To identify sociodemographic and structural factors associated with dentist availability in Indigenous localities of Peru in 2024. An observational, analytical, ecological cross-sectional study was conducted using secondary data from the National Health Establishment Registry (HISMINSA) and the Indigenous or Native Peoples Database (BDPI) for 2024. The sample included 1277 officially recognized Indigenous localities in the Andean and Amazonian regions. Dentist availability, defined as the presence of at least one registered dentist in the local health facility, was the dependent variable. Independent variables included demographic factors (population size and proportion of Indigenous language speakers), geographic characteristics (Andean or Amazonian region and department) and structural indicators (household access to water, sewerage and electricity). Logistic regression models, adjusted using a directed acyclic graph (DAG), were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Of 1277 Indigenous localities, 32.0% had at least one dentist and 68.0% had none. In adjusted models, Amazonian localities had significantly lower odds of dentist availability compared with Andean localities (aOR = 0.585; 95% CI: 0.41-0.83). Larger numbers of households and the presence of sewerage were modestly associated with higher availability, while substantial geographical disparities persisted. Geographic and structural factors were associated with dentist availability in Indigenous localities of Peru, with persistent disadvantages observed in Amazonian regions. These findings highlight territorial inequalities in the distribution of oral health services and support the need for policies aimed at improving access to dental care in underserved Indigenous communities.
Cone Beam Computed Tomography (CBCT) is a widely used imaging technology in dentistry, requiring specialized training and a specific license in Germany. This study aimed to evaluate the effectiveness of an e-learning platform for acquiring CBCT knowledge and to examine participant satisfaction and experiences. The study included German dentists, half with CBCT license and half without. The participants completed an online pre-test with 15 image-based questions to assess basic knowledge and then were given access to the e-platform containing 104 annotated CBCT cases (e.g. implant planning, cysts, or impacted teeth). After 8-10 weeks, a post-test similar to the pre-test was conducted. An 11-item questionnaire recorded participant experience. Data were analysed using independent and paired t-tests, and Fisher's exact test; p < 0.05 was considered statistically significant. Between May and October 2025, 32 dentists participated in the study (16 with and 16 without CBCT license). Learning with the e-learning platform led to a significant increase in knowledge (p < 0.001). Participants with CBCT license had higher baseline scores than those without (75.8% vs. 69.3%; p < 0.05); after the learning phase, the difference was no longer significant (p = 0.37), with final scores of 83.1% and 80.6%, respectively. Regardless of CBCT license status, dentists found the platform to be a valuable tool for enhancing diagnostic skills, offering a user-friendly, case-based structure. The digital learning platform significantly improved CBCT-related diagnostic skills and dentists, both with and without a CBCT license, found the platform practical and easy to use.
The potential influence of the initial child-dentist interaction on dental anxiety (DA) in preschool children remains insufficiently understood. Accurate assessment of DA using pictorial measures is essential to better characterize this relationship. However, pictorial self-report measures still have several limitations from a contemporary perspective, and evidence regarding the impact of the initial interaction on DA remains limited. This study aimed to evaluate the effect of the initial child-dentist interaction on DA and to explore potential Artificial Intelligence (AI)-based refinements in traditional pictorial measures. An observational pre-post (within-subject repeated-measures) study included 171 children aged 3-6 years attending their first dental visit. An AI-assisted pictorial measure (AI-PM) was designed through an expert panel process addressing the limitations of existing tools. DA was assessed pre and post the initial child-dentist interaction using established pictorial measures and the new tool. Validity, reliability (intraclass correlation coefficient), and inter-measurement agreement (Bland-Altman analysis) were evaluated. Changes in anxiety levels were analyzed using the Wilcoxon signed-rank test (p < 0.05). Anxiety scores decreased significantly post initial child-dentist interaction (p < 0.001). The AI-PM demonstrated good-to-excellent validity and reliability, with strong correlations with established pictorial measures (Spearman r = 0.72-0.96, p < 0.001). The reliability analysis using the intraclass correlation coefficient demonstrated good-to-excellent agreement between the AI-based assessment and the traditional measures. Agreement with traditional measures was good-to-excellent, with no evidence of proportional bias in Bland-Altman analyses (p > 0.05). The findings suggest that the initial child-dentist interaction may play an important role in children's DA and that the AI-PM may provide a basis for further refinement of traditional pictorial measures used to assess DA in early childhood. The study has been retrospectively registered in ClinicalTrials.gov (Identifier: NCT07387055).
