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PubMed1999

Professional burnout among Dutch dentists.

UNLABELLED: Professional burnout, a long-term consequence of occupational stress, is considered to be a factor that explains a substantial proportion of incapacity for work. Burnout is defined as emotional exhaustion, depersonalization, and diminished personal accomplishment. AIMS: To investigate levels of burnout among Dutch practising dentists, to compare dentists' scores with norm scores, and to determine the percentage of dentists "at risk". METHODS: The instrument used was the Dutch version of the Maslach Burnout Inventory (MBI-NL), a 20-item modified version of the original MBI. A highly representative group of Dutch dentists participated (n = 709, 75% response rate). RESULTS: Mean levels (and standard deviations) of burnout were: emotional exhaustion 13.7 (8.6); depersonalization 5.9 (3.9); personal accomplishment 30.8 (5.9). Dentists had more favourable means compared with standard scores, although in the 95th percentile dentists showed more emotional exhaustion than standards indicate. While no overall sex differences were found, male middle-aged dentists tended to show more burnout. Of the working Dutch dentists, 21% had a certain risk, 13% had high overall levels of burnout, and 2.5% were highly burned out. CONCLUSION: It is concluded that Dutch dentists have relatively favourable mean levels of burnout, but those who are exhausted are extremely exhausted. The male dentist in his forties appears to be most vulnerable to burnout.

Adult↗
PubMed1990

Dentists' and physicians' attitudes on the role of the dental health care team in a cardiovascular risk factor reduction program.

This study examines the attitudes of both dentists and physicians on the role of the dental health care team in a cardiovascular risk factor reduction program directed at a general "well" population. A questionnaire was sent to a stratified sample of primary care dentists and physicians in the Augusta, Georgia, metropolitan area. The questionnaire was divided into four parts: the demographic component and three attitude components (the affective component, the cognitive component, and the action component). Results showed that dentists tended to have a positive attitude about performing cholesterol screening, nutrition counseling, and blood pressure screening in the dental office. Physicians tended to be negative about the idea of dentists performing cholesterol screening and nutrition counseling and were undecided about this role for dentists in a cardiovascular risk factor reduction program. Both dentists and physicians had positive attitudes about the idea of dentists referring high cardiovascular risk patients to physicians, as well as about the role of dentists in blood pressure screening. Overall, although dentists and physicians expressed concerns about the role of dentists in a cardiovascular risk factor reduction program, responses of both groups demonstrated a willingness to explore this concept further.

Adult↗
PubMed1991

Time to adoption of an innovation by dentists in private practice: sealant utilization.

Dentists can be divided into five adoption categories based upon their time of adoption of pit and fissure sealants: innovators, early adopters, early majority, late majority, and laggards. The differences among dentists in the five adoption categories were examined for four classes of variables: practice characteristics, dentist characteristics, communication of information, and practice environment. Questionnaires were mailed in September 1984 to a random sample (N = 521) of Washington State dentists in general practices. A total of 376 completed questionnaires were returned, for a response rate of 72 percent. Adoption of sealants proceeded as follows: 5 percent of dentists through 1973, 24 percent through 1979, 50 percent through 1982, and 75 percent through 1984. Adoption category was related to percent of assistants who were certified, delegation to assistants and hygienists, magnitude of the fees charged by the practice, number of staff meetings per month, the dentist having been an officer in a dental organization, year the dentist adopted other new technologies, dentist's self-rating of willingness to try new things, percent of patients who are children, and percent of the dentist's colleagues who used sealants. These data lend some support to the two-stage or opinion-leader model of diffusion and suggest that new technologies can be promoted by first influencing dentists who consistently adopt early.

Adolescent↗
PubMed1994

Dentists and AIDS: a survey of knowledge, attitudes, and behavior in Italy.

