Dental Clinics

牙科诊所
  • 文章类型: Journal Article
    背景:牙科单元水线(DUWL)将水输送到牙科单元中的不同手持件。DUWL中的水在封闭系统中循环,它是从容器中取出的。牙科水的质量是相当重要的,因为患者和牙科工作人员经常暴露于由牙科设备产生的水和气溶胶。来自DUWL的输出水可能是牙科保健人员和患者的潜在感染源。
    目的:评估钦奈牙科诊所DUWL中的微生物污染。
    方法:于2019年12月对来自钦奈20个牙科诊所的60个水样进行了体外研究。根据ADA指南从牙科单元的三个不同来源收集水样。评估收集的样品是否存在曲霉,不动杆菌,铜绿假单胞菌,和军团菌采用琼脂平板法。使用SPSS软件版本20对数据进行分析。
    结果:军团菌是最普遍的微生物,在三通注射器中患病率为70%,在洁牙器和旋转器中患病率为50%,其次是铜绿假单胞菌和不动杆菌,在洁牙器和转体中的患病率为10%,在三通注射器中的患病率为10%。
    结论:大多数牙科单元被曲霉污染,军团菌,铜绿假单胞菌和不动杆菌对患者和牙医构成严重威胁。
    BACKGROUND: Dental Unit Water Line (DUWL) deliver water to different handpieces in a dental unit. The water in DUWL circulates in a closed system, where it is taken from a container. The quality of dental water is of considerable importance since patients and dental staff are regularly exposed to water and aerosols generated from dental equipment. Output water from DUWLs may be a potential source of infection for both dental health care personnel and patients.
    OBJECTIVE: To assess the microbial contamination in the DUWL among dental clinics in Chennai.
    METHODS: An in vitro study was conducted on 60 water samples from 20 dental clinics in Chennai in December 2019. Water samples were collected from three different sources of the Dental unit according to ADA guidelines. The collected samples were assessed for the presence of Aspergillus, Acinetobacter, Pseudomonas aeruginosa, and Legionella by agar plate method. The data were analysed using SPSS software version 20.
    RESULTS: Legionella was the most prevalent microorganism with 70% prevalence in a three-way syringe and 50% in scaler and airotor, followed by Pseudomonas aeruginosa and Acinetobacter with 10% prevalence in scaler and airotor and Aspergillus with a prevalence of 10% in the three-way syringe.
    CONCLUSIONS: Most of the dental units were contaminated with Aspergillus, Legionella, Pseudomonas aeruginosa and Acinetobacter which pose a serious threat to the patients as well as the dentists.
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    文章类型: Journal Article
    CareQuest口腔健康研究所的使命是改善所有人的口腔健康。实现这一目标的一个方法是通过方案倡议,训练牙科诊所提供公平的,为他们的社区提供综合和无障碍的护理。社区口腔健康转型(COrHT)倡议,允许CareQuest研究所与北卡罗来纳州口腔健康合作组织(NCOHC)和北卡罗来纳州基金会的蓝十字蓝盾(BCBS)合作,在北卡罗来纳州实施和支持该计划。这项混合方法研究旨在收集定量和定性数据,而11个牙科诊所和一个对照诊所在计划结束时参与了该计划。定量数据包括患者人口统计学,索赔数据,以及财务和数据措施。分析了参与诊所和对照诊所的描述性统计数据,汇总的临床数据显示患者护理服务措施有所改善.在中点和结论时也进行了定性访谈,结果评估完成。这份简短的报告将为读者提供COrHT倡议的结果,强调医疗-牙科一体化(MDI)是综合的一个组成部分,以人为中心的护理。对方案的优缺点进行了评估,以确定未来实施的潜力,可持续性和政策制定。
    CareQuest Institute for Oral Health\'s mission is to improve the oral health of all. One way to achieve this is through programmatic initiatives, which train dental clinics to provide equitable, integrated and accessible care for their communities. The Community Oral Health Transformation (COrHT) Initiative, allowed CareQuest Institute to collaborate with the North Carolina Oral Health Collaboration (NCOHC) and Blue Cross Blue Shield (BCBS) of North Carolina Foundation to implement and support the initiative in North Carolina. This mixed methods study was designed to collect quantitative and qualitative data while 11 dental clinics and a control clinic participated in the program through the end of the program. Quantitative data included patient demographics, claims data, and financial and data measures. Descriptive statistics of participating clinics and the control clinic were analyzed, and aggregated clinic data showed improvements in patient care delivery measures. Qualitative interviews were also conducted at midpoint and conclusion, and an outcome evaluation was completed. This short report will provide readers with results from the COrHT Initiative, with an emphasis on medical-dental integration (MDI) as an integral component of comprehensive, person-centered care. The evaluation of programmatic strengths and weaknesses has been included to identify the potential for future implementation, sustainability, and policy making.
