Abstract Maintaining good musculoskeletal health, including good oral health, is as important for women with bleeding disorders (WBD) as it is for men. Many people with bleeding disorders ignore ...bleeding from their gums, believing it to be part of their condition. However, it may be a sign of periodontal disease, which left untreated can lead to accelerated tooth loss and infection, adversely affecting overall health. A good diet and access to good dental care from childhood are important to maintaining good oral health in WBD. Joint bleeding and degeneration are not limited to people with more severe forms of haemophilia; joint-related diagnoses have been shown to be twice as common among haemophilia carriers and women with mild haemophilia than in the general population. Women with type 3 von Willebrand disease experience comparable joint outcomes to younger intensively treated patients with severe haemophilia. Neither gum nor joint bleeds should ever be considered normal, as both can be treated to avoid progressive disease. Dental and joint specialists and physiotherapists should work closely with haemophilia teams to ensure optimal care for long-term preservation of musculoskeletal health.
The aim of this systematic review was to update an existing review on the management of dental caries lesions in patients with disabilities so as to provide an up-to-date summary of the evidence. ...Randomized clinical trials and cohort studies related to preventive and restorative programmes for dental caries among people requiring special care, published in English, Spanish, Portuguese, French and German languages from February 1st 2011 to April 1st 2022, were retrieved from three databases (“updated review”). From the 1,105 titles identified using the search topic “Caries AND Disability”, 17 papers informed in the analyses: 6 referring to caries preventive strategies and 11 related to restorative care strategies. Most of these studies targeted children and adults with intellectual/physical disability, although preventive and therapeutic strategies were also reported for frail older adults and onchohematological patients. Fluorides in tablets, gels or varnishes forms and the use of xylitol as a sugar substitute were reported as effective approach to prevent the onset of caries in high-risk groups. Minimally intervention treatment options such as the Hall technique, the ART approach and the use of SDF for arresting caries, were deemed suitable and effective strategies for treating existing lesions in-office. In conclusion, in the past decade (2011–2022) an increased number of articles reported strategies to prevent and manage caries among people requiring special care. Although an array of preventive and therapeutic strategies for dental caries exists, more and better-quality clinical evidence is needed to offer guidance to inform policy and practice for special care dentistry.
Persons unable to access oral health care in the conventional primary health care setting suffer from inequalities in oral health, particularly in terms of unmet dental need. The International ...Classification of Functioning, disability and health (ICF) is designed to look beyond medical diagnosis and to describe individuals or populations in terms of their ability to function and participate in a social environment. The objective of the study was to describe an adult population requiring specialist oral health care using the ICF and to identify common factors of functioning, participation and environmental context.
The ICF Checklist for Oral Health was completed for 246 participants from five specialist dental services in five countries (mean age 36 ±16.44 years; 16-92). 'Developmental disability' and 'Medically compromised' groups were identified (72% and 28%).
Participants presented with oral disease (92%) and dysfunction (66% impaired chewing). 33 ICF items were affected in over 50% of participants in both groups. Impaired body functions included 'ingestion functions', 'energy and drive functions' and 'emotional functions'. Participation was restricted for "Acquiring, keeping and terminating a job", "Intimate relationships", "Handling stress and psychological demands", "Economic self-sufficiency", "Carrying out a daily routine", "Recreation and leisure", "Community life" and "Looking after one's health". In the environment domain, "Support and relationships" and "Attitudes" were rated as facilitators. Environmental barriers reported for over 25% of the whole group were related to "Services, systems and policies" including, health, social security, general support, transportation, and labour and employment.
Common aspects of functioning, participation and environment were found amongst a heterogeneous population of adults attending specialist dental services, alongside poor oral health and function. The ICF may be used to describe populations that suffer inequality in oral health in order to develop services that effectively target those in need of additional means.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
The International Classification of Functioning, Disability and Health Children and Youth version (ICF‐CY) (WHO) may serve as a tool for the application of holistic models of oral health.
...Aim
The ICF‐CY Global Oral Health Survey explored international professional opinion regarding factors relating to child oral health, including social environment, functioning, activity, and participation.
Methods
Networking resulted in 514 professionals from 81 countries registering for a two‐round Delphi survey online. Participants were pooled into 18 groups according to six WHO world regions and three professional groups. In a randomized stratification process, eight from each pool (n = 144) completed the survey. The first round consisted of eight open‐ended questions. Open‐expression replies were analysed for meaningful concepts and linked using established rules to the ICF‐CY. In the second round, items were rated for their relevance to oral health (86% response rate).
Results
A total of 86 ICF‐CY items and 31 other factors were considered relevant to child oral health and function by at least 80% of professionals.
Conclusions
The ICF‐CY can describe the holistic experience of oral health in children from the professional perspective. The data from this study will contribute to the development of an ICF‐CY Core Set in Oral Health.
