@Article{info:doi/10.2196/54650,
author="Al-Mansoori, Alghalia
and Al Hayk, Ola
and Qassmi, Sharifa
and Aziz, M. Sarah
and Haouari, Fatima
and Chivese, Tawanda
and Tamimi, Faleh
and Daud, Alaa",
title="Infoveillance of COVID-19 Infections in Dentistry Using Platform X: Descriptive Study",
journal="J Med Internet Res",
year="2025",
month="Apr",
day="3",
volume="27",
pages="e54650",
keywords="COVID-19",
keywords="dentistry",
keywords="infection",
keywords="patient",
keywords="infoveillance",
keywords="platform X",
keywords="Twitter",
abstract="Background: The effect of the COVID-19 pandemic on the well-being of dental professionals and patients has been difficult to track and quantify. X (formerly known as Twitter) proved to be a useful infoveillance tool for tracing the impact of the COVID-19 pandemic worldwide. Objective: This study aims to investigate the use of X to track COVID-19 infections and deaths associated with dental practices. Methods: English Tweets reporting infections or deaths associated with the dental practice were collected from January 1, 2020, to March 31, 2021. Tweets were searched manually using the X Pro search engine (previously known as TweetDeck [X Corp], Twitter Inc, and TweetDeck Ltd) and automatically using a tweet crawler on the X Academic Research application programming interface. Queries included keywords on infection or death of dental staff and patients caused by COVID-19. Tweets registering events on infection or death of dentists, dental staff, and patients as part of their conversation were included. Results: A total of 5641 eligible tweets were retrieved. Of which 1583 (28.1\%) were deemed relevant after applying the inclusion and exclusion criteria. Of the relevant tweets, 311 (19.6\%) described infections at dental practices, where 1168 (86.9\%) infection cases were reported among dentists, 134 (9.9\%) dental staff, and 41 (3.1\%) patients. The majority of reported infections occurred in the United States, India, and Canada, affecting individuals aged 20-51 years. Among the 600 documented deaths, 253 (42.2\%) were dentists, 22 (3.7\%) were dental staff, and 7 (1.2\%) were patients. The countries with the highest number of deaths were the United States, Pakistan, and India, with an affected age range of 23-83 years. Conclusions: The data suggest that analyses of X information in populations of affected areas may provide useful information regarding the impact of a pandemic on the dental profession and demonstrate a correlation with suspected and confirmed infection or death cases. Platform X shows potential as an early predictor for disease spread. However, further research is required to confirm its validity. ",
doi="10.2196/54650",
url="https://www.jmir.org/2025/1/e54650"
}


@Article{info:doi/10.2196/66061,
author="Liu, Hui
and Wang, Jieru
and Chen, Rui
and Xu, Xixing
and Pang, Mingli
and Feng, Kaiyuan
and Li, Bingsong
and Li, Qinling
and Qin, Ziwei
and Yan, Shuyi
and Ibn Ziyat, Nabila
and Kong, Fanlei",
title="Migrant-Local Differences in the Relationship Between Oral Health, Social Support, and Loneliness Among Older Adults in Weifang, China: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2025",
month="Mar",
day="13",
volume="11",
pages="e66061",
keywords="loneliness",
keywords="oral health",
keywords="social support",
keywords="migrant older adults",
keywords="local older adults",
abstract="Background: Increased aging and accelerated urbanization have led to the migration of older adults within China. Migrant older adults (MOAs) may experience physical and psychological discomfort in influx cities, and they are a vulnerable group that has emerged in the course of fast urbanization. Previous studies have confirmed the association between oral health and loneliness as well as the relationship between social support and loneliness; however, no research has been done to clarify the underlying mechanisms and the migrant-local difference between oral health, social support, and loneliness. Objective: This study aimed to test the association between oral health, social support, and loneliness among Chinese older adults, as well as the migrant-local difference on the above relationship. Methods: Multistage cluster random sampling was used to enroll a total of 1205 participants, including 613 MOAs and 592 local older adults (LOAs). Loneliness was assessed by the 6-item short-form UCLA Loneliness Scale; oral health was measured via the Chinese version Geriatric Oral Health Assessment Index (GOHAI); social support was evaluated by the Social Support Rating Scale (SSRS). Descriptive analysis, $\chi$2 tests, and t tests were conducted. Multigroup structural equation modeling (SEM) was employed to clarify the migrant-local difference on the association between oral health, social support, and loneliness among MOAs and LOAs. Results: The mean score of loneliness was 8.58 (SD 3.032) for MOAs and 8.00 (SD 2.790) for LOAs. Oral health and social support were found to be negatively related to loneliness among MOAs and LOAs; the standardized direct effects for MOAs were ?0.168 and ?0.444 (P<.001), and they were ?0.243 and ?0.392 (P<.001) for LOAs, respectively. Oral health generated a direct positive effect on social support, and the direct effect was 0.186 for MOAs (P<.001) and 0.247 for LOAs (P<.001). Conclusions: Loneliness was fairly low among older adults in Weifang, China, while MOAs showed higher loneliness than LOAs. Oral health had both direct and indirect negative effects on loneliness among MOAs and LOAs, with no significant path differences between MOAs and LOAs. Social support was found to be negatively associated with loneliness for both MOA and LOA, while the association was stronger among MOAs than LOAs. Oral health exerted a significantly positive effect on social support for both MOAs and LOAs, while no significant difference existed between them. Measures should be taken by the government, society, and families to increase social support, improve oral health, and further reduce loneliness among MOAs and LOAs. ",
doi="10.2196/66061",
url="https://publichealth.jmir.org/2025/1/e66061"
}


@Article{info:doi/10.2196/63480,
author="Basheer N, Amitha
and Jodalli, Praveen
and Shetty, Shishir
and Shenoy, Ramya
and Rao, Ashwini
and Pai, Mithun
and Gowdar, Murugendrappa Inderjit
and Almalki, Abdulrahman Sultan",
title="Development and Validation of the ``Basic Oral Health Assessment Tool'' (BOHAT) for Nondental Health Care Professionals to Use With the Indian Adult Population: Protocol for a Mixed Methods Study",
journal="JMIR Res Protoc",
year="2025",
month="Feb",
day="13",
volume="14",
pages="e63480",
keywords="oral health assessment tool",
keywords="oral health",
keywords="screening",
keywords="nondental health care professionals",
keywords="primary health centers",
keywords="India",
keywords="tool validation",
keywords="health care training",
keywords="mixed methods research",
abstract="Background: Oral health is a significant indicator of general health, well-being, and quality of life. The prevention of oral health problems requires periodic inspection of the oral cavity. Routine oral health examinations at the individual level appears to be one way to deliver quality oral health care but are too often missed as an opportunity for improved oral health in the nondental health care setting in India. This is because of limited training and inaccessible or lack of specialized oral health assessment tools. Objective: This study will focus on the development, validation, and implementation of the Basic Oral Health Assessment Tool (BOHAT) to improve the oral health assessment capabilities of nondental health care professionals and thus contribute to improved overall health outcomes of the Indian adult population. Methods: This study will be a mixed methods, multistage study conducted in 3 stages. The study will be conducted with 708 nondental health care professionals in 33 Primary Health Centers (PHCs) of Mangalore Taluk, Karnataka. Ethical approval was sought from the institutional ethics committee of Manipal College of Dental Sciences Mangalore. Informed consent will be obtained from every participant prior to the study. A literature review and qualitative interviews will be used for item and domain generation with respect to BOHAT, and an expert panel review and pilot testing will be used to refine the items and domains. Finally, statistical analyses will be conducted to validate the reliability and consistency. The second phase will involve capacity building and user experience exploration through comprehensive training for nondental health professionals using audio and visual aids, with hands-on learning methodologies including relevant feedback processes in the form of focus group discussions. The third stage will check the effectiveness of BOHAT regarding the changes in knowledge, attitudes, and practices through pre- and posttraining questionnaires, which will then be followed by a retention analysis 3 months later. Results: As of January 20, 2025, the study is in its preliminary phase: ``Substage A: Item and Domain\enspaceDevelopment.'' We have received institutional ethics committee and Institutional Protocol Approval Committee approval for the study. Data collection procedures have not started yet. The study is progressing as per the planned timeline. Conclusions: The BOHAT study holds considerable potential to promote oral health care through collaborative and interdisciplinary approaches. It will facilitate early diagnosis, timely referrals, and comprehensive care by integrating assessment actions for oral health into routine practices of nondental primary health care professionals. International Registered Report Identifier (IRRID): PRR1-10.2196/63480 ",
doi="10.2196/63480",
url="https://www.researchprotocols.org/2025/1/e63480"
}


@Article{info:doi/10.2196/65128,
author="Kim, Jaeyeon
and Choi, Yiseul
and Song, Yoolbin
and Park, Wonse",
title="Smartphone-Based Telemonitoring for Better Oral Health With Toothbrushes: 6-Month Randomized Controlled Trial",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="10",
volume="27",
pages="e65128",
keywords="clinical studies",
keywords="clinical trials",
keywords="oral hygiene",
keywords="plaque",
keywords="plaque biofilms",
keywords="halitosis",
keywords="microbiome",
abstract="Background: A toothbrush device that telemonitors toothbrushing is a technologically advanced solution providing personalized feedback on toothbrushing habits and oral hygiene. These devices integrate smartphone apps to enhance oral health compliance through dental professional feedback. Objective: This 6-month prospective randomized controlled trial aimed to compare the clinical effectiveness, defined as improved oral hygiene measured by plaque reduction and halitosis control, of an interactive telemonitoring toothbrush (ITT), an oscillating-rotating power toothbrush (ORT), and a manual toothbrush (MT). Methods: Participants were recruited offline from the Department of Advanced General Dentistry at Yonsei University Dental Hospital, South Korea. A total of 150 participants were randomly assigned to 3 groups (50 participants each): (1) an ITT connected to a smartphone app providing real-time feedback and weekly dental professional reviews, (2) an ORT with smartphone-based guidance requiring participants to send weekly brushing records via screenshots, and (3) an MT with a brushing diary for review. Data collection occurred in clinical settings. Primary outcomes included plaque reduction measured using the Simple Hygiene Score (SHS), while secondary outcomes included plaque reduction measured using the Turesky modification of the Quigley-Hein plaque index (QHI), reductions in halitosis, and changes in oral microbiota. All outcomes were assessed at baseline and 1 month, 3 months, and 6 months. Results: A total of 150 participants completed the study. Over 6 months, the SHS increased in the MT group (mean 3.16, SD 4.86 to mean 5.66, SD 5.20) but significantly decreased in the ITT group (mean 3.47, SD 5.50 to mean 2.27, SD 3.82; P=.004). Similarly, QHI decreased more in the ITT group (mean 1.79, SD 0.72 to mean 0.85, SD 0.63) than in the ORT (P<.001) and MT (P<.001) groups. Regarding microbiota, there were no significant differences in high-risk periodontal microbiota or the ratio of caries-risk to anticaries microbiota between the ITT and ORT groups. However, in the MT group, the ratio of caries-risk microbiota was significantly higher at the 3-month (P<.001) and 6-month (P=.005) recalls than at baseline and at the 3-month (P=.048) and 6-month (P=.03) recalls than at the 1-month recall. Poststudy questionnaires indicated that 45 of 50 ITT participants (92\%) and 37 of 50 ORT participants (76\%) reported improved brushing ability. The most effective feature in the ITT group was brushing training, while participants in the ORT group cited the brushing guide as most useful (P<.001). Satisfaction scores were higher in the ORT group (mean 7.90, SD 1.21) than in the ITT group (mean 7.15, SD 1.66; P=.004). The number of brushing events decreased significantly in the ORT group (P=.02), while brushing duration increased in the MT group (P=.01). Conclusions: ITTs enable better oral hygiene management than MTs through dental professional feedback. However, further studies are needed to optimize feedback intervals and improve long-term adherence. Trial Registration: Clinical Research Information Service (CRIS), Republic of Korea, KCT0009094; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=26110\&search\_page=L ",
doi="10.2196/65128",
url="https://www.jmir.org/2025/1/e65128"
}


@Article{info:doi/10.2196/70071,
author="BinHamdan, Hamdan Rahaf
and Alsadhan, Abdulrahman Salwa
and Gazzaz, Zohair Arwa
and AlJameel, Hassan AlBandary",
title="Social Media Use and Oral Health--Related Misconceptions in Saudi Arabia: Cross-Sectional Study",
journal="JMIR Form Res",
year="2025",
month="Feb",
day="10",
volume="9",
pages="e70071",
keywords="social media",
keywords="oral health",
keywords="health misinformation",
keywords="digital health",
keywords="Saudi Arabia",
keywords="public health",
keywords="Instagram",
keywords="Snapchat",
keywords="TikTok",
keywords="Twitter",
abstract="Background: Social media has become a central tool in health communication, offering both opportunities and challenges. In Saudi Arabia, where platforms like WhatsApp, Snapchat, and Instagram are widely used, the quality and credibility of oral health information shared digitally remain critical issues. Misconceptions about oral health can negatively influence individuals' behaviors and oral health outcomes. Objective: This study aimed to describe the patterns of social media use and estimate the prevalence of oral health--related misconceptions among adults in Saudi Arabia. Additionally, it assessed the associations between engagement with oral health information, self-reported oral health, and the presence and count of these misconceptions. Methods: A cross-sectional survey was conducted over 10 weeks, targeting adults aged 15 years and older in Saudi Arabia. Data were collected from a total sample size (n=387) via a questionnaire distributed through targeted advertisements on Instagram, TikTok, Snapchat, and X (Twitter). The prevalence of oral health--related misconceptions was estimated using descriptive statistics, including counts and percentages. Chi-square tests described sociodemographic, social media engagement, and self-reported oral health. Logistic and Poisson regression analyses were used to assess associations between engagement and self-reported oral health with misconceptions. Logistic regression models provided odds ratios and adjusted odds ratios with 95\% CI to assess the presence of oral health misconceptions. Poisson regression was used to calculate mean ratios and adjusted mean ratios (AMRs) for the count of misconceptions. Results: WhatsApp (n=344, 89.8\%) and Instagram (n=304, 78.9\%) were the most frequently used social media platforms daily. Common oral health misconceptions included beliefs that ``Pregnancy causes calcium loss in teeth'' (n=337, 87\%) and ``Dental treatment should be avoided during pregnancy'' (n=245, 63.3\%). Following dental-specific accounts was significantly associated with lower odds of having any misconceptions (adjusted odds ratio 0.41, 95\% CI 0.22-0.78) and a lower count of misconceptions (AMR 0.87, 95\% CI 0.77-0.98). Conversely, trust in social media as a source of oral health information was associated with a higher count of misconceptions (AMR 1.16, 95\% CI 1.02-1.31). Conclusions: Social media platforms are essential yet double-edged tools for oral health information dissemination in Saudi Arabia. Participants who followed dental-specific accounts had significantly lower misconceptions, while trust in social media as a source of information was linked to higher counts of misconceptions. These findings highlight the importance of promoting credible content from verified sources to combat misconceptions. Strategic collaborations with dental professionals are necessary to enhance the dissemination of accurate oral health information and public awareness and reduce the prevalence of oral health--related misconceptions. ",
doi="10.2196/70071",
url="https://formative.jmir.org/2025/1/e70071"
}


@Article{info:doi/10.2196/59379,
author="Tamannur, Tahazid
and Das, Kumar Sadhan
and Nesa, Arifatun
and Nahar, Foijun
and Nowshin, Nadia
and Binty, Haque Tasnim
and Shakil, Azam Shafiul
and Kundu, Kumar Shuvojit
and Siddik, Bakkar Md Abu
and Rafsun, Mahmud Shafkat
and Habiba, Umme
and Farhana, Zaki
and Sultana, Hafiza
and Kamil, Abdulbasah Anton
and Rahman, Meshbahur Mohammad",
title="Mothers' Knowledge of and Practices Toward Oral Hygiene of Children Aged 5-9 Years in Bangladesh: Cross-Sectional Study",
journal="JMIRx Med",
year="2025",
month="Feb",
day="3",
volume="6",
pages="e59379",
keywords="mothers' knowledge and practices",
keywords="oral hygiene",
keywords="child oral health",
keywords="Bangladesh",
abstract="Background: Healthy oral hygiene is crucial for overall health and well-being. Parents' dental care knowledge and practices affect their children's oral health. Objective: This study examined mothers' knowledge and practices regarding their children's oral hygiene through a cross-sectional survey. Methods: This cross-sectional survey was conducted from January 1 to December 31, 2022, in Dhaka, Bangladesh. Mothers' knowledge and practices regarding their children's oral hygiene were assessed through a semistructured questionnaire. Statistical analyses, including the $\chi$2 test and Pearson correlation test, were performed. The Mann-Whitney U and Kruskal-Wallis 1-way ANOVA tests were also used to show the average variations in knowledge and practices among different sociodemographic groups. Results: Of 400 participants, the mean age of mothers was 30.94 (SD 5.15) years, and 388 (97\%) were of the Muslim faith, 347 (86.8\%) were housewives, and 272 (68\%) came from nuclear families. A total of 165 (41.3\%) participants showed good knowledge of their children's oral hygiene, followed by 86 (21.5\%) showing moderately average knowledge, 75 (18.8\%) showing average knowledge, and 74 (18.5\%) showing poor knowledge. A total of 182 (45.5\%) mothers had children with good oral hygiene practices, followed by mothers with children who had average (n=78, 19.5\%), moderately average (n=75, 18.8\%), and poor (n=65, 16.3\%) oral hygiene practices. The mother's knowledge level was significantly associated with age (P=.01), education (P<.001), family size (P=.03), and monthly income (P<.001). On the other hand, educational status (P=.002) and income (P=.04) were significantly associated with the mother's practices regarding their children's oral hygiene. Nonparametric analysis revealed that mothers who were older (mean knowledge score: 12.13, 95\% CI 10.73-13.54 vs 11.21, 95\% CI 10.85-11.58; P=.01), with a bachelor's degree or higher (mean knowledge score: 12.93, 95\% CI 12.55?13.31 vs 9.66, 95\% CI 8.95?10.37; P<.001), who were working mothers (mean knowledge score: 12.30, 95\% CI 11.72?12.89 vs 11.45, 95\% CI 11.17?11.73; P=.03), and who had a higher family income (mean knowledge score: 12.49, 95\% CI 12.0?12.98 vs 10.92, 95\% CI 10.48?11.36; P<.001) demonstrated significantly higher levels of oral health knowledge. Conversely, good oral hygiene practices were significantly associated with higher maternal education (mean practice score: 6.88, 95\% CI 6.54?7.22 vs 6.01, 95\% CI 5.63?6.40; P<.001) and family income (mean practice score: 6.77, 95\% CI 6.40?7.14 vs 5.96, 95\% CI 5.68?6.24; P=.002). The mother's knowledge was also significantly and positively correlated (Pearson correlation coefficient r=0.301; P<.001) with their children's oral hygiene practices, shown by both the Pearson chi-square ($\chi$2=25.2; P<.001) test and correlation coefficient. Conclusions: The mothers' knowledge and their children's oral hygiene practices were inadequate. The mother's age, education level, family size, and monthly income significantly influenced their knowledge level. Children's oral hygiene habits were significantly associated with family income and the mother's educational status. This underscores the need for educational programs, accessible dental care services, oral health education in the curriculum, media and technology involvement in oral health educational campaigns, and proper research and monitoring. ",
doi="10.2196/59379",
url="https://xmed.jmir.org/2025/1/e59379"
}


@Article{info:doi/10.2196/62738,
author="Pupong, Kittiwara
and Hunsrisakhun, Jaranya
and Pithpornchaiyakul, Samerchit
and Naorungroj, Supawadee",
title="Development of Chatbot-Based Oral Health Care for Young Children and Evaluation of its Effectiveness, Usability, and Acceptability: Mixed Methods Study",
journal="JMIR Pediatr Parent",
year="2025",
month="Feb",
day="3",
volume="8",
pages="e62738",
keywords="chatbot",
keywords="conversational agents",
keywords="tele-dentistry",
keywords="oral health behavior",
keywords="in-person toothbrushing",
keywords="hands-on",
keywords="children",
keywords="covid-19",
keywords="oral health education",
keywords="development.",
abstract="Background: Chatbots are increasingly accepted in public health for their ability to replicate human-like communication and provide scalable, 24/7 services. The high prevalence of dental caries in children underscores the need for early and effective intervention. Objective: This study aimed to develop the 30-Day FunDee chatbot and evaluate its effectiveness, usability, and acceptability in delivering oral health education to caregivers of children aged 6 to 36 months. Methods: The chatbot was created using the artificial intelligence (AI) chatbot behavior change model, integrating behavioral change theories into content designed for 3?5 minutes of daily use over 30 days. A pre-post experimental study was conducted from December 2021 to February 2022 in Hat Yai District, Songkhla Province, and Maelan District, Pattani Province, Thailand. Fifty-eight caregivers completed a web-based structured questionnaire at baseline and 2 months post baseline to evaluate knowledge, protection motivation theory-based perceptions, and tooth-brushing practices. Usability was assessed via chatbot logfiles and a web-based questionnaire at 2 months post baseline. Acceptability was evaluated through three methods: (1) open-ended chatbot interactions on day 30, (2) a web-based structured questionnaire at 2 months post baseline, and (3) semistructured telephone interviews with 15 participants 2 weeks post intervention. Participants for interviews were stratified by adherence levels and randomly selected from Hatyai and Maelan districts. All self-reported variables were measured on a 5-point Likert scale (1=lowest, 5=highest). Results: The chatbot was successfully developed based on the 4 components of the AI chatbot behavior change model. Participants had a mean age of 34.5 (SD 8.6) years. The frequency of tooth brushing among caregivers significantly improved, increasing from 72.4\% at baseline to 93.1\% two months post baseline (P=.006). Protection motivation theory-based perceptions also showed significant improvement, with mean scores rising from 4.0 (SD 0.6) at baseline to 4.5 (SD 0.6) two months post baseline (P<.001). The chatbot received high ratings for satisfaction (4.7/5, SD 0.6) and usability (4.7/5, SD 0.5). Participants engaged with the chatbot for an average of 24.7 (SD 7.2) days out of 30. Caregivers praised the chatbot's content quality, empathetic communication, and multimedia design, but noted the intervention's lengthy duration and messaging system as limitations. Conclusions: The 30-Day FunDee chatbot effectively enhanced caregivers' perceptions of oral health care and improved tooth-brushing practices for children aged 6?36 months. High user satisfaction and engagement demonstrate its potential as an innovative tool for oral health education. These findings warrant further validation through large-scale, randomized controlled trials. Trial Registration: Thai Clinical Trials Registry Tctr20210927004; https://www.thaiclinicaltrials.org/show/Tctr20210927004 ",
doi="10.2196/62738",
url="https://pediatrics.jmir.org/2025/1/e62738"
}


@Article{info:doi/10.2196/53630,
author="Sutan, Rosnah
and Ismail, Shahida
and Ibrahim, Roszita",
title="Evaluating the Development, Reliability, and Validation of the Tele-Primary Care Oral Health Clinical Information System Questionnaire: Cross-Sectional Questionnaire Study",
journal="JMIR Hum Factors",
year="2025",
month="Jan",
day="29",
volume="12",
pages="e53630",
keywords="telehealth",
keywords="electronic health",
keywords="eHealth",
keywords="public health information system",
keywords="psychometric analysis",
abstract="Background: Evaluating digital health service delivery in primary health care requires a validated questionnaire to comprehensively assess users' ability to implement tasks customized to the program's needs. Objective: This study aimed to develop, test the reliability of, and validate the Tele-Primary Care Oral Health Clinical Information System (TPC-OHCIS) questionnaire for evaluating the implementation of maternal and child digital health information systems. Methods: A cross-sectional study was conducted in 2 phases. The first phase focused on content item development and was validated by a group of 10 experts using the content validity index. The second phase was to assess its psychometric testing for reliability and validity. Results: A structured questionnaire of 65 items was constructed to assess the TPC-OHCIS delivery for primary health care use based on literature and has been validated by 10 experts, and 319 respondents answered the 65-item TPC-OHCIS questionnaire, with mean item scores ranging from 1.99 (SD 0.67) to 2.85 (SD 1.019). The content validity, reliability, and face validity showed a scale-level content validity index of 0.90, scale-level content validation ratio of 0.90, and item-level face validity index of 0.76, respectively. The internal reliability was calculated as a Cronbach $\alpha$ value of 0.90, with an intraclass correlation coefficient of 0.91. Scales were determined by the scree plot with eigenvalues >1, and 13 subscales were identified based on principal component analysis. The Kaiser-Meyer-Olkin value was 0.90 (P<.049). The total variance explained was 76.07\%, and factor loading scores for all variables were >0.7. The Bartlett test of sphericity, determining construct validity, was found to be significant (P<.049). Conclusions: The TPC-OHCIS questionnaire is valid to be used at the primary health care level to evaluate the TPC-OHCIS implementation. It can assess health care workers' work performance and job acceptance and improve the quality of care. ",
doi="10.2196/53630",
url="https://humanfactors.jmir.org/2025/1/e53630"
}


@Article{info:doi/10.2196/65137,
author="Shirbhate, Unnati
and Bajaj, Pavan
and Wanjari, Mayur
and Patil, Manoj",
title="Role of Injectable Platelet-Rich Fibrin in the Management of Soft and Hard Tissue Periodontal Regeneration in Dentistry: Protocol for a Systematic Review",
journal="JMIR Res Protoc",
year="2025",
month="Jan",
day="23",
volume="14",
pages="e65137",
keywords="injectable platelet-rich fibrin",
keywords="pulp regeneration",
keywords="periodontal regeneration",
keywords="periodontium",
keywords="tissue engineering",
abstract="Background: Injectable platelet-rich fibrin (i-PRF) has the capacity to release great amounts of several growth factors, as well as to stimulate increased fibroblast migration and the expression of collagen, transforming growth factor $\beta$, and platelet-derived growth factor. Consequently, i-PRF can be used as a bioactive agent to promote periodontal tissue regeneration. Objective: We aim to compare and evaluate the effectiveness of i-PRF in periodontal tissue regeneration. Methods: We will conduct an electronic search in the following databases: PubMed, Cochrane Library, Google Scholar, Semantic Scholar, Scopus, and Web of Science. Papers will be restricted to those in English and to those that are randomized controlled trials comparing PRF or any other biomaterial with i-PRF for periodontal regeneration during dental treatment. The included papers in this review and the reference lists of pertinent reviews will be manually searched. The selection of studies, data extraction, and assessment will be carried out separately by 2 reviewers using the Risk of Bias 2 tool for the included research. Results: The success of i-PRF will be evaluated by comparing the mean difference in periodontal regeneration of soft and hard tissues in terms of gingival recession, probing pocket depth, clinical attachment level, bone gain, and gingival width. The combined effect size measurements and the associated 95\% CIs will be estimated using a random-effects model. The synthesis or work for this systematic review started in October 2023 and will last until December 2025. Conclusions: i-PRF may play a role in dentistry and could enhance soft and hard tissue regeneration. Trial Registration: PROSPERO CRD42023464250; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=464250 International Registered Report Identifier (IRRID): PRR1-10.2196/65137 ",
doi="10.2196/65137",
url="https://www.researchprotocols.org/2025/1/e65137"
}


@Article{info:doi/10.2196/67378,
author="Liu, Chaofeng
and Liu, Yan
and Yi, Chunyan
and Xie, Tao
and Tian, Jingjun
and Deng, Peishen
and Liu, Changyu
and Shan, Yan
and Dong, Hangyu
and Xu, Yanhua",
title="Application of a 3D Fusion Model to Evaluate the Efficacy of Clear Aligner Therapy in Malocclusion Patients: Prospective Observational Study",
journal="J Med Internet Res",
year="2025",
month="Jan",
day="15",
volume="27",
pages="e67378",
keywords="clear aligners",
keywords="CBCT",
keywords="intraoral scanning",
keywords="fusion model",
keywords="artificial intelligence",
keywords="efficacy evaluation",
keywords="orthodontic treatment",
abstract="Background: Investigating the safe range of orthodontic tooth movement is essential for maintaining oral and maxillofacial stability posttreatment. Although clear aligners rely on pretreatment digital models, their effect on periodontal hard tissues remains uncertain. By integrating cone beam computed tomography--derived cervical and root data with crown data from digital intraoral scans, a 3D fusion model may enhance precision and safety. Objective: This study aims to construct a 3D fusion model based on artificial intelligence software that matches cone beam computed tomography and intraoral scanning data using the Andrews' Six Element standard. The model will be used to assess the 3D effects of clear aligners on tooth movement, to provide a reference for the design of pretreatment target positions. Methods: Between May 2022 and May 2024, a total of 320 patients who completed clear aligner therapy at our institution were screened; 136 patients (aged 13-35 years, fully erupted permanent dentition and periodontal pocket depth <3 mm) met the criteria. Baseline (``simulation'') and posttreatment (``fusion'') models were compared. Outcomes included upper core discrepancy (UCD), upper incisors anteroposterior discrepancy (UAP), lower Spee curve deep discrepancy (LSD), upper anterior teeth width discrepancy (UAW), upper canine width discrepancy (UCW), upper molar width discrepancy (UMW), and total scores. Subanalyses examined sex, age stage (adolescent vs adult), and treatment method (extraction vs nonextraction). Results: The study was funded in May 2022, with data collection beginning the same month and continuing until May 2024. Of 320 initial participants, 136 met the inclusion criteria. Data analysis is ongoing, and final results are expected by late 2024. Among the 136 participants, 90 (66\%) were female, 46 (34\%) were male, 64 (47\%) were adolescents, 72 (53\%) were adults, 38 (28\%) underwent extraction, and 98 (72\%) did not. Total scores did not differ significantly by sex (mean difference 0.01, 95\% CI --0.13 to 0.15; P=.85), age stage (mean difference 0.03, 95\% CI --0.10 to 0.17; P=.60), or treatment method (mean difference 0.07, 95\% CI --0.22 to 0.07; P=.32). No significant differences were found in UCD (mean difference 0.001, 95\% CI --0.02 to 0.01; P=.90) or UAP (mean difference 0.01, 95\% CI --0.03 to 0.00; P=.06) by treatment method. However, adolescents exhibited smaller differences in UCD, UAW, UCW, and UMW yet larger differences in UAP and LSD (df=134; P<.001). Extraction cases showed smaller LSD, UAW, and UCW but larger UMW differences compared with nonextraction (df=134; P<.001). Conclusions: The 3D fusion model provides a reliable clinical reference for target position design and treatment outcome evaluation in clear aligner systems. The construction and application of a 3D fusion model in clear aligner orthodontics represent a significant leap forward, offering substantial clinical benefits while establishing a new standard for precision, personalization, and evidence-based treatment planning in the field. Trial Registration: Chinese Clinical Trial Registry ChiCTR2400094304, https://www.chictr.org.cn/hvshowproject.html?id=266090\&v=1.0 ",
doi="10.2196/67378",
url="https://www.jmir.org/2025/1/e67378"
}


@Article{info:doi/10.2196/66121,
author="Acosta, Macadaeg Joseph
and Detsomboonrat, Palinee
and Pisarnturakit, Pantuwadee Pagaporn
and Urwannachotima, Nipaporn",
title="The Use of Social Media on Enhancing Dental Care and Practice Among Dental Professionals: Cross-Sectional Survey Study",
journal="JMIR Form Res",
year="2025",
month="Jan",
day="3",
volume="9",
pages="e66121",
keywords="social media",
keywords="oral health promotion",
keywords="oral health education",
keywords="dentists",
keywords="dental practice",
keywords="dental professionals",
keywords="dental practitioners",
abstract="Background: As digitalization continues to advance globally, the health care sector, including dental practice, increasingly recognizes social media as a vital tool for health care promotion, patient recruitment, marketing, and communication strategies. Objective: This study aimed to investigate the use of social media and assess its impact on enhancing dental care and practice among dental professionals in the Philippines. Methods: A cross-sectional survey was conducted among dental practitioners in the Philippines. The study used a 23-item questionnaire, which included 5 questions on dentists' background and demographic information and 18 questions regarding the use, frequency, and purpose of social media in patient advising and quality of care improvement. Data were analyzed using SPSS software, with frequency distributions and $\chi$2 tests used to assess the association between social media use and demographic variables and the impact on dental practice. Results: The 265 dental practitioners in this study were predominantly female (n=204, 77\%) and aged between 20?30 years (n=145, 54.7\%). Most of the participants were general practitioners (n=260, 98.1\%) working in a private practice (n=240, 90.6\%), with 58.5\% (n=155) having 0?5 years of clinical experience. Social media use was significantly higher among younger practitioners (20?30 years old) compared to older age groups (P<.001), though factors such as sex, dental specialty, and years of clinical practice did not significantly influence use. The majority (n=179, 67.5\%) reported using social media in their practice, primarily for oral health promotion and education (n=191, 72.1\%), connecting with patients and colleagues (n=165, 62.3\%), and marketing (n=150, 56.6\%). Facebook (n=179, 67.5\%) and YouTube (n=163, 61.5\%) were the most frequented platforms for clinical information, with Twitter (subsequently rebranded X) being the least used (n=4, 1.5\%). Despite widespread social media engagement, only 8.7\% (n=23) trusted the credibility of web-based information, and 63.4\% (n=168) perceived a potential impact on the patient-dentist relationship due to patients seeking information on the internet. Social media was also perceived to enhance practice quality, with users reporting significant improvements in patient care (P=.001). Conclusions: The findings highlight that social media is widely used among younger dental practitioners, primarily for education, communication, and marketing purposes. While social media use is associated with perceived improvements in practice quality and patient care, trust in information on social media remains low, and concerns remain regarding its effect on patient relationships. It is recommended to establish enhanced guidelines and provide reliable web-based resources to help dental practitioners use social media effectively and responsibly. ",
doi="10.2196/66121",
url="https://formative.jmir.org/2025/1/e66121"
}


@Article{info:doi/10.2196/60684,
author="Stephan, Daniel
and Bertsch, Annika
and Burwinkel, Matthias
and Vinayahalingam, Shankeeth
and Al-Nawas, Bilal
and K{\"a}mmerer, W. Peer
and Thiem, GE Daniel",
title="AI in Dental Radiology---Improving the Efficiency of Reporting With ChatGPT: Comparative Study",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="23",
volume="26",
pages="e60684",
keywords="artificial intelligence",
keywords="ChatGPT",
keywords="radiology report",
keywords="dental radiology",
keywords="dental orthopantomogram",
keywords="panoramic radiograph",
keywords="dental",
keywords="radiology",
keywords="chatbot",
keywords="medical documentation",
keywords="medical application",
keywords="imaging",
keywords="disease detection",
keywords="clinical decision support",
keywords="natural language processing",
keywords="medical licensing",
keywords="dentistry",
keywords="patient care",
abstract="Background: Structured and standardized documentation is critical for accurately recording diagnostic findings, treatment plans, and patient progress in health care. Manual documentation can be labor-intensive and error-prone, especially under time constraints, prompting interest in the potential of artificial intelligence (AI) to automate and optimize these processes, particularly in medical documentation. Objective: This study aimed to assess the effectiveness of ChatGPT (OpenAI) in generating radiology reports from dental panoramic radiographs, comparing the performance of AI-generated reports with those manually created by dental students. Methods: A total of 100 dental students were tasked with analyzing panoramic radiographs and generating radiology reports manually or assisted by ChatGPT using a standardized prompt derived from a diagnostic checklist. Results: Reports generated by ChatGPT showed a high degree of textual similarity to reference reports; however, they often lacked critical diagnostic information typically included in reports authored by students. Despite this, the AI-generated reports were consistent in being error-free and matched the readability of student-generated reports. Conclusions: The findings from this study suggest that ChatGPT has considerable potential for generating radiology reports, although it currently faces challenges in accuracy and reliability. This underscores the need for further refinement in the AI's prompt design and the development of robust validation mechanisms to enhance its use in clinical settings. ",
doi="10.2196/60684",
url="https://www.jmir.org/2024/1/e60684"
}


@Article{info:doi/10.2196/53585,
author="Abogazalah, Naif
and Yiannoutsos, Constantin
and Soto-Rojas, E. Armando
and Bindayeld, Naif
and Yepes, F. Juan
and Martinez Mier, Angeles Esperanza",
title="Distal and Proximal Influences on Self-Reported Oral Pain and Self-Rated Oral Health Status in Saudi Arabia: Retrospective Study Using a 2017 Nationwide Database",
journal="JMIR Public Health Surveill",
year="2024",
month="Dec",
day="20",
volume="10",
pages="e53585",
keywords="dental health surveys",
keywords="nationwide database",
keywords="public health dentistry",
keywords="path analysis",
keywords="oral health influences",
keywords="oral pain",
keywords="self-rated oral health",
keywords="cross-sectional study",
keywords="dental health",
keywords="dentistry",
keywords="oral health",
keywords="self-reported",
keywords="retrospective study",
keywords="Saudi Arabia",
keywords="proximal",
keywords="distal",
keywords="adult",
keywords="children",
keywords="youth",
keywords="adolescent",
keywords="teen",
keywords="sociodemographic",
abstract="Background: Oral health significantly influences overall well-being, health care costs, and quality of life. In Saudi Arabia, the burden of oral diseases, such as dental caries and periodontal disease, has increased over recent decades, driven by various lifestyle changes. Objective: To explore the associations between proximal (direct) and distal (indirect) influences that affect oral pain (OP) and self-rated oral health (SROH) status in the Kingdom of Saudi Arabia (KSA) using an adapted conceptual framework. Methods: This retrospective cross-sectional study used data from a national health survey conducted in KSA in 2017. The sample included adults (N=29,274), adolescents (N=9910), and children (N=11,653). Sociodemographic data, health characteristics, and access to oral health services were considered distal influences, while frequency and type of dental visits, tooth brushing frequency, smoking, and consumption of sweets and soft drinks were considered proximal influences. Path analysis modeling was used to estimate the direct, indirect, and total effects of proximal and distal influences on OP and SROH status. Results: The mean age of adult respondents was 42.2 years; adolescents, 20.4 years; and children, 10.58 years. Despite OP reports from 39\% of children, 48.5\% of adolescents, and 47.1\% of adults, over 87\% across all groups rated their oral health as good, very good, or excellent. A higher frequency of tooth brushing showed a strong inverse relationship with OP and a positive correlation with SROH (P<.001). Frequent dental visits were positively associated with OP and negatively with SROH (P<.001). Sweet consumption increased OP in adolescents ($\beta$=0.033, P=.007) and negatively affected SROH in children ($\beta$=--0.086, P<.001), adolescents ($\beta$=--0.079, P<.001), and adults ($\beta$=--0.068, P<.001). Soft drink consumption, however, was associated with lower OP in adolescents ($\beta$=--0.034, P=.005) and improved SROH in adolescents ($\beta$=0.063, P<.001) and adults ($\beta$=0.068, P<.001). Smoking increased OP in adults ($\beta$=0.030, P<.001). Distal influences like higher education were directly linked to better SROH ($\beta$=0.046, P=.003) and less OP (indirectly through tooth brushing, $\beta$=--0.004, P<.001). For children, high household income correlated with less OP ($\beta$=--0.030, P=.02), but indirectly increased OP through other pathways ($\beta$=0.024, P=.003). Lack of access was associated with negative oral health measures (P<.001). Conclusions: Among the KSA population, OP and SROH were directly influenced by many proximal and distal influences that had direct, indirect, or combined influences on OP and SROH status. ",
doi="10.2196/53585",
url="https://publichealth.jmir.org/2024/1/e53585",
url="http://www.ncbi.nlm.nih.gov/pubmed/39706582"
}


@Article{info:doi/10.2196/48778,
author="Yuan, Lei
and Yuan, Yuan
and Ren, Haotian
and Zhang, Feng
and Zhao, Zhe
and Jiang, Qinqin
and Wei, Zhenbang
and Sun, Jin-hai",
title="Decomposition Analysis of the Prevalence of Denture Use Between Rural and Urban Older Individuals With Edentulism in China: Cross-Sectional Study",
journal="Interact J Med Res",
year="2024",
month="Dec",
day="13",
volume="13",
pages="e48778",
keywords="oral health",
keywords="older adults with edentulism",
keywords="edentulism",
keywords="denture",
keywords="decomposition analysis",
keywords="China",
abstract="Background: Edentulism impacts the physical health and quality of life of older individuals. The prevalence, influencing factors, and differences in terms of edentulism in urban and rural areas of China are unclear. Objective: This study investigated the denture-wearing conditions and causes affecting older patients with edentulism in urban and rural areas of China and analyzed the differences. Methods: This cross-sectional study included the data of 5139 older individuals (age>65 years) with edentulism obtained from 23 Chinese provinces in 2018. Participants were divided into urban and rural groups based on their household registration. Factors influencing denture use in both groups were explored using binary logistic regression, while factors influencing differences in denture wearing in both groups were explored using the Fairlie decomposition model. Results: Of the 5139 participants, 67.05\% (808/1205) from urban areas and 51.12\% (2011/3934) from rural areas wore dentures. In the urban group, participants with a higher level of education (1-6 years: odds ratio [OR] 2.093, 95\% CI 1.488-2.945; ?7 years: OR 2.187, 95\% CI 1.565-3.055) or who exercised (OR 2.840, 95\% CI 2.016-3.999) preferred wearing dentures, but individuals with BMI<18.5 kg/m2 (OR 0.558, 95\% CI 0.408-0.762) or widowed (OR 0.618, 95\% CI 0.414-0.921) did not. In the rural group, a higher level of education (1-6 years: OR 1.742, 95\% CI 1.429-2.123; ?7 years: OR 1.498, 95\% CI 1.246-1.802), living alone (OR 1.372, 95\% CI 1.313-1.663), exercise (OR 1.612, 95\% CI 1.340-1.940), high economic status (OR 1.234, 95\% CI 1.035-1.472), residence in the eastern area (OR 2.045, 95\% CI 1.723-2.427), presence of chronic diseases (1 disease: OR 1.534, 95\% CI 1.313-1.793; ?2 diseases: OR 1.500, 95\% CI 1.195-1.882) were positively associated and age?80 years (OR 0.318, 95\% CI 0.247-0.408), BMI<18.5 kg/m2 (OR 0.692, 95\% CI 0.590-0.813), and widowed (OR 0.566, 95\% CI 0.464-0.690) or other marital status (OR 0.600, 95\% CI 0.392-0.918) were negatively associated with denture use. The Fairlie decomposition model revealed that the number of chronic diseases (16.34\%), education level (11.94\%), region of residence (11.00\%), annual income (10.55\%), exercise (6.81\%), and age (--0.92\%) were the main factors responsible for differences between urban and rural edentulism and could explain the difference in the denture-wearing rate (58.48\%) between both groups. Conclusions: Older individuals with edentulism with a higher education level and who exercise are more willing to wear dentures, while those with BMI<18.5 kg/m2 show a decreased willingness to wear dentures in both urban and rural areas in China. Controlling the number of chronic diseases, improving the education level and annual income, cultivating good exercise habits, and bridging the gap between the economic status of the east and west can narrow the differences in denture wearing among urban and rural older individuals with edentulism. ",
doi="10.2196/48778",
url="https://www.i-jmr.org/2024/1/e48778"
}


@Article{info:doi/10.2196/60817,
author="Bryne, Emilie
and Bergum, H{\o}yvik Kathrine
and Gjedrem, Gilje William",
title="Improving Oral Health in Prisons (PriOH): Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2024",
month="Dec",
day="11",
volume="13",
pages="e60817",
keywords="intervention",
keywords="motivational interviewing",
keywords="oral care",
keywords="marginalized groups",
keywords="correctional services",
keywords="implementation",
keywords="oral hygiene",
keywords="oral health",
keywords="randomized controlled trial",
keywords="RCT",
keywords="prison",
keywords="dental care",
keywords="pilot study",
keywords="people living in prison",
abstract="Background: People living in prisons often experience poor oral health, which could be attributed to their limited access to (dental) care, financial constraints, and a general lack of awareness and prioritization toward their oral hygiene. A pilot study involving motivational interviewing (MI) has shown promising results for improving the oral health outcomes of people living in prisons. Objective: The protocol for this study aims to assess the efficacy of integrated MI and oral hygiene packages in improving oral health among people living in prisons, compared to controls without added MI. Methods: This oral health in prisons study is a multicenter, randomized, double-blinded controlled trial that recruited inmates from 4 prisons in Rogaland County.?The trial aimed to recruit 320 participants before randomly allocating them to either a control or intervention group. The intervention group received MI, consisting of a 30-minute session encouraging inmates to discuss their current and desired oral health behaviors and attitudes, highlighting discrepancies to motivate change. Assessments were conducted at 4 and 12 weeks after initiation. The primary outcome measurement is the mucosal-plaque scores to assess oral health behaviors, attitudes, and?oral?hygiene. Secondary outcome measurements are?oral hygiene routines, sugary food and drink intake, oral health perception, and oral health-related questions. Results: Data collection started in November 2021 and ended in June 2023. A total of 327 participants were recruited, of which 126 received the intervention. Conclusions: Integrating MI in oral health programs at prisons can significantly improve the oral health of incarcerated individuals. Should the results from this study demonstrate efficacy, it could be valuable insight for policy makers, oral health practitioners, and correctional services in addressing the needs of a traditionally underserved group before being scaled up to enhance dental care practices in prisons. Trial Registration: ClinicalTrials.gov NCT05695443; https://clinicaltrials.gov/study/NCT05695443 International Registered Report Identifier (IRRID): DERR1-10.2196/60817 ",
doi="10.2196/60817",
url="https://www.researchprotocols.org/2024/1/e60817",
url="http://www.ncbi.nlm.nih.gov/pubmed/39661440"
}


