Technology adoption among Canadian dentists

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

From theoretical concepts to policies and applied programmes: the landscape of integration of oral health in primary care

Background: Despite its importance, the integration of oral health into primary care is still an emerging practice in the field of health care services. This scoping review aims to map the literature and provide a summary on the conceptual frameworks, policies and programs related to this concept. Methods: Using the Levac et al. six-stage framework, we performed a systematic search of electronic databases, organizational websites and grey literature from 1978 to April 2016. All relevant original publications with a focus on the integration of oral health into primary care were retrieved. Content analyses were performed to synthesize the results. Results: From a total of 1619 citations, 67 publications were included in the review. Two conceptual frameworks were identified. Policies regarding oral heath integration into primary care were mostly oriented toward common risk factors approach and care coordination processes. In general, oral health integrated care programs were designed in the public health sector and based on partnerships with various private and public health organizations, governmental bodies and academic institutions. These programmes used various strategies to empower oral health integrated care, including building interdisciplinary networks, training nondental care providers, oral health champion modelling, enabling care linkages and care coordinated process, as well as the use of e-health technologies. The majority of studies on the programs outcomes were descriptive in nature without reporting long-term outcomes. Conclusions: This scoping review provided a comprehensive overview on the concept of integration of oral health in primary care. The findings identified major gaps in reported programs outcomes mainly because of the lack of related research. However, the results could be considered as a first step in the development of health care policies that support collaborative practices and patient-centred care in the field of primary care sector

Oral health technology assessment : study of mandibular 2-implant overdentures

There is little evidence that Health Technology Assessment (HTA) is much used in dentistry. Dental implant technology is an example of innovative oral health technology. The objectives of this research were to gather the evidence needed for the assessment of overdenture implant treatment so that both patients and dental practitioners can make informed decisions about this technology. These objectives included 1) investigating what types of dental clinicians adopt and provide dental implants 2) determining the effect of the clinicians' experience in the provision of implant supported prostheses and 3) measuring the patients' preference in provision of mandibular 2-implants overdenture technology.For the first part, a cross-sectional survey was sent to all licensed Canadian Dentists to measure the adoption and provision of implant technology. For the second part, we used the data on the first 140 edentulous elders who were enrolled in a randomized controlled clinical trial to compare the effects of mandibular conventional (CD) and 2-implant overdentures (IOD) on nutrition. The change in patient ratings of satisfaction after treatment, laboratory costs and the number of unscheduled visits were compared. For the last part, edentulous elders (N=36) who were wearing maxillary dentures and either a mandibular conventional denture (CD, n=13) or a two-implant overdenture (IOD, n=23) participated in this study. Participants' preference was measured during a 20-minute interview.Multivariate regression analysis on the data from the first part of the study shows that the Dentist's gender, province of practice, specialty, and whether they practice alone or in association with other practitioners, are significantly associated with the adoption of implant technology (p<0.05). It is also shown that there was no difference in satisfaction scores for either prosthesis between the groups treated by experienced specialists or new dentists. Furthermore, it is shown that IOD wearers were willing to pay three times more than the current cost of conventional dentures for implant prostheses (p<0.05).Overall, the results of this study 1) inform decision makers on what types of clinicians provide implant technology and 2) suggest that, with minimal training, all dental clinicians irrespective of their specialty, can provide successful implant overdenture prostheses that edentulous patients are willing to pay for

Additional file 1: of Cost-effectiveness analysis of the single-implant mandibular overdenture versus conventional complete denture: study protocol for a randomized controlled trial

CHEERS checklist. (DOC 113 kb

Should PGY-1 Be mandatory in dental education? Two viewpoints viewpoint 1: PGY-1 provides benefits that support making it mandatory

This Point/Counterpoint considers whether a general dentistry postgraduate year one (PGY-1) residency should be required for all new graduates who do not pursue specialty training. Currently, New York and Delaware require PGY-l for dental licensure, while other states offer it as an alternative to a clinical examination for obtaining licensure. Viewpoint 1 supports the position that PGY-l should be mandatory by presenting evidence that PGY-l residencies fulfill new graduates\u27 need for additional clinical training, enhance their professionalism and practice management skills, and improve access to care. The authors also discuss two barriers - the limited number of postdoctoral positions and the high cost - and suggest ways to overcome them. In contrast, Viewpoint 2 opposes mandatory PGY-l training. While these authors consider the same core concepts as Viewpoint 1 (education and access to care), they present alternative methods for addressing perceived educational shortcomings in predoctoral curricula. They also examine the competing needs of underserved populations and residents and the resulting impact on access to care, and they discuss the potential conflict of interest associated with asking PGY-1 program directors to assess their residents\u27 competence for licensure

Oral health-related quality of life in children and adolescents with osteogenesis imperfecta: cross-sectional study

