Search Results (1,490)

Background: Medical emergencies occur at varying rates across the globe. Given the significant effort invested in identifying them and assessing dentists’ preparedness to deliver treatment in these life-threatening conditions, a global overview was needed. Materials and Methods: In this scoping review, data from PubMed, Cochrane Library, and Google Scholar databases were examined to identify all relevant studies reporting on the impact of medical emergencies on dentists and determine their operational preparedness at a national or regional level. Operational preparedness was determined in accordance with existing emergency operational preparedness frameworks across six domains: Anticipate, Assess, Prevent, Prepare, Respond, and Recover. Significant Findings: Global data show that dentists will invariably encounter medical emergencies across their careers. However, our investigation found that in countries where there is strong foundational training and regular refresher training, fewer frequent emergencies and stronger operational preparedness are reported. Governmental regulation emerged as a key facilitator of operational preparedness. Still, barriers exist, primarily limited access to medical emergency courses, shortages of office supplies for emergency drugs and materials, and the absence of medical emergency registries. Conclusions: A reassessment of the medical emergency training courses’ content appropriateness is paramount. Training interventions should also focus on raising awareness about the importance of preventive measures and office optimization through planning. Further research is needed to identify any overlooked facilitators and barriers to operational preparedness in medical emergencies. This will help identify opportunities for improvement and minimize the impact of emergencies on dental practices. Full article

Background: Dentists constitute one of the most heavily burdened groups of healthcare professionals, experiencing high levels of musculoskeletal disorders, occupational stress, burnout, and diminished quality of life. Although extensive literature addresses these issues, no study has directly examined biological age or epigenetic markers of aging in this population. This narrative review, informed by systematic methodological principles, seeks to fill this gap by connecting established occupational stressors with contemporary concepts of biological aging and chronomedicine, ultimately proposing a preventive well-being framework specifically for dentists. Methods: A narrative review informed by systematic methodology was conducted following PRISMA 2020 guidelines. Searches in PubMed, Scopus, and the Cochrane Library (2015–2025) used combined keywords and MeSH terms related to lifestyle factors, occupational stress, musculoskeletal disorders, quality of life, and wellness among dentists. Of the 943 records identified, 15 met the inclusion criteria and were assessed for outcomes, methodological quality, and relevant risk factors. Results: The included studies consistently indicated a significant occupational burden, with musculoskeletal pain, emotional exhaustion, anxiety, and depersonalization as frequent findings. Quality of life was generally moderate to low, especially regarding mental health. Lifestyle patterns were characterized by inadequate sleep, limited physical activity, irregular eating habits, and insufficient recovery. These conditions-chronic stress, poor sleep, inactivity, and suboptimal nutrition-are recognized accelerators of biological aging, implying that the professional demands of dentistry may adversely influence the biological clock. Although none of the studies measured biological age directly, the collective evidence underscores the need for preventive strategies informed by chronomedicine. Conclusions: This review highlights a critical gap in the dental literature: the complete absence of biological-age assessment in a professional population exposed to multiple aging accelerators. Integrating occupational health data with modern concepts of biological aging and chronomedicine, the study proposes a targeted preventive framework to regulate biological rhythms, reduce cumulative biological deterioration, and improve the long-term quality of life and professional sustainability of dentists. Full article