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  • 文章类型: Journal Article
    患者满意度和生活质量是评估口腔保健质量的组成部分。对于许多仍在使用传统全口义齿(CD)或种植体保留的下颌覆盖义齿(IOD)的美国人来说,考虑改善他们的口腔健康结果和生活质量仍然至关重要.由于没有经验的学生牙医为牙科学校的患者提供牙科护理,病人的不满通常被认为是一个问题。患者反馈和满意度已被证明是监测和提高患者安全性的宝贵资源。虽然CD和IOD是两种主要的治疗方法,文献中更多的比较研究需要在学校环境中比较它们的结果。指导这种比较分析的研究问题是,“患者满意度和生活质量是否受假体类型和提供者的影响?”从2014年至2016年在肯塔基大学牙科学院学生口腔修复诊所接受无牙下颌骨治疗的患者记录中选出的520名患者邮寄了经过验证的问卷,随访时间至少1年。使用基于口腔健康影响概况(OHIP-19)的无牙患者的经过验证的问卷。此外,关于患者口腔健康相关生活质量的信息,包括与无牙患者对假牙的满意度有关的问题,被收集。应答率为33%(N=171)。这项研究的发现证实了以前的发现,提示IOD可能显著影响口腔健康相关生活质量。数据显示,IOD组中有76%的人报告说,在使用植入物保留下颌义齿时,经验有所改善。然而,总体CD组和IOD患者组之间的OHIP评分无统计学差异.患有IOD的男性身体疼痛较低,局限性,和残疾分数比男性有CD。然而,患有IOD的女性报告了与社会残疾和残疾领域相关的更重要的担忧。比较对两种治疗方案都有经验的用户,这项研究发现了有助于提高患者对IOD满意度的基本特征,并确定了性别对结局的意义.这些发现指导了口腔修复医生的患者护理实践,并确定了在牙科学校课程中讨论CD和IOD治疗方案的持续需求。
    Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CDs) or implant-retained mandibular overdentures (IODs), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CDs and IODs are the 2 leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, \"Is patient satisfaction and quality of life affected by the type of prostheses and provider?\" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least 1 year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients\' oral health-related quality of life, including questions related to the edentulous patients\' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study\'s findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IODs had lower physical pain, limitations, and disability scores than males with CD. However, females with IODs reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IODs and identified significance in outcomes by gender. These findings guide prosthodontic practitioners\' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.
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  • DOI:
    文章类型: Journal Article
    牙科专业与职业健康问题有关。牙医的工作环境与人体工程学风险因素有关,这些因素会显著降低牙医的工作能力,甚至导致他/她的专业活动终止。在不同的国家进行了许多研究(瑞典,丹麦,德国,波兰,澳大利亚,等。)评估牙医肌肉骨骼疾病的患病率,尽管在佐治亚州没有进行与牙科人体工程学原理相关的研究。该研究旨在评估第比利斯(佐治亚州首府)诊所牙医工作环境的人体工程学,并确定其中肌肉骨骼疾病的患病率。2023年4月至7月在第比利斯进行了一项观察性描述性研究。根据国际经验设计了40个问题的特别问卷。这项调查是通过随机抽样在选定的牙科诊所进行的。要求牙医在患者预约之间的空闲时间填写问卷。同意参加的人获得了问卷的电子版。五百名牙医应邀参加了调查,其中314人(62.8%)同意填写问卷。共有291份完整的问卷用于描述性统计分析。我们的研究表明,在第比利斯诊所,牙医平均工作5-6天(48.8%-6天,37.1%-5天)或每周40-48小时。大多数受访者表示,他们的工作场所符合人体工程学的要求(照明良好,椅子有一个靠背,仪器可以很容易地到达),然而他们中的大多数人很少靠在靠背上,从不或很少使用手休息方法,休息时从不或很少做轻度体育锻炼。调查显示,53.6%的牙医最常背部疼痛,其次是颈部疼痛(50.9%),肩部(47.9%)和下背部(47.1%)。他们中的大多数人说,由于疼痛,他们不得不减少工作。在牙科专业中引入人体工程学原理对于预防职业性肌肉骨骼疾病至关重要。重要的是为牙医提供持续的专业发展计划和信息手册,并为佐治亚州的牙科诊所管理提供主题在线网络研讨会。
    The dental profession is associated with occupational health problems. The working environment of a dentist is associated with ergonomic risk factors that can significantly reduce the dentist\'s working ability and even cause the termination of his/her professional activity. Numerous studies have been conducted in different countries (Sweden, Denmark, Germany, Poland, Australia, etc.) to assess the prevalence of musculoskeletal disorders in dentists, though no studies related to the principles of ergonomics in dentistry have been carried out in Georgia. The study aimed to assess the ergonomics of the working environment of dentists in Tbilisi (capital city of Georgia) clinics and to identify the prevalence of musculoskeletal disorders among them. An observational