D.L.M. Broers

Oral health status, treatment needs, and obstacles to dental care among noninstitutionalized children with severe mental disabilities in The Netherlands

The objective of this study was to assess the oral health status, treatment needs, and barriers to dental care of noninstitutionalized children in The Netherlands who have severe disabilities. The oral health status of 61 children (38% female; 4-12 years of age; M = 7.7, SD = 2.2), randomly selected from seven different daycare centers, was evaluated. Caretakers (n = 126) and dentists (n = 40) completed questionnaires concerning demographic information, oral hygiene, frequency of dental visits, and possible barriers to the daily oral care of the children. Of all the children, 57.4% had untreated caries (mean dmft/DMFT = 3.0; SD = 3.1). The proportion of caries-free children was 29.5%. In comparison to Dutch children, a significantly higher proportion of children with disabilities belonging to an ethnic minority did not receive any routine dental care (53.1% and 23.8%, respectively). Caretakers considered the noncooperation of their patients as the most troublesome aspect of their daily oral care (68%). Dentists considered communication problems as the most important barrier to treatment (75%). In conclusion, Dutch noninstitutionalized children with severe disabilities still receive a relatively low degree of quality dental care. This is particularly true for children from ethnic minority groups.

Do patients benefit from orthognathic surgery? A systematic review on the effects of elective orthognathic surgery on psychosocial functioning and patient satisfaction

The main purpose of this systematic review was to determine the current state of evidence regarding patient satisfaction with, and the impact of, orthognathic surgery on psychosocial functioning of patients 17 yr of age and older. A secondary aim was to determine whether individuals with psychiatric disorders and mental health conditions are more likely to be dissatisfied with the treatment outcome than those without. We systematically searched PubMed, PsycInfo, and Embase for relevant studies (up to 6 June 2016). After selection of articles we determined the Directness of Evidence (DoE) and Risk of Bias (RoB). We identified 3,948 studies (1,053 studies in Pubmed, 2,023 in Embase, and 872 in PsycInfo). Of these, 87 remained after screening of title and abstract, while after full-text screening only nine remained for DoE and RoB assessment. All nine studies had a high RoB and a low or moderate DoE. The quality of the methods of studies, published to date, on the effects of orthognathic surgery on patient satisfaction or the psychosocial impact carry a high RoB. Therefore, these do not allow inferences on the effects of orthognathic surgery on patient satisfaction or their psychosocial functioning.

Toediening van intraveneuze sedatie met midazolam door tandarts is onveilig

In de decembereditie van het Nederlands Tijdschrift voor Tandheelkunde in 2014 werd een artikel gewijd aan het gebruiken van lichte intraveneuze sedatie met midazolam door tandartsen. Een aantal tandartsen, werkzaam op het vakgebied van de Bijzondere Tandheelkunde (angstbegeleiding, gehandicaptenzorg), en een anesthesioloog geven een reactie op dat artikel en betogen dat toediening van intraveneuze sedatie met midazolam in de handen van tandartsen onveilig is.