To explore the attitudes, facilitators and barriers in providing oral care for inpatients with dysphagia post-stroke as perceived by healthcare professionals.
Dysphagia is a common complication of ...stroke and is associated with a higher incidence of aspiration pneumonia, malnutrition and dehydration. In the acute phase of stroke recovery, a dental professional is not usually part of the multidisciplinary team caring for the patient and oral care is the responsibility of the healthcare professionals in the stroke unit. There is a lack of high-quality evidence to demonstrate the most effective method of providing oral care for patients with dysphagia post-stroke.
This was a single-site study conducted with healthcare professionals working in the Stroke Unit of Cork University Hospital in Ireland, using focus groups and a qualitative thematic analysis approach.
A total of three focus groups were conducted in the Stroke Unit with 17 healthcare professionals. The focus groups included representation from all healthcare professional groups providing direct clinical care to patients on the Stroke Unit including geriatric medicine, dietetics, speech and language therapy, healthcare assistance, nursing, occupational therapy and physiotherapy. A qualitative thematic analysis was carried out and seven overarching themes emerged from the data. Three themes related to facilitators to providing oral care for this patient group: (i) a focus on oral care in both policy and practice, (ii) expanding professional roles in the provision of oral care, (iii) perceived importance of oral care in recovery and rehabilitation. Four themes related to barriers to the provision of oral care for this patient group: (i) lack of confidence and concerns related to the perceived risk for patients with dysphagia, (ii) unique challenges of patient and stroke-related factors, (iii) lack of resources and time and (iv) perceived importance of oral care in recovery and its relative importance with competing demands.
Members of the stroke multidisciplinary team believe that they all have a part to play in the delivery of oral care for patients with dysphagia post-stroke. Opportunities exist for the development of multidisciplinary interventions to improve the oral cavity assessment and oral care provided in the Stroke Unit.
Solid organ transplant provides a lifeline for people with end stage organ failure. Each year the number of individuals in receipt of a solid organ transplant is increasing. Prevention of ...post-transplant sepsis and infection are critical for transplant success. The oral cavity contains more than 700 different species of bacteria and is a potential reservoir for disease causing pathogens. Prior to undergoing solid organ transplant, individuals must receive a certification of dental health from a dental practitioner. There are currently no guidelines or protocols for dental practitioners to follow when certifying a patient as dentally fit. This allows for a wide variation of the term 'dentally fit'. This survey was conducted as part of a larger study assessing the oral health of adults with cystic fibrosis ongoing in Cork University Dental School and Hospital. The aim of the study was to ascertain current practices and attitudes of dental practitioners regarding the provision of dental treatment pre and post solid organ transplantation.
An anonymous cross sectional survey of dental practitioners in Ireland was conducted.
The data collected showed a wide variation in the provision of treatment for patient undergoing or in receipt of a solid organ transplant.
It demonstrates a need for further research to be conducted to ascertain the full impact solid organ transplant has on oral health, so that guidelines can be developed to aid both dental and medical professionals in the treatment of this vulnerable cohort.
The genetic basis of antigenic drift of human A/H3N2 influenza virus is crucial to understanding the constraints of influenza evolution and determinants of vaccine escape. Amino acid changes at only ...seven positions near the receptor binding site of the surface hemagglutinin protein have been shown to be responsible for the major antigenic changes for over forty years. Experimental structures of HA are now available for the majority of the observed antigenic clusters of A/H3N2. An analysis of the HA structures of these viruses reveals the likely consequences of these mutations on the structure of HA and thus, provides a structural basis for the antigenic changes seen in human influenza viruses.
Cystic Fibrosis is an autosomal recessive condition. It is a multisystem disease treated with a broad range of pharmacological therapies, diet and nutrition, and physiotherapy. Previous studies ...suggest that people with cystic fibrosis have a higher prevalence of developmental defects of enamel which may place this population at a greater risk of developing oral diseases such as caries. The aim of this study was to assess a cohort of people with cystic fibrosis (PwCF) for the presence of developmental defects of enamel and compare the results with a control group of people without cystic fibrosis.
A cross sectional study involving 92 participants with cystic fibrosis and 92 controls was conducted in Cork University Dental School & Hospital. All participants completed a detailed questionnaire prior to undergoing a full clinical examination. The Developmental Defect of Enamel Index was used as a measurement index. All data was statistically analysed with the help of statisticians from Cystic Fibrosis Registry of Ireland.