Background: Fear of malpractice and its potential legal, financial, and reputational consequences are associated with one of the most complex phenomena in the medical community: defensive medical practice (DMP). DMP is frequently analyzed in the specialized literature from the physician's perspective; however, the patient's role in triggering and maintaining defensive behaviors remains under-explored. Methods: This cross-sectional study examined contextual factors associated with fear of malpractice and the convergences between doctors' and patients' perspectives within a bilateral model (error-fear-perceived risk-prevention behaviors), without assuming direct causal relationship. Two questionnaires were administered in Romania to 240 dentists (March-June 2023) and 344 patients (June-December 2023). Associations were tested with chi-square and Fisher's exact tests (reporting Cramér's V and odds ratios), multivariate binary logistic regression, and post hoc power analysis. Results: Over half of dentists (53.3%) reported fear of malpractice despite minimal actual legal exposure (0.8%); this fear was associated with awareness of its potential consequences and perceiving patients as more demanding. In multivariate analysis, fear was the strongest independent predictor of perceiving patients as a threat (aOR = 3.98, 95% CI [1.67-9.48]). On the patient side, 57.9% would avoid a dentist with a known malpractice case and 34.0% had requested additional procedures for reassurance. Conclusions: The interaction between physician fear and patient pressure suggests the existence of a "reassurance loop", in which the patient's need for safety and the doctor's fear can mutually reinforce each other, fostering defensive behaviors. We propose an exploratory typology of patient-induced DMP-direct induction (explicit requests for additional investigations/procedures) and indirect induction (relational pressure and reassurance seeking)-to guide future research. By integrating the dentist and patient perspectives within a bilateral model, the study provides a context-specific account of patient-induced defensive practice in Romanian dentistry and identifies dual-target educational interventions (addressing both clinician communication and patient health literacy) as a potential preventive direction.
Scope expansion has been a growing concern among dermatology and medical organizations. There has been a recent push among dental organizations to allow dentists and dental hygienists to perform cosmetic injections into the face and neck. This study analyzes the scope expansion allowing dentists to offer cosmetic injectable procedures, such as botulinum toxin and dermal fillers. Statutes and rules and regulations from each state were searched using Westlaw Campus Research and BillTrack50. Dental boards were directly contacted for additional clarification of rules and opinions. Starting in 2011, several states authorized this practice, representing a significant redefinition of the practice of dentistry. This expansion of scope has been primarily nonlegislative, with State Boards of Dentistry or Dental Examiners using rulings and regulations in most cases, rather than a statutory redefinition through the legislative process. Furthermore, this scope expansion is broadening down the professional hierarchy, as multiple states now also permit licensed dental hygienists to administer certain cosmetic injections. The findings emphasize the dominant role of regulatory boards over the legislature in shaping the scope of practice. Dermatology advocacy organizations have primarily focused on combating pending legislation. However, advocacy efforts should expand to include monitoring and challenging administrative rulemaking processes, although these are more difficult to track.