descriptive study was conducted in April-July 2023 in Tbilisi. A special questionnaire of 40 questions was designed based on international experience. The survey was conducted by random sampling in selected dental clinics. Dentists were asked to fill out the questionnaire during their free time between patient appointments. Those who agreed to participate were provided with electronic versions of the questionnaire. Five hundred dentists were invited to participate in the survey, of whom 314 (62.8%) agreed to fill out the questionnaire. A total of 291 fully completed questionnaires were used for the descriptive statistical analysis. Our study shows that in Tbilisi clinics dentists work on average for 5-6 days (48.8% - 6 days, 37.1% - 5 days) or 40-48 hours a week. A majority of respondents said their workplace met the requirements of ergonomics (it had a good lighting, the chair had a back, instruments could be easily reached), yet most of them rarely lean on the backrest, never or rarely use the hand rest method, and never or rarely do light physical exercise during breaks. The survey shows that 53.6% of dentists most frequently suffer from pain in the back, followed by pain in the neck (50.9%), shoulders (47.9%) and lower back (47.1%). Most of them said they had to work less because of the pain. Introduction of the principles of ergonomics in dental profession is vital for preventing occupational musculoskeletal disorders. It is important to provide continuing professional development programs and information booklets for dentists and thematic online webinars for the management of dental clinics in Georgia.
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  • 文章类型: Journal Article
    这是第一个分析牙科诊所废水以估计儿童无症状SARS-CoV-2感染趋势的纵向研究。我们监测了14个月的废水,跨越由阿尔法驱动的三个主要的COVID-19波,Delta,和Omicron变体。每个星期六,在日本Sa玉县唯一一家牙科医院的儿科牙科诊所采样废水。研究了Sa玉县年龄<10岁(暴露)的每周病例数与废水SARS-CoV-2RNA检测(结果)之间的关系。病例数与废水SARS-CoV-2RNA阳性显着相关(风险比,5.36;95%置信区间,1.72-16.67;费希尔精确检验,p=0.0005)。2022年第8周的样本包含Omicron变体。与零星的个体测试相比,这种方法允许持续的人口水平监测,受医疗保健寻求和测试可用性的影响较小。由于儿科牙科诊所的废水来自无症状儿童的口腔,这种检测可以提供关于儿童无症状COVID-19的重要信息,补充临床儿科数据。
    This was the first longitudinal study to analyze dental clinic wastewater to estimate asymptomatic SARS-CoV-2 infection trends in children. We monitored wastewater over a 14-month period, spanning three major COVID-19 waves driven by the Alpha, Delta, and Omicron variants. Each Saturday, wastewater was sampled at the Pediatric Dental Clinic of the only dental hospital in Japan\'s Saitama Prefecture. The relationship between the weekly number of cases in Saitama Prefecture among residents aged < 10 years (exposure) and wastewater SARS-CoV-2 RNA detection (outcome) was examined. The number of cases was significantly associated with wastewater SARS-CoV-2 RNA positivity (risk ratio, 5.36; 95% confidence interval, 1.72-16.67; Fisher\'s exact test, p = 0.0005). A sample from Week 8 of 2022 harbored the Omicron variant. Compared to sporadic individual testing, this approach allows continuous population-level surveillance, which is less affected by healthcare seeking and test availability. Since wastewater from pediatric dental clinics originates from the oral cavities of asymptomatic children, such testing can provide important information regarding asymptomatic COVID-19 in children, complementing clinical pediatric data.
