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PubMed1979

Public opinions on dentists in Norway.

Interviews on the dentist-patient relationship were carried out among 1,221 persons representing the dentulous part of the Norwegian population aged 15 and over. Two thirds of the interviewees said that their dentists explained the treatment plan, and of these, every second interviewee received reasons for the treatment. One third said they discussed different treatment alternatives with the dentist. One third of the respondents said that the dentist had urged them to clean their teeth thoroughly and to use fluoride. Inly a minority thought that the dentist had sought to influence their dietary habits. When asked to give priority to alternative characteristics and qualities of dentists, accuracy and professional skills were those ranked the highest. Carefulness, willingness to listen and to discuss dental problems, and finally effective working habits were the qualities ranked thereafter. Out of the sample, 96% thought that their dentist did very good or good work, and 82% wanted to choose their own dentist.

Adolescent↗
PubMed2000

Australian dentists' views on toothbrush wear and renewal.

The purpose of this study was to survey the views of Australian dentists on toothbrush wear, toothbrush renewal periods and recommendations to patients and to investigate the relationship between dentists' views on patients' toothbrush renewal intervals and dentists' own renewal habits. Questionnaires were mailed to 5,596 Australian general dental practitioners and replies received from 3,406 (61 per cent response rate). The majority of respondents (85.7 per cent) felt patients should renew their toothbrushes more often. However, only 45.3 per cent usually made a recommendation to their patients as to when they should renew their toothbrush and only 41.7 per cent thought patients actually followed such recommendations. Most respondents (56.6 per cent) thought the average adult patient should renew a toothbrush every two-three months. A renewal period of one month or earlier was recommended by 23.8 per cent of dentists; four-five months by 8 per cent; and six months or longer by 11.5 per cent. A highly significant correlation was found between the renewal periods recommended for patients and the intervals selected by the dentists for their personal brushes (p < 0.001; chi-square test). Bending and splaying of bristles was the sign identified by the majority of dentists (70 per cent) as indicating the need for a new brush. The findings suggest dentists' recommendations concerning toothbrush renewal intervals may be based on their own toothbrush renewal habits. It is also concluded that dentists think patients comply poorly with their recommendations on toothbrush renewal.

Adult↗
PubMed2002

Ethical dilemmas confronting dentists in Queensland, Australia.

BACKGROUND: This paper details contemporary ethical dilemmas encountered by Queensland dentists. METHODS: An age-stratified sample of 499 dentists resident in Queensland was surveyed. The questionnaire contained scenarios of five common ethical dilemmas. In addition, open-ended questions sought the respondent's most frequent, difficult and recent ethical dilemmas, and where they would seek guidance in dealing with ethical problems. RESULTS: Respondents acknowledged the patient's rights in treatment decisions and the dentist's right to refuse demands for inappropriate treatment. However, responses varied in the extent to which dentists may influence treatment decisions. Few respondents would ignore evidence of poor dental treatment but they are evenly divided in choosing to inform the patient, the dentist or both. Poor quality treatment is the most frequent and difficult dilemma, and half have experienced this problem recently. Requests by patients for fraudulent receipts occur in a third of responses. Dentists develop ethical values from multiple sources but for help with dental ethical problems, 90 per cent of respondents would consult another dentist. CONCLUSIONS: Of the ethical dilemmas discussed in this survey, those relating to poor quality treatment confronted most respondents. Also the actions of dentists in dealing with these dilemmas were most varied.

Adult↗
PubMed2002

Dentists' perception of their treatment practices versus documented evidence.

