Background: Fluoride is vital in the prevention of dental caries in children. In 2014, the U.S. Preventive Services Task Force deemed fluoride varnish a recommended preventive service (grade B). Electronic health record-based clinical decision support (CDS) tools have shown variable ability to alter physicians' ordering behaviors.
Objectives: This study aimed to increase the application of fluoride varnish in children while analyzing the effect of two passive CDS tools-an order set and a note template.
Methods: Data on outpatient pediatric visits over an 18-month period before and after CDS implementation (October 15, 2020-April 15, 2022) were queried, while trends in application rate of fluoride were examined. We constructed a multiple logistic regression model with a primary outcome of whether a patient received fluoride at his/her visit. The primary predictor was a "phase" variable representing the CDS implemented. Physician interaction with CDS as well as the financial effects of the resulting service use were also examined.
Results: There were 3,049 well-child visits of children aged 12 months to 5 years. The addition of a fluoride order to a "Well Child Check" order set led to a 10.6% increase in ordering over physician education alone (25.4 vs. 14.8%, = 0.001), while the insertion of fluoride-specific text to drop-down lists in clinical notes led to a 6.2% increase (31.5 vs. 25.4%, = 0.005). Whether a patient received topical fluoride was positively associated with order set implementation (odds ratio [OR] = 5.87, 95% confidence interval [CI]: 4.20-8.21) and fluoride-specific drop-down lists (OR = 7.81, 95% CI: 5.41-11.28). Female providers were more likely to use order sets when ordering fluoride (56.2 vs. 40.9% for males, ≤ 0.0001). Added revenue totaled $15,084.
Conclusion: The targeted use of order sets and note templates was positively associated with the ordering of topical fluoride by physicians.
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http://dx.doi.org/10.1055/a-2011-8167 | DOI Listing |
Dermatitis
January 2025
Department of Dermatology, Park Nicollet Contact Dermatitis Clinic, Minneapolis, Minnesota, USA.
Colophony is a solid form of resin derived from coniferous trees that has both adhesive and water-resistant properties. For these reasons, this allergen is incorporated into many personal care products, medications, and occupational materials, and is thus commonly implicated in allergic contact dermatitis. Dedicated "dental" allergen series often include colophony, but dermatologists are likely not well-versed on its use in a dental setting.
View Article and Find Full Text PDFCureus
December 2024
Department of Periodontology and Implantology, Government Dental College and Hospital, Jamnagar, Jamnagar, IND.
Introduction In their routine practice, dentists frequently encounter dentinal hypersensitivity, which is caused by the pulpal nerves' increased excitability due to fluid movement in the dentinal tubules. It is treated in-office using dentin desensitizers, which reduce hypersensitivity by obstructing the open tubules or desensitizing the free nerve endings present within the tubules. However, no substance or treatment plan has ever been proven to be the gold standard for the efficient treatment of dentinal hypersensitivity.
View Article and Find Full Text PDFObjectiveThe shortage of oral health professionals in rural and remote regions of Australia directly impacts the access to oral health services for people who live in these regions, including Aboriginal and Torres Strait Islander peoples. This scoping review aims to explore where and how these services are provided for Aboriginal and Torres Strait Islander peoples and the relevant workforce model used.MethodsElectronic databases, including MEDLINE, EMBASE, Cochrane, and CINAHL, were searched.
View Article and Find Full Text PDFInt J Clin Pediatr Dent
November 2024
Department of Public Health Dentistry, Dr D Y Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pune, Maharashtra, India.
Introduction: Utilizing 38% silver diamine fluoride (SDF) has been demonstrated in clinical trials to prevent and halt early childhood caries (ECC). Based on a research evaluation, it has been found that 38% SDF can effectively prevent new tooth decay and stop existing tooth decay in children's primary teeth.
Objective: This study aimed to assess the survival of teeth treated with repeated applications of 38% SDF in children with ECC and to compare the outcomes between single and multiple applications.
BMC Oral Health
January 2025
Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Background: This in vitro study evaluated the efficacy of professional and home-use fluoride regimens for protecting irradiated enamel, undergoing pH cycling resembling xerostomia.
Methods: Sixty human premolar teeth were irradiated with a total dose of 70 Gy and subsequently sectioned into 3 × 3 cm enamel slabs. These slabs were randomly distributed into five groups (n = 12 per group): professional-use groups received fluoride varnish either weekly (FV1) or biweekly (FV2); home-use groups applied 5000 ppm (FT5) or 1450 ppm (FT) fluoride toothpaste; and a control group (control) received no treatment.
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