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Journal of the Canadian Dental Association
Journal Prestige (SJR): 0.312

Citation Impact (citeScore): 1
Number of Followers: 3

Full-text available via subscription

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ISSN (Print) 0709-8936 - ISSN (Online) 1488-2159
Published by Canadian Dental Association

[1 journal]

Advice for Dentists from Temporomandibular Disorder Patients: A
Phenomenological Study
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  Authors: jpnuyens
  Abstract: /*>Patients have a valuable perspective, which can be used in teaching patient–provider communication, pretesting health education material and improving health policy and administration.1 Patient-reported outcome measures also have the potential to improve both quality and cost of care.2-5 Health care providers, particularly dentists, focus on pathological problems and are rarely concerned about holistic treatment for patients.6,7 In this study, we identify what temporomandibular disorder (TMD) patients want their dentists to know and be able to do to improve services and guide them to cope with their chronic condition.TMD is a combination of clinical conditions that affect the temporomandibular joint (TMJ), the masticatory muscles and associated structures, such as the articular disc, capsule and retrodiscal tissue.8 These conditions create orofacial pain, which is defined as pain localized to the region in front of the ears, above the neck, below the orbitomeatal line or in the oral cavity. TMD limits lower jaw movement — causing stiffness or locking of the jaw or both. It affects 13.5–47% of the general population.9,10 TMD most often occurs as arthralgia or myofascial pain.11 The prevalence of the latter is about 30% in patients with local pain complaints seen in primary care clinics and up to 85% in patients at specialized pain management centres.9,10About 50% of patients who suffer from TMD look for professional dental or psychotherapeutic care, and 33% of them will continue to suffer from moderate to severe pain, disability and psychological distress independent of the treatment received.9,10 The etiology of TMD is still not well understood, even though the annual cost for its treatment doubled in the last decade to $4 billion.9 The poorly understood causes of TMD add complexity to its treatment, which includes physical, pharmacological, cognitive-behavioural and dietary therapies.11Unfortunately, health care providers who are concerned with alleviating pain take insufficient time to help their patients cope with day-to-day suffering.6,7 Understanding the perspective of persons who have TMD could improve the quality of future treatment.MethodsResearch ApproachA qualitative approach was chosen as most suitable for addressing this type of research, as it focuses on understanding the subjective experience of individuals.12,13 The exploratory nature of qualitative research enables the researcher to investigate the cultural, social, historical, linguistic and personal meanings and interpretations individuals give to their behaviour.12,13Interpretive phenomenological analysis (IPA) was selected as it emphasizes the experiences of the people participating in the research.14 IPA allows the researcher to learn more on the topic in question and gives him or her the chance to enter the participant’s world, while acknowledging the participant as the expert.15 IPA is subject to a “double hermeneutic” or second interpretation, as the researcher makes sense of each participant, who is making sense of his/her own experience.Patient RecruitmentParticipants were English-speaking, ≥18 years old and with chronic TMD, confirmed by a TMD specialist (Table 1). They were contacted through referrals from specialists at the Jewish General Hospital, the McGill Student Dental Clinic and the Montreal General Hospital in Montreal, Canada, between September and November 2017. We aimed at a sample size of 6 participants.16 In IPA, the number of participants can be 2–25.14, 17-18 Each participant provided informed consent.16,19In IPA, the goal is to reach a better understanding of the overall aspects among the participants lived experiences. According to Creswell,14 “It is essential that all participants have [similar lived] experience of the phenomenon being studied” (p. 155). Thus, sample size is based on the availability of suitable participants, not on their number.16 IPA studies are conducted on relatively small sample sizes, and the purpose is to get an almost homogeneous sample so that, within the sample, we can assess convergence and divergence in some detail.20Data CollectionWe used semi-structured qualitative interviews16 with open-ended questions to obtain rich and detailed data for each participant (Table 2).21 The open-ended format allowed patients to provide detail and raise issues that were not otherwise covered by the interviewer’s questions.20Data AnalysisThe strength of IPA is its ability to remain adaptive to the interviewee’s experien...
  PubDate: Wed, 23 Mar 2022 21:22:37 +000
Clinical Management of Interproximal and Occlusal Caries in Children and
Adolescents by Canadian Dentists: A Survey
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  Authors: jpnuyens
  Abstract: */Dental caries is a multifactorial disease resulting from a poor balance between demineralization and remineralization of tooth structure.1 Studies show that caries remain one of the most common infectious diseases worldwide in the 21st century.2 In Canada, although the incidence of dental caries has decreased significantly in the last 40 years, a quarter of children and more than half of adolescents still have at least one carious tooth.3 Clearly, caries in children and adolescents remains a problem in dental practices worldwide, including Canada.Caries management is an ever-evolving field of research aimed at improving knowledge in various therapeutic approaches. In the last decade, there has been a paradigm shift from early surgical caries management to more conservative, non-restorative approaches based on the remineralization potential of carious lesions confined to the enamel or even those affecting dentin.4 As a result, new guidelines for the diagnosis and management of interproximal and occlusal caries have been created to help dentists, including the well-known International Caries Classification and Management System.5For any recommended change in treatment modality that require behaviour modification, it is reasonable to determine whether such recommendations are implemented in