The primary aim was to assess the educational experience, knowledge, attitude, behaviour, and perceived barriers regarding silver diammine fluoride (SDF) use by Egyptian paediatric dentists. A secondary aim was to analyse how these domains are related. This cross-sectional survey used a pre-validated questionnaire, distributed electronically to all registered Egyptian paediatric dentists (n = 745) between March and May 2025. Data were analysed using SPSS version 23.0, with statistical significance set at p < 0.05. A total of 546 paediatric dentists completed the survey (73% response rate). Most respondents (96.7%) were familiar with SDF, mainly through dental school (53.8%), and reported greater exposure during postgraduate training. Overall, 84.1% demonstrated moderate-good knowledge and positive attitudes towards SDF use, particularly for non-aesthetic primary teeth (88.7%) and patients with behavioural (85.6%) or medical (85%) challenges. However, clinical application remained limited, mainly for arresting caries lesions in primary teeth (32.4%), with patient or caregiver non-acceptance (89.1%) being the main barrier. Knowledge, attitude, and practice were positively correlated, and higher academic qualifications were significantly associated with greater knowledge and more frequent SDF use. Although Egyptian paediatric dentists showed good awareness and positive attitudes towards SDF, its clinical use remained limited by parental reluctance and aesthetic concerns. Broader adoption may be supported by integrating SDF into undergraduate curricula, enhancing postgraduate training, and promoting targeted education campaigns. Improved education and training on SDF can enhance its clinical use for managing caries in uncooperative or high caries-risk children. Addressing aesthetic concerns and caregiver acceptance may further support its wider adoption in paediatric practice. Individualised caries-risk assessment, integrated within a holistic caries-management plan, is essential for achieving successful SDF outcomes.
This study aimed to evaluate the knowledge levels of dental students and graduate dentists regarding orthodontic emergencies and to identify factors independently associated with knowledge. This cross-sectional descriptive survey included fourth- and fifth-year dental students and graduate dentists from dental schools across Türkiye. Data were collected via an online questionnaire with three sections: demographic characteristics, knowledge regarding orthodontic emergencies (0-10 points), and awareness and perceived competence (5-25 points). Data were analysed using parametric and nonparametric statistical tests. Factors independently associated with knowledge level were examined using multiple linear regression analysis. The mean knowledge score of the 460 participants was 7.08 ± 2.31. Participants performed better in basic clinical management but showed significantly lower performance in clinical prioritization and emergency intervention scenarios (p < 0.001). A positive and statistically significant correlation was found between total knowledge score and awareness score (ρ = 0.295, p < 0.001). Multiple linear regression analysis showed that awareness score showed the strongest association with knowledge score in the adjusted regression model (β = 0.302, p < 0.001). Graduate dentists had significantly higher knowledge scores than students, whereas male gender was negatively associated with knowledge score. Although dentists and dental students demonstrated adequate basic management knowledge regarding orthodontic emergencies, they showed important deficiencies in clinical prioritization and decision-making. These findings may identify areas for further curricular evaluation, particularly regarding clinical prioritization and emergency decision-making. Scenario-based and practice-oriented approaches may be considered as evidence-informed options for future educational development; however, their effectiveness should be evaluated in prospective intervention studies.
This study aimed to evaluate pediatric dentists' knowledge and clinical practices regarding dentomaxillofacial imaging, with particular emphasis on guideline-consistent indication selection, radiation protection, and dose optimization principles, in accordance with established international guidelines (EAPD, AAPD, and DIMITRA). A structured cross-sectional questionnaire was distributed to pediatric dentists from eight countries (Egypt, Jordan, Mexico, Pakistan, Poland, Saudi Arabia, Türkiye, and the USA) through a convenience and snowball sampling approach. The survey assessed knowledge of radiation protection, radiographic parameters, cone-beam computed tomography (CBCT) indications and resolution selection, and routine clinical practices. Descriptive and comparative analyses were performed. A total of 488 pediatric dentists participated, with a mean knowledge score of 39.9 ± 4.7, and 75.8% demonstrated moderate knowledge. Awareness of dose-reduction strategies was limited, as 41.6% identified rectangular collimation as the most effective radiation protection measure and 17.7% recognized its impact on radiation dose. Knowledge of dose-optimization principles varied: 68.0% of respondents demonstrated knowledge of the ALARA/ALADA principle, whereas 46.5% demonstrated knowledge of the ALADAIP concept. Clinical practices showed patterns that were partially consistent with guideline recommendations. Regarding CBCT, 57.4% had not received formal training, 43.6% were uncertain about appropriate field-of-view selection, and 91.0% reported fewer than five scans per month. Pediatric dentists demonstrated moderate radiation knowledge but inconsistent application of radiation protection principles. These findings indicate a gap between theoretical knowledge and clinical practice. Targeted, practice-oriented education is needed to improve dose optimization and CBCT-related decision-making. Findings should be interpreted with caution due to the non-probability sampling design. This multinational study highlights persistent gaps in pediatric dental imaging practices and supports the need for standardized, competency-based training to improve radiation safety.
