RESUMEN
PURPOSE: To investigate the psychologic morbidities associated with tooth loss despite treatment with technically successful dentures. MATERIALS AND METHODS: This cross-sectional questionnaire-based study compared the psychologic disturbance and functional difficulties in two groups: individuals with tooth loss who wore optimal-quality removable dentures (test group), and individuals with tooth loss who did not wear dentures (control group). The questionnaire used was developed and validated previously. The short-form revised Eysenck personality questionnaire was also used to assess the relationship with personality traits. A total of 138 participants were recruited (denture group = 70; control group = 68). RESULTS: There was a significant difference in body image dissatisfaction between the groups (χ2 = 7.72, P value = .005). The denture group had 5.75-times higher probability than the control group of suffering from body image disturbance. Older patients were predicted to have 75% less probability of body image disturbance (OR = 0.25), and men were predicted to have up to 70% less disturbance (OR = 0.3). As for psychologic morbidities, participants in both groups presented with somatic symptoms related to depression or anxiety, which were nearly double that expected in the general population (15.7% and 7.8%, respectively). Furthermore, participants who complained about body image impairment were more likely to have higher scores on the neuroticism scale (OR = 3.64). CONCLUSION: Tooth loss and dentures could be associated with body image dissatisfaction and psychologic morbidity. Planning for patient-centered care is paramount prior to extracting any teeth and providing replacement options.
Asunto(s)
Pérdida de Diente , Masculino , Humanos , Pérdida de Diente/etiología , Dentaduras , Imagen Corporal , Estudios Transversales , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To develop and validate a self-reporting measure to assess the psychological disturbance in adult patients with tooth loss and dentures Methods: Ethical approval obtained from the Health Research Authority NHS England (Ref:17/NI/0098). 128 participants (100 patients - 28 clinicians) were recruited to participate in the development and validation of the questionnaire. Inclusion criteria included adults (age ≥18) with tooth loss/dentures. Exclusion criteria included patients with a history of psychotic mental illness or patients who had treatment with dental implants. The development processes included: Phase 1. Development of questionnaire: describing the aims/target population of the questionnaire, generating a pool of items, defining the constructs to be measured, adapting psychological morbidity screening tools, Items reduction and producing a preliminary questionnaire. Phase 2. Validation of questionnaire: content validation, face validation, establishing construct validity, pilot testing and establishing reliability. RESULTS: Face and content validation indicated that the questionnaire was an appropriate tool to measure the impact of tooth loss and related psychological morbidities. Reliability analysis (Test re-test reliability/internal consistency) indicated the questionnaire has satisfactory reliability (correlation >0.7). Testing the theoretical hypothesis structure of the impact of tooth loss has also enhanced the construct validity of the questionnaire (domains correlated mildly (r>5 & <3) to strongly (r>5). Pilot testing confirmed the scale adequacy and wording clarity (>90 % of respondents). Results indicated that the developed questionnaire has adequate psychometric properties. CONCLUSION: A disease-specific measure that assesses the psychological impact of tooth loss and the effectiveness of interventions (i.e. dentures) has been developed and validated. CLINICAL SIGNIFICANT: A patient outcome measure was developed which could be used to assess the psychological impact of tooth loss and compare the effectiveness of various interventions like dentures and implants.