OBJECTIVES: Italy, together with Spain, is second only to France in the total number of AIDS cases in Europe, with over 16,800 as of March 1993. The purpose of this study was to evaluate knowledge, attitudes, and behavior concerning AIDS and infection control among Italian dentists. METHODS: A questionnaire was mailed to 1,000 dentists randomly selected from the Italian Dental and Maxillo-Facial Association's register of dentists. RESULTS: Of the 715 dentists responding, 70.7 percent of dentists knew all the main risk groups able to transmit the infection and that semen is a biologic fluid potentially contaminated by HIV virus. This knowledge was greater if the number of patients per week was not higher than 55 and if the dentist had had a previous contact with an HIV-seropositive patient. Only a few (21.1%) knew all the oral manifestations of AIDS. Over 65 percent of the dentists indicated that they would treat HIV-seropositive patients (71.9%) or those with AIDS (66.8%). Dentists were more willing to care for an HIV-seropositive patient if they were involved in specialties with high blood contact, if they had a previous contact with an HIV patient, as the average number of patients per week increased, and if they did not consider saliva as a possible route of transmission of HIV. A small percentage of dentists who had the opportunity to treat patients at risk for AIDS (12.1%) or HIV seropositive (9.4%) refused to treat them. Willingness to treat was the most significant predictor of actual treatment of an infected patient. Only 24.4 percent routinely used all barrier techniques (gloves, masks, and protective eyewear). Predictors of routine use of all barrier techniques were specialties with high blood contact, considering saliva a possible route of transmission of HIV infection, average number of patients per week fewer than 40, and number of years of practice. CONCLUSIONS: Educational efforts for improving knowledge and finding and implementing ways to motivate dentists to the correct and routine use of infection control procedures are needed.

AIDS-Related Opportunistic Infections↗
PubMed1992

Factors affecting blood mercury concentrations in practicing dentists.

It has been suggested that mercury vapor may be transformed into highly toxic organomercury compounds by micro-organisms in the oral cavity and gastrointestinal tract. If this hypothesis is correct, practicing dentists might be expected to have concentrations of organic mercury in their blood higher than that found in non-dentists. Blood mercury concentrations of practicing dentists and non-dentists were determined by means of cold-vapor atomic absorption spectrophotometry. Potential sources of mercury exposure were identified in both dentists and non-dentists through a questionnaire completed at the time of sampling. Concentrations of total and inorganic blood mercury were significantly higher in dentists than in non-dentists. The organomercury concentrations of the two groups were not statistically different (p greater than or equal to 0.05). The high concentration of inorganic mercury in the blood of dentists was not related to the organomercury level, suggesting that biotransformation of inorganic mercury to organomercury does not occur in vivo. However, the concentration of blood organomercury was positively correlated with the frequency of fish consumption. There was no correlation between the number of amalgam restorations and the concentration of inorganic blood mercury for both groups. Accidental mercury spills in the dental operatory may contribute most to the concentration of inorganic blood mercury in the blood of dentists.

Accidents, Occupational↗
PubMed1985

A survey of retired dentists in the United States. Council on Dental Practice.

This paper reports on the results of a national survey of retired dentists carried out in the winter and spring of 1984. More than eight in ten of the respondents were general practitioners. Most retirees are between the ages of 60 and 69, married, and report their overall health at retirement to be excellent or good. As do retired scientists, dentists find intrinsic gratification in the work role, but apparently accept retirement as part of the life cycle. Retired dentists have income substantially greater than retirees in general. As is the case for the greater majority of older Americans, Social Security provides an important income support for respondent dentists. However, the primary source of retirement income for dentists comes from savings and investments. One of three retired dentists reports net worth in 1984 as between $200-$499,999. Retired dentists are well adjusted to retirement. Overall, most dentists report high satisfaction with retirement to date. Additional leisure time for hobbies, flexibility in owning one's time, and social activities with family and friends seem the main contributors to this satisfaction. Investment planning, health assessment, enthusiasm for outside interests, and personal preparation for retirement with a spouse are reported as important in retirement planning. Retirement is not a satisfying experience for all dentists. Some do report experiencing uselessness and depression. A still smaller proportion report feelings of loneliness and inadequacy. As is the case for older people in general, solitary activities including reading, watching television, and gardening are important for retired dentists. Most older people attempt to retain activity patterns and preferences developed earlier in life.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed2005

Nationwide survey of work environment perceptions and dentists' salaries in community health centers.

