OBJECTIVE: The dentist-patient relationship (DPR) is considered to be a key element in dental clinical settings. This scoping review aimed to examine the extent of previous research on DPR, focussing on its determinants for the reification of the construct.
METHODS: This research was directed by the guidance for systematic scoping reviews from the Joanna Briggs Institute. The inclusion/exclusion criteria were based on participants of general adults and dentists, the concept of determinants of DPR, and the context of dental health care encounters. A literature search was performed in 6 major electronic databases in July 2023. Key information from included articles was extracted to chart the results, mainly to identify the determinants of DPR. Each determinant of DPR was classified according to the conceptual model of DPR.
RESULTS: A total of 1727 records were initially identified, and 16 articles were included in the review. Nine studies used a quantitative method and 7 were nonempirical articles. All but 2 articles were from the perspective of patients. Factors were grouped into 6 main domains: dentist, patient, society/environment, clinical structure, clinical process, and outcome. Amongst the 6 domains of DPR, most determining factors were related to the clinical process. \"Communication\" was most frequently counted, at 8 times, followed by \"trust\" (frequency, 6). At the patient level, \"dental fear/anxiety\" was frequently used to measure DPR.
CONCLUSIONS: Previous literature about DPR indicated a few common and dentistry-specific determinants from the patient perspective. Further studies are encouraged to develop a more comprehensive framework and evaluation scale of DPR.

OBJECTIVE: To investigate the impact of a COVID-19 mandated lockdown on the type and frequency of dental services accessed at an undergraduate dental clinic in southwestern Ontario.
METHODS: We retrieved anonymized sociodemographic (n = 4791) and billing data (n = 11616) of patients for 2 periods of 199 days, before (T1) and after (T2) lockdown. We applied descriptive statistics and used Student\'s t test to compare the type and frequency of dental services provided between the 2 periods. We mapped forward sortation area (FSA) codes of each patient.
RESULTS: Of the 4791 patients seen collectively in T1 and T2, most (67%) sought care before the lockdown. In both periods, most patients were ≥ 60 years of age (51.8%), female (33.9%) and residing in an urban area (88.6%). Compared with T1, there was a significant increase in middle-aged adults (p = 0.002) and significantly fewer patients earning over CAD 100 000 (p = 0.021) in T2. A total of 11616 billable procedures were carried out during T1 and T2: in T1, most procedures were preventative, whereas in T2, most were related to urgent care. Significantly fewer males than females sought urgent care, regardless of time. Finally, mapping showed a decrease in patients from Toronto, central and northern Ontario and clustering of patients in southwestern Ontario.
CONCLUSIONS: We noted an overall reduction in billed services following the COVID-19 lockdown. The decrease in both billed services and patients seen during T2 demonstrates the impact of COVID-19 on access to timely and definitive dental care during the first 2 years of the pandemic.

As a new drug for local dental anesthesia, articaine has become popular in the clinic in recent years. In this review, we describe the development of articaine, explain its mechanism of action, compare its efficacy with that of other commonly used local anesthetics in dental treatment, and summarize the application of articaine in special populations. In conclusion, the anesthetic efficacy of articaine in clinical dental treatment is better than that of lidocaine, and its safety is not statistically different from that of lidocaine. In particular, articaine has several advantages and can be selected flexibly for clinical use. Atecaine has great potential for wide application in dental clinics in the near future.

