2-Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis-Part 1. Introduction, epidemiology, case series and case reports.

2-Hydroxyethyl methacrylate (HEMA) has been increasingly recognised as a contact allergen and was added to the European baseline series in 2019. In this article (2 parts), the results of an extensive literature review of the clinical aspects of contact allergy/allergic contact dermatitis to HEMA are presented. In part 1, the epidemiology of HEMA contact allergy is discussed and detailed information on published case series and case reports presented. HEMA is an important cause of contact allergy/allergic contact dermatitis in North America and Europe with recent prevalences of >3% in the USA + Canada and 1.5%-3.7% in Europe. Currently, most cases are caused by nail cosmetics, both in consumers and professional nail stylists. In our literature review, we have found 24 studies presenting case series of patients with allergic contact dermatitis attributed to HEMA and 168 case reports. However, the presence of HEMA in the products causing ACD was established in only a minority. Part 2 will discuss cross- and co-sensitisation, and other skin reactions to HEMA, will assess whether HEMA is the most frequent (meth)acrylate allergen and how sensitive HEMA as a screening agent is, investigate the presence of HEMA in commercial products and provide practical information on patch testing procedures.

The experiences of Finnish dental professionals in handling child abuse and neglect issues in their daily work.

OBJECTIVE: This study aimed to assess the experiences, attitudes and knowledge of child abuse and neglect (CAN) among dentists, dental hygienists and dental nurses in Finland. MATERIAL AND METHODS: A web-based CAN survey was sent to 8500 Finnish dental professionals, covering demographic characteristics, dental education, suspicion of CAN, actions taken and reasons for inaction as well as training on CAN issues. The chi-squared (χ2) test was used to analyse associations. RESULTS: In total, 1586 questionnaires with valid data were completed. Among respondents, 25.8% had received at least some undergraduate training and 36.3% had received postgraduate training on child maltreatment issues. In addition, 43% of respondents had at least one suspicion of CAN at some point during their career. Of those, 64.3% did not refer to social services. Training positively associated with the identification of CAN and referral frequencies. Uncertainty about an observation (80.1%) and a lack of knowledge regarding procedures (43.9%) were the most frequently reported barriers. CONCLUSIONS: Finnish dental professionals need more education on child abuse and neglect issues. Competence related to CAN is fundamental to their skills given that all dental professionals regularly work with children and are obligated to report their concerns to proper authorities.

Evaluating occupational exposures of dental nurses: A retrospective study.

Objective: The objective of this study was to investigate occupational blood-borne pathogen exposure among dental nurses and their attitudes toward infected patients, as well as the effectiveness of the training course, to provide a scientific basis for improving the quality of safety management in the dental hospital. Materials and methods: The study was conducted using questionnaires administered from November 2019 to December 2019 in three hospitals in Sichuan Province, China. Frequencies for answers were calculated and presented as percentages. Results: In total, 257 valid questionnaires were returned. Most (61.9%) nurses stated that they were involved in occupational exposure. Among them, 154 had experienced sharp injuries, and the syringe needle was the most common instrument for injuries (45.8%). Twenty-two individuals had mucosal exposure, and the proportion of eye exposure was the highest (90.9%). Only associations between training and mucosal membrane exposure were found; however, the relevance was weak (r = 0.141). Of the participants, 86.4% felt morally responsible for taking care of patients with infectious diseases, and most (92.6%) said they would continue with this career. Conclusion: Occupational exposure, particularly to sharp injuries, was common in medical care among dental nurses; however, vocational training had little effect on their incidence. As dental nurses still have positive attitudes toward patients with infectious diseases, more effective training should be conducted.

Establishment and effect of standardized training base of dental nurses in Chongqing / 中华医学教育探索杂志

In order to build a standardized training base for dental nurses in Chongqing, explore and improve the dental nursing talent training system, the standardized training and management leading group of dental nurses has established a training program centered on job competence and a clinical competency training center based on simulated dental clinics, which has improved the comprehensive capabilities of dental nursing teachers, implemented the assessment of "equal emphasis on process and results" system, and taken measures to provide comprehensive protection to gradually build the base. After 6 years of construction, the base has completed the training of 139 dental nursing training students, with an average passing rate of 91.21%. Among them, 92.81%(129/139) are engaged in professional dental nursing work, and 14.73%(19/129) have grown into nursing backbones. In the future, it is necessary to further strengthen the standardized training and publicity of dental nurses and expand the scope of radiation.

Evaluation of time and resources required for professional dental cleaning in nursing home residents.