Background/Objectives: Regular dental visits are key to early oral cancer detection, especially for tobacco users. Effective dentist–patient communication about oral cancer examinations (OCEs) and quitting tobacco could influence patients’ actual OCE behavior. This study investigated the association of dental visits and dentist–patient communication with OCE behavior among tobacco/nicotine product users in Western India. Methods: A cross-sectional study was conducted among 350 current tobacco/nicotine product users from a dental hospital and 15 dental camps in Daman, India, between July 2023 and January 2024. The outcome variable was OCE behavior; the explanatory variables included past dental visits and dentist–patient communication about the benefits of quitting tobacco and importance of OCEs; and the covariates were socio-demographic factors and past 30-day smoking and smokeless tobacco use. The data was analyzed using bivariate and multivariable logistic regression models. Results: Only 8.7% of participants reported having undergone an OCE. Those who visited a dentist within the past year were approximately 10 times more likely to have had an OCE (OR = 9.95, p = 0.01). Participants whose dentist discussed the importance of OCE (aOR = 2.59, p = 0.04) and the benefits of quitting tobacco (OR = 2.45, p = 0.04) were 2.5 times more likely to have had an OCE. Conclusions: Our findings highlight the important role of dental visits and effective dentist–patient communication in promoting OCEs among tobacco/nicotine product users. Public health campaigns should prioritize enhancing dental visits and dentist–patient communication to emphasize the benefits of tobacco cessation and regular OCEs to reduce the oral cancer burden in this population. Full article

Background/Objectives: Healthcare worker (HCW) sickness absenteeism can disrupt healthcare service delivery and increase workload pressures, yet evidence from Kuwait remains limited. This study examined patterns of sick leave episodes and duration among HCWs in Kuwait and identified associated predictors. Methods: We conducted a nationwide retrospective analysis of sick leave utilization using Ministry of Health (MOH) administrative records for 2022, including 51,204 HCWs across all MOH healthcare facilities. Outcomes were sick leave episodes and sick leave duration. Independent variables included age, gender, nationality, place of residence, profession, managerial position, and influenza vaccination status. Zero-inflated negative binomial regression models were used to estimate adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Results: In 2022, 196,840 sick leave episodes and 295,206 sick leave days were recorded, with 53% of HCWs experiencing at least one episode. Upper respiratory tract infection (URTI)-related sick leave exhibited seasonal variation, with higher proportions during winter months. Younger age, female sex, Kuwaiti nationality, non-managerial position, and medical technician professions were associated with higher sick leave episodes and duration, while physicians, dentists, and pharmacists had lower sick leave utilization compared with nurses. Influenza vaccination was associated with fewer sick leave episodes and shorter duration. Conclusions: Sick leave patterns among HCWs in Kuwait show noticeable seasonal, demographic, and occupational variation. Targeted preventive strategies and workforce policies may help reduce sick leave burden. Full article

Background/Objectives: Dental caries remains a global challenge, with high prevalence among five-year-old children and regional inequalities. The aim of this study is to identify factors associated with protection from dental caries in five-year-old children, using Salutogenic Theory as a reference. Methods: Secondary data were analyzed from the Minas Gerais Oral Health Survey. Five-year-old children (n = 1193) were examined. Parents or guardians answered a questionnaire addressing individual variables and the use of dental services. Dependent variables were the absence of caries activity (ACA) and absence of caries experience (ACE), which were extracted from the decayed–missing–filled primary teeth (dmft) index. Logistic regression analysis was used to estimate odds ratios with 95% confidence intervals for each block of variables on the hierarchical levels. The Complex Samples module of the SPSS 19.0 program was used. Results: Five hundred ninety-five children (50.5%) in the overall sample were caries-free. In the final model, white skin color, monthly family income greater than R$1500, having more than six material goods, and not visiting a dentist in the previous year were associated with ACA and ACE. Conclusions: Factors related to socioeconomic conditions were associated with protection from dental caries in early childhood, supporting equity-based public policies to increase the number of children not affected by caries. Full article