64 % (n = 59) of PwCF had enamel defects compared to just 30 % (n = 28) of people without cystic fibrosis. The median number of teeth affected by enamel defects in the study group was 1.5, compared to 0 in the control group.
In this study the cohort of PwCF had more enamel defects than people without CF. Further research is required to investigate the aetiology of these findings.
Clinicians should be vigilant after teeth have erupted in PwCF as they may have an increased susceptibility to developmental defects of enamel.
Objective
The aim of this systematic review was to compare cumulative failure rates of different restorative materials in carious class V lesions on the root surfaces of adult patients.
Background
...The prevalence of root caries is set to increase in the coming years as a result of ageing of the population and a concomitant reduction in levels of edentulousness. Evidence is needed to assist practitioners to select the most appropriate restorative material for use in these lesions.
Methods
A search of the literature was undertaken using the electronic databases of PubMed, Embase, CENTRAL and OpenSIGLE using keywords relevant to the search question. Two review authors conducted the electronic search independently, and any conflict was resolved by discussion. The references quoted in the full text articles extracted were hand searched for any further eligible studies.
Results
Sixty non‐duplicate citations were screened. Following review of the titles, s, texts and application of the pre‐determined inclusion/exclusion criteria, five studies remained.
Conclusion
There is a need for more research in this area as many of the studies identified in this systematic review treated post‐radiation, xerostomic patients which are not typical of the general population. Increased adherence to CONSORT guidelines for reporting is also advised to facilitate future systematic review and meta‐analysis in this area.
Abstract Objectives The aim of this systematic review was to identify from in vitro studies the effect of endodontic access on the fracture resistance and damage around the access cavity of ...all-ceramic crowns. Data The articles identified were screened by two reviewers according to inclusion and exclusion criteria. The reference lists of articles advanced to second round screening were hand searched to identify additional potential articles. The risk of bias for the articles was independently performed by two reviewers. Sources An electronic search was conducted on PubMed/Medline, Web of Science, Scopus and Embase databases with no limitations. Study selection 383 articles were identified, of which, eight met the inclusion criteria and formed the basis of this systematic review. Factors investigated in the selected articles included the, presence of microcracks at the access cavity, repair protocol, ceramic type, crown fabrication method, luting agent and grit size of the diamond bur. The risk of bias was deemed to be high for three, medium for two and low for three of the reviewed studies. The high level of heterogeneity across the studies precluded meta-analyses. Conclusion Based on the currently available scientific evidence, a ‘best practice’ protocol with regard to improving the fracture resistance of endodontically accessed and repaired all-ceramic crowns cannot be conclusively identified. However, some key factors which potentially impact on the fracture resistance of endodontically accessed and repaired all-ceramic crowns have been isolated. Cautious clinical interpretation of these factors is concluded for the maintenance of the crown as a permanent restoration. Clinical significance Key factors which impact on the fracture resistance of endodontically accessed and repaired all-ceramic crowns have been isolated from in vitro studies. Cautious clinical interpretation of these factors is advised for the maintenance of the crown as a permanent restoration.
Oral health impacts systemic health, individual well-being, and quality of life. It is important to identify conditions that may exacerbate oral disease to aid public health and policy development ...and promote targeted patient treatment strategies. Developmental defects can increase an individual's risk of dental caries, hypersensitivity, premature tooth wear, erosion, and poor aesthetics. As part of an ongoing study assessing oral health in adults with cystic fibrosis at Cork University Dental School and Hospital, a systematic review of available literature was conducted to assess the prevalence of enamel defects in people with cystic fibrosis.
To critically evaluate the literature to determine if the prevalence of developmental defects of enamel is higher in people with cystic fibrosis (PwCF).
Data Sources: Three online databases were searched Embase, Scopus, and Web of Science Core Collection. Studies that examined an association between cystic fibrosis and developmental defects of enamel were included in this systematic review.
The initial search identified 116 publications from the following databases Embase, Web of Science Core Collection, and Scopus. Eleven studies were included for qualitative analysis. Nine studies concluded that PwCF had a higher prevalence of enamel defects than control people and one study found no difference in cystic fibrosis (CF) status. All studies had a risk of bias that may influence study results and their interpretation.