Due to the global prevalence of oral disease, tooth extraction is the most common surgical procedure required in general population thus likely to be similarly common in patients with haemophilia, ...especially those in older age and those living in countries with restricted resources. There are little or no consensus about optimal level and duration of factor replacement (FRP) therapy required to prevent bleeding complication following surgery and low levels of evidence to inform protocols and guidelines. The goal of this article was to review the literature regarding haematological treatment protocols and to assess their effectiveness in prevention of bleeding complications during and after tooth extractions in people with haemophilia. A total number of 29 articles were identified. Only two of the studies were randomized controlled trials, and meta‐analysis was not possible. Significant heterogeneity regarding haematological regimes, dental surgical procedures, disease severity and sample size of published studies which are unable to reliably inform the provision of safe dental surgery was noted. Based on the haematological regimens, all studies were classified into one of three groups: pre‐ and postoperative FRP or DDAVP, single preoperative FRP or DDAVP, and no FRP treatment. The overall reported bleeding rate in case of both pre‐ and postoperative FRP and single dose FRP preoperative is similar, 11.9% and 11.4%, respectively, indicating that minimizing the use of clotting factor concentrate is possible if proper local haemostatic measures are provided. Strictly designed prospective studies with higher number of patients are necessary to get firm conclusions about optimal FRP treatment required to prevent bleeding complications during and after oral surgery in patients with haemophilia.
Abstract Objectives The concept of oral health is frequently reduced to the absence of disease, despite existing conceptual models exploring the wider determinants of oral health and quality of life. ...The International Classification of Functioning, Disability and Health (ICF) (WHO) is designed to qualify functional, social and environmental aspects of health. This survey aimed to reach a consensual description of adult oral health, derived from the ICF using international professional opinion. Methods The Global Oral Health Survey involved a two-round, online survey concerning factors related to oral health including functioning, participation and social environment. Four hundred eighty-six oral health professionals from 74 countries registered online. Professionals were pooled into 18 groups of six WHO world regions and three professional groups. In a randomised stratification process, eight professionals from each pool ( n = 144) completed the survey. The first round consisted of eight open-ended questions. Open expression replies were analysed for meaningful concepts and linked using established rules to the ICF. In Round 2, items were rated for their relevance to oral health (88% response rate). Results Eighty-nine ICF items and 30 other factors were considered relevant by at least 80% of participants. International professionals reached consensus on a holistic description of oral health, which could be qualified and quantified using the ICF. Conclusions These results represent the first step towards developing an ICF Core Set in Oral Health, which would provide a practical tool for reporting outcome measures in clinical practice, for research and epidemiology, and for the improvement of interdisciplinary communication regarding oral health. Clinical significance Professional consensus reached in this survey is the foundation stone for developing an ICF Core Set in Oral Health, allowing the holistic aspects of oral health to be qualified and quantified. This tool is necessary to widen our approach to clinical decision making, measurement of clinical outcomes, research and epidemiology.
This study aimed to generate prioritised goals for oral health services for people with disabilities as a first step in meeting the need for evidence based oral health services for people with ...disabilities in Ireland.
The study used a three round modified e-Delphi method, involving dental service professionals and people with disabilities or their representatives, in Ireland. Three rounds were completed online using SurveyMonkey. Round 1 asked: "List what you think dental services for people with disabilities in Ireland should be like." Items for subsequent rounds were generated from responses to Round 1. Round 2 and Round 3 used 5 point Likert scales to rank these items by priority: from No Priority (1) to Top Priority (5). Consensus was achieved on each item where at least 80% of respondents considered an item either High or Top Priority. A consensus meeting concluded the process.
Sixty-one panelists started and 48 completed the survey. The Delphi panel agreed on level of priority for 69 items and generated 16 consensus statements. These statements covered a range of topics such as access to care, availability of information and training, quality of care, dental treatment and cost. A recurrent theme relating to the appropriateness of care to individual need arose across topics suggesting a need to match service delivery according to the individual's needs, wants and expectations rather than the disability type/diagnosis based service which predominates today.
This process produced a list of prioritised goals for dental services for people with disabilities. This creates a foundation for building evidence-based service models for people with disabilities in Ireland.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
WFH Guidelines for the Management of Hemophilia, 3rd edition Srivastava, Alok; Santagostino, Elena; Dougall, Alison ...
Haemophilia : the official journal of the World Federation of Hemophilia,
August 2020, 2020-08-00, 20200801, 2020-08-01, Letnik:
26, Številka:
S6
Journal Article
Education in Special Care Dentistry (SCD) at undergraduate and postgraduate levels is often limited when compared with other dental specialities, even though dental professionals encounter people ...with Special Healthcare Needs (SHCNs) on a very regular basis. This literature review examined whether education at undergraduate and postgraduate level increases dental students’ and professionals’ confidence in managing a patient with SHCN. It also appraised whether there was a correlation between increased practitioner confidence and increased quality of care for people with SHCN. This review also examined educational efforts worldwide, and whether there is an increased emphasis on providing education in SCD to dental students. It was found that those who received high‐quality practical and theoretical education on how to properly manage patients with SHCN reported having higher levels of confidence than those who did not. People also reported being far more likely to employ the proper behavior management techniques and were more likely to treat people with SHCN regularly. There has been an increased emphasis on providing education in SCD worldwide in recent years, but a number of barriers still exist to providing complete education in the area.
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