Social dentistry: an old heritage for a new professional approach.

If dental professionals want to improve the oral health of their patients, they need to address what makes them sick: the social determinants of health. In this article, we propose a model of 'social dentistry' that shows how dentists could tackle these fundamental causes of oral disease. Socially engaged dentists conduct actions at three levels. At the individual level, they provide patient-centred care and, when necessary, liaise with local resources to better address what makes their patients sick. At the community level, they adapt their practice to the needs of the most vulnerable groups and advocate for healthier local policies. At the societal level, they are engaged in upstream actions addressing the social determinants of health.

Time to Develop Social Dentistry.

Knowledge Transfer Statement: We are calling researchers, educators, and dental professionals to be at the forefront of actions addressing social determinants of health. We indeed argue that 1) it is the dentists' and other oral health care professionals' role to tackle social determinants of health and 2) as researchers and educators, we need to help clinicians in this endeavor and lead the development of a "social dentistry" movement.

Use and perception of nitrous oxide sedation by French dentists in private practice: a national survey.

AIM: The aim of this national survey was to record the use of nitrous oxide and the perceptions of French dental practitioners to this form of sedation. The use of nitrous oxide sedation (NOS) has been authorised in private dental practice in France since December 2009 but, to date, no study implementing both quantitative and qualitative methods has explored such use. METHODS: The data were collected using a Google Forms questionnaire. A mixed methodology was used for data analysis: a quantitative approach to explore the use of conscious sedation and a qualitative thematic approach (using Nvivo software) to determine the practitioner's perception of it. RESULTS: Responses were collected from 225 practitioners (19% of the target population of 1185). Most of the responders were trained in NOS use in private dental clinics. Seventy-three percent of those who trained privately actually used NOS, compared to 53% of those trained at university (p-value = 0.0052). Above all, NOS was used for children requiring restorative dentistry. The average price of the sedation was 50 Euros and it lasted, on average, for 37 min. The qualitative and thematic analysis revealed the financial and technical difficulties of implementing NOS in private practice. However, it also showed the benefits and pleasure associated with NOS use. CONCLUSION: This statistical survey of French dental practitioners offers an insight of the current state of the use of conscious sedation with nitrous oxide in private general dental practice in France. It also includes the first report of dental practitioners' perceptions of NOS use and may lead to a better understanding of the reasons why sedation is sometimes not used in private practice.

How can we provide person-centred dental care?

Patient- or person-centred care is the current paradigm in the health profession yet there is still no clear understanding of what it means or how it could be implemented in dentistry. Building on a previously proposed person-centred model in clinical dentistry, in this article a person-centred dental clinical approach is presented. The approach consists of three guiding principles - humility, hospitality and mindfulness - that influence the different processes of the dental clinical encounter: connecting, examining, sharing, and intervening. The presented approach provides a rich opportunity for dentists to fine tune their own clinical approach in order to keep up with the upcoming expectations of their patients.

Behind the Dam.

KNOWLEDGE TRANSFER STATEMENT:: This fictional narrative can be used by dental education professionals when teaching about the patient-dentist relationship. In particular, this narrative may be useful in patient-centered programs in dental education.

Efficacy of periodontal treatment on glycaemic control in diabetic patients: A meta-analysis of interventional studies.

AIM: There is growing evidence that periodontal disease may favour the incidence or aggravation of diabetes and its complications. To investigate the issue, we conducted a meta-analysis of the effect of periodontal therapy on glycaemic control in diabetic patients. METHODS: A literature search was carried out using seven databases (Medline, EMBASE, LILACS, The Cochrane Library, Pascal, IADR Abstracts and Current Contents), with no language restrictions. We followed the QUOROM-recommended standards for improving the quality of reporting meta-analyses of interventional studies. RESULTS: Twenty-five studies, involving 976 subjects altogether, were included in the present systematic review. Of these, nine studies, involving a total of 485 patients, were controlled trials and were included in the meta-analysis. The standardized mean difference in HbA(1c) with the treatment of periodontal disease was 0.46 (95% CI: 0.11, 0.82). These findings suggest that periodontal treatment could lead to a significant 0.79% (95% CI: 0.19, 1.40) reduction in HbA(1c) level. CONCLUSION: The present meta-analysis represents the best information available to date that addresses this issue, and suggests that periodontal treatment could improve glycaemic control. Nevertheless, these results need to be viewed with caution because of a lack of robustness, and deficiencies in the design of some of the studies included. A randomized controlled trial with sufficient statistical power would help to confirm the results of this meta-analysis.