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PubMed1978

Hepatitis B virus infections among Danish dentists.

Since type B hepatitis is generally regarded as an occupational risk for dentists, the participants at the 1976 annual meeting of the Danish Dental Association were examined for hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). A total of 1,338 dentists (89% of the dentists at the meeting and 29% of all Danish dentists) were included in the study by completion of a questionnaire and by radioimmunoassay of a blood sample for HGsAg and anti-HBs. None of the dentists was HBsAg-positive, but 110 (8.2%) had anti-HBs. An increasing frequency of anti-HBs was found with increasing age, but the figures were similar to the findings in a control population. Evidence is presented that hepatitis found before admittance to or during the time at dental school was predominantly not of type B. In contrast, type B hepatitis predominated during the professional activity of the dentists. On the basis of the serological findings in 29% of all Danish dentists, it is concluded that dentists cannot be regarded as a high-risk group for hepatitis B.

Aging↗
PubMed1991

Development of an instrument to measure job satisfaction among dentists.

Because of the rapid changes that have occurred in the dental profession, the Dentist Satisfaction Survey (DSS) was developed to assess both facet and overall job satisfaction among dentists. The DSS was administered to a sample of 558 California general dentists. The results suggest that the DSS is a practical, reliable, and valid measure of dentists' job satisfaction. Internal consistency reliability coefficients for all facet subscales and the overall job satisfaction scale ranged from 0.60-0.92. The DSS discriminated between groups of dentists known to have different levels of job satisfaction; dentists identified by dental society presidents as being very dissatisfied scored significantly differently in the hypothesized direction on the DSS. A high correlation (r = 0.68) was found between judges' independent ratings of dentists' satisfaction based on their open-ended comments and DSS scores. While the majority of respondents were satisfied with most facets of their jobs, substantial variation was found among dentists in their levels of satisfaction.

Adult↗
PubMed1994

Relationship between dentists' treatment attitudes and restorative decisions made on the basis of simulated bitewing radiographs.

The implicit valuations which dentists place on the outcomes of their treatment decisions may be a major contributory factor in dentists' decisions about when to restore teeth. This study sought to examine the relationship between dentists' treatment attitudes and restorative dental treatment decision making. A group of 20 dentists were asked to indicate teeth in need of filling from 15 simulated bitewing radiographs. The dentists graded their level of certainty about their treatment decision as "definite", "probable" or "possible". Afterwards, the teeth were sectioned and examined using a microscope in order to determine how far through the tooth the caries had penetrated. The gold standard treatment criterion was that caries extending into the dentine of the tooth would require restoration. Receiver Operator Characteristic (ROC) analysis was used to examine the apparent weighting the dentists were giving to decision errors when planning treatment on the basis of bitewing radiographs. The dentists also completed a treatment attitudes questionnaire to determine their views about the relative importance of false negative and false positive treatment decisions. The results suggest that the most appropriate operating point for most of these dentists to achieve an outcome which matched their views about the relative importance of the two types of treatment error would be the point at which a filling would "definitely" be required.

Attitude of Health Personnel↗
PubMed1992

Antibiotic prescribing practices among Norwegian dentists.

There is scarce information on antibiotics prescription habits among dentists in general. The present investigation was undertaken to study some patterns of antibiotics prescription among Norwegian dentists. A total of 459 dentists (approximately 10% of Norwegian dentists) were randomly selected, and to each was mailed a letter describing the survey, accompanied by a questionnaire about age, type of practice, educational background and pattern of prescription of antibiotics. 78% of the dentists responded to these questions. The results indicate that during a typical week, 32% did not prescribe antibiotics, whereas 5% wrote greater than 5 prescriptions. The mean weekly number of prescriptions per dentist was 2.04. Periodontists and oral surgeons prescribed antibiotics significantly more often than did general practitioners and other disciplines. In addition, those with research and/or teaching experience seemed to prescribe significantly more often than those without. More than 1/3 of the sample indicated that they may prescribe antibiotics when treating periodontal diseases. Compared with other disciplines, periodontists prescribed such drugs significantly more often when treating periodontitis, but significantly less often in acute gingivitis, stomatitis and herpes simplex infections. Moreover, 22% of the dentists might prescribe antibiotics when the patient is in pain, 73 and 38% in cases of abscesses with or without generalized malaise, 2.5% in endodontic therapy, 60% to prevent general complications, and 68% for prophylactic use if the patient revealed a history of endocarditis. Norwegian dentists are somewhat restrictive in their prescription of antibiotics, but they mostly prescribe the correct drugs for the different conditions.

