Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are prov...Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are proven to be efficient in treating mild to moderate sleep apnea and snoring. We examined patients who had been treated in Community Dental Care with a titrable Herbst-type MAD. The aim of the study was to evaluate the quality of sleep based on self report. Methods: A questionnaire was mailed to patients (n = 184) who had received treatment for OSA or snoring between 2007 and2010 inthe Helsinki Health Centre Oral Care Unit. The patients were referred to the clinic for primary treatment, or because another treatment modality had failed. Results: Of the respondents (n = 142, 78.4%), OSA had been diagnosed in 74%, while the MAD was applied for snoring to the remaining. Among all respondents, 78.4% had worn the MAD at least three nights per week. With the MAD in situ, sleep was felt significantly less disrupted (p < 0.001) and more restorative (p < 0.001), and snoring was markedly reduced (p < 0.001). Daytime tiredness was also markedly less frequent (p < 0.001). Conclusions: Treatment with a MAD improved perceived sleep quality and awoke alertness in mild and moderate OSA patients and in snorers. This study supports such treatment to be initiated and monitored in community dental care.展开更多
Introduction: The effective sterilization of reusable instruments in dental care is a crucial issue for public health. The aim of this study was to contribute to improving the processing conditions of reusable care in...Introduction: The effective sterilization of reusable instruments in dental care is a crucial issue for public health. The aim of this study was to contribute to improving the processing conditions of reusable care instruments in dental practices in the city of Conakry. Methods: We carried out an observational and cross-sectional study of a descriptive type lasting three months from January to April 2022 in public and private dental practices approved for activities. Results: A total of 48 dental practices were surveyed, including 7 public and 41 private. 91.67% had the trays for instrument sterilization. 77.08% had a sterilization device. The instruments were: cleaned 100%, disinfected 70.83%, sterilized 20.83% and 20.83% reused the instruments without being sterilized. 72.97% sterilized the instruments at the end of the day. 50% of respondents declared that there were six stages of sterilization. According to standard standards, one dental office or 2.70% respected the normal sterilization process and 13.51% respected the duration and temperature. The storage quality was inadequate at 95.83%. 95.83% of dental practices are at high risk of contamination. The difficulties encountered by staff in daily activity during our study were lack of hygienists (87.50%), insufficient material resources (58.33%), and lack of protocol procedure (45.83%). Conclusion: This study allowed us to note shortcomings of dental surgeons in the process of processing reusable care materials.展开更多
The main role of this article is to describe dental assistants and the dental department’s role in the dental delivery system for Special health care needs (SCHN) by creating a structure to educate the dental assisti...The main role of this article is to describe dental assistants and the dental department’s role in the dental delivery system for Special health care needs (SCHN) by creating a structure to educate the dental assisting profession and project factors that have a significant impact on the dental assistant. The dental assisting management of SCHN patient’s profession including dental Assistance general responsibilities, regulation credentialing, and education. The SCHN patient’s management creates a challenge in all area of the dental department. Handling patient with a SCHN is underexplored throughout the dental staff especially when there is not enough theoretical foundation, education and training to deal with this category of patients. SCHN patients are defined as individuals who have abnormal behavioral impairments, mental conditions or/and chronic disease or abnormal laboratory results. Thus, the aim of this article is to guide all dental assistance staff in the best dental management choice for SCHN patients. All health care teams are part of patient care in most medical settings. A work environment supportive ensures positive outcomes for patient care. This article was considered as those categories of patients required more care and special way to deal with, moreover language, age, gender and education level of the patient are also considered significant parries. Not Many studies were found to support the care of SCHN patients in dentistry department. Taking experience from other area help to design a system to handle the SCHN even if it requires hiring a Dentist who is specialized in that filed.展开更多