BACKGROUND: Experienced private practitioners make up a significant proportion of dentists entering community health center (CHC) practices. The authors conducted a study to identify sources of dissatisfaction that affect the retention of these dentists and to determine current CHC dentist salaries. METHODS: CHC dentists nationwide were surveyed regarding salary and job satisfaction indicators. The authors mailed 569 surveys, and the response rate was 73.8 percent. The authors explored associations between job satisfaction indicators, salaries and dentists' intentions to leave the CHCs. RESULTS: Practitioners in private practice are the largest group of dentists recruited by CHCs (54.5 percent). However, 31.2 percent of currently employed dentists do not intend to remain in CHC dental practices. Salary was not associated significantly with the intention to leave. Years of experience, freedom of professional judgment, altruistic motivation, importance placed on loan repayment and amount of administrative time allowed were associated significantly with career change intentions. CONCLUSIONS: Periodic salary surveys can monitor factors associated with recruitment and retention of dentists in community and migrant health centers, and standardized exit surveys can identify factors causing dissatisfaction among dentists who leave. PRACTICE IMPLICATIONS: Employment opportunities in public nonprofit practices are increasing under current federal grant programs. However, unless job satisfaction issues are addressed adequately with dentists in social safety net programs, additional work force needs will not be met.

Attitude of Health Personnel↗
PubMed2001

The dentist as biobehavioral clinician.

At the core of all clinical dental practice is the interpersonal interaction between dentist and patient. An expansion of the dentist's responsibility in the unique dentist-patient relationship is suggested. Such an expanded role encourages dentists to engage the emotional and behavioral health of dental patients who are appearing in dental offices for treatment of orofacial diseases and other conditions. The term "biobehavioral clinician" is used to refer to this broadened role for the dentist. It is suggested that such a biobehaviorally oriented dentist will be a powerful ally on behalf of the health of patients, attending to more dimensions of the patient's presentation and management than the diagnosis and treatment of oral pathobiology. It seems entirely appropriate that dentists have such a role in its future, engaging as they do millions and millions of Americans on a regular basis and a productive and collaborative dentist-patient relationship is already an accomplished fact for most dentists with most of their patients across all stages of the life span. The benefit to patients' overall health and well-being could be tremendous and would add an enriching and personally rewarding dimension to being a dentist.

Adolescent↗
PubMed2001

Temporomandibular disorders in children and adolescents: a survey of dentists' attitudes, routine and experience.

The aim of this study was to survey the experience and routine of, attitudes toward, and need for specialist resources in the treatment of temporomandibular disorders (TMD) in children and adolescents among public dentists. A questionnaire study was conducted in three counties in Sweden: Ostergötland, Västmanland, and Göteborg. The questionnaire was sent to 286 Public Dental Service dentists. It contained questions on demographic issues, quality assurance, clinical experience and expertise, attitudes, and the need for specialist resources. Eighty-seven per cent (250) of the dentists answered the questionnaire. The dentists in the three areas reported good routine and safety in occlusal splint treatments (74%-81%), occlusal equilibration (28%-55%), jaw exercise (25%-29%), and medication treatments (3%-55%). Good experience concerning diagnostics and therapy decision was reported by 25%-50% of the dentists. A significantly greater portion of the dentists in Västmanland had attended courses in TMD compared with the two other counties (p = 0.001). Registrations of quality variables such as verbal and/or written case histories with questions on facial pain and tension-type headache (1%-39%) and measurements of jaw openings were performed less frequently in the three counties (0%-5%). Fifty-five per cent of the dentists had a positive attitude toward the care of children and adolescents with TMD. A large need for specialist resources with the possibility to send referrals or to consult was reported by 98%-100% of the respondents, to participate in continuing education by 97%-98%, and to do auscultation by 61%-82%. In conclusion, many of the dentists lacked routines for making diagnoses, deciding therapy, and judging treatment results. Good routines were reported only in occlusal splint therapy. The majority of the dentists had a positive attitude toward the care of children and adolescents with TMD-related symptoms. The majority of the dentists reported a great need for TMD specialists.he

Adolescent↗
PubMed2001

The delivery of orthodontic care in New Zealand. Part II: Analysis of a census of dentists.

