Background Uninformed opioid prescribing by dentists has contributed to the current opioid crisis... more Background Uninformed opioid prescribing by dentists has contributed to the current opioid crisis. This report describes the development and implementation of an innovative, interactive, multidisciplinary, and participant-centric telementoring program “Pain Management and Substance Use Disorders Dental ECHO (Extension for Community Health Care Outcomes)”. We disseminated information to dentists about appropriate opioid prescribing practices and engaged them with a focus on pain management and substance use disorders. The objective of this study was to assess the effectiveness of this program for self-reported: (1) change in knowledge and confidence related to clinical skills for dental pain management of patients with substance use disorders; (2) change in clinical behavior of dentists for safe opioids prescribing; and (3) change in clinic policies regarding safe opioids prescribing. Methods An interdisciplinary panel of experts in medicine, pharmacy, social work, and dentistry desi...
Before the impact of employer-provided dental benefit schemes on the dental care delivery system ... more Before the impact of employer-provided dental benefit schemes on the dental care delivery system can be evaluated in Hong Kong, the prevalence of these schemes and their structures must be established. A mailed questionnaire survey was conducted of a representative group of companies with more than 100 employees (n = 495). Response rate to the mail survey was 38 per cent (n = 186). Non-respondents were stratified according to their nature of business and one third was randomly selected for a follow-up by telephone to which 84 per cent responded (n = 81). After adjustment, 16 per cent of companies of that size were found to be providing dental benefit schemes to their staff. The prevalence was related to the nature of business of the companies. Among companies providing dental benefits, administrators from selected companies were interviewed. It was found that dental benefit schemes could be broadly divided into two types: One characterised by cash-benefit and the other by service-benefit. Treatment items covered by the schemes were mostly simple services such as diagnostic items, simple restorations and simple extractions. The influence of these dental benefit schemes on the dental care-seeking behaviour of the beneficiaries is under investigation.
Advances in modern technology have undoubtedly been of benefit to dentistry in its preventive and... more Advances in modern technology have undoubtedly been of benefit to dentistry in its preventive and curative activities for populations worldwide. Studies, mainly from Western societies, show nonetheless that utilisation of services or adoption of preventive methods are not taken up at satisfactory levels. The focus of this paper is on the special problems in a Chinese society where major differences exist between the traditional lay health concepts and the modernised professional ones. Traditional Chinese health concepts comprise the balance between and interaction of 'Yin' and 'Yang', the vital forces in both the universe and in man's body, as the basis for maintaining health. To restore a disturbed equilibrium of vital forces, which will manifest itself as disease, a range of dietary products are available in Hong Kong, for example cooling herb tea to reduce fire from the stomach producing gum disease. Seeking dental treatment from dentists could be delayed or made 'unnecessary' due to reliance on home remedies. This could reduce the effectiveness of any planned health education activities and dental services available for improving the oral health status of the community according to prevailing Western concepts. An understanding of the cultural meaning of dental disease is fundamental to changing beliefs and attitudes of people in order to improve the oral health of the community.
Both oral disease and middle ear infections are highly prevalent in Pacific Island children. Thes... more Both oral disease and middle ear infections are highly prevalent in Pacific Island children. These diseases are multifactorial and likely attributable in part to both social and environmental factors. It has been two decades since these diseases were defined in Palau, and at the time were noted to be among the most common conditions and presented a substantial burden among Palau's children. In 2006, the Ministry of Health in Palau began conducting comprehensive school health screenings in grades 1-11. While primarily used as a referral tool, this survey can also be used in epidemiologic studies to describe health trends. The current study utilized this screening data from the 2011-12 school year to characterize the prevalence of dental caries and otitis media and explore a previously suggested relationship between the two conditions, including common risk factors. It was found that over one-quarter (28.9%) of Palauan students had abnormal tympanometry results, with up to 17% indicating active otitis media. In addition, 85% of students had at least one decayed or filled tooth, with an average of 3.9 decayed or filled teeth in 12-year-olds. Both conditions were found to be more prevalent in public than in private schools; however, the two disorders were not significantly associated with each other. These findings place the prevalence of decayed, missing, and filled teeth, and otitis media in Palauan schoolchildren among the highest reported in the world. The widely recognized consequences of poor oral health and hearing impairment on learning, nutrition, and chronic disease make urgent the need for early intervention.
Community Dentistry and Oral Epidemiology, Oct 1, 1994
... Wang, ZJ, Shen, Y. and Schwarz, E. (1994), Dental caries prevalence of 6–14 ... Department of... more ... Wang, ZJ, Shen, Y. and Schwarz, E. (1994), Dental caries prevalence of 6–14 ... Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University of Medical Sciences ... Department of Periodontology and Public Health, The University of Hong Kong, Faculty of Dentistry ...
