2024 Publication Highlights

• Publications Highlights

2024 Publications Highlights

These publications demonstrate your National Dental PBRN’s commitment to addressing a wide range of practical clinical and public health issues in dentistry. We highlight seven articles from this year, but see here if you would like to access all 17.

Antibiotic Prescribing Practices

What we learned: Based on interviews with National Dental PBRN dentists, specific barriers and facilitators exist that seem to drive whether dentists properly follow guidelines regarding prescription of antibiotics in dental care.

What you might want to do: Be sure that you are familiar with the latest clinical guidelines. The whole notion of “antibiotic stewardship” has taken on greater importance in recent years and patients may ask you to justify what you do. References cited in this article point you to the latest clinical guidelines. Nonetheless, some of these guidelines have been criticized for being ambiguous, so you may want to ponder the caveats and role-play in your mind what you will tell a patient to justify what you recommend. The Discussion section in this article does a nice job of pondering the numerous caveats.

Survival Analysis of Posterior Composite Restorations

What we learned: The median survival time of more than 700,000 posterior composite restorations in National Dental PBRN practices was 13.3 years. Several tooth-level and patient-level factors predicted longevity (e.g., size of the restoration, interproximal surface involved, etc.), but no single factor predominated.

What you might want to do: You could mention to your patients that real-world data from your Network suggest how long posterior composites last, and factors that predict this longevity. This study was based on practices that used Dentrix and EagleSoft electronic dental records. Working with your software vendor, you might be able to use the electronic dental record data in your practice to measure how long composites in your practice last and what factors predict their longevity.

Evidence-practice gap in minimal intervention dentistry

What we learned: In two articles [1, 2], we worked with international colleagues to evaluate the “evidence-practice gap” (EPG) — the difference between what the latest evidence says should be happening in everyday clinical practice as compared to what is actually happening. The focus was on “minimal-intervention dentistry” – using conservative, less-surgical approaches to treat interproximal caries, deep occlusal caries, and assess caries risk. This study validated the notion that an EPG is common in this clinical area, for Japan, Brazil, and the United States.

What you might want to do: Your participation in the National Dental PBRN is an easy way to stay abreast of recent clinical guidelines. PBRN patients have consistently told us that they are glad that their dentists are in the National Dental PBRN because surely it means that their dentists are trying to “stay current”!

Oral Lesion Diagnostic Approaches

What we learned: Researchers examined how general dentists approach diagnosis and/or referral of suspicious oral lesions. Most refer to an oral/maxillofacial surgeon. Only 22% of general dentists personally biopsied at least one suspicious lesion in the previous six months. Most written referrals took place electronically and included specific information. Almost all referring clinicians were informed of the findings via a written report. About half of general dentists confirm that their patients with suspicious lesions kept their referral appointment.

What you might want to do: If you do not already do so, you may want to routinely confirm that your patients kept their referral appointment. Perhaps assign someone in your practice that responsibility and ask them to report on it quarterly. You may improve your patients’ lives as a result.

Mental Health Screenings in Dental Settings

What we learned: This study demonstrated the feasibility and outcomes of conducting mental health screenings in dental practices. Over 60% of participating practices successfully integrated mental health screenings into routine dental visits, improving patient care coordination.

What you might want to do: When this study was in early development, we were initially very skeptical that dentists would be interested in this topic, owing to concerns about mental health being outside the scope of dental practice. We were mistaken — practitioners told us powerful anecdotes and personal experiences of how they forever impacted the lives of some of their patients. Consider the mental health questions that you include in your routine assessment of medical history. Have a look at the ones used in this study. Consider providing a written handout of mental health resources in your community that you could hand to specific patients who screen positive.

Patient-Reported Outcomes Collection

What we learned: Based on interviews with National Dental PBRN practitioners and patients, patient-reported outcomes are important in dental care and most patients are open to using mobile telephone technology to report them to you.

What you might want to do: Experienced dentists already understand that patient-reported outcomes of care are at least as important to patients as clinical measures that we as dentists measure. However, during treatment planning you may want to re-visit with patients which outcomes are most important to them. You may also want to explore systematically capturing this information using mobile or other digital technology pre-operatively, post-operatively, and during long-term maintenance. As a result of preparing for this study, we learned that a few dentists in the network already do this.

Practice-based research methodologies

What we learned: This article is the latest in a multi-year series of articles that your network has published to share lessons learned for the continuous quality improvement of all PBRNs, dental or otherwise.

What you might want to do: Your participation in the National Dental PBRN is gradually helping to transform the dental profession to incorporate research and quality improvement into everyday clinical practice – just because that it what we do as a profession. We do so because dentistry cares so much about making dental care the best that is can be. And your National Dental PBRN participation is even helping non-dental PBRNs function more effectively.