@Article{info:doi/10.2196/60590,
author="Nascimento da Silva Mulder, J{\'u}lia
and Ramos Pinto, Marcelo
and An{\'i}bal, Isabelle
and Dornellas, Paula Ana
and Garrido, Deise
and Huanca, Camila
and Haddad, Estela Ana
and Mendes Abdala, Ver{\^o}nica Carmen",
title="Teledentistry Applied to Health and Education Outcomes: Evidence Gap Map",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="27",
volume="26",
pages="e60590",
keywords="teledentistry",
keywords="systematic review",
keywords="dental education",
keywords="dentistry",
keywords="telemedicine",
keywords="research design",
keywords="health information technologies",
keywords="mobile phone",
abstract="Background: Teledentistry is a field of activities that comprises information and communication technologies (ICTs) applied to dentistry, including the exchange of clinical information, patient care, and the use of educational strategies across remote distances. Its use has grown progressively over the past decades---intensified by the COVID-19 pandemic---and has been improving the provision of dental services and educational strategies ever since. Objective: This evidence gap map (EGM) study aims to present a collection of systematic reviews (SRs) with meta-analyses to answer the question ``What are the applications of teledentistry in dental services and dental education?'' by identifying gaps and current evidence on the improvement of health care and education. Methods: The EGM methodology has been developed by the Latin American and Caribbean Center on Health Sciences Information and is based on the concept created by the International Initiative for Impact Evaluation. Embase, PubMed, and Virtual Health Library databases were used for the literature research, using terms for teledentistry associated with eHealth, dental education, and oral health care. The data obtained from the included studies were then characterized in a Microsoft Excel spreadsheet, with a matrix containing 8 intervention groups (combined interventions, e-learning and tele-education, teleconsultation and teleservice, telemonitoring, telediagnosis, telescreening, ICTs, and artificial intelligence) and 8 outcome groups (diagnosis accuracy, education and professional training, user behavior, clinical practice, patient-centered outcomes, clinical outcomes, health services management, and access to health services). The quality of the studies was assessed using AMSTAR2 (A Measurement Tool to Assess Systematic Reviews). The visual analytics platform Tableau (Salesforce) was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects. Results: The confidence level obtained by the criteria applied was high for 28\% (19/68) of the studies, moderate for 6\% (4/68), low for 15\% (10/68), and critically low for 51\% (35/68). Among the interventions, the ICT group stood out with 182 (36.8\%) out of 494 associations, followed by interventions with e-learning and tele-education (n=96, 19.4\% of associations), telediagnosis (n=67, 13.6\%), and combined interventions (n=53, 10.7\%). Most of the outcomes were aimed at education and professional training (97/494, 19.6\% of associations), patient-centered outcomes (74/494, 15\%), and health services management (60/494, 12.1\%). Conclusions: This EGM presents an overview of the contributions of teledentistry in patient care, health services, clinical practice, and education. The study results may help guide future research and policy decisions and serve as a convenient virtual tool for accessing valuable evidence-based information on teledentistry. ",
doi="10.2196/60590",
url="https://www.jmir.org/2024/1/e60590",
url="http://www.ncbi.nlm.nih.gov/pubmed/39602783"
}


@Article{info:doi/10.2196/56765,
author="Vargas Villafuerte, R. Kelly
and Palucci Vieira, H. Luiz
and Oliveira Santos, Karina",
title="Influence of Psychological Stress on the Response to Periodontal Treatment: Protocol for a Systematic Review",
journal="JMIR Res Protoc",
year="2024",
month="Nov",
day="12",
volume="13",
pages="e56765",
keywords="periodontal disease",
keywords="periodontal therapy",
keywords="integral health",
keywords="oral health",
keywords="evidence-based",
keywords="periodontitis",
keywords="inflammatory diseases",
keywords="inflammatory response",
keywords="anxiety",
keywords="stress",
keywords="depression",
keywords="periodontal health",
abstract="Background: The interaction between stress and periodontal treatment is a topic of growing interest. It stands out as a field of research that sheds light on the complexity of oral health in individuals subjected to high levels of emotional stress. Objective: This paper aims to provide a protocol for a systematic review to examine the scientific evidence related to the influence of psychological stress on the response to periodontal treatment. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be followed, and the study is based on a formulation of PECO (Participants, Exposure, Comparators, and Outcomes) questions. This systematic review will involve a literature search covering studies published from January 2000 to May 2024. It will include searching the PubMed, Web of Science, EBSCOHost, Scopus, and ProQuest databases to identify relevant studies. After selection, data extraction and quality assessment (using the Ottawa-Newcastle Scale) of the included studies will be carried out. The objective is to integrate high-quality evidence on how psychological stress impacts the outcomes of periodontal treatment. Depending on the number and methodological consistency of included studies, the results may be presented by meta-analysis or qualitative synthesis. Results: The current stage of the study consists of selecting studies for the systematic review as outlined by this protocol. The search, screening, and data extraction began in January 2024. The final results are expected by July 2024, with final manuscript submission planned for November 2024. Conclusions: This review will help clarify how psychological factors, such as stress, influence the results of periodontal treatment, providing valuable guidelines for future research and helping clinicians make decisions about the best treatment options for patients. Trial Registration: Open Science Framework (OSF) Registries qfs6p; https://osf.io/qfs6p International Registered Report Identifier (IRRID): PRR1-10.2196/56765 ",
doi="10.2196/56765",
url="https://www.researchprotocols.org/2024/1/e56765"
}


@Article{info:doi/10.2196/50389,
author="Pang, MengWei
and Lu, WeiYu
and Huang, Chuling
and Lin, Meixiu
and Ran, Jiangsheng
and Tang, Xiaomei
and Huang, YuanDing
and Yang, Sheng
and Song, Jinlin",
title="Development of an Interprofessional Education Project in Dentistry Based on the Positive Behavior Support Theory: Pilot Curriculum Development and Validation Study",
journal="JMIR Form Res",
year="2024",
month="Nov",
day="11",
volume="8",
pages="e50389",
keywords="innovative interprofessional education",
keywords="dentistry",
keywords="dental technology",
keywords="positive behavior support",
keywords="IPE",
keywords="positive behavior",
keywords="training system",
keywords="dental education",
keywords="",
abstract="Background: Effective interprofessional education (IPE) can facilitate teamwork between dentists and dental technicians, thereby enabling the efficient provision of high-quality dental care. Objective: This study aimed to design and assess an IPE module named Project 35, which was offered to dental and dental technology students early in their undergraduate training as a precursor to a more comprehensive IPE curriculum in dentistry and dental technology. Methods: Leveraging positive behavior support (PBS) theory, Project 35 was devised as an innovation and entrepreneurship educational training framework. It used project-based learning to cultivate teamwork skills and to promote the professional development of dental and dental technology students. The pilot study was designed to present the IPE module and preliminarily assess its validity. In survey 1, which was conducted immediately after the course, the dental and dental technology students' self-reported skill acquisition and attitudes were assessed and compared. Survey 2, conducted 1 year after the course, focused on the comparative benefits of Project 35 training for dental technology students versus an untrained group. Results: A total of 66 students, including 36 dental students and 30 dental technology students who had undertaken the training, were recruited. Project 35 training improved teamwork skills for students in both disciplines comparably, and the students recognized the training as highly valuable and effective. The mean values for all items indicating skills improvement of students ranged from 4.13 (SD 0.797) to 4.63 (SD 0.495) for dental students and from 4.13 (SD 0.869) to 4.74 (SD 0.619) for dental technology students. Among the dental technology students, the trained group showed greater independent and innovative approaches and was more optimistic about the future of the profession than the nontrained group (P<.05). Conclusions: Despite the small sample size, the validity of the Project 35 training system was evident, and the success of our pilot study provides a sound basis for the future development of IPE in clinical dental and dental technology education programs. ",
doi="10.2196/50389",
url="https://formative.jmir.org/2024/1/e50389"
}


@Article{info:doi/10.2196/49975,
author="Corr{\^e}a, Laura
and J{\'u}dice, Andr{\'e}
and Scoz, Robson
and Machado, Vanessa
and Mendes, Jo{\~a}o Jos{\'e}
and Proen{\c{c}}a, Lu{\'i}s
and Botelho, Jo{\~a}o
and Ferreira, Luciano",
title="Portuguese Version of the Oral Frailty Index-8: Instrument Validation Study",
journal="Interact J Med Res",
year="2024",
month="Oct",
day="28",
volume="13",
pages="e49975",
keywords="oral frailty",
keywords="oral health",
keywords="functional disability",
keywords="frailty",
keywords="aging",
keywords="dentistry",
keywords="confirmatory factor analysis",
keywords="psychometric validity",
keywords="questionnaire development",
abstract="Background: The concept of oral frailty has gained scientific and clinical relevance in recent years, and early detection can facilitate timely intervention to manage its progression. The Oral Frailty Index-8 (OFI-8) was developed to assess community-dwelling older adults at risk for oral frailty. Objective: This study aims to investigate the psychometric validity of the OFI-8 in the Portuguese population, named the Portuguese version of the OFI-8 (OFI-8-PT), which may serve as a reference for future studies related to longevity and oral function. Methods: This study included 2 main phases, involving patients aged 60 years or older, Portuguese speakers, and those who consented to participate in the study. First, the researchers translated and cross-culturally adapted the original questionnaire to make it suitable for native Portuguese speakers. The translated tool was then assessed for psychometric validation, which consisted of test-retest reliability, internal consistency, construct validity, and sex invariance measurement. Results: A total of 159 older adults participated in the baseline survey, with almost equal numbers of male (n=79, 49.7\%) and female participants (n=80, 50.3\%). The OFI-8-PT demonstrated good reliability (Cronbach $\alpha$=0.95) and construct validity (goodness-of-fit index=0.96; comparative fit index=0.85; and root mean square error of approximation=0.05, 90\% CI 0.00-0.09). The study found sex invariance, indicating that the OFI-8-PT is equally valid for male and female participants, and the tested-retest reliability of the OFI-8-PT was good, indicating consistent results over time. Conclusions: The OFI-8-PT showed psychometric validity and good reliability to be used in the Portuguese population. ",
doi="10.2196/49975",
url="https://www.i-jmr.org/2024/1/e49975",
url="http://www.ncbi.nlm.nih.gov/pubmed/39466299"
}


@Article{info:doi/10.2196/51351,
author="Mohamed, Abubaker
and Ismail, Enas
and Adam, Z. Razia",
title="A Comparison of Conventional Root Canal Sealers With Ones That Use Green Synthesized Nanoparticles for Antimicrobial Activity: Protocol for a Systematic Review",
journal="JMIR Res Protoc",
year="2024",
month="Oct",
day="11",
volume="13",
pages="e51351",
keywords="root-canal sealers",
keywords="nanoparticles",
keywords="antimicrobial activity",
keywords="root canal",
keywords="antimicrobial",
keywords="dentistry",
abstract="Background: Root canal failure and secondary endodontic infection are frequent clinical scenarios in dentistry. The main microorganisms implicated in root canal therapy failure are persistent Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. To combat the impact of disease resistance, scientists are concentrating on alternative antimicrobial root canal sealers. Nanomaterials are a recent development in endodontic materials that exhibit great antimicrobial properties, making them an ideal material choice for root canal sealers. Objective: This systematic review aims to compare the antimicrobial properties of conventional root canal sealers to those incorporating green synthesized nanoparticles between 2010 and 2024. Methods: A well-constructed protocol was established and registered with PROSPERO (CRD42021286373). Ethics approval was obtained from the Biomedical Research and Ethics Committee from the University of the Western Cape (UWC; BM22/1/4). PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) reporting guidelines were followed. The included criteria demonstrate the green synthesized nanoparticles studies where the nanoparticles (NPs) are incorporated in root canal sealers. MeSH (Medical Subject Headings) terms were used for the search strategy of the systematic electronic databases for articles published in English between 2010 and 2024. The selected databases included Scopus, PubMed, Web of Science, Science Direct, EBSCOhost, SpringerLink, and Wiley Online. A quality assessment tool for laboratory studies will be used to critically appraise the included studies. If applicable, statistical measures (mean, SD, etc) will be used for data analysis and presentation of the results. Results: The protocol is registered with PROSPERO. A preliminary search was conducted using a determined search strategy across 8 electronic databases, and the review is now complete. Conclusions: It is anticipated that the results of this systematic review may reveal the increased interest and application for nanoparticle-enhanced root canal sealers. This will aid in the future development of root canal sealants and mitigate the risk of endodontic failure. Trial Registration: PROSPERO CRD42021286373; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=286373 International Registered Report Identifier (IRRID): DERR1-10.2196/51351 ",
doi="10.2196/51351",
url="https://www.researchprotocols.org/2024/1/e51351"
}


@Article{info:doi/10.2196/59999,
author="Kaurani, Pragati
and Hindocha, Amit
and Porwal, Amit
and Tambe, Abhijit
and Price, Carrie
and Goel, Vidhani
and Krasner, Henry
and Khubchandani, Jagdish
and Batra, Kavita",
title="Effect of Addition of Metal Oxide Nanoparticles on the Strength of Heat-Cured Denture Base Resins: Protocol for Systematic Review and Meta-Analysis of In Vitro Studies",
journal="JMIR Res Protoc",
year="2024",
month="Sep",
day="25",
volume="13",
pages="e59999",
keywords="nanoparticles",
keywords="strength",
keywords="denture base resins",
keywords="polymethyl methacrylate",
keywords="denture",
keywords="dentures",
keywords="resin",
keywords="resins",
keywords="metal oxide",
abstract="Background: Metal oxide nanoparticle--reinforced polymethyl methacrylate (PMMA) has been shown to improve mechanical properties, such as strength. Different types of metal oxide nanoparticles have been used previously, but the comparative effect on the strength of heat-cured denture base resins remains unclear. Objective: This is a protocol for a systematic review and meta-analysis that will aim to pool evidence to compare and analyze the effects of the addition of different metal oxide nanoparticles, with varied sizes and concentrations, on the strength (flexural, impact, transverse, compressive tensile strength, and fracture toughness) of heat-cured PMMA. In addition, this review aims to analyze methodological factors, such as adherence to testing and sample-making guidelines, and the effects of surface treatments of the nanoparticles on the strength of heat-cured denture base resins. Methods: The protocol has been registered in the Open Science Framework. Search strategies to identify studies on the effect of metal oxide nanoparticles on the strength of heat-cured PMMA were developed by the subject matter expert in library science. Following this, a systematic search of 5 electronic databases (PubMed [NCBI], Scopus [Elsevier], Cochrane Library [Wiley], CINAHL Plus with Full Text [EBSCO], and Dimensions Free Web App) was conducted to retrieve in vitro studies published in English from January 2012 to October 2023. Along with this citation chasing, other online sources and gray literature were also searched. Furthermore, papers will be screened, and appropriate data elements will be extracted in a standardized manner. A risk-of-bias assessment will be performed using a modified Cochrane Risk of Bias Tool. A meta-analysis will be performed using a random-effects model. Results: Search in databases resulted in 1837 papers, of which 1752 were duplicates, leaving 85 records that were screened for titles and abstracts based on the eligibility criteria. A similar search run on other online sources identified 129 papers that will be further analyzed for inclusion. The study was initiated in November 2023 and research questions and search strategies were formulated. The proposed study is expected to be completed by December 2024. Conclusions: This systematic review will comprehensively analyze the effects of the incorporation of metal oxide nanoparticles in heat-cured denture base resins on the strength of the material. We anticipate gaining a deeper understanding of the effects and method of use of metal oxide nanoparticles to improve the strength of PMMA denture base resins. International Registered Report Identifier (IRRID): PRR1-10.2196/59999 ",
doi="10.2196/59999",
url="https://www.researchprotocols.org/2024/1/e59999"
}


@Article{info:doi/10.2196/54999,
author="LaVine, Danielle
and Greer, Zara
and Kim, Jiyun
and Kumar, Santosh
and Belin, Thomas
and Shetty, Vivek",
title="A Remote Oral Self-Care Behaviors Assessment System in Vulnerable Populations: Usability and Feasibility Study",
journal="JMIR Form Res",
year="2024",
month="Aug",
day="2",
volume="8",
pages="e54999",
keywords="dental disease",
keywords="underserved populations",
keywords="mHealth",
keywords="usability testing",
keywords="feasibility testing, mobile phone",
abstract="Background: Preventative self-care can reduce dental disease that disproportionately burdens vulnerable populations. Personalized digital oral self-care behavioral interventions offer a promising solution. However, the success of these digital interventions depends on toothbrushing data collection e-platforms attuned to the needs and preferences of vulnerable communities. Objective: The aim of this study is to assess the usability and feasibility of the Remote Oral Behaviors Assessment System (ROBAS), which has been adapted to address the unique requirements of socioeconomically disadvantaged minority individuals. Methods: A cohort of 53 community-clinic participants, including 31 (58\%) Latino and 22 (42\%) Black individuals with no prior experience using electric toothbrushes, were recruited to use ROBAS, with planned assessments at baseline, 2 months, and 4 months. Beyond evaluating ROBAS's technical performance, extensive feedback was gathered to gauge users' experiences, viewpoints, and overall contentment. The System Usability Scale (SUS) served as a primary metric for assessing user satisfaction and acceptability. Results: ROBAS exhibited largely reliable and consistent data-gathering capabilities. SUS scores (mean 75.6, SD 14.5) reflected participant contentment within a range of values for other commonly used digital devices and technologies. Among participants who answered questions about willingness to pay for ROBAS, 97\% (30/31) indicated that they were willing to pay for ROBAS either as a one-time payment or as a subscription-based service. Additionally, 87.5\% of participants expressed that they would endorse it to acquaintances. Most participants expressed no reservations about privacy; among those who expressed privacy concerns (n=20, 50\%), the concerns included exposure of information (n=18, 45\%), monitoring of brushing habits (n=12, 30\%), and collection of information (n=14, 35\%), although these concerns did not significantly correlate with specific participant traits. In qualitative terms, users valued ROBAS's ability to monitor brushing habits but called for refinements, especially in Wi-Fi and application connectivity. Recommendations for system improvements encompassed enhanced app functionality, individualized coaching, more comprehensive brushing data, and the addition of flossing activity tracking. Conclusions: The research highlights ROBAS's promise as a digital platform for unobtrusively tracking daily oral self-care activities in marginalized communities. The system proved to be both feasible, as evidenced by its stable and accurate data capture of brushing behaviors, and user-friendly, as reflected by strong SUS scores and positive user feedback. Influential factors for its uptake included ease of learning and operation, and the feedback provided. ",
doi="10.2196/54999",
url="https://formative.jmir.org/2024/1/e54999"
}


@Article{info:doi/10.2196/50479,
author="Musa, Reem
and Elamin, Dalia
and Barrie, Robert
and Kimmie-Dhansay, Faheema",
title="Effectiveness of Mobile App Interventions to Improve Periodontal Health: Protocol for a Systematic Review and Meta-Analysis",
journal="JMIR Res Protoc",
year="2024",
month="Jul",
day="31",
volume="13",
pages="e50479",
keywords="mobile app",
keywords="periodontal health",
keywords="text messages",
keywords="application",
keywords="effectiveness",
keywords="physical well-being",
keywords="mental well-being",
keywords="social well-being",
keywords="oral hygiene",
keywords="oral disease",
keywords="disease prevention",
keywords="periodontal",
keywords="health education",
keywords="systematic review",
abstract="Background: Periodontal health plays a key role as a shared reference point for evaluating periodontal diseases and identifying significant treatment outcomes. Providing adequate instruction and enhancing the motivation of patients to maintain proper oral hygiene are crucial factors for successful periodontal treatment, with self-performed regular oral hygiene identified as a critical factor in improving the outcomes of treatment for periodontal diseases. Recently, mobile health (mHealth) solutions, especially mobile apps, have emerged as valuable tools for self-management in chronic diseases such as periodontal disease, providing essential health education and monitoring capabilities. However, the use of mHealth apps for periodontal health is complex owing to various interacting components such as patient behavior, socioeconomic status, and adherence to oral hygiene practices. Existing literature has indicated positive effects of mHealth on oral health behaviors, knowledge, attitude, practice, plaque index score, and gingivitis reduction. However, there has been no systematic review of mobile apps specifically targeting patients with periodontal disease. Understanding the design and impact of mHealth apps is crucial for creating high-quality apps. Objective: The aim of this systematic review and meta-analysis is to evaluate the effectiveness of existing mobile apps in promoting periodontal health. Methods: A comprehensive search strategy will be performed in multiple electronic databases (PubMed, EBSCOhost, CINAHL Plus, Dentistry \& Oral Sciences, ScienceDirect, Scopus, and Cochrane Central Register of Controlled Trials) with the following keywords in the title/abstract: ``mobile application,'' ``mobile health,'' ``mHealth,'' ``telemedicine,'' ``periodontal health,'' ``periodontitis,'' and ``text message.'' Only randomized controlled trials will be included that assessed the following outcomes to measure periodontal health improvement: gingival index, bleeding index, periodontal pocket depth, and clinical attachment loss. Covidence will be used for data collection, and a PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flowchart will be used to describe the selection process of the included, identified, and excluded studies. The Confidence in Network Meta-Analysis approach will be used for meta-analysis of the extracted data from the included studies. Results: This review will not require ethical approval since no primary data will be included. As of July 2024, a total of 83 articles retrieved from various databases have been imported to Covidence with 13 articles deemed eligible for inclusion in the review. The review is currently ongoing and is expected to be complete by the end of 2024 with the results published in early 2025. Conclusions: This systematic review and meta-analysis will contribute to developing mobile apps with enhanced criteria to improve periodontal clinical outcomes. The review emphasizes the importance of mHealth and preventing periodontal disease, which can set the stage for informed global health care strategies. Trial Registration: PROSPERO CRD42022340827; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=340827 International Registered Report Identifier (IRRID): DERR1-10.2196/50479 ",
doi="10.2196/50479",
url="https://www.researchprotocols.org/2024/1/e50479"
}


@Article{info:doi/10.2196/51087,
author="Navaneethan, Praveena
and Mohammed, Pasha Imran
and Shenoy, P. Rekha
and Junaid, Junaid
and Amanna, Supriya
and Alsughier, Zeyad
and Kolarkodi, Hameed Shaul",
title="Evaluation of Staining Propensity of Silver Diamine Fluoride With and Without Potassium Iodide in Children (Project Healthy Smiles): Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2024",
month="Jul",
day="23",
volume="13",
pages="e51087",
keywords="silver diamine fluoride",
keywords="SDF",
keywords="potassium iodide",
keywords="KI",
keywords="tooth discoloration",
keywords="dental caries",
keywords="dental esthetics",
keywords="dental",
keywords="teeth",
keywords="healthy smile",
keywords="staining",
keywords="treatment",
keywords="oral health",
keywords="child",
abstract="Background: Silver diamine fluoride (SDF) is becoming more widely recognized as a simple, cost-effective approach to minimize sensitivity and arrest caries. However, SDF results in caries that are stained black. Potassium iodide (KI) treatment with SDF may minimize or lessen the staining. However, the effectiveness of KI on staining has not been investigated. Studies demonstrating that potassium iodide reduces the black staining are still insufficient. This paper presents the study protocol for Healthy Smiles, a randomized controlled trial implemented to compare the staining propensity of SDF and SDF+KI. Objective: This study, Healthy Smiles, aims to evaluate the staining propensity of SDF and SDF+KI using a Nix Mini color sensor among children aged 4 to 6 years. Another objective of the study is to evaluate the caries-arresting effect of SDF and SDF+KI in the treatment of carious primary teeth. Methods: This study is a randomized controlled trial. A total of 60 children with caries that meet the criteria of the International Caries Detection and Assessment System (code 1 or above) will be randomly assigned to treatment groups, where group 1 will be treated with SDF and group 2 will be treated with SDF+KI. Discoloration of treated lesions will be assessed digitally using a Nix Mini color sensor. Participants will be followed up at 1, 3, and 6 months after treatment to digitally record the ?L and ?E values using the Nix Mini color sensor. Data will be analyzed using SPSS (version 28; IBM Corp). Independent sample t tests and the Mann-Whitney U test will be used to compare the 2 groups. Results: Enrollment started in October 2023. It is estimated that the enrollment period will be 12 months. Data collection is planned to be completed in 2024. Conclusions: The presented paper describes Happy Smiles, a project that provides an opportunity to address the aesthetic inconvenience of patients without compromising the effectiveness of the SDF treatment. The trial findings will contribute to the limited evidence base related to discoloration after SDF intervention to improve aesthetic appearances in child oral health. If the results from the trial are promising, it will lead to the development of a model for child oral health and pave the way for further research in child oral health. International Registered Report Identifier (IRRID): PRR1-10.2196/51087 ",
doi="10.2196/51087",
url="https://www.researchprotocols.org/2024/1/e51087"
}


@Article{info:doi/10.2196/49922,
author="Ruslin, Muhammad
and Hamrun, Nurlindah
and Tajrin, Andi
and Yusuf, Hajrah Andi Sitti
and Nurrahma, Rifaat
and Natsir-Kalla, Sabrina Diandra
and Ariestiana, Yoanita Yossy
and Nur Anam, Mukhtar
and Liu, Chung-Ming
and Ou, Keng-Liang",
title="Feasibility and Preliminary Efficacy of $\alpha$--Calcium Sulfate Hemihydrate in Socket Preservation: Protocol for a Pilot Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2024",
month="Jul",
day="19",
volume="13",
pages="e49922",
keywords="$\alpha$--calcium sulfate hemihydrate",
keywords="$\alpha$-CSH",
keywords="bone graft",
keywords="bone regeneration",
keywords="socket preservation",
keywords="pilot",
keywords="feasibility",
keywords="efficacy",
keywords="impacted tooth",
keywords="tooth extraction",
keywords="radiographic imaging",
keywords="bone",
keywords="dentist",
keywords="dentistry",
keywords="dental",
keywords="bone resorption",
keywords="graft",
keywords="bone loss",
keywords="alveolar bone",
keywords="regeneration",
abstract="Background: Tooth extraction procedures often lead to bone resorption, which can have adverse effects on the dimensions of the alveolar ridge. Research has shown that socket preservation techniques using bone graft substitutes can effectively minimize early bone loss in such cases. $\alpha$--calcium sulfate hemihydrate ($\alpha$-CSH) has garnered significant attention as a potential bone graft material due to its favorable properties, including osteoconductivity, angiogenic potential, and biocompatibility. Considering these facts, we developed a preliminary protocol for applying $\alpha$-CSH in addressing alveolar bone loss following tooth extraction. Objective: This research's general objective is to evaluate the feasibility and initial effectiveness of $\alpha$-CSH as bone-inducing graft material for socket preservation after tooth extraction. Methods: This preliminary clinical trial will involve 30 fresh extraction sockets from individuals aged 18-35 years. The participants will be divided into 2 groups: one group will receive $\alpha$-CSH graft material after tooth extraction for socket preservation, while the other group will not receive any graft material. Throughout the study, the participants will be closely monitored for safety measures, which will include clinical examinations, radiographic imaging, and blood tests. Radiographic imaging will be used extensively to assist the progress of bone formation. Results: The study commenced enrollment in August 2022 and is scheduled to conclude post assessments and analyses by the end of 2023. The results of the study are anticipated to be accessible in late 2024. Conclusions: This clinical study represents the initial investigation in humans to assess the feasibility and efficacy of $\alpha$-CSH in alveolar bone regeneration. We hypothesize that the inclusion of $\alpha$-CSH can greatly expedite the process of bone formation within fresh sockets, resulting in a swift restoration of bone height without the disadvantages associated with harvesting autogenous bone graft. Trial Registration: Indonesia Registry Center INA-D02FAHP; https://tinyurl.com/2jnf6n3s International Registered Report Identifier (IRRID): DERR1-10.2196/49922 ",
doi="10.2196/49922",
url="https://www.researchprotocols.org/2024/1/e49922",
url="http://www.ncbi.nlm.nih.gov/pubmed/39028555"
}


@Article{info:doi/10.2196/56759,
author="Reshetnikov, Aleksey
and Shaikhattarova, Natalia
and Mazurok, Margarita
and Kasatkina, Nadezhda",
title="Dental Tissue Density in Healthy Children Based on Radiological Data: Retrospective Analysis",
journal="JMIRx Med",
year="2024",
month="Jun",
day="20",
volume="5",
pages="e56759",
keywords="density",
keywords="teeth",
keywords="tooth",
keywords="dental",
keywords="dentist",
keywords="dentists",
keywords="dentistry",
keywords="oral",
keywords="tissue",
keywords="enamel",
keywords="dentin",
keywords="Hounsfield",
keywords="pathology",
keywords="pathological",
keywords="radiology",
keywords="radiological",
keywords="image",
keywords="images",
keywords="imaging",
keywords="teeth density",
keywords="Hounsfield unit",
keywords="diagnostic imaging",
abstract="Background: Information about the range of Hounsfield values for healthy teeth tissues could become an additional tool in assessing dental health and could be used, among other data, for subsequent machine learning. Objective: The purpose of our study was to determine dental tissue densities in Hounsfield units (HU). Methods: The total sample included 36 healthy children (n=21, 58\% girls and n=15, 42\% boys) aged 10-11 years at the time of the study. The densities of 320 teeth tissues were analyzed. Data were expressed as means and SDs. The significance was determined using the Student (1-tailed) t test. The statistical significance was set at P<.05. Results: The densities of 320 teeth tissues were analyzed: 72 (22.5\%) first permanent molars, 72 (22.5\%) permanent central incisors, 27 (8.4\%) second primary molars, 40 (12.5\%) tooth germs of second premolars, 37 (11.6\%) second premolars, 9 (2.8\%) second permanent molars, and 63 (19.7\%) tooth germs of second permanent molars. The analysis of the data showed that tissues of healthy teeth in children have different density ranges: enamel, from mean 2954.69 (SD 223.77) HU to mean 2071.00 (SD 222.86) HU; dentin, from mean 1899.23 (SD 145.94) HU to mean 1323.10 (SD 201.67) HU; and pulp, from mean 420.29 (SD 196.47) HU to mean 183.63 (SD 97.59) HU. The tissues (enamel and dentin) of permanent central incisors in the mandible and maxilla had the highest mean densities. No gender differences concerning the density of dental tissues were reliably identified. Conclusions: The evaluation of Hounsfield values for dental tissues can be used as an objective method for assessing their densities. If the determined densities of the enamel, dentin, and pulp of the tooth do not correspond to the range of values for healthy tooth tissues, then it may indicate a pathology. ",
doi="10.2196/56759",
url="https://xmed.jmir.org/2024/1/e56759"
}


@Article{info:doi/10.2196/49262,
author="Larsen, Maria
and Holde, Eirin Gro
and Johnsen, Kolset Jan-Are",
title="Investigating Patient Satisfaction Through Web-Based Reviews of Norwegian Dentists: Quantitative Study Using the Meaning Extraction Method",
journal="J Particip Med",
year="2024",
month="May",
day="3",
volume="16",
pages="e49262",
keywords="internet use",
keywords="Linguistic Inquiry and Word Count",
keywords="LIWC",
keywords="patient satisfaction",
keywords="patient preference",
keywords="challenging encounters",
keywords="preventive dentistry",
keywords="population surveillance",
abstract="Background: Challenging encounters in health care professions, including in dentistry, are relatively common. Challenging encounters can be defined as stressful or emotional situations involving patients that could impact both treatment outcomes and patients' experiences. Through written web-based reviews, patients can share their experiences with health care providers, and these posts can be a useful source for investigating patient satisfaction and their experiences of challenging encounters. Objective: This study aims to identify dominant themes from patient-written, web-based reviews of dentists and investigate how these themes are related to patient satisfaction with dental treatment. Methods: The study data consisted of 11,764 reviews written by dental patients, which included 1- to 5-star ratings on overall satisfaction and free-text comments. The free-text comments were analyzed using Linguistic Inquiry and Word Count software, and the meaning extraction method was used to group words into thematic categories. These themes were used as variables in a multilevel logistic regression analysis to predict patient satisfaction. Results: Eight themes emerged from the analyses, of which 6 (75\%)---explanation (odds ratio [OR] 2.56, 95\% CI 2.16-3.04; P<.001), assurance (OR 3.61, 95\% CI 2.57-5.06; P<.001), performance assessment (OR 2.17, 95\% CI 1.84-2.55; P<.001), professional advice (OR 1.81, 95\% CI 1.55-2.13; P<.001), facilities (OR 1.78, 95\% CI 1.08-2.91; P=.02), and recommendation (OR 1.31, 95\% CI 1.12-1.53; P<.001)---increased the odds of high patient satisfaction. The remaining themes (2/8, 25\%)---consequences of treatment need (OR 0.24, 95\% CI 0.20-0.29; P<.001) and patient-centered care (OR 0.62, 95\% CI 0.52-0.74; P<.001)---reduced the odds of high patient satisfaction. Conclusions: The meaning extraction method is an interesting approach to explore patients' written accounts of encounters with dental health professionals. The experiences described by patients provide insight into key elements related to patient satisfaction that can be used in the education of dental health professionals and to improve the provision of dental health services. ",
doi="10.2196/49262",
url="https://jopm.jmir.org/2024/1/e49262",
url="http://www.ncbi.nlm.nih.gov/pubmed/38700933"
}


@Article{info:doi/10.2196/56143,
author="Detsomboonrat, Palinee
and Pisarnturakit, Pantuwadee Pagaporn",
title="Time Efficiency, Reliability, and User Satisfaction of the Tooth Memo App for Recording Oral Health Information: Cross-Sectional Questionnaire Study",
journal="JMIR Form Res",
year="2024",
month="Apr",
day="10",
volume="8",
pages="e56143",
keywords="capability",
keywords="health survey",
keywords="oral health",
keywords="mobile apps",
keywords="personal health information",
keywords="PHI",
keywords="satisfaction",
keywords="tooth",
keywords="teeth",
keywords="oral",
keywords="dental",
keywords="dentist",
keywords="dentistry",
keywords="data entry",
keywords="data collection",
keywords="mHealth",
keywords="mobile health",
keywords="app",
keywords="apps",
keywords="applications",
keywords="periodontal",
keywords="survey",
keywords="questionnaire",
keywords="questionnaires",
abstract="Background: Digitalizing oral health data through an app can help manage the extensive data obtained through oral health surveys. The Tooth Memo app collects data from oral health surveys and personal health information. Objective: This study aims to evaluate the evaluate the time efficiency, reliability, and user satisfaction of the Tooth Memo app. Methods: There are 2 sections in the Tooth Memo app: oral health survey and personal oral health record. For the oral health survey section of the Tooth Memo app, different data entry methods were compared and user satisfaction was evaluated. Fifth-year dental students had access to the oral health survey section in the Tooth Memo app during their clinical work. The time required for data entry, analysis, and summary of oral health survey data by 3 methods, that is, pen-and-paper (manual), Tooth Memo app on iOS device, and Tooth Memo app on Android device were compared among 3 data recorders who entered patients' information on decayed, missing, and filled permanent teeth (DMFT) index and community periodontal index (CPI), which were read aloud from the database of 103 patients by another dental personnel. The interobserver reliability of the 3 different data-entering procedures was evaluated by percent disagreement and kappa statistic values. Laypeople had access to the personal oral health record section of this app, and their satisfaction was evaluated through a Likert scale questionnaire. The satisfaction assessments for both sections of the Tooth Memo app involved the same set of questions on the app design, usage, and overall satisfaction. Results: Of the 103 dental records on DMFT and CPI, 5.2\% (177/3399) data points were missing in the manual data entries, but no data on tooth status were missing in the Android and iOS methods. Complete CPI information was provided by all 3 methods. Transferring data from paper to computer took an average of 55 seconds per case. The manual method required 182 minutes more than the iOS or Android methods to clean the missing data and transfer and analyze the tooth status data of 103 patients. The users, that is, 109 fifth-year dental students and 134 laypeople, expressed high satisfaction with using the Tooth Memo app. The overall satisfaction with the oral health survey ranged between 3 and 10, with an average (SD) of 7.86 (1.46). The overall satisfaction with the personal oral health record ranged between 4 and 10, with an average (SD) of 8.09 (1.28). Conclusions: The Tooth Memo app was more efficacious than manual data entry for collecting data of oral health surveys. Dental personnel as well as general users reported high satisfaction when using this app. ",
doi="10.2196/56143",
url="https://formative.jmir.org/2024/1/e56143",
url="http://www.ncbi.nlm.nih.gov/pubmed/38598287"
}


@Article{info:doi/10.2196/46789,
author="Liu, KeXin
and Xu, YaQian
and Ma, ChaoYi
and Yu, Na
and Tan, FaBing
and Li, Yi
and Bai, YaXin
and Fu, XiaoMing
and Wan, JiaWu
and Fan, DongQi
and Yin, HuBin
and Chen, MeiXi
and Chen, HongJi
and Jiang, Lin
and Song, JinLin
and Ji, Ping
and Zhao, XiaoHan
and Pang, MengWei",
title="Efficacy of a Virtual 3D Simulation--Based Digital Training Module for Building Dental Technology Students' Long-Term Competency in Removable Partial Denture Design: Prospective Cohort Study",
journal="JMIR Serious Games",
year="2024",
month="Apr",
day="5",
volume="12",
pages="e46789",
keywords="removable partial denture",
keywords="RPD",
keywords="virtual simulation",
keywords="dental technology",
keywords="computer-aided design",
keywords="CAD",
keywords="clinical practice",
keywords="efficacy",
keywords="cohort study",
keywords="digital training",
keywords="training",
keywords="dentistry",
keywords="treatment",
keywords="design",
keywords="virtual",
keywords="assessment",
abstract="Background: Removable partial denture (RPD) design is crucial to long-term success in dental treatment, but shortcomings in RPD design training and competency acquisition among dental students have persisted for decades. Digital production is increasing in prevalence in stomatology, and a digital RPD (D-RPD) module, under the framework of the certified Objective Manipulative Skill Examination of Dental Technicians (OMEDT) system reported in our previous work, may improve on existing RPD training models for students. Objective: We aimed to determine the efficacy of a virtual 3D simulation--based progressive digital training module for RPD design compared to traditional training. Methods: We developed a prospective cohort study including dental technology students at the Stomatology College of Chongqing Medical University. Cohort 1 received traditional RPD design training (7 wk). Cohort 2 received D-RPD module training based on text and 2D sketches (7 wk). Cohort 3 received D-RPD module pilot training based on text and 2D sketches (4 wk) and continued to receive training based on 3D virtual casts of real patients (3 wk). RPD design tests based on virtual casts were conducted at 1 month and 1 year after training. We collected RPD design scores and the time spent to perform each assessment. Results: We collected the RPD design scores and the time spent to perform each assessment at 1 month and 1 year after training. The study recruited 109 students, including 58 (53.2\%) female and 51 male (56.8\%) students. Cohort 1 scored the lowest and cohort 3 scored the highest in both tests (cohorts 1-3 at 1 mo: mean score 65.8, SD 21.5; mean score 81.9, SD 6.88; and mean score 85.3, SD 8.55, respectively; P<.001; cohorts 1-3 at 1 y: mean score 60.3, SD 16.7; mean score 75.5, SD 3.90; and mean score 90.9, SD 4.3, respectively; P<.001). The difference between cohorts in the time spent was not statistically significant at 1 month (cohorts 1-3: mean 2407.8, SD 1370.3 s; mean 1835.0, SD 1329.2 s; and mean 1790.3, SD 1195.5 s, respectively; P=.06) but was statistically significant at 1 year (cohorts 1-3: mean 2049.16, SD 1099.0 s; mean 1857.33, SD 587.39 s; and mean 2524.3, SD 566.37 s, respectively; P<.001). Intracohort comparisons indicated that the differences in scores at 1 month and 1 year were not statistically significant for cohort 1 (95\% CI --2.1 to 13.0; P=.16), while cohort 3 obtained significantly higher scores 1 year later (95\% CI 2.5-8.7; P=.001), and cohort 2 obtained significantly lower scores 1 year later (95\% CI --8.8 to --3.9; P<.001). Conclusions: Cohort 3 obtained the highest score at both time points with retention of competency at 1 year, indicating that progressive D-RPD training including virtual 3D simulation facilitated improved competency in RPD design. The adoption of D-RPD training may benefit learning outcomes. ",
doi="10.2196/46789",
url="https://games.jmir.org/2024/1/e46789"
}


@Article{info:doi/10.2196/35132,
author="Moreira, Rui
and Silveira, Augusta
and Sequeira, Teresa
and Dur{\~a}o, Nuno
and Louren{\c{c}}o, Jessica
and Cascais, In{\^e}s
and Cabral, Maria Rita
and Taveira Gomes, Tiago",
title="Gamification and Oral Health in Children and Adolescents: Scoping Review",
journal="Interact J Med Res",
year="2024",
month="Apr",
day="4",
volume="13",
pages="e35132",
keywords="gamification",
keywords="mechanisms of gamification",
keywords="gamification components",
keywords="intrinsic and extrinsic motivators",
keywords="oral health care",
keywords="health behavior",
keywords="oral health care applications",
abstract="Background: Oral health is a determinant of overall well-being and quality of life. Individual behaviors, such as oral hygiene and dietary habits, play a central role in oral health. Motivation is a crucial factor in promoting behavior change, and gamification offers a means to boost health-related knowledge and encourage positive health behaviors. Objective: This study aims to evaluate the impact of gamification and its mechanisms on oral health care of children and adolescents. Methods: A systematic search covered multiple databases: PubMed/MEDLINE, PsycINFO, the Cochrane Library, ScienceDirect, and LILACS. Gray literature, conference proceedings, and WHOQOL internet resources were considered. Studies from January 2013 to December 2022 were included, except for PubMed/MEDLINE, which was searched until January 2023. A total of 15 studies were selected following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The eligibility criteria were peer-reviewed, full-text, and empirical research related to gamification in oral health care, reports of impact, and oral health care outcomes. The exclusion criteria encompassed duplicate articles; unavailable full texts; nonoriginal articles; and non--digital game--related, non--oral health--related, and protocol studies. Selected studies were scrutinized for gamification mechanisms and outcomes. Two main questions were raised: ``Does gamification in oral health care impact oral health?'' and ``Does oral health care gamification enhance health promotion and literacy?'' The PICO (Patient, Intervention, Comparison, Outcome) framework guided the scoping review. Results: Initially, 617 records were obtained from 5 databases and gray literature sources. After applying exclusion criteria, 15 records were selected. Sample size in the selected studies ranged from 34 to 190 children and adolescents. A substantial portion (11/15, 73\%) of the studies discussed oral self-care apps supported by evidence-based oral health. The most clearly defined data in the apps were ``brushing time'' (11/11, 100\%) and ``daily amount brushing'' (10/11, 91\%). Most studies (11/15, 73\%) mentioned oral health care behavior change techniques and included ``prompt intention formation'' (11/26, 42\%), ``providing instructions'' (11/26, 42\%), ``providing information on the behavior-health link'' (10/26, 38\%), ``providing information on consequences'' (9/26, 35\%), ``modeling or demonstrating behavior'' (9/26, 35\%), ``providing feedback on performance'' (8/26, 31\%), and ``providing contingent rewards'' (8/26, 31\%). Furthermore, 80\% (12/15) of the studies identified game design elements incorporating gamification features in oral hygiene applications. The most prevalent gamification features were ``ideological incentives'' (10/12, 83\%) and ``goals'' (9/16, 56\%), which were found in user-specific and challenge categories, respectively. Conclusions: Gamification in oral health care shows potential as an innovative approach to promote positive health behaviors. Most studies reported evidence-based oral health and incorporated oral health care behavior change techniques. ",
doi="10.2196/35132",
url="https://www.i-jmr.org/2024/1/e35132",
url="http://www.ncbi.nlm.nih.gov/pubmed/38573750"
}


@Article{info:doi/10.2196/51141,
author="Al-Sbei, Rasha
and Ataya, Jawdat
and Jamous, Issam
and Dashash, Mayssoon",
title="The Impact of a Web-Based Restorative Dentistry Course on the Learning Outcomes of Dental Graduates: Pre-Experimental Study",
journal="JMIR Form Res",
year="2024",
month="Mar",
day="5",
volume="8",
pages="e51141",
keywords="restorative dentistry",
keywords="online learning",
keywords="dental education",
keywords="dental graduates",
keywords="Syria",
keywords="education",
keywords="dental",
keywords="dentistry",
keywords="dental practice",
keywords="effectiveness",
keywords="educational program",
keywords="survey",
abstract="Background: Restorative dentistry plays a crucial role in dental practice, necessitating professionals to stay abreast with the latest advancements in the field. The advancement of technology has made web-based learning a widely used method of education delivery in dentistry, providing learners with extensive information and flexibility. Objective: This study aims to evaluate how effective an online educational course in restorative dentistry is for dental graduates in Syria. Methods: This study used a pre-experimental study design, with pretest and posttest assessments to measure changes in participants' knowledge and skills. A total of 21 dental graduates completed the online course in restorative dentistry, which was hosted on Moodle, using the learning management system of the Syrian Virtual University. Participants were provided with a suggested learning sequence and had the flexibility to navigate the course on their own and at their own pace. The course was developed based on the principles of web course design and web-based course development using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) general instructional design model. The pretest and posttest assessments consisted of 50 multiple-choice questions with a single correct answer, aligning with the course content. Furthermore, participants were asked to complete a course acceptance survey upon finishing the course. Results: The results showed a significant improvement in the participants' knowledge of restorative dentistry, supported by a statistically significant P value of less than .05. The effect size of the difference between the pre and posttest indicated that the effect size, as indicated by $\omega$2, demonstrated a significant 62.1\% difference between the pre and posttest, indicating a high and statistically significant effect. Furthermore, the value derived from the Haridy obtained work ratio formula indicated that the educational program was effective, with an effectiveness amount of 3.36\%. Additionally, 93\% (n=19) of respondents expressed confidence in having gained the expected benefits from the educational course upon its completion. Conclusions: The findings indicated a notable enhancement in the participants' understanding of restorative dentistry. The participants' high satisfaction rate and positive feedback from the course acceptance survey further emphasize the favorable reception of the web-based learning approach. This study highlights the potential of web-based learning in dental education, opening the door for future research in this area. The findings of this study carry important implications for the design and implementation of web-based educational programs in dentistry, suggesting that such programs can serve as an effective tool for continuous professional development in the field. ",
doi="10.2196/51141",
url="https://formative.jmir.org/2024/1/e51141",
url="http://www.ncbi.nlm.nih.gov/pubmed/38441921"
}


