Patient and dentist perspectives on collecting patient reported outcomes after painful dental procedures in the National Dental PBRN

SUPPLEMENTARY MATERIAL 1: Provider and patient semi-structured interview questionsDATA AVAILABILITY : The datasets generated and/or analyzed during the current study are not publicly available as they consist of transcripts that convey the thoughts and opinions of the providers and patients that were interviewed. Informed consent was obtained for using these data as part of the specific study only and not for wider sharing or distribution. Fully deidentified data are however available from the corresponding author upon reasonable request.BACKGROUND : Dental Patient Reported Outcomes (PROs) relate to a dental patient’s subjective experience of their oral health. How practitioners and patients value PROs influences their successful use in practice. METHODS : Semi-structured interviews were conducted with 22 practitioners and 32 patients who provided feedback on using a mobile health (mHealth) platform to collect the pain experience after dental procedures. A themes analysis was conducted to identify implementation barriers and facilitators. RESULTS : Five themes were uncovered: (1) Sense of Better Care. (2) Tailored Follow-up based on the dental procedure and patient’s pain experience. (3) Effective Messaging and Alerts. (4) Usable Digital Platform. (5) Routine mHealth Integration. CONCLUSION : Frequent automated and preferably tailored follow-up messages using an mHealth platform provided a positive care experience for patients, while providers felt it saved them time and effort. Patients thought that the mHealth questionnaires were well-developed and of appropriate length. The mHealth platform itself was perceived as user-friendly by users, and most would like to continue using it. PRACTICAL IMPLICATIONS : Patients are prepared to use mobile phones to report their pain experience after dental procedures. Practitioners will be able to close the post-operative communication gap with their patients, with little interruption of their workflow.The National Institutes of Health through a grant from the National Institute of Dental and Craniofacial Research with additional infrastructure and study-specific funding from NIDCR.https://bmcoralhealth.biomedcentral.comhj2024Dental Management SciencesSDG-03:Good heatlh and well-bein

Smokeless Tobacco Use and Oral Pre-malignant Lesions in the Indian Population

Background: Eighty percent of total smokeless tobacco users in the world are from India and Bangladesh. According to the Global Adult Tobacco Survey (2009), the percentage of adults who used smokeless tobacco in India was 25.9% with a 32.9% prevalence in males and 18.4% prevalence in females. Due to smokeless tobacco products being available and distributed in a variety of forms, independently or in different combinations; it’s use being addictive, lethal and carcinogenic; and the prevalence of varied beliefs, habits and misinformation influencing the use of smokeless tobacco products in India, it is necessary to understand the prevalence of smokeless tobacco use and prevalence of oral pre-malignant lesions in this population. Methodology: In this study, two datasets obtained from the Indian Dental Association under their ‘National Oral Health Programme’ initiative were analyzed. One dataset belonged to the truck driver population and the other dataset to the general population. Quantitative data analysis of these two cross-sectional studies for prevalence of smokeless tobacco use and oral pre-malignant lesions was conducted using STATA15 software. Results: The prevalence of smokeless tobacco use was 75.3% among truck drivers and 28.3% in the general population. The prevalence of oral pre-malignant lesions and conditions in the truck drivers was found to be 17.5% and 15.7% in the general population. The odds ratio for the presence of oral lesions and smokeless tobacco use was 2.84 (95% CI = 0.578 – 27.424) in the truck drivers, however the association was not found to be significant (p-value = 0.22). The association between smokeless tobacco use and presence of oral lesions showed a significant association (p-value \u3c 0.001) in the general population with an odds ratio of 11.7 (95% CI = 4.475 – 32.503). Conclusion: This study did provide a good insight of the prevalence of smokeless tobacco use in truck drivers. Since there are limited number of studies conducted in this population to assess their smokeless tobacco use and prevalence of oral lesions, the findings from this study are among the few early estimates that will help to provide basis for future studies. The relatively high use of smokeless tobacco in the truck drivers does point to existence of certain risk factors specific to the occupation which need further investigation. In the general male population, the high odds of prevalence of oral pre-malignant lesions in smokeless tobacco users indicate the susceptibility of this population in developing these lesions which can further advance into oral cancer

Opioid and Antibiotic Prescribing in the US Academic Dental Setting

Background: In the United States, dentists are responsible for millions of opioid and antibiotic medication prescriptions annually and have been recognized as the one of the leading healthcare professionals to be prescribing opioids and third leading prescribers of antibiotics, thereby contributing to the opioid crisis and antibiotic resistance. Clinically, opioids and antibiotics are frequently inappropriately prescribed for managing acute dental conditions, where they may be of little clinical benefit, as such ignoring established guidelines for prescribing these medications. Methods: In this research, factors associated with prescribing of opioids and antibiotics by dentists at academic dental institutions in the US were determined through quantitative and qualitative data analysis. For the quantitative analysis, data from electronic dental records collected through the BigMouth data repository from 9 dental institutions across the years 2011 – 2020 was used. Prescribing rates were calculated, trends in prescribing assessed and statistical analysis using multi-level mixed effects logistic regression model was performed to identify the factors associated with prescribing. For the qualitative analysis, 10 dental care providers at 1 dental institution were interviewed in the year 2020 and the data was analyzed using thematic analysis method to determine the behavioral factors that influence opioid prescribing behaviors. Lastly, adherence to prescribing guidelines was determined by reviewing 200 electronic dental records with opioid and antibiotic prescriptions during the year 2021 at 1 dental institution. Results: The opioid prescribing rate between the years 2011 – 2020 was 2.00% which saw a sharp decline from 2014 to 2019 and increased in 2020, with Oral Surgeons contributing to 49% of the opioid prescriptions. The antibiotic prescribing rate was 2.70% which remained steady across the years. 91% opioid and 69% antibiotic prescriptions were prescribed when the patient had at least one dental procedure associated with post-operative dental pain. Opioid prescribing had greater odds for patients between 15 to 24 years of age and dentists who were Oral Surgeons. Antibiotic prescribing had greater odds for patients more than 65 years old and dentists who were Periodontists and Implant specialists. Additionally, the odds of opioid and antibiotic prescription being made were greater when the dental visit had at least one pain-associated procedure and multiple dental procedures at the same visit. Dentists’ prescribing behavior was determined by multiple factors and was patient-centered varying from case to case. Dentists’ specialty, peer influence, faculty mentorship, complexity of dental procedure, contraindications to non-opioid analgesics and meeting patient expectations were the factors found to be influencers of dentists’ opioid prescribing behavior. Low adherence to prescribing guidelines was found with 0% complete guideline concordance for opioid prescriptions and 59% guideline discordance for antibiotic prescriptions. Conclusion: This research provided a comprehensive understanding of the factors associated with prescribing of opioid and antibiotic medications; identified trends in prescribing; and determined the extent and sources of unindicated prescriptions. The results of this research can contribute further towards the development of dental specialty specific interventions to reduce prescribing and the development of clinical decision support systems for prescribing these medications appropriately in the future