practice. Surveys are common tools to assess the practice of health care professions. Several studies6-8 have been conducted to evaluate caries management in adults, many using the same survey to determine at which stage of carious lesion evolution dental practitioners decided on surgical removal of tooth structure. Treatment modalities were evaluated as well. Although there are fewer studies evaluating caries management in children and adolescents, a calibrated survey adapted for the pediatric population was recently used in France and Australia.6,9,10 In 1994, a study of the management of carious lesions on a first permanent molar of 12-year-old adolescents was conducted in Ontario.8The purpose of our study was to assess management of interproximal and occlusal caries in children and adolescents by Canadian dentists, using a validated survey similar to those used in France and Australia, not only to establish a national baseline, but also to compare our findings with those of other countries. The secondary objective was to assess differences in treatment modalities relative to sociodemographic data.Materials and MethodsUsing REDCap, an online protected server, available in English and French, we adopted a survey developed by Michèle Mullet-Bolla and Sophie Doméjean, lead authors of similar studies conducted in France and Australia; this survey has been validated.10 However, a few questions were adapted to better address demographic factors and newer caries management strategies. The main components, such as figures, photographs and radiographs, were not altered so as to conform as much as possible to the original survey for data comparison.Recruitment StrategyWe contacted all Canadian provincial dental regulatory authorities and/or associations, asking them to send the survey to their members directly or in a newsletter. Thus, no email lists were sent to the research team. Dental regulatory authorities in Quebec, Ontario, Saskatchewan and Nova Scotia accepted the offer and sent the survey to their members. According to the most recent figures from the Canadian Dental Association (CDA) in 2013, there were 21,109 registered dentists in Canada. When we add up just the organizations that accepted our request, that resulted in 14,574 in 2013. With more recent figures from Quebec in 2016, the extrapolated numbers can reach up to about 15,029 for our sample size. To increase our sample size, the Canadian Dental Association also agreed to share the survey on its Online Advice & Searchable Information Service (Oasis) platform.Survey Design and VariablesDemographic data, collected in questions 1–8, included participants’ year of birth, gender, year of graduation, university of graduation, province of practice and practice environment, type of practice, level of training post-dentistry and frequency of treating children. Questions 9–11 served the main objective of the study: to determine at what stage of a carious lesion Canadian dentists treat caries by surgical removal of tooth structure in primary and permanent dentition. These questions consisted of clinical scenarios combined with radiographic representations and/or images corresponding to caries lesions 1–6, in the International Caries Detection and Assessment System (ICDAS).11 Collected data included choice of lesions where a restoration with caries removal would first be performed for interproximal and occlusal carious lesions on primary and permanent teeth, preparation techniques and restorative materials. Responses were then analyzed in relation to the various sociodemographic factors.Statistical Analysis...
  PubDate: Wed, 02 Mar 2022 21:07:11 +000
Developing a Classification System for Prioritizing Pediatric Dental
Patients Needing Treatment under General Anesthesia
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  Authors: jpnuyens
  Abstract: Basing OR scheduling on severity of caries, pain and abscess can minimize adverse events among patients waiting for treatment.
  PubDate: Mon, 31 Jan 2022 00:00:00 -050
Does Vaping Increase the Risk of COVID-19 Transmission and Make
Individuals Who Vape Susceptible to Infection and Prone to Severe
Illness' A Review
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  Authors: jpnuyens
  Abstract: This synthesis provides evidence that will help dental professionals inform patients who vape about the potential risks of COVID-19.
  PubDate: Tue, 18 Jan 2022 00:00:00 -050
Evaluation of the Online Learning Experience of Dalhousie Dentistry and
Dental Hygiene Students during COVID-19 Pandemic Outbreak
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  Authors: jpnuyens
  Abstract: Creative, understanding and flexible faculty are key to successful transition to online teaching.
  PubDate: Mon, 29 Nov 2021 00:00:00 -050
Comparison of Adjusted Fluoride Concentrations Between Water Treatment
Facilities and Endpoints in Alberta, Canada
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  Authors: jpnuyens
  Abstract: Despite slight variations, fluoride concentration in Alberta’s drinking water matches the amount added at water treatment facilities.
  PubDate: Thu, 07 Oct 2021 00:00:00 -040
Impact of the COVID-19 Pandemic on the Diagnosis of Oral and Maxillofacial
Malignancies: A Retrospective Study
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  Authors: jpnuyens
  Abstract: Data from a pathology service highlight the importance of dentists in diagnosing oral and maxillofacial malignancies.
  PubDate: Fri, 24 Sep 2021 00:00:00 -040
Daily Use of Biologic Indicators in General Dental Practice
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  Authors: jpnuyens
  Abstract: Alberta’s dental offices show high compliance with new requirements for daily testing of sterilizers.
  PubDate: Tue, 07 Sep 2021 00:00:00 -040
How Often Are Dental Care Workers Exposed to Occupational Characteristics
that Put Them at Higher Risk of Exposure and Transmission of COVID-19'
A Comparative Analysis
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  Authors: jpnuyens
  Abstract: Dental care workers’ high risk of occupational exposure to disease points to the need for guidance to reduce transmission and ensure the well-being of this workforce.
  PubDate: Thu, 19 Aug 2021 00:00:00 -040
Characteristics of Emergent and Essential Dental Services in University
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  Authors: jpnuyens
  Abstract: This descriptive data on urgent and essential dental care will help with planning for future limitations secondary to a pandemic.
  PubDate: Mon, 12 Jul 2021 00:00:00 -040