Trusted evidence. Informed decisions. Better health. Cochrane Database of Systematic Reviews Main results We included two RCTs (212 participants), one of which was a cluster-randomised trial. Adjusting for the design e ect from clustering, reduced the total sample size to 210. Both studies were carried out in dental clinics and assessed ergonomic interventions in the physical domain, one by evaluating a multi-faceted ergonomic intervention, which consisted of imparting knowledge and training about ergonomics, work station modification, training and surveying ergonomics at the work station, and a regular exercise program; the other by studying the e ectiveness of two di erent types of instrument used for scaling in preventing WMSDs. We were unable to combine the results from the two studies because of the diversity of interventions and outcomes. Physical ergonomic interventions. Based on one study, there is very low-quality evidence that a multi-faceted intervention has no clear e ect on dentists' risk of WMSD in the thighs (RR 0.57, 95% CI 0.23 to 1.42; 102 participants), or feet (RR 0.64, 95% CI 0.29 to 1.41; 102 participants) when compared to no intervention over a six-month period. Based on one study, there is low-quality evidence of no clear di erence in elbow pain (MD −0.14, 95% CI −0.39 to 0.11; 110 participants), or shoulder pain (MD −0.32, 95% CI −0.75 to 0.11; 110 participants) in participants who used light weight curettes with wider handles or heavier curettes with narrow handles for scaling over a 16-week period. Cognitive ergonomic interventions. We found no studies evaluating the e ectiveness of cognitive ergonomic interventions. Organisational ergonomic interventions. We found no studies evaluating the e ectiveness of organisational ergonomic interventions. Authors' conclusions There is very low-quality evidence from one study showing that a multi-faceted intervention has no clear e ect on dentists' risk of WMSD in the thighs or feet when compared to no intervention over a six-month period. This was a poorly conducted study with several shortcomings and errors in statistical analysis of data. There is low-quality evidence from one study showing no clear di erence in elbow pain or shoulder pain in participants using light weight, wider handled curettes or heavier and narrow handled curettes for scaling over a 16-week period. We did not find any studies evaluating the e ectiveness of cognitive ergonomic interventions or organisational ergonomic interventions. Our ability to draw definitive conclusions is restricted by the paucity of suitable studies available to us, and the high risk of bias of the studies that are available. This review highlights the need for well-designed, conducted, and reported RCTs, with long-term follow-up that assess prevention strategies for WMSDs among dental care practitioners.
This Cochrane review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease.
Organized evidence-based practice is said to have started in the medical field in the late 20th century. Its principles and usage eventually spread to other health sciences, including orthodontics. Although the conceptual foundations and basic tenets of evidence-based orthodontics are based on the classical approach of testing medical interventions, differences unravel as we encounter the ground realities in orthodontics, which are unique due to the length, complexity, and diversity involved in orthodontic treatment and research. How has this led to the evolution of evidence-based orthodontics and changes in its applications? Is it being translated to better clinical answers, treatment strategies, patient satisfaction, and information for orthodontists? What more needs to be done, considering the rapidly changing orthodontic scenario? This article aims to explore these questions to evaluate how evidence-based orthodontics has played itself out so far, so that it can continue to grow strong and stand up to the challenges of 21st century orthodontics.
Dentistry is highly energy and resource intensive with significant environmental impact. Factors inherent in the profession such as enormous electricity demands of electronic dental equipment, voluminous water requirements, environmental effects of biomaterials (before, during and after clinical use), the use of radiation and the generation of hazardous waste involving mercury, lead etc have contributed towards this. With rising temperatures across the world due to global warming, efforts are being made worldwide to mitigate the effects of environmental damage by resorting to sustainability concepts and green solutions in a myriad of ways. In such a scenario, a professional obligation and social responsibility of dentists makes it imperative to transform the practice of dentistry from a hazardous to a sustainable one, by adopting environmental-friendly measures or 'green dentistry'. The NHS in the UK has been proactive in implementing sustainability in healthcare by setting targets, developing guidance papers, initiating steering groups to develop measures and implementing actions through its Sustainable Development Unit (SDU). Such sustainable frameworks, specific to dentistry, are not yet available and even the scientific literature is devoid of studies in this field although anecdotal narratives abound. Hence this paper attempts to present a comprehensive evaluation of the existing healthcare sustainability principles, for their parallel application in the field of dentistry and lays out a blueprint for integrating the two main underlying principles of sustainability - resource use efficiency and eliminating or minimising pollution - in the day-to-day practice. The article also highlights the importance of social values, community care, engaging stakeholders, economic benefits, developing policy and providing leadership in converting the concept of green dentistry into a practised reality.
Background Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health. Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. Objectives To assess methods of treating dental complications in people with sickle cell disease. Search methods We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books.
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