OBJECTIVE: To compare the quality of real-life treatment practices to dentists' perceptions of treatment rendered. SETTING: One administrative unit of the Finnish public oral health service. METHODS: The original oral health records of a randomly selected sample of young adults who received treatment during 1994-1996 provided data on actual clinical examinations (n=208), radiographs (n=312), and root canal treatment courses (n=148) carried out by 50 dentists. Dentists' perceptions of the treatment rendered were obtained through a structured questionnaire completed during their working hours in 1996. OUTCOME MEASURES: Criteria for assessing the quality of treatment practices were based on Finnish health legislation, authoritative instructions, and consensus reports. RESULTS: Based on responses, 77% of the dentists followed the prevailing instructions on oral health record keeping (82%, if partial agreement included). Most dentists (88% fully agreed, 95% at least partly) perceived that their knowledge gained through continuing education was being applied in practice; no one answered no. A gap was found between dentists' perception of the treatment rendered and everyday treatment practices as recorded on patient documents. CONCLUSIONS: Overall, dentists' perception of the quality of their treatment practices exceeded that found in patient documents. This gap deserves consideration while planning research, education, or quality-improvement projects that relate to dentists' opinions.

Adult↗
PubMed2004

Assessing differences in hours worked between male and female dentists: an analysis of cross-sectional national survey data from 1979 through 1999.

BACKGROUND: Women are increasingly entering the dental work force. This study examines the impact of sex, age and other demographic characteristics on dentists' work force participation and on hours worked from 1979 through 1999. METHODS: The study drew on cross-sectional data on dentists (4,209 men and 354 women) from national population surveys conducted by the U.S. Bureau of Labor Statistics from 1979 through 1999. The authors used descriptive statistics and regression analyses to examine sex differences in work force participation and in hours worked across age, as well as other factors. RESULTS: Work force participation was high for both men and women. Men worked more hours and worked part time less frequently; they worked more than 42 hours per week more frequently. Older dentists worked fewer hours, with a larger impact of age seen among men. Having children had a significantly greater effect on the number of hours worked per week among female dentists than among male dentists. CONCLUSIONS: There were significant differences in dentists' hours worked by sex and by age. The consistency of the results with past studies suggests these differences will hold in the near future. PRACTICE IMPLICATIONS: Women's entry into the dental work force has been significant and has helped maintain the supply of dentists. Sex differences in the work force should be considered in evaluating the supply of dentists and related work force policy.

Adult↗
PubMedDate not supplied

Oral and pharyngeal cancer: knowledge and opinions of dentists in British Columbia and Nova Scotia.

Oral and pharyngeal cancers are largely preventable and can be successfully treated when diagnosed at an early stage. Dentists in British Columbia and Nova Scotia were surveyed regarding their knowledge and opinions about oral and pharyngeal cancer. In February 1998 a pretested 41-item survey was mailed to a random sample of dentists in British Columbia and the population of dentists in Nova Scotia. A reminder postcard and one additional mailing were sent to nonrespondents. Of the 670 dentists supplying usable responses (response rate 55.2%) only 56.7% agreed that their knowledge of the subject was current. Most dentists correctly identified tobacco use (99.4%) and alcohol use (90.4%) as risk factors, but fewer correctly identified factors such as the use of spicy foods (57.0%) and poor oral hygiene (46.3%) as not being risk factors. Only 42.5% identified both erythroplakia and leukoplakia, in that order, as the conditions most likely associated with oral cancer. Indices of risk and diagnostic knowledge were constructed by summing the number of correct responses to items in each domain. On 16 risk factors the mean correct score was 9.2, and on 14 diagnostic procedures the mean correct score was 10.0. Only 38.5% of dentists had consistent levels of knowledge on both indices. Differences between the provinces were statistically significant (p < 0.01) for only 2 knowledge items. About three-quarters of all dentists (77.0%) were interested in taking continuing education courses. Dentists in British Columbia and Nova Scotia could benefit from undergraduate and continuing education courses to increase their knowledge of risk and diagnostic factors for oral cancer.

Adult↗
PubMed2004

Barriers to the treatment of childhood caries perceived by dentists working in different countries.