OBJECTIVES This study aimed to assess the knowledge, attitudes, and practices surrounding the pre... more OBJECTIVES This study aimed to assess the knowledge, attitudes, and practices surrounding the prescribing of opioids and addiction in a dental school population. METHODS Predoctoral dental students, residents, and dental faculty were surveyed about their beliefs, awareness, opinions about, and prior training in the prescribing of opioids, current prescribing practices, and confidence with risk mitigation strategies. Demographic information collected included gender, race/ethnicity, faculty/student role, year of birth, and year of graduation. RESULTS Responses were received from 220 faculty and students (n = 47 and n = 173, respectively). Both faculty and students agreed that opioids were overprescribed for the treatment of dental pain. A majority of faculty and dental students (DS)3 + DS4 and DS1 + DS2 students expressed no or limited prior training in (1) the approved state opioid guidelines (75%, 79%, and 95%, respectively), (2) the identification/assessment of substance use disorders (68%, 81%, and 92%, respectively), and (3) patient education to accompany the prescribing of opioids (71%, 80%, and 92%, respectively). A majority of faculty reported moderate or extreme confidence in their clinical skills related to the prescribing of opioids (75%), their ability to identify patients with substance use disorders (55%), and their ability to discuss addiction risk and secure storage of opioids (65%). In contrast, DS3 + DS4 and DS1 + DS2 students expressed significantly less confidence and training. Faculty and students agreed that the role of a dentist included risk mitigation, but reported actions did not match their beliefs, reportedly due to lack of time, less confidence, and the assumption that a pharmacist would assume risk mitigation conversations. CONCLUSIONS A cohesive curriculum across the four predoctoral years is needed focusing on factual knowledge about the prescribing of opioids, safe prescribing, and confidence with patient communication and risk mitigation strategies. In addition, a need for parallel faculty development synchronized with and reinforced by curricular content was identified.
For many oral health professionals, an academic career is both appealing and meaningful because i... more For many oral health professionals, an academic career is both appealing and meaningful because it provides the opportunity to impart professional knowledge and skills to the next generation of oral health professionals. An academic career combines clinical skills development with the rewards of teaching others. This chapter will provide the background and context for choosing an academic career, with its many options for development and professional satisfaction. The intention is to make the academic career path more transparent and understandable as an additional choice for any oral health professional. This also entails describing the opportunities to take on leadership and management roles such as becoming a dental Dean or Head of School.
Background Uninformed opioid prescribing by dentists has contributed to the current opioid crisis... more Background Uninformed opioid prescribing by dentists has contributed to the current opioid crisis. This report describes the development and implementation of an innovative, interactive, multidisciplinary, and participant-centric telementoring program “Pain Management and Substance Use Disorders Dental ECHO (Extension for Community Health Care Outcomes)”. We disseminated information to dentists about appropriate opioid prescribing practices and engaged them with a focus on pain management and substance use disorders. The objective of this study was to assess the effectiveness of this program for self-reported: (1) change in knowledge and confidence related to clinical skills for dental pain management of patients with substance use disorders; (2) change in clinical behavior of dentists for safe opioids prescribing; and (3) change in clinic policies regarding safe opioids prescribing. Methods An interdisciplinary panel of experts in medicine, pharmacy, social work, and dentistry desi...
Before the impact of employer-provided dental benefit schemes on the dental care delivery system ... more Before the impact of employer-provided dental benefit schemes on the dental care delivery system can be evaluated in Hong Kong, the prevalence of these schemes and their structures must be established. A mailed questionnaire survey was conducted of a representative group of companies with more than 100 employees (n = 495). Response rate to the mail survey was 38 per cent (n = 186). Non-respondents were stratified according to their nature of business and one third was randomly selected for a follow-up by telephone to which 84 per cent responded (n = 81). After adjustment, 16 per cent of companies of that size were found to be providing dental benefit schemes to their staff. The prevalence was related to the nature of business of the companies. Among companies providing dental benefits, administrators from selected companies were interviewed. It was found that dental benefit schemes could be broadly divided into two types: One characterised by cash-benefit and the other by service-benefit. Treatment items covered by the schemes were mostly simple services such as diagnostic items, simple restorations and simple extractions. The influence of these dental benefit schemes on the dental care-seeking behaviour of the beneficiaries is under investigation.