Hepatitis C(HCV)is a viral infection that affects an estimated 71 million people worldwide,with over 1 million new infec-tions yearly.While medical treatments exist,HCV continues to be a significant public health conc...Hepatitis C(HCV)is a viral infection that affects an estimated 71 million people worldwide,with over 1 million new infec-tions yearly.While medical treatments exist,HCV continues to be a significant public health concern.Primary prevention and transmission risk factor identification remain key in helping decrease disease prevalence.While intravenous drug use,healthcare exposure(i.e.blood transfusions and surgical care),and body modification(i.e.tattooing and piercings)are well accepted risk factors for HCV transmission,others remain controversial.Because dental practice is often asso-ciated with procedures and bleeding,the possibility of HCV transmission seemed reasonable to investigate.Here,we review the evidence for dental care as a potential risk factor for HCV transmission.We identified a total of 1,180 manu-scripts related to HCV and dental care,of which 26 manu-scripts were included in the study after exclusionary criteria were applied.As per our review of the available literature,in the developing world,the improper use of sterile technique and lack of provider education likely increases the risk of HCV transmission during dental care.In developed nations,on the other hand,general dental care does not appear to be a significant risk factor for HCV transmission in non-intravenous drug user patients;although,the improper use and reuse of anesthetics during procedures poses a rare potential risk for viral transmission.展开更多
近年来,医疗机构陆续建立以公益性为导向的绩效分配制度,充分利用以资源为基础的相对价值比率(resource-based relative value scale,RBRVS)等方法和经验,将技术水平、疑难系数、工作质量、患者满意度等作为绩效分配重点考核指标,使医...近年来,医疗机构陆续建立以公益性为导向的绩效分配制度,充分利用以资源为基础的相对价值比率(resource-based relative value scale,RBRVS)等方法和经验,将技术水平、疑难系数、工作质量、患者满意度等作为绩效分配重点考核指标,使医务人员收入真正体现劳动价值和技术价值,实现优绩优酬。口腔专科医院具有“大门诊小病房”特色,口腔患者更需要一个团队为其提供优质、有效的个体化综合性治疗方案。文章以口腔正畸学科为例,重点分析某口腔医院在实行绩效二次分配过程中遇到的痛点及难点,旨在多维度探讨主诊医师负责制在口腔专科医院的应用,加快推进绩效核算在二次分配层面的落实,提升工作积极性,实现医务人员及患者的“双满意”。展开更多
Aim The objective of this discussion paper is to investigate whether the experience gained through the German paradigm shift in dental care can be of benefit in China's deliberations on the introduction of universal ...Aim The objective of this discussion paper is to investigate whether the experience gained through the German paradigm shift in dental care can be of benefit in China's deliberations on the introduction of universal dental care for its people. Methodology A comparison of representative oral health outcome data from China and Germany, two countries at different stages in their development, is presented here in order to analyse whether the findings meet expected outcome and confirm the presumption that more developed countries perform better. Results The epidemiological comparison reveals surprising findings concerning the severity of dental diseases and, in particular, missing teeth per person in adults and rates of total edentulousness in seniors. In all of these areas German adults and seniors show significantly inferior outcomes compared with the Chinese population. The mainreason for these striking discrepancies, as it turned out, is the decisive role played by the treatment philosophies and strategies of German dentists. Conelusion and recommendations If dentists take a less interventionist approach, checking as well as treating dental diseases with preventive and strictly tooth-preserving methods, dental treatment results in oral health. Under these condi- tions it can be assumed that modem dentistry is generally good for the teeth. These findings are important for developing countries that are seeking to integrate dental care into their health care system. On the basis of long-term experience from highly industrialized Western countries and especially from Germany we will attempt to put forward proposals for creating an effective and efficient dental care system in China.展开更多
Every city above a certain size has health services that are located, to a large extent, close to their patients. This study analyzes the spatial distribution of dental office and the change in the number of dental of...Every city above a certain size has health services that are located, to a large extent, close to their patients. This study analyzes the spatial distribution of dental office and the change in the number of dental offices in Ciudad Juárez, Chihuahua, Mexico over a 15-year time period. Research was conducted in 1996 and 2011. Maps showing the location of dental offices for these two years indicate a clustering of dental offices within one and one-half miles of the city’s two principal border-crossing points between the United States and Mexico. Provider-based surveys were also used to determine the mix of patients (US or Mexican citizens) at the dental offices found throughout the city. By 2011, nearly all of the dental offices clustered within one and one-half miles of the two principal US-Mexico border crossings had 100% of their patients from the United States.展开更多