Patient and dentist perspectives on collecting patient reported outcomes after painful dental procedures in the National Dental PBRN.

BACKGROUND: Dental Patient Reported Outcomes (PROs) relate to a dental patients subjective experience of their oral health. How practitioners and patients value PROs influences their successful use in practice. METHODS: Semi-structured interviews were conducted with 22 practitioners and 32 patients who provided feedback on using a mobile health (mHealth) platform to collect the pain experience after dental procedures. A themes analysis was conducted to identify implementation barriers and facilitators. RESULTS: Five themes were uncovered: (1) Sense of Better Care. (2) Tailored Follow-up based on the dental procedure and patients pain experience. (3) Effective Messaging and Alerts. (4) Usable Digital Platform. (5) Routine mHealth Integration. CONCLUSION: Frequent automated and preferably tailored follow-up messages using an mHealth platform provided a positive care experience for patients, while providers felt it saved them time and effort. Patients thought that the mHealth questionnaires were well-developed and of appropriate length. The mHealth platform itself was perceived as user-friendly by users, and most would like to continue using it. PRACTICAL IMPLICATIONS: Patients are prepared to use mobile phones to report their pain experience after dental procedures. Practitioners will be able to close the post-operative communication gap with their patients, with little interruption of their workflow

Patient and dentist perspectives on collecting patient reported outcomes after painful dental procedures in the National Dental PBRN

Abstract Background Dental Patient Reported Outcomes (PROs) relate to a dental patient’s subjective experience of their oral health. How practitioners and patients value PROs influences their successful use in practice. Methods Semi-structured interviews were conducted with 22 practitioners and 32 patients who provided feedback on using a mobile health (mHealth) platform to collect the pain experience after dental procedures. A themes analysis was conducted to identify implementation barriers and facilitators. Results Five themes were uncovered: (1) Sense of Better Care. (2) Tailored Follow-up based on the dental procedure and patient’s pain experience. (3) Effective Messaging and Alerts. (4) Usable Digital Platform. (5) Routine mHealth Integration. Conclusion Frequent automated and preferably tailored follow-up messages using an mHealth platform provided a positive care experience for patients, while providers felt it saved them time and effort. Patients thought that the mHealth questionnaires were well-developed and of appropriate length. The mHealth platform itself was perceived as user-friendly by users, and most would like to continue using it. Practical implications Patients are prepared to use mobile phones to report their pain experience after dental procedures. Practitioners will be able to close the post-operative communication gap with their patients, with little interruption of their workflow

Identifying Contributing Factors Associated With Dental Adverse Events Through a Pragmatic Electronic Health Record-Based Root Cause Analysis

Objective This study assessed contributing factors associated with dental adverse events (AEs). Methods Seven electronic health record-based triggers were deployed identifying potential AEs at 2 dental institutions. From 4106 flagged charts, 2 reviewers examined 439 charts selected randomly to identify and classify AEs using our dental AE type and severity classification systems. Based on information captured in the electronic health record, we analyzed harmful AEs to assess potential contributing factors; harmful AEs were defined as those that resulted in temporary moderate to severe harm, required hospitalization, or resulted in permanent moderate to severe harm. We classified potential contributing factors according to (1) who was involved (person), (2) what were they doing (tasks), (3) what tools/technologies were they using (tools/technologies), (4) where did the event take place (environment), (5) what organizational conditions contributed to the event? (organization), (6) patient (including parents), and (7) professional-professional collaboration. A blinded panel of dental experts conducted a second review to confirm the presence of an AE. Results Fifty-nine cases had 1 or more harmful AEs. Pain occurred most frequently (27.1%), followed by nerve injury (16.9%), hard tissue injury (15.2%), and soft tissue injury (15.2%). Forty percent of the cases were classified as "temporary not moderate to severe harm."Person (training, supervision, and fatigue) was the most common contributing factor (31.5%), followed by patient (noncompliance, unsafe practices at home, low health literacy, 17.1%), and professional-professional collaboration (15.3%). Conclusions Pain was the most common harmful AE identified. Person, patient, and professional-professional collaboration were the most frequently assessed factors associated with harmful AEs.</p

Additional file 1 of Patient and dentist perspectives on collecting patient reported outcomes after painful dental procedures in the National Dental PBRN

Supplementary Material 1: Provider and patient semi-structured interview question