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  • 文章类型: Journal Article
    背景:我们的目标是创建一个有意的跨专业教育体验(IEE),以满足药学教育促进中心(CAPE2013)提出的要求,药学教育认证委员会(ACPE)标准11和跨专业教育合作(IPEC)能力。这些框架提高了药学跨专业教育的重要性。它们不仅指导教育标准,而且强调协作医疗实践在确保全面患者护理和改善健康结果方面的关键作用。我们对PharmD学生的跨专业教育(IPE)学习成果的评估采用了定量和定性评估方法,以全面了解他们的成就。
    十四名PharmD学生在社区牙科诊所参加了有意的IEE体验,与牙科诊所团队和患者合作。评估方法将SPICE-R2的定量数据与日常反思的定性见解以及基于IPEC能力的IPE现场遭遇相结合。这种方法确保了对个人经验的全面评估。
    结论:定量分析显示,SPICE-R2仪器上十个问题中有四个问题的平均得分在统计学上增加。定性数据分析利用扎根理论来分析新兴主题。
    结论:在这种有意的IEE环境中采用定量和定性评估方法已被证明对评估IPE学习成果有益。PharmD的学生能够提供以患者为中心的护理作为跨专业医疗团队的宝贵成员。
    BACKGROUND: Our objective was to create an intentional Interprofessional Education Experience (IEE) that satisfied the requirements set forth by the Center for the Advancement of Pharmacy Education (CAPE 2013), the Accreditation Council for Pharmacy Education (ACPE) Standard 11, and the Interprofessional Education Collaborative (IPEC) Competencies. These frameworks elevate the importance of interprofessional education in pharmacy. They not only guide educational standards but also emphasize the crucial role of collaborative healthcare practices in ensuring comprehensive patient care and improving health outcomes. Our evaluation of PharmD students\' attainment of Interprofessional Education (IPE) learning outcomes employed both quantitative and qualitative assessment methods to provide a comprehensive understanding of their achievements.
    UNASSIGNED: Fourteen PharmD students participated in an intentional IEE experience in a community dental clinic, collaborating with the dental clinic team and patients. Assessment methods combined quantitative data from SPICE-R2 with qualitative insights from daily reflections and an IPE Field Encounter based on IPEC Competencies. This approach ensured a thorough evaluation across individual experiences.
    CONCLUSIONS: Quantitative analysis revealed a statistically increase in mean scores for four out of ten questions on the SPICE-R2 instrument. Qualitative data analysis utilized grounded theory to analyze emerging themes.
    CONCLUSIONS: Employing both quantitative and qualitative assessment methods in this intentional IEE environment has proved beneficial in assessing IPE learning outcomes. The PharmD students were able to deliver patient-centered care as valuable members of an interprofessional healthcare team.
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  • 文章类型: Journal Article
    目的:调查在挪威公共下班后紧急公共牙科(EPD)诊所就诊1年的儿童的外伤性牙齿损伤(TDI)。
    方法:该研究包括在EPD诊所就诊的7-18岁(n=312),接受了牙科临床检查,并同意披露临床信息。TDI的记录仅限于恒牙前牙。还分析了潜在的TDI预测因子。
    结果:几乎一半(n=148)的儿童接受了恒牙TDI评估,显示平均年龄为11.0(标准偏差[SD]:3.5)岁。男性占54.7%。孩子们经常在课余时间经历TDI(43.9%),大部分(58.1%)是由跌倒/意外造成的。其中60只经历了一次TDI。最常见的位置是上颌中切牙。根据严重程度评估TDI,只能在131个人中完成,涉及253个TDI。其中,81.8%为轻度。在先前患有TDI的儿童中,前往急诊诊所接受TDI的几率较高(比值比[OR]=2.64,置信区间[CI]:1.61-4.31),而较低(OR=0.28,CI:0.12-0.68)。
    结论:外伤性牙齿损伤是寻求紧急治疗的常见原因。轻伤占主导地位,主要涉及一个上颌中切牙。以前的TDI事件和出勤模式似乎与寻求TDI的护理有关。
    OBJECTIVE: To investigate traumatic dental injuries (TDIs) among children who for 1 year attended a Norwegian public after-hours emergency public dental (EPD) clinic.
    METHODS: The study included 7-18-year-olds (n = 312) who presented at the EPD clinic, underwent a clinical dental examination, and consented to the disclosure of clinical information. Recording of TDIs was restricted to anterior permanent teeth. Potential TDI predictors were also analysed.