Asunto(s)
Pérdida de Diente , Adulto , Humanos , Psicometría , Calidad de Vida , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
PURPOSE: To systematically review the available evidence on screening tools to detect the psychological disturbance in patients with tooth loss and technically successful removable dentures (partial and complete). MATERIALS AND METHODS: The study protocol was registered with the National Institute of Health Research Database (I.D. CRD42017082125). The PICOS tool (patients, intervention, control, outcomes measure, and study design) was used to formulate an effective search strategy. Participants were adults (≥ 18), who were edentulous or had significant tooth loss (< 9 remaining teeth). The intervention included undergoing replacement with technically successful dentures (partial or complete). A control group of adults were either edentulous or had significant tooth loss and without dentures. Outcomes included assessing psychological disturbance due to treatment with dentures or due to no treatment using a validated tool. A structured search strategy was used to complete a standard systematic search of the electronic database without any date limit and/or language restriction. Only quantitative studies using a validated measuring tool to screen for psychological distress in adults with significant tooth loss were included. Two authors independently assessed the risk of bias in the included studies. Data homogeneity was assessed in regards to the screening tools to measure psychological disturbance following the management of tooth loss with dentures. The significant level was set at 0.05, using IBM SPSS Statistics 24.0 (SPSS Inc., New York, NY). The psychometric properties and the validation processes of the screening tools were assessed. RESULTS: From the original 3510 studies identified, only eight studies were found to meet the inclusion criteria. All eight studies used the same questionnaire to screen for the emotional distress of tooth loss. In addition, one study also used the Patient Health Questionnaire-9 (PHQ-9) to screen for the association of depression with tooth loss. Six studies suggested that a significant number of patients have difficulties in accepting tooth loss, were less confident, and had emotional distress related to tooth loss. However, two studies reported no significant link. All studies found a marked impact on functional activities and social interaction. However, four studies had a potentially biased selection process, and the questionnaire used was assessed to be at high-risk of measurement bias, as the development and validation process was not clear. There was also a lack of well-defined control groups in all studies. CONCLUSION: Tooth loss could cause psychological disturbance in some patients. To date, there is a lack of available tools that are suitable to screen and measure psychological disturbance in patients with tooth loss. Additional research is required to develop tools to identify and measure such impact and to recommend suitable interventions when needed.
Asunto(s)
Boca Edéntula , Pérdida de Diente , Adulto , Dentaduras , Depresión , Humanos , Calidad de VidaRESUMEN
Facial skin lesions are common; patients may present with a.nodule, crack, ulcer or abnormal discoloration of the skin that is not normally present. Ideally, dentists should include face examination in their routine clinical examination. Any suspicious lesion should be referred to a dermatologist as an early diagnosis and treatment could be life-saving. This article will discuss the diagnosis and treatment of common lesions of the face.
Asunto(s)
Dermatosis Facial/diagnóstico , Neoplasias Faciales/diagnóstico , Neoplasias Cutáneas/diagnóstico , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Odontólogos , Humanos , Hiperplasia , Queratosis Actínica/diagnóstico , Queratosis Seborreica/diagnóstico , Melanoma/diagnóstico , Nevo Azul/diagnóstico , Glándulas Sebáceas/patologíaRESUMEN
UNLABELLED: Patients with bleeding disorders pose a challenge for dentists. Most of these conditions can be safely treated in the general dental practice. Patients who are on anticoagulants represent a large group of bleeding disorders. This article reviews the latest evidence in regard to managing those patients. Most of the articles reviewed seem to agree on the negligible risk of modification or interruption of oral anticoagulants when performing most dental treatments because a decreased risk of excessive bleeding might be associated with an increased risk of thrombo-embolic complications. However, extensive pre-operative assessment is essential to reduce the risk of serious complications. CLINICAL RELEVANCE: Patients with bleeding disorders pose a challenge for dentists. Adequate understanding of the underlying medical condition is essential to reduce the risk of dangerous complications.
Asunto(s)
Anticoagulantes/uso terapéutico , Trastornos de la Coagulación Sanguínea/tratamiento farmacológico , Atención Dental para Enfermos Crónicos , Heparina/uso terapéutico , Humanos , Planificación de Atención al Paciente , Atención Perioperativa , Medición de Riesgo , Warfarina/uso terapéuticoRESUMEN
Dentists may encounter patients with various types of bleeding disorders in their daily practice. Initial recognition of such bleeding disorders and their possible systemic causes, as well as knowing when to refer those cases to secondary care, plays a crucial and important role in reducing potential complications and negative side-effects. This article will give an account of the most common bleeding disorders that dentists might find in their daily dental practice. This will be followed by another article that will cover the management of congenital and acquired disorders found in the dental practice.