this information. Results Eight cohort studies met inclusion criteria. No randomized control trials were found. All included studies assessed the effect of PM recall intervals in terms of compliance with a recommended regimen (3 to 6 months) as a primary outcome. Shorter PM intervals (3-6 months) favored more teeth retention but also statistically insignificant differences between RC and IC/EC, or converse findings are also found. In the 2 studies reporting mean recall interval in groups, significant tooth loss differences were noted as the interval neared the 12 month limit. Conclusions Evidence for a specific recall interval (e.g. every 3 months) for all patients following periodontal therapy is weak. Further studies, such as RCTs or large electronic database evaluations would be appropriate. The merits of risk-based recommendations over fixed recall interval regimens should be explored.


      PubDate: 2015-11-25T08:20:14Z
       
  • Visual inspection displays good accuracy for detecting caries lesions
    • Abstract: Publication date: Available online 17 November 2015
      Source:Journal of Evidence Based Dental Practice
      Author(s): Svante Twetman



      PubDate: 2015-11-21T04:32:28Z
       
  • A history of periodontitis suggests a higher risk for implant loss
    • Abstract: Publication date: Available online 24 October 2015
      Source:Journal of Evidence Based Dental Practice
      Author(s): Bruno Ramos Chrcanovic
      ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Periodontitis, implant loss and peri-implantitis. A meta-analysis. Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Clin Oral Implants Res 2015;26(4): e8-16. REVIEWER NAME and CONTACT INFORMATION Bruno Ramos Chrcanovic. DDS, MSc, PhD student PURPOSE/QUESTION To compare the risks of implant loss, implant bone loss, and peri-implantitis between subjects with and without a history of periodontal disease. SOURCE OF FUNDING The authors reported that no external funding sources directly supported this study. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data LEVEL OF EVIDENCE Level 2: Limited-quality, patient-oriented evidence STRENGTH OF RECOMMENDATION GRADE Grade B: Inconsistent or limited-quality patient-oriented evidence


      PubDate: 2015-10-27T19:19:11Z
       
  • Evaluating the risk of bias of a study
    • Abstract: Publication date: Available online 2 October 2015
      Source:Journal of Evidence Based Dental Practice
      Author(s): Clovis Mariano Faggion



      PubDate: 2015-10-06T13:31:31Z
       
  • Provider attitudes toward the implementation of clinical decision support
           tools in dental practice
    • Abstract: Publication date: Available online 21 September 2015
      Source:Journal of Evidence Based Dental Practice
      Author(s): Elizabeth A. Mertz, Olumide Bolarinwa, Cynthia Wides, Steven Gregorich, Kristen Simmons, Ram Vaderhobli, Joel White
      Purpose The objective of this paper is to assess clinical dental providers’ baseline knowledge and attitudes about the implementation of three clinical decision support (CDS) tools built into the electronic health record (EHR) of a multi-specialty group dental practice. Procedures An electronic survey designed to examine predisposing factors for acceptance of EHR-based tools, caries and periodontal disease management by risk assessment and a risk assessment-based Proactive Dental Care Plan, was distributed to all Willamette Dental Group (WDG) employees. The survey collected demographic data, along with measures of job experience and satisfaction, comfort with dental information technology, and attitudes and knowledge of each CDS tool. WDG provided data on site-level patient and financing mix, patient satisfaction data, employee role (e.g. dentist) and tenure with company. The survey was conducted three months prior to the rollout of the CDS tools in November 2013. The survey was distributed electronically to all WDG employees (n=1166), of whom 58.5% (n=682) were clinicians, located in 53 sites in Oregon, Washington and Idaho. The overall response rate was 79.8% (n=930), with a response rate of 83.1% (n=567) from all clinicians. Of these, 24.3% were general and specialist dentists (n=138); 26.6% were dental hygienists (n=151), and 49% were dental assistants (n=278). Principal Findings The clinicians surveyed reported being highly amenable to implementation of the three CDS tools. Clinicians’ attitudes reflected higher expected improvement in patient care and quality than in business processes due to the implementation. The clinician characteristics most strongly correlated with a positive attitude toward the CDS tool implementation (as measured on Likert scale 1=low to 5= high) included satisfaction with the EHR (0.499, p<0.001), job satisfaction (0.458, p<0.001), finding change to be exciting (0.398, p<0.001), degree of control perceived over work (0.352, p<0.001), and a perception of having adequate tools to get work done (0.340, p<0.001). Higher reported frequency (scale 1=never, 7=always) of feeling burned out (-0.297, p<0.001), feeling emotionally drained (-0.265, p<0.001), and feeling work is a strain (-0.205, p<0.001) had the greatest correlation with negative attitudes. Conclusion This is the first study to examine dental provider attitudes toward the implementation of CDS tools incorporated within an electronic health record. Provider attitudes toward CDS tools can shape the entire implementation process for better or worse. This study contributes to the literature by providing an understanding of factors related to positive attitudes at the outset of a system change and can help guide organizational administrators to better prepare their workforce and organization for adoption of evidence-based dentistry tools such as a CDS system.


      PubDate: 2015-09-24T00:38:29Z
       
  • Toward Implementing Primary Care at Chairside: Developing a Clinical
           Decision Support System for Dental Hygienists
    • Abstract: Publication date: Available online 28 August 2015
      Source:Journal of Evidence Based Dental Practice
      Author(s): Stefanie L. Russell, Ariel Port Greenblatt, Danni Gomes, Shirley Birenz, Cynthia A. Golembeski, Donna Shelley, Matthew McGuirk, Elise Eisenberg, Mary E. Northridge
      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.
      Graphical abstract image

      PubDate: 2015-08-28T22:25:05Z
       
 
 
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