Mobile Health Assessment of Traumatic Dental Injuries Using Smartphone-Acquired Photographs: A Multicenter Diagnostic Accuracy Study.

Background: Mobile health (mHealth) has an emerging potential for remote assessment of traumatic dental injuries (TDI) and support of emergency care. This study aimed to determine the diagnostic accuracy of TDI detection from smartphone-acquired photographs. Methods: The upper and lower anterior teeth of 153 individuals aged ≥ 6 years were photographed using a smartphone camera app. The photos of 148 eligible participants were reviewed independently by a dental specialist, two general dentists, and two dental therapists, using predetermined TDI classification and criteria. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and inter-rater reliability were estimated to evaluate the diagnostic performance of the photographic method relative to the reference standard established by the dental specialist. Results: Of the 1,870 teeth screened, one-third showed TDI; and one-seventh of the participants had primary or mixed dentitions. Compared between the specialist's reference standard and four dental professionals' reviews, the diagnostic sensitivity and specificity for TDI versus non-TDI were 59-95% and 47-93%, respectively, with better performance for urgent types of TDI (78-89% and 99-100%, separately). The diagnostic consistency was also better for the primary/mixed dentitions than the permanent dentition. Conclusion: This study suggested a valid mHealth practice for remote assessment of TDI. A better diagnostic performance in the detection of urgent types of TDI and examination of the primary/mixed dentition was also reported. Future directions include professional development activities involving dental photography and photographic assessment, incorporation of a machine learning technology to aid photographic reviews, and randomized controlled trials in multiple clinical settings.

EXISTING EVIDENCE FOR DENTAL HYGIENE AND DENTAL THERAPY INTERVENTIONS: A DETERMINATION OF DISTINCT PATIENT POPULATIONS.

BACKGROUND: Dental patients seeking care expect to receive treatment options that are supported by evidence-based dental research based on dental patient-reported outcomes (dPROs). In dental hygiene and dental therapy, there is little usage of dPROs and dental patient-reported outcome measures (dPROMs) to assess the four-dimensions of oral health-related quality of life (OHRQoL). In order to assess the current evidence for dental hygiene and dental therapy interventions, the determination of distinct patient populations is essential. AIMS: To determine patient populations that are clinically distinct groups of dental hygiene and dental therapy patients. To provide a preliminary literature search for a systematic review to identify interventions that provide four-dimensional oral health impact information for these patient populations. METHODS: This narrative and methodological manuscript utilizes an allied dental expert panel consisting of two dental hygienists, two dental therapists, and a moderator to generate a list of clinically distinct patient populations within the scopes of dental hygiene and dental therapy. Additionally, a preliminary literature search utilizing PubMed was completed to assess the current research within the scopes of practice of dental hygiene and dental therapy that uses dPROs and dPROMs to assess the four-dimensions of OHRQoL. The patient population list generated by the allied dental expert panel and the patient populations from the articles identified in the preliminary literature search were compared to determine the needed and available evidence for dental hygiene and dental therapy interventions. RESULTS: There were 19 distinct patient populations derived from the allied dental expert panel. Nine of the distinct patient populations were shared in the dental hygiene and dental therapy scopes of practice, six were specific to the dental hygiene scope of practice, and four were specific to the dental therapy scope of practice. From the preliminary literature search, five distinct patient populations had corresponding research. Of those, three distinct populations were shared between dental hygiene and dental therapy, and two were dental hygiene specific. There  : were no distinct patient populations found from the preliminary search specific to dental therapy. CONCLUSION: There is a lack of research in the dental hygiene and dental therapy scopes of practice regarding utilization of dPROs and dPROMs to assess the four-dimensions of OHRQoL. In order to standardize the assessment of OHRQoL, the development of a list of distinct patient populations for dental hygiene and dental therapy interventions is essential. This initiative identifies which populations are lacking evidence and provides a pragmatic approach to conducting a systematic review to assess the four-dimensions of OHRQoL in the field of dental hygiene and dental therapy.

A comparison of dental therapy and dental students' clinical performance.

The aim of the study was to determine if there is a difference between dental therapy students' clinical performance as compared to dental students at the University of Minnesota. An ex post facto research design was used to compare dental therapy students' and dental students' performance on selected clinical procedures. Dental students and dental therapy students from the graduating classes of 2016, 2017, and 2019 at the University of Minnesota comprised the study sample. Fisher's exact test was used to compare pass rates, and Wilcox rank sum test was used to compare performance scores. Dental therapy students' clinical performance on competency examinations and scores on daily clinical procedures showed no statistically significant difference when compared to dental student performance. There was no overall statistical difference in clinical performance between the three student cohorts. Dental therapy students performed equally as well as the dental students.

A survey of dental therapists' practice patterns and training in Minnesota.

BACKGROUND: Expansion of the dental team may play a role in increasing access to oral health care. In 2009, Minnesota became the first state to formally license dental therapists (DTs). METHODS: The authors surveyed DTs and advanced dental therapists (ADTs) in Minnesota to gain a better understanding of those who enter the profession and their motivation for doing so, as well as to solicit their opinions on the overall structure of dental therapy education and the regulatory aspects of the profession. RESULTS: The response rate was 53.1%. DTs and ADTs were split on whether a dental hygiene degree should be required. Primary reasons for entering dental therapy included more autonomy and a larger scope of practice. Respondents expressed a desire for broadened prescribing rights. The median annual income was in the $81,000 through $90,000 bracket. CONCLUSIONS: Minnesota DTs and ADTs must practice in underserved communities. However, their ability to expand access to oral health care is affected by their licensure requirement, scope of practice, and prescription rights. PRACTICAL IMPLICATIONS: Policy makers considering dental therapy legislation must consider educational requirements and scope of practice when crafting state legislation. Broadening the scope of practice may allow for more impactful care for at-risk communities.