Anti-Bacterial Agents↗
PubMedDate not supplied

Patient death and bereavement: what is the dentist's role?

The dentist's role following a patient's death has not been examined to date; neither has the attrition rate of a dental practice because of deaths of patients belonging to that practice. This topic was explored through a survey of 400 Oregon dentists. Seventy-two percent of dentists in active practice who participated in the survey had at least one patient death each year; the mean number of patient deaths per year was five. Following these deaths, most dentists reported providing some type of emotional support to the bereaved survivors. Dentists send sympathy cards 72% of the time and attend funerals 27% of the time; 55% of dentists regard the majority of their patient deaths as unexpected. These deaths are a source of emotional stress for dentists, as are subsequent discussions with survivors. Only 3% of the respondents reported having received formal education in death and bereavement, and 66% of dentists believe that some type of education in dying and bereavement should be included in dental school.

Bereavement↗
PubMed1986

Determinants of requests for water fluoride assay among North Carolina dentists.

Fluoride content of drinking water is an important criterion in prescribing fluoride supplements. The majority of practicing dentists and physicians prescribe fluoride supplements, yet many apparently are unaware of the fluoride levels in their patients' drinking water. Characteristics of North Carolina (NC) dentists, their practices, and their communities were investigated to determine factors associated with whether they requested fluoride assays of their patients' drinking water. Comparisons were made between dentists sampling (assaying) and those not sampling. Licensure renewal files provided characteristics of the 79 pedodontists and 1768 general practitioners (GP's) active in NC. Eighty-eight GP's (5%) and 26 pedodontists (33%) requested water fluoride analyses between December, 1982, and May, 1983. Significant predictors of fluoride assay request by GP's were the dentist's age, the geographic region of the state, the number of dentists in the practice, and an interaction between geographic region and the number of dentists in the practice. Younger GP's and those with fewer dentists in the practice were more likely to request fluoride assays of patients' water. For pedodontists, dentist's age and geographic region were significant predictors. Additional training concerning the need for water fluoride assay appears necessary, especially among older practitioners.

Age Factors↗
PubMed1993

Agreement among dentists' recommendations for restorative treatment.

Differences among dentists in their decisions to recommend treatment have been studied principally at a "macro" level by examinations of variations in dentists' treatment recommendations for individual patients, or for patients aggregated to the practice level. If reasons for these differences are to be understood, however, a "micro" level examination of differences in dentists' decisions to recommend treatment for individual teeth is necessary. Extent of agreement to recommend treatment among dentists was explored for 1187 teeth in 43 patients. Each tooth was examined by a mean of 6.6 general practitioners. A modified reliability index and distributions of raw levels of agreement were used for quantification of agreement rates across an incomplete cross-classification for practitioners and patients. Overall inter-dentist reliability in recommending individual teeth for treatment was moderate, p = 0.62. Among unrestored teeth with no clinically evident caries, as judged by an independent experienced evident caries, as judged by an independent experienced examiner, reliability in treatment recommendations due to caries was fair, p = 0.51. Reliability was lowest for recommendations concerning previously restored teeth, p = 0.43. Among all teeth receiving at least one recommendation for treatment, only 22% received a unanimous recommendation. Over one-half of all instances of lack of agreement resulted from a single dentist's recommendation differing from those of all other dentists examining the tooth. The results suggest that much of the variation in dentists' practice profiles is due to basic differences in decisions to recommend treatment for individual teeth with specific conditions, and that the presence of previous restorations seems to magnify these differences.

Adult↗
PubMed2004

Attitude of the Belgian dentist population towards radiation protection.