Advances in modern technology have undoubtedly been of benefit to dentistry in its preventive and... more Advances in modern technology have undoubtedly been of benefit to dentistry in its preventive and curative activities for populations worldwide. Studies, mainly from Western societies, show nonetheless that utilisation of services or adoption of preventive methods are not taken up at satisfactory levels. The focus of this paper is on the special problems in a Chinese society where major differences exist between the traditional lay health concepts and the modernised professional ones. Traditional Chinese health concepts comprise the balance between and interaction of 'Yin' and 'Yang', the vital forces in both the universe and in man's body, as the basis for maintaining health. To restore a disturbed equilibrium of vital forces, which will manifest itself as disease, a range of dietary products are available in Hong Kong, for example cooling herb tea to reduce fire from the stomach producing gum disease. Seeking dental treatment from dentists could be delayed or made 'unnecessary' due to reliance on home remedies. This could reduce the effectiveness of any planned health education activities and dental services available for improving the oral health status of the community according to prevailing Western concepts. An understanding of the cultural meaning of dental disease is fundamental to changing beliefs and attitudes of people in order to improve the oral health of the community.
Both oral disease and middle ear infections are highly prevalent in Pacific Island children. Thes... more Both oral disease and middle ear infections are highly prevalent in Pacific Island children. These diseases are multifactorial and likely attributable in part to both social and environmental factors. It has been two decades since these diseases were defined in Palau, and at the time were noted to be among the most common conditions and presented a substantial burden among Palau's children. In 2006, the Ministry of Health in Palau began conducting comprehensive school health screenings in grades 1-11. While primarily used as a referral tool, this survey can also be used in epidemiologic studies to describe health trends. The current study utilized this screening data from the 2011-12 school year to characterize the prevalence of dental caries and otitis media and explore a previously suggested relationship between the two conditions, including common risk factors. It was found that over one-quarter (28.9%) of Palauan students had abnormal tympanometry results, with up to 17% indicating active otitis media. In addition, 85% of students had at least one decayed or filled tooth, with an average of 3.9 decayed or filled teeth in 12-year-olds. Both conditions were found to be more prevalent in public than in private schools; however, the two disorders were not significantly associated with each other. These findings place the prevalence of decayed, missing, and filled teeth, and otitis media in Palauan schoolchildren among the highest reported in the world. The widely recognized consequences of poor oral health and hearing impairment on learning, nutrition, and chronic disease make urgent the need for early intervention.
Community Dentistry and Oral Epidemiology, Oct 1, 1994
... Wang, ZJ, Shen, Y. and Schwarz, E. (1994), Dental caries prevalence of 6–14 ... Department of... more ... Wang, ZJ, Shen, Y. and Schwarz, E. (1994), Dental caries prevalence of 6–14 ... Department of Stomatology, The First Affiliated Hospital, Sun Yat-sen University of Medical Sciences ... Department of Periodontology and Public Health, The University of Hong Kong, Faculty of Dentistry ...
OBJECTIVES This study aimed to assess the knowledge, attitudes, and practices surrounding the pre... more OBJECTIVES This study aimed to assess the knowledge, attitudes, and practices surrounding the prescribing of opioids and addiction in a dental school population. METHODS Predoctoral dental students, residents, and dental faculty were surveyed about their beliefs, awareness, opinions about, and prior training in the prescribing of opioids, current prescribing practices, and confidence with risk mitigation strategies. Demographic information collected included gender, race/ethnicity, faculty/student role, year of birth, and year of graduation. RESULTS Responses were received from 220 faculty and students (n = 47 and n = 173, respectively). Both faculty and students agreed that opioids were overprescribed for the treatment of dental pain. A majority of faculty and dental students (DS)3 + DS4 and DS1 + DS2 students expressed no or limited prior training in (1) the approved state opioid guidelines (75%, 79%, and 95%, respectively), (2) the identification/assessment of substance use disorders (68%, 81%, and 92%, respectively), and (3) patient education to accompany the prescribing of opioids (71%, 80%, and 92%, respectively). A majority of faculty reported moderate or extreme confidence in their clinical skills related to the prescribing of opioids (75%), their ability to identify patients with substance use disorders (55%), and their ability to discuss addiction risk and secure storage of opioids (65%). In contrast, DS3 + DS4 and DS1 + DS2 students expressed significantly less confidence and training. Faculty and students agreed that the role of a dentist included risk mitigation, but reported actions did not match their beliefs, reportedly due to lack of time, less confidence, and the assumption that a pharmacist would assume risk mitigation conversations. CONCLUSIONS A cohesive curriculum across the four predoctoral years is needed focusing on factual knowledge about the prescribing of opioids, safe prescribing, and confidence with patient communication and risk mitigation strategies. In addition, a need for parallel faculty development synchronized with and reinforced by curricular content was identified.
For many oral health professionals, an academic career is both appealing and meaningful because i... more For many oral health professionals, an academic career is both appealing and meaningful because it provides the opportunity to impart professional knowledge and skills to the next generation of oral health professionals. An academic career combines clinical skills development with the rewards of teaching others. This chapter will provide the background and context for choosing an academic career, with its many options for development and professional satisfaction. The intention is to make the academic career path more transparent and understandable as an additional choice for any oral health professional. This also entails describing the opportunities to take on leadership and management roles such as becoming a dental Dean or Head of School.
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