Background: Cone-beam computed tomography (CBCT) is increasingly applied for the assessment of periodontal bone levels. However, its measurement reliability and consistency depend strongly on image quality parameters such as voxel size, noise, and reconstruction sharpness. With the growing use of CBCT datasets for artificial intelligence (AI)-based diagnostics, it is essential to understand how image degradation conditions affect examiner-derived measurement outcomes and the reliability of reference data used for AI training. Methods: An anonymized CBCT dataset containing one periodontally healthy tooth (31) and one tooth with pronounced periodontal bone loss (41) was analyzed. The original DICOM data were systematically degraded using controlled voxel enlargement (double and triple voxel size) and simulated image blur (Gaussian and median filtering). Six dentists (n = 6) independently performed standardized linear bone-level measurements, with three repeated measurements per tooth and image condition. Data were analyzed using the Shapiro–Wilk test for normality assessment, the Kruskal–Wallis H test for group comparisons, Bonferroni-adjusted Mann–Whitney U tests for post hoc pairwise comparisons, and intraclass correlation coefficients (ICC (2,1)) for inter-examiner reliability assessment. Results: A total of 180 measurements were evaluated. Image degradation conditions were associated with statistically significant differences in bone-level measurements for both teeth (tooth 31: p = 0.017; tooth 41: p = 0.0049). Significant pairwise differences were primarily observed between the original dataset and specific degraded conditions involving blur and reduced spatial resolution, while several comparisons remained non-significant. Inter-examiner reliability varied across image groups and decreased notably with pronounced voxel enlargement, particularly in the periodontally compromised tooth. Conclusions: Controlled image degradation conditions of CBCT image quality significantly affect measurement outcomes and inter-examiner reproducibility of periodontal bone measurements. These findings demonstrate that image quality is a critical determinant of measurement reliability and examiner-dependent interpretation. From both a clinical and AI-development perspective, maintaining adequate CBCT resolution may contribute to more consistent measurement behavior and more reliable training datasets. Full article

Background: Early childhood caries (ECC) affects a substantial proportion of young children worldwide, and timely screening is essential for early intervention and referral. While deep learning has shown promise for automated dental diagnostics, many existing approaches rely on computationally heavy models that limit deployment in community and mobile settings. This study investigates whether compact convolutional neural networks can achieve clinically meaningful performance for screening dental caries from oral photographs. Methods: We curated a dataset of 435 intraoral images from children aged 3–14 years, annotated by licensed dentists, and performed patient-level stratified splitting to prevent data leakage. Three convolutional neural networks (ResNet-18, MobileNetV3-Small, and EfficientNet-B0) were fine-tuned using ImageNet-pretrained weights and comparatively evaluated for the detection of dental caries from oral photographs. Models were trained with class-weighted cross-entropy loss and evaluated on a held-out test set using sensitivity, specificity, balanced accuracy, ROC-AUC, and PR-AUC with bootstrap 95% confidence intervals. Results: ResNet-18 achieved the highest balanced accuracy (0.929), weighted F1-score (0.954), and perfect sensitivity (1.00), while EfficientNet-B0 achieved the strongest threshold-independent discrimination with the highest ROC-AUC (0.978) and PR-AUC (0.990). MobileNetV3-Small maintained competitive performance (ROC-AUC 0.952; PR-AUC 0.976) with substantially lower computational complexity. Conclusions: In addition to performance evaluation, we incorporated an interpretability analysis using Grad-CAM to examine model decision behavior. The resulting attribution maps predominantly highlighted clinically relevant tooth regions associated with caries, providing evidence that the models rely on meaningful dental features rather than background artifacts. These results demonstrate that compact, deployment-friendly architectures can achieve clinically meaningful performance for ECC detection, supporting their suitability for scalable, real-world screening applications. Full article

Background: Medical emergencies in dental practice are uncommon but may have serious consequences if not promptly recognized and managed. Dentists are expected to identify and initiate appropriate interventions during such events; however, the extent to which theoretical knowledge translates into clinical confidence and preparedness remains unclear. Methods: This nationwide cross-sectional survey evaluated dentists’ knowledge, attitudes, and preparedness regarding medical emergencies encountered in routine dental practice. A total of 300 dentists practicing in Türkiye completed two structured questionnaires: a scenario-based single-best-answer multiple-choice questionnaire assessing knowledge of medical emergencies and a Likert-scale questionnaire evaluating attitudes and clinical preparedness. Of the 450 dentists invited to participate, 300 completed the survey (response rate: 66.6%). Overall knowledge scores were calculated from 16 emergency scenarios, and participants were categorized into knowledge-level groups. Associations between knowledge, attitudes, and availability of emergency resources were analyzed using chi-square tests with effect size estimation. Results: The median overall knowledge score was 11 (IQR: 9–13). While high correct response rates were observed for commonly encountered emergencies such as syncope and intraoral bleeding, lower accuracy was noted for high-risk conditions including hypertensive crisis, anaphylaxis, and epileptic seizures. Only 40% of dentists reported feeling sufficiently competent to manage medical emergencies, and avoidance of treating high-risk patients was common. Higher knowledge levels and availability of emergency equipment and medications were significantly associated with greater self-perceived competence and reduced avoidance behavior. Conclusions: Although dentists demonstrate adequate theoretical knowledge of medical emergencies, significant gaps persist in clinical confidence, preparedness, and management of high-risk scenarios. Strengthening emergency preparedness in dental practice requires structured, hands-on training and improved access to essential emergency resources to ensure patient safety and support effective clinical decision-making. Full article