OBJECTIVES: To perform a survey of private dental offices in Belgium and gain insight in the knowledge and attitude of Belgian dentists towards quality care in radiography and radiation protection. METHODS: A questionnaire was distributed among 700 Belgian dental offices, which were included based on demographic data and the use of intraoral radiographic equipment. RESULTS: The response rate was 71%. Implementation of standards for quality care and radiation protection was suboptimal. In most offices, exposure settings of the intraoral radiation tube were 65 kV/kVp to 70 kV/kVp and 10 mA to 12 mA, with an average exposure time of 0.45 s. No reduction of exposure time was noticed when using faster film types. About one-third of the responders worked with digital image receptors. Aiming devices and rectangular collimation were used in a minority of practices (40% and 6%, respectively). The distance of the dentist to the radiation tube during exposure was on average 2.2 m, although 8% of the dentists assisted in holding the image receptor inside the patient's mouth. One quarter of the dentists were standing behind a wall when taking radiographs. Lead aprons were worn more often by female dentists. Dose estimation revealed that male dentists received a significantly larger effective dose per year than female dentists (8.3 mSv vs 3.2 mSv). CONCLUSIONS: The implementation of standards of quality care for radiography and radiation protection could be improved among Belgian dentists. An elaborate educational programme in dental radiography is a prerequisite. Furthermore, recommendations could help to attain a change in attitude towards the use of ionizing radiation in order to meet European guidelines.

Adult↗
PubMed1999

Retirement savings of dentists in private practice.

BACKGROUND: Retirement planning is an issue that concerns all working people. In this article, the authors present their analysis of the results of a 1995 American Dental Association survey that asked dentists questions about their plans to finance their retirement. METHODS: The ADA's Survey Center conducts a periodic "Survey of Current Issues in Dentistry," which gauges dentists' opinions about a variety of topics of interest to dentistry. The authors analyzed the results of the 1995 survey in which retirement savings was one of the topics. RESULTS: The majority of responding owner/dentists whose primary occupation was private practice (40.7 percent) indicated that they were relying only "a little" on the sales of their practices to finance their retirements. Overall, dentists whose primary occupation was private practice reported saving an average of 10.5 percent of their income specifically for retirement. The average total amount of money dentists invested in various retirement plans increased with age and was highest for the 55 to 59 and the 60 to 64 years of age cohorts. The only exception was the 401(k) plan, in which the peak occurred in the 65 years of age and older cohort. CONCLUSIONS: Fifteen years ago most dentists retired between the ages of 60 and 69 years. Recent trends show that dentists are retiring at younger ages. This means that while in practice, dentists must save enough to support themselves for 20 or more years of retirement. PRACTICE IMPLICATIONS: The transition from private practice to retirement can be difficult. Therefore, planning for the future is important. Dentists can benefit from making appropriate decisions based on age, investment goals, risk tolerance, monetary constraints and time until retirement.

Adult↗
PubMed2002

Using a geographical information system to map the distribution of dentists in Ohio.

BACKGROUND: Studies have reported that dental care is the highest unmet health care need in the United States and have evaluated this in terms of individual determinants of access and utilization. None of these studies took into consideration the provider issues of availability and accessibility or of spatial relations. The aim of this study was to analyze issues of provider availability and accessibility in Ohio using a geographical information system, or GIS. METHODS: Three Ohio databases were geocoded using GIS software. The databases included all 6,132 dentists licensed to practice in Ohio, 1,898 dentists who had billed the state Medicaid program in 1998 and safety-net clinics that provided free or low-cost care. Each practitioner was mapped at the county and ZIP code levels. RESULTS: Results are reported using maps at the county and ZIP code levels. The maps showed that 69.4 percent of dentists practiced in 12 metropolitan counties, 14 percent in 17 suburban counties and 16.6 percent in 59 rural counties (rural non-Appalachian counties plus Appalachian counties). In Appalachia, the dentist-to-population ratio was about one-half that of the metropolitan counties. CONCLUSION: Obvious disparities exist in the distribution of dentists in Ohio, particularly in rural and Appalachian counties. The need to increase the availability of dentists in these counties is evident. PRACTICE IMPLICATIONS: GIS is a useful tool for evaluating provider distribution and availability and planning programs to attract dentists to areas with small numbers of dentists.

Adult↗
PubMed2006

Sex differences among dentists regarding eating disorders and secondary prevention practices.