@Article{info:doi/10.2196/53222,
author="Conte, Gianluca
and Pacino, Antonio Sebastiano
and Urso, Salvatore
and Greiling, Doris
and Caponnetto, Pasquale
and Pedull{\`a}, Eugenio
and Generali, Luigi
and Consolo, Ugo
and Checchi, Vittorio
and Gospodaru, Stefan
and Bordeniuc, Gheorghe
and Fala, Valeriu
and Kowalski, Jan
and Nowak, Maciej
and G{\'o}rska, Renata
and Amaliya, Amaliya
and Chapple, Iain
and Milward, Michael
and Maclure, Robert
and Nardi, Maria Gianna
and Polosa, Riccardo",
title="Changes in Oral Health and Dental Esthetic in Smokers Switching to Combustion-Free Nicotine Alternatives: Protocol for a Multicenter and Prospective Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2024",
month="Feb",
day="23",
volume="13",
pages="e53222",
keywords="electronic cigarettes",
keywords="heated tobacco products",
keywords="tobacco harm reduction",
keywords="smoking",
keywords="oral health",
keywords="gingivitis",
keywords="periodontitis",
keywords="Modified Gingival Index",
keywords="MGI",
keywords="dental plaque imaging",
keywords="dental shade",
keywords="smartphone",
keywords="mobile phone",
abstract="Background: Although the detrimental effects of conventional combustible cigarettes on oral health and dental esthetics are well known, there is limited information about the long-term impact of combustion-free nicotine alternatives (C-F NA) such as e-cigarettes or heated tobacco products. Objective: This multicenter, prospective, 3-parallel-arm randomized controlled trial will investigate whether switching from combustible cigarettes to C-F NA will lead to measurable improvements in oral health parameters and dental esthetics over 18 months in adult smokers with limited gum disease. Methods: Regular smokers not intending to quit and without clinical signs of periodontitis will be randomly assigned (1:4 ratio) to either standard of care with brief cessation advice (control group; arm A) or C-F NA use (intervention group; arm B). The study will also include a reference group of never smokers (reference group; arm C). The primary end point is the change in the Modified Gingival Index (MGI) score from baseline between the control arm (arm A) and the intervention arm (arm B) at the 18-month follow-up. In addition, the study will analyze the within- and between-group (arms A, B, and C) changes in MGI assessment, plaque imaging, dental shade quantitation, tooth stain scores, and oral health--related quality of life questionnaires measured at each study time point. All participants will attend a total of 7 clinic visits: screening, enrollment, and randomization (visit 0); baseline visit---day 14 (visit 1); day 90 (visit 2); day 180 (visit 3); day 360 (visit 4); and day 540 (visit 5). This multicenter study will be conducted in 4 dental clinics in 4 countries. The statistical analysis will involve descriptive statistics for continuous and categorical data. Primary end points will undergo tests for normality and, based on distribution, either a 2-sided t test or Mann-Whitney U test. Linear mixed model with random factors center and study arms by center will also be applied. Secondary end points, including MGI assessment and quality of life, will be subjected to similar tests and comparisons. Only if one value of the parameter MGI is missing after day 1, the last available observation will be carried forward. The analysis will be performed on the substituted data. Secondary parameters will not have missing value replacement. Results: Participant recruitment began in October 2021, and enrollment was completed in June 2023. Results will be reported in 2025. Conclusions: This will be the first study to provide key insights into oral health benefits or risks associated with using C-F NA in smokers who are seeking alternatives to cigarette smoking. Trial Registration: ClinicalTrials.gov NCT04649645; https://clinicaltrials.gov/ct2/show/NCT04649645 International Registered Report Identifier (IRRID): DERR1-10.2196/53222 ",
doi="10.2196/53222",
url="https://www.researchprotocols.org/2024/1/e53222",
url="http://www.ncbi.nlm.nih.gov/pubmed/38393754"
}


@Article{info:doi/10.2196/49514,
author="Holland, Lena
and Kanzow, Friederike Amelie
and Wiegand, Annette
and Kanzow, Philipp",
title="Quality of Patient-Centered eHealth Information on Erosive Tooth Wear: Systematic Search and Evaluation of Websites and YouTube Videos",
journal="J Med Internet Res",
year="2024",
month="Jan",
day="31",
volume="26",
pages="e49514",
keywords="consumer health information",
keywords="dental erosion",
keywords="dental sciences",
keywords="digital media",
keywords="erosive tooth wear",
keywords="evidence-based dentistry",
keywords="health education",
keywords="information quality",
keywords="internet",
keywords="shared decision making",
abstract="Background: Due to the declining prevalence of dental caries, noncarious tooth defects such as erosive tooth wear have gained increased attention over the past decades. While patients more frequently search the internet for health-related information, the quality of patient-centered, web-based health information on erosive tooth wear is currently unknown. Objective: This study aimed to assess the quality of patient-centered, web-based health information (websites and YouTube videos) on erosive tooth wear. Methods: German-language websites were systematically identified through 3 electronic search engines (google.de, bing.de or yahoo.de, and duckduckgo.com) in September 2021. Eligible websites were independently assessed for (1) technical and functional aspects via the LIDA instrument, (2) readability via the Flesch reading-ease score, (3) comprehensiveness of information via a structured checklist, and (4) generic quality and risk of bias via the DISCERN instrument by 2 different reviewers. An overall quality score (ie, higher scores being favored) generated from all 4 domains was used as the primary outcome. Quality scores from each domain were separately analyzed as secondary outcomes and compared by the Friedman test. The effect of practice-specific variables on quality scores of websites from private dental offices was assessed using generalized linear modeling. Eligible YouTube videos were judged based on (1) the comprehensiveness of information, (2) viewers' interaction, and (3) viewing rate. The comprehensiveness of information was compared between websites and YouTube videos using the Wilcoxon rank-sum test. Results: Overall, 231 eligible websites and 7 YouTube videos were identified and assessed. The median overall quality of the websites was 33.6\% (IQR 29.8\%-39.2\%). Secondary outcome scores amounted to 64.3\% (IQR 59.8\%-69.0\%) for technical and functional aspects, 40.0\% (IQR 34.0\%-49.0\%) for readability, 11.5\% (IQR 3.9\%-26.9\%) for comprehensiveness of information, and 16.7\% (IQR 8.3\%-23.3\%) for generic quality. While the comprehensiveness of information and generic quality received low scores, technical and functional aspects as well as readability resulted in higher scores (both Padjusted<.001). Regarding practice-specific variables, websites from private dental offices outside Germany (P=.04; B=--6.64, 95\% CI --12.85 to --0.42) or from dentists who are a dental society member (P=.049; B=--3.55, 95\% CI --7.09 to --0.01) resulted in lower readability scores (ie, were more difficult to read), while a shorter time since dentists' examination resulted in higher readability scores (P=.01; B=0.24 per year, 95\% CI 0.05-0.43). The comprehensiveness of information from YouTube videos was 34.6\% (IQR 13.5\%-38.5\%). However, the comprehensiveness of information did not vary between websites and YouTube videos (P=.09). Additionally, viewers' interaction (1.7\%, IQR 0.7\%-3.4\%) and viewing rates (101\%, IQR 54.6\%-112.6\%) were low. Conclusions: The quality of German-language, patient-centered, web-based information on erosive tooth wear was limited. Especially, the comprehensiveness and trustworthiness of the available information were insufficient. Web-based information on erosive tooth wear requires improvement to inform patients comprehensively and reliably. ",
doi="10.2196/49514",
url="https://www.jmir.org/2024/1/e49514",
url="http://www.ncbi.nlm.nih.gov/pubmed/38167299"
}


@Article{info:doi/10.2196/51344,
author="Kavadella, Argyro
and Dias da Silva, Antonio Marco
and Kaklamanos, G. Eleftherios
and Stamatopoulos, Vasileios
and Giannakopoulos, Kostis",
title="Evaluation of ChatGPT's Real-Life Implementation in Undergraduate Dental Education: Mixed Methods Study",
journal="JMIR Med Educ",
year="2024",
month="Jan",
day="31",
volume="10",
pages="e51344",
keywords="ChatGPT",
keywords="large language models",
keywords="LLM",
keywords="natural language processing",
keywords="artificial Intelligence",
keywords="dental education",
keywords="higher education",
keywords="learning assignments",
keywords="dental students",
keywords="AI pedagogy",
keywords="dentistry",
keywords="university",
abstract="Background: The recent artificial intelligence tool ChatGPT seems to offer a range of benefits in academic education while also raising concerns. Relevant literature encompasses issues of plagiarism and academic dishonesty, as well as pedagogy and educational affordances; yet, no real-life implementation of ChatGPT in the educational process has been reported to our knowledge so far. Objective: This mixed methods study aimed to evaluate the implementation of ChatGPT in the educational process, both quantitatively and qualitatively. Methods: In March 2023, a total of 77 second-year dental students of the European University Cyprus were divided into 2 groups and asked to compose a learning assignment on ``Radiation Biology and Radiation Protection in the Dental Office,'' working collaboratively in small subgroups, as part of the educational semester program of the Dentomaxillofacial Radiology module. Careful planning ensured a seamless integration of ChatGPT, addressing potential challenges. One group searched the internet for scientific resources to perform the task and the other group used ChatGPT for this purpose. Both groups developed a PowerPoint (Microsoft Corp) presentation based on their research and presented it in class. The ChatGPT group students additionally registered all interactions with the language model during the prompting process and evaluated the final outcome; they also answered an open-ended evaluation questionnaire, including questions on their learning experience. Finally, all students undertook a knowledge examination on the topic, and the grades between the 2 groups were compared statistically, whereas the free-text comments of the questionnaires were thematically analyzed. Results: Out of the 77 students, 39 were assigned to the ChatGPT group and 38 to the literature research group. Seventy students undertook the multiple choice question knowledge examination, and examination grades ranged from 5 to 10 on the 0-10 grading scale. The Mann-Whitney U test showed that students of the ChatGPT group performed significantly better (P=.045) than students of the literature research group. The evaluation questionnaires revealed the benefits (human-like interface, immediate response, and wide knowledge base), the limitations (need for rephrasing the prompts to get a relevant answer, general content, false citations, and incapability to provide images or videos), and the prospects (in education, clinical practice, continuing education, and research) of ChatGPT. Conclusions: Students using ChatGPT for their learning assignments performed significantly better in the knowledge examination than their fellow students who used the literature research methodology. Students adapted quickly to the technological environment of the language model, recognized its opportunities and limitations, and used it creatively and efficiently. Implications for practice: the study underscores the adaptability of students to technological innovations including ChatGPT and its potential to enhance educational outcomes. Educators should consider integrating ChatGPT into curriculum design; awareness programs are warranted to educate both students and educators about the limitations of ChatGPT, encouraging critical engagement and responsible use. ",
doi="10.2196/51344",
url="https://mededu.jmir.org/2024/1/e51344",
url="http://www.ncbi.nlm.nih.gov/pubmed/38111256"
}


@Article{info:doi/10.2196/49561,
author="Al-yaseen, Waraf
and Raggio, Procida Daniela
and Araujo, Mariana
and Innes, Nicola",
title="``I Just Wanted a Dentist in My Phone''---Designing Evidence-Based mHealth Prototype to Improve Preschool Children's Oral and Dental Health: Multimethod Study of the Codevelopment of an App for Children's Teeth",
journal="JMIR Form Res",
year="2024",
month="Jan",
day="30",
volume="8",
pages="e49561",
keywords="oral health promotion",
keywords="mobile health",
keywords="mHealth",
keywords="children",
keywords="oral health",
keywords="behavior change",
keywords="coproduction",
keywords="mobile phone",
abstract="Background: Dental caries in preschool children is a global health concern. With increased access to technology and the disruption of health care during the pandemic, mobile health apps have been of interest as potential vehicles for individuals' health maintenance. However, little is known about caring for their child's teeth and what their preferences would be regarding the content or design of an oral health app. Objective: This study aims to co-design the prototype of an app named App for Children's Teeth with parents, providing a source of information for them about caring for their children's teeth and promoting positive dental habits. Methods: This multimethod study conducted user involvement research with a purposive sample of parents or carers of children aged ?6 years to (1) understand their use of the internet through the eHealth Literacy Scale and interviews, (2) determine their opinions about content related to children's oral health, and (3) collect feedback about the app's acceptability using the Theoretical Framework of Acceptability. There were three stages: (1) interviews with parents to understand their needs, preferences, and abilities; (2) prototype design with app developers; and (3) parent feedback interviews using the think aloud method for data collection. Data were deductively analyzed using a codebook strategy, whereas data from the think aloud sessions were analyzed inductively using reflexive thematic analysis. Results: The prototype design stage involved 10 parents who reported using the internet for health information but found it to be scattered and contradictory. Parents generally welcomed the App for Children's Teeth but expressed concerns about screen time and practicality. They suggested guidance regarding oral hygiene practices, teething symptoms, and pain relief. Parents appreciated features such as clear fonts, categorization according to their child's age, and ``In a Nutshell'' bullet points. Topics that resonated with parents included information about teething, finding a dentist, and breastfeeding. They believed that the app aligned with their goals and offered suggestions for future developments, such as outlining the process of finding a dentist and incorporating a forum for parents to communicate and exchange ideas. Conclusions: The coproduction design approach highlighted parents' need for solutions such as mobile health apps to access reliable information about oral health. Parents identified key design concepts for the app, including a simple and uncluttered interface, content categorization according to their child's age, and practical guidance supported by visual aids. Despite potential challenges related to screen time restrictions, parents provided insights into how such an app could fit seamlessly into their lives. Trial Registration: Open Science Framework; https://osf.io/uj9az ",
doi="10.2196/49561",
url="https://formative.jmir.org/2024/1/e49561",
url="http://www.ncbi.nlm.nih.gov/pubmed/38289667"
}


@Article{info:doi/10.2196/53644,
author="Cheng, Siyuan",
title="Investigation of the Association Between e-Cigarette Smoking and Oral Mucosal Health Status Among Young People: Protocol for a Case-Control Trial",
journal="JMIR Res Protoc",
year="2024",
month="Jan",
day="26",
volume="13",
pages="e53644",
keywords="oral mucosal lesions",
keywords="e-cigarette",
keywords="youth",
keywords="oral",
keywords="moth",
keywords="lesion",
keywords="lesions",
keywords="cigarette",
keywords="cigarettes",
keywords="smoker",
keywords="smoking",
keywords="smokers",
keywords="smoke",
keywords="mucosa",
keywords="mucosal",
keywords="dental",
keywords="dentist",
keywords="dentistry",
abstract="Background: Given the paucity of current safety studies related to e-cigarettes, there are no definitive studies on whether e-cigarettes cause oral mucosal lesions or even oral cancer. Although it is still undetermined whether e-cigarettes are harmless, an increasing number of teenagers choose to smoke e-cigarettes and believe that they are not harmful to the human body. Objective: This aims to determine whether e-cigarettes cause damage to the oral mucosa. This study also aims to evaluate the association between e-cigarette smoking and oral mucous membrane lesions in young adults. The objectives are to (1) compare the oral mucosal conditions in participants with and without e-cigarette smoking habits, (2) assess the effect of the amount of e-cigarette smoking on oral mucosal conditions, and (3) assess the effect of the duration of e-cigarette smoking on oral mucosal conditions. Methods: In this prospective study, 304 youths aged 15 to 24 years (n=152, 50\% who smoke only e-cigarettes and n=152, 50\% who do not smoke e-cigarettes or cigarettes) will be divided into 2 groups for a controlled study. Whether e-cigarettes cause oral mucosal lesions will be verified by comparing the odds of oral mucosal lesions in the 2 experimental groups. For this experiment, the predefined power is 80\% (P=.04), and the predefined proportions of groups 1 and 2 are 11\% and 2.5\%, respectively. Results: This experiment is at the conceptualization phase and has not yet been carried out. Experimenters have not been recruited and no data have been collected. Conclusions: e-Cigarettes are still an unfamiliar topic to the public, and it is still unknown whether they can cause damage to the oral mucosa. This experiment aims to find out whether there is a link between the 2. There are still many limitations in this study, such as the lack of categorization of e-cigarettes and the lack of testing methods for oral mucosal status. These limitations are expected to be addressed in the future as the experiment is formally conducted and further optimized. International Registered Report Identifier (IRRID): PRR1-10.2196/53644 ",
doi="10.2196/53644",
url="https://www.researchprotocols.org/2024/1/e53644",
url="http://www.ncbi.nlm.nih.gov/pubmed/38171545"
}


@Article{info:doi/10.2196/44653,
author="Pang, MengWei
and Dong, YanLing
and Zhao, XiaoHan
and Wan, JiaWu
and Jiang, Li
and Song, JinLin
and Ji, Ping
and Jiang, Lin",
title="Virtual and Interprofessional Objective Structured Clinical Examination in Dentistry and Dental Technology: Development and User Evaluations",
journal="JMIR Form Res",
year="2024",
month="Jan",
day="17",
volume="8",
pages="e44653",
keywords="dentist",
keywords="dental technician",
keywords="objective structured clinical examination",
keywords="OSCE",
keywords="interprofessional education",
keywords="interprofessional collaborative practice",
abstract="Background: Interprofessional education (IPE) facilitates interprofessional collaborative practice (IPCP) to encourage teamwork among dental care professionals and is increasingly becoming a part of training programs for dental and dental technology students. However, the focus of previous IPE and IPCP studies has largely been on subjective student and instructor perceptions without including objective assessments of collaborative practice as an outcome measure. Objective: The purposes of this study were to develop the framework for a novel virtual and interprofessional objective structured clinical examination (viOSCE) applicable to dental and dental technology students, to assess the effectiveness of the framework as a tool for measuring the outcomes of IPE, and to promote IPCP among dental and dental technology students. Methods: The framework of the proposed novel viOSCE was developed using the modified Delphi method and then piloted. The lead researcher and a group of experts determined the content and scoring system. Subjective data were collected using the Readiness for Interprofessional Learning Scale and a self-made scale, and objective data were collected using examiner ratings. Data were analyzed using nonparametric tests. Results: We successfully developed a viOSCE framework applicable to dental and dental technology students. Of 50 students, 32 (64\%) participated in the pilot study and completed the questionnaires. On the basis of the Readiness for Interprofessional Learning Scale, the subjective evaluation indicated that teamwork skills were improved, and the only statistically significant difference in participant motivation between the 2 professional groups was in the mutual evaluation scale (P=.004). For the viOSCE evaluation scale, the difference between the professional groups in removable prosthodontics was statistically significant, and a trend for negative correlation between subjective and objective scores was noted, but it was not statistically significant. Conclusions: The results confirm that viOSCE can be used as an objective evaluation tool to assess the outcomes of IPE and IPCP. This study also revealed an interesting relationship between mutual evaluation and IPCP results, further demonstrating that the IPE and IPCP results urgently need to be supplemented with objective evaluation tools. Therefore, the implementation of viOSCE as part of a large and more complete objective structured clinical examination to test the ability of students to meet undergraduate graduation requirements will be the focus of our future studies. ",
doi="10.2196/44653",
url="https://formative.jmir.org/2024/1/e44653",
url="http://www.ncbi.nlm.nih.gov/pubmed/38231556"
}


@Article{info:doi/10.2196/42371,
author="Natsir Kalla, Sabrina Diandra
and Alkaabi, Salem
and Fauzi, Abul
and Tajrin, Andi
and Nurrahma, Rifaat
and M{\"u}ller, G. Werner E.
and Schr{\"o}der, C. Heinz
and Wang, Xiaohong
and Forouzanfar, Tymour
and Helder, N. Marco
and Ruslin, Muhammad",
title="Microfragmented Fat and Biphasic Calcium Phosphates for Alveolar Cleft Repair: Protocol for a Prospective, Nonblinded, First-in-Human Clinical Study",
journal="JMIR Res Protoc",
year="2024",
month="Jan",
day="15",
volume="13",
pages="e42371",
keywords="microfragmented fat",
keywords="calcium phosphate",
keywords="bone regeneration",
keywords="regenerative medicine",
keywords="alveolar",
keywords="bone grafting",
keywords="bone",
keywords="graft",
keywords="alveolar cleft",
keywords="surgery",
keywords="surgical",
keywords="perioperative",
keywords="mouth",
keywords="oral surgery",
keywords="maxillofacial",
keywords="jaw",
keywords="oral pathology",
keywords="oral",
keywords="dentistry",
keywords="dental",
keywords="tooth",
keywords="teeth",
keywords="osteo",
keywords="osteoconductive biphasic calcium phosphate",
keywords="autograft",
keywords="operation",
abstract="Background: Biphasic calcium phosphates (BCP) may serve as off-the-shelf alternatives for iliac crest-derived autologous bone in alveolar cleft reconstructions. To add osteoinductivity to the osteoconductive BCPs to achieve similar regenerative capacity as autologous bone, a locally harvested buccal fat pad will be mechanically fractionated to generate microfragmented fat (MFAT), which has been shown to have high regenerative capacity due to high pericyte and mesenchymal stem cell content and a preserved perivascular niche. Objective: Our primary objectives will be to assess the feasibility and safety of the BCP-MFAT combination. The secondary objective will be efficacy, which will be evaluated using radiographic imaging and histological and histomorphometric evaluation of biopsies taken 6 months postoperatively, concomitant with dental implant placement. Methods: Eight patients with alveolar cleft (?15 years) will be included in this prospective, nonblinded, first-in-human clinical study. MFAT will be prepared intraoperatively from the patient's own buccal fat pad. Regular blood tests and physical examinations will be conducted, and any adverse events (AEs) or serious EAs (SAEs) will be meticulously recorded. Radiographic imaging will be performed prior to surgery and at regular intervals after reconstruction of the alveolar cleft with the BCP-MFAT combination. Biopsies obtained after 6 months with a trephine drill used to prepare the implantation site will be assessed with histological and histomorphometric analyses after methylmethacrylate embedding and sectioning. Results: The primary outcome parameter will be safety after 6 months' follow-up, as monitored closely using possible occurrences of SAEs based on radiographic imaging, blood tests, and physical examinations. For efficacy, radiographic imaging will be used for clinical grading of the bone construct using the Bergland scale. In addition, bone parameters such as bone volume, osteoid volume, graft volume, and number of osteoclasts will be histomorphometrically quantified. Recruitment started in November 2019, and the trial is currently in the follow-up stage. This protocol's current version is 1.0, dated September 15, 2019. Conclusions: In this first-in-human study, not only safety but also the histologically and radiographically assessed regenerative potential of the BCP-MFAT combination will be evaluated in an alveolar cleft model. When an SAE occurs, it will be concluded that the BCP-MFAT combination is not yet safe in the current setting. Regarding AEs, if they do not occur at a higher frequency than that in patients treated with standard care (autologous bone) or can be resolved by noninvasive conventional methods (eg, with analgesics or antibiotics), the BCP-MFAT combination will be considered safe. In all other cases, the BCP-MFAT combination will not yet be considered safe. Trial Registration: Indonesia Clinical Trial Registry INA-EW74C1N; https://tinyurl.com/28tnrr64 International Registered Report Identifier (IRRID): DERR1-10.2196/42371 ",
doi="10.2196/42371",
url="https://www.researchprotocols.org/2024/1/e42371",
url="http://www.ncbi.nlm.nih.gov/pubmed/38224475"
}


@Article{info:doi/10.2196/51200,
author="Li, Shuning
and Felix Gomez, Gomez Grace
and Xu, Huiping
and Rajapuri, Singh Anushri
and Dixon, E. Brian
and Thyvalikakath, Thankam",
title="Dentists' Information Needs and Opinions on Accessing Patient Information via Health Information Exchange: Survey Study",
journal="JMIR Form Res",
year="2024",
month="Jan",
day="11",
volume="8",
pages="e51200",
keywords="dentistry",
keywords="medical history",
keywords="integrated medical and dental records",
keywords="health information exchange",
keywords="medical record",
keywords="dental record",
keywords="dental",
keywords="medical information",
keywords="dental care",
keywords="adverse drug effect",
keywords="medication",
keywords="allergies",
keywords="cost",
keywords="data safety",
keywords="data accuracy",
abstract="Background: The integration of medical and dental records is gaining significance over the past 2 decades. However, few studies have evaluated the opinions of practicing dentists on patient medical histories. Questions remain on dentists' information needs; their perception of the reliability of patient-reported medical history; satisfaction with the available information and the methods to gather this information; and their attitudes to other options, such as a health information exchange (HIE) network, to collect patient medical history. Objective: This study aims to determine Indiana dentists' information needs regarding patients' medical information and their opinions about accessing it via an HIE. Methods: We administered a web-based survey to Indiana Dental Association members to assess their current medical information-retrieval approaches, the information critical for dental care, and their willingness to access or share information via an HIE. We used descriptive statistics to summarize survey results and multivariable regression to examine the associations between survey respondents' characteristics and responses. Results: Of the 161 respondents (161/2148, 7.5\% response rate), 99.5\% (n=160) respondents considered patients' medical histories essential to confirm no contraindications, including allergies or the need for antibiotic prophylaxis during dental care and other adverse drug events. The critical information required were medical conditions or diagnosis, current medications, and allergies, which were gathered from patient reports. Furthermore, 88.2\% (n=142) of respondents considered patient-reported histories reliable; however, they experienced challenges obtaining information from patients and physicians. Additionally, 70.2\% (n=113) of respondents, especially those who currently access an HIE or electronic health record, were willing to use an HIE to access or share their patient's information, and 91.3\% (n=147) shared varying interests in such a service. However, usability, data accuracy, data safety, and cost are the driving factors in adopting an HIE. Conclusions: Patients' medical histories are essential for dentists to optimize dental care, especially for those with chronic conditions. In addition, most dentists are interested in using an HIE to access patient medical histories. The findings from this study can provide an alternative option for improving communications between dental and medical professionals and help the health information technology system or tool developers identify critical requirements for more user-friendly designs. ",
doi="10.2196/51200",
url="https://formative.jmir.org/2024/1/e51200",
url="http://www.ncbi.nlm.nih.gov/pubmed/38206667"
}


@Article{info:doi/10.2196/51580,
author="Giannakopoulos, Kostis
and Kavadella, Argyro
and Aaqel Salim, Anas
and Stamatopoulos, Vassilis
and Kaklamanos, G. Eleftherios",
title="Evaluation of the Performance of Generative AI Large Language Models ChatGPT, Google Bard, and Microsoft Bing Chat in Supporting Evidence-Based Dentistry: Comparative Mixed Methods Study",
journal="J Med Internet Res",
year="2023",
month="Dec",
day="28",
volume="25",
pages="e51580",
keywords="artificial intelligence",
keywords="AI",
keywords="large language models",
keywords="generative pretrained transformers",
keywords="evidence-based dentistry",
keywords="ChatGPT",
keywords="Google Bard",
keywords="Microsoft Bing",
keywords="clinical practice",
keywords="dental professional",
keywords="dental practice",
keywords="clinical decision-making",
keywords="clinical practice guidelines",
abstract="Background: The increasing application of generative artificial intelligence large language models (LLMs) in various fields, including dentistry, raises questions about their accuracy. Objective: This study aims to comparatively evaluate the answers provided by 4 LLMs, namely Bard (Google LLC), ChatGPT-3.5 and ChatGPT-4 (OpenAI), and Bing Chat (Microsoft Corp), to clinically relevant questions from the field of dentistry. Methods: The LLMs were queried with 20 open-type, clinical dentistry--related questions from different disciplines, developed by the respective faculty of the School of Dentistry, European University Cyprus. The LLMs' answers were graded 0 (minimum) to 10 (maximum) points against strong, traditionally collected scientific evidence, such as guidelines and consensus statements, using a rubric, as if they were examination questions posed to students, by 2 experienced faculty members. The scores were statistically compared to identify the best-performing model using the Friedman and Wilcoxon tests. Moreover, the evaluators were asked to provide a qualitative evaluation of the comprehensiveness, scientific accuracy, clarity, and relevance of the LLMs' answers. Results: Overall, no statistically significant difference was detected between the scores given by the 2 evaluators; therefore, an average score was computed for every LLM. Although ChatGPT-4 statistically outperformed ChatGPT-3.5 (P=.008), Bing Chat (P=.049), and Bard (P=.045), all models occasionally exhibited inaccuracies, generality, outdated content, and a lack of source references. The evaluators noted instances where the LLMs delivered irrelevant information, vague answers, or information that was not fully accurate. Conclusions: This study demonstrates that although LLMs hold promising potential as an aid in the implementation of evidence-based dentistry, their current limitations can lead to potentially harmful health care decisions if not used judiciously. Therefore, these tools should not replace the dentist's critical thinking and in-depth understanding of the subject matter. Further research, clinical validation, and model improvements are necessary for these tools to be fully integrated into dental practice. Dental practitioners must be aware of the limitations of LLMs, as their imprudent use could potentially impact patient care. Regulatory measures should be established to oversee the use of these evolving technologies. ",
doi="10.2196/51580",
url="https://www.jmir.org/2023/1/e51580",
url="http://www.ncbi.nlm.nih.gov/pubmed/38009003"
}


@Article{info:doi/10.2196/48351,
author="Teza, Htun
and Pattanateepapon, Anuchate
and Lertpimonchai, Attawood
and Vathesatogkit, Prin
and J McKay, Gareth
and Attia, John
and Thakkinstian, Ammarin",
title="Development of Risk Prediction Models for Severe Periodontitis in a Thai Population: Statistical and Machine Learning Approaches",
journal="JMIR Form Res",
year="2023",
month="Dec",
day="14",
volume="7",
pages="e48351",
keywords="periodontitis",
keywords="prediction",
keywords="machine learning",
keywords="repeated measures",
keywords="panel data",
abstract="Background: Severe periodontitis affects 26\% of Thai adults and 11.2\% of adults globally and is characterized by the loss of alveolar bone height. Full-mouth examination by periodontal probing is the gold standard for diagnosis but is time- and resource-intensive. A screening model to identify those at high risk of severe periodontitis would offer a targeted approach and aid in reducing the workload for dentists. While statistical modelling by a logistic regression is commonly applied, optimal performance depends on feature selections and engineering. Machine learning has been recently gaining favor given its potential discriminatory power and ability to deal with multiway interactions without the requirements of linear assumptions. Objective: We aim to compare the performance of screening models developed using statistical and machine learning approaches for the risk prediction of severe periodontitis. Methods: This study used data from the prospective Electricity Generating Authority of Thailand cohort. Dental examinations were performed for the 2008 and 2013 surveys. Oral examinations (ie, number of teeth and oral hygiene index and plaque scores), periodontal pocket depth, and gingival recession were performed by dentists. The outcome of interest was severe periodontitis diagnosed by the Centre for Disease Control--American Academy of Periodontology, defined as 2 or more interproximal sites with a clinical attachment level ?6 mm (on different teeth) and 1 or more interproximal sites with a periodontal pocket depth ?5 mm. Risk prediction models were developed using mixed-effects logistic regression (MELR), recurrent neural network, mixed-effects support vector machine, and mixed-effects decision tree models. A total of 21 features were considered as predictive features, including 4 demographic characteristics, 2 physical examinations, 4 underlying diseases, 1 medication, 2 risk behaviors, 2 oral features, and 6 laboratory features. Results: A total of 3883 observations from 2086 participants were split into development (n=3112, 80.1\%) and validation (n=771, 19.9\%) sets with prevalences of periodontitis of 34.4\% (n=1070) and 34.1\% (n=263), respectively. The final MELR model contained 6 features (gender, education, smoking, diabetes mellitus, number of teeth, and plaque score) with an area under the curve (AUC) of 0.983 (95\% CI 0.977-0.989) and positive likelihood ratio (LR+) of 11.9 (95\% CI 8.8-16.3). Machine learning yielded lower performance than the MELR model, with AUC (95\% CI) and LR+ (95\% CI) values of 0.712 (0.669-0.754) and 2.1 (1.8-2.6), respectively, for the recurrent neural network model; 0.698 (0.681-0.734) and 2.1 (1.7-2.6), respectively, for the mixed-effects support vector machine model; and 0.662 (0.621-0.702) and 2.4 (1.9-3.0), respectively, for the mixed-effects decision tree model. Conclusions: The MELR model might be more useful than machine learning for large-scale screening to identify those at high risk of severe periodontitis for periodontal evaluation. External validation using data from other centers is required to evaluate the generalizability of the model. ",
doi="10.2196/48351",
url="https://formative.jmir.org/2023/1/e48351",
url="http://www.ncbi.nlm.nih.gov/pubmed/38096008"
}


@Article{info:doi/10.2196/51578,
author="Jones, Bree
and Michou, Stavroula
and Chen, Tong
and Moreno-Betancur, Margarita
and Kilpatrick, Nicky
and Burgner, David
and Vannahme, Christoph
and Silva, Mihiri",
title="Caries Detection in Primary Teeth Using Intraoral Scanners Featuring Fluorescence: Protocol for a Diagnostic Agreement Study",
journal="JMIR Res Protoc",
year="2023",
month="Dec",
day="14",
volume="12",
pages="e51578",
keywords="dental caries",
keywords="diagnosis",
keywords="oral",
keywords="technology",
keywords="dental",
keywords="image interpretation",
keywords="computer-assisted",
keywords="imaging",
keywords="3D",
keywords="quantitative light-induced fluorescence",
keywords="diagnostic agreement",
keywords="intra oral scanners",
keywords="oral health",
keywords="teeth",
keywords="3D model",
keywords="color",
keywords="fluorescence",
keywords="intraoral scanner",
keywords="device",
keywords="dentistry",
abstract="Background: Digital methods that enable early caries identification can streamline data collection in research and optimize dental examinations for young children. Intraoral scanners are devices used for creating 3D models of teeth in dentistry and are being rapidly adopted into clinical workflows. Integrating fluorescence technology into scanner hardware can support early caries detection. However, the performance of caries detection methods using 3D models featuring color and fluorescence in primary teeth is unknown. Objective: This study aims to assess the diagnostic agreement between visual examination (VE), on-screen assessment of 3D models in approximate natural colors with and without fluorescence, and application of an automated caries scoring system to the 3D models with fluorescence for caries detection in primary teeth. Methods: The study sample will be drawn from eligible participants in a randomized controlled trial at the Royal Children's Hospital, Melbourne, Australia, where a dental assessment was conducted, including VE using the International Caries Detection and Assessment System (ICDAS) and intraoral scan using the TRIOS 4 (3Shape TRIOS A/S). Participant clinical records will be collected, and all records meeting eligibility criteria will be subject to an on-screen assessment of 3D models by 4 dental practitioners. First, all primary tooth surfaces will be examined for caries based on 3D geometry and color, using a merged ICDAS index. Second, the on-screen assessment of 3D models will include fluorescence, where caries will be classified using a merged ICDAS index that has been modified to incorporate fluorescence criteria. After 4 weeks, all examiners will repeat the on-screen assessment for all 3D models. Finally, an automated caries scoring system will be used to classify caries on primary occlusal surfaces. The agreement in the total number of caries detected per person between methods will be assessed using a Bland-Altman analysis and intraclass correlation coefficients. At a tooth surface level, agreement between methods will be estimated using multilevel models to account for the clustering of dental data. Results: Automated caries scoring of 3D models was completed as of October 2023, with the publication of results expected by July 2024. On-screen assessment has commenced, with the expected completion of scoring and data analysis by March 2024. Results will be disseminated by the end of 2024. Conclusions: The study outcomes may inform new practices that use digital models to facilitate dental assessments. Novel approaches that enable remote dental examination without compromising the accuracy of VE have wide applications in the research environment, clinical practice, and the provision of teledentistry. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12622001237774; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384632 International Registered Report Identifier (IRRID): DERR1-10.2196/51578 ",
doi="10.2196/51578",
url="https://www.researchprotocols.org/2023/1/e51578",
url="http://www.ncbi.nlm.nih.gov/pubmed/38096003"
}


@Article{info:doi/10.2196/49179,
author="Carpenter, M. Stephanie
and Greer, M. Zara
and Newman, Rebecca
and Murphy, A. Susan
and Shetty, Vivek
and Nahum-Shani, Inbal",
title="Developing Message Strategies to Engage Racial and Ethnic Minority Groups in Digital Oral Self-Care Interventions: Participatory Co-Design Approach",
journal="JMIR Form Res",
year="2023",
month="Dec",
day="11",
volume="7",
pages="e49179",
keywords="engagement",
keywords="oral health",
keywords="mobile health intervention",
keywords="mHealth intervention",
keywords="formative",
keywords="racial and ethnic minority group",
keywords="digital health",
keywords="mobile health",
keywords="mHealth",
keywords="message development",
keywords="health equity",
keywords="racial minority",
keywords="ethnic minority",
keywords="digital intervention",
keywords="dental care",
keywords="barrier",
keywords="oral self-care",
keywords="mobile phone",
abstract="Background: The prevention of oral health diseases is a key public health issue and a major challenge for racial and ethnic minority groups, who often face barriers in accessing dental care. Daily toothbrushing is an important self-care behavior necessary for sustaining good oral health, yet engagement in regular brushing remains a challenge. Identifying strategies to promote engagement in regular oral self-care behaviors among populations at risk of poor oral health is critical. Objective: The formative research described here focused on creating messages for a digital oral self-care intervention targeting a racially and ethnically diverse population. Theoretically grounded strategies (reciprocity, reciprocity-by-proxy, and curiosity) were used to promote engagement in 3 aspects: oral self-care behaviors, an oral care smartphone app, and digital messages. A web-based participatory co-design approach was used to develop messages that are resource efficient, appealing, and novel; this approach involved dental experts, individuals from the general population, and individuals from the target population---dental patients from predominantly low-income racial and ethnic minority groups. Given that many individuals from racially and ethnically diverse populations face anonymity and confidentiality concerns when participating in research, we used an approach to message development that aimed to mitigate these concerns. Methods: Messages were initially developed with feedback from dental experts and Amazon Mechanical Turk workers. Dental patients were then recruited for 2 facilitator-mediated group webinar sessions held over Zoom (Zoom Video Communications; session 1: n=13; session 2: n=7), in which they provided both quantitative ratings and qualitative feedback on the messages. Participants interacted with the facilitator through Zoom polls and a chat window that was anonymous to other participants. Participants did not directly interact with each other, and the facilitator mediated sessions by verbally asking for message feedback and sharing key suggestions with the group for additional feedback. This approach plausibly enhanced participant anonymity and confidentiality during the sessions. Results: Participants rated messages highly in terms of liking (overall rating: mean 2.63, SD 0.58; reciprocity: mean 2.65, SD 0.52; reciprocity-by-proxy: mean 2.58, SD 0.53; curiosity involving interactive oral health questions and answers: mean 2.45, SD 0.69; curiosity involving tailored brushing feedback: mean 2.77, SD 0.48) on a scale ranging from 1 (do not like it) to 3 (like it). Qualitative feedback indicated that the participants preferred messages that were straightforward, enthusiastic, conversational, relatable, and authentic. Conclusions: This formative research has the potential to guide the design of messages for future digital health behavioral interventions targeting individuals from diverse racial and ethnic populations. Insights emphasize the importance of identifying key stimuli and tasks that require engagement, gathering multiple perspectives during message development, and using new approaches for collecting both quantitative and qualitative data while mitigating anonymity and confidentiality concerns. ",
doi="10.2196/49179",
url="https://formative.jmir.org/2023/1/e49179",
url="http://www.ncbi.nlm.nih.gov/pubmed/38079204"
}


@Article{info:doi/10.2196/52233,
author="Jamieson, Lisa
and Luzzi, Liana
and Chrisopoulos, Sergio
and Roberts, Rachel
and Arrow, Peter
and Kularatna, Sanjeewa
and Mittinty, Murthy
and Haag, Dandara
and Ribeiro Santiago, Henrique Pedro
and Mejia, Gloria",
title="Oral Health, Social and Emotional Well-Being, and Economic Costs: Protocol for the Second Australian National Child Oral Health Survey",
journal="JMIR Res Protoc",
year="2023",
month="Nov",
day="14",
volume="12",
pages="e52233",
keywords="Australian children",
keywords="cost-effective analysis",
keywords="dental caries",
keywords="social and emotional well-being",
abstract="Background: Given the significant investment of governments and families into the provision of child dental care services in Australia, continued population oral health surveillance through national oral health surveys is imperative. Objective: The aims of this study are to conduct a second National Child Oral Health Survey (NCOHS-2) to (1) describe the prevalence, extent, and impact of oral diseases in contemporary Australian children; (2) evaluate changes in the prevalence and extent of oral diseases in the Australian child population and socioeconomic subgroups since the first National Child Oral Health Study (NCOHS-1) in 2012-2013; and (3) use economic modeling to evaluate the burden of child oral disease from the NCOHS-1 and NCOHS-2 and to estimate the cost-effectiveness of targeted programs for high-risk child groups. Methods: The NCOHS-2 will closely mimic the NCOHS-1 in being a cross-sectional survey of a representative sample of Australian children aged 5-14 years. The survey will comprise oral epidemiological examinations and questionnaires to elucidate associations between dental disease in a range of outcomes, including social and emotional well-being. The information will be analyzed within the context of dental service organization and delivery at national and jurisdictional levels. Information from the NCOHS-1 and NCOHS-2 will be used to simulate oral disease and its economic burden using both health system and household costs of childhood oral health disease. Results: Participant recruitment for the NCOHS-2 will commence in February 2024. The first results are expected to be submitted for publication 6 months after NCOHS-2 data collection has been completed. Thematic workshops with key partners and stakeholders will also occur at this time. Conclusions: Regular surveillance of child oral health at an Australian level facilitates timely policy and planning of each state and territory's dental public health sector. This is imperative to enable the most equitable distribution of scarce public monies, especially for socially disadvantaged children who bear the greatest dental disease burden. The last NCOHS was conducted in 2012-2014, meaning that these data need to be updated to better inform effective dental health policy and planning. The NCOHS-2 will enable more up-to-date estimates of dental disease prevalence and severity among Australian children, with cost-effective analysis being useful to determine the economic burden of poor child dental health on social and emotional well-being and other health indicators. International Registered Report Identifier (IRRID): PRR1-10.2196/52233 ",
doi="10.2196/52233",
url="https://www.researchprotocols.org/2023/1/e52233",
url="http://www.ncbi.nlm.nih.gov/pubmed/37962928"
}


@Article{info:doi/10.2196/49956,
author="Wu, Wenjia
and Le May, Sylvie
and Hung, Nicole
and Fortin, Olivier
and Genest, Christine
and Francoeur, Maxime
and Guingo, Estelle
and St-Arneault, Kate
and Sylfra, Annie
and Vu, Kateri An
and Carmel, Janick
and Lessard, Laurence
and Cara-Slavich, Stephany
and De Koven, Katheryn
and Paquette, Julie
and Hoffman, Hunter
and Asselin, Marie-Eve",
title="Effects of a Virtual Reality Game on Children's Anxiety During Dental Procedures (VR-TOOTH): Protocol for a Pilot Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2023",
month="Nov",
day="10",
volume="12",
pages="e49956",
keywords="virtual reality",
keywords="pediatrics",
keywords="children",
keywords="dentistry",
keywords="procedures",
keywords="fear",
keywords="anxiety",
keywords="child",
keywords="pediatric",
keywords="dentist",
keywords="dental",
keywords="tooth",
keywords="teeth",
keywords="oral",
keywords="anxious",
keywords="immersion",
keywords="immersive",
keywords="RCT",
keywords="randomized",
keywords="controlled trial",
abstract="Background: Dental fear and anxiety (DFA) is a condition that affects approximately one-quarter of children and adolescents. It is a significant cause for pediatric patients to avoid dental care later in adulthood. Lack of patient cooperation due to DFA can create an environment of stress, often obligating dentists to end appointments prematurely and consider alternative pharmacological treatment options. Virtual reality (VR) use during dental care, providing an immersive experience through sensory stimuli, is potentially an additional nonpharmacologic tool to better manage DFA in children with special health care needs (SHCN) undergoing dental procedures. Objective: This pilot study aims to assess the feasibility and acceptability of VR immersion as a tool to reduce DFA in pediatric special needs patients undergoing dental procedures. The study also aims to gain insight on parent and health care provider perspectives on the use of VR during dental appointments. Methods: This pilot randomized controlled trial study will follow a parallel design including 2 groups: a control group (clinic's standard care using a wall TV) and an experimental group (using a VR game). We will randomize 20 participants to either group. Recruitment will be carried out at the dental clinic of the Centre Hospitalier Universitaire Sainte-Justine, a tertiary-quaternary care center that mostly serves pediatric patients with SHCN. The primary outcome will be patient recruitment rates and completion rates of planned procedures. DFA in children will be assessed using both an observation-based proxy assessment with the Venham Anxiety and Behavior Rating Scale and physiological assessments using parameters such as change in heart rate and levels of salivary alpha-amylase as a stress biomarker before and 10 minutes after the procedure. Sociodemographic characteristics, measures of the levels of parent and health care professional satisfaction, occurrence of side effects, and any deviation from normal procedure length will also be collected. Descriptive statistics, nonparametric tests, and effect sizes will be used for demographic and clinical variables and to present parent and health care professional satisfaction levels as well as procedural time. Results: This study will be conducted from May 2023 to May 2024, with results expected to be available in December 2024. Conclusions: The pilot study will provide insight on the feasibility and acceptability of VR use in clinical dentistry to reduce DFA for pediatric patients with SHCN. This study will guide future research on VR use in pediatric dentistry and can serve as a framework for a larger randomized clinical trial. Trial Registration: ClinicalTrials.gov NCT05898100; https://classic.clinicaltrials.gov/ct2/show/NCT05898100 International Registered Report Identifier (IRRID): DERR1-10.2196/49956 ",
doi="10.2196/49956",
url="https://www.researchprotocols.org/2023/1/e49956/"
}