Pediatric obstructive sleep apnea (OSA) is a prevalent and underdiagnosed condition associated with significant neurocognitive, behavioral, and systemic consequences. Sleep-related breathing disorders (SRBDs) in children range from primary snoring to OSA, with even mild forms increasingly linked to adverse outcomes. Given their frequent contact with pediatric patients, pediatric dentists and orthodontists are uniquely positioned to contribute to early identification and management within a multidisciplinary framework. Objectives: This narrative review aimed to summarize and critically appraise current evidence to clarify the clinical role, scope of practice, and responsibilities of pediatric dentists and orthodontists within the multidisciplinary management of pediatric obstructive sleep apnea. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and EMBASE up to 1 November 2025. Review articles addressing the involvement of pediatric dentists and orthodontists in pediatric OSA were included. No restriction was applied to language or publication year. Two authors independently performed study selection and data extraction. The methodological quality and data extraction of the studies were structured according to the SANRA scale. Ten studies were deemed suitable for inclusion in the current review. After examination of the full texts, the available evidence was filtered into specific clinical domains aimed at clarifying the role of the pediatric dentist and orthodontist in the management of pediatric obstructive sleep apnea (OSA). Qualitative thematic analysis of the included studies identified three main areas in which pediatric dentists and orthodontists contribute to the management of pediatric OSA. The first area involves screening through recognition of clinical signs and symptoms, use of validated questionnaires, and identification of craniofacial and occlusal features associated with increased airway risk. The second area concerns participation in the diagnostic–therapeutic pathway and multidisciplinary care, including timely referral, clinical documentation, and collaboration with pediatricians, otolaryngologists, and sleep specialists. The third area relates to orthodontic treatments such as rapid maxillary expansion and mandibular advancement appliances, which may provide adjunctive benefits in selected patients, although current evidence is limited by heterogeneity and growth-related confounding factors. Pediatric dentists and orthodontists play a pivotal yet complementary role in the management of pediatric OSA. In particular, all the involved specialists are encouraged to actively participate in the screening process, interdisciplinary communication, and diagnostic and therapeutic decision-making processes. Full article

Background/Objectives: The early detection of oral squamous cell carcinoma (OSCC), especially when in the presence of oral potentially malignant disorders (OPMDs), may be challenging and would assist in improving poor OSCC survival rates reported in the literature. We conducted a systematic review to evaluate the utility of adjunctive aids that could assist during clinical examination of the oral cavity to identify suspicious mucosal lesions. Methods: Three databases (CENTRAL, PubMed/MEDLINE, Embase) were screened, limiting results from 2015 to November 2025. Inclusion criteria were: articles written in English; investigating the diagnostic accuracy of diagnostic visual aids compared to conventional oral examination under white light in the assessment of oral mucosal lesions. Extracted data were analysed narratively. Studies not reporting diagnostic accuracy using biopsy results as the gold standard were excluded. Results: The search produced 137 articles; after removing duplicates, 105 were screened through inclusion/exclusion criteria, leading to 17 papers included in the review. Eight articles investigated diagnostic accuracy of narrow band imaging (NBI), seven visually enhanced lesion scopes (VELscopes), one Glasses for Oral Cancer Curing Light Exposed Screening (GOCCLES), one ViziLite chemiluminescence system, and two toluidine blue (TB). Conclusions: High study heterogeneity and lack of randomized clinical trials limit the conclusions of this review. In this context, among the investigated visual aids for expert use, NBI (sensitivity 85–100%, specificity 75–98%) emerges as the most promising tool (VELscope sensitivity 76–87.1%, specificity 21.4–90%; GOCCLES 66%, 48%; ViziLite 77.3%, 27.8%, TB 56.8–91%, 65.3–68%), due to its ability to highlight sub epithelial vascular abnormalities, considered as early indicators of dysplastic or neoplastic progression even. None of the investigated visual aids seem suited for screening purposes/use by the general dentist. Full article