OBJECTIVE: To explore whether dentists' beliefs and attitudes to providing preventive and restorative dental care for young children can form a barrier to the provision of care. BASIC RESEARCH DESIGN: The Barriers to Childhood Caries Treatment (BaCCT) Questionnaire, a standardised international measure was developed and applied. PARTICIPANTS: Through a research consortium, each site was asked to recruit 100 dentists. The sample participating was not intended to be nationally representative. Dentists were mainly randomly selected and contacted by mail with one or more mailings depending on site. RESULTS: 2,333 dentists in 14 countries and 17 sites participated. Factor analysis identified four factors as potential barriers. Two factors were found to be barriers in many sites. First, in most countries, dentists agreed that young children's coping skills limit their ability to accept dental care. Secondly, dentists with negative personal feelings, for example, that providing care can be stressful and troublesome and that they feel time constrained. Differences in dentists' beliefs can be partly explained by their work profile, with those treating children often, and those working under systems where they feel they can provide quality care being least likely to identify barriers to providing care for children. CONCLUSIONS: The BaCCT Questionnaire was determined to be a valid psychometric measure. Separately, it was found that health systems do impact on dentists' ability to deliver preventive and restorative care for children but that these effects vary across countries and further work is needed to determine how best these should be examined.

Attitude of Health Personnel↗
PubMed1990

Do dentists have sufficient information about their patients to control infection?

This study examined dentists' knowledge of infection control, what dentists say they do to control infection, and what procedures they actually take to prevent the transmission of disease. A professional actor, obviously in need of dental care and playing the part of a patient, was sent to three groups of randomly selected dentists in general practice. The dentists were uninformed subjects who were debriefed about the research immediately after their part in the experiment was completed. The study found that dentists apparently know what they should do to protect themselves from contamination. However, very few dentists discussed HIV or AIDS while taking a pretreatment history of a new patient even if that patient was perceived to belong to a high-risk group. The behavior of the dentists indicates a neglect of this important aspect of a thorough history, providing more evidence that emphasis on infection and infection control is necessary in the dental school curriculum and beyond. Unless dentists learn to fully understand what infections their patients may have, they take the chance of transmitting diseases to other patients as well as to themselves, their staff, and their families.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Tobacco and oral health: attitudes and opinions of European dentists; a report of the EU working group on tobacco and oral health.

AIM: To discover whether dentists are prepared to advise their patients to stop smoking. DESIGN: Postal questionnaire. SETTING: Member countries of the European Union. PARTICIPANTS: Dentists in 12 EU countries. MAIN OUTCOME MEASURES: Dentists' knowledge of links between tobacco-use, general health and periodontal health. Knowledge of, and preparedness to offer, tobacco-cessation activities for patients. Personal and practice smoking policies. RESULTS: EU-dentists are aware of the harmful effects of tobacco use in general and on oral tissues in particular. Over two-thirds of EU-dentists feel that offering information about tobacco cessation is the dentist's duty, while slightly less actually do so. Lack of time and reimbursement mechanisms are the most often mentioned barriers for co-operation with a campaign. Less than 10 per cent of EU-dentists smoke every day while three-quarters of practices are totally smoke free. CONCLUSIONS: EU-dentists want to be informed and supported on the issue by leaflets, brochures, continuing education and patient education materials. More attention should be paid to the relation of smoking and implant failure.

Adult↗
PubMed1989

Dentists' professional satisfaction with adolescent dentistry and its association with adolescent dental health behavior.

This study examines dentists' perceptions of behaviors felt to interfere with providing adequate dental care to adolescents. We analyzed gender differences, and whether the dentists' perceptions of adolescent patients were associated with their professional satisfaction. A stratified random sample of 227 graduates (males = 180, females = 47) from a Southern dental school were asked to complete a questionnaire assessing professional satisfaction. Based on Kruskall-Wallis analysis of variance tests, female dentists expressed generally higher levels of satisfaction than males with adolescent dentistry, diagnosis and treatment planning, patient education, preventive procedures, and the adolescent dentistry curricula during dental school. Male dentists felt that the male adolescents' failure to keep appointments, communication problems, seeking dental care only in emergency situations, and resentment of authority interfered more with their providing adequate dental care than did female dentists. Male dentists also felt that the female patients' menstrual period, communication problems, low tolerance of pain, seeking dental care only in emergency situations, and resentment toward authority were more significant problems than did the female dentists. Communication problems with both male and female adolescents were more strongly correlated with the dentists' satisfaction with adolescent dentistry than any other variable.