@Article{info:doi/10.2196/45311,
author="Zhang, Yue Xi
and Arata Found, Anelyse
and Butler, Sheila",
title="Effects of Distance-Learning Strategies in Dental Fixed Prosthodontics Amidst the COVID-19 Pandemic: Cross-Sectional Questionnaire Study on Preclinical Dental Students' Perspective",
journal="JMIR Form Res",
year="2023",
month="Nov",
day="8",
volume="7",
pages="e45311",
keywords="dental education",
keywords="dental",
keywords="dentist",
keywords="dentistry",
keywords="technology-based learning",
keywords="online learning",
keywords="pre-clinical training",
keywords="distance learning",
keywords="transmissibility",
keywords="dental school",
keywords="mental health",
keywords="COVID-19",
keywords="student perception",
keywords="online teaching",
keywords="survey",
keywords="teaching methods",
keywords="training",
keywords="isolation",
keywords="teaching",
keywords="module",
keywords="education",
abstract="Background: COVID-19's high transmissibility led to gathering restrictions where dental schools experienced disruptions due to restrictions on attending in-person lectures and limitations placed on applied preclinical and clinical activities. Students not only had to rapidly switch to digital technology-based learning (TB-learning) modules but also experienced high levels of social isolation and anxiety around virus transmission. Objective: This study aims to evaluate the preclinical students' perception of switching TB-learning modules amidst the COVID-19 pandemic, identifying which module parameters were associated with strong student outcomes. Methods: A web-based survey of 39 Likert scale questions was delivered to preclinical dental students (Western University) to evaluate students' perceptions concerning TB-learning, fear amidst the COVID-19 pandemic, and the impact on their preclinical training. A Spearman rank correlation coefficient was determined to estimate the relationship between 2 variables in isolation (P=.01). An ordinal regression analysis was performed on variables of interest to determine how module variables (typically within the instructor's control) influenced the student outcomes (P=.05). Results: The response rate was 30\% (n=39). TB-learning was considered vital (34/39, 87.2\%) as the students' education improved (18/39, 46.2\%). However, 53.8\% (n=21) of students showed increased difficulties in retaining, visualizing, or understanding the materials using TB-learning, and 64.1\% (n=25) found it more difficult to concentrate than in in-person classes. In total, 79.5\% (n=31) of students showed different levels of agreement about feeling fatigued from TB-learning. Through Spearman $\rho$ correlation analysis, the quality of questions in quizzes ($\rho$=0.514; P<.001), relevant handouts ($\rho$=0.729; P<.001), and high-quality audiovisuals ($\rho$=0.585; P<.001) were positively correlated with students responding that the modules were useful to preclinical training. Similarly, good organization ($\rho$=0.512; P<.001), high-quality questions in quizzes ($\rho$=0.431; P=.01), and relevant handouts ($\rho$=0.551; P<.001) were positively correlated with web-based classes as an effective way to learn. In total, 91.6\% (n=36) of the students agreed that COVID-19 was a dangerous disease, whereas 53.8\% (n=21) showed different levels of agreement that they were afraid to be infected personally, and 69.2\% (n=27) feared passing COVID-19 along to family and friends. A total of 82.1\% (n=32) of the students showed that COVID-19 impacted their overall learning process and had a negative impact on their practical preclinical training (31/39, 79.5\%). Conclusions: The students found a difference between TB-learning and face-to-face learning methods, where the students perceived fatigue toward the web-based method with difficulty concentrating and visualizing the subject. Moreover, there was a consensus that COVID-19 itself affected the students' overall learning process and preclinical training. As dental schools continue implementing TB-learning into their curriculum, this investigation identifies the students' struggles with the paradigm shift. In an effort to improve TB-learning, this work highlights 4 variables (organization, quizzes, quality handouts, and quality audiovisuals) within the control of instructors that can help improve content deliverance, improving the students' experience. ",
doi="10.2196/45311",
url="https://formative.jmir.org/2023/1/e45311",
url="http://www.ncbi.nlm.nih.gov/pubmed/37938882"
}


@Article{info:doi/10.2196/48558,
author="Hedges, Joanne
and Hermes Soares, Gustavo
and Cadet-James, Yvonne
and Dodd, Zell
and Cooney, Sinon
and Newman, James
and Mittinty, Murthy
and Kularatna, Sanjeewa
and Larkins, Priscilla
and Zwolak, Roman
and Roberts, Rachel
and Jamieson, Lisa",
title="A Silver Fluoride Intervention to Improve Oral Health Trajectories of Young Indigenous Australians: Protocol for a Cluster Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2023",
month="Nov",
day="2",
volume="12",
pages="e48558",
keywords="clinical trial",
keywords="community",
keywords="dental caries",
keywords="Indigenous Australian",
keywords="intervention",
keywords="silver fluoride intervention",
abstract="Background: Indigenous Australian children and adolescents experience profound levels of preventable dental disease. The application of silver fluoride (AgF) to active dental caries is a noninvasive alternative to traditional dental treatment approaches. There is particular utility among Indigenous children and young people with dental fear, who may not have access to timely or culturally safe dental service provisions. Objective: The aims of this study are to: (1) assess levels of active dental caries among Indigenous children and young people in 6 Australian states and territories; (2) determine if an AgF intervention reduces levels of active disease over 12-24 months; (3) measure the impact of improved oral health on social and emotional well-being (SEWB) and oral health-related quality of life; and (4) calculate the cost-effectiveness of implementing such an initiative. Methods: The study will use a 2-arm, parallel cluster randomized controlled trial design. Approximately 1140 Indigenous children and youth aged between 2 and 18 years will be recruited. Each state or territory will have 2 clusters. The intervention group will receive the AgF intervention at the start of the study, with the delayed intervention group receiving the AgF intervention 12 months after study commencement. The primary outcome will be the arrest of active carious lesions, with arrested caries defined as nonpenetration by a dental probe. Secondary outcomes will include SEWB, oral health-related quality of life, and dental anxiety, with covariates including dental behaviors (brushing and dental visits). Effectiveness measures for the economic evaluation will include the number of children and young people managed in primary oral health care without the need for specialist referral, changes in SEWB, the numbers and types of treatments provided, and caries increments. Results: Participant recruitment will commence in May 2023. The first results are expected to be submitted for publication 1 year after a 24-month follow-up. Conclusions: Our findings have the potential to change the way in which active dental disease among Indigenous children and young people can be managed through the inclusion of specifically tailored AgF applications to improve dental health and SEWB delivered by Indigenous health care workers. Desired impacts include cost savings on expensive dental treatments; improved SEWB, nutrition, social, and learning outcomes; and improved quality of life for both children and young people and their caregivers and the broader Indigenous community. The AgF application could be easily implemented into the training program of Indigenous health workers and yield critical information in the management armamentarium of health and well-being recommendations for Australia's First Peoples. International Registered Report Identifier (IRRID): PRR1-10.2196/48558 ",
doi="10.2196/48558",
url="https://www.researchprotocols.org/2023/1/e48558",
url="http://www.ncbi.nlm.nih.gov/pubmed/37917128"
}


@Article{info:doi/10.2196/51505,
author="Lampl, Stephan
and Gurunathan, Deepa
and Krithikadatta, Jogikalmat
and Mehta, Deepak
and Moodley, Desigar",
title="Reasons for Crown Failures in Primary Teeth: Protocol for a Systematic Review and Meta-Analysis",
journal="JMIR Res Protoc",
year="2023",
month="Nov",
day="1",
volume="12",
pages="e51505",
keywords="crowns",
keywords="primary teeth",
keywords="biological complications",
keywords="technical complications",
keywords="survival rates",
keywords="pediatric",
keywords="dental",
keywords="dentistry",
keywords="teeth",
keywords="dentists",
keywords="survival",
keywords="quality assessment",
abstract="Background: There is a tendency nowadays to restore large defects in primary dentition with pediatric crowns instead of conventional restorations. Thus, understanding the factors contributing to the survival or failure of dental crowns in pediatric dentistry is essential for optimizing treatment outcomes. Objective: The primary objective of this protocol is to outline the methodological approach for analyzing data from observational studies and randomized controlled trials to investigate reasons for the failure of dental crowns in primary teeth and to compute their survival and failure rates. Methods: A comprehensive literature review will be performed in electronic databases, including PubMed (MEDLINE), Cochrane, Embase, and Web of Science. As per predefined inclusion criteria, we will include observational studies (prospective clinical studies) and randomized clinical trials that have an English abstract and involve children aged 1-10 years undergoing crown restorations. Two independent reviewers will independently screen all retrieved records and full-text articles and extract data. The study's methodological quality will be appraised using suitable tools. Assessments of publication bias will be performed using funnel plots. The findings will be described qualitatively for the systematic review. If possible, a meta-analysis will be performed to estimate failure rates by dividing the number of failures by the total exposure time. A Poisson regression model, assuming constant event rates, will be used to compute 3-year and 5-year survival proportions. The Pearson goodness-of-fit statistics will be used to assess the heterogeneity of the model. A P value <.05 will be considered significant. All analyses will be performed using R Statistical software (version 4.1.2; R Core Team). Results: This systematic review and synthesis aim to assess the survival and failure rates of dental crowns in pediatric dentistry. By following this rigorous methodology, we seek to provide valuable insights into the factors contributing to the success or failure of these restorations. The results of our full review will have implications for pediatric dentists, researchers, and policy makers, helping to improve dental care for children. Conclusions: This systematic review protocol helps in establishing a thorough approach for reviewing failures in pediatric crowns. By following this methodology, standardization and transparency of the process as well as accountability for the stated methods and outcomes will be ensured. The findings of this review and analysis will provide useful data on the survival of crowns to pediatric dentists and researchers. Trial Registration: PROSPERO CRD42023442266; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=442266 International Registered Report Identifier (IRRID): PRR1-10.2196/51505 ",
doi="10.2196/51505",
url="https://www.researchprotocols.org/2023/1/e51505",
url="http://www.ncbi.nlm.nih.gov/pubmed/37910174"
}


@Article{info:doi/10.2196/30443,
author="del Carmen, Carmen Mar{\'i}a del
and Cagigas-Mu{\~n}iz, Daniel
and Garc{\'i}a-Robles, Roc{\'i}o
and Oprescu, Madalina Andreea",
title="Reducing Dental Anxiety in Children Using a Mobile Health App: Usability and User Experience Study",
journal="JMIR Form Res",
year="2023",
month="Oct",
day="27",
volume="7",
pages="e30443",
keywords="dentistry",
keywords="dental anxiety",
keywords="children",
keywords="mobile",
keywords="app",
keywords="usability",
keywords="user experience",
keywords="human-centered design",
keywords="mobile health",
keywords="mHealth",
keywords="digital health",
keywords="mobile application",
keywords="application development",
abstract="Background: Dentistry interventions cause common anxiety and fear problems in children (6-11 years), and according to scientific evidence, this causes a decrease in their quality of life. Therapies mediated by IT-based tools have been shown to positively influence children's mood based on distraction as well as relaxing activities, but there is no evidence of their use to reduce dental anxiety in children. Objective: The aim of this study was to answer the following research question: Does our new children-centered codesign methodology contribute to achieving a usable mobile-based product with a highly scored user experience? Methods: A mobile health app was developed to reduce dental anxiety in children using rapid application development following the usage-centered design methodology. Structured interviews were conducted to test the usability and user experience of the app prototype among 40 children (n=20, 50\%, boys and n=20, 50\%, girls; age 6-11 years) using a children-adapted questionnaire and the 7-point Single Ease Question rating scale. The Smiley Faces Program---Revised questionnaire was used to assess the level of dental anxiety in participants. Results: There were no significant differences between girls and boys. The task completion rate was 95\% (n=19) for children aged 6-8 years (group 1) and 100\% (n=20) for children aged 9-11 years (group 2). Group 1 found watching the relaxing video (task C) to be the easiest, followed by playing a video minigame (task B) and watching the narrative (task A). Group 2 found task C to be the easiest, followed by task A and then task B. The average time spent on the different types of tasks was similar in both age groups. Most of the children in both age groups were happy with the app and found it funny. All children thought that having the app in the waiting room during a dental visit would be useful. Conclusions: The findings confirmed that the app is usable and provides an excellent user experience. Our children-adapted methodology contributes to achieving usable mobile-based products for children with a highly scored user experience. ",
doi="10.2196/30443",
url="https://formative.jmir.org/2023/1/e30443",
url="http://www.ncbi.nlm.nih.gov/pubmed/37889521"
}


@Article{info:doi/10.2196/46926,
author="Melbye, Lind Elisabeth
and Bull, Hervik Vibeke
and Hidle, S{\o}llesvik Kristin",
title="Assessment of the SmartJournal Intervention for Improved Oral Care in Nursing Homes: Protocol for a Cluster Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2023",
month="Oct",
day="6",
volume="12",
pages="e46926",
keywords="cluster randomized controlled trial",
keywords="digital tool",
keywords="gerodontology",
keywords="intervention",
keywords="nursing homes",
keywords="oral health",
abstract="Background: Poor oral health is common in nursing home residents, and health care professionals report numerous barriers when it comes to the provision of oral care for care-dependent older adults, such as a lack of oral health knowledge and skills, care-resistant behaviors in residents, lack of adequate oral care routines, insufficient systems for documentation of issues related to oral health, a high workload, and unclear responsibilities. An intervention, SmartJournal, has been developed to assist health personnel in preserving older patients' oral health. SmartJournal is a digital tool with three components: (1) documentation of oral hygiene routines; (2) monthly oral health assessment; and (3) education on geriatric oral care. An updated framework for research on complex interventions has been used to guide the various phases in the development of this intervention. This study focuses on the evaluation phase. Objective: We aim to assess (1) the effectiveness of SmartJournal use in enhancing nursing home caregivers' capability, opportunity, motivation, and routines related to oral care; and (2) whether SmartJournal use results in improved oral health for nursing home residents. Methods: We will use a cluster randomized controlled trial to assess impacts of SmartJournal use as specified under study objectives. Nursing homes located in Rogaland, Norway, will be recruited and randomly assigned to an intervention and a control group. The intervention group will be provided with tablets containing SmartJournal and support from research staff, while the control group will continue with existing oral care routines. Both groups will receive oral hygiene packages. The intervention will last for 12 weeks. Measurements will be performed in both groups at baseline, 3 months, and 9 months and include (1) a survey assessing caregivers' capability, opportunity, motivation, and routines related to oral care; and (2) assessment of oral health status in residents using mucosal-plaque score as a primary outcome measure. Analyses will include descriptive statistics and statistical techniques to look for changes and differences in the study variables within and between the intervention and control groups throughout the study period. Associations between study variables will also be investigated. Results: Recruitment of nursing homes for the intervention and control groups was completed in February 2023. Recruitment of individual participants (ie, nursing home residents and caregivers) is ongoing, and baseline measurements are being performed consecutively. Results are expected to be ready for analyses in fall 2024. Conclusions: We aim to assess the effects of SmartJournal use on oral care and oral health in nursing homes. Results from this work may inform further development and implementation of SmartJournal and similar digital tools aiming to enhance health care services offered to care-dependent people. Finally, SmartJournal may have potential as a learning tool in educational programs for nurses and other health care professionals. Trial Registration: ClinicalTrials.gov NCT05724043; https://clinicaltrials.gov/study/NCT05724043 International Registered Report Identifier (IRRID): DERR1-10.2196/46926 ",
doi="10.2196/46926",
url="https://www.researchprotocols.org/2023/1/e46926",
url="http://www.ncbi.nlm.nih.gov/pubmed/37801358"
}


@Article{info:doi/10.2196/46381,
author="Kalmus, Olivier
and Smits, Kirsten
and Seitz, Max
and Haux, Christian
and Robra, Bernt-Peter
and Listl, Stefan",
title="Evaluation of a Digital Decision Support System to Integrate Type 2 Diabetes Mellitus and Periodontitis Care: Case-Vignette Study in Simulated Environments",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="2",
volume="25",
pages="e46381",
keywords="digital health",
keywords="integrated care",
keywords="decision support",
keywords="oral health",
keywords="diabetes",
keywords="periodontitis",
keywords="oral care",
keywords="type 2 diabetes",
keywords="evaluation",
keywords="survey",
keywords="hemoglobin",
keywords="diagnostic device",
keywords="telemedicine",
abstract="Background: As highlighted by the recent World Health Organization Oral Health Resolution, there is an urgent need to better integrate primary and oral health care. Despite evidence and guidelines substantiating the relevance of integrating type 2 diabetes mellitus (T2DM) and periodontitis care, the fragmentation of primary and oral health care persists. Objective: This paper reports on the evaluation of a prototype digital decision support system (DSS) that was developed to enhance the integration of T2DM and periodontitis care. Methods: The effects of the prototype DSS were assessed in web-based simulated environments, using 2 different sets of case vignettes in combination with evaluation surveys among 202 general dental practitioners (GDPs) and 206 general practitioners (GPs). Each participant evaluated 3 vignettes, one of which, chosen at random, was assisted by the DSS. Logistic regression analyses were conducted at the participant and case levels. Results: Under DSS assistance, GPs had 8.3 (95\% CI 4.32-16.03) times higher odds of recommending a GDP visit. There was no significant impact of DSS assistance on GP advice about common risk factors for T2DM and periodontal disease. GDPs had 4.3 (95\% CI 2.08-9.04) times higher odds of recommending a GP visit, 1.6 (95\% CI 1.03-2.33) times higher odds of giving advice on disease correlations, and 3.2 (95\% CI 1.63-6.35) times higher odds of asking patients about their glycated hemoglobin value. Conclusions: The findings of this study provide a proof of concept for a digital DSS to integrate T2DM and periodontal care. Future updating and testing is warranted to continuously enhance the functionalities of the DSS in terms of interoperability with various types of data sources and diagnostic devices; incorporation of other (oral) health dimensions; application in various settings, including via telemedicine; and further customization of end-user interfaces. ",
doi="10.2196/46381",
url="https://www.jmir.org/2023/1/e46381",
url="http://www.ncbi.nlm.nih.gov/pubmed/37782539"
}


@Article{info:doi/10.2196/46143,
author="V{\"a}yrynen, Elina
and Hakola, Sanna
and Keski-Salmi, Anniina
and J{\"a}ms{\"a}, Hannaleena
and Vainionp{\"a}{\"a}, Raija
and Karki, Saujanya",
title="The Use of Patient-Oriented Mobile Phone Apps in Oral Health: Scoping Review",
journal="JMIR Mhealth Uhealth",
year="2023",
month="Sep",
day="6",
volume="11",
pages="e46143",
keywords="oral health",
keywords="dentistry",
keywords="mobile apps",
keywords="mobile health",
keywords="mHealth",
keywords="mobile phone",
abstract="Background: Oral health is a significant part of general health. Poor oral health can influence an individual's appearance, self-esteem, eating, and speaking. The use of mobile phone apps has been growing in the field of medicine, including dentistry. However, to date, there is no evidence related to the availability of mobile apps focusing on various branches of dentistry. Objective: The aim of this study was to review the scientific literature on the use of patient-oriented mobile phone apps in oral health and summarize the key findings. Methods: A scoping review of published scientific literature on the use of patient-oriented mobile phone apps in oral health was conducted in accordance with the Joanna Briggs Institute. A search was performed in PubMed and Scopus for studies published between January 2000 and June 2021 that were written in English. All study types except for those reporting developmental protocols were included in this review. In total, 2 reviewers independently screened the studies using the eligibility criteria. The study protocol was registered in the Open Science Framework registries in June 2021. Results: The initial search yielded a total of 977 studies, 45 (4.6\%) of which met the inclusion criteria. All the studies (45/45, 100\%) were published after 2009. Most studies (31/45, 69\%) concerned oral health promotion using mobile phone apps, followed by behavior management (5/45, 11\%). More than half (23/45, 51\%) of the included studies were conducted in Asian countries. Overall, 31\% (14/45) of the studies focused on adolescents. A total of 51\% (23/45) of the studies were randomized controlled trials (RCTs). Approximately 39\% (9/23) of the included RCT studies reported a substantial reduction in dental plaque, and 26\% (6/23) of the studies reported significant improvement in gingival health. Regarding dental anxiety management, 13\% (3/23) of the RCT studies reported a significant decrease in mean heart rate and lower Facial Image Scale scores. Conclusions: According to the literature, the use of mobile apps in oral health is increasing among patients, mainly children and adolescents. Many studies that have used mobile apps have focused on promoting oral health. However, other areas such as diagnostic and remote consultations (teledentistry) have until recently been neglected despite their great potential. ",
doi="10.2196/46143",
url="https://mhealth.jmir.org/2023/1/e46143",
url="http://www.ncbi.nlm.nih.gov/pubmed/37672331"
}


@Article{info:doi/10.2196/41719,
author="Kreibig, D. Sylvia
and ten Brink, Maia
and Mehta, Ashish
and Talmon, Anat
and Zhang, Jin-Xiao
and Brown, S. Alan
and Lucas-Griffin, S. Sawyer
and Axelrod, K. Ariel
and Manber, Rachel
and Lavigne, J. Gilles
and Gross, J. James",
title="The Role of Emotion Regulation, Affect, and Sleep in Individuals With Sleep Bruxism and Those Without: Protocol for a Remote Longitudinal Observational Study",
journal="JMIR Res Protoc",
year="2023",
month="Aug",
day="24",
volume="12",
pages="e41719",
keywords="sleep bruxism",
keywords="emotion regulation",
keywords="ecological momentary assessment",
keywords="rhythmic masticatory muscle activity",
keywords="heart rate variability",
keywords="wrist actigraphy",
abstract="Background: Sleep bruxism (SB) is an oral behavior characterized by high levels of repetitive jaw muscle activity during sleep, leading to teeth grinding and clenching, and may develop into a disorder. Despite its prevalence and negative outcomes on oral health and quality of life, there is currently no cure for SB. The etiology of SB remains poorly understood, but recent research suggests a potential role of negative emotions and maladaptive emotion regulation (ER). Objective: This study's primary aim investigates whether ER is impaired in individuals with SB, while controlling for affective and sleep disturbances. The secondary aim tests for the presence of cross-sectional and longitudinal mediation pathways in the bidirectional relationships among SB, ER, affect, and sleep. Methods: The study used a nonrandomized repeated-measures observational design and was conducted remotely. Participants aged 18-49 years underwent a 14-day ambulatory assessment. Data collection was carried out using electronic platforms. We assessed trait and state SB and ER alongside affect and sleep variables. We measured SB using self-reported trait questionnaires, ecological momentary assessment (EMA) for real-time reports of SB behavior, and portable electromyography for multinight assessment of rhythmic masticatory muscle activity. We assessed ER through self-reported trait questionnaires, EMA for real-time reports of ER strategies, and heart rate variability derived from an electrocardiography wireless physiological sensor as an objective physiological measure. Participants' trait affect and real-time emotional experiences were obtained using self-reported trait questionnaires and EMA. Sleep patterns and quality were evaluated using self-reported trait questionnaires and sleep diaries, as well as actigraphy as a physiological measure. For the primary objective, analyses will test for maladaptive ER in terms of strategy use frequency and effectiveness as a function of SB using targeted contrasts in the general linear model. Control analyses will be conducted to examine the persistence of the SB-ER relationship after adjusting for affective and sleep measures, as well as demographic variables. For the secondary objective, cross-sectional and longitudinal mediation analyses will test various competing models of directional effects among self-reported and physiological measures of SB, ER, affect, and sleep. Results: This research received funding in April 2017. Data collection took place from August 2020 to March 2022. In all, 237 participants were eligible and completed the study. Data analysis has not yet started. Conclusions: We hope that the effort to thoroughly measure SB and ER using gold standard methods and cutting-edge technology will advance the knowledge of SB. The findings of this study may contribute to a better understanding of the relationship among SB, ER, affect, and sleep disturbances. By identifying the role of ER in SB, the results may pave the way for the development of targeted interventions for SB management to alleviate the pain and distress of those affected. International Registered Report Identifier (IRRID): DERR1-10.2196/41719 ",
doi="10.2196/41719",
url="https://www.researchprotocols.org/2023/1/e41719",
url="http://www.ncbi.nlm.nih.gov/pubmed/37616042"
}


@Article{info:doi/10.2196/45418,
author="Xiao, Jin
and Kopycka-Kedzierawski, Dorota
and Ragusa, Patricia
and Mendez Chagoya, Alberto Luis
and Funkhouser, Kimberly
and Lischka, Tamara
and Wu, Tong Tong
and Fiscella, Kevin
and Kar, Saswati Kumari
and Al Jallad, Nisreen
and Rashwan, Noha
and Ren, Johana
and Meyerowitz, Cyril
and ",
title="Acceptance and Usability of an Innovative mDentistry eHygiene Model Amid the COVID-19 Pandemic Within the US National Dental Practice-Based Research Network: Mixed Methods Study",
journal="JMIR Hum Factors",
year="2023",
month="Aug",
day="18",
volume="10",
pages="e45418",
keywords="teledentistry",
keywords="mDentistry",
keywords="oral diseases",
keywords="virtual visit",
keywords="intraoral camera",
keywords="COVID-19",
keywords="pandemic response",
keywords="mobile phone",
abstract="Background: Amid the COVID-19 pandemic and other possible future infectious disease pandemics, dentistry needs to consider modified dental examination regimens that render quality care and ensure the safety of patients and dental health care personnel (DHCP). Objective: This study aims to assess the acceptance and usability of an innovative mDentistry eHygiene model amid the COVID-19 pandemic. Methods: This pilot study used a 2-stage implementation design to assess 2 critical components of an innovative mDentistry eHygiene model: virtual hygiene examination (eHygiene) and patient self-taken intraoral images (SELFIE), within the National Dental Practice-Based Research Network. Mixed methods (quantitative and qualitative) were used to assess the acceptance and usability of the eHygiene model. Results: A total of 85 patients and 18 DHCP participated in the study. Overall, the eHygiene model was well accepted by patients (System Usability Scale [SUS] score: mean 70.0, SD 23.7) and moderately accepted by dentists (SUS score: mean 51.3, SD 15.9) and hygienists (SUS score: mean 57.1, SD 23.8). Dentists and patients had good communication during the eHygiene examination, as assessed using the Dentist-Patient Communication scale. In the SELFIE session, patients completed tasks with minimum challenges and obtained diagnostic intraoral photos.?Patients and DHCP suggested that although eHygiene has the potential to improve oral health care services, it should be used selectively depending on patients' conditions. Conclusions: The study results showed promise for the 2 components of the eHygiene model. eHygiene offers a complementary modality for oral health data collection and examination in dental offices, which would be particularly useful during an infectious disease outbreak. In addition, patients being able to capture critical oral health data in their home could facilitate dental treatment triage and oral health self-monitoring and potentially trigger oral health--promoting behaviors. ",
doi="10.2196/45418",
url="https://humanfactors.jmir.org/2023/1/e45418",
url="http://www.ncbi.nlm.nih.gov/pubmed/37594795"
}


@Article{info:doi/10.2196/40003,
author="Long, Memphis
and Forbes, E. Laura
and Papagerakis, Petros
and Lieffers, L. Jessica R.",
title="YouTube Videos on Nutrition and Dental Caries: Content Analysis",
journal="JMIR Infodemiology",
year="2023",
month="Aug",
day="10",
volume="3",
pages="e40003",
keywords="dental caries",
keywords="diet",
keywords="nutrition",
keywords="YouTube",
keywords="internet",
keywords="consumer health information",
abstract="Background: Dental caries is the most common health condition worldwide, and nutrition and dental caries have a strong interconnected relationship. Foods and eating behaviors can be both harmful (eg, sugar) and healthful (eg, meal spacing) for dental caries. YouTube is a popular source for the public to access information. To date, there is no information available on the nutrition and dental caries content of easily accessible YouTube videos. Objective: This study aimed to analyze the content of YouTube videos on nutrition and dental caries. Methods: In total, 6 YouTube searches were conducted using keywords related to nutrition and dental caries. The first 20 videos were selected from each search. Video content was scored (17 possible points; higher scores were associated with more topics covered) by 2 individuals based on the inclusion of information regarding various foods and eating behaviors that impact dental caries risk. For each video, information on video characteristics (ie, view count, length, number of likes, number of dislikes, and video age) was captured. Videos were divided into 2 groups by view rate (views/day); differences in scores and types of nutrition messages between groups were determined using nonparametric statistics. Results: In total, 42 videos were included. Most videos were posted by or featured oral health professionals (24/42, 57\%). The mean score was 4.9 (SD 3.4) out of 17 points. Videos with >30 views/day (high view rate; 20/42, 48\% videos) had a trend toward a lower score (mean 4.0, SD 3.7) than videos with ?30 views/day (low view rate; 22/42, 52\%; mean 5.8, SD 3.0; P=.06), but this result was not statistically significant. Sugar was the most consistently mentioned topic in the videos (31/42, 74\%). No other topics were mentioned in more than 50\% of videos. Low--view rate videos were more likely to mention messaging on acidic foods and beverages (P=.04), water (P=.09), and frequency of sugar intake (P=.047) than high--view rate videos. Conclusions: Overall, the analyzed videos had low scores for nutritional and dental caries content. This study provides insights into the messaging available on nutrition and dental caries for the public and guidance on how to make improvements in this area. ",
doi="10.2196/40003",
url="https://infodemiology.jmir.org/2023/1/e40003",
url="http://www.ncbi.nlm.nih.gov/pubmed/37561564"
}


@Article{info:doi/10.2196/46275,
author="Xu, Ting
and Ma, Yuming
and Pan, Tianya
and Chen, Yifei
and Liu, Yuhua
and Zhu, Fudong
and Zhou, Zhiguang
and Chen, Qianming",
title="Visual Analytics of Multidimensional Oral Health Surveys: Data Mining Study",
journal="JMIR Med Inform",
year="2023",
month="Aug",
day="1",
volume="11",
pages="e46275",
keywords="visual analytics",
keywords="oral health data mining",
keywords="knowledge graph",
keywords="multidimensional data visualization",
abstract="Background: Oral health surveys largely facilitate the prevention and treatment of oral diseases as well as the awareness of population health status. As oral health is always surveyed from a variety of perspectives, it is a difficult and complicated task to gain insights from multidimensional oral health surveys. Objective: We aimed to develop a visualization framework for the visual analytics and deep mining of multidimensional oral health surveys. Methods: First, diseases and groups were embedded into data portraits based on their multidimensional attributes. Subsequently, group classification and correlation pattern extraction were conducted to explore the correlation features among diseases, behaviors, symptoms, and cognitions. On the basis of the feature mining of diseases, groups, behaviors, and their attributes, a knowledge graph was constructed to reveal semantic information, integrate the graph query function, and describe the features of intrigue to users. Results: A visualization framework was implemented for the exploration of multidimensional oral health surveys. A series of user-friendly interactions were integrated to propose a visual analysis system that can help users further achieve the regulations of oral health conditions. Conclusions: A visualization framework is provided in this paper with a set of meaningful user interactions integrated, enabling users to intuitively understand the oral health situation and conduct in-depth data exploration and analysis. Case studies based on real-world data sets demonstrate the effectiveness of our system in the exploration of oral diseases. ",
doi="10.2196/46275",
url="https://medinform.jmir.org/2023/1/e46275",
url="http://www.ncbi.nlm.nih.gov/pubmed/37526971"
}


@Article{info:doi/10.2196/44218,
author="Kengne Talla, Pascaline
and Inquimbert, Camille
and Dawson, Aim{\'e}e
and Zidarov, Diana
and Bergeron, Fr{\'e}d{\'e}ric
and Chandad, Fatiha",
title="Barriers and Enablers to Implementing Teledentistry From the Perspective of Dental Health Care Professionals: Protocol for a Systematic Quantitative, Qualitative, and Mixed Studies Review",
journal="JMIR Res Protoc",
year="2023",
month="Jul",
day="26",
volume="12",
pages="e44218",
keywords="teledentistry",
keywords="oral health",
keywords="barrier",
keywords="enabler",
keywords="dental health care providers",
keywords="information and communication technology",
keywords="protocol",
keywords="dental",
keywords="dentist",
keywords="telehealth",
keywords="telemedicine",
keywords="theoretical domain framework",
keywords="remote care",
keywords="virtual care",
keywords="perception",
keywords="facilitator",
keywords="systematic review",
keywords="review method",
keywords="librarian",
keywords="PRISMA",
abstract="Background: There is growing literature on the potential of digital technologies for improving access to, ensuring continuity and quality of health care, and to strengthen health systems. Some studies have reported the cost-effectiveness of teledentistry, its reliability for remote dental screening, diagnosis, consultation, and treatment planning. Nonetheless, current evidence suggests that teledentistry implementation faces many challenges and is not yet adopted by dental health care providers (DHCPs). Developing strategies to improve teledentistry adoption requires an understanding of the factors that promote or hinder its successful implementation. Objective: This systematic review aims to identify and synthetize barriers and enablers to implementing teledentistry as perceived by DHCPs in their clinical practices, using the Theoretical Domains Framework (TDF) and the Capacity, Opportunity, and Motivation Behavior (COM-B) model. Methods: This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Protocols) checklist. Literature will be searched in the following databases: PubMed, Cochrane Library, Web of Science, CINAHL, Embase, and PsycINFO. We will perform additional searches on Google, Google Scholar, and ProQuest Dissertations \& Theses Global, screen the references of the included studies to capture additional relevant studies, and contact the authors of studies if we need more details. We will consider studies using qualitative, quantitative, and mixed methods. There will be no restrictions on the publication date and dental setting. We will include studies published in French, English, and Portuguese. Two independent reviewers will select the study, extract data, and assess methodological quality using the Mixed Methods Appraisal Tool's checklist. Data analysis will include a descriptive and a thematic content analysis. We will synthetize and categorize the barriers and enablers using the TDF and COM-B model and present a narrative synthesis of our results using tables, figures, and quotes. Results: By March 2023, the literature search has retrieved 7355 publications. We will identify the range of barriers and enablers to implementing teledentistry through DHCPs' perspectives. Considering the critical need for theory-based implementation interventions to improve the use of evidence-informed practices, we will synthesize the factors influencing the adoption of teledentistry based on the TDF domains and the 3 essential conditions predicting behavior change in accordance with the COM-B model. As needed, we will include additional determinants if not included in the TDF. We will conduct some subgroups analyses if studies are sufficient. We expect to complete the review by July 2024. Conclusions: This review will provide some insights on the determinants of teledentistry implementation as perceived by DHCPs in dental settings. These findings will cater to patients, families, DHCPs, researchers, academic and professional decision-makers, and policy makers. The results of the systematic review could be used to develop theory-led interventions in improving teledentistry implementation. Trial Registration: PROSPERO CRD42021293376; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=293376 International Registered Report Identifier (IRRID): PRR1-10.2196/44218 ",
doi="10.2196/44218",
url="https://www.researchprotocols.org/2023/1/e44218",
url="http://www.ncbi.nlm.nih.gov/pubmed/37494093"
}


@Article{info:doi/10.2196/46144,
author="Basheer N, Amitha
and Jodalli, S. Praveen
and Nayak, Namratha
and K S, Aparna
and Badekkila, R. Avinash",
title="Effectiveness of Silver Diamine Fluoride for Early Childhood Caries Among Children Aged 24 to 72 Months: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2023",
month="Jun",
day="7",
volume="12",
pages="e46144",
keywords="silver diamine fluoride",
keywords="children",
keywords="caries",
keywords="childhood",
keywords="dental",
keywords="dentist",
keywords="oral health",
keywords="child",
keywords="pediatric",
keywords="RCT",
keywords="randomized",
keywords="fluoride",
keywords="prevention",
abstract="Background: Dental caries is a serious public health issue globally. It is one of the most prevalent chronic disease in children worldwide. An important public health concern is the existence of one or more decayed, missing, or filled tooth surfaces in any primary teeth of preschool children. Early childhood caries (ECC) can be halted with the use of silver diamine fluoride (SDF) solution. Previous research has indicated that it may have a preventive impact in the treatment of ECC. It is well known that 38\% silver diamine fluoride (SDF) is helpful at preventing dental caries. On the other hand, there is not enough evidence on SDF's ability to prevent caries in primary teeth. To date, no well-planned clinical study has been carried out to investigate SDF's impact on caries protection. Objective: The study's objective is to evaluate and compare the efficacy of 12\%, 30\%, and 38\% silver diamine fluoride in preventing ECC in children aged 24 to 72 months in Mangaluru Taluk. Methods: This is a single-center, randomized, active-controlled, parallel-group pragmatic trial. Children attending preschool in Mangalore Taluk aged 24 to 72 months will be included in the study. There will be three study groups: group 1 will receive 12\% SDF semiannually; group 2 will receive 30\% SDF semiannually; and group 3 will receive 38\% SDF semiannually. After 6 and 12 months, the principal examiner will conduct a clinical examination of the teeth with a visual and tactile assessment. The effectiveness of the various concentrations of SDF will be determined after 12 months. Results: The research was funded in September 2020, and data collection started in September 2022. As of February 2023, 150 participants have enrolled in the study. The project is still underway, and it is expected to be completed in December 2023. Conclusions: Uncertainty surrounds the efficacy of 38\% SDF in preventing ECC. Consensus-Based Clinical Case Reporting (CARE) guidelines recommending the use of SDF for ECC prevention will be modified if the findings are as expected. Additionally, since the findings will be broadly disseminated, more nations will implement the use of SDF, easing the burden of ECC on the entire world. Future research on the treatment and prevention of ECC will benefit from the study results. If SDF is successful in preventing caries in a classroom or community context, it will mark an important turning point for preventive dentistry. Trial Registration: Clinical Trial Registry of India CTRI/2020/02/023420; https://tinyurl.com/3ju2apab International Registered Report Identifier (IRRID): PRR1-10.2196/46144 ",
doi="10.2196/46144",
url="https://www.researchprotocols.org/2023/1/e46144",
url="http://www.ncbi.nlm.nih.gov/pubmed/37285186"
}


@Article{info:doi/10.2196/36815,
author="Weil, Marie-Theres
and Spinler, Kristin
and Lieske, Berit
and Dingoyan, Demet
and Walther, Carolin
and Heydecke, Guido
and Kofahl, Christopher
and Aarabi, Ghazal",
title="An Evidence-Based Digital Prevention Program to Improve Oral Health Literacy of People With a Migration Background: Intervention Mapping Approach",
journal="JMIR Form Res",
year="2023",
month="May",
day="11",
volume="7",
pages="e36815",
keywords="oral health",
keywords="health behavior",
keywords="oral health knowledge",
keywords="migration",
keywords="mobile health",
keywords="mHealth",
keywords="preventive dentistry",
keywords="intervention mapping",
keywords="mobile phone",
abstract="Background: Studies in Germany have shown that susceptible groups, such as people with a migration background, have poorer oral health than the majority of the population. Limited oral health literacy (OHL) appears to be an important factor that affects the oral health of these groups. To increase OHL and to promote prevention-oriented oral health behavior, we developed an evidence-based prevention program in the form of an app for smartphones or tablets, the F{\"o}rderung der Mundgesundheitskompetenz und Mundgesundheit von Menschen mit Migrationshintergrund (MuMi) app. Objective: This study aims to describe the development process of the MuMi app. Methods: For the description and analysis of the systematic development process of the MuMi app, we used the intervention mapping approach. The approach was implemented in 6 steps: needs assessment, formulation of intervention goals, selection of evidence-based methods and practical strategies for behavior change, planning and designing the intervention, planning the implementation and delivery of the intervention, and planning the evaluation. Results: On the basis of our literature search, expert interviews, and a focus group with the target population, we identified limited knowledge of behavioral risk factors or proper oral hygiene procedures, limited proficiency of the German language, and differing health care socialization as the main barriers to good oral health. Afterward, we selected modifiable determinants of oral health behavior that were in line with behavior change theories. On this basis, performance objectives and change objectives for the relevant population at risk were formalized. Appropriate behavior change techniques to achieve the program objectives, such as the provision of health information, encouragement of self-control and self-monitoring, and sending reminders, were identified. Subsequently, these were translated into practical strategies, such as multiple-choice quizzes or videos. The resulting program, the MuMi app, is available in the Apple app store and Android app store. The effectiveness of the app was evaluated in the MuMi intervention study. The analyses showed that users of the MuMi app had a substantial increase in their OHL and improved oral hygiene (as measured by clinical parameters) after 6 months compared with the control group. Conclusions: The intervention mapping approach provided a transparent, structured, and evidence-based process for the development of our prevention program. It allowed us to identify the most appropriate and effective techniques to initiate behavior change in the target population. The MuMi app takes into account the cultural and specific determinants of people with a migration background in Germany. To our knowledge, it is the first evidence-based app that addresses OHL among people with a migration background. ",
doi="10.2196/36815",
url="https://formative.jmir.org/2023/1/e36815",
url="http://www.ncbi.nlm.nih.gov/pubmed/37166956"
}


@Article{info:doi/10.2196/44989,
author="Frank, Charis Ariadne
and Jennrich, Linda
and Kanzow, Philipp
and Wiegand, Annette
and Krantz-Sch{\"a}fers, Christiane",
title="A Sex-Specific Evaluation of Dental Students' Ability to Perform Subgingival Debridement: Randomized Trial",
journal="JMIR Med Educ",
year="2023",
month="Apr",
day="28",
volume="9",
pages="e44989",
keywords="dental",
keywords="dental education",
keywords="dentist",
keywords="education",
keywords="gender",
keywords="periodontics",
keywords="preclinical education",
keywords="root debridement",
keywords="sex",
keywords="student",
abstract="Background: A successful periodontitis treatment demands good manual skills. A correlation between biological sex and dental students' manual dexterity is currently unknown. Objective: This study examines performance differences between male and female students within subgingival debridement. Methods: A total of 75 third-year dental students were divided by biological sex (male/female) and randomly assigned to one of two work methods (manual curettes n=38; power-driven instruments n=37). Students were trained on periodontitis models for 25 minutes daily over 10 days using the assigned manual or power-driven instrument. Practical training included subgingival debridement of all tooth types on phantom heads. Practical exams were performed after the training session (T1) and after 6 months (T2), and comprised subgingival debridement of four teeth within 20 minutes. The percentage of debrided root surface was assessed and statistically analyzed using a linear mixed-effects regression model (P<.05). Results: The analysis is based on 68 students (both groups n=34). The percentage of cleaned surfaces was not significantly different (P=.40) between male (mean 81.6\%, SD 18.2\%) and female (mean 76.3\%, SD 21.1\%) students, irrespective of the instrument used. The use of power-driven instruments (mean 81.3\%, SD 20.5\%) led to significantly better results than the use of manual curettes (mean 75.4\%, SD 19.4\%; P=.02), and the overall performance decreased over time (T1: mean 84.5\%, SD 17.5\%; T2: mean 72.3\%, SD 20.8\%; P<.001). Conclusions: Female and male students performed equally well in subgingival debridement. Therefore, sex-differentiated teaching methods are not necessary. ",
doi="10.2196/44989",
url="https://mededu.jmir.org/2023/1/e44989",
url="http://www.ncbi.nlm.nih.gov/pubmed/37002956"
}


@Article{info:doi/10.2196/46305,
author="Haupt, Franziska
and Kanzow, Philipp",
title="The Relation Between Students' Theoretical Knowledge and Practical Skills in Endodontics: Retrospective Analysis",
journal="Interact J Med Res",
year="2023",
month="Apr",
day="18",
volume="12",
pages="e46305",
keywords="curricula",
keywords="curriculum",
keywords="dental",
keywords="dental education",
keywords="dentist",
keywords="dentistry",
keywords="endodontics",
keywords="endodontology",
keywords="educational assessment",
keywords="educational measurement",
keywords="examination",
keywords="knowledge assessment",
keywords="practical skills",
keywords="skill assessment",
keywords="theoretical knowledge",
keywords="undergraduate",
keywords="undergraduate curriculum",
keywords="undergraduate education",
abstract="Background: Dental undergraduate students are required to show sufficient practical skills prior to treating patients. Practical skills and the underlying theoretical knowledge are taught in preclinical courses. Usually, the learning outcome is assessed in written multiple-choice examinations (theoretical knowledge) and practical skills tests. However, students' assessment of practical skills is more time consuming and prone to bias than objective multiple-choice examinations. Objective: This study aims to analyze the relation between students' theoretical knowledge and practical skills in endodontics. Furthermore, the predictive validity of a theoretical knowledge assessment on students' practical skills was assessed. Methods: Examination results from all students who participated in the preclinical phantom course in Operative Dentistry (sixth semester of the undergraduate dental curriculum in Germany) between the 2015 summer term and the 2022 summer term were retrospectively evaluated (N=447). The effects of age, sex, previous course participation, and theoretical knowledge on students' practical skills were assessed, using Pearson correlations, Wilcoxon rank sum tests, and a linear regression analysis. Subsequently, students' theoretical knowledge and practical skills were compared via a Fisher exact test to identify a suitable pass mark for students' theoretical knowledge that was associated with sufficient practical skills (?60\%). Results: Students' theoretical knowledge was significantly associated with practical skills (Padjusted=.02; r=0.13). By using the current pass mark for theoretical knowledge (ie, 60\%), a significant differentiation between insufficient practical skills (<60\%) and sufficient practical skills (?60\%) was achieved (P=.02). However, for the discrimination between students with sufficient practical skills and students with insufficient practical skills, an adapted pass mark for theoretical knowledge would be more appropriate. The ideal pass mark amounted to 58\% (P=.02). Conclusions: Students' practical skills and theoretical knowledge are significantly correlated. By objectively measuring students' theoretical knowledge, a rough estimation of students' practical skills (ie, a differentiation between sufficient and insufficient practical skills) is possible. ",
doi="10.2196/46305",
url="https://www.i-jmr.org/2023/1/e46305",
url="http://www.ncbi.nlm.nih.gov/pubmed/36994987"
}