Early childhood caries (ECC) is a complex, multifactorial disease shaped by biofilm ecology, host susceptibility, diet and behaviors, and structural determinants of health. Silver diamine fluoride (SDF) is an effective non-restorative option for arresting cavitated lesions in many settings and can support access when definitive care is delayed. However, translating short-horizon “arrest” outcomes into broad policy claims—that SDF-first, delegated pathways can substitute for dentist-led diagnosis and comprehensive rehabilitation—risks institutionalizing a two-tier standard of care for children facing the greatest access barriers. This perspective critically appraises evidence-to-implementation pathways for SDF and delegated ECC management, using risk-of-bias and reporting guidance as interpretive tools and drawing on pragmatic regimen trials, microbiome substudies, oral health-related quality of life (OHRQoL) analyses, and implementation work including the Canadian Caries Risk Assessment Tool (CCRAT) in primary care. We explicitly distinguish what studies demonstrate (e.g., feasibility and short-term arrest differences by reapplication interval) from what they do not establish (e.g., long-term tooth survival, pulpal outcomes, definitive treatment completion, and equity impacts). We propose practical guardrails that position SDF as interim management within a continuum of care: dentist-led diagnosis and escalation when pulpal risk is suspected; time-bound referral pathways with completion tracking; protocolized follow-up aligned with lesion/risk status; outcome sets that extend beyond “arrest” to include pain, function, OHRQoL, tooth survival, and equity stratification; and lesion-site sampling plus preregistered analyses when mechanistic claims are advanced. Full article

Background/Objectives: Cone beam computed tomography (CBCT) is vital in endodontics but suffers from beam-hardening artifacts caused by metallic restorations, which can obscure diagnostic details. This study evaluated a novel patient positioning protocol—a controlled head tilt—designed to mitigate these artifacts by moving contralateral metallic structures outside the primary X-ray path in small field of view (FoV) CBCTs. Methods: Using a skull phantom with metallic restorations CBCT scans were acquired in three positions: standard alignment, a 12° tilt toward the region of interest (ROI), and a 12° tilt to the opposite side. Fifty experienced dentists, blinded to the protocol, subjectively compared image quality and artifact severity between the tilted and reference images. Results: The tilt away from the ROI was rated as providing better image quality significantly more often than the tilt towards the side of the ROI (442 of 585 non-tied comparisons; p < 0.001). A complementary rater-clustered GEE analysis adjusted for slide confirmed higher odds of “better” ratings under head tilt away from the ROI for image quality (OR = 4.16, 95% CI 3.12–5.56) and artefacts (OR = 2.87, 95% CI 1.93–4.26). An individual head tilt significantly improves subjective small-FoV CBCT image quality, most evidently in the longitudinal plane, by reducing artifact interference from contralateral metals, and should be considered a practical strategy for clinical use, and may serve as a practical chairside strategy, pending clinical validation. Full article