Special care dentistry (SCD) addresses the oral health needs of individuals whose disabilities, medical complexities, or social circumstances limit access to dental care. With rapid population ageing and a high disability prevalence, the Asia-Pacific region faces a growing demand for dentists competent in managing patients requiring special care. For the majority of patients requiring special care, routine basic dental care is helmed by the general dentist. While the International Association for Disability and Oral Health (iADH) has published undergraduate curriculum guidance for SCD, its implementation and attainment of learning objectives within dental schools in this region has not been examined. This study aimed to describe the status of undergraduate SCD education across dental schools in Asia-Pacific, using the iADH guidance as a benchmark, and to identify strengths and gaps to inform future curriculum development. A descriptive survey was conducted among faculty members involved in undergraduate SCD teaching in dental schools in the Asia-Pacific region. An online questionnaire was administered between December 2025 to February 2026, assessing the extent to which programmes fulfilled learning outcomes across the 6 competency domains of the iADH guidance. Data on course structure, teaching hours, educational modalities, and perceived limitations were collected. Quantitative data was analysed using descriptive statistics, while open-ended responses were analysed thematically. Thirty-one dental schools from 11 countries and jurisdictions participated. SCD was more commonly delivered as an independent subject, with a median of 15 h of didactic teaching and 8 h of clinical exposure. Overall, more schools reported sufficient fulfilment of the learning outcomes, although only three fully adopted the guidance. Common challenges included limited clinical exposure, shortages of trained academic staff, and considerations in adapting the guidance to local contexts. Undergraduate SCD education in the Asia-Pacific region is active but variable within the sample institutions. Given uneven regional representation, the findings of this study serve as useful exploratory data. While the iADH guidance provides a valuable framework, greater flexibility, contextual relevance, and support for clinical training and educational leadership should be advocated to ensure graduates are practice-ready to meet the oral health needs of patients requiring special care.
Parents play a pivotal role in shaping children's oral health behaviors and practices. This study aimed to assess parental awareness and attitudes regarding children's oral health and pediatric dental care, and to evaluate the influence of socioeconomic factors on these parameters. A cross-sectional questionnaire-based study was conducted from June to December 2025 among parents of children aged below 10 years. Participants were recruited using convenience sampling from the Departments of Pediatrics and Pediatric and Preventive Dentistry at Yenepoya University. Data were collected using a Google Forms-based questionnaire. The sample size was calculated using Cochran's formula, yielding a final sample of 384 participants. Data were analyzed using the Pearson's chi-square test and multivariable binary logistic regression, with simultaneous adjustment for education and income. Statistical significance was set at p < 0.05. Regarding parental awareness, 53.6% acknowledged that problems in deciduous teeth can affect permanent dentition, 89.1% knew the recommended brushing frequency, 85.4% recognised the importance of diet in oral health, and 91.7% acknowledged pediatric dentistry as a dental specialty. However, 46.1% were uncertain about the benefits of fluoride, and only 33.9% identified all recommended preventive measures against dental caries. Regarding parental attitudes, 70.1% believed that the first dental visit should be delayed until a problem arose, while 67.7% believed deciduous teeth deserved equal care as permanent teeth. Moreover, 90.6% of parents sought help from a pediatric dentist. Education and income significantly influenced parental awareness and attitudes on multiple parameters (p < 0.05). Multivariable logistic regression (adjusted for both education and income simultaneously) revealed that higher education was the strongest independent predictor of fluoride awareness (adjusted OR = 3.46, 95% CI: 2.18-5.50, p < 0.001), while neither education nor income independently predicted appropriate first dental visit timing (p > 0.05 for both). Parental awareness regarding basic oral hygiene practices was comparatively high; however, knowledge regarding fluoride, preventive measures, and the significance of primary dentition was relatively low. Socioeconomic status is a crucial independent determinant of parental awareness and attitude. The universal attitude of delayed first dental visits warrants population-wide health education campaigns.