@Article{info:doi/10.2196/43792,
author="Kanzow, Philipp
and Schmidt, Dennis
and Herrmann, Manfred
and Wassmann, Torsten
and Wiegand, Annette
and Raupach, Tobias",
title="Use of Multiple-Select Multiple-Choice Items in a Dental Undergraduate Curriculum: Retrospective Study Involving the Application of Different Scoring Methods",
journal="JMIR Med Educ",
year="2023",
month="Mar",
day="27",
volume="9",
pages="e43792",
keywords="dental education",
keywords="education system",
keywords="educational assessment",
keywords="educational measurement",
keywords="examination",
keywords="k of n",
keywords="Kprim",
keywords="K'",
keywords="MTF",
keywords="Multiple-True-False",
keywords="Pick-N",
keywords="scoring",
keywords="scoring system",
keywords="Type X",
keywords="undergraduate",
keywords="undergraduate curriculum",
keywords="undergraduate education",
abstract="Background: Scoring and awarding credit are more complex for multiple-select items than for single-choice items. Forty-one different scoring methods were retrospectively applied to 2 multiple-select multiple-choice item types (Pick-N and Multiple-True-False [MTF]) from existing examination data. Objective: This study aimed to calculate and compare the mean scores for both item types by applying different scoring methods, and to investigate the effect of item quality on mean raw scores and the likelihood of resulting scores at or above the pass level (?0.6). Methods: Items and responses from examinees (ie, marking events) were retrieved from previous examinations. Different scoring methods were retrospectively applied to the existing examination data to calculate corresponding examination scores. In addition, item quality was assessed using a validated checklist. Statistical analysis was performed using the Kruskal-Wallis test, Wilcoxon rank-sum test, and multiple logistic regression analysis (P<.05). Results: We analyzed 1931 marking events of 48 Pick-N items and 828 marking events of 18 MTF items. For both item types, scoring results widely differed between scoring methods (minimum: 0.02, maximum: 0.98; P<.001). Both the use of an inappropriate item type (34 items) and the presence of cues (30 items) impacted the scoring results. Inappropriately used Pick-N items resulted in lower mean raw scores (0.88 vs 0.93; P<.001), while inappropriately used MTF items resulted in higher mean raw scores (0.88 vs 0.85; P=.001). Mean raw scores were higher for MTF items with cues than for those without cues (0.91 vs 0.8; P<.001), while mean raw scores for Pick-N items with and without cues did not differ (0.89 vs 0.90; P=.09). Item quality also impacted the likelihood of resulting scores at or above the pass level (odds ratio ?6.977). Conclusions: Educators should pay attention when using multiple-select multiple-choice items and select the most appropriate item type. Different item types, different scoring methods, and presence of cues are likely to impact examinees' scores and overall examination results. ",
doi="10.2196/43792",
url="https://mededu.jmir.org/2023/1/e43792",
url="http://www.ncbi.nlm.nih.gov/pubmed/36841970"
}


@Article{info:doi/10.2196/42040,
author="Mai, Hang-Nga
and Dam, Viet Van
and Lee, Du-Hyeong",
title="Accuracy of Augmented Reality--Assisted Navigation in Dental Implant Surgery: Systematic Review and Meta-analysis",
journal="J Med Internet Res",
year="2023",
month="Jan",
day="4",
volume="25",
pages="e42040",
keywords="augmented reality",
keywords="accuracy",
keywords="computer-guided surgery",
keywords="dental implants",
keywords="systematic review",
keywords="meta-analysis",
abstract="Background: The novel concept of immersive 3D augmented reality (AR) surgical navigation has recently been introduced in the medical field. This method allows surgeons to directly focus on the surgical objective without having to look at a separate monitor. In the dental field, the recently developed AR-assisted dental implant navigation system (AR navigation), which uses innovative image technology to directly visualize and track a presurgical plan over an actual surgical site, has attracted great interest. Objective: This study is the first systematic review and meta-analysis study that aimed to assess the accuracy of dental implants placed by AR navigation and compare it with that of the widely used implant placement methods, including the freehand method (FH), template-based static guidance (TG), and conventional navigation (CN). Methods: Individual search strategies were used in PubMed (MEDLINE), Scopus, ScienceDirect, Cochrane Library, and Google Scholar to search for articles published until March 21, 2022. This study was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO) database. Peer-reviewed journal articles evaluating the positional deviations of dental implants placed using AR-assisted implant navigation systems were included. Cohen d statistical power analysis was used to investigate the effect size estimate and CIs of standardized mean differences (SMDs) between data sets. Results: Among the 425 articles retrieved, 15 articles were considered eligible for narrative review, 8 articles were considered for single-arm meta-analysis, and 4 were included in a 2-arm meta-analysis. The mean lateral, global, depth, and angular deviations of the dental implant placed using AR navigation were 0.90 (95\% CI 0.78-1.02) mm, 1.18 (95\% CI 0.95-1.41) mm, 0.78 (95\% CI 0.48-1.08) mm, and 3.96{\textdegree} (95\% CI 3.45{\textdegree}-4.48{\textdegree}), respectively. The accuracy of AR navigation was significantly higher than that of the FH method (SMD=?1.01; 95\% CI ?1.47 to ?0.55; P<.001) and CN method (SMD=?0.46; 95\% CI ?0.64 to ?0.29; P<.001). However, the accuracies of the AR navigation and TG methods were similar (SMD=0.06; 95\% CI ?0.62 to 0.74; P=.73). Conclusions: The positional deviations of AR-navigated implant placements were within the safety zone, suggesting clinically acceptable accuracy of the AR navigation method. Moreover, the accuracy of AR implant navigation was comparable with that of the highly recommended dental implant--guided surgery method, TG, and superior to that of the conventional FH and CN methods. This review highlights the possibility of using AR navigation as an effective and accurate immersive surgical guide for dental implant placement. ",
doi="10.2196/42040",
url="https://www.jmir.org/2023/1/e42040",
url="http://www.ncbi.nlm.nih.gov/pubmed/36598798"
}


@Article{info:doi/10.2196/31433,
author="Khanna, K. Raj
and Cecchetti, A. Alfred
and Bhardwaj, Niharika
and Muto, Steele Bobbi
and Murughiyan, Usha",
title="Understanding Emergency Room Visits for Nontraumatic Oral Health Conditions in a Hospital Serving Rural Appalachia: Dental Informatics Study",
journal="JMIR Form Res",
year="2022",
month="Dec",
day="23",
volume="6",
number="12",
pages="e31433",
keywords="dental informatics",
keywords="visualization",
keywords="nontraumatic dental care",
keywords="emergency room",
keywords="cost",
keywords="utilization",
keywords="economic impact",
abstract="Background: In the Appalachian region, a variety of factors will impact the ability of patients to maintain good oral health, which is essential for overall health and well-being. Oral health issues have led to high costs within the Appalachian hospital system. Dental informatics examines preventable dental conditions to understand the problem and suggest cost containment. Objective: We aimed to demonstrate the value of dental informatics in dental health care in rural Appalachia by presenting a research study that measured emergency room (ER) use for nontraumatic dental conditions (NTDCs) and the associated economic impact in a hospital system that primarily serves rural Appalachia. Methods: The Appalachian Clinical and Translational Science Institute's oral health data mart with relevant data on patients (n=8372) with ER encounters for NTDC between 2010 and 2018 was created using Appalachian Clinical and Translational Science Institute's research data warehouse. Exploratory analysis was then performed by developing an interactive Tableau dashboard. Dental Informatics provided the platform whereby the overall burden of these encounters, along with disparities in burden by age groups, gender, and primary payer, was assessed. Results: Dental informatics was essential in understanding the overall problem and provided an interactive and easily comprehensible visualization of the situation. We found that ER visits for NTDCs declined by 40\% from 2010 to 2018, but a higher percentage of visits required inpatient care and surgical intervention. Conclusions: Dental informatics can provide the necessary tools and support to health care systems and state health departments across Appalachia to address serious dental problems. In this case, informatics helped identify that although inappropriate ER use for NTDCs diminished due to ER diversion efforts, they remain a significant burden. Through its visualization and data extraction techniques, dental informatics can help produce policy changes by promoting models that improve access to preventive care. ",
doi="10.2196/31433",
url="https://formative.jmir.org/2022/12/e31433",
url="http://www.ncbi.nlm.nih.gov/pubmed/36563041"
}


@Article{info:doi/10.2196/39685,
author="Sethi, Sneha
and Poirier, Faye Brianna
and Hedges, Joanne
and Dodd, Zell
and Larkins, Priscilla
and Zbierski, Cindy
and McDonald, P. Stephen
and Jesudason, Shilpanjali
and Jamieson, Lisa
and ",
title="Maximizing Oral Health Outcomes of Aboriginal and Torres Strait Islander People With End-stage Kidney Disease Through Culturally Secure Partnerships: Protocol for a Mixed Methods Study",
journal="JMIR Res Protoc",
year="2022",
month="Dec",
day="16",
volume="11",
number="12",
pages="e39685",
keywords="end-stage kidney disease",
keywords="Aboriginal and Torres Strait Islander health",
keywords="oral health",
keywords="health promotion",
keywords="cultural security",
keywords="health services",
keywords="Indigenous health",
abstract="Background: Dialysis for end-stage kidney disease (ESKD) is the leading cause of hospitalization among Aboriginal and Torres Strait Islander individuals in Australia. Poor oral health is commonly the only obstacle preventing Aboriginal and Torres Strait Islander people with ESKD in Australia from receiving kidney transplant. Objective: This study aims to improve access, provision, and delivery of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD in South Australia through the following objectives: investigate the facilitators of and barriers to providing oral health care to Aboriginal and Torres Strait Islander patients with ESKD in South Australia; investigate the facilitators of and barriers to maintaining oral health among Aboriginal and Torres Strait Islander people with ESKD in South Australia; facilitate access to and completion of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD and their families; provide oral health promotion training for Aboriginal health workers (AHWs) at each of the participating Aboriginal Community Controlled Health Services, with a specific emphasis on oral health needs of patients with ESKD; generate co-designed strategies to better facilitate access to and provision of culturally secure dental services for Aboriginal and Torres Strait Islander people living with ESKD; and evaluate participant progress and AHW oral health training program. Methods: This collaborative study is divided into 3 phases: exploratory phase (baseline), intervention phase (baseline), and evaluation phase (after 6 months). The exploratory phase will involve collaboration with stakeholders in different sectors to identify barriers to providing oral health care; the intervention phase will involve patient yarns, patient oral health journey mapping, clinical examinations, culturally secure dental care provision, and strategy implementation workshops; and the evaluation phase will involve 6-month follow-up clinical examinations, participant evaluations of dental care provision, and AHW evaluation of oral health training. Results: Stakeholder interviews were initiated in November 2021, and participant recruitment commenced in February 2022. The first results are expected to be submitted for publication in December 2022. Conclusions: Expected outcomes will identify the burden of oral disease experienced by Aboriginal and Torres Strait Islander people with ESKD in South Australia. Qualitative outcomes are expected to develop a deeper appreciation of the unique challenges regarding oral health for individuals with ESKD. Through stakeholder engagement, responsive strategies and policies will be co-designed to address participant-identified and stakeholder-identified challenges to ensure accessibility to culturally secure dental services for Aboriginal and Torres Strait Islander individuals with ESKD. International Registered Report Identifier (IRRID): PRR1-10.2196/39685 ",
doi="10.2196/39685",
url="https://www.researchprotocols.org/2022/12/e39685",
url="http://www.ncbi.nlm.nih.gov/pubmed/36525292"
}


@Article{info:doi/10.2196/38640,
author="Kim, Changgyun
and Jeong, Hogul
and Park, Wonse
and Kim, Donghyun",
title="Tooth-Related Disease Detection System Based on Panoramic Images and Optimization Through Automation: Development Study",
journal="JMIR Med Inform",
year="2022",
month="Oct",
day="31",
volume="10",
number="10",
pages="e38640",
keywords="object detection",
keywords="tooth",
keywords="diagnosis",
keywords="panorama",
keywords="dentistry",
keywords="dental health",
keywords="oral health",
keywords="dental caries",
keywords="image analysis",
keywords="artificial intelligence",
keywords="detection model",
keywords="machine learning",
keywords="automation",
keywords="diagnosis system",
abstract="Background: Early detection of tooth-related diseases in patients plays a key role in maintaining their dental health and preventing future complications. Since dentists are not overly attentive to tooth-related diseases that may be difficult to judge visually, many patients miss timely treatment. The 5 representative tooth-related diseases, that is, coronal caries or defect, proximal caries, cervical caries or abrasion, periapical radiolucency, and residual root can be detected on panoramic images. In this study, a web service was constructed for the detection of these diseases on panoramic images in real time, which helped shorten the treatment planning time and reduce the probability of misdiagnosis. Objective: This study designed a model to assess tooth-related diseases in panoramic images by using artificial intelligence in real time. This model can perform an auxiliary role in the diagnosis of tooth-related diseases by dentists and reduce the treatment planning time spent through telemedicine. Methods: For learning the 5 tooth-related diseases, 10,000 panoramic images were modeled: 4206 coronal caries or defects, 4478 proximal caries, 6920 cervical caries or abrasion, 8290 periapical radiolucencies, and 1446 residual roots. To learn the model, the fast region-based convolutional network (Fast R-CNN), residual neural network (ResNet), and inception models were used. Learning about the 5 tooth-related diseases completely did not provide accurate information on the diseases because of indistinct features present in the panoramic pictures. Therefore, 1 detection model was applied to each tooth-related disease, and the models for each of the diseases were integrated to increase accuracy. Results: The Fast R-CNN model showed the highest accuracy, with an accuracy of over 90\%, in diagnosing the 5 tooth-related diseases. Thus, Fast R-CNN was selected as the final judgment model as it facilitated the real-time diagnosis of dental diseases that are difficult to judge visually from radiographs and images, thereby assisting the dentists in their treatment plans. Conclusions: The Fast R-CNN model showed the highest accuracy in the real-time diagnosis of dental diseases and can therefore play an auxiliary role in shortening the treatment planning time after the dentists diagnose the tooth-related disease. In addition, by updating the captured panoramic images of patients on the web service developed in this study, we are looking forward to increasing the accuracy of diagnosing these 5 tooth-related diseases. The dental diagnosis system in this study takes 2 minutes for diagnosing 5 diseases in 1 panoramic image. Therefore, this system plays an effective role in setting a dental treatment schedule. ",
doi="10.2196/38640",
url="https://medinform.jmir.org/2022/10/e38640",
url="http://www.ncbi.nlm.nih.gov/pubmed/36315222"
}


@Article{info:doi/10.2196/39218,
author="Pithpornchaiyakul, Samerchit
and Naorungroj, Supawadee
and Pupong, Kittiwara
and Hunsrisakhun, Jaranya",
title="Using a Chatbot as an Alternative Approach for In-Person Toothbrushing Training During the COVID-19 Pandemic: Comparative Study",
journal="J Med Internet Res",
year="2022",
month="Oct",
day="21",
volume="24",
number="10",
pages="e39218",
keywords="mHealth",
keywords="tele-dentistry",
keywords="digital health",
keywords="chatbot",
keywords="conversional agents",
keywords="oral hygiene",
keywords="oral health behaviors",
keywords="protection motivation theory",
keywords="young children",
keywords="caregiver",
keywords="in-person toothbrushing training",
keywords="COVID-19",
abstract="Background: It is recommended that caregivers receive oral health education and in-person training to improve toothbrushing for young children. To strengthen oral health education before COVID-19, the 21-Day FunDee chatbot with in-person toothbrushing training for caregivers was used. During the pandemic, practical experience was difficult to implement. Therefore, the 30-Day FunDee chatbot was created to extend the coverage of chatbots from 21 days to 30 days by incorporating more videos on toothbrushing demonstrations and dialogue. This was a secondary data comparison of 2 chatbots in similar rural areas of Pattani province: Maikan district (Study I) and Maelan district (Study II). Objective: This study aimed to evaluate the effectiveness and usability of 2 chatbots, 21-Day FunDee (Study I) and 30-Day FunDee (Study II), based on the protection motivation theory (PMT). This study explored the feasibility of using the 30-Day FunDee?chatbot to increase toothbrushing behaviors?for caregivers in oral hygiene care for children aged 6 months to 36 months without in-person training during the COVID-19 pandemic. Methods: A pre-post design was used in both studies. The effectiveness was evaluated among caregivers in terms of oral hygiene practices, knowledge, and oral health care perceptions based on PMT. In Study I, participants received in-person training and a 21-day chatbot course during October 2018 to February 2019. In Study II, participants received only daily chatbot programming for 30 days during December 2021 to February 2022. Data were gathered at baseline of each study and at 30 days and 60 days after the start of Study I and Study II, respectively. After completing their interventions, the chatbot's usability was assessed using open-ended questions. Study I evaluated the plaque score, whereas Study II included an in-depth interview. The 2 studies were compared to determine the feasibility of using the 30-Day FunDee chatbot as an alternative to in-person training. Results: There were 71 pairs of participants: 37 in Study I and 34 in Study II. Both chatbots significantly improved overall knowledge (Study I: P<.001; Study II: P=.001), overall oral health care perceptions based on PMT (Study I: P<.001; Study II: P<.001), and toothbrushing for children by caregivers (Study I: P=.02; Study II: P=.04). Only Study I had statistically significant differences in toothbrushing at least twice a day (P=.002) and perceived vulnerability (P=.003). The highest overall chatbot satisfaction was 9.2 (SD 0.9) in Study I and 8.6 (SD 1.2) in Study II. In Study I, plaque levels differed significantly (P<.001). Conclusions: This was the first study using a chatbot in oral health education. We established the effectiveness and usability of 2 chatbot programs for promoting oral hygiene care of young children by caregivers. The 30-Day FunDee chatbot showed the possibility of improving toothbrushing skills without requiring in-person training. Trial Registration: Thai Clinical Trials Registry TCTR20191223005; http://www.thaiclinicaltrials.org/show/TCTR20191223005 and TCTR20210927004; https://www.thaiclinicaltrials.org/show/TCTR20210927004 ",
doi="10.2196/39218",
url="https://www.jmir.org/2022/10/e39218",
url="http://www.ncbi.nlm.nih.gov/pubmed/36179147"
}


@Article{info:doi/10.2196/36079,
author="Pang, Mengwei
and Zhao, Xiaohan
and Lu, Daiyu
and Dong, Yihan
and Jiang, Lin
and Li, Jie
and Ji, Ping",
title="Preliminary User Evaluation of a New Dental Technology Virtual Simulation System: Development and Validation Study",
journal="JMIR Serious Games",
year="2022",
month="Sep",
day="12",
volume="10",
number="3",
pages="e36079",
keywords="virtual simulation",
keywords="dental technology",
keywords="OSCE",
keywords="virtual reality",
keywords="dentistry",
keywords="dental technician",
keywords="framework",
keywords="certified dental technician",
keywords="development",
keywords="validation",
keywords="serious game",
keywords="dental",
keywords="technology",
abstract="Background: With the advancements in the dental health care industry, the demand for dental technicians has increased. Dental technicians should be thoroughly assessed and trained in practical skills and pass professional certification examinations to ensure that they are competent to work closely with dentists. Unfortunately, such training courses and tests are in short supply worldwide. The use of virtual simulation technology can help solve these problems. Objective: This study presents a new strategic framework design for a certified dental technician practical examination called as the certified Objective Manipulative Skill Examination of Dental Technicians (OMEDT), which is based on the Objective Structured Clinical Examination (OSCE). We present the development and validation of the OMEDT system, a new virtual simulated training system, to meet the demands of the OMEDT framework. The combination of OMEDT and the OMEDT system can solve the complex problems encountered in the certified dental technician practical examination with excellent efficiency, high quality, and low cost. Methods: The OMEDT framework design was constructed according to the OSCE guide and the Chinese vocational skill standards for dental technicians. To develop the OMEDT system, we organized a new framework based on the virtual learning network platform, the haptic feedback system, and the real-time dental training and evaluation system. The effectiveness evaluation of the OMEDT system was divided into 2 phases: in the first phase, 36 students were recruited to use the test module to finish the task and their performance data were collected and analyzed; and in the second phase, a questionnaire was administered to 30 students who used the system for their studies and graduation exams. Results: The OMEDT and the corresponding skill training virtual simulation OMEDT system were developed, and preliminary user evaluation was performed to assess their effectiveness and usefulness. The OMEDT system was found to improve students' practical skills by training with the evaluation results. In addition, several key research topics were explored, including the effects of positive feedback of the knowledge of results on the improvement of the students' skill level and the common sense transformation of educators in the virtual simulation technology environment. Conclusions: The development of OMEDT and the OMEDT system has been completed and their effectiveness has been verified. ",
doi="10.2196/36079",
url="https://games.jmir.org/2022/3/e36079",
url="http://www.ncbi.nlm.nih.gov/pubmed/36094803"
}


@Article{info:doi/10.2196/39683,
author="van Spreuwel, M. Peggy C. J.
and Jerkovi{\'c}-{\'C}osi{\'c}, Katarina
and van Loveren, Cor
and van der Heijden, G. Geert J. M.",
title="Oral Health Coaches at Well-Baby Clinics to Promote Oral Health in Preschool Children From the First Erupted Tooth: Protocol for a Multisite, Pragmatic Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2022",
month="Aug",
day="31",
volume="11",
number="8",
pages="e39683",
keywords="randomized clinical trial",
keywords="dental caries",
keywords="early childhood caries",
keywords="oral health promotion",
keywords="behavior change",
keywords="motivational interviewing",
keywords="dental public health",
keywords="child health care",
keywords="health inequality",
keywords="prevention",
abstract="Background: Early childhood caries is considered one of the most prevalent diseases in childhood, affecting almost half of preschool-age children globally. In the Netherlands, approximately one-third of children aged 5 years already have dental caries, and dental care providers experience problems reaching out to these children. Objective: Within the proposed trial, we aim to test the hypothesis that, compared to children who receive usual care, children who receive the Toddler Oral Health Intervention as add-on care will have a reduced cumulative caries incidence and caries incidence density at the age of 48 months. Methods: This pragmatic, 2-arm, individually randomized controlled trial is being conducted in the Netherlands and has been approved by the Medical Ethics Research Board of University Medical Center Utrecht. Parents with children aged 6 to 12 months attending 1 of the 9 selected well-baby clinics are invited to participate. Only healthy children (ie, not requiring any form of specialized health care) with parents that have sufficient command of the Dutch language and have no plans to move outside the well-baby clinic region are eligible. Both groups receive conventional oral health education in well-baby clinics during regular well-baby clinic visits between the ages of 6 to 48 months. After concealed random allocation of interventions, the intervention group also receives the Toddler Oral Health Intervention from an oral health coach. The Toddler Oral Health Intervention combines behavioral interventions of proven effectiveness in caries prevention. Data are collected at baseline, at 24 months, and at 48 months. The primary study endpoint is cumulative caries incidence for children aged 48 months, and will be analyzed according to the intention-to-treat principle. For children aged 48 months, the balance between costs and effects of the Toddler Oral Health Intervention will be evaluated, and for children aged 24 months, the effects of the Toddler Oral Health Intervention on behavioral determinants, alongside cumulative caries incidence, will be compared. Results: The first parent-child dyads were enrolled in June 2017, and recruitment was finished in June 2019. We enrolled 402 parent-child dyads. Conclusions: All follow-up interventions and data collection will be completed by the end of 2022, and the trial results are expected soon thereafter. Results will be shared at international conferences and via peer-reviewed publication. Trial Registration: Netherlands Trial Register NL8737; https://trialsearch.who.int/Trial2.aspx?TrialID=NL8737 International Registered Report Identifier (IRRID): DERR1-10.2196/39683 ",
doi="10.2196/39683",
url="https://www.researchprotocols.org/2022/8/e39683",
url="http://www.ncbi.nlm.nih.gov/pubmed/36044251"
}


@Article{info:doi/10.2196/38386,
author="Fredericks-Younger, Janine
and Fine, H. Daniel
and Subramanian, Gayathri
and Coker, O. Modupe
and Meyerowitz, Cyril
and Ragusa, Patricia
and Allareddy, Veerasathpurush
and McBurnie, Ann Mary
and Funkhouser, Ellen
and Gennaro, Laura Maria
and Feldman, A. Cecile",
title="The Pragmatic Return to Effective Dental Infection Control Through Triage and Testing (PREDICT) Study: Protocol for a Prospective Clinical Study in the National Dental Practice--Based Research Network",
journal="JMIR Res Protoc",
year="2022",
month="Aug",
day="31",
volume="11",
number="8",
pages="e38386",
keywords="COVID-19",
keywords="COVID-19 triage",
keywords="COVID-19 testing",
keywords="SARS-CoV-2",
keywords="feasibility study",
keywords="National Dental Practice--Based Research Network",
keywords="PBRN",
keywords="dental practice",
keywords="dental health",
keywords="dentist",
keywords="dentistry",
keywords="safety",
keywords="healthcare professional safety",
keywords="health care",
keywords="patient safety",
keywords="dental healthcare staff",
abstract="Background: Dental practice has been greatly affected by the COVID-19 pandemic. As SARS-CoV-2 infection is transmitted by respiratory fluids, dental practice techniques, which include aerosol-generating procedures, can increase the risk of transmission causing heightened safety concerns for both dental health care workers (DHCWs) and patients. These concerns have resulted in the reduction in patient volume and the available workforce within dental practices across the United States. Standardized methods for COVID-19 triage and testing may lead to increased safety and perceptions of safety for DHCWs and their patients and promote willingness to provide and access oral health care services. Objective: This study is designed to develop procedures that test the feasibility of enhanced COVID-19 triage and testing in dental offices. It will provide preliminary data to support a larger network-wide study grant application aimed at developing protocols to address safety concerns of patients and DHCWs in a peri--COVID-19 pandemic era. Methods: The feasibility study is being conducted in 4 private dental practices, each of which has a dentist member of the National Dental Practice--Based Research Network. Participants include the DHCWs and patients of the dental practice. Study procedures include completion of COVID-19 triage, completion of COVID-19 testing (point-of-care [POC] or laboratory-based [LAB] SARS-CoV-2 viral, antigen, and antibody tests based on office designation), and administration of perception and attitude surveys for participating DCHWs and patients of the dental practice over a defined study period. The office designation and the participant's role in the practice determines which testing protocol is executed within the office. There are 4 study groups following 4 distinct protocols: (1) POC DHCWs, (2) POC patients, (3) LAB DHCWs, and (4) LAB patients. Results: Data collection began in December of 2021 and concluded in March 2022. Study results are expected to be published in fall 2022. Conclusions: The results of this feasibility study will help identify the viability and functionality of COVID-19 triage and testing in dental practices and inform a larger network-wide study grant application that develops protocols that address safety concerns of patients and DHCWs in a COVID-19 environment. Trial Registration: ClinicalTrials.gov NTC05123742; https://clinicaltrials.gov/ct2/show/NCT05123742?term=NCT05123742 International Registered Report Identifier (IRRID): DERR1-10.2196/38386 ",
doi="10.2196/38386",
url="https://www.researchprotocols.org/2022/8/e38386",
url="http://www.ncbi.nlm.nih.gov/pubmed/35944181"
}


@Article{info:doi/10.2196/39955,
author="Hung, Man
and Lipsky, S. Martin
and Phuatrakoon, N. Teerarat
and Nguyen, Mindy
and Licari, W. Frank
and Unni, J. Elizabeth",
title="Teledentistry Implementation During the COVID-19 Pandemic: Scoping Review",
journal="Interact J Med Res",
year="2022",
month="Jul",
day="21",
volume="11",
number="2",
pages="e39955",
keywords="teledentistry",
keywords="telehealth",
keywords="COVID-19",
keywords="pandemic",
keywords="innovation",
keywords="implementation",
keywords="dental profession",
abstract="Background: COVID-19 spreads via aerosol droplets. The dental profession is at high risk of contracting the virus since their work includes treatment procedures that produce aerosols. Teledentistry offers an opportunity to mitigate the risk to dental personnel by allowing dentists to provide care without direct patient contact. Objective: The purpose of this scoping review was to examine the implementation, challenges, strategies, and innovations related to teledentistry during the COVID-19 pandemic lockdown. Methods: This scoping review evaluated teledentistry use during the pandemic by searching for articles in PubMed and Google Scholar using the search terms teledentistry, tele-dentistry, covid-19, coronavirus, telehealth, telemedicine, and dentistry. Inclusion criteria consisted of articles published in English from March 1, 2020, to April 1, 2022, that were relevant to dentistry and its specialties, and that included some discussion of teledentistry and COVID-19. Specifically, the review sought to explore teledentistry implementation, challenges, strategies to overcome challenges, and innovative ideas that emerged during the pandemic. It followed the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). This approach is organized into 5 distinct steps: formulating a defined question, using the question to develop inclusion criteria to identify relevant studies, an approach to appraise the studies, summarizing the evidence using an explicit methodology, and interpreting the findings of the review. Results: A total of 32 articles was included in this scoping review and summarized by article type, methodology and population, and key points about the aims; 9 articles were narrative review articles, 10 were opinion pieces, 4 were descriptive studies, 3 were surveys, 2 were integrative literature reviews, and there was 1 each of the following: observational study, systematic review, case report, and practice brief. Teledentistry was used both synchronously and asynchronously for virtual consultations, often employing commercial applications such as WhatsApp, Skype, and Zoom. Dental professionals most commonly used teledentistry for triage, to reduce in-person visits, and for scheduling and providing consultations remotely. Identified challenges included patient and clinician acceptance of teledentistry, having adequate infrastructure, reimbursement, and security concerns. Strategies to address these concerns included clinician and patient training and utilizing Health Insurance Portability and Accountability Act-compliant applications. Benefits from teledentistry included providing care for patients during the pandemic and extending care to areas lacking access to dental care. Conclusions: Pandemic lockdowns led to new teledentistry implementations, most commonly for triage but also for follow-up and nonprocedural care. Teledentistry reduced in-person visits and improved access to remote areas. Challenges such as technology infrastructure, provider skill level, billing issues, and privacy concerns remain. ",
doi="10.2196/39955",
url="https://www.i-jmr.org/2022/2/e39955",
url="http://www.ncbi.nlm.nih.gov/pubmed/35862174"
}


@Article{info:doi/10.2196/36315,
author="Yashpal, Shahen
and Raghunath, Ananditha
and Gencerliler, Nihan
and Burns, E. Lorel",
title="Exploring Public Perceptions of Dental Care Affordability in the United States: Mixed Method Analysis via Twitter",
journal="JMIR Form Res",
year="2022",
month="Jul",
day="1",
volume="6",
number="7",
pages="e36315",
keywords="dentistry",
keywords="oral health",
keywords="social media",
keywords="access to care",
keywords="healthcare reform",
keywords="COVID-19",
keywords="dental care",
keywords="health care service",
keywords="twitter",
keywords="public health",
keywords="health communication",
keywords="dental treatment",
keywords="health policy",
keywords="dental professional",
keywords="thematic analysis",
abstract="Background: Dental care expenses are reported to present higher financial barriers than any other type of health care service in the United States. Social media platforms such as Twitter have become a source of public health communication and surveillance. Previous studies have demonstrated the usefulness of Twitter in exploring public opinion on aspects of dental care. To date, no studies have leveraged Twitter to examine public sentiments regarding dental care affordability in the United States. Objective: The aim of this study is to understand public perceptions of dental care affordability in the United States on the social media site, Twitter. Methods: Tweets posted between September 1, 2017, and September 30, 2021, were collected using the Snscrape application. Query terms were selected a priori to represent dentistry and financial aspects associated with dental treatment. Data were analyzed qualitatively using both deductive and inductive approaches. In total, 8\% (440/5500) of all included tweets were coded to identify prominent themes and subthemes. The entire sample of included tweets were then independently coded into thematic categories. Quantitative data analyses included geographic distribution of tweets by state, volume analysis of tweets over time, and distribution of tweets by content theme. Results: A final sample of 5314 tweets were included in the study. Thematic analysis identified the following prominent themes: (1) general sentiments (1614 tweets, 30.4\%); (2) delaying or forgoing dental care (1190 tweets, 22.4\%); (3) payment strategies (1019 tweets, 19.2\%); (4) insurance (767 tweets, 14.4\%); and (5) policy statements (724 tweets, 13.6\%). Geographic distributions of the tweets established California, Texas, Florida, and New York as the states with the most tweets. Qualitative analysis revealed barriers faced by individuals to accessing dental care, strategies taken to cope with dental pain, and public perceptions on aspects of dental care policy. The volume and thematic trends of the tweets corresponded to relevant societal events, including the COVID-19 pandemic and debates on health care policy resulting from the election of President Joseph R. Biden. Conclusions: The findings illustrate the real-time sentiment of social media users toward the cost of dental treatment and suggest shortcomings in funding that may be representative of greater systemic failures in the provision of dental care. Thus, this study provides insights for policy makers and dental professionals who strive to increase access to dental care. ",
doi="10.2196/36315",
url="https://formative.jmir.org/2022/7/e36315",
url="http://www.ncbi.nlm.nih.gov/pubmed/35658090"
}


@Article{info:doi/10.2196/39133,
author="Lotto, Matheus
and Santana Jorge, Olivia
and S{\'a} Menezes, Tamires
and Ramalho, Maria Ana
and Marchini Oliveira, Thais
and Bevilacqua, Fernando
and Cruvinel, Thiago",
title="Psychophysiological Reactions of Internet Users Exposed to Fluoride Information and Disinformation: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2022",
month="Jun",
day="16",
volume="11",
number="6",
pages="e39133",
keywords="fluoride",
keywords="disinformation",
keywords="randomized controlled trial",
keywords="social media",
keywords="internet",
abstract="Background: False messages on the internet continually propagate possible adverse effects of fluoridated oral care products and water, despite their essential role in preventing and controlling dental caries. Objective: This study aims to evaluate the patterns of psychophysiological reactions of adults after the consumption of internet-based fluoride-related information and disinformation. Methods: A 2-armed, single-blinded, parallel, and randomized controlled trial will be conducted with 58 parents or caregivers of children who attend the Clinics of Pediatric Dentistry at the Bauru School of Dentistry, considering an attrition of 10\% and a significance level of 5\%. The participants will be randomized into test and intervention groups, being respectively exposed to fluoride-related information and disinformation presented on a computer with simultaneous monitoring of their psychophysiological reactions, including analysis of their heart rates (HRs) and 7 facial features (mouth outer, mouth corner, eye area, eyebrow activity, face area, face motion, and facial center of mass). Then, participants will respond to questions about the utility and truthfulness of content, their emotional state after the experiment, eHealth literacy, oral health knowledge, and socioeconomic characteristics. The Shapiro-Wilk and Levene tests will be used to determine the normality and homogeneity of the data, which could lead to further statistical analyses for elucidating significant differences between groups, using parametric (Student t test) or nonparametric (Mann-Whitney U test) analyses. Moreover, multiple logistic regression models will be developed to evaluate the association of distinct variables with the psychophysiological aspects. Only factors with significant Wald statistics in the simple analysis will be included in the multiple models (P<.2). Furthermore, receiver operating characteristic curve analysis will be performed to determine the accuracy of the remote HR with respect to the measured HR. For all analyses, P<.05 will be considered significant. Results: From June 2022, parents and caregivers who frequent the Clinics of Pediatric Dentistry at the Bauru School of Dentistry will be invited to participate in the study and will be randomized into 1 of the 2 groups (control or intervention). Data collection is expected to be completed in December 2023. Subsequently, the authors will analyze the data and publish the findings of the clinical trial by June 2024. Conclusions: This randomized controlled trial aims to elucidate differences between psychophysiological patterns of adults exposed to true or false oral health content. This evidence may support the development of further studies and digital strategies, such as neural network models to automatically detect disinformation available on the internet. Trial Registration: Brazilian Clinical Trials Registry (RBR-7q4ymr2) U1111-1263-8227; https://tinyurl.com/2kf73t3d International Registered Report Identifier (IRRID): PRR1-10.2196/39133 ",
doi="10.2196/39133",
url="https://www.researchprotocols.org/2022/6/e39133",
url="http://www.ncbi.nlm.nih.gov/pubmed/35708767"
}


@Article{info:doi/10.2196/35145,
author="Duangthip, Duangporn
and He, Shuyang
and Gao, Shiqian Sherry
and Chu, Hung Chun
and Lo, Man Edward Chin",
title="Effectiveness of Silver Diamine Fluoride for Preventing Occlusal Caries in the Primary Teeth of Preschool Children: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2022",
month="May",
day="23",
volume="11",
number="5",
pages="e35145",
keywords="silver diamine fluoride",
keywords="sodium fluoride",
keywords="children",
keywords="early childhood caries",
keywords="prevention",
abstract="Background: Tooth decay is a significant public health problem globally. The caries-arrest effectiveness of 38\% silver diamine fluoride (SDF) has been well documented. However, information on the caries-preventive effect of SDF on primary teeth is insufficient. Objective: The aim of this trial is to investigate the effectiveness of semiannual application of 38\% SDF and that of 5\% sodium fluoride (NaF) varnish when compared with placebo control for preventing occlusal caries in the primary molars of preschool children over 30 months. Methods: This 3-arm, parallel design, double-blind, randomized controlled trial involves 791 preschool children. Children are randomly allocated to receive 1 of 3 interventions as follows: Group 1, 38\% SDF; Group 2, 5\% NaF varnish; and Group 3, placebo control (tonic water). The intervention and dental examination will be carried out every 6 months. A parent-administered questionnaire, including the children's demographic background and oral health--related behaviors, has been collected at baseline. Follow-up examinations to detect new caries development will be conducted every 6 months by a masked examiner. Caries development will be diagnosed at the cavitation level. Chi-square tests and logistic regression analyses will be adopted. A 2-level logistic regression analysis will be performed to investigate the effects of the study interventions and other potential confounding factors on the development of occlusal caries. Results: This study was started on September 1, 2020, and the recruitment process ended on September 30, 2021. At present, a total of 791 children are participating in the study. This 30-month clinical trial is expected to be completed in March 2024. Conclusions: If SDF application is more effective than NaF varnish for preventing caries on occlusal surfaces of primary teeth, it can be a preferred choice for caries prevention in a kindergarten-based program. Results of this trial will provide valuable clinical evidence for the development of oral health strategies and policies on the promotion of child oral health. Trial Registration: HKU Clinical Registry HKUCTR-2844, https://tinyurl.com/bdhz9yuk; ClinicalTrials.gov NCT05084001, https://clinicaltrials.gov/ct2/show/NCT05084001 International Registered Report Identifier (IRRID): DERR1-10.2196/35145 ",
doi="10.2196/35145",
url="https://www.researchprotocols.org/2022/5/e35145",
url="http://www.ncbi.nlm.nih.gov/pubmed/35604758"
}


@Article{info:doi/10.2196/38508,
author="Taramarcaz, Victor
and Herren, Tara
and Golay, Eric
and Regard, Simon
and Martin-Achard, S{\'e}bastien
and Mach, Francois
and Schnetzler, Nicolas
and Ricci, Ga{\"e}tan
and Zamberg, Ido
and Larribau, Robert
and Niquille, Marc
and Suppan, M{\'e}lanie
and Schiffer, Eduardo
and Suppan, Laurent",
title="A Short Intervention and an Interactive e-Learning Module to Motivate Medical and Dental Students to Enlist as First Responders: Implementation Study",
journal="J Med Internet Res",
year="2022",
month="May",
day="18",
volume="24",
number="5",
pages="e38508",
keywords="basic life support",
keywords="cardiopulmonary resuscitation",
keywords="first responder",
keywords="undergraduate medical education",
keywords="out-of-hospital cardiac arrest",
keywords="medical education",
keywords="e-learning",
keywords="digital education",
keywords="medical student",
keywords="blended learning",
abstract="Background: Prompt and proficient basic life support (BLS) maneuvers are essential to increasing the odds of survival after out-of-hospital cardiac arrest. However, significant time can elapse before the arrival of professional rescuers. To decrease these delays, many countries have developed first responder networks. These networks are composed of BLS-certified lay or professional rescuers who can be dispatched by emergency medical communication centers to take care of those who experience out-of-hospital cardiac arrest. Many systems are, however, limited by a relatively low number of active first responders, and first-year medical and dental students may represent an almost untapped pool of potential rescuers. On top of providing an enhanced BLS coverage to the population, this could also help medical students be better prepared to their future role as certified health care providers and address societal expectations regarding health care students. Objective: Our objective was to describe the impact of a short motivational intervention followed by a blended BLS course (e-learning and practice session) designed to motivate first-year medical and dental students to enlist as first responders. Methods: A short, web-based, motivational intervention presenting this project took place, and first-year University of Geneva, Faculty of Medicine students were provided with a link to the study platform. Those who agreed to participate were redirected to a demographic questionnaire before registering on the platform. The participants were then asked to answer a second questionnaire designed to determine their baseline knowledge prior to following an interactive e-learning module. Upon completion, a web-based booking form enabling them to register for a 1-hour practice session was displayed. These sessions were held by senior medical students who had been trained and certified as BLS instructors. The participants who attended these practice sessions were asked to answer a postcourse questionnaire before receiving the certificate enabling them to register as first responders. Results: Out of the 529 first-year students registered at University of Geneva, Faculty of Medicine on January 14, 2021, 190 (35.9\%) initially agreed to participate. Moreover, 102 (19.3\%) attended the practice sessions, and 48 (9.1\%) had completed all training and enlisted as first responders on the dedicated platform, Save a Life, at 6 months (July 14, 2021). Postcourse confidence in resuscitation skills was associated with a higher likelihood of registering as first responder (P=.03). No association was found between prior BLS knowledge and the probability of registering to a practice session (P=.59), of obtaining a course completion certificate (P=.29), or of enlisting as first responder (P=.56). Conclusions: This study shows that a motivational intervention associated with a short BLS course can convince medical students to enlist as first responders. Further studies are needed to understand the rather low proportion of medical students finally registering as first responders. International Registered Report Identifier (IRRID): RR2-10.2196/24664 ",
doi="10.2196/38508",
url="https://www.jmir.org/2022/5/e38508",
url="http://www.ncbi.nlm.nih.gov/pubmed/35583927"
}


@Article{info:doi/10.2196/35533,
author="Kakei, Yasumasa
and Ioroi, Takeshi
and Ito, Takahiro
and Okazaki, Yutaro
and Hasegawa, Takumi
and Yano, Ikuko
and Akashi, Masaya",
title="Efficacy of Ibuprofen Gargle for Postoperative Pain After Mandibular Third Molar Extraction: Protocol for a Phase II, Placebo-Controlled, Double-Blind, Randomized Crossover Trial",
journal="JMIR Res Protoc",
year="2022",
month="May",
day="16",
volume="11",
number="5",
pages="e35533",
keywords="protocol",
keywords="phase II",
keywords="placebo-controlled",
keywords="double-blind",
keywords="randomized crossover trial",
keywords="mandibular third molar extraction",
keywords="pain management",
keywords="ibuprofen",
keywords="gargle",
abstract="Background: Extraction of mandibular third molars is one of the most commonly performed oral surgical procedures, and nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain management. Oral NSAIDs are associated with adverse events such as gastrointestinal disorders, renal and hepatic dysfunction, and platelet dysfunction. Topical analgesics have been proposed as alternatives to oral and injectable medications to safely improve postoperative pain relief. We will conduct a single-center, placebo-controlled, double-blind, randomized crossover trial to assess the pain-relieving effect of an ibuprofen-containing gargle in patients undergoing extraction of mandibular third molars when compared with a placebo gargle. Objective: This will be the first clinical study to compare the efficacy of an ibuprofen gargle with that of a placebo for relieving postoperative pain in addition to loxoprofen after mandibular third molar extraction. Methods: This study will be performed at Kobe University Hospital. Participants (N=40) will be randomized equally to 1 of 2 groups. The ibuprofen-placebo group will receive an ibuprofen gargle on postoperative day (POD) 1 and a placebo gargle on POD 2. The placebo-ibuprofen group will receive a placebo gargle on POD 1 and an ibuprofen gargle on POD 2. Both groups will receive ibuprofen gargles on PODs 3-5 at least once daily. The primary objective is to estimate the within-subject difference on a visual analog scale (VAS) before and 5 minutes after using the ibuprofen or placebo gargle on PODs 1 and 2. The secondary objectives are to estimate the within-subject differences in $\Delta$VAS before and 15 minutes after using the ibuprofen or placebo gargle on PODs 1 and 2, $\Delta$VAS before and 5 or 15 minutes after using the ibuprofen gargle on PODs 3-5, overall efficacy (self-completion, 5 scales) on PODs 1-5, daily frequency of use (ibuprofen or placebo gargle and analgesics) on PODs 1-7, and the occurrence of adverse events. Results: The Certified Review Board of Kobe University approved the study. The intervention was implemented in May 2021. For the primary analysis, we will calculate the mean and SD of $\Delta$VAS5 on PODs 1 and 2 and the within-study difference in $\Delta$VAS5. The treatment effect will be estimated by dividing the mean $\Delta$VAS5 in the within-subject difference by 2 and calculating the P value using an unpaired t test. For the secondary analysis, we will calculate the mean and SD of $\Delta$VAS15 on PODs 1 and 2 and the within-study difference in $\Delta$VAS15. The treatment effect will be estimated as in the primary analysis. Conclusions: This trial will provide exploratory evidence of the efficacy and safety of an ibuprofen gargle for pain reduction after mandibular third molar extraction. Trial Registration: Japan Registry of Clinical Trials jRCTs051210022; https://tinyurl.com/39ej23zu International Registered Report Identifier (IRRID): DERR1-10.2196/35533 ",
doi="10.2196/35533",
url="https://www.researchprotocols.org/2022/5/e35533",
url="http://www.ncbi.nlm.nih.gov/pubmed/35459640"
}


