Dentists have been inundated by patients with an array of complicated medical conditions and pain/sedation management issues. This is in addition to a variety of legal regulations dentists must ...follow regarding the storage and recordkeeping of controlled substances. Avoid unknowingly putting your practice at risk by becoming victim to a scam or violating a recordkeeping requirement with The ADA Practical Guide to Substance Use Disorders and Safe Prescribing. This Practical Guide is ideal for dentists and staff as they navigate: • Detecting and deterring substance use disorders (SUD) and drug diversion in the dental office (drug-seeking patients) • Prescribing complexities • Treating patients with SUD and complex analgesic and sedation (pain/sedation management) needs and the best use of sedation anxiety medication • Interviewing and counselling options for SUD • Federal drug regulations Commonly used illicit, prescription, and over-the-counter drugs, as well as alcohol and tobacco, are also covered. Special features include: • Clinical tools proven to aid in the identification, interviewing, intervention, referral and treatment of SUD • Basic elements of SUD, acute pain/sedation management, and drug diversion • Summary of evidence-based literature that supports what, when and how to prescribe controlled substances to patients with SUD • Discussion of key federal controlled substance regulations that frequently impact dental practitioners • Checklists to help prevent drug diversion in dental practices • Chapter on impaired dental professionals • Case studies that examine safe prescribing and due diligence
IMPORTANCE: Through prescription writing, dental clinicians are a potential source of initial opioid exposure and subsequent abuse for adolescents and young adults. OBJECTIVE: To examine the ...association between index dental opioid prescriptions from dental clinicians for opioid-naive adolescents and young adults in 2015 and new persistent use and subsequent diagnoses of abuse in this population. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study examined outpatient opioid prescriptions for patients aged 16 to 25 years in the Optum Research Database in 2015. Prescriptions were linked by National Provider Identifier number to a clinician category. EXPOSURES: Individuals were included in the index dental opioid (opioid-exposed) cohort if they filled an opioid prescription from a dental clinician in 2015, had continuous health plan coverage and no record of opioid prescriptions for 12 months before receiving the prescription, and had 12 months of health plan coverage after receiving the prescription. Two age- and sex-matched opioid-nonexposed control individuals were selected for each opioid-exposed individual and were assigned a corresponding phantom prescription date. MAIN OUTCOMES AND MEASURES: Receipt of an opioid prescription within 90 to 365 days, a health care encounter diagnosis associated with opioid abuse within 365 days, and all-cause mortality within 365 days of the index opioid or phantom prescription date. RESULTS: Among 754 002 individuals with continuous enrollment in 2015, 97 462 patients (12.9%) received 1 or more opioid prescriptions, of whom 29 791 (30.6%) received prescriptions supplied by a dental clinician. The opioid-exposed cohort included 14 888 participants (7882 women 52.9%, 11 273 white 75.7%, with mean SD age, 21.8 2.4 years), and the randomly selected opioid-nonexposed cohort included 29 776 participants (15 764 women 52.9%, 20 078 67.4% white, with mean SD age, 21.8 2.4 years). Among the 14 888 individuals in the index dental opioid cohort, 1021 (6.9%) received another opioid prescription 90 to 365 days later compared with 30 of 29 776 (0.1%) opioid-nonexposed controls (adjusted absolute risk difference, 6.8%; 95% CI, 6.3%-7.2%), and 866 opioid-exposed individuals (5.8%) experienced 1 or more subsequent health care encounters with an opioid abuse–related diagnosis compared with 115 opioid-nonexposed controls (0.4%) (adjusted absolute risk difference, 5.3%; 95% CI, 5.0%-5.7%). There was only 1 death in each cohort. CONCLUSIONS AND RELEVANCE: The findings suggest that a substantial proportion of adolescents and young adults are exposed to opioids through dental clinicians. Use of these prescriptions may be associated with an increased risk of subsequent opioid use and abuse.
Despite the availability of prevention guidelines and recommendations on infection control, many dental practices lack the minimum requirements for infection control.
This study aimed to assess the ...level of awareness, perception, and attitude regarding the coronavirus disease (COVID-19) and infection control among Jordanian dentists.
The study population consisted of dentists who worked in private clinics, hospitals, and health centers in Jordan. An online questionnaire was sent to a sample of Jordanian dentists in March 2020. The questionnaire was comprised of a series of questions about dentists' demographic characteristics; their awareness of the incubation period, the symptoms of the disease, mode of transmission of COVID-19 and infection control measures for preventing COVID-19; and their attitude toward treating patients with COVID-19.
This study included a total of 368 dentists aged 22-73 years (mean 32.9 years, SD 10.6 years). A total of 112 (30.4%) dentists had completed a master or residency program in dentistry, 195 (53.0%) had received training in infection control in dentistry, and 28 (7.6%) had attended training or lectures regarding COVID-19. A total of 133 (36.1%) dentists reported that the incubation period is 1-14 days. The majority of dentists were aware of COVID-19 symptoms and ways of identifying patients at risk of having COVID-19, were able to correctly report known modes of transmission, and were aware of measures for preventing COVID-19 transmission in dental clinics. A total of 275 (74.7%) believed that it was necessary to ask patients to sit far from each other, wear masks while in the waiting room, and wash hands before getting in the dental chair to decrease disease transmission.
Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, and infection controls and measures in dental clinics. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and other patients from COVID-19. National and international guidelines should be sent by the regional and national dental associations to all registered dentists during a crisis, including the COVID-19 pandemic, to make sure that dentists are well informed and aware of best practices and recommended disease management approaches.
My military and dental career started when I won the Dental Cadetship, a scholarship scheme of the Nigerian Army in October 1967 to read Dentistry at the College of Medicine, University of Lagos, Idi ...Araba (CMUL). Suddenly, the Nigerian Civil War started and I had to undergo my basic military training at the Army Depot, Abeokuta. I completed my dental training in June 1972. I was in the second set of Dentists graduated from CMUL and the first Odogbolu dentist.
This study aims to explore dentists' knowledge, attitudes, and perceptions regarding antibiotic use.
We conducted a systematic review of dentists' knowledge, attitudes and perceptions regarding ...antibiotic use, by searching the MEDLINE, EMBASE and Web of Science for all original paper published from January 1990 to July 2023, in accordance with the Preferred Reporting Items for systematic Reviews and Meta-analyses (PRISMA 2020) guidelines.
The review included 37 papers, (7 qualitative and 30 quantitative studies). Modifiable factors (knowledge, attitudes) were reported as being associated with antibiotic prescribing by dentists which were cited in 30 of the 37. These attitudes most frequently identified by dentists were: complacency (22/29); lack of trust (16/29); the need to postpone the dental procedure (17/29); and fear (8/29). Gaps in knowledge were also identified (15/29). Only one of the included articles quantified the influence between the reported modifiable factors and antibiotic prescribing.
The review emphasizes that dentists' antibiotic prescribing is predominantly influenced by modifiable factors. This insight informs the potential for targeted interventions to curtail inappropriate antibiotic use, contributing to global efforts in reducing antibiotic resistance.
The protocol of this systematic review can be found in PROSPERO under registration no. CRD42021253937.
•Factors associated with antibiotics prescribing in dentistry are modifiable.•Attitudes like complacency or lack of confidence influence antibiotic prescribing.•Educational interventions based on identified factors would improve prescriptions.
An older adult with diabetes is taking glipizide, a sulfonylurea class drug. Subsequently, she experiences a hypoglycemic episode in the dental office. Prompt recognition of hypoglycemia and ...administration of glucose or sugar is vital. Patient and provider education about the risks of hypoglycemia in older adults may help to prevent future hypoglycemic episodes.
In this case a patient has multiple risk factors for diabetes including periodontal disease, family history positive for diabetes, and body mass index of 24 in an Asian American. He has no medical or ...dental home and upon presenting to the dental office would be a good candidate for diabetes screening.
Introduction
This study examines undergraduate dental students' perceptions of their self‐confidence in communicating with patients and paradental staff.
Materials and Methods
A survey questionnaire ...was designed based on a literature review and input from students and academic staff relating to clinical communication skills with 19 questions across 7 domains. Through email, a convenience sampling of undergraduate students were invited to complete the survey questionnaire. Qualitative and quantitative analysis of the responses was performed with a thematic analysis to the open‐ended questions.
Results
In total, 102 students were surveyed from 4 years of students with a 36.6% response rate. Students reported some areas of low confidence across various communication domains, in particular, building rapport, behavioural change, management of patient expectation and breaking bad news. Students reported insufficient confidence and knowledge in specialist clinical areas, layperson terms and success rates and longevity of treatment items when communicating with patients. Information sheets and visual aids such as models or photos were suggested by students to be helpful in patient communication. Students also reported challenges in communication with nurses when they might challenge or change their clinical decisions in front of their patients.
Conclusion
Our study reveals areas of low confidence among undergraduate dental students in communication towards patients and paradental staff. Barriers and challenges have been identified with an action plan suggested accordingly. There is a need for additional training in the form of learning content and communications experiences, and channels of communications for undergraduate students.
Trust has a central role in healthcare encounters. This review explored concepts relevant to trust in dentist‐patient relationships. The findings were demonstrated by drawing visual system maps for ...better understanding of the inherent complexity. A pragmatic approach was employed to search for evidence. The approach was initiated with a systematised searching protocol and followed by an iterative process of drawing maps and complementing references. The analysis‐synthesis process found relevant key concepts and sub‐concepts presented within three frameworks: the continuum of studying trust (utilisation, measurement, and establishment); beneficiaries of trust utilisation (patients, dentists, and oral health system); and a transformational model of trust development (identification‐based, knowledge‐based, and deterrence/calculus‐based trust). Trust in dentist‐patient relationships needs to be assessed in a multidisciplinary approach for interconnectedness among relevant concepts. The findings are represented in patient‐centred care and quality of care with common underlying values. Despite the centrality of trust in medical/dental contexts, empirical evidence is insufficient beyond normative suggestions from previous studies. Based on the implications of thematic analysis and interpretation of the system maps, this paper can serve as a guide and source of information for further research of trust in dentist‐patient relationships.
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