Dentists, in the practice of their profession, are exposed to infectious diseases (most commonly hepatitis and HIV), biological accidents involving needles or sharp instruments and chemical intoxication from disinfectants, cements or dental resins. Also, they may suffer musculoskeletal disorders due to bad ergonomic postures, hearing loss and eye splashes or vision loss due to curing light, intense artificial lighting from dental units and constant visual strain in a limited space. Moreover, mental illnesses have been detected such as psychological issues like stress, fatigue, burnout, and depression. They are exposed to ionizing radiation and they may suffer from cancer more often than the general population. A bibliographic search was carried out in the following electronic databases: PubMed/MEDLINE and the Cochrane Library Plus. Musculoskeletal problems, infectious diseases, visual and hearing impairments, and psychological disorders are some of the occupational diseases dentists may develop during their careers. A series of preventive measures are analyzed and proposed. The practice of dentistry carries the risk of various types of occupational diseases, which must be understood and prevented.
The loss of tooth structure following endodontic treatment weakens endodontically treated teeth, often requiring post and core to ensure the stability of restorations. Post and core restoration can be performed using direct techniques, which involve a prefabricated post combined with a coronal reconstruction in a single session, or using indirect techniques requiring the fabrication of an inlay core in a laboratory. This study aimed to evaluate the techniques and materials currently used by dentists in the Casablanca-Anfa prefecture. A descriptive cross-sectional study was conducted between February and June 2024 among private dental practitioners in the Casablanca-Anfa prefecture, Morocco. A simple random sample of 245 dentists was selected from the official registry of the Southern Regional Council of Dentists. Data were collected using a validated structured questionnaire assessing practitioners' demographics and corono-radicular restoration practices. Statistical analysis was performed using SPSS version 20.0, with qualitative variables expressed as frequencies and percentages. A total of 244 valid responses were analyzed. Direct post and core restorations were frequently used in 90.2% of cases, mainly with fiberglass posts (91.5%), non-adhesive cements (48.5%), and flowable composite (73.3%). Indirect techniques were reserved for severe decay, and computer-aided design/computer-aided manufacturing (CAD/CAM) inlay cores were rarely used (5.2%).
Background/Objectives: Although contemporary preventive concepts are well established in dentistry, their consistent integration into routine clinical practice remains uncertain. This study aimed to assess how preventive strategies are understood and applied in daily dental practice, and to explore the relationship between clinicians' level of familiarity with preventive concepts and their implementation in patient care. Materials and Methods: A cross-sectional survey was conducted among 202 practicing dentists between October 2024 and May 2025 using a structured, anonymous questionnaire comprising 34 items. The instrument explored professional characteristics, knowledge of preventive concepts, clinical decision-making, use of fluoride-based interventions and minimally invasive approaches, and familiarity with risk-based systems. Data were analyzed using descriptive statistics and chi-square and Fisher's exact tests (p < 0.05). Results: Most respondents reported moderate to high familiarity with contemporary preventive concepts, particularly remineralization and fluoride-based prevention. Preventive measures were commonly used; however, their implementation was often not structured. Formal caries risk assessment was routinely or often performed by 69.3% of clinicians, yet structured systems such as CAMBRA were routinely or often used by only 19.8%. Continuing professional education was significantly associated with greater use of preventive technologies (p = 0.018), and the use of structured risk assessment was associated with risk-based restorative decision-making (p = 0.041). Conclusions: Respondents reported a high level of familiarity with preventive concepts, but their application appeared inconsistent and frequently unstructured. These findings highlight a persistent gap between familiarity and implementation and point toward the need for clinically feasible, structured approaches that can support preventive decision-making in routine care.