@Article{info:doi/10.2196/33552,
author="El Tantawi, Maha
and Folayan, O. Morenike
and Bhayat, Ahmed",
title="Oral Health Status and Practices, and Anthropometric Measurements of Preschool Children: Protocol for a Multi-African Country Survey",
journal="JMIR Res Protoc",
year="2022",
month="Apr",
day="27",
volume="11",
number="4",
pages="e33552",
keywords="oral health",
keywords="early childhood caries",
keywords="oral hygiene",
keywords="dietary intake",
keywords="Africa",
keywords="preschool children",
keywords="dentistry",
keywords="oral disease",
abstract="Background: Oral diseases are among the most prevalent conditions with significant impact on the growth and development of young children. Data are required to plan effectively for the management of early childhood caries (ECC) and other oral diseases in this age. There are currently very few African countries with updated and nationally representative data on ECC prevalence, and risk indicators and regional data on ECC and other oral diseases are scarce. Objective: We aim to determine the oral health status and practices, dietary intake, and anthropometric measurements of preschool children in several African countries. Methods: A cross-sectional study will be conducted in several African countries using a standardized questionnaire and clinical examination for data collection from healthy preschool children in kindergartens and primary health care facilities. The clinical examination will assess ECC using the decayed, missing due to caries, and filled teeth (dmft) index according to the World Health Organization (WHO) criteria, dental erosion (using the Basic Erosive Wear Examination Index), deciduous molar hypomineralization (using the European Association of Paediatric Dentistry criteria), dental fluorosis (using Dean's Index), oral hygiene status (using the Oral Hygiene Index Simplified), and oral mucosal lesions. Oral hygiene habits and dental visits will be assessed using the WHO child questionnaire, and dietary intake will be assessed using the Food and Agriculture Organization method. Anthropometric measurements will be obtained following the International Society for the Advancement of Kinanthropometry standard protocol, and the children's nutritional status will be assessed following the WHO child growth standards. To train and calibrate examiners, educational resources and electronic forms will be used to reach interexaminer and intraexaminer reliability with $\kappa$>0.6. Descriptive analysis will determine the prevalence of clinical conditions by age and sex. Bivariate analysis and multivariable regression will assess associations between the clinical conditions and sociodemographic factors, and oral health behaviors. Results: Data collection will begin after approvals and ethical clearance are obtained. The first stage will include 3 countries, namely Egypt, Nigeria, and South Africa, and collaborators from other African countries will join afterward. Conclusions: This study will lay down the foundations for using validated tools to collect data on the oral health of young children in Africa, allowing researchers from different countries across Africa to collect standardized data on ECC and other oral conditions. This will facilitate comparisons and analysis of risk factors that might be unique to the African continent. The results will provide baseline data on the prevalence of oral diseases and enable planning to address the treatment needs of young African children and design programs to prevent oral diseases in the African continent. International Registered Report Identifier (IRRID): PRR1-10.2196/33552 ",
doi="10.2196/33552",
url="https://www.researchprotocols.org/2022/4/e33552",
url="http://www.ncbi.nlm.nih.gov/pubmed/35476047"
}


@Article{info:doi/10.2196/35415,
author="Aminabadi, Asl Naser
and Golsanamlou, Ozra
and Halimi, Zohreh
and Jamali, Zahra",
title="Assessing the Different Levels of Virtual Reality That Influence Anxiety, Behavior, and Oral Health Status in Preschool Children: Randomized Controlled Clinical Trial",
journal="JMIR Perioper Med",
year="2022",
month="Apr",
day="18",
volume="5",
number="1",
pages="e35415",
keywords="virtual reality",
keywords="anxiety",
keywords="behavior",
keywords="oral health training",
abstract="Background: Compared with a traditional behavior management strategy and oral health training, virtual reality (VR) integrated with multisensory feedback possesses potential advantages in dentistry. Objective: This study aimed to assess the impact of different levels of VR on anxiety, behavior, and oral health status. Methods: This study was carried out in the Department of Pediatric Dentistry at the Tabriz University of Medical Sciences from December 2020 to June 2021. We randomly assigned 60 healthy children aged 4 years to 6 years to 4 groups, each consisting of 15 children. The study consisted of 2 consecutive sessions. During the first visit, the plaque index was calculated, and oral health education was carried out in all groups using Immersive VR (group I), Semi-immersive VR (group II), Nonimmersive VR (group III), and tell-show-do (TSD; group IV). In the second session, an amalgam restoration was performed in all groups. Participants' anxiety and behavior were recorded using the face version of the Modified Child Dental Anxiety Scale (MCDAS[f]) and Frankl scale. The plaque index was recorded in 2 follow-up sessions. Results: The greatest prevalence of positive behavior (P=.004) and the lowest anxiety (P<.001) were recorded in group I, followed by group II, group III, and group IV. The plaque index scores showed a reduced trend between the first session and follow-up sessions (P<.001), but the values did not differ significantly between the 4 groups during the 3 sessions (P=.28, P=.54, P=.18). Conclusions: The most positive behavior was observed in the Immersive VR group, followed by the Semi-immersive VR, Nonimmersive VR, and TSD groups. Moreover, oral health education using VR resources can improve oral health status in children. Trial Registration: Iranian Registry of Clinical Trials 20210103049926N1; https://www.irct.ir/trial/53475 ",
doi="10.2196/35415",
url="https://periop.jmir.org/2022/1/e35415",
url="http://www.ncbi.nlm.nih.gov/pubmed/35436233"
}


@Article{info:doi/10.2196/37200,
author="Cunha-Cruz, Joana
and Ko, K. Linda
and Mancl, Lloyd
and Rothen, L. Marilynn
and Harter, Catherine
and Davis, Stephen
and Koday, Mark",
title="Home Delivery of Water for Caries Prevention in Latinx Children (``Sediento por una Sonrisa,'' Thirsty for a Smile): Protocol for a Single-Arm Feasibility Study",
journal="JMIR Res Protoc",
year="2022",
month="Apr",
day="15",
volume="11",
number="4",
pages="e37200",
keywords="dental caries",
keywords="behavioral intervention",
keywords="environmental restructuring",
keywords="practice-based research",
keywords="sugar consumption",
keywords="feasibility",
keywords="water consumption",
keywords="nutrition",
keywords="oral health",
keywords="Latino (a) health",
keywords="dental health",
keywords="dentistry",
keywords="dental",
keywords="public health",
abstract="Background: Dental caries has significant public health implications afflicting young children. In addition to low social economic status, the most prominent risk factor for early childhood caries is sugar in the diet, particularly sugar-sweetened beverages. Dental treatment for caries in young children is commonly performed under general anesthesia and a significant proportion of children require repeated treatment. Interventions to reduce sugar-sweetened beverage consumption could lead to reduced rates of retreatment for dental caries in young children. Objective: This protocol describes the rationale, design, and methods of the ``Thirsty for a Smile'' feasibility study. The aim of the study is to assess the feasibility, acceptability, and appropriateness of a dietary intervention promoting water consumption in lieu of sugar-sweetened beverages among young patients, mostly from Latino heritage. Methods: This protocol describes a single-arm feasibility study. Twenty-one dyads of children and their caregivers will be recruited. Children between 2 and 9 years old who recently had treatment under general anesthesia for early childhood dental caries will be eligible to participate. The intervention has two components: (1) environmental, in which bottled water is delivered to participants' homes; and (2) behavioral, in which caregivers will receive patient-centered counseling to increase children's water intake and reduce sugar-sweetened beverages consumption. Dental caries and anthropometric data will be collected at examination during baseline and final visits. The primary outcome is feasibility and secondary outcomes are acceptability and appropriateness of the intervention. Results: Funding has been obtained from the National Institute of Dental and Craniofacial Research and the University of Washington approved the study. The feasibility study was conducted from March to November 2019. Conclusions: This feasibility study will test the study processes prior to a two-arm randomized controlled trial to determine feasibility and acceptability of the intervention and study procedures. This study may provide useful information for other researchers attempting to test similar interventions. International Registered Report Identifier (IRRID): RR1-10.2196/37200 ",
doi="10.2196/37200",
url="https://www.researchprotocols.org/2022/4/e37200",
url="http://www.ncbi.nlm.nih.gov/pubmed/35436235"
}


@Article{info:doi/10.2196/30653,
author="Li, Yaning
and Ye, Hongqiang
and Wu, Siyu
and Zhao, Xiaohan
and Liu, Yunsong
and Lv, Longwei
and Zhang, Ping
and Zhang, Xiao
and Zhou, Yongsheng",
title="Mixed Reality and Haptic--Based Dental Simulator for Tooth Preparation: Research, Development, and Preliminary Evaluation",
journal="JMIR Serious Games",
year="2022",
month="Mar",
day="9",
volume="10",
number="1",
pages="e30653",
keywords="dental education",
keywords="simulator",
keywords="mixed reality",
keywords="tooth preparation",
abstract="Background: Virtual reality (VR) dental simulators are currently used in preclinical skills training. However, with the development of extended reality technologies, the use of mixed reality (MR) has shown significant advantages over VR. Objective: This study aimed to describe the research and development of a newly developed MR and haptic--based dental simulator for tooth preparation and to conduct a preliminary evaluation of its face validity. Methods: A prototype of the MR dental simulator for tooth preparation was developed by integrating a head-mounted display (HMD), special force feedback handles, a foot pedal, computer hardware, and software program. We recruited 34 participants and divided them into the Novice group (n=17) and Skilled group (n=17) based on their clinical experience. All participants prepared a maxillary right central incisor for an all-ceramic crown in the dental simulator, completed a questionnaire afterward about their simulation experience, and evaluated hardware and software aspects of the dental simulator. Results: Of the participants, 74\% (25/34) were satisfied with the overall experience of using the Unidental MR Simulator. Approximately 90\% (31/34, 91\%) agreed that it could stimulate their interest in learning, and 82\% (28/34) were willing to use it for skills training in the future. Differences between the 2 study groups in their experience with the HMD (resolution: P=.95; wearing comfort: P=.10), dental instruments (P=.95), force feedback of the tooth (P=.08), simulation of the tooth preparation process (P=.79), overall experience with the simulation (P=.47), and attitude toward the simulator (improves skills: P=.47; suitable for learning: P=.36; willing to use: P=.89; inspiring for learning: P=.63) were not significant. The Novice group was more satisfied with the simulator's ease of use (P=.04). There were significant positive correlations between the overall experience with the simulation and the HMD's resolution (P=.03) and simulation of the preparation process (P=.001). Conclusions: The newly developed Unidental MR Simulator for tooth preparation has good face validity. It can achieve a higher degree of resemblance to the real clinical treatment environment by improving the positional adjustment of the simulated patients, for a better training experience in dental skills. ",
doi="10.2196/30653",
url="https://games.jmir.org/2022/1/e30653",
url="http://www.ncbi.nlm.nih.gov/pubmed/35262501"
}


@Article{info:doi/10.2196/27843,
author="Mendon{\c{c}}a, L. Fernanda
and Regnault, Campli Fabiana Giuseppina Di
and Di Leone, L. Camilla C.
and Grizzo, C. Isabella
and Bisaia, Aliny
and Fragelli, Camila
and Oliveira, M. Thais
and Magalh{\~a}es, C. Ana
and Rios, Daniela",
title="Sensitivity Treatments for Teeth with Molar Incisor Hypomineralization: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2022",
month="Jan",
day="6",
volume="11",
number="1",
pages="e27843",
keywords="sensitivity",
keywords="molar incisor hypomineralization",
keywords="fluoride",
keywords="dentistry",
keywords="pediatric dentistry",
keywords="dental care",
abstract="Background: The sensitivity of teeth with molar incisor hypomineralization (MIH) can affect children's quality of life and is a challenging problem for dentists. Remineralizing agents such as sodium fluoride varnish seem to reduce the sensitivity of teeth with MIH, but long-term clinical trials with large samples are still needed for more evidence about its effectiveness as a desensitizing agent before its clinical recommendation. Objective: This randomized clinical trial aims to compare three treatment interventions for teeth with MIH and hypersensitivity. Methods: A total of 60 children aged 6-10 years presenting with at least one first permanent molar with sensitivity and no loss of enamel will be randomly assigned to three groups: the control group (sodium fluoride varnish; Duraphat, Colgate); experimental group I (4\% titanium tetrafluoride varnish); and experimental group II (a coating resin containing surface prereacted glass-ionomer filler; PRG Barrier Coat, Shofu). The sodium fluoride varnish and 4\% titanium tetrafluoride varnish will be applied once per week for 4 consecutive weeks and the PRG Barrier Coat resin will be applied in the first session and the application will be simulated the following 3 weeks to guarantee the blinding of the study. The primary outcome will be sensitivity level measured at different moments (before each material application, immediately after application or simulation, and 1, 2, 4, and 6 months after the last application/simulation) by one examiner using the Wong-Baker FACES Pain Rating Scale, the Schiff Cold Air Sensitivity Scale, and the FLACC (Face, Legs, Activity, Cry, Consolability) scale. As secondary outcomes, parental satisfaction and child self-reported discomfort after the treatment will be measured with a questionnaire prepared by the researcher. The data will undergo statistical analysis and the significance level will be set at 5\%. Results: The project was funded in 2018, and enrollment was completed in November 2019. The recruitment of participants is currently underway and the first results are expected to be submitted for publication in 2022. Conclusions: If found effective in reducing the patient's sensitivity long term, these agents can be considered as a treatment choice, and the findings will contribute to the development of a treatment protocol for teeth with sensitivity due to MIH. Trial Registration: Brazilian Registry of Clinical Trials Universal Trial Number U1111-1237-6720; https://tinyurl.com/mr4x82k9 International Registered Report Identifier (IRRID): DERR1-10.2196/27843 ",
doi="10.2196/27843",
url="https://www.researchprotocols.org/2022/1/e27843",
url="http://www.ncbi.nlm.nih.gov/pubmed/34989687"
}


@Article{info:doi/10.2196/31852,
author="Krishna, Meenakshi
and Sybil, Deborah
and Shrivastava, Kumar Priyanshu
and Premchandani, Shubhangi
and Kumar, Himanshu
and Kumar, Pintu",
title="An Innovative App (ExoDont) for Postoperative Care of Patients After Tooth Extraction: Prototype Development and Testing Study",
journal="JMIR Perioper Med",
year="2021",
month="Dec",
day="31",
volume="4",
number="2",
pages="e31852",
keywords="ExoDont",
keywords="Android app",
keywords="teledentistry",
keywords="mHealth",
keywords="tooth extraction",
keywords="postoperative",
keywords="dentistry",
keywords="dentist",
keywords="teeth",
keywords="dental surgery",
keywords="oral surgery",
abstract="Background: The postoperative period is crucial for the initiation of healing and prevention of complications after any surgical procedure. Due to factors such as poor compliance, comprehension, and retention of instructions, and other unaccounted factors, the objectives of postoperative care are not always achieved. Therefore, an Android-based mobile health app (ExoDont) was developed to ensure a smooth postoperative period for patients after a dental extraction. The ExoDont app delivers reminders for postoperative instructions and drug intake at defined intervals, thus fostering self-reliance among patients in taking their prescribed dose of medication. Objective: The aim of this study is to design, develop, and validate ExoDont, an innovative app for improved adherence to postoperative instructions after tooth extraction. Methods: A postoperative treatment protocol was developed by a team of oral and maxillofacial surgeons and general dentists, following which the clinical and technological requirements of the app were determined along with the software engineers, graphic designers, and applications architect in the team. ExoDont was developed to provide timely reminders for medication and postoperative care. The app was field tested and validated using the User Version of the Mobile Application Rating Scale. Results: The ExoDont software design was divided into a 3-level architecture comprising a user interface application, logical layer, and database layer. The software architecture consists of an Android-based ExoDont app for patients and a web version of the admin panel. The testing and validation of the ExoDont app revealed that Perceived Impact received the highest mean score of all rated components (mean 4.6, SD 0.5), while Engagement received the lowest mean score (mean 3.5, SD 0.8). Conclusions: The testing and validation of the app support its usability and functionality, as well as its impact on users. The ExoDont app has been designed, keeping the welfare of patients in view, in a user-friendly manner that will help patients adhere to the prescribed drug regimen and ensure easy and efficient dissemination of postoperative instructions. It could play an instrumental role in fostering compliance among patients and significantly decrease the complication rate following dental extractions. ",
doi="10.2196/31852",
url="https://periop.jmir.org/2021/2/e31852",
url="http://www.ncbi.nlm.nih.gov/pubmed/34982720"
}


@Article{info:doi/10.2196/33104,
author="Sreekumar, Saranya
and Janakiram, Chandrashekar
and Mathew, Anil",
title="Effects of Prosthetic Rehabilitation on Temporomandibular Disorders: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2021",
month="Dec",
day="24",
volume="10",
number="12",
pages="e33104",
keywords="orofacial pain",
keywords="joint pain",
keywords="prosthesis, edentulism",
keywords="TMD",
keywords="temporomandibular disorder",
keywords="prosthetic rehabilitation",
abstract="Background: Loss of teeth or occlusal imbalance is one of the proposed dental risk factors for temporomandibular disorders (TMDs). Losing some non--free-end teeth cause the original occluding tooth/teeth to supraerupt from the original upright position and causes neighboring tooth/teeth to shift in an angle, causing biomechanical imbalance on the mandible. Based on these sequelae, rehabilitation of missing teeth is the first step in managing TMD in edentulous patients. Even though the prevalence of TMD in association with edentulism and in rehabilitated patients has been increasing, proper guidelines for the management of such cases have not been established. This study describes the protocol to analyze the effect of prosthetic rehabilitation on patients with TMD. Objective: This study aims to determine the effectiveness of prosthetic rehabilitation in the reduction of pain in edentulous patients with TMD and to determine the effect of the span of edentulism, the number of quadrants involved, pathological migration, the type of Kennedy classification, and the prosthetic status on temporomandibular joint dysfunction signs and symptoms. Methods: In this randomized controlled trial, 300 patients diagnosed with TMD will be grouped into one of the three interventional groups based on the type of their edentulous state. The interventional groups are (1) partially edentulous arch: Kennedy Class I and II (prosthetic rehabilitation without splint); (2) partially edentulous arch: Kennedy Class III and IV (prosthetic rehabilitation with a splint); and (3) completely edentulous arches (prosthetic rehabilitation without splint). All three of the mentioned interventional groups have corresponding control groups that will receive symptomatic treatment and comprehensive counseling. The measured primary outcomes are pain and electromyogram, and the secondary outcomes include pain drawing, Graded Chronic Pain Scale, Jaw Functional Limitation Scale, Oral Behaviours Checklist, depression, physical symptoms, and anxiety. The outcome measurements will be recorded at baseline and at the end of 24 hours, 7 days, 28 days, and 3 months. Results: Ethical approval was obtained from the Institutional Review Board of Amrita Institute of Medical Sciences, Kochi, India. Study participants' recruitment began in May 2021 and is expected to conclude in March 2023. This clinical trial protocol was developed based on the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013 Statement. Conclusions: The purpose of this study is to gather data on prosthetic rehabilitation as a treatment for TMD. Obtaining this goal will aid in the development of evidence-based therapy protocols for prosthetic rehabilitation in TMD management. Trial Registration: Clinical Trials Registry - India CTRI/2020/06/026169; http://ctri.nic.in/Clinicaltrials/pdf\_generate.php?trialid=42381 International Registered Report Identifier (IRRID): DERR1-10.2196/33104 ",
doi="10.2196/33104",
url="https://www.researchprotocols.org/2021/12/e33104",
url="http://www.ncbi.nlm.nih.gov/pubmed/34951603"
}


@Article{info:doi/10.2196/33677,
author="Hazenberg, L. Hanna M. J.
and Dubbink, Henk Jan
and Sesay, Issa
and Versteege, Tom
and Bangura, Hassan
and Hoevenaars, K. Louise
and Falama, M. Abdul
and Koudijs, M. Heleen
and Roemers, Rosa
and Bache, B. Emmanuel
and Kelling, F. Emil
and Schaumburg, Frieder
and Spijkervet, L. Fred K.
and Grobusch, P. Martin",
title="Complicated Odontogenic Infections at 2 District Hospitals in Tonkolili District, Sierra Leone: Protocol for a Prospective Observational Cohort Study (DELAY)",
journal="JMIR Res Protoc",
year="2021",
month="Dec",
day="13",
volume="10",
number="12",
pages="e33677",
keywords="complicated odontogenic infection",
keywords="dental abscess",
keywords="deep neck space infection",
keywords="Ludwig angina",
keywords="necrotizing fasciitis",
keywords="prospective observational cohort study",
abstract="Background: Deficits in global oral health care are paramount, and complications of odontogenic infections constitute a considerable global health problem, particularly in low-income countries. A high mortality rate has been observed for patients who have been admitted with complicated odontogenic infections to our facilities in Tonkolili District, Sierra Leone, although exact data have not been published yet. Data regarding who in this region is at risk and why are lacking. Objective: The Dental Abscess Study (DELAY) aims to prospectively investigate morbidity and mortality from complicated dental abscesses and to analyze patients' characteristics and microbial findings to examine predisposing factors for poor outcomes. In particular, the incidence and the clinical and microbial characteristics of complicated odontogenic infections, as well as the sociodemographic data and comorbidities of affected patients, will be studied to develop improved management algorithms based on circumstance-specific factors. Methods: Patients who present with complicated dental infections requiring hospital admission in Masanga Hospital or Lion Heart Medical Centre will be consecutively selected for possible inclusion in the study (starting on September 4, 2021) over a study period of 1 year, and individual routine follow-ups will be conducted at least 3 months after discharge. The results of standardized questionnaires will be obtained, and clinical measurements as well as medical photos will be taken. Standard laboratory tests (eg, full blood count and HIV status tests) will be performed, and pus specimens will be examined. Local treatment guidelines will be adhered to, and data on medical and surgical treatment as well as data on outcomes will be collected. The study results will be reported according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) criteria. Routine follow-ups will take place at 1 and 3 months postdischarge. Results: The DELAY protocol was endorsed by the Masanga Medical Research Unit's Scientific Review Committee on June 16, 2021, and ethical approval was granted on July 5, 2021, by the Sierra Leone National Ethics Committee. The funding of the budgeted study costs was approved by Dental Health International Netherlands in August 2021. The projected start date of data collection was September 4, 2021, and the study period will most likely last for 1 year. As such, data collection is expected to be complete in November 2022. Conclusions: The aim of our prospective observational cohort study is to gain more knowledge about complicated odontogenic infections in Tonkolili District, Sierra Leone, to further improve treatment strategies. International Registered Report Identifier (IRRID): DERR1-10.2196/33677 ",
doi="10.2196/33677",
url="https://www.researchprotocols.org/2021/12/e33677",
url="http://www.ncbi.nlm.nih.gov/pubmed/34898462"
}


@Article{info:doi/10.2196/29702,
author="Roomaney, A. Imaan
and Kabbashi, Salma
and Chetty, Manogari",
title="Enamel Renal Syndrome: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2021",
month="Nov",
day="30",
volume="10",
number="11",
pages="e29702",
keywords="enamel renal syndrome",
keywords="amelogenesis imperfecta",
keywords="gingival fibromatosis",
keywords="FAM20A gene",
keywords="nephrocalcinosis",
keywords="dentistry",
keywords="failed tooth eruption",
keywords="scoping review",
keywords="dentist",
keywords="renal evaluation",
keywords="oral rehabilitation",
keywords="quality of life",
keywords="rare conditions",
keywords="pathophysiology",
keywords="dental perspective",
abstract="Background: Enamel renal syndrome (ERS) (OMIM 204690) is a rare autosomal recessive disorder characterized by hypoplastic amelogenesis imperfecta, failed tooth eruption, intrapulpal calcifications, gingival enlargement, and nephrocalcinosis. The rarity of the condition and the variability of the phenotype has led to ERS not being fully characterized. Objective: This scoping review aims to account for the range and current state of knowledge on ERS and synthesize these findings into a comprehensive summary, focusing on the pathophysiology, genotype-phenotype correlations, and patient management from a dental perspective. Methods: The authors will conduct a systematic search of PubMed (MEDLINE), BioMed Central, EbscoHost Web, Web of Science, and WorldCat. We will include all studies with human participants with a confirmed diagnosis of ERS. Articles will be screened in two stages (ie, initially by title and abstract screening and then full-text screening by two independent reviewers). Data extraction will be conducted using a customized electronic data extraction form. We will provide a narrative synthesis of the findings from the included studies. We will structure the results according to themes. Results: This protocol is registered with the Open Science Framework. The electronic search was conducted in July 2020 and updated in April 2021. The research findings will be published in an open access journal. Conclusions: Dentists should be able to identify patients with clinical features of ERS so that they receive appropriate referrals for renal evaluation, genetic counseling, and oral rehabilitation to increase the patient's quality of life. A scoping review is the most appropriate method to conduct this comprehensive exploration of the current evidence, which may be sparse due to the rarity of the condition. It will also enable us to identify gaps in the research. Trial Registration: Open Science Framework; https://osf.io/cghsa International Registered Report Identifier (IRRID): DERR1-10.2196/29702 ",
doi="10.2196/29702",
url="https://www.researchprotocols.org/2021/11/e29702",
url="http://www.ncbi.nlm.nih.gov/pubmed/34851300"
}


@Article{info:doi/10.2196/32345,
author="Xiao, Jin
and Meyerowitz, Cyril
and Ragusa, Patricia
and Funkhouser, Kimberly
and Lischka, R. Tamara
and Mendez Chagoya, Alberto Luis
and Al Jallad, Nisreen
and Wu, Tong Tong
and Fiscella, Kevin
and Ivie, Eden
and Strange, Michelle
and Collins, Jamie
and Kopycka-Kedzierawski, T. Dorota
and ",
title="Assessment of an Innovative Mobile Dentistry eHygiene Model Amid the COVID-19 Pandemic in the National Dental Practice--Based Research Network: Protocol for Design, Implementation, and Usability Testing",
journal="JMIR Res Protoc",
year="2021",
month="Oct",
day="26",
volume="10",
number="10",
pages="e32345",
keywords="teledentistry",
keywords="mDentistry",
keywords="oral diseases",
keywords="virtual visit",
keywords="intraoral camera",
keywords="pandemic response",
keywords="COVID-19",
keywords="mHealth",
abstract="Background: Amid COVID-19, and other possible future infectious disease pandemics, dentistry needs to consider modified dental examination regimens that render quality care, are cost effective, and ensure the safety of patients and dental health care personnel (DHCP). Traditional dental examinations, which number more than 300 million per year in the United States, rely on person-to-person tactile examinations, pose challenges to infection control, and consume large quantities of advanced-level personal protective equipment (PPE). Therefore, our long-term goal is to develop an innovative mobile dentistry (mDent) model that takes these issues into account. This model supplements the traditional dental practice with virtual visits, supported by mobile devices such as mobile telephones, tablets, and wireless infrastructure. The mDent model leverages the advantages of digital mobile health (mHealth) tools such as intraoral cameras to deliver virtual oral examinations, treatment planning, and interactive oral health management, on a broad population basis. Conversion of the traditional dental examinations to mDent virtual examinations builds upon (1) the reliability of teledentistry, which uses intraoral photos and live videos to make diagnostic decisions, and (2) rapid advancement in mHealth tool utilization. Objective: In this pilot project, we designed a 2-stage implementation study to assess 2 critical components of the mDent model: virtual hygiene examination (eHygiene) and patient self-taken intraoral photos (SELFIE). Our specific aims are to (1) assess the acceptance and barriers of mDent eHygiene among patients and DHCP, (2) assess the economic impact of mDent eHygiene, and (3) assess the patient's capability to generate intraoral photos using mHealth tools (exploratory aim, SELFIE). Methods: This study will access the rich resources of the National Dental Practice-Based Research Network to recruit 12 dentists, 12 hygienists, and 144 patients from 12 practices. For aims 1 and 2, we will use role-specific questionnaires to collect quantitative data on eHygiene acceptance and economic impact. The questionnaire components include participant characteristics, the System Usability Scale, a dentist-patient communication scale, practice operation cost, and patient opportunity cost. We will further conduct a series of iterative qualitative research activities using individual interviews to further elicit feedback and suggestion for changes to the mDent eHygiene model. For aim 3, we will use mixed methods (quantitative and qualitative) to assess the patient's capability of taking intraoral photos, by analyzing obtained photos and recorded videos. Results: The study is supported by the US National Institute of Dental and Craniofacial Research. This study received ``single'' institutional review board approval in August 2021. Data collection and analysis are expected to conclude by December 2021 and March 2022, respectively. Conclusions: The study results will inform the logistics of conducting virtual dental examinations and empowering patients with mHealth tools, providing better safety and preserving PPE amid the COVID-19 and possible future pandemics. International Registered Report Identifier (IRRID): PRR1-10.2196/32345 ",
doi="10.2196/32345",
url="https://www.researchprotocols.org/2021/10/e32345",
url="http://www.ncbi.nlm.nih.gov/pubmed/34597259"
}


@Article{info:doi/10.2196/32921,
author="Xiao, Jin
and Luo, Jiebo
and Ly-Mapes, Oriana
and Wu, Tong Tong
and Dye, Timothy
and Al Jallad, Nisreen
and Hao, Peirong
and Ruan, Jinlong
and Bullock, Sherita
and Fiscella, Kevin",
title="Assessing a Smartphone App (AICaries) That Uses Artificial Intelligence to Detect Dental Caries in Children and Provides Interactive Oral Health Education: Protocol for a Design and Usability Testing Study",
journal="JMIR Res Protoc",
year="2021",
month="Oct",
day="22",
volume="10",
number="10",
pages="e32921",
keywords="artificial intelligence",
keywords="smartphone app",
keywords="mDentistry",
keywords="dental caries",
keywords="underserved population",
keywords="mobile dentistry",
abstract="Background: Early childhood caries (ECC) is the most common chronic childhood disease, with nearly 1.8 billion new cases per year worldwide. ECC afflicts approximately 55\% of low-income and minority US preschool children, resulting in harmful short- and long-term effects on health and quality of life. Clinical evidence shows that caries is reversible if detected and addressed in its early stages. However, many low-income US children often have poor access to pediatric dental services. In this underserved group, dental caries is often diagnosed at a late stage when extensive restorative treatment is needed. With more than 85\% of lower-income Americans owning a smartphone, mobile health tools such as smartphone apps hold promise in achieving patient-driven early detection and risk control of ECC. Objective: This study aims to use a community-based participatory research strategy to refine and test the usability of an artificial intelligence--powered smartphone app, AICaries, to be used by children's parents/caregivers for dental caries detection in their children. Methods: Our previous work has led to the prototype of AICaries, which offers artificial intelligence--powered caries detection using photos of children's teeth taken by the parents' smartphones, interactive caries risk assessment, and personalized education on reducing children's ECC risk. This AICaries study will use a two-step qualitative study design to assess the feedback and usability of the app component and app flow, and whether parents can take photos of children's teeth on their own. Specifically, in step 1, we will conduct individual usability tests among 10 pairs of end users (parents with young children) to facilitate app module modification and fine-tuning using think aloud and instant data analysis strategies. In step 2, we will conduct unmoderated field testing for app feasibility and acceptability among 32 pairs of parents with their young children to assess the usability and acceptability of AICaries, including assessing the number/quality of teeth images taken by the parents for their children and parents' satisfaction. Results: The study is funded by the National Institute of Dental and Craniofacial Research, United States. This study received institutional review board approval and launched in August 2021. Data collection and analysis are expected to conclude by March 2022 and June 2022, respectively. Conclusions: Using AICaries, parents can use their regular smartphones to take photos of their children's teeth and detect ECC aided by AICaries so that they can actively seek treatment for their children at an early and reversible stage of ECC. Using AICaries, parents can also obtain essential knowledge on reducing their children's caries risk. Data from this study will support a future clinical trial that evaluates the real-world impact of using this smartphone app on early detection and prevention of ECC among low-income children. International Registered Report Identifier (IRRID): PRR1-10.2196/32921 ",
doi="10.2196/32921",
url="https://www.researchprotocols.org/2021/10/e32921",
url="http://www.ncbi.nlm.nih.gov/pubmed/34529582"
}


@Article{info:doi/10.2196/26125,
author="Tobias, Guy
and Sgan-Cohen, Harold
and Spanier, B. Assaf
and Mann, Jonathan",
title="Perceptions and Attitudes Toward the Use of a Mobile Health App for Remote Monitoring of Gingivitis and Willingness to Pay for Mobile Health Apps (Part 3): Mixed Methods Study",
journal="JMIR Form Res",
year="2021",
month="Oct",
day="5",
volume="5",
number="10",
pages="e26125",
keywords="mHealth",
keywords="public health",
keywords="oral health promotion",
keywords="gum health",
keywords="willingness to pay",
keywords="willingness to use",
keywords="willingness",
keywords="perception",
keywords="attitude",
keywords="mouth",
keywords="oral health",
keywords="dentist",
keywords="app",
keywords="monitoring",
keywords="mixed method",
abstract="Background: Gum infection, known as gingivitis, is a global issue. Gingivitis does not cause pain; however, if left untreated, it can worsen, leading to bad breath, bleeding gums, and even tooth loss, as the problem spreads to the underlying structures anchoring the teeth in the jaws. The asymptomatic nature of gingivitis leads people to postpone dental appointments until clinical signs are obvious or pain is evident. The COVID-19 pandemic has necessitated social distancing, which has caused many people to postpone dental visits and neglect gingival health. iGAM is a dental mobile health (mHealth) app that remotely monitors gum health, and an observational study demonstrated the ability of iGAM to reduce gingivitis. We found that a weekly dental selfie using the iGAM app reduced the signs of gingivitis and promoted oral health in a home-based setting. Objective: The aim of this mixed methods study is to assess perceptions, attitudes, willingness to pay, and willingness to use an mHealth app. Methods: The first qualitative phase of the study included eight semistructured interviews, and the second quantitative phase included data collected from responses to 121 questionnaires. Results: There was a consensus among all interviewees that apps dealing with health-related issues (mHealth apps) can improve health. Three themes emerged from the interviews: the iGAM app is capable of improving health, the lack of use of medical apps, and a contradiction between the objective state of health and the self-definition of being healthy. Participants were grouped according to how they responded to the question about whether they believed that mHealth apps could improve their health. Participants who believed that mHealth apps can enhance health (mean 1.96, SD 1.01) had a higher willingness to pay for the service (depending on price) than those who did not believe in app efficacy (mean 1.31, SD 0.87; t119=?2417; P=.02). A significant positive correlation was found between the amount a participant was willing to pay and the benefits offered by the app (rs=0.185; P=.04). Conclusions: Potential mHealth users will be willing to pay for app use depending on their perception of the app's ability to help them personally, provided they define themselves as currently unhealthy. ",
doi="10.2196/26125",
url="https://formative.jmir.org/2021/10/e26125",
url="http://www.ncbi.nlm.nih.gov/pubmed/34609320"
}


@Article{info:doi/10.2196/24955,
author="Tobias, Guy
and Spanier, B. Assaf",
title="Using an mHealth App (iGAM) to Reduce Gingivitis Remotely (Part 2): Prospective Observational Study",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Sep",
day="16",
volume="9",
number="9",
pages="e24955",
keywords="mHealth",
keywords="public health",
keywords="oral health promotion",
keywords="gum health",
keywords="COVID-19",
abstract="Background: Gingivitis is a nonpainful, inflammatory condition that can be managed at home. Left untreated, gingivitis can lead to tooth loss. Periodic dental examinations are important for early diagnosis and treatment of gum diseases. To contain the spread of the coronavirus, governments, including in Israel, have restricted movements of their citizens which might have caused routine dental checkups to be postponed. Objective: This study aimed to examine the ability of a mobile health app, iGAM, to reduce gingivitis, and to determine the most effective interval between photograph submissions. Methods: A prospective observational cohort study with 160 unpaid participants divided into 2 equal groups using the iGAM app was performed. The intervention group photographed their gums weekly for 8 weeks. The wait-list control group photographed their gums at the time of recruitment and 8 weeks later. After photo submission, the participants received the same message ``we recommended that you read the information in the app regarding oral hygiene habits.'' A single-blinded researcher examined all the images and scored them according to the Modified Gingival Index (MGI). Results: The average age of the intervention group was 26.77 (SD 7.43) and 28.53 (SD 10.44) for the wait-list control group. Most participants were male (intervention group: 56/75,74.7\%; wait-list control group: 34/51, 66.7\%) and described themselves as ``secular''; most were ``single'' non-smokers (intervention group: 56/75, 74.7\%; wait-list control group: 40/51, 78.4\%), and did not take medications (intervention group: 64/75, 85.3\%; wait-list control group: 40/51, 78.4\%). A total of 126 subjects completed the study. A statistically significant difference (P<.001) was found in the dependent variable (MGI). Improvements in gingival health were noted over time, and the average gingivitis scores were significantly lower in the intervention group (mean 1.16, SD 1.18) than in the wait-list control group (mean 2.16, SD 1.49) after 8 weeks. Those with more recent dental visits had a lower MGI (P=.04). No association was found between knowledge and behavior. Most participants were familiar with the recommendations for maintaining oral health, yet they only performed some of them. Conclusions: A dental selfie taken once a week using an mobile health app (iGAM) reduced the signs of gingivitis and promoted oral health. Selfies taken less frequently yielded poorer results. During the current pandemic, where social distancing recommendations may be causing people to avoid dental clinics, this app can remotely promote gum health. ",
doi="10.2196/24955",
url="https://mhealth.jmir.org/2021/9/e24955",
url="http://www.ncbi.nlm.nih.gov/pubmed/34528897"
}


@Article{info:doi/10.2196/29372,
author="Li, Li
and Liu, Xiaobin
and Chen, Zeyuan
and Wang, Liyuan
and Lian, Xiaoli
and Zou, Huiru",
title="The Application of a Case-Based Social Media--Assisted Teaching Method in Cariology Education?Comparative Study",
journal="J Med Internet Res",
year="2021",
month="Aug",
day="13",
volume="23",
number="8",
pages="e29372",
keywords="social media",
keywords="case-based learning",
keywords="cariology",
keywords="dental cavity preparation",
keywords="college students",
abstract="Background: Current cariology education based on the traditional teaching method faces a lot of challenges. Meanwhile, the COVID-19 pandemic caused an unprecedented disruption in medical education and health care systems worldwide. Innovation in the teaching mode of cariology education is required to change the situation. Objective: The goal of the research was to evaluate the application effects of a case-based social media--assisted teaching method in cariology education. Methods: Dental students of class 2019 were enrolled into the experimental group, while students of class 2018 served as control. A case-based social media--assisted teaching method was used in the experimental group, which included preclass activity via social media, additional discussion and practice process record in class, and questions and answers on the platform after class. The traditional teaching method, which consisted of conventional preparation before class, traditional lectures and demonstrations followed by students practice in class, and questions and answers step after class, was used in the control group. The teaching materials were the same in both groups. At the end of the program, students from both groups took cavity preparation skill evaluation tests. Questionnaires were tested on the case-based social media--assisted teaching group students anonymously. All data were analyzed using SPSS statistical software (version 22.0, IBM Corp). Results: The mean student cavity preparation skill evaluation scores was 82.51 (SD 6.82) in the experimental group and 77.19 (SD 5.98) in the control group (P<.05). The questionnaire response rate was 100\%. Of those, 94.3\% (100/106) of the students recommended the case-based social media--assisted teaching method in cariology education. The majority of the participants agreed that it helped them memorize the theoretical knowledge of cariology, facilitated in-depth discussion, improved their enthusiasm and initiative in learning, and enhanced the relationship between teachers and students (104/106, 98.1\%). They also recognized that the classroom atmosphere was active (94/106, 88.7\%). Conclusions: The case-based social media--assisted teaching method was beneficial in terms of learning, as demonstrated by the statistically significant improvement of the cavity preparation skill evaluation scores and satisfaction from attending students. This method could be used to supplement the teaching of cariology. ",
doi="10.2196/29372",
url="https://www.jmir.org/2021/8/e29372",
url="http://www.ncbi.nlm.nih.gov/pubmed/34397390"
}


@Article{info:doi/10.2196/25795,
author="Kimmie-Dhansay, Faheema
and Barrie, Robert
and Naidoo, Sudeshni
and Roberts, Sharon Tina",
title="Prevalence of Early Childhood Caries in South Africa: Protocol for a Systematic Review",
journal="JMIR Res Protoc",
year="2021",
month="Aug",
day="3",
volume="10",
number="8",
pages="e25795",
keywords="dmft",
keywords="prevalence",
keywords="dental caries",
keywords="South Africa",
keywords="early childhood caries",
abstract="Background: Young children are at the highest risk of developing dental caries as they have a lack of autonomy over their diet and oral hygiene practices. Dental caries develops over time due to demineralization of tooth substance (enamel), which results from acid production during sugar metabolism by bacteria. Early onset of dental caries often results in asymptomatic presentation, but if left untreated, it can result in severe pain, infection, and dentoalveolar abscesses. Early childhood caries (ECC) is defined as dental caries in children aged 6 years and younger and is a significant public health problem in South Africa. According to the Global Burden of Disease study, untreated dental caries of primary teeth affects 532 million children. Untreated dental caries has many detrimental effects which can affect the physical development and reduce the quality of life of affected children. Furthermore, long-term untreated dental caries can result in school absenteeism, low BMI, and poor educational outcomes. Objective: The purpose of this study was to determine the prevalence and severity of ECC in South Africa in children under the age of 6 years. Methods: All cross-sectional studies documenting the prevalence and severity of dental disease (decayed, missing, and filled teeth scores) will be included. Various databases will be searched for eligible studies. Only studies conducted on South African children aged 6 years and under will be included. There will be no restriction on the time or language of publication. The quality of all eligible studies will be analyzed by a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be conducted. Results: The protocol is registered with PROSPERO. The literature search was initially conducted in November 2018 and was repeated in November 2020. Conclusions: The results of this study will be used to advise stakeholders of the prevalence and severity of dental disease in children under 6 years of age in South Africa. Trial Registration: PROSPERO CRD42018112161;    International Registered Report Identifier (IRRID): DERR1-10.2196/25795 ",
doi="10.2196/25795",
url="https://www.researchprotocols.org/2021/8/e25795",
url="http://www.ncbi.nlm.nih.gov/pubmed/34342587"
}


@Article{info:doi/10.2196/27471,
author="Jeftha, Anthea
and Roberts, Tina
and Kimmie-Dhansay, Faheema",
title="The Effect of Periodontal Disease on Metabolic Control in Patients With Diabetes Mellitus in South Africa: Protocol for a Systematic Review",
journal="JMIR Res Protoc",
year="2021",
month="Jul",
day="22",
volume="10",
number="7",
pages="e27471",
keywords="periodontal disease",
keywords="periodontitis",
keywords="bleeding on probing, type 2 diabetes mellitus",
keywords="fasting glucose",
keywords="HbA1C",
keywords="South Africa",
abstract="Background: The increase in the prevalence of type 2 diabetes mellitus (T2DM) and its associated complications is burdensome to the South African health system. Understanding the role of comorbid diseases, such as periodontal disease (PD), and their effect on metabolic control in patients with DM in South Africa will raise awareness about the importance of periodontal interventions among patients with DM in South Africa. Objective: The review will aim to determine the effect of PD on the metabolic control of T2DM in a South African population. Methods: A systematic review of the relationship between PD and metabolic control in patients with T2DM in a South African population will be conducted. Cohort, cross-sectional, and case-controlled studies will be considered in which the outcome of interest is diabetic control. A search will be done in the following sources: EBSCOhost (academic search complete; dentistry and oral sciences), PubMed, ScienceDirect, and the South African National ETD Portal for articles published in English. There will be no limit placed on the date of the publication. The reference list of articles will be reviewed for further inclusion of critical articles. Two independent reviewers (AJ and FK-D) will do study selection, data extraction, and quality analysis. All disputes will be resolved by discussion, and the entire team will verify final decisions. Results: The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO). A preliminary search was conducted using the keywords ((perio*) AND (diabet*)) AND (``South Africa''). The review process should be completed by December 2021. Conclusions: The review will determine the effect of PD on metabolic control in patients with T2DM in South Africa. The outcome would inform health policy to highlight the need to include periodontal care into treatment protocols in patients with T2DM. In this process, the feasibility for future research in this area of interest will also be defined. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42020221064; https://www.crd.york.ac.uk/PROSPERO/display\_record.php?RecordID=221064 International Registered Report Identifier (IRRID): PRR1-10.2196/27471 ",
doi="10.2196/27471",
url="https://www.researchprotocols.org/2021/7/e27471",
url="http://www.ncbi.nlm.nih.gov/pubmed/34292169"
}


