The imbalance between demand and supply in Dutch healthcare led to the introduction of task redistribution at the beginning of the 21st century. Some new occupations arrived, and many, especially occupations in allied healthcare, underwent major changes in scope of practice and authorization. One example is dental hygiene, which is the field of study chosen for this thesis.
DOCUMENT
BACKGROUND: Regular inspection of the oral cavity is required for prevention, early diagnosis and risk reduction of oral- and general health-related problems. Assessments to inspect the oral cavity have been designed for non-dental healthcare professionals, like nurses. The purpose of this systematic review was to evaluate the content and the measurement properties of oral health assessments for use by non-dental healthcare professionals in assessing older peoples' oral health, in order to provide recommendations for practice, policy, and research.METHODS: A systematic search in PubMed, EMBASE.com, and Cinahl (via Ebsco) has been performed. Search terms referring to 'oral health assessments', 'non-dental healthcare professionals' and 'older people (60+)' were used. Two reviewers individually performed title/abstract, and full-text screening for eligibility. The included studies have investigated at least one measurement property (validity/reliability) and were evaluated on their methodological quality using "The Consensus-based Standards for the selection of health Measurement Instruments" (COSMIN) checklist. The measurement properties were then scored using quality criteria (positive/negative/indeterminate).RESULTS: Out of 879 hits, 18 studies were included in this review. Five studies showed good methodological quality on at least one measurement property and 14 studies showed poor methodological quality on some of their measurement properties. None of the studies assessed all measurement properties of the COSMIN. In total eight oral health assessments were found: the Revised Oral Assessment Guide (ROAG); the Minimum Data Set (MDS), with oral health component; the Oral Health Assessment Tool (OHAT); The Holistic Reliable Oral Assessment Tool (THROAT); Dental Hygiene Registration (DHR); Mucosal Plaque Score (MPS); The Brief Oral Health Screening Examination (BOHSE) and the Oral Assessment Sheet (OAS). Most frequently assessed items were: lips, mucosa membrane, tongue, gums, teeth, denture, saliva, and oral hygiene.CONCLUSION: Taken into account the scarce evidence of the proposed assessments, the OHAT and ROAG are most complete in their included oral health items and are of best methodological quality in combination with positive quality criteria on their measurement properties. Non-dental healthcare professionals, policymakers and researchers should be aware of the methodological limitations of the available oral health assessments and realize that the quality of the measurement properties remains uncertain.
DOCUMENT
This prospective randomized clinical trial evaluated tooth sensitivity and patient satisfaction after the provision of partial ceramic restorations bonded using immediate (IDS) or delayed dentin sealing (DDS) on vital molar teeth through a within-subject comparison study. Between December 2013 and May 2016, a total of 30 patients (13 women, 17 men; mean age, 54 years old) received two lithium disilicate ceramic (IPS-e.max press, Ivoclar Vivadent) partial restorations on vital first or second molar teeth (N=60). The two teeth randomly received either IDS (test group, n=30) or DDS (control group, n=30). Partial preparations were performed on all teeth and directly after tooth preparation. IDS was achieved using self-etch adhesive (Clearfil SE Primer and Adhesive, Kuraray) followed by the application of flowable resin (Clearfil Majesty Flow, Kuraray). Partial ceramic restorations were bonded (Variolink Ultra, Ivoclar Vivadent) two weeks after preparation. The teeth were evaluated preoperatively and at one week, three months, and 12 months postoperatively using a cold test and a questionnaire for perceived tooth sensitivity. Patient satisfaction was evaluated using a visual analog scale (VAS). Data were analyzed using McNemar, chi-squared, and Wilcoxon signed rank tests (α=0.01). There was no significant difference in patient-reported tooth sensitivity between the preoperative phase and all other time points (p>0.01). There was also no significant difference between IDS and DDS (p>0.01) for all items on the questionnaire. VAS scores did not differ significantly between the IDS and DDS groups for all items in the questionnaire at all time points (p>0.01). No tooth sensitivity change was noticed with the application of partial ceramic indirect restorations. This clinical study could not confirm that IDS is more advantageous than DDS in terms of tooth sensitivity and patient satisfaction at 1 year of clinical service of partial ceramic restorations.
DOCUMENT