This narrative review aims to compile and analyse infection prevention and control (IPAC) practices followed by dental clinics during 3 coronavirus outbreaks: SARS (2002-2004), MERS (2012-2014), and COVID-19 (2019-); and to draw parallels from them for future epidemics.
Data were collected from 3 databases: Google Scholar, PubMed, and Embase using search terms \"SARS,\" \"MERS,\" \"COVID-19,\" \"infection control,\" \"disinfection,\" and \"sterilization\".
Careful examination of 108 peer-reviewed articles on the 3 outbreaks revealed the following commonalities in the IPAC practices of dental clinics: use of sodium hypochlorite (surface disinfectant), ethanol and 1-propanol (hand hygiene), povidone-iodine (oral rinse), high-volume evacuation (HVE), rubber dam isolation, anti-retraction handpieces, and fogging.
Ethanol, 1-propanol, sodium hypochlorite, povidone-iodine, photocatalysis, and fogging have been shown to be effective against various coronaviruses. However, more studies are required to validate the effectiveness of anti-retraction handpieces, rubber dam isolation, HVE, and cold atmospheric plasma specifically in infection control of the current coronavirus strain, SARS-CoV-2.
La présente revue narrative vise à compiler et à analyser les pratiques de prévention et de contrôle des infections (PECI) que les cliniques dentaires ont suivies pendant 3 éclosions du coronavirus : le SRAS (2002–2004), le SRMO (2012–2014) et la COVID-19 (2019–), et à en établir des parallèles pour les épidémies futures.
Les termes de recherche : « SRAS », « SRMO », « COVID-19 », « contrôle des infections », « désinfection » et « stérilisation » ont été utilisés pour recueillir des données dans les 3 bases de données qui suivent : Google Scholar, PubMed et Embase.
Un examen minutieux de 108 articles évalués par des pairs sur les 3 éclosions a révélé les éléments communs suivants en matière de pratiques de PECI dans les cliniques dentaires : utilisation d’hypochlorite de sodium (désinfectant de surface), d’éthanol et d’éthylcarbinol (hygiène des mains), de povidone iode (rince-bouche), d’aspiration à haute vélocité, d’isolation par digue en caoutchouc, de pièces à main anti-rétraction et de buée.
L’éthanol, l’éthylcarbinol, l’hypochlorite de sodium, la povidone iode, la photocatalyse et la buée se sont avérés efficaces contre divers coronavirus. Cependant, d’autres études sont nécessaires pour valider l’efficacité des pièces à main anti-rétraction, de l’isolation par digue en caoutchouc, de l’aspiration à haute vélocité et du plasma atmosphérique froid, en particulier dans la lutte contre l’infection par la souche actuelle du coronavirus, le SRAS-CoV-2.

Anxiety is an adaptive emotional response to potentially threatening or dangerous situations; moderated by the sympathetic nervous system. Dental anxiety is common and presents before, during or after dental treatment. The physiological response includes an increase in heart rate, blood pressure, respiratory rate, and cardiac output. Consequently, extensive distress leads to avoidance of dental treatment and multiple failed appointments, impacting both oral and general health. Dental anxiety can generate a variety of negative consequences for both the dentist and the patient. Evidence-based strategies are essential for mitigating and relieving anxiety in the dental clinic. Psychotherapeutic behavioural strategies can modify the patient\'s experience through a minimally invasive approach with nil or negligible side effects, depending on patient characteristics, anxiety level and clinical situations. These therapies involve muscle relaxation, guided imagery, physiological monitoring, utilizing biofeedback, hypnosis, acupuncture, distraction and desensitization. Pharmacological intervention utilizes either relative analgesia (nitrous oxide), conscious intravenous sedation or oral sedation, which can have undesirable side effects, risks and contraindications. These modalities increase the cost and availability of dental treatment.

By considering the recently proposed definitions and metrics, oral healthcare quality management (OHQM) emerges as a distinct field in the wider healthcare area. The goal of this paper is to systematically review quality management initiatives (QMIs) implementation by dental clinics. The research methodology approach is a review of 72 sources that have been analyzed using the Context-Intervention-Mechanism-Outcome Framework (CIMO). The analysis identifies five mechanisms that explain how quality management initiatives are implemented by dental clinics. The simplest QMIs implementations are related to (1) overall quality. The next ones, in terms of complexity, are related to (2) patient satisfaction, (3) service quality, (4) internal processes improvement, and (5) business outcomes. This paper is the first attempt to provide a critical review of this topic and represents an important advancement by providing a theoretical framework that explains how quality management is implemented by practitioners in this field. The results can be used by scholars for advancing their studies related to this emerging research area and by healthcare managers in order to better implement their quality management initiatives.