@Article{info:doi/10.2196/26701,
author="Kimmie-Dhansay, Faheema
and Barrie, Robert
and Roberts, Tina
and Naidoo, Sudeshni",
title="Risk Indicators for Early Childhood Caries in South Africa: Protocol for a Systematic Review",
journal="JMIR Res Protoc",
year="2021",
month="Jun",
day="24",
volume="10",
number="6",
pages="e26701",
keywords="dmft",
keywords="infant",
keywords="risk factors",
keywords="dental caries",
keywords="South Africa",
keywords="early childhood caries",
abstract="Background: Early childhood caries (ECC) is a common disorder characterized by the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces of primary teeth in children 71 months old or younger. South Africa has a diverse population in terms of culture, education, income, and occupation. This diversity is due to the consequences of historical racial discrimination, poverty, unemployment, lack of accessibility to health services, and quality of education. These factors make South Africa unique, and the disease and risk profiles for this country differ from those of other countries at similar stages of development. For these reasons, it is important to identify the unique maternal and infant risk factors for ECC in the South African context. Objective: The purpose of this study is to determine the risk factors associated with the incidence and prevalence of ECC in South Africa in children under the age of 6 years. Methods: All cross-sectional and cohort studies documenting risk factors associated with the prevalence and incidence of dental disease and severity (decayed, missing, and filled scores) will be included. We will search 7 databases for eligible studies, and those included will be based on prespecified inclusion criteria. Only studies conducted with South African children who are aged 6 years and younger in which dental caries risk factors are documented will be included. There is no restriction on the time or language of publication. Included articles will be scrutinized for quality by using a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be performed. Results: The literature search was conducted in November 2020. Conclusions: The results of this study will provide a framework to inform medical and dental personnel to highlight mothers and infants at risk of developing ECC. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42020216455; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=216455 International Registered Report Identifier (IRRID): DERR1-10.2196/26701 ",
doi="10.2196/26701",
url="https://www.researchprotocols.org/2021/6/e26701/",
url="http://www.ncbi.nlm.nih.gov/pubmed/34170258"
}


@Article{info:doi/10.2196/25767,
author="Afrashtehfar, Ian Kelvin
and Bryant, Ross Stephen",
title="Understanding the Lived Experience of North American Dental Patients With a Single-Tooth Implant in the Upper Front Region of the Mouth: Protocol for a Qualitative Study",
journal="JMIR Res Protoc",
year="2021",
month="Jun",
day="18",
volume="10",
number="6",
pages="e25767",
keywords="esthetic dentistry",
keywords="esthetics",
keywords="implant dentistry",
keywords="patient perception",
keywords="patient-reported outcome measures",
keywords="personal satisfaction",
keywords="phenomenology",
keywords="single-tooth dental implants",
keywords="single-unit implant-supported restoration",
abstract="Background: Assessment of the subjective experiences of individuals with maxillary anterior (ie, the upper front region of the mouth) single-tooth implants is limited mainly to quantitative measurements of satisfaction with appearance. Interestingly, there is unexplained variability in the relationship between satisfaction and appearance. Objective: This qualitative study protocol aims to explore and better understand the satisfaction with appearance and function in a Canadian population with maxillary anterior single-tooth implants treated at a postgraduate university clinic. Thus, we aim to obtain diversity among participants relating to the identification of esthetically pleasing and displeasing cases from a clinician perspective. Methods: A qualitative research design using interpretative phenomenology analysis (IPA) will provide an adaptable inductive research approach. The participants will be recruited, and consent documents, photographs, digital intraoral scans, and self-administered questionnaire responses will be obtained from them. The transcribed verbatim data from audio-recorded, in-depth, semistructured, one-to-one interviews of the participants will be managed, coded, and analyzed thematically with computer-assisted qualitative data analysis software. The IPA will consider the COnsolidated criteria for REporting Qualitative (COREQ) guidelines when applicable. Results: For the qualitative interview, we plan to include at least eight patients to conduct up to 1.5 hours of open-ended interviews with each participant aided by an interview guide. Ethical approval was granted by the University of British Columbia Behavioral Research Ethics Board (H19-00107) in May 2019. Two American dental foundations funded this study. Conclusions: The analysis in this study will elucidate the aspects (including their value) that influence participant satisfaction at different dental implant treatment stages. This will be the first qualitative study on this group of the population to explore and obtain a better understanding of their satisfaction with appearance and function, as well as any other patient-reported outcome measures that could be identified. International Registered Report Identifier (IRRID): DERR1-10.2196/25767 ",
doi="10.2196/25767",
url="https://www.researchprotocols.org/2021/6/e25767",
url="http://www.ncbi.nlm.nih.gov/pubmed/33886491"
}


@Article{info:doi/10.2196/29145,
author="Tao, Zhuo-Ying
and Su, Yu-Xiong",
title="Authors' Reply to: Methodological Clarifications and Generalizing From Weibo Data. Comment on ``Nature and Diffusion of COVID-19--related Oral Health Information on Chinese Social Media: Analysis of Tweets on Weibo''",
journal="J Med Internet Res",
year="2021",
month="May",
day="21",
volume="23",
number="5",
pages="e29145",
keywords="COVID-19",
keywords="dentistry",
keywords="oral health",
keywords="dental health",
keywords="online health",
keywords="social media",
keywords="tweet",
keywords="Weibo",
keywords="China",
keywords="health information",
doi="10.2196/29145",
url="https://www.jmir.org/2021/5/e29145",
url="http://www.ncbi.nlm.nih.gov/pubmed/33989166"
}


@Article{info:doi/10.2196/26255,
author="Yadav, Prakash Om",
title="Methodological Clarifications and Generalizing From Weibo Data. Comment on ``Nature and Diffusion of COVID-19--related Oral Health Information on Chinese Social Media: Analysis of Tweets on Weibo''",
journal="J Med Internet Res",
year="2021",
month="May",
day="21",
volume="23",
number="5",
pages="e26255",
keywords="COVID-19",
keywords="dentistry",
keywords="oral health",
keywords="dental health",
keywords="online health",
keywords="social media",
keywords="tweet",
keywords="Weibo",
keywords="China",
keywords="health information",
doi="10.2196/26255",
url="https://www.jmir.org/2021/5/e26255",
url="http://www.ncbi.nlm.nih.gov/pubmed/33989161"
}


@Article{info:doi/10.2196/25244,
author="Mallick, Rizwana
and Pisulkar, Kale Sweta
and Reddy, Gosla Srinivas",
title="Assessment of Outcomes of Immediately Loaded Dental Implants in Orofacial Cleft Patients: Protocol for a Single-Arm Clinical Trial",
journal="JMIR Res Protoc",
year="2021",
month="May",
day="5",
volume="10",
number="5",
pages="e25244",
keywords="clinical trial protocols",
keywords="dental implants",
keywords="dentistry",
keywords="immediate dental implant loading",
keywords="implant-supported dental prosthesis",
keywords="mouth rehabilitation",
keywords="oral health",
keywords="orofacial cleft",
keywords="quality of life",
keywords="rehabilitation research",
keywords="treatment outcome",
abstract="Background: Orofacial cleft, one of the most common congenital deformities, presents with a plethora of defects, subjecting the patient to a multitude of treatments from a young age. Among the oral hard tissue problems, absence of a maxillary permanent tooth in the cleft region either due to congenital absence or extraction due to compromised prognosis is a common finding. Conventionally, the missing tooth is replaced using a removable or fixed partial denture; however, the treatment modality does not satisfactorily meet patient expectations. The most recent decade has seen increasing use of dental implants in the cleft region; however, the outcome of an immediately loaded dental implant is still elusive for orofacial cleft patients. Objective: This protocol is for a single-arm clinical trial aimed at determining the treatment outcome of immediately loaded dental implants in patients with a nonsyndromic orofacial cleft. Methods: Patients meeting the set criteria will be sequentially enrolled until a sample size of 30 dental implants is met and will undergo the proposed treatment according to the predecided protocol. All patients will be followed up at the designated time intervals to record various clinical and radiographic parameters. Implant success will be defined based on the criteria elucidated by Misch et al in the Pisa, Italy Consensus. A quality-of-life assessment questionnaire will also be recorded at the end of patient's follow-up to determine their acceptance of the treatment. Results: A total of 30 dental implants will be placed in patients with a nonsyndromic orofacial cleft. Obtained results will be statistically analyzed to determine the treatment outcomes and success. Conclusions: This study will help determine the feasibility of immediately loaded dental implants in compromised bone sites such as those presented in cleft patients and will help in generating findings that can be used to fill the lacunae currently present in the holistic treatment of cleft patients. Trial Registration: Clinical Trial Registry of India CTRI/2020/09/027997; http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=47659\&EncHid=\&userName=dental\%20implants International Registered Report Identifier (IRRID): PRR1-10.2196/25244 ",
doi="10.2196/25244",
url="https://www.researchprotocols.org/2021/5/e25244",
url="http://www.ncbi.nlm.nih.gov/pubmed/33949960"
}


@Article{info:doi/10.2196/24342,
author="Rindal, Brad D.
and Asche, E. Stephen
and Gryczynski, Jan
and Kane, M. Sheryl
and Truitt, R. Anjali
and Shea, L. Tracy
and Ziegenfuss, Y. Jeanette
and Schwartz, P. Robert
and Worley, C. Donald
and Mitchell, G. Shannon",
title="De-Implementing Opioid Use and Implementing Optimal Pain Management Following Dental Extractions (DIODE): Protocol for a Cluster Randomized Trial",
journal="JMIR Res Protoc",
year="2021",
month="Apr",
day="12",
volume="10",
number="4",
pages="e24342",
keywords="analgesics",
keywords="opioid",
keywords="prescriptions",
keywords="tooth extraction",
keywords="pain, postoperative",
keywords="dentistry",
keywords="oral surgery",
keywords="shared decision-making",
keywords="health communications",
keywords="implementation science",
abstract="Background: Overdose deaths from prescription opioid analgesics are a continuing crisis in the United States. Opioid analgesics are among the most frequently prescribed drugs by dentists. An estimated 5 million people undergo third-molar extractions in the United States each year, resulting in postoperative pain. Studies show that, in most cases, the combination of ibuprofen and acetaminophen is an effective alternative to commonly prescribed opioid analgesics for the management of postextraction pain. Nevertheless, many dentists routinely prescribe opioids after dental extractions. Objective: We describe the rationale, design, and methods for a randomized trial of interventions designed to de-implement opioid prescribing by dentists while implementing effective nonopioid analgesics following dental extractions. Methods: Using a prospective, 3-arm, cluster randomized trial design with dentists as the unit randomized and patient-level prescribing data as the primary outcome, we will compare different strategies to reduce the reliance on opioids and increase the use of alternative pain management approaches utilizing information support tools aimed at both providers and their patients. The study will test the efficacy of 2 interventions to decrease opioid prescribing following dental extractions: clinical decision support with (CDS-E) and without patient education (CDS). Providers will be randomized to CDS, CDS-E, or standard practice. Patient-level outcomes will be determined via review of comprehensive electronic health records. We will compare study arms on differential change in prescribing patterns from pre- to postimplementation of the intervention. The primary outcome of interest is a binary indicator of whether or not the patient received an opioid prescription on the day of the extraction encounter. We will also examine recommendations or prescriptions for nonopioid analgesics, patients' perceptions of shared decision making, and patients' pain experiences following the extraction. Results: The HealthPartners Institutional Review Board approved the study. All study materials including the CDS and patient education materials have been developed and pilot tested, and the protocol has been approved by the National Institute of Dental and Craniofacial Research. The intervention was implemented in February 2020, with 51 dentists who were randomized to 1 of the 3 arms. Conclusions: If the intervention strategies are shown to be effective, they could be implemented more broadly in dental settings with high levels of opioid prescribing. Trial Registration: ClinicalTrials.gov NCT03584789, https://clinicaltrials.gov/ct2/show/NCT03584789 International Registered Report Identifier (IRRID): DERR1-10.2196/24342 ",
doi="10.2196/24342",
url="https://www.researchprotocols.org/2021/4/e24342",
url="http://www.ncbi.nlm.nih.gov/pubmed/33843594"
}


@Article{info:doi/10.2196/23635,
author="Li, Yaning
and Ye, Hongqiang
and Ye, Fan
and Liu, Yunsong
and Lv, Longwei
and Zhang, Ping
and Zhang, Xiao
and Zhou, Yongsheng",
title="The Current Situation and Future Prospects of Simulators in Dental Education",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="8",
volume="23",
number="4",
pages="e23635",
keywords="dental simulator",
keywords="dental education",
keywords="virtual reality",
doi="10.2196/23635",
url="https://www.jmir.org/2021/4/e23635",
url="http://www.ncbi.nlm.nih.gov/pubmed/33830059"
}


@Article{info:doi/10.2196/15350,
author="Pouly, Sandrine
and Ng, Teck Wee
and Benzimra, Muriel
and Soulan, Alexandre
and Blanc, Nicolas
and Zanetti, Filippo
and Picavet, Patrick
and Baker, Gizelle
and Haziza, Christelle",
title="Effect of Switching to the Tobacco Heating System Versus Continued Cigarette Smoking on Chronic Generalized Periodontitis Treatment Outcome: Protocol for a Randomized Controlled Multicenter Study",
journal="JMIR Res Protoc",
year="2021",
month="Jan",
day="18",
volume="10",
number="1",
pages="e15350",
keywords="smoking",
keywords="tobacco",
keywords="periodontitis",
keywords="oral health",
keywords="Tobacco Heating System",
keywords="modified risk tobacco product",
keywords="clinical attachment level",
keywords="probing depth",
keywords="periodontal pocket",
abstract="Background: Smoking is a significant risk factor for periodontal disease and tooth loss, as shown in several clinical studies comparing smokers and nonsmokers. Although only a few longitudinal studies have assessed the outcome of periodontal disease after smoking cessation, they indicated that recovery after nonsurgical treatment was more successful in those who had quit smoking. As part of tobacco harm reduction strategies, substituting cigarettes with alternative, less harmful tobacco products is an approach complementary to cessation for smokers who would otherwise continue to smoke. The Tobacco Heating System (THS), developed by Philip Morris International (commercialized as IQOS), is part of the heat-not-burn product category. The IQOS device electrically heats tobacco instead of burning it, at much lower temperatures than cigarettes, thereby producing substantially lower levels of harmful and potentially harmful constituents, while providing the nicotine, taste, ritual, and a sensory experience that closely parallel those of cigarettes. Phillip Morris International has published the results from a broad clinical assessment program, which was established to scientifically substantiate the harm reduction potential of the THS among adult healthy smokers switching to the THS. The program is now progressing toward including adult smokers with smoking-related diseases. Objective: The goal of this study is to demonstrate favorable changes of periodontal endpoints in response to mechanical periodontal therapy in patients with generalized chronic periodontitis who completely switched to THS use compared with continued cigarette smoking. Methods: This is a randomized controlled two-arm parallel-group multicenter Japanese study conducted in patients with chronic generalized periodontitis who switch from cigarettes to THS compared with smokers continuing to smoke cigarettes for 6 months. The patients were treated with mechanical periodontal therapy as per standard of care in Japan. The primary objective of the study is to demonstrate the beneficial effect of switching to THS use compared with continued cigarette smoking on pocket depth (PD) reduction in all sites with an initial PD?4 mm. The secondary objectives include evaluation of other periodontal parameters (eg, clinical attachment level or gingival inflammation) and overall oral health status upon switching to THS. Safety was monitored throughout the study. Results: In total, 172 subjects were randomized to the cigarette (n=86) or THS (n=86) groups, and all 172 completed the study. The conduct phase of the study is completed, while data cleaning and analyses are ongoing. Conclusions: This study is the first to test a heat-not-burn tobacco product in smokers with an already established disease. The results should further strengthen the evidence that switching to THS can significantly reduce the risk of smoking-related diseases if favorable changes in the evolution of chronic generalized periodontitis after mechanical therapy are found when compared with continued cigarette smoking. Trial Registration: ClinicalTrials.gov NCT03364751; https://clinicaltrials.gov/ct2/show/NCT03364751 International Registered Report Identifier (IRRID): DERR1-10.2196/15350 ",
doi="10.2196/15350",
url="http://www.researchprotocols.org/2021/1/e15350/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33459599"
}


@Article{info:doi/10.2196/19958,
author="Chen, Rebecca
and Santo, Karla
and Wong, Grace
and Sohn, Woosung
and Spallek, Heiko
and Chow, Clara
and Irving, Michelle",
title="Mobile Apps for Dental Caries Prevention: Systematic Search and Quality Evaluation",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Jan",
day="13",
volume="9",
number="1",
pages="e19958",
keywords="dental caries",
keywords="oral hygiene",
keywords="self-management",
keywords="mobile applications",
abstract="Background: Dental caries is the most common multifactorial oral disease; it affects 60\% to 90\% of the global population. Dental caries is highly preventable through prevention behaviors aimed at improving oral hygiene, adequate fluoride usage, and dietary intake. Mobile apps have the potential to support patients with dental caries; however, little is known about the availability, target audience, quality, and features of these apps. Objective: This review aims to systematically examine dental caries prevention apps; to describe their content, availability, target audience, and features; and to assess their quality. Methods: We systematically identified and evaluated apps in a process paralleling a systematic review. This included a search strategy using search terms; an eligibility assessment using inclusion and exclusion criteria focused on accessibility and dental caries self-management behaviors, including oral hygiene, dietary intake, and fluoride usage; data extraction on app characteristics, including app store metrics; prevention behavior categorization; feature identification and description; a quality appraisal of all apps using the validated Mobile App Rating Scale (MARS) assessment tool; and data comparison and analysis. Results: Using our search strategy, we retrieved 562 apps from the Google Play Store and iTunes available in Australia. Of these, 7.1\% (40/562) of the apps fit our eligibility criteria, of which 55\% (22/40) targeted adults, 93\% (37/40) were free to download, and 65\% (26/40) were recently updated. Oral hygiene was the most common dental caries prevention behavior domain, addressed in 93\% (37/40) of the apps, while dietary intake was addressed in 45\% (18/40) of the apps and fluoride usage was addressed in 42\% (17/40) of the apps. Overall, 50\% (20/40) of the apps addressed only 1 behavior, and 38\% (15/40) of the apps addressed all 3 behaviors. The mean MARS score was 2.9 (SD 0.7; range 1.8-4.4), with 45\% (18/40) of the apps categorized as high quality, with a rating above 3.0 out of 5.0. We identified 21 distinctive features across all dental caries prevention behaviors; however, the top 5 most common features focused on oral hygiene. The highest-ranking app was the Brush DJ app, with an overall MARS score of 4.4 and with the highest number of features (n=13). We did not find any apps that adequately addressed dental caries prevention behaviors in very young children. Conclusions: Apps addressing dental caries prevention commonly focus on oral hygiene and target young adults; however, many are not of high quality. These apps use a range of features to support consumer engagement, and some of these features may be helpful for specific patient populations. However, it remains unclear how effective these apps are in improving dental caries outcomes, and further evaluation is required before they are widely recommended. ",
doi="10.2196/19958",
url="http://mhealth.jmir.org/2021/1/e19958/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33439141"
}


@Article{info:doi/10.2196/24371,
author="Obeidat, Lina
and Masarwa, Nader
and AlWarawreh, Amjad
and El-Naji, Waddah",
title="Dental Treatments During the COVID-19 Pandemic in Three Hospitals in Jordan: Retrospective Study",
journal="Interact J Med Res",
year="2020",
month="Dec",
day="29",
volume="9",
number="4",
pages="e24371",
keywords="COVID-19",
keywords="dental treatments",
keywords="Jordan",
keywords="lockdown",
keywords="pandemic",
abstract="Background: Cases of COVID-19 first emerged in December 2019. Since then, the virus has spread rapidly worldwide, with daily increases in the numbers of infections and deaths. COVID-19 spreads via airborne transmission, which renders dental treatment a potential source of virus transmission. Dental treatments require the use of handpieces, ultrasonic devices, or air--water syringes, which generate considerable amounts of aerosols. Jordan, being one of the affected countries, instituted preventive lockdown measures on March 17, 2020. Emergency dental treatments were only allowed in dental clinics of the Royal Medical Services of Jordan Armed Forces and Ministry of Health, and were prohibited in other sectors such as private clinics and universities. Objective: The aim of this study is to investigate the dental treatments performed in three military hospitals during the 44-day lockdown period in Jordan. The investigation explores the impact of COVID-19 on the number of patients and types of performed dental treatments. Methods: Data such as number of patients, patients' age and gender, and performed dental treatments were collected retrospectively from the hospital records and were analyzed. Results: Our results showed a 90\% (17,591 to 1689) decrease in patient visits during the lockdown period compared to regular days. The total number of treatments (n=1689) during the lockdown period varied between endodontic cases (n=877, 51.9\%), extraction and other surgical cases (n=374, 22.1\%), restorative cases (n=142, 8.4\%), orthodontic treatments (n=4, 0.2\%), and other procedures (n=292, 17.3\%). The differences in gender and age group among all clinics were statistically significant (P<.001 and P=.02, respectively). Conclusions: The COVID-19 pandemic had a significant effect on the number of patients seeking dental treatments. It also affected the types of treatments performed. Endodontic treatment accounted for almost 50\% of patient load during the lockdown compared to approximately 20\% during regular days. ",
doi="10.2196/24371",
url="http://www.i-jmr.org/2020/4/e24371/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33325372"
}


@Article{info:doi/10.2196/17150,
author="O'Toole, Saoirse
and Bartlett, David
and Keeling, Andrew
and McBride, John
and Bernabe, Eduardo
and Crins, Luuk
and Loomans, Bas",
title="Influence of Scanner Precision and Analysis Software in Quantifying Three-Dimensional Intraoral Changes: Two-Factor Factorial Experimental Design",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="27",
volume="22",
number="11",
pages="e17150",
keywords="diagnostic systems",
keywords="digital imaging/radiology",
keywords="engineering",
keywords="imaging",
keywords="outcomes research",
keywords="tooth wear",
abstract="Background: Three-dimensional scans are increasingly used to quantify biological topographical changes and clinical health outcomes. Traditionally, the use of 3D scans has been limited to specialized centers owing to the high cost of the scanning equipment and the necessity for complex analysis software. Technological advances have made cheaper, more accessible methods of data capture and analysis available in the field of dentistry, potentially facilitating a primary care system to quantify disease progression. However, this system has yet to be compared with previous high-precision methods in university hospital settings. Objective: The aim of this study was to compare a dental primary care method of data capture (intraoral scanner) with a precision hospital-based method (laser profilometer) in addition to comparing open source and commercial software available for data analysis. Methods: Longitudinal dental wear data from 30 patients were analyzed using a two-factor factorial experimental design. Bimaxillary intraoral digital scans (TrueDefinition, 3M, UK) and conventional silicone impressions, poured in type-4 dental stone, were made at both baseline and follow-up appointments (mean 36 months, SD 10.9). Stone models were scanned using precision laser profilometry (Taicaan, Southampton, UK). Three-dimensional changes in both forms of digital scans of the first molars (n=76) were quantitatively analyzed using the engineering software Geomagic Control (3D Systems, Germany) and freeware WearCompare (Leeds Digital Dentistry, UK). Volume change (mm3) was the primary measurement outcome. The maximum point loss ($\mu$m) and the average profile loss ($\mu$m) were also recorded. Data were paired and skewed, and were therefore compared using Wilcoxon signed-rank tests with Bonferroni correction. Results: The median (IQR) volume change for Geomagic using profilometry and using the intraoral scan was --0.37 mm3 (--3.75-2.30) and +0.51 mm3 (--2.17-4.26), respectively (P<.001). Using WearCompare, the median (IQR) volume change for profilometry and intraoral scanning was --1.21 mm3 (--3.48-0.56) and --0.39 mm3 (--3.96-2.76), respectively (P=.04). WearCompare detected significantly greater volume loss than Geomagic regardless of scanner type. No differences were observed between groups with respect to the maximum point loss or average profile loss. Conclusions: As expected, the method of data capture, software used, and measurement metric all significantly influenced the measurement outcome. However, when appropriate analysis was used, the primary care system was able to quantify the degree of change and can be recommended depending on the accuracy needed to diagnose a condition. Lower-resolution scanners may underestimate complex changes when measuring at the micron level. ",
doi="10.2196/17150",
url="https://www.jmir.org/2020/11/e17150",
url="http://www.ncbi.nlm.nih.gov/pubmed/33245280"
}


@Article{info:doi/10.2196/17881,
author="Kim, Jun-Min
and Lee, Ram Woo
and Kim, Jun-Ho
and Seo, Jong-Mo
and Im, Changkyun",
title="Light-Induced Fluorescence-Based Device and Hybrid Mobile App for Oral Hygiene Management at Home: Development and Usability Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Oct",
day="16",
volume="8",
number="10",
pages="e17881",
keywords="dental plaque",
keywords="oral hygiene",
keywords="red fluorescence",
keywords="mobile health",
keywords="deep learning",
keywords="object detection",
keywords="instance segmentation",
abstract="Background: Dental diseases can be prevented through the management of dental plaques. Dental plaque can be identified using the light-induced fluorescence (LIF) technique that emits light at 405 nm. The LIF technique is more convenient than the commercial technique using a disclosing agent, but the result may vary for each individual as it still requires visual identification. Objective: The objective of this study is to introduce and validate a deep learning--based oral hygiene monitoring system that makes it easy to identify dental plaques at home. Methods: We developed a LIF-based system consisting of a device that can visually identify dental plaques and a mobile app that displays the location and area of dental plaques on oral images. The mobile app is programmed to automatically determine the location and distribution of dental plaques using a deep learning--based algorithm and present the results to the user as time series data. The mobile app is also built with convergence of naive and web applications so that the algorithm is executed on a cloud server to efficiently distribute computing resources. Results: The location and distribution of users' dental plaques could be identified via the hand-held LIF device or mobile app. The color correction filter in the device was developed using a color mixing technique. The mobile app was built as a hybrid app combining the functionalities of a native application and a web application. Through the scrollable WebView on the mobile app, changes in the time series of dental plaque could be confirmed. The algorithm for dental plaque detection was implemented to run on Amazon Web Services for object detection by single shot multibox detector and instance segmentation by Mask region-based convolutional neural network. Conclusions: This paper shows that the system can be used as a home oral care product for timely identification and management of dental plaques. In the future, it is expected that these products will significantly reduce the social costs associated with dental diseases. ",
doi="10.2196/17881",
url="https://mhealth.jmir.org/2020/10/e17881",
url="http://www.ncbi.nlm.nih.gov/pubmed/33064097"
}


@Article{info:doi/10.2196/17840,
author="Nelson, Suchitra
and Albert, M. Jeffrey
and Milgrom, Peter",
title="Comparative Effectiveness of Two Nonsurgical Treatments to Reduce Oral Health Disparities From Untreated Tooth Decay in Older Adults: Protocol for a Cluster Randomized Trial",
journal="JMIR Res Protoc",
year="2020",
month="Sep",
day="8",
volume="9",
number="9",
pages="e17840",
keywords="dental caries",
keywords="older adults",
keywords="atraumatic restorative treatment",
keywords="silver diamine fluoride",
keywords="fluoride varnish",
abstract="Background: The majority of dental caries lesions in older adults are at the gumline, at the edges of failed fillings and crowns, and in the surfaces of roots after gum recession. These lesions are difficult to restore with conventional surgical treatments using a dental drill and restorations often fail. Clinical guidelines are general and apply treatments that were designed for younger individuals in the dental care of older adults. Objective: This study will compare the effectiveness of 2 evidence-based nonsurgical strategies to manage dental caries lesions in adults aged 62 or older: (1) biannual topical application of silver diamine fluoride versus (2) atraumatic restorative treatment + biannual fluoride varnish. Methods: A cluster randomized clinical trial is being conducted in 22 publicly subsidized and other low-income housing facilities/sites (Arm 1: 11 sites, 275 participants; Arm 2: 11 sites, 275 participants). At baseline, participants will be screened for caries lesions. Those with nonurgent lesions will be treated according to the treatment arm to which the housing site was randomly assigned. The primary outcomes are caries lesion arrest, tooth sensitivity, and tooth pain at 52 weeks after treatment. Analytic methods for the primary aim include a generalized estimating equation approach to determine noninferiority of silver diamine fluoride relative to atraumatic restorative treatment + fluoride varnish treatment. Results: The trial was funded in April 2019. Enrollment began in September 2019 and results are expected in June 2023. Conclusions: This study will inform the standard of care for treating caries lesions in older adults. If effective, either of these interventions has broad applicability in clinical and community-based settings. Trial Registration: ClinicalTrials.gov NCT03916926; https://clinicaltrials.gov/ct2/show/NCT03916926 International Registered Report Identifier (IRRID): DERR1-10.2196/17840 ",
doi="10.2196/17840",
url="http://www.researchprotocols.org/2020/9/e17840/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32897236"
}


@Article{info:doi/10.2196/18570,
author="Vila-Blanco, Nicol{\'a}s
and Freire, Vicente
and Balsa-Castro, Carlos
and Tom{\'a}s, Inmaculada
and Carreira, J. Mar{\'i}a",
title="DenTiUS Plaque, a Web-Based Application for the Quantification of Bacterial Plaque: Development and Usability Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="3",
volume="22",
number="9",
pages="e18570",
keywords="computer-aided diagnoses",
keywords="computer-based biomedical applications",
keywords="dental health",
keywords="dental plaque quantification",
keywords="web-based tools",
keywords="medical informatics",
abstract="Background: In the dentistry field, the analysis of dental plaque is vital because it is the main etiological factor in the 2 most prevalent oral diseases: caries and periodontitis. In most of the papers published in the dental literature, the quantification of dental plaque is carried out using traditional, non-automated, and time-consuming indices. Therefore, the development of an automated plaque quantification tool would be of great value to clinicians and researchers. Objective: This study aimed to develop a web-based tool called DenTiUS and various clinical indices to evaluate dental plaque levels using image analysis techniques. Methods: The tool was executed as a web-based application to facilitate its use by researchers. Expert users are free to define experiments, including images from either a single patient (to observe an individual plaque growth pattern) or several patients (to perform a group characterization) at a particular moment or over time. A novel approach for detecting visible plaque has been developed as well as a new concept known as nonvisible plaque. This new term implies the classification of the remaining dental area into 3 subregions according to the risk of accumulating plaque in the near future. New metrics have also been created to describe visible and nonvisible plaque levels. Results: The system generates results tables of the quantitative analysis with absolute averages obtained in each image (indices about visible plaque) and relative measurements (indices about visible and nonvisible plaque) relating to the reference moment. The clinical indices that can be calculated are the following: plaque index of an area per intensity (API index, a value between 0 and 100), area growth index (growth rate of plaque per unit of time in hours; percentage area/hour), and area time index (the time in days needed to achieve a plaque area of 100\% concerning the initial area at the same moment). Images and graphics can be obtained for a moment from a patient in addition to a full report presenting all the processing data. Dentistry experts evaluated the DenTiUS Plaque software through a usability test, with the best-scoring questions those related to the workflow efficiency, value of the online help, attractiveness of the user interface, and overall satisfaction. Conclusions: The DenTiUS Plaque software allows automatic, reliable, and repeatable quantification of dental plaque levels, providing information about area, intensity, and growth pattern. Dentistry experts recognized that this software is suitable for quantification of dental plaque levels. Consequently, its application in the analysis of plaque evolution patterns associated with different oral conditions, as well as to evaluate the effectiveness of various oral hygiene measures, can represent an improvement in the clinical setting and the methodological quality of research studies. ",
doi="10.2196/18570",
url="https://www.jmir.org/2020/9/e18570",
url="http://www.ncbi.nlm.nih.gov/pubmed/32663148"
}


@Article{info:doi/10.2196/19433,
author="Tobias, Guy
and Spanier, B. Assaf",
title="Developing a Mobile App (iGAM) to Promote Gingival Health by Professional Monitoring of Dental Selfies: User-Centered Design Approach",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Aug",
day="14",
volume="8",
number="8",
pages="e19433",
keywords="mHealth",
keywords="telemedicine",
keywords="public health",
keywords="oral health promotion",
keywords="gum health",
keywords="flow of information",
keywords="COVID-19",
abstract="Background: Dental visits are unpleasant; sometimes, patients only seek treatment when they are in intolerable pain. Recently, the novel coronavirus (COVID-19) pandemic has highlighted the need for remote communication when patients and dentists cannot meet in person. Gingivitis is very common and characterized by red, swollen, bleeding gums. Gingivitis heals within 10 days of professional care and with daily, thorough oral hygiene practices. If left untreated, however, its progress may lead to teeth becoming mobile or lost. Of the many medical apps currently available, none monitor gingivitis. Objective: This study aimed to present a characterization and development model of a mobile health (mHealth) app called iGAM, which focuses on periodontal health and improves the information flow between dentists and patients. Methods: A focus group discussed the potential of an app to monitor gingivitis, and 3 semistructured in-depth interviews were conducted on the use of apps for monitoring gum infections.  We used a qualitative design process based on the Agile approach, which incorporated the following 5 steps: (1) user story, (2) use cases, (3) functional requirements, (4) nonfunctional requirements, and (5) Agile software development cycles. In a pilot study with 18 participants aged 18-45 years and with different levels of health literacy, participants were given a toothbrush, toothpaste, mouthwash, toothpicks, and dental floss. After installing iGAM, they were asked to photograph their gums weekly for 4 weeks. Results: All participants in the focus group believed in the potential of a mobile app to monitor gingivitis and reduce its severity. Concerns about security and privacy issues were discussed. From the interviews, 2 themes were derived: (1) ``what's in it for me?'' and (2) the need for a take-home message.  The 5 cycles of development highlighted the importance of communication between dentists, app developers, and the pilot group. Qualitative analysis of the data from the pilot study showed difficulty with: (1) the camera, which was alleviated with the provision of mouth openers, and (2) the operation of the phone, which was alleviated by changing the app to be fully automated, with a weekly reminder and an instructions document. Final interviews showed satisfaction. Conclusions: iGAM is the first mHealth app for monitoring gingivitis using self-photography.  iGAM facilitates the information flow between dentists and patients between checkups and may be useful when face-to-face consultations are not possible (such as during the COVID-19 pandemic). ",
doi="10.2196/19433",
url="http://mhealth.jmir.org/2020/8/e19433/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32795985"
}


@Article{info:doi/10.2196/17677,
author="Rosso, T. Matthew
and Sharma, Akshay",
title="Willingness of Adults in the United States to Receive HIV Testing in Dental Care Settings: Cross-Sectional Web-Based Study",
journal="JMIR Public Health Surveill",
year="2020",
month="Jul",
day="21",
volume="6",
number="3",
pages="e17677",
keywords="HIV testing",
keywords="HIV prevention",
keywords="dental care settings",
abstract="Background: The Centers for Disease Control and Prevention estimates that 1.1 million people in the United States are living with HIV and 1 in 8 are estimated to be unaware of their serostatus. Little is known about whether individuals would consider being tested for HIV in nontraditional health care settings such as a dentist's office. Studies in selected US cities have indicated high acceptability of receiving an HIV test among people attending dental clinics. However, we are not aware of studies that have assessed willingness to receive HIV testing in dental care settings at a national level. Objective: Using a web-based sample of adult residents of the United States, we sought to assess the self-reported willingness to receive any type of HIV testing (ie, oral fluid rapid testing, finger-stick blood rapid testing, or venipuncture blood testing) in a dental care setting and evaluate independent associations of willingness with the extent to which dental care providers were perceived as knowledgeable about HIV and how comfortable participants felt discussing HIV with their dental care providers. Methods: Participants were recruited using banner advertisements featured on social networking platforms (Facebook and Instagram) from December 2018 to February 2019. Demographic and behavioral data including information on sexual behaviors in the past 6 months, HIV testing history, and dental/health care--seeking history were collected using an anonymous web-based survey. Willingness to receive any type of HIV testing in a dental care setting was assessed on 4-point scale from very willing to very unwilling. Factors independently associated with participants' willingness were identified using a multivariable logistic regression model. Results: Of the 421 participants in our study aged 18 to 73 years, 271 (64.4\%) reported having oral sex, 197 (46.8\%) reported having vaginal sex, and 136 (32.3\%) reported having anal sex in the past 6 months. Approximately one-third had never been tested for HIV (137/421, 32.5\%), and the same proportion had not been tested in the past year (137/421, 32.5\%). Most participants had dental insurance coverage (356/421, 84.6\%), and more than three-fourths reported being very or somewhat willing (326/421, 77.4\%) to receive any type of HIV testing in a dental care setting. Higher levels of willingness were associated with being 18 to 24 years versus ?35 years (aOR 3.22, 95\% CI 1.48-6.98), 25 to 34 years versus ?35 years (aOR 5.26, 95\% CI 2.52-10.98), believing that one's dental care provider is knowledgeable about HIV (aOR 2.04, 95\% CI 1.06-3.92), and feeling comfortable discussing HIV with one's dental care provider (aOR 9.84, 95\% CI 3.99-24.27). Conclusions: Our data indicate high acceptability of receiving HIV testing in a dental care setting, especially among those who report having a positive patient-provider relationship. Future research should focus on assessing dental care providers' attitudes, self-efficacy, and beliefs about whether HIV testing fits into the scope of dentistry. ",
doi="10.2196/17677",
url="http://publichealth.jmir.org/2020/3/e17677/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32706732"
}


@Article{info:doi/10.2196/16365,
author="Fija{\v c}ko, Nino
and Gosak, Lucija
and Cilar, Leona
and Nov{\vs}ak, Alenka
and Creber, Masterson Ruth
and Skok, Pavel
and {\vS}tiglic, Gregor",
title="The Effects of Gamification and Oral Self-Care on Oral Hygiene in Children: Systematic Search in App Stores and Evaluation of Apps",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Jul",
day="8",
volume="8",
number="7",
pages="e16365",
keywords="mobile health",
keywords="oral health care",
keywords="gamification",
keywords="mobile store",
keywords="evidence-based dentistry",
keywords="behavior change technique",
keywords="Mobile Application Rating Scale user version",
abstract="Background: Poor oral hygiene is a great public health problem worldwide. Oral health care education is a public health priority as the maintenance of oral hygiene is integral to overall health. Maintaining optimal oral hygiene among children is challenging and can be supported by using relevant motivational approaches. Objective: The primary aim of this study was to identify mobile smartphone apps that include gamification features focused on motivating children to learn, perform, and maintain optimal oral hygiene. Methods: We searched six online app stores using four search terms (``oral hygiene game,'' ``oral hygiene gamification,'' ``oral hygiene brush game,'' and ``oral hygiene brush gamification''). We identified gamification features, identified whether apps were consistent with evidence-based dentistry, performed a quality appraisal with the Mobile App Rating Scale user version (uMARS), and quantified behavior scores (Behavior Change score, uMARS score, and Coventry, Aberdeen, and London-Refined [CALO-RE] score) using three different instruments that measure behavior change. Results: Of 612 potentially relevant apps included in the analysis, 17 met the inclusion criteria. On average, apps included 6.87 (SD 4.18) out of 31 possible gamification features. The most frequently used gamification features were time pressure (16/17, 94\%), virtual characters (14/17, 82\%), and fantasy (13/17, 76\%). The most common oral hygiene evidence-based recommendation was brushing time (2-3 minutes), which was identified in 94\% (16/17) of apps. The overall mean uMARS score for app quality was high (4.30, SD 0.36), with good mean subjective quality (3.79, SD 0.71) and perceived impact (3.58, SD 0.44). Sufficient behavior change techniques based on three taxonomies were detected in each app. Conclusions: The majority of the analyzed oral hygiene apps included gamification features and behavior change techniques to perform and maintain oral hygiene in children. Overall, the apps contained some educational content consistent with evidence-based dentistry and high-quality background for oral self-care in children; however, there is scope for improvement. ",
doi="10.2196/16365",
url="https://mhealth.jmir.org/2020/7/e16365",
url="http://www.ncbi.nlm.nih.gov/pubmed/32673235"
}


@Article{info:doi/10.2196/18652,
author="Lin, Ye
and Hong, Alicia Y.
and Henson, S. Bradley
and Stevenson, D. Robert
and Hong, Simon
and Lyu, Tianchu
and Liang, Chen",
title="Assessing Patient Experience and Healthcare Quality of Dental Care Using Patient Online Reviews in the United States: Mixed Methods Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="7",
volume="22",
number="7",
pages="e18652",
keywords="dental care",
keywords="healthcare quality",
keywords="consumer health informatics",
keywords="patient online reviews",
keywords="patient review websites",
keywords="natural language processing",
abstract="Background: Over the last two decades, patient review websites have emerged as an essential online platform for doctor ratings and reviews. Recent studies suggested the significance of such websites as a data source for patients to choose doctors for healthcare providers to learn and improve from patient feedback and to foster a culture of trust and transparency between patients and healthcare providers. However, as compared to other medical specialties, studies of online patient reviews that focus on dentists in the United States remain absent. Objective: This study sought to understand to what extent online patient reviews can provide performance feedbacks that reflect dental care quality and patient experience. Methods: Using mixed informatics methods incorporating statistics, natural language processing, and domain expert evaluation, we analyzed the online patient reviews of 204,751 dentists extracted from HealthGrades with two specific aims. First, we examined the associations between patient ratings and a variety of dentist characteristics. Second, we identified topics from patient reviews that can be mapped to the national assessment of dental patient experience measured by the Patient Experience Measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey. Results: Higher ratings were associated with female dentists (t71881=2.45, P<.01, g=0.01), dentists at a younger age (F7, 107128=246.97, P<.001, g=0.11), and those whose patients experienced a short wait time (F4, 150055=10417.77, P<0.001, g=0.18). We also identified several topics that corresponded to CAHPS measures, including discomfort (eg, painful/painless root canal or deep cleaning), and ethics (eg, high-pressure sales, and unnecessary dental work). Conclusions: These findings suggest that online patient reviews could be used as a data source for understanding the patient experience and healthcare quality in dentistry. ",
doi="10.2196/18652",
url="https://www.jmir.org/2020/7/e18652",
url="http://www.ncbi.nlm.nih.gov/pubmed/32673240"
}


@Article{info:doi/10.2196/17347,
author="Shetty, Vivek
and Morrison, Douglas
and Belin, Thomas
and Hnat, Timothy
and Kumar, Santosh",
title="A Scalable System for Passively Monitoring Oral Health Behaviors Using Electronic Toothbrushes in the Home Setting: Development and Feasibility Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Jun",
day="24",
volume="8",
number="6",
pages="e17347",
keywords="health behaviors",
keywords="oral self-care",
keywords="digital tools",
keywords="remote monitoring",
keywords="passive measurement",
abstract="Background: Dental disease (including dental caries and periodontal disease) is largely preventable and closely linked to inadequate oral health behaviors. Digital health technologies have great potential for unobtrusively monitoring brushing behaviors in home settings and promoting optimal oral self-care routines at scale. Objective: The aim of this study is to leverage the ubiquity of electronic toothbrushes and smartphones with the development of a Remote Oral Behaviors Assessment System (ROBAS) and evaluate its feasibility for passively tracking brushing behaviors in real-world settings. Methods: We developed ROBAS by linking inertial sensors contained within consumer electronic toothbrushes to a scalable software platform comprised of a smartphone app linked to a cloud platform. First, the criterion validity of ROBAS for accurately capturing brushing details was established in a laboratory setting. Next, real-world performance and usability were evaluated in a stratified community sample of 32 participants who used ROBAS daily for 1 month and maintained a diary of their brushing episodes. Semistructured interviews at baseline and exit captured the user experience. We used regression models and Bland-Altman analyses to assess the criterion validity, functionality, accuracy, and consistency of ROBAS. Results: Using a stopwatch as the criterion reference, ROBAS showed a mean absolute percent error (MAPE) of 1.8\%, an estimated bias of 0.64 seconds that was not statistically distinguishable from zero (95\% CI --0.93 to 2.22 seconds, SE 0.79), and a connection failure rate of 6.7\% (95\% CI 0.8\%-22.1\%, SE 4.6\%). In real-world testing, ROBAS showed close agreement with the daily diary recordings of brushing episodes; estimated average discrepancies between the diary and ROBAS were 0.13 sessions per day (95\% CI 0.01-0.26, SE 0.06), 8.0 seconds per brushing session (95\% CI 1.4-14.7, SE 3.3), and 30 seconds of brushing per day (95\% CI 9.3-50.1, SE 10.0). Retrospective self-reports produced substantially higher estimates of brushing frequency and duration compared to ROBAS measurements. Participants reported ROBAS was easy to use and expressed an interest in receiving ROBAS-delivered feedback on their brushing behaviors. Most participants were bothered by the use of an additional study phone, and some reported connectivity-related issues. Conclusions: ROBAS has a high criterion validity for measuring oral health behaviors. It can accurately and reliably monitor brushing patterns in home settings for extended periods. Unobtrusive data collection through ROBAS sets the stage for automated coaching and optimization of oral self-care practices at the individual and population level. ",
doi="10.2196/17347",
url="http://mhealth.jmir.org/2020/6/e17347/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32579118"
}