Adolescent↗
PubMed2005

Outcome of direct restorations placed within the general dental services in England and Wales (Part 3): variation by dentist factors.

AIM: It is the aim of this paper to investigate the survival of direct-placement restorations provided within the General Dental Services in England and Wales, in relation to the dentist factors which may affect this. METHODS: For this work, survival of a restoration was considered to be the time between the date of completion of the course of treatment in which it was placed and the date of acceptance of the course of treatment when the next tooth-specific treatment was carried out on the same tooth. A modified version of Kaplan-Meier statistical methodology was used to plot survival curves for restorations placed by different subgroups of dentists. RESULTS: The age and experience of the dentist who placed the original restoration were found to be related to restoration survival, with older dentists having shorter intervals from placement of restorations to re-intervention (P<0.001). Country of qualification seems not to be relevant within Europe in terms of restoration survival, but dentists who qualified outside Europe achieve different restoration survival times for the restorations that they place. Dentist's gender has no relationship with time from restoration to re-intervention. CONCLUSIONS: Dentist factors such as age, country of qualification, and employment status, but not the gender of the dentist, have been found to influence the survival of directly placed restorations.

Adult↗
PubMed1995

A survey of the radiographic practices of general dentists for edentulous patients.

OBJECTIVE: The objective of the study was to evaluate the radiographic practice of general dentists for edentulous patients. STUDY DESIGN: A questionnaire was sent to a sample of graduates from the two Ontario dental schools. RESULTS: The adjusted response rate for the survey was 80%. Fifty-three percent of the respondents used screening radiography for new patients. The overwhelming choice for these dentists was the panoramic film. There was a significant positive association between ownership of a panoramic unit and use of this radiograph. Dentists who do not own a panoramic unit rarely chose to refer their patients for this radiograph either routinely or selectively. When dentists, rather than the auxiliaries, made the greater proportion of the radiographs, they tended to use selective radiography. Most dentists chose selective radiography for the recall patient. CONCLUSIONS: Almost half the dentists did not follow the Food and Drug Administration/American Dental Association guideline of screening radiography for the new edentulous patient. Of those dentists who did follow the guideline the vast majority both owned panoramic units and chose to use a panoramic survey. Most dentists followed the guideline for selective radiography for the recall patient.

American Dental Association↗
PubMed2003

Effectiveness of interventions to promote continuing professional development for dentists.

BACKGROUND: Continuing education is incumbent upon dentists as health professionals, but its promotion may be required, particularly in order to ensure regular professional updating. Continuing professional development may be delivered in a variety of ways, and new strategies and techniques must be evaluated for effectiveness. AIM: To evaluate the effectiveness of two interventions utilizing the philosophies and techniques of the discipline of Quality Improvement. METHOD: A self-assessment instrument (a manual) for quality dental practice was developed using the Delphi technique. A randomized, controlled trial of the interventions was conducted under field conditions for dental practice in Victoria, Australia. Dentists in Test Groups 1 and 2 completed the self-assessment manual, and received relevant references and their own scores for the manual in comparison with empirical standards. Dentists in Test Group 1 also attended a continuing education course on Quality Improvement. Dentists in Control Group 1 completed the manual only and received feedback of their scores. Dentists in Test Groups 1 and 2, and in Control Group 1 completed the manual again after 1 year as a post-intervention follow-up. Dentists in Control Group 2 completed the manual only at 1 year. RESULTS: The intervention involving self-assessment, receipt of scores and references for the manual resulted in modest improvements in total scores for dentists after 1 year, although a response bias was apparent. CONCLUSION: An effective method of facilitating change in quality dental practice was identified. Assessment of strategies and techniques for professional development of dentists should include observation of patterns of participation.

Attitude of Health Personnel↗
PubMed2000

Burnout and health among Dutch dentists.