OBJECTIVE: We aimed to explore the scientific literature on accessible dental clinics for wheelchair users. More specifically, we sought out literature addressing how the human environment and physical space shape the dental services of accessible dental clinics.
METHODS: We conducted a scoping review (May 2019) in Embase, PubMed, Web of Science, and the Avery index of architectural Periodicals (3994 articles). We followed Arksey and O\'Malley\'s recommended procedures; after screening, we retained 17 articles. We performed a critical appraisal, followed by thematic content analyses of extracted data.
RESULTS: The articles originated mainly from the United States and United Kingdom. Only three reported original research. We illustrated the results within a three-step dental care pathway cycle. In each step, the interaction between accessibility of the physical and human environments (ie, the layout/design of the clinic and the attitudes and skills of the dental professional, respectively) contributed to the overall accessibility. We also found that empirical evidence on clinics\' accessibility was lacking: many articles resorted to broad \"one size fits all\" recommendations and fragmented information on accessibility. Finally, the voice of wheelchair users was missing.
CONCLUSIONS: There are knowledge gaps in terms of dental clinics\' accessibility. We thus invite researchers to conduct original studies with dental professionals, wheelchair users, and their caregivers.

UNASSIGNED: To review the available bibliographic data to identify the best screening methods to detect potential obstructive sleep apnea (OSA) patients during dental clinical practice.
UNASSIGNED: Relevant studies published up to April 2020 were sourced from PubMed, Embase, MEDLINE, Cochrane, and LILACS databases.
UNASSIGNED: Thirty studies were selected. For adults, the screening methods available to the dentist included questionnaires, scales, indexes, pulse oximetry, and anatomical factors. A combination of questionnaires is potentially the most reliable method to detect OSA risk. For children, only information on questionnaires and anatomical factors was found; two questionnaires accurately identified potential OSA risk cases. Anatomical factors also displayed a significant relation with OSA for both populations.
UNASSIGNED: Dentists have a fundamental role in early detection of potential OSA cases since they can use the methods identified in this review to perform an initial screening of the population.
UNASSIGNED: OSA: Obstructive sleep apnea; PSG: Polysomnography; HST: Home sleep study; BMI: Body mass index; PPV: Positive predictive value; NPV: Negative predictive value; AHI: Apnea hypopnea index; RDI: Respiratory disturbance index; ODI: Oxygen desaturation index; PSQ: Pediatric Sleep Questionnaire; SRBD: Sleep-related breathing disorder; CSHQ: Children\'s Sleep Habits Questionnaire; ESS: Epworth Sleepiness Scale; PSQI: Pittsburgh Sleep Quality Index.

UNASSIGNED: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes serious acute respiratory diseases including pneumonia and bronchitis with approximately 2.3% fatality occurrence.
UNASSIGNED: This study argues the main concepts that need to be considered for the gradual reopening of dental offices include treatment planning approaches, fundamental elements needed to prevent transmission of SARS-CoV-2 virus in dental healthcare settings, personal protection equipment (PPE) for dental health care providers, environmental measures, adjunctive measures, and rapid point of care tests in dental offices.
UNASSIGNED: This article seeks to provide an overview of existing scientific evidence to suggest a guideline for reopening dental offices.

The aim of this study was to use electronic health care records (EHRs) to examine retrospectively the incidence of and attributes associated with dental implant failures necessitating implant removal in a large cohort of patients treated in the student clinics of a U.S. dental school over three and a half years. EHRs were searched for all patients who received dental implants between July 1, 2011, and December 31, 2014. Characteristics of patients and implants that were actively removed due to irrevocable failure of any etiology (\"failure cohort\") during this period were compared to those of all other patients who received dental implants during the same time frame (\"reference cohort\"). Differences in the frequency distribution of various characteristics between the failure and reference cohorts were compared. Of a total 6,129 implants placed in 2,127 patients during the study period, 179 implants (2.9%) in 120 patients (5.6%) were removed. In the multivariate analysis, presence of a removable (OR=2.86) or fixed temporary prosthesis (OR=3.71) was statistically significantly associated with increased risk for implant failure. In contrast, antibiotic coverage (pre- and post-surgery OR=0.16; post-surgery only OR=0.38) and implants of certain manufacturers were associated with lower risk of implant failure. In this sizeable cohort of patients receiving care in dental student clinics, the review of EHRs facilitated identification of multiple variables associated with implant failure resulting in removal; however, these findings do not suggest causative relationships. The adopted analytical approach can enhance quality assurance measures and may contribute to the identification of true risk factors for dental implant failure.