Oral health professionals may play a key role in promoting HPV vaccination among adults through counseling and health education. Understanding their impact and the effectiveness of educational interventions is crucial for public health strategies. To assess the influence of oral health professionals on adherence to HPV vaccination in adults and to identify the effectiveness of educational strategies aimed at improving their counseling practices. This review included cross-sectional and interventional studies evaluating adult-focused HPV vaccination counseling provided by oral health professionals. Searches were conducted in PubMed, EBSCO, the Cochrane Library, Science Direct, Wiley, and TRIP Database from inception to April 21, 2025. Data were analyzed using a random-effects meta-analysis model in RStudio (version 4.2.2) to estimate pooled proportions with 95% confidence intervals (CIs). A total of 10 studies were included, involving 9,575 participants, of which 3 studies implemented educational interventions. Prior to educational interventions, many dentists demonstrated limited knowledge about HPV and its link to oropharyngeal cancer, and only a few routinely discussed HPV vaccination with patients. Post-intervention, there was a notable improvement in professionals' knowledge, confidence, and frequency of patient counseling. Educational interventions were effective in enhancing dentist's preparedness to address HPV vaccination. However, barriers such as lack of privacy, discomfort discussing the topic, and limited prior training were also reported. Heterogeneity in study design, limited geographic diversity, and variability in intervention approaches were noted. Oral health professionals can significantly contribute to adult HPV vaccination efforts through targeted counseling, especially when supported by ongoing education and institutional strategies that address systemic barriers. PROSPERO ID: CRD42024617902.
To analyse the presence of women on the boards of directors of Spanish dental scientific societies affiliated with the General Council of Dentists of Spain, based on those for which information was available, from their establishment to December 2025. A descriptive study based on a documentary review of public sources (official websites, minutes and reports) was conducted. Of the 29 affiliated societies, valid information was obtained for 15 (51.7%), which constituted the study sample. The term of office, type of position and gender of the office holder were recorded. A descriptive analysis was performed using absolute frequencies and percentages. A total of 1496 positions were analysed, of which 287 (19.18%) were held by women. In recent periods, female representation reached 34.62%, increasing to 38.46% in 2025. Female participation was higher in intermediate positions and lower in presidencies (9.36%). The presence of women has increased in recent years, in parallel with the feminisation of the profession; however, relevant inequalities persist, particularly in top leadership positions. Results should be interpreted with caution due to potential selection bias.
Background/Objectives: Contemporary periodontal therapy is increasingly guided by evidence-based clinical protocols, particularly the European Federation of Periodontology (EFP) S3 Clinical Practice Guidelines. The present study aimed to assess dentists' perceptions regarding modern periodontal therapy and to perform a preliminary psychometric evaluation of a newly developed questionnaire. Methods: A cross-sectional questionnaire-based study was conducted among 109 dental practitioners. The questionnaire evaluated perceptions regarding non-surgical periodontal therapy, surgical periodontal therapy, and the comparative role of both therapeutic approaches. Descriptive statistical analysis, internal consistency analysis using Cronbach's Alpha, Intraclass Correlation Coefficient (ICC), repeated measures ANOVA, and exploratory factor analysis (Principal Component Analysis-PCA) with Varimax rotation were performed to evaluate the psychometric properties of the instrument. Results: The questionnaire demonstrated good internal consistency, with Cronbach's Alpha values ranging from 0.77 to 0.86. ICC analysis confirmed satisfactory reliability. Respondents showed favorable attitudes toward evidence-based periodontal management, supporting non-surgical therapy as first-line treatment and the staged integration of surgical approaches in complex cases. Exploratory factor analysis identified a coherent factorial structure, with four components explaining 73.94% of the total variance. Conclusions: The questionnaire showed good psychometric properties, supporting its potential utility as a reliable and useful instrument for evaluating professional attitudes and clinical decision-making in periodontology.