Part I of this study reported the level and distribution of the supply of specialist orthodontic services in New Zealand. This paper focuses on the amount and variety of orthodontic services supplied by dentists. A questionnaire sent to all dentists in New Zealand sought information on the amount and type of orthodontic treatment carried out between 1 July 1998 and 30 June 1999. The reply rate was 80.9 percent. The majority of dentists carried out some form of orthodontic treatment, predominantly of a minor nature. A small number provided significant amounts of treatment, both simple and complex. The majority of orthodontic treatment and the majority of comprehensive fixed-appliance treatment were undertaken by orthodontists. One-quarter of all orthodontic patients in New Zealand were treated by dentists, irrespective of the complexity of treatment. Nearly a fifth of all full fixed upper and lower appliances, and nearly a third of all single-arch fixed appliances were placed by dentists during the study period. In general, male dentists, dentists over the age of 40, those who had attended an orthodontic continuing education course in the previous 5 years, and those who referred fewer patients to an orthodontist carried out more procedures, including those of a complex nature; they also had a higher average active orthodontic patient load. Wanting to be more or less busy had little influence on the amount or complexity of treatment performed. Dentists in regions with a low supply of specialist orthodontic services provided more comprehensive fixed appliance treatment and had a higher orthodontic patient load. However, the presence or absence of an orthodontist in an urban area seemed to have little impact on the complexity of treatment or the orthodontic patient load of dentists. Despite fewer orthodontists in secondary and minor urban areas, dentists in these areas did not have a higher orthodontic patient load, but carried out a wider range of procedures and more complex procedures than those in main urban areas.

Adult↗
PubMed2002

Right- and left-handed dentists in periodontal therapy.

The purpose of this study was to determine whether successful dental therapy (scaling and root planing) depends upon handedness of dentists in right-handed dental chairs (units) Participants were 28 voluntary dentists (14 female and 14 male, ranging in age from 26 to 34 years). Patients (7 female and 7 male with a mean age of 39.6 years) had advanced periodontitis. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. There were two equal groups of dentists: left-handers (7 female, 7 male) and right-handers (7 female, 7 male). Initial examination of patients was performed using a pressure-controlled periodontal probe. During scaling and root planing, the negative interstroke forces were recorded using a piezo-electric receiver, an electronic transducer, and an analogue writer. The results showed that during scaling, mean negative forces reached a mean of 0.74 N in left-handed dentists and 0.52 N in right-handed dentists. During root planing, these forces were 0.86 N in left-handed dentists, and 0.63 N in right-handed dentists. These differences were statistically significant. The right-handed dentists were more successful than the left-handed dentists at scaling and root planing, provided that both of them used the same right-sided dental chairs. The importance of handedness of the dentists was accentuated in dental practice.

Adult↗
PubMedDate not supplied

Dentists' and parents' perceptions of health, esthetics, and treatment of maxillary primary incisors.

PURPOSE: Dentists' and parents' assessment of primary maxillary incisors regarding attractiveness, perceived health, and treatment preferences were investigated in this study. METHODS: Sample groups of 103 general dentists, 67 pediatric dentists, 97 parents of children in low-income families and 112 parents of children in high-income families completed questionnaires presenting color photographs and radiographs of maxillary incisors. Questions addressed treatment need, health beliefs, and demographics. RESULTS: All groups recognized grossly carious teeth and carious teeth with visible sinus tracts as unhealthy and unattractive. All agreed that grossly carious teeth warranted extraction (dentists = 92%, parents = 73%). For carious teeth with sinus tracts, dentists favored extraction and restorations while parents favored fluoride application. Dentists rated a dark incisor as healthy and not requiring treatment. Parents rated a dark incisor as neutral for attractiveness and health, but favored extraction or restoration. All groups found anterior steel crowns esthetically unacceptable. Trust of the dentist, pain for the child, and dentist skill was important for parents in treatment plan acceptance. CONCLUSIONS: A dentist's inexperience in pediatrics may result in a failure to diagnose or recognize the significance of some conditions. Proper parental education can better inform parents on dental conditions requiring prompt professional attention. Although parents today are more involved in clinical decision-making, they still rely on the dentist's expertise and advice.

Attitude of Health Personnel↗
PubMed2005

Removal, replacement and placement of amalgam restorations by Ontario dentists in 2002.