文摘Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are proven to be efficient in treating mild to moderate sleep apnea and snoring. We examined patients who had been treated in Community Dental Care with a titrable Herbst-type MAD. The aim of the study was to evaluate the quality of sleep based on self report. Methods: A questionnaire was mailed to patients (n = 184) who had received treatment for OSA or snoring between 2007 and2010 inthe Helsinki Health Centre Oral Care Unit. The patients were referred to the clinic for primary treatment, or because another treatment modality had failed. Results: Of the respondents (n = 142, 78.4%), OSA had been diagnosed in 74%, while the MAD was applied for snoring to the remaining. Among all respondents, 78.4% had worn the MAD at least three nights per week. With the MAD in situ, sleep was felt significantly less disrupted (p < 0.001) and more restorative (p < 0.001), and snoring was markedly reduced (p < 0.001). Daytime tiredness was also markedly less frequent (p < 0.001). Conclusions: Treatment with a MAD improved perceived sleep quality and awoke alertness in mild and moderate OSA patients and in snorers. This study supports such treatment to be initiated and monitored in community dental care.
文摘Introduction: The effective sterilization of reusable instruments in dental care is a crucial issue for public health. The aim of this study was to contribute to improving the processing conditions of reusable care instruments in dental practices in the city of Conakry. Methods: We carried out an observational and cross-sectional study of a descriptive type lasting three months from January to April 2022 in public and private dental practices approved for activities. Results: A total of 48 dental practices were surveyed, including 7 public and 41 private. 91.67% had the trays for instrument sterilization. 77.08% had a sterilization device. The instruments were: cleaned 100%, disinfected 70.83%, sterilized 20.83% and 20.83% reused the instruments without being sterilized. 72.97% sterilized the instruments at the end of the day. 50% of respondents declared that there were six stages of sterilization. According to standard standards, one dental office or 2.70% respected the normal sterilization process and 13.51% respected the duration and temperature. The storage quality was inadequate at 95.83%. 95.83% of dental practices are at high risk of contamination. The difficulties encountered by staff in daily activity during our study were lack of hygienists (87.50%), insufficient material resources (58.33%), and lack of protocol procedure (45.83%). Conclusion: This study allowed us to note shortcomings of dental surgeons in the process of processing reusable care materials.
文摘The main role of this article is to describe dental assistants and the dental department’s role in the dental delivery system for Special health care needs (SCHN) by creating a structure to educate the dental assisting profession and project factors that have a significant impact on the dental assistant. The dental assisting management of SCHN patient’s profession including dental Assistance general responsibilities, regulation credentialing, and education. The SCHN patient’s management creates a challenge in all area of the dental department. Handling patient with a SCHN is underexplored throughout the dental staff especially when there is not enough theoretical foundation, education and training to deal with this category of patients. SCHN patients are defined as individuals who have abnormal behavioral impairments, mental conditions or/and chronic disease or abnormal laboratory results. Thus, the aim of this article is to guide all dental assistance staff in the best dental management choice for SCHN patients. All health care teams are part of patient care in most medical settings. A work environment supportive ensures positive outcomes for patient care. This article was considered as those categories of patients required more care and special way to deal with, moreover language, age, gender and education level of the patient are also considered significant parries. Not Many studies were found to support the care of SCHN patients in dentistry department. Taking experience from other area help to design a system to handle the SCHN even if it requires hiring a Dentist who is specialized in that filed.