Background/Objectives: An effective dental workforce is essential to ensure timely, high-quality oral healthcare across health systems worldwide. Many countries are currently facing challenges related to workforce supply, professional mobility, and the alignment between training capacity and population needs. Using Israel as an empirical case, this study examines long-term trends in the national dental workforce and explores their relevance for international workforce planning. Methods: A retrospective longitudinal analysis was conducted using Israel's National Health Professions Database ("Oskim"), supplemented by data on dental education and specialty training. Descriptive longitudinal analyses were performed to evaluate workforce trends over time, and inferential statistical analyses were used to assess differences in demographic and geographic workforce distributions. Workforce indicators were analyzed using internationally standardized metrics to enable comparison with OECD healthcare systems. Results: The number of licensed dentists increased substantially, while the number of actively practicing dentists grew more moderately, reflecting a widening gap between licensure and workforce participation. Between 2008 and 2023, the number of licensed dentists increased by 49.9%, compared with a 40.4% increase in the actively practicing workforce. Accordingly, the practicing dentist-to-population ratio increased only slightly, from 0.80 to 0.84 per 1000 population. Israel reported 0.84 practicing dentists per 1000 population in 2023, exceeding the OECD average of 0.70. However, despite exceeding the OECD average, the relatively modest increase in the practicing workforce suggests that higher dentist-to-population ratios may overestimate actual workforce capacity when workforce participation patterns are not taken into account. Internationally trained dentists accounted for approximately 75% of new licensees, highlighting the role of professional mobility in shaping workforce supply. The proportion of dental specialists remained relatively stable at approximately 10%. In addition, the number of licensed dental hygienists increased by 96.1% (from 1468 to 2879), while the number of newly licensed hygienists declined by approximately 43% (from 174 to 100 annually). Conclusions: Despite substantial growth in the number of licensed dentists, the practicing workforce and specialist capacity expanded only modestly, and geographic disparities persisted. The difference between growth in licensed dentists and the actively practicing workforce highlights the importance of incorporating participation measures into national monitoring and oral health planning policies. The Israeli experience illustrates how workforce expansion driven by internationally trained dentists may coexist with structural challenges in participation, specialization, and distribution. These findings highlight broader considerations for oral health workforce planning and may provide insights for other health systems facing similar demographic and staffing dynamics. Because indicators of oral health need, service utilization, disease burden, and workforce productivity were unavailable, the study could not determine whether the observed workforce supply was adequate to meet population oral health needs.