AIM: To determine the patterns of removal, replacement and placement of amalgam restorations by Ontario dentists. METHODS: A structured self-administered postal survey was sent to dentists randomly selected from the list of all dentists licensed to practise dentistry in Ontario. The questionnaire sought information on the numbers of 1-, 2-, 3- and > or = 4-surfaced amalgam restorations and core amalgam build-ups that each dentist removed, replaced and placed during a 7-day period. RESULTS: A total of 878 (44%) of 1,994 dentists responded to the survey. Most dentists (82%) who returned completed questionnaires (n = 837) had removed, replaced or placed at least one amalgam restoration during the 7-day period. Most respondents (90%) were general practitioners; respondents practised for a mean of 45.7 weeks each year and had practised for a mean of 20.1 years. On average, each dentist removed 8.91 (standard deviation [SD] 17.32) amalgam restorations during the 7-day period. However, the mean number of new amalgam restorations placed was just 6.64 (SD 18.88): 2.99 (SD 8.74) new restorations in previously unrestored teeth and 3.65 (SD 11.40) replacements of amalgam restorations removed from previously restored teeth. For the year 2002, it was estimated that the 6,915 dentists registered to practise in Ontario had removed 2,855,178 (95% confidence interval [CI] 2,484,566-3,225,790) amalgam restorations. Overall, the dentists placed 2,112,800 (95% CI 1,682,307-2,543,292) amalgam restorations; 1,163,665 (95% CI 919,204-1,408,126) to replace amalgams in previously restored teeth and 949,135 (95% CI 763,103-1,135,166) as new amalgam restorations. CONCLUSIONS: Removal of old amalgam restorations by Ontario dentists exceeds current levels of placement and replacement of amalgam restorations.

Analysis of Variance↗
PubMedDate not supplied

Working relationship between dentists and dental hygienists: their perceptions.

The purpose of this study was to reexamine the working relationship between the dentist and the dental hygienist with regard to delegation and professional interaction. A questionnaire was mailed to Michigan dentists and dental hygienists to acquire data regarding dental hygiene practice, office procedures, and employer/employee interaction. Of the 500 dentists surveyed, 289 (58%) returned questionnaires, and of the 360 hygienists surveyed, 298 (83%) returned questionnaires. The dental hygienists' perception of their practice is significantly different from the dentists' in several major areas. More than half of the dentists reported checking the hygienist's work all of the time, whereas only one third of the hygienists reported always being checked. Assessment of patient needs by a clinical caries examination is perceived differently. Most of the hygienists reported they perform clinical caries examinations all of the time, whereas only two thirds of the dentists reported the hygienist always performs an examination. Delegation of auxiliary procedures is viewed similarly by both dentists and hygienists, but procedures which can be performed are not being delegated. With respect to professional communications, half of the dentists perceive that they provide feedback to the hygienist all of the time, while only one third of the hygienists feel they receive feedback all of the time. In determining the recall interval, most of the dentists reported establishing it in consultation with the hygienist, whereas half of the hygienists reported setting it alone. Data suggest that the dentists' perceptions are inconsistent with the hygienists' in role delineation and patient care.

Adult↗
PubMed1990

Cervical pain and discomfort among dentists. Epidemiological, clinical and therapeutic aspects. Part 1. A survey of pain and discomfort.

The aim of the investigation was to study the frequency of pain, ache and discomfort in the musculoskeletal system among dentists, above all concerning headache, cervical and shoulder pain and further, to find possible correlations between these symptoms and various working positions and different working actions. A questionnaire was answered by 359 dentists (90.8%). Of those who answered the questionnaire 72% had pain and discomfort from either the neck, shoulders or headaches. Only 60 dentists had no pain or discomfort. Concerning the male dentists, the investigation revealed that younger dentists had pain and discomfort in the neck, shoulders and headaches to a greater extent than the older dentists. Younger female dentists had a significantly higher frequency of pain and discomfort in the neck and headaches than older colleagues. The results showed that dentist who positioned the patient carefully so that a direct view gained had a significantly lower frequency of headaches. Of the 359 dentists 55% mostly used the mirror to facilitate a direct view. From the answers it was clear that those dentists who did not have discomfort in the upper locomotor system used the mirror more often than those who did suffer discomfort.