In this study, it was hypothesised that dentists with a high burnout risk would experience more health complaints and show more unhealthy behaviour when compared with dentists with a low burnout risk. With a response rate of 75%, a representative group of 709 actively practising dentists responded to a questionnaire containing the Dutch version of the Maslach Burnout Inventory (MBI-NL), a health complaints measure (VOEG), and items on health behaviour. Results showed that dentists with a high burnout risk reported health complaints to a greater extent than dentists with a low burnout risk. They also reported more unhealthy behaviour in some aspects (physical exercise/sporting, increase in alcohol consumption, unhealthy diet), but not in others. It also appeared that one out of ten dentists reported having poor general health, and that three out of ten reported to have poor physical condition. In general, dentists' self-reports appeared favourable in comparison with the Dutch population. It is concluded from this study that among dentists burnout and poor health are strongly related. It is discussed that in order to deal preventively with burnout in dentistry, attention to physical health, including ergonomics, is essential.

Adult↗
PubMed2002

An investigation of paediatric dentists' attitudes towards parental accompaniment and behavioural management techniques in the UK.

OBJECTIVE: Good behavioural management techniques are essential for treating children. Recent research has investigated parental and paediatric attitudes towards various behavioural management techniques. However, in the UK, very little is known about paediatric attitudes towards such issues. Accordingly, the aim of this investigation was to conduct a survey in order to provide insight into the current thinking of paediatric dentists across the UK. STUDY DESIGN: A questionnaire was developed for this study on the basis of previous surveys investigating the attitudes of paediatric dentists towards the use of various behavioural management techniques in Australia and the USA. Areas covered in the questionnaire included: attitudes towards parental accompaniment; attitudes regarding parental expectations; and attitudes towards the use of various different child management techniques. The questionnaire was sent out to all registered members of the British Society of Paediatric Dentistry (n = 304). RESULTS: 245 responses (80.5%) were returned, of which 218 provided valid and useable information (72%). A majority of 80% of respondents supported parental accompaniment of the child during the course of treatment. Separate analysis of variance (ANOVA) procedures revealed significant differences between acceptability of parental accompaniment and the year in which dentists had qualified (P < 0.05). More recently qualified dentists were less accepting of parental accompaniment. Only a minority of dentists reported feeling pressured by parental expectations with regard to their child's treatment. However, an independent sample t-test revealed that male dentists experienced greater perceived conflict between dental and parental expectations, than female dentists (P < 0.05). In terms of specific behavioural management techniques, the most favoured was 'tell-show-do' with 87% of respondents citing this as their most commonly used method. Least acceptable were 'hand over mouth' techniques, followed closely by active restraint and papoose board. CONCLUSION: In general, paediatric dentists in the UK favoured less 'restraining' methods of behavioural management. There was widespread support for parental accompaniment in the dental operatory and a desire to work in participation with parents in order to facilitate the child's good behaviour and more effective dental treatment. Further studies comparing the effectiveness of various techniques used with regard to treatment time and clinical outcomes, are now required.

Adult↗
PubMed2004

Mercury vapour levels in dental practices and body mercury levels of dentists and controls.