Background/Objectives: Emergency department healthcare professionals are often the first to provide treatment, yet studies indicate limited knowledge in Traumatic Dental Injuries (TDIs) management among these providers. While research on TDI management in emergency departments exists globally, recent data from Saudi Arabia is lacking. This study aims to assess the knowledge, attitude, and practice of emergency department physicians, nurses, and Emergency Medical Services (EMS) regarding TDIs in three major hospitals in Riyadh, Saudi Arabia. Results: Physicians (46.4%) were significantly (p = 0.02) more likely to respond that they have sufficient knowledge about TDIs compared to nurses and EMS personnel. Of the 221 respondents, 136 (62%) were in the age group of 30–40 years, while females (OR 4.23, p = 0.00, CI 2.29–23.13) and nurses (OR 4.88, p = 0.00, CI 2.39–9.96) were more likely to say ‘No’ for any form of training they received in dental trauma during their education. Young (20–30 years old) professionals (OR 3.70, p = 0.04, CI 1.53–8.92) were less likely to feel confident in managing cases of dental trauma compared to their senior colleagues. Conclusions: In this study, nurses’ and EMS personnel’s knowledge of dental trauma management was poorer than that of physicians. Most respondents reported that dental trauma management was not part of their curriculum or training, which, in turn, was reflected in their low confidence in managing such cases. Full article

Background: Oral health (OH) is integral to general health, well-being, and quality of life; however, in long-term care (LTC) settings, it is often neglected due to residents’ functional limitations, high care dependency, and the prioritization of underlying medical conditions by healthcare staff. Previous studies have highlighted this issue and identified multiple barriers to OH promotion in institutional settings. Objectives: To assess OH practices among nurses (NUR) and nursing assistants (NA) in LTC units and to identify barriers compromising effective oral care delivery. Methods: An observational, cross-sectional, descriptive study was conducted across five LTC facilities in Porto, Portugal. A structured survey was administered to 145 healthcare workers out of a total of 259 eligible participants, yielding a response rate of 55.98%. Data were collected via Google Forms and analyzed using IBM SPSS Statistics v.26. Descriptive statistics, analysis of variance, the Mann–Whitney U test, and Chi-square tests were applied, with a significance level of 0.05. Results: The main primary barriers to OH promotion included poor patient cooperation (74.6%), lack of dentists (74.6%), insufficient material (62.7%), limited time (45.8%) and inadequate staffing (40.7%). Chlorhexidine (94.50%) and oral sponges (70%) were the most frequently used resources, whereas other methods were underutilized. No statistically significant differences were observed between professional groups, irrespective of prior training. Although 48.5% of NUR and 51.5% of NA reported not perceiving barriers, substantial gaps in practice were identified. Only 1.9% of untrained NA reported consulting evidence-based scientific sources, compared with 44.7% of untrained NUR. Conclusions: Despite limited perceived barriers, significant deficiencies in OH practices persist in LTC settings, highlighting the need for structured, interdisciplinary training programs to improve oral care delivery. Full article

Background: The clinical translation of natural nanomaterials and smart delivery systems in regenerative dentistry relies heavily on practitioner acceptance; however, end-user perspectives remain under-investigated. Objective: This study evaluated dental practitioners’ self-reported knowledge, attitudes, and perceived barriers regarding these innovations. The questionnaire examined stated intention and self-reported willingness, not clinical behaviour. Methods: A cross-sectional survey using convenience sampling was conducted among 713 Romanian dentists. Statistical analysis included Chi-square tests and odds ratio estimation to identify factors associated with willingness to adopt nano-formulations. Results: Self-reported familiarity was moderate, with only 19.1% of respondents describing themselves as “very familiar” with nanodentistry; nevertheless, 77.3% believed natural nano-formulations could match synthetic efficacy. High costs (36.5%), lack of long-term evidence (35.9%), and staining concerns (46.0%) were identified as primary perceived barriers. Experience with digital technologies (CAD/CAM) was significantly associated with a positive attitude toward adoption (OR = 2.05, 95% CI: 1.41–2.98, p < 0.001). Conclusions: Respondents demonstrated a generally positive attitude toward integrating bioactive nanomaterials, though widespread adoption is currently limited by economic, educational, and evidentiary gaps. Future strategies should focus on establishing clear clinical protocols, providing robust long-term safety data, and improving the aesthetic stability of natural biomaterials. Full article