Background This study aimed to measure the frequency of dental visits before and during the COVID-19 pandemic and to evaluate if dental visits can be predicted from demographics, socioeconomic status, oral problem diagnoses, and received dental services. Methods Participants for this retrospective study were patients visiting dental providers at the hospital- and community-based outpatient clinics in Alberta, Canada. Data were retrieved from electronic databases from March 12 th to the end of September 2020 and the same period for 2018 and 2019. Also, the lockdown was declared for March 12 to May 14, 2020. Data were analyzed using ANOVA test and multiple logistic regression at α=0.05. Results From a total of 14,319 dental visits, 5,671, 5,036, and 3612 occurred in 2018, 2019, and 2020. The mean (SD) frequency of daily visits was 36.69 (15.64), 32.09 (15.51), and 24.24 (14.78) respectively (P<0.001). Despite the overall decrease, the frequency of visits for infections, salivary problems, and temporomandibular disorders increased during the pandemic. The dental visits during the pandemic were associated with increased oral problems, complicated dental procedures, and higher economic status. Conclusion During the pandemic, the frequency of dental visits decreased specifically during the lockdown. Patients with complicated problems needing urgent treatments mainly visited dental clinics. Reduced access to care was observed primarily among socially disadvantaged groups. Practical Implications Although the current guidelines and related recommendations have been effective during the pandemic in restoring the compromised dental system, further modifications are needed to promote in-person visits to improve oral health status of patients.
Background and objectives Unintended injuries or complications in hospitalized patients are common, potentially preventable, and associated with adverse consequences, including greater mortality and health care costs. Patients with CKD may be at higher risk of hospital-acquired complications (HACs).Design, setting, participants, & measurements Adults from a population-based cohort (Alberta Kidney Disease Network) who were hospitalized from April 1, 2003, to March 31, 2008, made up the study cohort. Kidney function was defined using outpatient eGFR and proteinuria (protein-to-creatinine ratio or dipstick) in the year before index hospitalization. Comorbid conditions were identified using validated algorithms applied to administrative data. A specific diagnostic indicator was used to identify HACs. Complications were classified into clinically homogeneous groups and subclassified as potentially preventable (p-HACs) or always preventable (a-HACs). Multivariable logistic regressions models were used to examine the association of CKD with HACs, accounting for confounders.Results Of 536,549 patients, 8.5% had CKD; those with CKD were older and more likely to be admitted for circulatory system diseases than those without CKD. In fully adjusted models, the odds ratio (OR) of any hospital complication in patients with CKD (reference: no CKD) was 1.19 (95% confidence interval [95% CI], 1.18 to 1.26); there was a graded relation between the risk of HACs and CKD severity, with an OR of 1.81 (95% CI, 1.51 to 2.17) in those with the most severe CKD (eGFR, 15-29 ml/min per 1.73 m 2 and proteinuria, .30 mg/mmol). Findings were similar for p-HACs (OR, 1.20 [95% CI, 1.16 to 1.24] and 1.78 [95% CI, 1.43 to 2.11], respectively). The a-HACs had similar point estimates.Conclusions The presence of CKD and its severity are associated with a higher risk of HACs, including those considered preventable. Targeted strategies to reduce complications in patients with CKD admitted to the hospital should be considered.
Background: This study aimed to explore the predictors of regular dental attendance behavior and caries experience among children of newcomers to Canada using the Theory of Planned Behavior (TPB). Methods: A total of 274 newcomer parents with a child aged 1 to 12 years old who had lived in Canada for 10 years or less participated in this cross-sectional study. Children underwent a dental examination to measure their deft/DEFT, and parents completed a self-administered questionnaire. Parental attitudes, subjective norms, perceived behavioral control (PBC), and intention were examined using Structural Equation Modeling (SEM) as predictors of dental attendance behavior and caries experience using the TPB model. Results: Out of all the components of the model, attitude and PBC significantly predicted the intention (p < 0.05) while the subjective norm had no statistical effects on the loading of the model (p > 0.05). Intention significantly predicted behavior, but behavior could not predict caries experience. Although 51.6% of the variance of intention was predicted by this model, only 0.2% of the variance for dental attendance behavior was explained. Conclusions: The theory of planned behavior was successful in predicting dental attendance intention and behavior for children among newcomers, but this behavior could not predict caries experience in children.
Preventable HACs are associated with higher mortality, incremental LOS, and greater risk of readmission, especially in people with CKD. Targeted strategies to reduce complications should be a high priority.
Objectives: Self-efficacy is a strong health predictor as it affects patients' certainty about their ability to perform recommended behaviours to improve their health. The aim of this study was to examine the associations between perceived self-efficacy and oral health behaviours among adolescents. Methods:A convenience sample of adolescents aged 12 to 18 years old was recruited from the University of Alberta dental clinic. Demographics, oral health behaviours, self-rated oral health and task-specific and general self-efficacy were assessed using a questionnaire with three sections. For the comparisons of outcomes across different categories, Student t-test, multivariate regression and chi-squared tests were used.Results: A total of 252 adolescents with average (SD) age of 14 (1.7) years participated in the study; 60% were girls; 81% were born in Canada; 56% were White; and 61% had dental coverage. Demographic characteristics had no significant correlation with general self-efficacy. However, correlation coefficients indicated that younger adolescents had higher dietary self-efficacy (negative correlation), girls had higher toothbrushing and dental visit self-efficacy, and those with dental coverage had higher dental visit self-efficacy. A significant association was found between toothbrushing, dietary habits and dental visits self-efficacy (subscales of task-specific self-efficacy) and their respective outcomes (frequency of toothbrushing, sugar intake and regular dentist visits). General self-efficacy was significantly associated with frequency of toothbrushing and participant's self-rated oral health. Conclusion:Higher task-specific and general self-efficacy correlated with better oral health behaviours among adolescents. Therefore, behavioural interventions should be designed to enhance self-efficacy among adolescents in order to improve their oral health outcomes.
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