Abstract Background Osteogenesis imperfecta (OI) affects dental and craniofacial development and may therefore impair Oral Health-Related Quality of Life (OHRQoL). However, little is known about OHRQoL in children and adolescents with OI. The aim of this study was to explore the influence of OI severity on oral health-related quality of life in children and adolescents. Methods Children and adolescents aged 8–14 years were recruited in the context of a multicenter longitudinal study (Brittle Bone Disease Consortium) that enrolls individuals with OI in 10 centers across North America. OHRQoL was assessed using the Child Perceptions Questionnaire (CPQ) versions for 8 to 10-year-olds (CPQ8–10) and for 11 to 14-year-olds (CPQ11–14). Results A total of 138 children and adolescents (62% girls) diagnosed with OI types I, III, IV, V and VI (n = 65, 30, 37, 4 and 2, respectively) participated in the study. CPQ8–10 scores were similar between OI types in children aged 8 to 10 years. In the 11 to 14-year-old group, CPQ11–14-scores were significantly higher (i.e. worse) for OI types III (24.7 [SD 12.5]) and IV (23.1 [SD 14.8]) than for OI type I (16.5 [SD 12.8]) (P < 0.05). The difference between OI types was due to the association between OI types and the functional limitations domain, as OI types III and IV were associated with significantly higher grade of functional limitations compared to OI type I. Conclusion The severity of OI impacts OHRQoL in adolescents aged 11 to 14 years, but not in children age 8 to 10 years

Additional file 1: of Single-implant overdentures retained by the Novaloc attachment system: study protocol for a mixed-methods randomized cross-over trial

SPIRIT 2013 Checklist. (DOC 121 kb

Oral health-related quality of life in children and adolescents with osteogenesis imperfecta: Cross-sectional study

© 2018 The Author(s). Background: Osteogenesis imperfecta (OI) affects dental and craniofacial development and may therefore impair Oral Health-Related Quality of Life (OHRQoL). However, little is known about OHRQoL in children and adolescents with OI. The aim of this study was to explore the influence of OI severity on oral health-related quality of life in children and adolescents. Methods: Children and adolescents aged 8-14 years were recruited in the context of a multicenter longitudinal study (Brittle Bone Disease Consortium) that enrolls individuals with OI in 10 centers across North America. OHRQoL was assessed using the Child Perceptions Questionnaire (CPQ) versions for 8 to 10-year-olds (CPQ 8-10 ) and for 11 to 14-year-olds (CPQ 11-14 ). Results: A total of 138 children and adolescents (62% girls) diagnosed with OI types I, III, IV, V and VI (n = 65, 30, 37, 4 and 2, respectively) participated in the study. CPQ 8-10 scores were similar between OI types in children aged 8 to 10 years. In the 11 to 14-year-old group, CPQ 11-14 -scores were significantly higher (i.e. worse) for OI types III (24.7 [SD 12.5]) and IV (23.1 [SD 14.8]) than for OI type I (16.5 [SD 12.8]) (P \u3c 0.05). The difference between OI types was due to the association between OI types and the functional limitations domain, as OI types III and IV were associated with significantly higher grade of functional limitations compared to OI type I. Conclusion: The severity of OI impacts OHRQoL in adolescents aged 11 to 14 years, but not in children age 8 to 10 years

Malocclusion traits and oral health–related quality of life in children with osteogenesis imperfecta: A cross-sectional study

© 2020 American Dental Association Background: The incidence of malocclusion is higher among people with osteogenesis imperfecta (OI) than the general population, and treatment options are limited due to the weak structure of bones and teeth. Focusing on those malocclusion traits that might have a high impact on a patient\u27s oral health–related quality of life (OHRQoL) is warranted. Methods: A total of 138 children and adolescents with OI were examined for malocclusion traits. OHRQoL was measured using age-specific versions (8 through 10 years and 11 through 14 years) of the Child Perceptions Questionnaire (CPQ), considering the following domains: oral symptoms, functional limitation, emotional well-being, and social well-being. Higher scores implied worse OHRQoL. Multivariable ordinal logistic regression was used to estimate the association between malocclusion traits and OHRQoL. Results: Among children aged 8 through 10 years (n = 56), the CPQ and its constituent domain scores were relatively similar between those with malocclusion (higher scores) and those without. In the adolescent (n = 82) group aged 11 through 14 years; however, those with posterior crossbite (odds ratio, 5.01; 95% confidence interval, 1.40 to 12.41) or open bite (odds ratio, 3.21; 95% confidence interval, 1.21 to 10.23) experienced statistically significantly higher degrees of functional limitations (a higher functional limitation score) than those without. Conclusions: Adolescents with OI and posterior open bites or crossbites have substantial self-reported functional limitations and worse oral symptoms, which warrants additional investigation and therapeutic trials in an attempt to improve the malocclusion. In addition, the authors found that the CPQ can be a useful tool in a clinical trial of orthodontic interventions in OI