AIM: A study of 180 dentists in the West of Scotland was conducted to determine their exposure to mercury during the course of their work and the effects on their health and cognitive function. DESIGN: Data were obtained from questionnaires distributed to dentists and by visiting their surgeries to take measurements of environmental mercury. METHODS: Dentists were asked to complete a questionnaire including items on handling of amalgam, symptoms experienced, diet and possible influences on psychomotor function such as levels of stress and alcohol intake. They also completed the 12-item General Health Questionnaire. Dentists were asked to complete a dental chart of their own mouths and to give samples of urine, hair and nails for mercury analysis. The dentists were visited at their surgeries where environmental measurements were made in eight areas of the surgery and they undertook a computerised package of psychomotor tests. One hundred and eighty control subjects underwent a similar procedure, completing a questionnaire, having their amalgam surfaces counted, giving urine, hair and nail samples and undergoing the psychomotor test procedure. RESULTS: Dentists were found to have, on average, urinary mercury levels over 4 times that of control subjects although all but one dentist had urinary mercury below the Health and Safety Executive health guidance value of 20 mumol mmol(-1) creatinine. Urine was found to be a better biological marker for mercury exposure than hair or nails.Dentists were significantly more likely than control subjects to have suffered from disorders of the kidney but these symptoms were not significantly associated with their level of mercury exposure as measured in urine. One hundred and twenty two (67.8%) of the 180 surgeries visited had environmental mercury measurements in one or more areas above the Occupational Exposure Standard (OES) set by the Health and Safety Executive. In the majority of these surgeries the high levels of mercury were found at the skirting and around the base of the dental chair. In 45 surgeries (25%) the personal dosimetry measurement (ie in the breathing zone of dental staff) was above the OES. CONCLUSION: On the basis of these findings, it is recommended that greater emphasis should be made relating to safe handling of amalgam in the training and continuing professional development of dentists, that further studies are carried out on levels of mercury exposure of dental team members during the course of their working day, and that periodic health surveillance, including urinary mercury monitoring, of dental personnel should be conducted to identify possible effects of practising dentistry.

Air Pollutants, Occupational↗
PubMed2001

High risk of Helicobacter pylori infection in young Japanese dentists.

BACKGROUND AND AIM: The route of person-to-person transmission of Helicobacter pylori may be either fecal-oral or oral-oral, because the bacterium is found in both dental plaque and feces. We assessed the prevalence of H. pylori seropositivity, which reflects present or past infection, in Japanese dentists exposed occupationally to dental plaque. METHODS: We examined the sera of 60 dentists (34 who were 20-29 years or older, and 26 who were over 30 years of age) and 60 age-matched controls by using quantitative ELISA for antibodies of the immunoglobulin G class to H. pylori. RESULTS: The proportion of dentists seropositive for H. pylori (42 of 60, 70%) was higher than in controls (23 of 60, 38%). The odds ratio for H. pylori seropositivity (3.8; 95% CI, 1.76-8.02) was high in the dentists. When dentists were classified in terms of the length of their practice, the odds ratio for seropositivity (10.4; 95% CI, 3.26-32.85) was high in the dentists practising for fewer than 4 years. The proportion of dentists in their 20s who were seropositive was greater than that in the group of age-matched controls. CONCLUSION: Japanese young dentists are at a high risk for H. pylori infection, with the oral-oral transmission route being possibly the most common.

Adult↗
PubMed1988

A study of mercury in the hair of dentists and dental-related professionals in 1985 and subcohort comparison of 1972 and 1985 mercury hair levels.

Dentists may be exposed to mercury used in dental restorations. An epidemiologic study was conducted in central New York in 1985 comparing the concentration of mercury in the hair of 85 dentists to that of 23 dental-related health professionals (mainly orthodontists and oral surgeons) who do not use mercury. Mercury in the hair of dentists was nominally higher (2.98 +/- 0.57 ppm, mean +/- SE) than that of the control group (1.84 +/- 0.20 ppm) but not significantly so. There was a significant positive linear trend in the concentration of mercury in the dentists' hair with the number of years they had been in practice. Those dentists who wore masks when removing old mercury containing fillings showed significantly (p = 0.03) lower mercury concentrations in hair (1.7 +/- 0.26 ppm, mean +/- SE) than those who did not (3.65 +/- 0.85 ppm). Mercury concentration in the hair of 23 of the above dentists analyzed in 1972 was 16.77 +/- 4.00 ppm (mean +/- SE), significantly higher (p = 0.008) than that of the same dentists in 1985 (5.27 +/- 1.85 ppm). The reduction is believed due to the currently used pre-prepared disposable or reusable capsules containing the amalgam versus formerly mixing the ingredients manually. This may also account for the lack of a significant difference in mercury in the hair of the dentists versus that of the control group in 1985. The statistical relationships between mercury concentrations in hair of the two groups and reported health effects, as well as other factors including fish consumption, number of restorations per day, office floor covering, and urban or rural domicile, are discussed.

Adult↗