The results of the systematic review show a consistent pattern that PwCF have a higher prevalence of DDE than people without CF. Genetic dysfunction, chronic systemic infections, and long-term antibiotic use are possible aetiological causes. This review highlights the need for future studies to investigate if DDEs are caused by the underlying CFTR mutation or as a consequence of disease manifestations and/or management.
To investigate the attitudes of adults with Cystic Fibrosis (CF) towards dental attendance and any perceived barriers to treatment.
A cross sectional survey in the form of a structured, anonymous ...questionnaire was used to obtain information regarding adults with CF's feelings towards dentists and dental treatment. The final version of the questionnaire was based on a collaborative effort between researchers at Cork University Dental School and Hospital and Cystic Fibrosis (CF) patient advocates from CF Ireland. Participants were recruited via CF Ireland's mailing list and social media channels. The responses underwent descriptive statistical analysis and inductive thematic analysis.
A total of 71 people (33 Male: 38 Female) over the age of 18 living with CF in the Republic of Ireland responded to the survey. 54.9% of respondents were unhappy with their teeth. 63.4% felt that CF had an impact on oral health. 33.8% were anxious about attending their dentist. Respondents believed that CF has impacted on their oral health due to the medications and dietary requirements involved, as well as tiredness and other side effects of CF. Reasons for being anxious about attending the dentist included cross infection concerns, issues with the dentist, with tolerating treatment, and with the teeth themselves. Respondents wanted dentists to be aware of the practicalities of dental treatment for people with CF, especially their discomfort with lying back. They also want the dentist to be aware of the impact that their medication, treatment and diet has on their oral health.
Over one third of adults with CF reported anxiety about attending the dentist. Reasons for this included fear, embarrassment, cross infection concerns and problems with treatment, especially being in the supine position. Adults with CF want dentists to be aware of the impact that CF can have upon dental treatment and oral health care.
Background
Cystic fibrosis (CF) is the most common autosomal recessive condition in Caucasian populations globally. To date, there has been very little research conducted into the oral health of ...adults with CF possibly due to historic premature mortality. The purpose of this survey was to ascertain knowledge, attitude and practices among dental professionals regarding the oral health of people with cystic fibrosis (PWCF) as part of a larger study being conducted in Ireland.
Methods
A cross‐sectional survey of dental practitioners in Ireland was conducted via an online questionnaire. The survey contained close‐ended questions, and clinical scenarios which allowed for both close‐ended and free text responses in relation to the provision of dental treatment for PWCF. Data was subject to descriptive data analysis using IBM SPSS 29.
Results
The results from the survey indicate a wide variety in the knowledge, attitudes and practices of dental practitioners regarding the oral health of PWCF. There is significant variation in the provision of dental treatment and the conditions under which such treatment is provided.
Conclusion
There is a paucity of information and guidelines specific to this vulnerable population which can make the provision of dental treatment challenging for practitioners. Dental professionals may benefit from continuing professional development and further education targeting patient‐specific populations.
A cross‐sectional study of Irish dental practitioners revealed a paucity of information, guidance and standardized oral healthcare treatment for adults with cystic fibrosis despite the identification of disease‐specific risks to oral health in people with cystic fibrosis.
Abstract Objectives It is proposed that a non-uniform rational B-spline (NURBS) based solid geometric model of a ceramic crown would be a flexible and quick approach to virtually simulate root canal ...access cavities. The computation of strain components orthogonal to surface flaws generated during the drilling would be an appropriate way of comparing different access cavity configurations. Methods A μCT scan is used to develop a full 3D NURBS geometric solid model of a ceramic crown. Three different access cavity configurations are created virtually in the geometric model and there are then imported into proprietary finite element software. A linear analysis of the each crown is carried out under appropriate in vivo loading and the results are post-processed to carry out a quantitative comparison of the three configurations Results The geometric model is shown to be a flexible and quick way of simulation access cavities. Preliminary indications are that post processed strain results from the finite element analysis are good comparators of competing access cavity configurations. Significance The generation of geometric solid models of dental crowns from μCT scans is a flexible and efficient methodology to simulate a number of access cavity configurations. Furthermore, advanced post-processing of the primary finite element analysis results is worthwhile as preliminary results indicate that improved quantitative comparisons between different access cavity configurations are possible.
