Acute dental infections managed in an outpatient parenteral antibiotic program setting: prospective analysis and public health implications

Connors, William; Rabie, Heidi; Figueiredo, Rafael; Holton, Donna; Parkins, Michael D.

doi:10.1186/s12879-017-2303-2

Cited by 13 publications

(8 citation statements)

References 35 publications

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“…The main reason that led patients to seek urgent dental care was pain, followed by complaints of broken tooth and gingival inflammation, as also observed in other studies [16,17,18].…”

Section: Discussionsupporting

confidence: 67%

Impact of risk assessment on the demand for dental services in Primary Health Care

Ramos

Monteiro

Borchardt

et al. 2019

Preprint

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Background: The access to dental health services is a big problem in many parts of the world. The Primary Health Care proposes the organization of the access with equity and it can be done by stratification of risk and scale of vulnerabilities. The aim was to evaluate the impact of the implementation of risk classification tools to improve the access to dental health demand in Primary Health Care and to evaluate the effectiveness of implantation of the tool: risk classification and Coelho and Savassi's scale for organization of dental health service demand in one Primary Health Service in São Paulo city.Method: This was a cross-sectional study in which medical records (n = 1215) were evaluated before and after the implementation of the tool. The outcomes were 'immediate care', 'first dental appointment' and 'treatment completed', the independent variables were risk classification, Coelho and Savassi's scale, caries risk, periodontal disease, soft tissue, age and gender. Descriptive analyzes were performed comparing the variables of the study before and after the implantation of the tools (risk classification and "Coelho and Savassi" scale). Logistic Regression models and chi-square tests were performed to analyze these associations.Results: The most prevalent age group was 20 to 59 years old, 62.2% before and 59.4% after implantation. The main complaint of dental demand was pain. Regarding the "Coelho and Savassi" scale", 87.1% presented low social risk (R1), 8.5% medium risk (R2), 4.2% high risk (R3). The immediate care before implantation was 9.4% (n=56) and 39.9% (n=246) after implantation (p <0.001). The first dental appointment was 20.7% before implantation and 34.9% after the implantation (p <0.001). Regarding the treatment completed, there was an increase from 10% to 14.1% after the implantation of the tools (p = 0.001).Conclusions: The implementation of the tools 'risk classification and "Coelho and Savassi" scale' had impact in organization of odontological demand, with indicated an increase in the number of visits on the same day, first dental appointments and completed treatments. These results reinforce the importance of use of the tools to organize oral health care access. Background 4The access to dental services is still a problem in many places around the world. The ways in which the health systems are organized and social determinants are factors influencing the access to dental services, with effects on the population's oral health [1,2,3] Access is a big challenge in a universal health system, as oral health is necessary to ensure the comprehensiveness of care. Efforts seeking to broaden this access in an equitable manner are essential.In Brazil, for many decades, oral health care was typically sought by pregnant women and children, while other population groups accessed dental care services in emergency situations only, or did not access them [4]. Allied to this, the demographic and epidemiological transition, with population aging the increase in the number of non-communicable chronic disease...

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“…The main reason that led patients to seek urgent dental care was pain, followed by complaints of broken tooth and gingival inflammation, as also observed in other studies [16,17,18].…”

Section: Discussionsupporting

confidence: 67%

Impact of risk assessment on the demand for dental services in Primary Health Care

Ramos

Monteiro

Borchardt

et al. 2019

Preprint

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“…Improving access through universal dental coverage could reduce the use of hospital emergency departments and physician offices for non-traumatic dental problems (i.e. toothache), issues that have received significant policy attention in Canada [37][38][39][40][41][42][43][44][45][46]. Additionally, depending on the Restricted to Ontarians who visited dentist in past 12 months, and have at least one of their own teeth at the time of survey completion c Adjusted for age, sex, dental insurance, income quintile, household education, self-perceived general health, geographic peer group, and having at least one of your own teeth d Adjusted for age, sex, dental insurance, income quintile, household education, self-perceived general health and geographic peer group Table 3 Marginal effects of dental insurance on dental visiting behaviours.…”

