Our research findings
eviDent Foundation facilitates dental practice-based research for better oral and general health.
Preliminary findings:
A total of 187 responses were received from registered dental practitioners, the majority of whom were dentists (n=85) or either oral health therapists or dental therapists (n=91). Similar number of participants worked in the public and private sectors, with 35 working in both sectors. Most respondents (n=137, 83.5%) had used SDF in clinical practice. Lack of knowledge was the most common reason cited by those who did not use it but many of them were planning to use SDF in the future. Most respondents who currently use SDF were using it for treating children, but many were also using SDF in adult populations. The most frequently reported concern related to the use of SDF was tooth staining/aesthetics.
The project found a total of 262 people contracted SARS-CoV-2 between March 2020 and December 2021 working in a dental setting during their acquisition period – including 62 dentists and 175 dental assistants. Only four cases were likely to have been acquired from a patient during the provision of dental treatment. Crude prevalence of SARS-COV-2 infection was estimated to be 13.4 per 1,000 dentists, and for the general community 27.1 per 1,000 people.
The evidence from Victoria suggests no increased risk of transmission of SARS-CoV-2 during dental treatment, with only four documented cases from patient to dentist between March 2020 and December 2021. Future outbreaks should focus on ensuring risk mitigation procedures but not deferral of dental care.
Preliminary findings show:
- Reduced access/suspended routine dental care is associated with an increase in the use of antibiotics
- Workplace factors, e.g. time limitations, restriction on procedures, patient expectations, all influence prescribing decisions
- In the context of antibiotic resistance, providing appropriate and timely dental care is critical to tackling the problem.
Dental practitioners were found to have a high burden of mental health concerns, with close to one-third reporting experiencing moderate to severe psychological distress, and about one in four were found likely to be experiencing burnout.
Key findings from the study:
- 17.6% reported thoughts of taking their own life in the preceding 12 months;
- 31.4% reported thoughts of taking their own life prior to the preceding 12 months;
- 5.6% reported ever having made an attempt to take their own life;
- 32% were rated as having moderate-severe psychological distress;
- 59.4% were rated as having minor-severe non-psychotic psychiatric morbidity;
- 24.8% were classified as likely to be experiencing burnout;
- 11.5% reported a current diagnosis of depression
- 12.9% reported a current diagnosis of anxiety disorder
- Younger practitioners (<30 years) were more than twice as likely to have had thoughts of suicide in the previous 12 months than older practitioners (61+ years);
- Male dental practitioners were twice as likely as females to have had thoughts of suicide in the previous 12 months.
Preliminary findings found:
- Several difficulties, such as financial implications, multidisciplinary care and clinical decision making, were barriers to effectively managing MIH by GDPs in primary care
- In the private sector in Australia, efficient and effective relationships between general dentists and specialists were reported seemingly stemming from clinician driven informal networks and mutually beneficial referral relationships
- In the public sector in Australia and NHS in the UK the more formal specialist referral process led to a sense of relinquishing care with an apparent disconnect between referral and outcome which was exacerbated by long waiting times.
The project found:
- Over the period of March to September, there were 881,454 fewer dental services provided in 2020 than 2019, with the largest decline seen in April. There was a greater decline in preventive and diagnostic services, and a smaller decline in endodontic and oral surgery services.
- A second wave of COVID-19 in Victoria saw 198,609 fewer dental services provided in that state from July to September 2020 than 2019. Dental service provision had still not returned to normal levels across Australia by September 2020.
- The COVID-19 pandemic has had a significant impact on the provision of dental services to children from lower socioeconomic backgrounds who already experience higher levels of dental disease and disadvantage in accessing dental care.
- Although the restriction of dental services was deemed necessary in order to minimize the risk of transmission of COVID-19 in the dental setting, the impact of these restrictions on oral health will be long lasting.
- Given the chronic and progressive nature of dental disease, the deferral of necessary dental care is likely to contribute to poorer oral health and long-term problems for many Australians.
The project found:
- Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods.
- While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country.
- These findings may help to better plan oral health care for future pandemic events.
The project found:
- Oral Health Professionals (OHPs) have an important role to in type 2 diabetes (T2D) prevention and identification
- T2D screening programs in an oral healthcare setting is well accepted and effective
- OHPs were found to have an overall fair knowledge about T2D and positive attitudes to screening
- Cost and effectiveness of the program could be improved if targeted populations with increased risk of T2D.