@Article{info:doi/10.2196/19981,
author="Tao, Zhuo-Ying
and Chu, Guang
and McGrath, Colman
and Hua, Fang
and Leung, Yan Yiu
and Yang, Wei-Fa
and Su, Yu-Xiong",
title="Nature and Diffusion of COVID-19--related Oral Health Information on Chinese Social Media: Analysis of Tweets on Weibo",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="15",
volume="22",
number="6",
pages="e19981",
keywords="COVID-19",
keywords="dentistry",
keywords="oral health",
keywords="online health",
keywords="social media",
keywords="tweet",
keywords="Weibo",
keywords="China",
keywords="health information",
abstract="Background: Social media has become increasingly important as a source of information for the public and is widely used for health-related information. The outbreak of the coronavirus disease (COVID-19) has exerted a negative impact on dental practices. Objective: The aim of this study is to analyze the nature and diffusion of COVID-19--related oral health information on the Chinese social media site Weibo. Methods: A total of 15,900 tweets related to oral health and dentistry information from Weibo during the COVID-19 outbreak in China (December 31, 2019, to March 16, 2020) were included in our study. Two researchers coded 1000 of the total tweets in advance, and two main thematic categories with eight subtypes were refined. The included tweets were analyzed over time and geographic region, and coded into eight thematic categories. Additionally, the time distributions of tweets containing information about dental services, needs of dental treatment, and home oral care during the COVID-19 epidemic were further analyzed. Results: People reacted rapidly to the emerging severe acute respiratory syndrome coronavirus 2 threat to dental services, and a large amount of COVID-19--related oral health information was tweeted on Weibo. The time and geographic distribution of tweets shared similarities with epidemiological data of the COVID-19 outbreak in China. Tweets containing home oral care and dental services content were the most frequently exchanged information (n=4803/15,900, 30.20\% and n=4478, 28.16\%, respectively). Significant differences of public attention were found between various types of bloggers in dental services--related tweets (P<.001), and the tweets from the government and media engaged the most public attention. The distributions of tweets containing information about dental services, needs of dental treatment, and home oral care information dynamically changed with time. Conclusions: Our study overviewed and analyzed social media data on the dental services and oral health information during the COVID-19 epidemic, thus, providing insights for government organizations, media, and dental professionals to better facilitate oral health communication and efficiently shape public concern through social media when routine dental services are unavailable during an unprecedented event. The study of the nature and distribution of social media can serve as a useful adjunct tool to help make public health policies. ",
doi="10.2196/19981",
url="http://www.jmir.org/2020/6/e19981/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32501808"
}


@Article{info:doi/10.2196/14140,
author="Lara, Sebastian Juan
and Braga, Minatel Mariana
and Zagatto, Gustavo Carlos
and Wen, Lung Chao
and Mendes, Medeiros Fausto
and Murisi, Uribe Pedroza
and Haddad, Estela Ana",
title="A Virtual 3D Dynamic Model of Caries Lesion Progression as a Learning Object for Caries Detection Training and Teaching: Video Development Study",
journal="JMIR Med Educ",
year="2020",
month="May",
day="22",
volume="6",
number="1",
pages="e14140",
keywords="3d virtual models",
keywords="dental education",
keywords="e-learning",
keywords="learning object",
keywords="caries",
keywords="cariology",
abstract="Background: In the last decade, 3D virtual models have been used for educational purposes in the health sciences, specifically for teaching human anatomy and pathology. These models provide an opportunity to didactically visualize key spatial relations that can be poorly understood when taught by traditional educational approaches. Caries lesion detection is a crucial process in dentistry that has been reported to be difficult to learn. One especially difficult aspect is linking clinical characteristics of the different severity stages with their histological features, which is fundamental for treatment decision-making. Objective: This project was designed to develop a virtual 3D digital model of caries lesion formation and progression to aid the detection of lesions at different severity stages as a potential complement to traditional lectures. Methods: Pedagogical planning, including identification of objectives, exploration of the degree of difficulty of caries diagnosis--associated topics perceived by dental students and lecturers, review of the literature regarding key concepts, and consultation of experts, was performed prior to constructing the model. An educational script strategy was created based on the topics to be addressed (dental tissues, biofilm stagnation areas, the demineralization process, caries lesion progression on occlusal surfaces, clinical characteristics related to different stages of caries progression, and histological correlations). Virtual 3D models were developed using the Virtual Man Project and refined using multiple 3D software applications. In the next phase, computer graphic modelling and previsualization were executed. After that, the video was revised and edited based on suggestions. Finally, explanatory subtitles were generated, the models were textured and rendered, and voiceovers in 3 languages were implemented. Results: We developed a 6-minute virtual 3D dynamic video in 3 languages (English, Spanish, and Brazilian Portuguese) intended for dentists and dental students to support teaching and learning of caries lesion detection. The videos were made available on YouTube; to date, they have received more than 100,000 views. Conclusions: Complementary pedagogical tools are valuable to support cariology education. This tool will be further tested in terms of utility and usability as well as user satisfaction in achieving the proposed objectives in specific contexts. ",
doi="10.2196/14140",
url="http://mededu.jmir.org/2020/1/e14140/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32441661"
}


@Article{info:doi/10.2196/15304,
author="Gaiser, Meike
and Kirsch, Joachim
and Mutzbauer, Sebastian Till",
title="Using Nonexpert Online Reports to Enhance Expert Knowledge About Causes of Death in Dental Offices Reported in Scientific Publications: Qualitative and Quantitative Content Analysis and Search Engine Analysis",
journal="J Med Internet Res",
year="2020",
month="Apr",
day="17",
volume="22",
number="4",
pages="e15304",
keywords="dental death",
keywords="dental practice",
keywords="dental sedation",
keywords="risk",
keywords="internet search engine",
abstract="Background: Fatalities rarely occur in dental offices. Implications for clinicians may be deduced from scientific publications and internet reports about deaths in dental offices. Objective: Data involving deaths in dental facilities were analyzed using Google as well as the PubMed database. By comparing both sources, we examined how internet data may enhance knowledge about deaths in dental offices obtained from scientific medical publications, which causes of death are published online, and how associated life-threatening emergencies may be prevented. Methods: To retrieve relevant information, we searched Google for country-specific incidents of death in dental practices using the following keywords: ``death at the dentist,'' ``death in dental practice,'' and ``dying at the dentist.'' For PubMed searches, the following keywords were used: ``dentistry and mortality,'' ``death and dental treatment,'' ``dentistry and fatal outcome,'' and ``death and dentistry.'' Deaths associated with dental treatment in a dental facility, attributable causes of death, and documented ages of the deceased were included in our analysis. Deaths occurring in maxillofacial surgery or pre-existing diseases involved in the death (eg, cancer and abscesses) were excluded. A total of 128 cases from online publications and 71 cases from PubMed publications that met the inclusion criteria were analyzed using chi-square statistics after exclusion of duplicates. Results: The comparison between the fatalities from internet (n=117) and PubMed (n=71) publications revealed that more casualties affecting minors appeared online than in PubMed literature (online 68/117, 58.1\%; PubMed 20/71, 28\%; P<.001). In PubMed articles, 10 fatalities in patients older than 70 years of age were described, while online sources published 5 fatalities (P=.02). Most deaths, both from internet publications and PubMed literature, could be assigned to the category anesthesia, medication, or sedation (online 80/117, 68.4\%; PubMed 25/71, 35\%; P<.001). Deaths assigned to the categories infection and cardiovascular system appeared more often in the PubMed literature (infection: online 10/117, 8.5\%; PubMed 15/71, 21\%; P=.01; cardiovascular system: online 5/117, 4.3\%; PubMed 15/71, 21\%; P<.001). Furthermore, sedative drugs were involved in a larger proportion of fatal incidents listed online compared to in PubMed (online 41/117, 35.0\%; PubMed: 14/71, 20\%, P=.03). In the United States, more deaths occurred under sedation (44/96, 46\%) compared to those in the other countries (Germany and Austria 1/17, 6\%, P=.002; United Kingdom 1/14, 7\%, P=.006). Conclusions: Online and PubMed databases may increase awareness of life-threatening risks for patients during dental treatment. Negative aspects of anesthesia and sedation, as well as the number of deaths of young patients, were underestimated when reviewing PubMed literature only. Medical history of patients, medication dosages, and vital function monitoring are significant issues for practitioners. A high-impact finding from online reports was the underestimation of risks when performing sedation and even general anesthesia. Detailed knowledge of the definition and understanding of deep sedation and general anesthesia by dentists is of major concern. By avoiding potentially hazardous procedures, such as sedation-aided treatments performed solely by dentists, the risk of treatment-induced life-threatening emergencies may be reduced. ",
doi="10.2196/15304",
url="http://www.jmir.org/2020/4/e15304/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32038029"
}


@Article{info:doi/10.2196/17250,
author="Kanzow, Philipp
and B{\"u}ttcher, Friederike Amelie
and Wiegand, Annette
and Schwendicke, Falk",
title="Quality of Information Regarding Repair Restorations on Dentist Websites: Systematic Search and Analysis",
journal="J Med Internet Res",
year="2020",
month="Apr",
day="15",
volume="22",
number="4",
pages="e17250",
keywords="evidence-based dentistry",
keywords="internet",
keywords="restoration repair",
keywords="shared decision making",
abstract="Background: Repairing instead of replacing partially defective dental restorations represents a minimally invasive treatment concept, and repairs are associated with advantages over complete restoration replacement. To participate in the shared decision-making process when facing partially defective restorations, patients need to be aware of the indications, limitations, and advantages or disadvantages of repairs. Patients are increasingly using the internet to gain health information like this online. Objective: We aimed to assess the quality of German-speaking dentist websites on repairs of partially defective restorations. Methods: Three electronic search engines were used to identify German-speaking websites of dental practices mentioning repairs. Regarding information on repairs, websites were assessed for (1) technical and functional aspects, (2) comprehensiveness of information, and (3) generic quality and risk of bias. Domains 1 and 3 were scored using validated tools (LIDA and DISCERN). Comprehensiveness was assessed using a criterion checklist related to evidence, advantages and disadvantages, restorations and defects suitable for repairs, and information regarding technical implementation. Generalized linear modeling was used to assess the impact of practice-specific parameters (practice location, practice setting, dental society membership, and year of examination or license to practice dentistry) on the quality of information. An overall quality score was calculated by averaging the quality scores of all three domains and used as primary outcome parameter. Quality scores of all three domains were also assessed individually and used as secondary outcomes. Results: Fifty websites were included. The median score of quality of information was 23.2\% (interquartile range [IQR] 21.7\%-26.2\%). Technical and functional aspects (55.2\% [IQR 51.7\%-58.6\%]) showed significantly higher quality than comprehensiveness of information (8.3\% [IQR 8.3\%-16.7\%]) and generic quality and risk of bias (3.6\% [IQR 0.0\%-7.1\%]; P<.001/Wilcoxon). Quality scores were not related to practice-specific parameters (P>.05/generalized linear modeling). Conclusions: The quality of German-speaking dentist websites on repairs was limited. Despite sufficient technical and functional quality, the provided information was neither comprehensive nor trustworthy. There is great need to improve the quality of information to fully and reliably inform patients, thereby allowing shared decision making. ",
doi="10.2196/17250",
url="http://www.jmir.org/2020/4/e17250/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32062595"
}


@Article{info:doi/10.2196/15152,
author="Jeong, Jin-Sun
and Pang, Nan-Sim
and Choi, Yiseul
and Park, Kyeong-Mee
and Kim, Taekbin
and Xu, Xin
and Park, Wonse",
title="Importance of Photography Education to Improve Image Quality for Accurate Remote Diagnoses in Dental Trauma Patients: Observational Study",
journal="JMIR Mhealth Uhealth",
year="2020",
month="Mar",
day="26",
volume="8",
number="3",
pages="e15152",
keywords="telemedicine",
keywords="remote consultation",
keywords="emergencies",
keywords="tooth injuries",
keywords="cell phone",
abstract="Background: High-quality photos are critical for the remote diagnosis of dental trauma and thus are beneficial to the prognosis. The quality of the images obtained using a cell phone depends on the level of dental and photography knowledge of the person who is taking the photos. Objective: This study aimed to determine the efficacy of photography education in improving images used for the remote diagnosis of dental trauma. Methods: The subjects comprised 30 laypeople and 30 dentists who were randomly assigned to 15 subgroups with 2 subjects in each. Each subject was asked to take photos of their own anterior teeth and those of their partner on the assumption that an accident occurred using both an iPhone 4s and iPhone 6. Education about how to take an appropriate photo of the anterior teeth for teleconsultation purposes was then provided, after which photos were taken again. Photos were assessed by a dentist for their usefulness in diagnosis. Results: This study analyzed 965 photos: 441 taken by laypeople and 524 taken by dentists. Photos taken after providing education had significantly higher scores for all assessment items than those taken before education (P<.05). The scores were also significantly higher for photos taken using the rear camera than those taken using the front camera (P<.02). The iPhone 6 did not have overwhelming advantages. The photos taken by dentists had significantly higher scores than those taken by laypeople for most of the evaluated items. Conclusions: Both laypeople and dentists might find photography education useful for when they are taking photos to be used in teleconsultations. The type of cell phone does not significantly affect the usefulness of such photos. ",
doi="10.2196/15152",
url="http://mhealth.jmir.org/2020/3/e15152/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32213475"
}


@Article{info:doi/10.2196/14156,
author="Melo, Paulo
and Malone, Sinead
and Rao, Arathi
and Fine, Charlotte",
title="A 21-Day School-Based Toothbrushing Intervention in Children Aged 6 to 9 Years in Indonesia and Nigeria: Protocol for a Two-Arm Superiority Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2020",
month="Feb",
day="21",
volume="9",
number="2",
pages="e14156",
keywords="school children",
keywords="oral health",
keywords="OHIs",
keywords="DMFT",
keywords="school program",
keywords="knowledge transfer",
keywords="behavior change",
abstract="Background: The World Health Organization reports that dental cavities affect 60\% to 90\% of children globally. FDI World Dental Federation and Unilever Oral Care have developed public health programs to improve brushing habits over their 12-year partnership. The last of these (phase III) named Brush Day \& Night aimed to educate children on brushing twice daily with a fluoride toothpaste and gave useful information for a new project, phase IV. The 21-day Brush Day \& Night program is an intense education activity designed to establish the habit of brushing day and night with a fluoride toothpaste. The program involves daily brushing instruction and includes free toothpaste and toothbrushes. Objective: The main objective of the study is to evaluate the impact of a 21-day school program on children's oral health. As a secondary objective, we aim to evaluate the impact on the knowledge, behavior, toothbrushing habits, and quality of life in school children aged 6 to 9 years after a 21-day school program and compare with baseline and a control group as measured by the self-reported questionnaires issued to children (in particular, the self-reported brushing frequency and positive responses on fluoridated toothpaste use). The enduring nature of the program will be determined by the inclusion of 8- and 24-week time points. Methods: The study is a 2-arm superiority randomized controlled trial. Clusters in this study are infant and junior schools in Indonesia and Nigeria. The study aims to recruit 20 schools with children aged 6 to 9 years in each country. At baseline, children in both intervention and control schools will answer a questionnaire and have their clinical oral health assessed using the Simplified Oral Hygiene Index (OHI) and Decayed Missing and Filled Teeth index. Children in the intervention schools will then take part in a structured 21-day Brush Day \& Night intervention. Children in the control schools will be provided with free toothpaste and toothbrushes but will not receive the 21-day intervention. The questionnaires and OHI assessments are repeated after the 21-day program is completed and again 8 weeks later and 24 weeks later for all participating children. Parents/carers/guardians of all children will sign the informed consent and complete questionnaires on their own experience and attitudes toward oral health and toothbrushing routine at each of the four times points (baseline, 21 days, 8 weeks, and 24 weeks). The study will be conducted by the national dental associations of Indonesia and Nigeria and was approved by the ethics committees of both countries. Results: The study is ongoing. Recruitment of schools started in Indonesia in February 2018 and in Nigeria in April 2018 for the first part of the study, which concluded in Indonesia in September 2018 and in Nigeria in November 2018. The second part of the study (the second half of the schools) started in November 2018 in Indonesia and December 2018 in Nigeria. Conclusions: We expect to collect all the data during 2019 and publish findings from the study by March 2020. Trial Registration: ClinicalTrials.gov NCT04001296; https://tinyurl.com/selxraa International Registered Report Identifier (IRRID): DERR1-10.2196/14156 ",
doi="10.2196/14156",
url="http://www.researchprotocols.org/2020/2/e14156/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32130186"
}


@Article{info:doi/10.2196/13656,
author="Aguirre, Ayala Patricia Estefania
and Lotto, Matheus
and Strieder, Paola Anna
and Cruvinel, Pereira Agnes F{\'a}tima
and Cruvinel, Thiago",
title="The Effectiveness of Educational Mobile Messages for Assisting in the Prevention of Early Childhood Caries: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2019",
month="Sep",
day="03",
volume="8",
number="9",
pages="e13656",
keywords="eHealth",
keywords="dental caries",
keywords="randomized controlled trial",
abstract="Background: In 2017, approximately 3.7 billion downloads of health apps were made on mobile phones and tablets. In this sense, a massive number of people could benefit by electronic mobile--based health interventions, making information available even with the lack of material and human resources. Hence, the use of electronic apps for dental education might be extremely useful for the prevention of early childhood caries (ECC). Objective: This study aims to evaluate the effectiveness of messages sent via mobile phones as an adjuvant method for the prevention of ECC. Methods: A single-blinded, randomized, and parallel-group clinical trial will be conducted with dyads of parents or caregivers and children aged between 36 and 60 months, recruited from kindergartens and schools of Bauru, S{\~a}o Paulo. The determination of sample size resulted in a total of 104 dyads of parents and children, considering a power of 80\%, a significance level of 5\%, and an attrition of 30\%. This sample will be randomly assigned to test and control groups, being divided in 52 dyads per group according to the health literacy levels of parents and the age, gender, and oral health status of children. Every 2 weeks, only participants in the test group will receive messages via WhatsApp containing preventive and education-related ECC information. The dyads will visit the dentist every 3 months during a year for the assessment of primary outcomes (sugar consumption and the International Caries Detection and Assessment System, visible plaque, and community periodontal indices) and to receive dental care measures. Secondary outcomes (electronic health literacy and general perceived self-efficacy) will be determined only at baseline and after 12-month follow-up. The quality of randomization will be evaluated throughout the study, comparing the test and control groups systematically by Student t tests for continuous variables and chi-square tests for categorical variables. Listwise deletion method will be applied in cases of dropouts, if the missing values satisfy the criteria of missing completely at random; otherwise, multiple imputation data strategy will be conducted. The Kolmogorov-Smirnov and Levene tests will be used to determine the normality and homogeneity of data, respectively, which will indicate further statistical analyses for elucidating significant differences between groups (P<.05). A Student t test or Mann-Whitney U test will be employed for parametric or nonparametric analyses, respectively. Results: The project was funded in 2018, and enrollment was completed in August 2019. Allocation is currently under way and the first results are expected to be submitted for publication in 2020. Conclusions: The results will contribute to understanding the importance of educational mobile messages toward the adoption of healthy behaviors for the prevention of ECC in a given population. Trial Registration: Brazilian Registry of Clinical Trials Universal Trial Number U1111-1216-1393; http://www.ensaiosclinicos.gov.br/rg/RBR-2b6r7q/ International Registered Report Identifier (IRRID): PRR1-10.2196/13656 ",
doi="10.2196/13656",
url="https://www.researchprotocols.org/2019/9/e13656/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31482856"
}


@Article{info:doi/10.2196/13237,
author="Kumar, Satheesh Preeti
and KS, Kumar Satheesh
and Grandhi, Venkatesh Vyoma
and Gupta, Vrinda",
title="The Effects of Titanium Implant Surface Topography on Osseointegration: Literature Review",
journal="JMIR Biomed Eng",
year="2019",
month="Jun",
day="8",
volume="4",
number="1",
pages="e13237",
keywords="implant interface",
keywords="TPS",
keywords="acid etching",
keywords="alkaline etching",
keywords="anodisation",
keywords="polymer demixing",
keywords="sol gel",
abstract="Background: A variety of claims are made regarding the effects of surface topography on implant osseointegration. The development of implant surfaces topography has been empirical, requiring numerous in vitro and in vivo tests. Most of these tests were not standardized, using different surfaces, cell populations, or animal models. The exact role of surface chemistry and topography on the early events of the osseointegration of dental implants remains poorly understood. Objective: The aim of this study was to consider the major claims made concerning the effects of titanium implant surface topography on osseointegration. The osseointegration rate of titanium dental implants is related to their composition and surface roughness. The different methods used for increasing surface roughness or applying osteoconductive coatings to titanium dental implants were reviewed. Important findings of consensus were highlighted, and existing controversies were revealed. Methods: This paper considered many of the research publications listed in Medical Literature Analysis and Retrieval System Online and presented in biomedical research publications and textbooks. Surface treatments, such as titanium plasma spraying, grit blasting, acid etching, alkaline etching, anodization, polymer demixing, sol-gel conversion, and their corresponding surface morphologies and properties were described. Results: Many in vitro evaluations are not predictive of or correlated with in vivo outcomes. In some culture models, increased surface topography positively affects proosteogenic cellular activities. Many studies reveal increase in bone-to-implant contact (BIC), with increased surface topography modifications on implant surfaces. Conclusions: Increased implant surface topography improves the BIC and the mechanical properties of the enhanced interface. ",
doi="10.2196/13237",
url="http://biomedeng.jmir.org/2019/1/e13237/"
}


@Article{info:doi/10.2196/13008,
author="Levitin, Aaron Seth
and Grbic, T. John
and Finkelstein, Joseph",
title="Completeness of Electronic Dental Records in a Student Clinic: Retrospective Analysis",
journal="JMIR Med Inform",
year="2019",
month="Mar",
day="21",
volume="7",
number="1",
pages="e13008",
keywords="electronic medical records",
keywords="patient record completeness",
keywords="dentistry",
abstract="Background: A well-designed, adequately documented, and properly maintained patient record is an important tool for quality assurance and care continuity. Good clinical documentation skills are supposed to be a fundamental part of dental student training. Objective: The goal of this study was to assess the completeness of electronic patient records in a student clinic. Methods: Completeness of patient records was assessed using comparative review of validated cases of alveolar osteitis treated between August 2011 and May 2017 in a student clinic at Columbia University College of Dental Medicine, New York, USA. Based on a literature review, population-based prevalence of nine most frequently mentioned symptoms, signs, and treatment procedures of alveolar osteitis was identified. Completeness of alveolar osteitis records was assessed by comparison of population-based prevalence and frequency of corresponding items in the student documentation. To obtain all alveolar osteitis cases, we ran a query on the electronic dental record, which included all cases with diagnostic code Z1820 or any variation of the phrases ``dry socket'' and ``alveolar osteitis'' in the notes. The resulting records were manually reviewed to definitively confirm alveolar osteitis and to extract all index items. Results: Overall, 296 definitive cases of alveolar osteitis were identified. Only 22\% (64/296) of cases contained a diagnostic code. Comparison of the frequency of the nine index categories in the validated alveolar osteitis cases between the student clinic and the population showed the following results: severe pain: 94\% (279/296) vs 100\% (430/430); bare bone/missing blood clot: 27\% (80/296) vs 74\% (35/47) to 100\% (329/329); malodor: 7\% (22/296) vs 33\%-50\% (18/54); radiating pain to the ear: 8\% (24/296) vs 56\% (30/54); lymphadenopathy: 1\% (3/296) vs 9\% (5/54); inflammation: 14\% (42/296) vs 50\% (27/54); debris: 12\% (36/296) vs 87\% (47/54); alveolar osteitis site noted: 96\% (283/296) vs 100\% (430/430; accepted documentation requirement); and anesthesia during debridement: 77\% (20/24) vs 100\% (430/430; standard of anesthetization prior to debridement). Conclusions: There was a significant discrepancy between the index category frequency in alveolar osteitis cases documented by dental students and in the population (reported in peer-reviewed literature). More attention to clinical documentation skills is warranted in dental student training. ",
doi="10.2196/13008",
url="http://medinform.jmir.org/2019/1/e13008/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30896435"
}


@Article{info:doi/10.2196/12127,
author="Zhang, Wei
and Li, Zheng-Rong
and Li, Zhi",
title="WeChat as a Platform for Problem-Based Learning in a Dental Practical Clerkship: Feasibility Study",
journal="J Med Internet Res",
year="2019",
month="Mar",
day="19",
volume="21",
number="3",
pages="e12127",
keywords="PBL",
keywords="app",
keywords="WeChat",
keywords="clerkship",
keywords="dental medicine",
abstract="Background: Problem-Based-Learning (PBL) has been widely accepted in student-centered medical education. Since WeChat is the most popular communication app in China, we have chosen to use WeChat as new platform for online PBL in order to reduce the limitations of traditional PBL in dental practical clerkships. Objective: This study aims to demonstrate the feasibility and acceptability of online PBL using WeChat (WeChat-PBL) in a dental practical clerkship. Methods: A total of 72 students in a dental practical clerkship and 10 tutors participated in this study from June to August 2017. We created 10 WeChat groups to provide a communication platform for the PBL teaching, in which the students selected the PBL cases themselves from their practical clerkship. After each individual PBL case, group members were required to complete an evaluation on the PBL process itself. A final questionnaire survey was completed by the participants to summarize the long-term evaluation of the whole WeChat-PBL experience after the 3-month clerkship. Data from the PBL cases, WeChat messages, periodic evaluations, and long-term evaluations were collected for analysis. Results: There were 45 cases presented in the WeChat-PBL within the 3-month clerkship. All students had positive reactions to the communication within the PBL groups. The results of the periodic evaluation showed that the students and tutors were quite satisfied with the process of WeChat-PBL and appreciated the group members' contributions and performance. The final questionnaire results indicated that the WeChat-PBL had achieved positive effects. Conclusions: The results of this study indicate the feasibility and acceptability of the app, WeChat, for problem-based learning in a dental practical clerkship. ",
doi="10.2196/12127",
url="http://www.jmir.org/2019/3/e12127/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30888328"
}


@Article{info:doi/10.2196/10885,
author="Said Yekta-Michael, Sareh
and Sch{\"u}ppen, Andr{\'e}
and Gaebler, Johannes Arnim
and Ellrich, Jens
and Koten, Willem Jan",
title="Expertise Modulates Students' Perception of Pain From a Self-Perspective: Quasi-Experimental Study",
journal="J Med Internet Res",
year="2019",
month="Jan",
day="23",
volume="21",
number="1",
pages="e10885",
keywords="medical education",
keywords="virtual reality",
keywords="questionnaires",
keywords="physician",
abstract="Background: Perception of stimuli presented in a virtual dentistry environment affects regions of the brain that are related to pain perception. Objective: We investigated whether neural correlates of virtual pain perception are affected by education in dentistry. Methods: In this functional magnetic resonance imaging study, a sample of 20 dental students and 20 age-matched controls viewed and listened to video clips presenting a dental treatment from the first?person perspective. An anxiety questionnaire was used to assess the level of dental anxiety. Neural correlates of pain perception were investigated through classic general linear model analysis and in-house classification methods. Results: Dental students and na{\"i}ve controls exhibited similar anxiety levels for invasive stimuli. Invasive dentistry scenes evoked a less affective component of pain in dental students compared with na{\"i}ve controls (P<.001). Reduced affective pain perception went along with suppressed brain activity in pain matrix regions including the insula, anterior cingulate cortex, and basal ganglia. Furthermore, a substantial reduction of brain activity was observed in motor-related regions, particularly the supplementary motor area, premotor cortex, and basal ganglia. Within this context, a classifier analysis based on neural activity in the nucleus lentiformis could identify dental students and controls on the individual subject level in 85\% of the cases (34 out of 40 participants, sensitivity=90\%, specificity=80\%). Conclusions: Virtual dental treatment activates pain-related brain regions in controls. By contrast, dental students suppress affective and motor-related aspects of pain. We speculate that dental students learn to control motoric aspects of pain perception during their education because it is a prerequisite for the professional manual treatment of patients. We discuss that a specific set of learning mechanisms might affect perceived self-efficacy of dental students, which in turn might reduce their affective component of pain perception. ",
doi="10.2196/10885",
url="http://www.jmir.org/2019/1/e10885/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30674449"
}


@Article{info:doi/10.5210/ojphi.v10i3.9487,
title="Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review",
journal="Online J Public Health Inform",
year="2018",
volume="10",
number="3",
pages="e9487",
doi="10.5210/ojphi.v10i3.9487",
url="",
url="http://www.ncbi.nlm.nih.gov/pubmed/30680052"
}


@Article{info:doi/10.2196/11347,
author="Reddy, Shravya
and Kumar, S. Preeti
and Grandhi, V. Vyoma",
title="Relationship Between the Applied Occlusal Load and the Size of Markings Produced Due to Occlusal Contact Using Dental Articulating Paper and T-Scan: Comparative Study",
journal="JMIR Biomed Eng",
year="2018",
month="Oct",
day="02",
volume="3",
number="1",
pages="e11347",
keywords="occlusal indicator",
keywords="occlusal load",
keywords="articulating paper",
keywords="T-Scan",
abstract="Background: The proposed experimental design was devised to determine whether a relationship exists between the occlusal load applied and the size of the markings produced from tooth contact when dental articulating paper and T-Scan are interposed alternatively. Objective: The objective of our study was to compare the relationship between contact markings on an articulating paper and T-Scan for an applied occlusal load. Methods: In this in vitro study, dentulous maxillary and mandibular dies were mounted on a metal jig and articulating paper and T-Scan sensor were placed alternatively between the casts. Loads simulating occlusal loads began at 25 N and incrementally continued up to 450 N. The resultant markings (180 marks resulting from articulating paper and 138 from T-Scan) were photographed, and the marks were analyzed using MOTIC image analysis and sketching software. Descriptive statistical analyses were performed using one-way analysis of variance, Student t test, and Pearson correlation coefficient method. Results: Statistical interpretation of the data indicated that with articulating paper, the mark area increased nonlinearly with increasing load and there was a false-positive result. The characteristics of the paper mark appearance did not describe the amount of occlusal load present on a given tooth. The contact marking obtained using T-Scan for an applied occlusal load indicated that the mark area increased with increase in the load and provided more predictable results of actual load content within the occlusal contact. Conclusions: The size of an articulating paper mark may not be a reliable predictor of the actual load content within the occlusal contact, whereas a T-Scan provides more predictable results of the actual load content within the occlusal contact. ",
doi="10.2196/11347",
url="http://biomedeng.jmir.org/2018/1/e11347/"
}


@Article{info:doi/10.2196/mhealth.9626,
author="Scheerman, Maria Janneke Francisca
and van Empelen, Pepijn
and van Loveren, Cor
and van Meijel, Berno",
title="A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach",
journal="JMIR Mhealth Uhealth",
year="2018",
month="Aug",
day="17",
volume="6",
number="8",
pages="e163",
keywords="health behavior",
keywords="mHealth",
keywords="oral health",
keywords="oral hygiene",
keywords="dental caries",
keywords="adolescent",
keywords="dental plaque",
keywords="prevention",
keywords="intervention mapping",
abstract="Background: The insertion of fixed orthodontic appliances increases the risk of dental caries, particularly in adolescents. Caries can be prevented through good oral health behavior. To support adolescents with fixed orthodontic appliances and for promoting oral health behavior, we developed a theory- and evidence-based mHealth program, the WhiteTeeth app. Objective: The objective of our paper was to describe the systematic development and content of the WhiteTeeth app. Methods: For systematic development of the program, we used the intervention mapping (IM) approach. In this paper, we present the results of applying the first 5 steps of IM to the design of an mHealth program: (1) identifying target behaviors and determinants through problem analysis, including a literature search, a survey study, and semistructured interviews, to explore adolescent oral health behavior during orthodontic therapy; (2) defining program outcomes and objectives; (3) selecting theoretical methods and translating them into practical strategies for the program design; (4) producing the program, including a pilot test with 28 adolescents testing the acceptability and usability of the WhiteTeeth app; and (5) planning implementation and adoption. Results: On the basis of our literature search, we identified fluoride use and control of dental plaque levels (eg, tooth brushing and proxy brush usage) as target behaviors for preventing caries. Next, we identified important and changeable determinants of oral health behavior that fitted the theoretical concepts of the Health Action Process Approach (HAPA) theory. The HAPA theory, the self-regulation theory, and the results of the semistructured interviews were used to define the program objectives, that is, the performance and change objectives. After defining the objectives, we identified multiple behavior change techniques that could be used to achieve these objectives, such as providing oral health information and feedback, prompting self-monitoring, coaching of set actions and coping plans, and sending reminders. We translated these methods into practical strategies, such as videos and a brushing timer. Next, we combined these strategies into a single program resulting in the WhiteTeeth app (which is available on both iTunes and Google Play stores as ``Witgebit''). Adolescents with fixed orthodontic appliances and dental professionals were included in the development process to increase the success of implementation. The pilot test revealed that the app users appreciated and liked the app. The WhiteTeeth app can be integrated into current orthodontic care. Conclusions: IM allowed us to identify multiple techniques that have been shown to be the most effective in initiating behavior change, but have not yet been incorporated into existing orthodontic apps. The WhiteTeeth app contains all these techniques, which makes it a unique and promising home-based app for promoting oral health in adolescents with fixed orthodontic appliances. ",
doi="10.2196/mhealth.9626",
url="http://mhealth.jmir.org/2018/8/e163/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30120085"
}


@Article{info:doi/10.2196/10322,
author="Arrow, Peter
and McPhee, Rob
and Atkinson, David
and Mackean, Tamara
and Kularatna, Sanjeewa
and Tonmukayakul, Utsana
and Brennan, David
and Palmer, David
and Nanda, Soniya
and Jamieson, Lisa",
title="Minimally Invasive Dentistry Based on Atraumatic Restorative Treatment to Manage Early Childhood Caries in Rural and Remote Aboriginal Communities: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2018",
month="Jul",
day="25",
volume="7",
number="7",
pages="e10322",
keywords="cost-effectiveness analysis",
keywords="early childhood caries",
keywords="health utility",
keywords="health-related quality of life",
abstract="Background: The caries experience of Aboriginal children in Western Australia (WA) and elsewhere in Australia is more than twice that of non-Aboriginal children. Early childhood caries (caries among children <6 years) has a significant impact on the quality of life of children and their caregivers, and its management is demanding and commonly undertaken under general anesthesia. A randomized controlled trial using a minimally invasive dentistry approach based on Atraumatic Restorative Treatment (ART) in metropolitan Perth, WA, has demonstrated a significant reduction in the rate of referral to a dental specialist for dental care among children with early childhood caries, potentially reducing the need for treatment under general anesthesia. The tested approach was clinically successful and was without adverse effects on child dental anxiety. The model of ART-based primary care requires further testing and development if similar outcomes for Aboriginal children in remote and rural settings are to be achieved. Objective: The study aims to develop, implement, and evaluate a remote primary care model to deliver effective primary dental services, encompassing treatment and preventive services, to Aboriginal preschool children (based on minimally invasive approaches including ART). Methods: This is a two-arm parallel cluster randomized controlled study in which a test group will be provided with the intervention treatment at the start of the study and a control group will be provided with the intervention treatment 12 months after study commencement (delayed intervention). Participating communities, stratified by size of community (ie, number of children in the sample frame) and baseline caries experience, will be randomly assigned using a computer-generated block randomized list into immediate (test group) or delayed intervention (control group; provided with standard care). Informed consent will be obtained from all participants. Aboriginal research assistants will explain the study to the parents and assist the parents in completing the questionnaires. Participants in the randomized study will be examined at baseline and at 12 months follow-up by a calibrated examiner. Test group participants will subsequently be contacted and appropriate appointments coordinated for treatment. Control group participants will be provided with standard preventive care by the Aboriginal Health Workers and managed for treatment as per standard procedures. Results: Community consultations have been undertaken and 26 communities have agreed to participate. Fieldwork is in progress to recruit study participants. Conclusions: The significance of the study lies in its holistic approach to testing the model of care. Clinical evaluations as well as oral health?related quality of life evaluations will be undertaken. Cost-effectiveness and cost-utility evaluations will assist in the development of policy options for oral health services for rural and remote communities. The elicitation of caregiver perspectives through focus group interviews will supplement the clinical, psychosocial, and cost-utility evaluations and provide a richer evaluation of the intervention. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12616001537448; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371735 (Archived by WebCite at http://www.webcitation.org/70UMxndFZ) Registered Report Identifier: RR1-10.2196/10322 ",
doi="10.2196/10322",
url="http://www.researchprotocols.org/2018/7/e10322/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30045834"
}


@Article{info:doi/10.2196/10053,
author="Andiesta, Survia Niekla
and Hamid, A. Maimunah
and Lee, KKC
and Pau, Allan",
title="Dental Home Visits for Caries Prevention Among Preschool Children: Protocol for a Cost-Effectiveness Analysis on a Randomized Control Trial",
journal="JMIR Res Protoc",
year="2018",
month="Jun",
day="06",
volume="7",
number="6",
pages="e10053",
keywords="cost-effectiveness analysis",
keywords="dental home visits",
keywords="caries prevention",
keywords="preschool children",
abstract="Background: In 2012, nearly 4000 children in Malaysia were referred to hospital pediatric dental services due to dental caries. Recent research has reported the effectiveness of dental home visits in preventing caries development in young children. Dental home visits (DHVs) are described as an ongoing relationship between the dentist and their patients, providing all aspects of a preventive oral health care program in the presence of the parents at home. Objective: The objective of this study is to evaluate the cost-effectiveness of dental home visits and oral health information, in the form of educational leaflets, in preventing new caries development in young children, compared to those receiving only educational leaflets over a period of two years. Cost-effectiveness analysis will be used to evaluate the cost-effectiveness of dental home visits. Methods: This is a collaborative project with the Oral Health Division of the Ministry of Health Malaysia. The Oral Health Division will provide access to a subsample from the National Oral Health of Preschoolers Survey which was carried out in 2015. The population of interest is children aged 5 and 6 years from kindergartens in the Selangor state of Malaysia. The study adopted a societal perspective for cost-effectiveness analysis and all types of resources that are of value to society will be included in analyzing the costs; such as cost to the patient, cost to the provider or institution, and indirect costs because of loss of productivity. Results: The trial has been approved by the International Medical University Malaysia's Joint Research and Ethics Committee (Project ID: IMU R157-2014 [File III -- 2016]). This trial is currently recruiting participants. Conclusions: The number of young children in Malaysia who have been referred to the hospital children's dentistry service for severe caries is disturbing. The cost of dental treatment in young children is high due to the severity of the caries which require an aggressive treatment, and the need for general anesthesia or sedation. This study will provide information on the cost and effectiveness of DHVs in caries prevention of young children in Malaysia. Registered Report Identifier: RR1-10.2196/10053 ",
doi="10.2196/10053",
url="http://www.researchprotocols.org/2018/6/e10053/"
}


@Article{info:doi/10.2196/resprot.4485,
author="Cunha-Cruz, Joana
and Milgrom, Peter
and Shirtcliff, Michael R.
and Huebner, E. Colleen
and Ludwig, Sharity
and Allen, Gary
and Scott, JoAnna",
title="``Everybody Brush!'': Protocol for a Parallel-Group Randomized Controlled Trial of a Family-Focused Primary Prevention Program With Distribution of Oral Hygiene Products and Education to Increase Frequency of Toothbrushing",
journal="JMIR Res Protoc",
year="2015",
month="May",
day="22",
volume="4",
number="2",
pages="e58",
keywords="oral hygiene",
keywords="toothbrushing",
keywords="dental devices, home care",
keywords="dental care",
keywords="communication",
keywords="social support",
abstract="Background: Twice daily toothbrushing with fluoridated toothpaste is the most widely advocated preventive strategy for dental caries (tooth decay) and is recommended by professional dental associations. Not all parents, children, or adolescents follow this recommendation. This protocol describes the methods for the implementation and evaluation of a quality improvement health promotion program. Objective: The objective of the study is to show a theory-informed, evidence-based program to improve twice daily toothbrushing and oral health-related quality of life that may reduce dental caries, dental treatment need, and costs. Methods: The design is a parallel-group, pragmatic randomized controlled trial. Families of Medicaid-insured children and adolescents within a large dental care organization in central Oregon will participate in the trial (n=21,743). Families will be assigned to one of three groups: a test intervention, an active control, or a passive control condition. The intervention aims to address barriers and support for twice-daily toothbrushing. Families in the test condition will receive toothpaste and toothbrushes by mail for all family members every three months. In addition, they will receive education and social support to encourage toothbrushing via postcards, recorded telephone messages, and an optional participant-initiated telephone helpline. Families in the active control condition will receive the kit of supplies by mail, but no additional instructional information or telephone support.  Families assigned to the passive control will be on a waiting list. The primary outcomes are restorative dental care received and, only for children younger than 36 months old at baseline, the frequency of twice-daily toothbrushing.  Data will be collected through dental claims records and, for children younger than 36 months old at baseline, parent interviews and clinical exams. Results: Enrollment of participants and baseline interviews have been completed. Final results are expected in early summer, 2017. Conclusions: If proven effective, this simple intervention can be sustained by the dental care organization and replicated by other organizations and government. Trial Registration: Trial Registration: ClinicalTrials.gov NCT02327507; http://clinicaltrials.gov/ct2/show/NCT02327507 (Archived by WebCite at http://www.webcitation.org/6YCIxJSor). ",
doi="10.2196/resprot.4485",
url="http://www.researchprotocols.org/2015/2/e58/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26002091"
}


@Article{info:doi/10.2196/ijmr.3210,
author="S Parthasarathy, Divya
and Bridges, M. Susan
and McGrath, PJ Colman
and Au, KF Terry
and Wong, Ming Hai
and Yiu, KY Cynthia",
title="The Relation Between Caregivers' Multiliterate Reading Habits and Their Children's Oral Health Status",
journal="Interact J Med Res",
year="2014",
month="Sep",
day="18",
volume="3",
number="3",
pages="e13",
keywords="health literacy",
keywords="multilingualism",
keywords="multiliteracies",
keywords="health informatics",
keywords="medical consumerism",
keywords="digital",
keywords="caregiver",
keywords="oral health status",
keywords="paediatrics",
abstract="Background: Caregivers' oral health literacy (OHL) assessment results have been found to be related to their children's oral health status. A further aspect of this relationship may be the role of caregivers' reading habits. Objective: Our goal was to describe the relationship between caregivers' multimodal (digital and print) and multilingual (English and Chinese) reading habits, their OHL, and their child's oral health status in Hong Kong. Methods: A random sample of 301 child-caregiver dyads was recruited from kindergartens in Hong Kong. Data included sociodemographic information and caregivers' self-reported digital print and reading habits across two languages (Chinese and English). Caregivers' OHL levels were assessed by two locally developed and validated oral health literacy assessment tasks: Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) and the Hong Kong Oral Health Literacy Assessment Task for Pediatric Dentistry (HKOHLAT-P). Children's oral health status was assessed using two measures: dental caries experience (number of decayed, missing, and filled teeth) and oral hygiene status (Visible Plaque Index). Results: Bivariate variations revealed significant differences in mean OHL scores between caregivers with different reading habits (P<.01). Correlations revealed significant associations between caregivers' practices of reading multimodal (print/digital) and multilingual (English/Chinese) texts, their literacy levels, and their children's oral health status (P<.01). Adjusting for sociodemographics and all other reading habits in the regression analysis, the caregivers' habit of reading digital and print texts was significantly retained in the final model. Regression analysis revealed significant associations between caregivers' reading habits (digital Chinese) and their OHL word recognition scores: OR 5.00, 95\% CI 1.10-3.65, P=.027. Significant associations were also evident for their OHL comprehension scores (digital Chinese: OR 2.30, 95\% CI 1.30-4.20, P=.004; print Chinese: OR 2.50, 95\% CI 1.40-4.30, P=.001). However, no significant associations were found between caregivers' reading habits and child's oral health status (P>.05). Conclusions: Caregivers' habits of reading print and digital Chinese texts are significantly associated with their OHL scores. Their reading habits, however, do not affect their children's oral health status. ",
doi="10.2196/ijmr.3210",
url="http://www.i-jmr.org/2014/3/e13/",
url="http://www.ncbi.nlm.nih.gov/pubmed/25236188"
}


@Article{info:doi/10.5210/ojphi.v5i1.4407,
title="Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review",
journal="Online J Public Health Inform",
year="2013",
volume="5",
number="1",
pages="e4407",
doi="10.5210/ojphi.v5i1.4407",
url=""
}


@Article{info:doi/10.5210/ojphi.v5i1.4412,
title="Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review",
journal="Online J Public Health Inform",
year="2013",
volume="5",
number="1",
pages="e4412",
doi="10.5210/ojphi.v5i1.4412",
url=""
}


@Article{info:doi/10.5210/ojphi.v5i1.4452,
title="Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review",
journal="Online J Public Health Inform",
year="2013",
volume="5",
number="1",
pages="e4452",
doi="10.5210/ojphi.v5i1.4452",
url=""
}


@Article{info:doi/10.5210/ojphi.v4i3.4279,
title="Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review",
journal="Online J Public Health Inform",
year="2012",
volume="4",
number="3",
pages="e4279",
doi="10.5210/ojphi.v4i3.4279",
url="",
url="http://www.ncbi.nlm.nih.gov/pubmed/23569642"
}


@Article{info:doi/10.5210/ojphi.v3i2.3800,
title="Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review",
journal="Online J Public Health Inform",
year="2011",
volume="3",
number="2",
pages="e3800",
doi="10.5210/ojphi.v3i2.3800",
url="",
url="http://www.ncbi.nlm.nih.gov/pubmed/23569611"
}