AIM: We aimed to describe time requirements and costs associated with professional dental cleaning (PDC) performed by a dental nurse in one German nursing home, and to reveal potential differences in required time for demented versus nondemented and mobile versus immobile residents. METHODS AND RESULTS: We performed a retrospective, cross-sectional analysis of treatment time and costs, including a transparent, easily adaptable path of action that allows implementation of PDC in nursing homes. Total mean (±SD) treatment time for one session per resident was documented, including differences in demented and immobile residents, and projected treatment costs (€/$) per resident. We found no differences in required time for one PDC (37 ± 11 minutes) in residents with or without dementia (P = 0.803) or, immobile versus mobile residents (P = 0.396). Mean projected treatment costs of PDC were €14.98/$17.07 per resident per cleaning session, resulting in total costs of €13.5 million ($15.4 million). CONCLUSION: Cognitive status and mobility does not affect the mean time required to perform PDC by a dental nurse in nursing home residents. Main cost factor is working time of dental staff; consumable supplies have less impact. Our data may stimulate to include PDC as initial step toward implementation of long-term oral hygiene strategies.

New Zealand's School Dental Service over the Decades: Its Response to Social, Political, and Economic Influences, and the Effect on Oral Health Inequalities.

New Zealand's School Dental Service (SDS) was founded in 1921, partly as a response to the "appalling" state of children's teeth, but also at a time when social policy became centered on children's health and welfare. Referring to the Commission on Social Determinants of Health (CSDH) conceptual framework, this review reflects upon how SDS policy evolved in response to contemporary constraints, challenges, and opportunities and, in turn, affected oral health. Although the SDS played a crucial role in improving oral health for New Zealanders overall and, in particular, children, challenges in addressing oral health inequalities remain to this day. Supported by New Zealand's Welfare State policies, the SDS expanded over several decades. Economic depression, war, and the "baby boom" affected its growth to some extent but, by 1976, all primary-aged children and most preschoolers were under its care. Despite SDS care, and the introduction of water fluoridation in the 1950s, oral health surveys in the 1970s observed that New Zealand children had heavily-filled teeth, and that adults lost their teeth early. Changes to SDS preventive and restorative practices reduced the average number of fillings per child by the early 1980s, but statistics then revealed substantial inequalities in child oral health, with Ma¯ ori and Pacific Island children faring worse than other children. In the 1990s, New Zealand underwent a series of major structural "reforms," including changes to the health system and a degree of withdrawal of the Welfare State. As a result, children's oral health deteriorated and inequalities not only persisted but also widened. By the beginning of the new millennium, reviews of the SDS noted that, as well as worsening oral health, equipment and facilities were run-down and the workforce was aging. In 2006, the New Zealand Government invested in a "reorientation" of the SDS to a Community Oral Health Service (COHS), focusing on prevention. Ten years on, initial evaluations of the COHS appear to be mostly positive, but oral health inequalities persevere. Innovative strategies at COHS level may improve oral health but inequalities will only be overcome by the implementation of policies that address the wider social determinants of health.

Saskatchewan's school-based dental program staffed by dental therapists: a retrospective case study.

OBJECTIVES: The poor oral health of Saskatchewan's children, in concert with a significant shortage of dentists, prompted the province in the early 1970s to seek an alternative method of addressing the oral health care needs of children. The result was the Saskatchewan Health Dental Plan (SHDP), which trained and employed dental therapists in school-based clinics to provide basic dental care to all children. The program was initiated over the opposition of Saskatchewan's dentists. The purpose of this research was to provide information and data previously not documented in the refereed dental literature regarding the only school-based program staffed by dental therapists to ever exist in North America. METHODS: This case study reviews the program's planning, opposition, implementation, and achievements based on a comprehensive review of published articles as well as a search of the grey literature. Additionally, Saskatchewan Health provided annual reports for each year of the program's existence. RESULTS: During its thirteen years of existence, the school-based program proved popular with parents and achieved significant success in providing necessary dental care for children. It was terminated in 1987 by the newly elected provincial Conservative government, which was not supportive of such social programs. CONCLUSIONS: The SHDP serves as a successful model of school-based dental care for children. However, the termination of the plan demonstrates the vulnerability of publicly funded dental health programs to conflicting political ideologies and special interest groups.

Occupational contact dermatitis to acrylates in a manicurist.

We report the case of a manicurist who developed an allergic skin reaction to acrylates, manifested by bullous lesions on fingertips and eczema of the hands and ears. Patch tests showed positive reactions to 2-hydroxyethyl methacrylate, 2-hydroxypropyl methacrylate, ethyleneglycol dimethacrylate, triethyleneglycol dimethacrylate, 1,6-hexandiol diacrylate, 2-hydroxyethyl acrylate and triethyleneglycol diacrylate. Because of her skin disorder, she had to give up her job. She was not correctly advised on retraining and started to work as a dental nurse. Soon after re-exposure to acrylates in dental materials, she experienced recurrence of the skin symptoms.