Adult↗
PubMed2004

Patient orientation and professional orientation of Dutch dentists.

By providing dental health care, dentists dedicate themselves to the preservation and/or improvement of oral health in their patients. By adequately carrying out this care providers' role, dentists will gain recognition, esteem and respect from both patients and colleagues. This analysis aims to assess the patient and professional orientation of dentists and investigate which of their personal and practice characteristics can be regarded determining for these two aspects of their role as care providers. In the year 2000, data was collected via a written questionnaire sent to a random, stratified sample of 790 dentists, of whom 607 (77%) responded. Multivariate regression analysis shows that the preventive treatment concept, professional satisfaction and the number of hours per week that household tasks are performed are positive determinants for dentists' patient orientation. Also, the longer dentists are active in their profession, the more patient oriented they will be, and with more hours per week support from oral hygienists they are less patient oriented. As for professional orientation, dentists' preventive treatment concept and their professional satisfaction can also be considered positive determinants. Furthermore, dentists are more profession oriented when their partner works in the practice, with more hours per week support from oral hygienist(s) and with more collaboration contacts with other care providers. Compared to men, women are on average less profession oriented. Among Dutch dentists, there exist clear differences in the way they take on their role as care providers with regard to patient orientation and professional orientation.

Attitude of Health Personnel↗
PubMed1998

Patient attitudes to glove use by dentists.

OBJECTIVE: To evaluate the attitudes of patients on the importance of glove wearing by dentists. DESIGN: A patient survey using a self-completed patient questionnaire. SETTING: Ireland. SUBJECTS AND METHODS: 164 consecutive patients attending a dental accident and emergency department were asked to participate. All the patients were aged 16 years or over. Of the surveyed patients, 157 completed a questionnaire designed to elucidate the patients' attitudes to the wearing of gloves by dentists. RESULTS: Most patients (93.6%; n = 147) considered that dentists should routinely wear gloves, while 1.9% (n = 3) thought the wearing of gloves was unnecessary. 94.9% (n = 149) considered that gloves were worn to protect both the dentist and the patient, with 1.9% (n = 3) feeling that only the dentist was protected. 72% of patients (n = 113) would not attend a dentist who did not wear gloves. 87.2% (n = 138) of patients thought that the dentist should change gloves between patients, while 1.3% (n = 2) considered glove washing to be sufficient. The remaining 11.4% (n = 17) felt that this decision should be left to the dentist. CONCLUSION: The majority of surveyed individuals indicated that dentists should wear gloves while treating patients. The results suggest that many patients refuse to have dental treatment carried out by a dentist who does not wear gloves.

Adolescent↗
PubMed1996

The use of dental sealants by Ohio dentists.

OBJECTIVES: To assess the extent to which Ohio dentists report using pit and fissure sealants and factors associated with sealant use. METHODS: A mail survey of a random sample of Ohio dentists was conducted in 1989 and repeated in 1992 with a newly drawn sample. Only responses from general dentists were analyzed using univariate analyses and multiple regression. RESULTS: Dentists who reported using sealants increased from 79.4 percent in 1989 to 91.8 percent in 1992. In 1992, 42.9 percent were low-level users (< 15% of school-aged patients), 41.7 percent were moderate-level users (15-39%), and 15.3 percent were high-level users (> 39%). Over three-fourths of sealant-using dentists expressed some degree of willingness to seal incipient caries. The level of sealant use was associated with dentists' knowledge about sealants, conservative management of dental caries, number of children seen in the practice, and influence of insurance coverage for sealants. The regression model explained 22.0 percent of the variance. Clinical factors associated with the level of use were: dentists' willingness to seal premolars; caries-free teeth; teeth with deep, narrow pits and fissures; teeth with small, frank occlusal caries; and patients 18 years of age or older. This regression model explained only 15.1 percent of the variance. CONCLUSIONS: The grate majority of Ohio dentists report using sealants. The percent of reported sealant users increased between 1989 and 1992. Ohio dentists are not consistent with regard to the percent of their child patients for whom they apply sealants or their willingness to seal incipient caries. Dentists continue to identify lack of insurance coverage for sealant application as a major barrier to patients receiving the service.

Adolescent↗