Should Dental Care Make a Transition?

Ludwig, David C.; Morrison, Shane D

doi:10.1016/j.adaj.2017.11.035

Cited by 9 publications

(3 citation statements)

References 18 publications

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“…Focusing on the oral care for transgender patients, the literature in the field is very scarce and mainly centered around dental fear [29] and dental education related to the topic [30,31,32], with only one clinical case published that related to full mouth rehabilitation of a transgender patient [33]. Unfortunately, there are no references to the bone parameters of the transgender population linked to oral and maxillofacial surgery or implant procedures, and, as Ludwig et al (2018) stated, “We cannot provide evidence-based dental care to a subset of the population, if that population has yet to be studied.” [34].…”

Section: Introductionmentioning

confidence: 99%

Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy

Delgado-Ruíz

Swanson

Romanos

2019

JCM

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This study seeks to evaluate the long-term effects of pharmacologic therapy on the bone markers and bone mineral density of transgender patients and to provide a basis for understanding its potential implications on therapies involving implant procedures. Following the referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and well-defined PICOT (Problem/Patient/Population, Intervention, Comparison, Outcome, Time) questionnaires, a literature search was completed for articles in English language, with more than a 3 year follow-up reporting the long-term effects of the cross-sex pharmacotherapy on the bones of adult transgender patients. Transgender demographics, time under treatment, and treatment received were recorded. In addition, bone marker levels (calcium, phosphate, alkaline phosphatase, and osteocalcin), bone mineral density (BMD), and bone turnover markers (Serum Procollagen type I N-Terminal pro-peptide (PINP), and Serum Collagen type I crosslinked C-telopeptide (CTX)) before and after the treatment were also recorded. The considerable variability between studies did not allow a meta-analysis. All the studies were completed in European countries. Transwomen (921 men to female) were more frequent than transmen (719 female to male). Transwomen’s treatments were based in antiandrogens, estrogens, new drugs, and sex reassignment surgery, meanwhile transmen’s surgeries were based in the administration of several forms of testosterone and sex reassignment. Calcium, phosphate, alkaline phosphatase, and osteocalcin levels remained stable. PINP increased in transwomen and transmen meanwhile, CTX showed contradictory values in transwomen and transmen. Finally, reduced BMD was observed in transwomen patients receiving long-term cross-sex pharmacotherapy. Considering the limitations of this systematic review, it was concluded that long-term cross-sex pharmacotherapy for transwomen and transmen transgender patients does not alter the calcium, phosphate, alkaline phosphatase, and osteocalcin levels, and will slightly increase the bone formation in both transwomen and transmen patients. Furthermore, long-term pharmacotherapy reduces the BMD in transwomen patients.

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Section: Introductionmentioning

confidence: 99%

Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy

Delgado-Ruíz

Swanson

Romanos

2019

JCM

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show abstract

“…Education on the care of sexual and gender minority patients has been found to be lacking not only in medical education and medical residency programs, but in predoctoral dental education. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] For this reason, many providers may be uncomfortable with the delivery of care to transgender people.…”

mentioning

confidence: 99%

U.S. Oral and Maxillofacial Residents’ Experience with Transgender People and Perceptions of Gender‐Affirmation Education: A National Survey

Ludwig

Dodson

Morrison

2019

Journal of Dental Education

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With a growing number of individuals seeking gender‐affirming surgery, there is a greater need for providers, including oral and maxillofacial surgeons, experienced in the surgical care of transgender people. The aim of this study was to evaluate oral and maxillofacial surgery (OMS) residents’ exposure to the care of transgender people and their perceived importance of education in gender‐affirming surgery. All 1,174 OMS residents in accredited U.S. training programs were invited to participate in this cross‐sectional study between July 1, 2017, and January 30, 2018. The predictor variables were residents’ gender, program region, program type, and level of training. The outcome variables were frequency of exposure to the care of transgender people, aspects of care covered, perceived importance of such training, and perceived need for fellowship opportunities in gender‐affirming surgery. Results were analyzed for 87 respondents, for a 7.4% response rate. Among the respondents, 81.6% were male; 64.4% were training in combined MD degree‐OMS certificate programs; and 31% reported having had exposure to the care of transgender people during their residency. On a scale from 1=neutral to 3=very important, the respondents’ mean reported importance of receiving training in gender‐affirming surgery was 1.37±0.94. Also, 37.9% reported that fellowship training should be offered in gender‐affirming surgery, specifically facial feminization/masculinization. These results showed that the OMS residents had had limited exposure to the care of transgender people, but they perceived that such exposure should be an important component of their training. Further research is needed to collect results from a larger sample and to better understand the role of oral and maxillofacial surgeons in gender‐affirmation surgery.

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“…Dr Miah et al recommend that integration of further training in gender-affirmation surgery and transgender healthcare be implemented in undergraduate and graduate medical education in the UK. We have similarly felt that inclusion of gender-minority healthcare should be implemented by our medical boards in surgical specialties in the USA 7–10. Without the inclusion of standardized gender-minority healthcare educational opportunities for all our surgical trainees, our patients may suffer from the lack of adequately prepared surgeons and further discrimination against this population.…”

mentioning

confidence: 99%

<p>Surgical healthcare needs for transgender patients: surgeons’ perspectives</p>

Gresty¹,

Miah²,

Morley³

2019

AMEP

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Should Dental Care Make a Transition?

Cited by 9 publications

References 18 publications

Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy

Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy

U.S. Oral and Maxillofacial Residents’ Experience with Transgender People and Perceptions of Gender‐Affirmation Education: A National Survey

<p>Surgical healthcare needs for transgender patients: surgeons’ perspectives</p>

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Should Dental Care Make a Transition?

Cited by 9 publications

References 18 publications

Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy

Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy

U.S. Oral and Maxillofacial Residents’ Experience with Transgender People and Perceptions of Gender‐Affirmation Education: A National Survey

<p>Surgical healthcare needs for transgender patients: surgeons&rsquo; perspectives</p>

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<p>Surgical healthcare needs for transgender patients: surgeons’ perspectives</p>