Title: Oral and dental health and health care for M?ori with type 2 diabetes: A qualitative study

Abstract:

Oral and dental health and health care for Māori with type 2 diabetes: A qualitative study

Objectives

Type 2 diabetes mellitus (T2DM) and periodontal disease are two highly prevalent, directly and independently associated long‐term conditions that disproportionately impact Indigenous Māori in New Zealand (NZ). Although poorly understood, a number of social and biological mechanisms connect these conditions. This qualitative study explored experiences of T2DM and oral and dental (hereafter oral/dental) health; access to oral/dental health care; whether participants’ experiences supported or challenged existing evidence; and sought suggestions for improving oral/dental health in a high‐deprivation rural area of Northland, NZ.

Methods

Participants (n = 33) meeting the study criteria: self‐identified Māori ethnicity, aged ≥ 18‐years with glycated haemoglobin (HBA1c) >65 mmol/L were recruited via the local primary care clinic in September‐December 2015; two left the study prior to data collection. During face‐to‐face semi‐structured interviews, participants (n = 31) were asked How does diabetes affect your teeth? and When did you last access dental care? Kaupapa Māori (KM) theory and methodology provided an important decolonizing lens to critically analyse the fundamental causes of Indigenous health inequities.

Results

Independent analysis of qualitative data by three KM researchers identified four themes: access barriers to quality care; pathways to edentulism; the ‘cost’ of edentulism; and, unmet need. Results contributed towards informing Mana Tū—an evidence‐based KM programme for diabetes in primary care—to be introduced in this and other communities from 2018.

Conclusions

Oral health is integral to diabetes management, and vice versa. Subsidized specialist referrals for oral‐dental health care for Māori with T2DM could improve glycaemic control and diabetes outcomes and reduce diabetes‐related complications among this population.

Biography:

Master Clinician, co-director of clinic, research advisor University of Illinois Department of Orthodontics 1972-2006 (ret). Adjunct professor and research advisor, University of Illinois Department of Orthodontics 2006 – present Member ADA, AAO, WFO, FDI, numerous other professional organization International lecturer (audiences on 6 continents) on the business principles of orthodontics.  Published numerous articles in refereed journals His book on the Bioprogressive Treatment Philosophy has been translated into 4 languages Private practice in Lake County, Illinois, USA, 1974 to present Consultant to Dental Monitoring

Title: How Artificial Intelligence (AI) is Reshaping Dentistry

Abstract:

How artificial intelligence (AI) is reshaping dentistry

Artificial Intelligence (AI), the use of machines that can learn, predict and act faster than humans and at a fraction of the cost, has come a long way since it was first conceptualized in 1936 by Alan Turing. Today it is a key tool in the modernization of the healthcare industry, reinventing the field by helping healthcare professionals and organizations perform more efficiently. AI is now being integrated into the world of dentistry at a rapid pace. Join this session to understand what AI is, how it's changing the dental world, and how you can integrate it into your clinic to boost acceptance and improve your efficiency and the quality of your treatments.

Biography:

Dr. Rayan Skafi received his DMD degree from the University of Saint-Joseph where he also earned a certificate of advanced graduate studies in prosthodontics. He worked in a private dental practice for four years before pursuing a master’s degree in biotechnologies management from ESCP Europe in Paris. After that, he started working at Dental Monitoring, a leading innovator of dental technology, as a Clinical Education Officer. Dr. Skafi works closely with global Key Opinion Leaders in the dental industry to develop and implement a strong educational program teaching dental professionals how to adopt innovative technologies, such as AI-driven solutions and teledentistry, in order to evolve their practices. Dr. Skafi believes that patient empowerment and technological development are making space for the delocalization of healthcare, requiring not only the adoption of disruptive technologies but also changes in stakeholders’ systems and attitudes

Title: Dental Health State Utilities among Dental Patients

Abstract:

  Dental health state utilities among dental patients

Objectives

To test the efficacy of a dental health state utility measure among a sample of dental patients using the standard gamble (SG) method and to examine its association with two quality of life constructs, namely the Oral Health Impact Profile‐14 questionnaire and the global oral health item.

Methods

A cross‐sectional study was conducted with a sample of 202 adult dental patients. Demographic and clinical data were collected. The 14 item oral health impact profile (OHIP‐14) and Locker's global rating scale for oral health were administered and a SG utility valuation was carried out.

Results

The mean age of the patients was 38.6 ± 14.1 years. The mean SG score was 0.2 ± 0.2. Bivariate and negative binomial regression using the SG score as the outcome variable showed significant associations between SG scores and the OHIP‐14 summary scores, global oral health rating values, as well as with age, gender, and nature/severity of the oral problem.

Conclusion

The SG method was effective in assessing dental health state utilities in the patient population. Determining patients’ risk tolerance through the SG method may lead to greater awareness about factors that could influence their choice of treatment and could help in planning treatment regimens.

Biography:

I graduated from Edinburgh Dental School in 1977 and have been involved in Dentistry over the last 40 years. I have worked in both clinical practice and in University Dental Hospitals as well as in Industry (1998-2001) initially with SmithKline Beecham and subsequently with Block Drug Company. From 2003 to 2008 I worked with a Clinical Research Organization and currently I am a Senior Clinical Lecturer in Periodontology at the Bart's and the London School of Medicine and Dentistry QMUL in London (2009-). My main interests are in the area of the Management of Dentine Hypersensitivity and I have published over 85 papers on a number of dental topics as well as contributing to several book chapters.

Title: Oral and dental health of Italian drug addicted in methadone treatment

Abstract:

Oral and dental health of Italian drug addicted in methadone treatment

Objectives

Our group recorded the characteristic of oro‐dental health among a group of drug addicts in recovery treatment with methadone, and it evaluated the changes related to the withdrawal therapy.

Methodology

A sample of 50 drug addicts in treatment with methadone was included in this study. At the beginning of the withdrawal therapy, the authors recorded the parameters involved in the most common oral diseases. Moreover, it was evaluated how, during the rehabilitation protocol, the behavioral parameters and the xerostomia that influence the oral health changed. A medical history especially referring to drug addiction features was made. An intraoral objective exam was done for each patient, at the beginning of the therapy and after 3 and 6 months.

Results

82% of the subjects showed a DMFT > 0. No patient showed any presences of previous restorative therapies. Lowenthal's caries, mostly localized in the cervical upper maxillary incisor, were found in 12% of the subjects. The Löe and Silness index showed marginal gingivitis in 95% of subjects, whereas 44% showed improper occlusion and/or parafunctional habits. 52% of the subjects had a normal diet, but a qualitative evaluation showed a high percentage (48%) of immoderate refined sugars use. Xerostomia, that was present in 72% of patients during the drug dependence period, showed a marked reduction in the withdrawal period.

Conclusion

The group analyzed made a combined use with other drugs. They showed a high rate of caries and marginal periodontitis. The statistical analysis of the data proves how the methadone rehabilitation program is effective even on the oral health. It will show its effects over two different time related phases: after a first phase of decreased attention to oral health (0‐3 months), all index will increase in the long term (3‐6 months). The rehabilitation program contributes to an improved oral health of drug addicts.

Biography:

Dr. Pinar Cevik is an Associate Professor in Gazi University Faculty of Dentistry Department of Prosthodontics in Ankara/Turkey and holds a doctorate in the field of Prosthodontics. As an investigator, she has published 25 peer-reviewed papers primarily related to maxillofacial prosthodontics. She has presented/co-presented over 25 presentations in various scientific congress. She was a principal and co-principal investigator of two completed project funded by The Scientific and Technological Research Council of Turkey