The project found:
- The group had a higher dental caries experience than the same age cohort in Australia generally, although there was no strong association between individual caries and HbA1c levels. A consistent multidisciplinary approach is recommended to improve the future cardiovascular health of young people with Type 1 Diabetes Mellitus (T1DM). Furthermore, many of the participants in the study cited cost of dental care as a major barrier. It is recommended that optimum oral health care be made available to those with T1DM.
- Findings showed that in SES matched young people that both those with and without T1DM had suboptimal dental care, with the consequences being much more critical in those with T1DM.
The project found:
- Women were more likely to present with high scores on the Dysmorphic Concern Questionnaire (DCQ) as well as people with a history of mental health problems, including anxiety
- The cosmetic practice, implant clinic and prosthodontic practice received higher proportions of patients with high DCQ scores than the general family practice
- The DCQ seems to be a suitable tool to be used by dentists as part of history taking and patient examination due to its brevity, simplicity and the good sensitivity/specificity reported in the literature
The project found:
- General medical practitioners and dentists often feel uneasy when starting conversations with their patients about halitosis
- Most general medical practitioners, dentists and pharmacists find it challenging to manage patients with halitosis and are interested in working together
- Improving health professionals’ knowledge and training will contribute to comprehensive interprofessional halitosis management
- Prior to the training, the majority of dentists often provided dietary advice and agreed that they were confident to do so
- The majority of dentists found that the online training module had clear learning objectives, was easy to navigate and were satisfied with the module
- Following the training, dentists felt slightly more confident providing dietary advice
The project found:
- There is a need for additional education and professional training for oral health professionals
- Further training in oral cancer screening practice and patient advice-giving will be an important step in improving prevention and early detection of oral cancers
The project found:
- Health promotion was generally viewed positively by patients and practitioners, with both indicating that they preferred the specific health promotion advice be related to the type of practitioner involved in that discussion
- There are opportunities to increase practitioner confidence in delivering health promotion messages, through the provision of education and supporting resources
Results of this study indicate a high survival rate of anterior resin bonded bridges provided by a group of clinicians in Melbourne from 1990 to 2012. The simple and affordable ARBBs with two different modified tooth preparation designs performed well with a survival rate of 98% at five years. There was no significant difference in the survival of ARBBs between the two design preparations.
The project found:
- Preferred provider schemes impact on dentists’ decision-making autonomy and potentially influence the development of trust and rapport within the dentist-patient relationship
- A need to develop strategies to respond to altered work conditions
The project:
- Found that Victorian dentists who took part in this study are using the appropriate clinical parameters to diagnose periodontal disease
- Found that the diagnosis of periodontal disease by the practitioners that took part is generally accurate, but with a tendency to over-diagnose moderate periodontitis as severe
- Will help in understanding decision-making criteria used in practice regarding periodontal therapy
- Will aid the design of further studies looking at the effectiveness of the treatment of periodontal diseases
The project found that the targeted school dental check-up program was beneficial for increasing child dental access and retention for referred follow-up dental appointments and treatment. The second stage (project 10) has commenced.
The project successfully created and used a model that helped GMPs to identify patients at risk of dry mouth, diagnose dry mouth and implement a dry mouth management program that included improved communication between GMPs and dental professionals.
The project developed:
- An education program to show GMPs how to identify patients at risk of oral health problems caused by dry mouth, and improve patient oral and general health outcomes through enhanced knowledge
- Fact sheets for practitioners and patients: ‘What is dry mouth?’ and ‘Managing dry mouth’
The project:
- Provided a detailed description of six characteristics of hypomineralisation of first permanent molars (FPMs) and permanent incisors. The condition was found to conform to a spectrum of increasing severity from MH to MIH
- Produced an information sheet about MH
- Found that the trial of the MHSI was predictive of treatment undertaken for affected FPMs and the Index can guide clinical management of affected children
The project found that most complications appeared within the first year. Patient demographics showed that practitioners are treating an older seminal population than often reported in clinical trials. Their patients have a complex medical history and are taking multiple medications. Provision of single units was far greater than larger more complex restorations and the understanding of implant care needs to reflect the proportion of prescription of these. The findings will allow the development of practitioner guidelines for treatment planning, case management and complication management.
The project found that practitioners reported personal, practice and societal benefits of eviDent involvement and challenges to participation were few. A series of recommendations for improvements to eviDent were made to the DPBRN Committee, and were designed to encourage greater participation by the profession.