To assess the association between race/skin color and educational level with toothache and access to dental care among adults aged 35-44 years in Brazil. This cross-sectional study included 8,597 adults who participated in the Brazilian National Oral Health Survey 2023 (SB 2023). Two outcomes were evaluated: the prevalence of toothache in the previous six months and access to dental care among adults who reported toothache. Crude and adjusted Poisson regression models with robust variance were used to estimate the associations of race/skin color, educational level, and the intersection of these two social markers with the outcomes. The prevalence of toothache in the previous six months was 23.7%. Among adults who reported toothache, 34.1% did not access dental care. Black adults (adjusted prevalence ratio [PRa]=1.32; 95%CI 1.1-1.7; p=0.034) and those with low educational attainment (aPR=2.1; 95%CI 1.4-2.9; p<0.0001) showed a higher prevalence of toothache. In the intersectional analysis, Black adults with low educational attainment had a higher prevalence of toothache (aPR=3.5; 95%CI 2.0-6.0; p<0.0001) and of not having consulted a dentist despite experiencing pain (PRa=2.5; 95%CI 1.3-4.0; p=0.006) compared with White adults with high educational attainment. Black adults with low educational attainment showed a higher prevalence of toothache and lack of access to dental care even when experiencing pain, indicating that race/skin color and educational level are important determinants of oral health inequalities in Brazil. mensurar a associação da raça/cor de pele e do nível de escolaridade com a dor de dente e o acesso ao dentista entre adultos de 35-44 anos no Brasil. estudo transversal com 8.597 adultos que participaram da Pesquisa Nacional de Saúde Bucal 2023 (SB 2023). Foram mensurados dois desfechos: a prevalência de dor de dente entre os adultos nos últimos 6 meses e o acesso ao dentista entre os adultos que tiveram dor de dente. Modelos de regressão de Poisson, com variância robusta, brutos e ajustados, foram utilizados para mensurar a associação da raça/cor de pele, da escolaridade e da intersecção desses dois marcadores com os desfechos analisados. a prevalência de dor de dente entre os adultos nos últimos 6 meses foi de 23,7%. Entre esses adultos, 34,1% não tiveram acesso ao dentista. Os adultos negros (RPa=1,32, IC95% 1,1–1,7, p=0,034) e os com baixa escolaridade (RPa=2,1, IC95% 1,4–2,9, p<0,0001) apresentaram maior prevalência de dor de dente. Quanto à interseccionalidade, adultos negros com baixo nível de escolaridade apresentaram uma prevalência maior de dor de dente (RPa=3,5, IC95% 2,0–6,0, p<0,0001) e de não terem consultado um dentista mesmo em caso de dor (RPa=2,5, IC95% 1,3–4,0, p=0,006) comparados aos adultos brancos com alto nível de escolaridade. adultos negros com baixa escolaridade apresentaram uma maior prevalência de dor de dente e de não terem consultado um dentista mesmo em caso de dor, indicando que a raça/cor de pele e o nível de escolaridade são importantes determinantes para a saúde bucal no Brasil.
Deep margin elevation (DME) has been introduced as a restorative approach to manage subgingival margins and facilitate adhesive procedures. Despite its clinical description in the literature, limited information is available regarding dentists' awareness of the technique and their willingness to incorporate it into practice. To assess awareness, perceptions and clinical use of DME for subgingival restorative cases among practicing dentists from selected regions. A cross-sectional, questionnaire-based study was conducted among dentists working in academic institutions, private practices, or combined settings across centers in the Middle East, the United States, Asia (India), Europe (UK) and practicing dentists in the fellows of the Academy of Dentistry International, stated as other regions. A 20-item closed-ended, self-administered questionnaire assessed awareness and clinical acceptance of DME. Data were analyzed using descriptive statistics and the Chi-square test using SAS (SAS Institute, Cary, NC), with significance set at 0.05. Of 450 invited dentists, 349 completed the survey (response rate: 77.6%). Participants practiced in academic institutions (23%), private settings (39%), or combined academic-private environments (38%). Most respondents (77%) were familiar with DME, and 66% considered adhesive bonding to cervical or root dentin in deep margin situations to be predictable. However, when favorable clinical conditions were present, 75% reported preferring surgical crown lengthening. Reported routine use of DME for extensive subgingival proximal lesions in posterior teeth was limited. Most respondents were aware of deep marginal elevation (DME) as a successful approach for improving tooth longevity and restoration success when managing deep subgingival margins, provided proper isolation is maintained during the procedure. Few clinicians had concerns regarding cervical marginal adaptation and restoration failure. However, the routine clinical use of DME varied among practitioners across different regions and practice settings. These findings indicate variability in clinicians' perceptions and application of DME in restorative practice.