Section: Discussionmentioning

confidence: 99%

Providing dental insurance can positively impact oral health outcomes in Ontario

Zivkovic

Aldossri

Gomaa

et al. 2020

BMC Health Serv Res

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Background: Universal coverage for dental care is a topical policy debate across Canada, but the impact of dental insurance on improving oral health-related outcomes remains empirically unexplored in this population. Methods: We used data on individuals 12 years of age and older from the Canadian Community Health Survey 2013-2014 to estimate the marginal effects (ME) of having dental insurance in Ontario, Canada's most populated province (n = 42,553 representing 11,682,112 Ontarians). ME were derived from multi-variable logistic regression models for dental visiting behaviour and oral health status outcomes. We also investigated the ME of insurance across income, education and age subgroups. Results: Having dental insurance increased the proportion of participants who visited the dentist in the past year (56.6 to 79.4%, ME: 22.8, 95% confidence interval (CI): 20.9-24.7) and who reported very good or excellent oral health (48.3 to 57.9%, ME: 9.6, 95%CI: 7.6-11.5). Compared to the highest income group, having dental insurance had a greater ME for the lowest income groups for dental visiting behaviour: dental visit in the past 12 months (ME highest: 17.9; 95% CI: 15.9-19.8 vs. ME lowest: 27.2; 95% CI: 25.0-29.3) and visiting a dentist only for emergencies (ME highest: -11.5; 95% CI: − 13.2 to − 9.9 vs. ME lowest: -27.2; 95% CI: − 29.5 to − 24.8).Conclusions: Findings suggest that dental insurance is associated with improved dental visiting behaviours and oral health status outcomes. Policymakers could consider universal dental coverage as a means to support financially vulnerable populations and to reduce oral health disparities between the rich and the poor.

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“…Odontogenic abscesses are the most common inflammatory diseases in the oral and maxillofacial region [2,24]. Such infections are endogenous and can be prevented by adequate pre-emptive care [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…Odontogenic infections are among the most common inflammatory diseases in the head and neck region [1,2]. Frequently, these infections lead to abscesses, which can usually be treated by incision and drainage and, if necessary, by concomitant antibiotic therapy [3].…”

Section: Introductionmentioning

confidence: 99%

Clinical Relevance of the Microbiome in Odontogenic Abscesses

Böttger

Zechel-Gran

Schmermund

et al. 2021

Biology

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Odontogenic abscesses are usually caused by bacteria of the oral microbiome. However, the diagnostic culture of these bacteria is often prone to errors and sometimes fails completely due to the fastidiousness of the relevant bacterial species. The question arises whether additional pathogen diagnostics using molecular methods provide additional benefits for diagnostics and therapy. Experimental 16S rRNA gene analysis with next-generation sequencing (NGS) and bioinformatics was used to identify the microbiome of the pus in patients with severe odontogenic infections and was compared to the result of standard diagnostic culture. The pus microbiome was determined in 48 hospitalized patients with a severe odontogenic abscess in addition to standard cultural pathogen detection. Cultural detection was possible in 41 (85.42%) of 48 patients, while a pus-microbiome could be determined in all cases. The microbiomes showed polymicrobial infections in 46 (95.83%) cases, while the picture of a mono-infection occurred only twice (4.17%). In most cases, a predominantly anaerobic spectrum with an abundance of bacteria was found in the pus-microbiome, while culture detected mainly Streptococcus, Staphylococcus, and Prevotella spp. The determination of the microbiome of odontogenic abscesses clearly shows a higher number of bacteria and a significantly higher proportion of anaerobes than classical cultural methods. The 16S rRNA gene analysis detects considerably more bacteria than conventional cultural methods, even in culture-negative samples. Molecular methods should be implemented as standards in medical microbiology diagnostics, particularly for the detection of polymicrobial infections with a predominance of anaerobic bacteria.

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Acute dental infections managed in an outpatient parenteral antibiotic program setting: prospective analysis and public health implications

Cited by 13 publications

References 35 publications

Impact of risk assessment on the demand for dental services in Primary Health Care

Impact of risk assessment on the demand for dental services in Primary Health Care

Providing dental insurance can positively impact oral health outcomes in Ontario

Clinical Relevance of the Microbiome in Odontogenic Abscesses

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