文摘Hepatitis C(HCV)is a viral infection that affects an estimated 71 million people worldwide,with over 1 million new infec-tions yearly.While medical treatments exist,HCV continues to be a significant public health concern.Primary prevention and transmission risk factor identification remain key in helping decrease disease prevalence.While intravenous drug use,healthcare exposure(i.e.blood transfusions and surgical care),and body modification(i.e.tattooing and piercings)are well accepted risk factors for HCV transmission,others remain controversial.Because dental practice is often asso-ciated with procedures and bleeding,the possibility of HCV transmission seemed reasonable to investigate.Here,we review the evidence for dental care as a potential risk factor for HCV transmission.We identified a total of 1,180 manu-scripts related to HCV and dental care,of which 26 manu-scripts were included in the study after exclusionary criteria were applied.As per our review of the available literature,in the developing world,the improper use of sterile technique and lack of provider education likely increases the risk of HCV transmission during dental care.In developed nations,on the other hand,general dental care does not appear to be a significant risk factor for HCV transmission in non-intravenous drug user patients;although,the improper use and reuse of anesthetics during procedures poses a rare potential risk for viral transmission.
文摘近年来,医疗机构陆续建立以公益性为导向的绩效分配制度,充分利用以资源为基础的相对价值比率(resource-based relative value scale,RBRVS)等方法和经验,将技术水平、疑难系数、工作质量、患者满意度等作为绩效分配重点考核指标,使医务人员收入真正体现劳动价值和技术价值,实现优绩优酬。口腔专科医院具有“大门诊小病房”特色,口腔患者更需要一个团队为其提供优质、有效的个体化综合性治疗方案。文章以口腔正畸学科为例,重点分析某口腔医院在实行绩效二次分配过程中遇到的痛点及难点,旨在多维度探讨主诊医师负责制在口腔专科医院的应用,加快推进绩效核算在二次分配层面的落实,提升工作积极性,实现医务人员及患者的“双满意”。
文摘Aim The objective of this discussion paper is to investigate whether the experience gained through the German paradigm shift in dental care can be of benefit in China's deliberations on the introduction of universal dental care for its people. Methodology A comparison of representative oral health outcome data from China and Germany, two countries at different stages in their development, is presented here in order to analyse whether the findings meet expected outcome and confirm the presumption that more developed countries perform better. Results The epidemiological comparison reveals surprising findings concerning the severity of dental diseases and, in particular, missing teeth per person in adults and rates of total edentulousness in seniors. In all of these areas German adults and seniors show significantly inferior outcomes compared with the Chinese population. The mainreason for these striking discrepancies, as it turned out, is the decisive role played by the treatment philosophies and strategies of German dentists. Conelusion and recommendations If dentists take a less interventionist approach, checking as well as treating dental diseases with preventive and strictly tooth-preserving methods, dental treatment results in oral health. Under these condi- tions it can be assumed that modem dentistry is generally good for the teeth. These findings are important for developing countries that are seeking to integrate dental care into their health care system. On the basis of long-term experience from highly industrialized Western countries and especially from Germany we will attempt to put forward proposals for creating an effective and efficient dental care system in China.
文摘Every city above a certain size has health services that are located, to a large extent, close to their patients. This study analyzes the spatial distribution of dental office and the change in the number of dental offices in Ciudad Juárez, Chihuahua, Mexico over a 15-year time period. Research was conducted in 1996 and 2011. Maps showing the location of dental offices for these two years indicate a clustering of dental offices within one and one-half miles of the city’s two principal border-crossing points between the United States and Mexico. Provider-based surveys were also used to determine the mix of patients (US or Mexican citizens) at the dental offices found throughout the city. By 2011, nearly all of the dental offices clustered within one and one-half miles of the two principal US-Mexico border crossings had 100% of their patients from the United States.