    RESULTS: Almost half (n = 148) of the children were assessed with TDIs in permanent teeth, showing a mean age of 11.0 (standard deviation [SD]: 3.5) years. Males constituted 54.7%. The children experienced TDIs often outside school hours (43.9%), and the majority (58.1%) were caused by falls/accidents. Sixty of them experienced only one TDI. The most common location was the maxillary central incisors. Assessment of TDIs according to severity, could only be done in 131 individuals, involving 253 TDIs. Of these, 81.8% were mild. The odds of visiting the emergency clinic for a TDI were higher (odds ratio [OR] = 2.64, confidence interval [CI]: 1.61-4.31) among children with previous TDIs and lower (OR = 0.28, CI: 0.12-0.68) among those with poor dental attendance.
    CONCLUSIONS: Traumatic dental injuries were a common reason for seeking emergency care. Milder injuries dominated and involved mostly one maxillary central incisor. Previous episodes of TDIs and attendance patterns seemed to be associated with seeking care for TDIs.
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  • DOI:
    文章类型: Journal Article
    目的:评估医院儿科牙科诊所记录的噪声水平,并评估职业暴露人员对噪声的潜在危险水平。方法:使用SoundAdvisor™831C型声级计收集19天的背景声音数据(等效连续声级,以LAeq表示)在开放式海湾中,安静的房间,镇静套房,和手术室设置。使用Spartan™无线噪声剂量计型号730(LarsonDavis)来捕获有关81次诊所期间儿科牙科住院医师的个人噪声暴露的数据。将个人噪声暴露与职业安全与健康管理局(OSHA)标准进行比较。结果:开放海湾的背景A加权声压级明显低于手术室,安静的房间,和口服镇静设置(P<0.05),而手术室明显少于口服镇静(P=0.038)。开放海湾的个人LAeq明显低于安静的房间(P=0.007)和口服镇静设置(P=0.007)。与开放式间隔(P=0.010)或手术室(P=0.023)相比,口服镇静套件中捕获的超过80dBA的时间百分比明显更高。结论:每日职业噪声暴露未超过OSHA规定的阈值。镇静和安静的房间治疗设置被认为是最响亮的儿科牙科临床环境。
    Purpose: To evaluate the noise levels recorded in a hospital-based pediatric dental clinic and evaluate the occupational exposure personnel have to potentially hazardous levels of noise. Methods: A SoundAdvisor™ Sound Level Meter Model 831C was used to gather 19 days of background sound data (equivalent continuous sound levels, measured as LAeq) in the open bay, quiet room, sedation suite, and operating room settings. A Spartan™ Wireless Noise Dosimeter Model 730 (Larson Davis) was utilized to capture data about personal noise exposure of pediatric dental residents over 81 clinic sessions. Personal noise exposure was compared to the Occupational Safety and Health Administration (OSHA) stand- ard. Results: Background A-weighted sound pressure level was significantly less for the open bay than in the operating room, quiet room, and oral sedation setting (P<0.05), while the operating room was significantly less than the oral sedation setting (P=0.038). Personal LAeq was significantly less for the open bay than the quiet room (P=0.007) and oral sedation settings (P=0.007). There was a significantly larger percentage of time above 80 dBA captured in the oral sedation suite compared to the open bay (P=0.010) or operating room (P=0.023). Conclusions: Daily occupational noise exposure did not exceed the thresholds set forth by OSHA. Sedation and quiet room treatment settings were noted to be the loudest pediatric dental clinical environments.
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  • 文章类型: Journal Article
    目的:牙病关系(DPR)被认为是牙科临床环境中的关键要素。这项范围审查旨在检查以前对DPR的研究程度,专注于其对结构具体化的决定因素。
    方法:本研究由JoannaBriggs研究所的系统范围评价指南指导。纳入/排除标准基于一般成年人和牙医的参与者,DPR决定因素的概念,以及牙科保健的背景。2023年7月在6个主要电子数据库中进行了文献检索。从包含的文章中提取关键信息以绘制结果,主要是确定DPR的决定因素。根据DPR的概念模型对DPR的每个决定因素进行分类。
    结果:最初总共确定了1727条记录,和16篇文章被纳入审查。9项研究使用了定量方法,7项为非经验性文章。除了两篇文章外,所有文章都是从患者的角度出发的。因素分为6个主要领域:牙医,病人,社会/环境,临床结构,临床过程,和结果。在DPR的6个领域中,大多数决定因素与临床过程有关。“沟通”是最常见的计数,8次,后跟“信任”(频率,6).在患者层面,“牙科恐惧/焦虑”经常被用来衡量DPR。
    结论:以前关于DPR的文献从患者的角度指出了一些常见的和牙科特异性的决定因素。鼓励进一步研究,以制定更全面的DPR框架和评估量表。
    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.
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