BACKGROUND: The purpose of this cross-sectional study was to assess sex differences among dentists pertaining to current behaviors and behavioral beliefs with regard to eating disorders. METHODS: The authors collected data via a self-administered paper-and-pencil questionnaire from a randomized sample of 350 practicing male and female dentists. RESULTS: The results showed a low level of practice regarding secondary prevention (that is, measures leading to early diagnosis and prompt intervention) of eating disorders. The authors found statistically significant differences, with more female than male dentists reporting that they assessed patients for oral cues (P < .001), more female dentists reporting that they provided specific dental care instructions (P = .038) and more female dentists referring patients who have oral signs of eating disorders (P = .028). They also found sex differences with regard to mediating factors. Female dentists had greater knowledge of oral manifestations of eating disorders (P = .001), greater knowledge of physical cues of anorexia nervosa (P < .001), greater perception of the severity of anorexia nervosa (P = .007) and greater knowledge of physical cues of bulimia nervosa (P < .001). CONCLUSIONS: Although the dentist may be the first health care provider to assess oral effects of eating disorders, his or her involvement may be influenced in part by sex and sex-related health beliefs. CLINICAL IMPLICATIONS: Female dentists may be more sensitive to oral cues related to women's health issues. Further research is warranted to explore the mediating factors regarding secondary prevention of eating disorders.

Adult↗
PubMed2005

Tobacco smoking prevalence among a cross-section of dentists in Queensland, Australia.

The purpose of this study was to investigate the epidemiology of tobacco smoking among dentists in Queensland, Australia. We utilized an anonymous, self-reporting questionnaire which was posted to 400 dentists during 2004. The overall response rate was 72.1%, among whom the prevalence of current smoking was estimated to be 3.9% (95%CI: 2.2-6.9), with a further 11.0% being ex-smokers (95%CI: 7.9-15.2). Smoking rates varied by age, with 6.1% of dentists aged younger than 30 years who were smokers. The lowest smoking prevalence was seen among dentists aged between 30 and 40 years (1.4%), and the highest among those aged over 60 years (7.1%). Regarding weekly work hours, the highest smoking prevalence was seen among dentists who worked between 25 and 35 hrs per week (6.8%). Ex-smokers were more likely to work less than 25 hrs per week (21.7%). Smoking rates also varied by career length, with the lowest prevalence among dentists who had worked 10 to 20 years (1.3%) and the highest rate among those who had worked over 40 years (6.7%). A similar trend was revealed for ex-smokers, with prevalence rates of 1.7% and 33.3%, respectively. Overall, our study suggests that the prevalence of smoking is rather low among Queensland dentists. As the distribution of smoking was not uniform however, future preventive measures will need to consider the individual situation of dentists who smoke, particularly those in the older age groups.

Adult↗
PubMed1994

Lack of HIV transmission in the practice of a dentist with AIDS.

OBJECTIVE: To determine whether dentist-to-patient or patient-to-patient transmission of human immunodeficiency virus (HIV) occurred in the practice of a dentist who had the acquired immunodeficiency syndrome (AIDS). DESIGN: Retrospective epidemiologic investigation supported by molecular virology studies. SETTING: The practice of a dentist with AIDS in an area with a high AIDS prevalence. PARTICIPANTS: A dentist with AIDS, his former employees, and his former patients, including 28 patients with HIV infection. MEASUREMENTS: Identification of potential risks for acquisition of HIV infection, genetic relatedness among HIV strains, and infection-control practices. RESULTS: A dentist with known behavioral risks for HIV infection, who was practicing in an area of Miami, Florida, that had a high rate of reported AIDS cases, disclosed that he frequently did invasive procedures and did not always follow recommended infection-control procedures. Of 6474 patients who had records of receiving care from the dentist during his last 5 years of practice, 1279 (19.8%) were known to have been tested for HIV infection and 24 of those (1.9%) were seropositive. Four other patients with HIV infection were identified through additional case-finding activities. Of these 28 patients with HIV infection, all but 4 had potential behavioral risk factors for infection. Phylogenetic tree analysis of HIV genetic sequences from the dentist and 24 of the patients with HIV infection showed an absence of strong bootstrap support for any grouping and therefore did not indicate that the virus strains were linked. CONCLUSIONS: Despite identifying numerous patients with HIV infection, we found no evidence of dentist-to-patient or patient-to-patient transmission of HIV during dental care. Our findings are consistent with those of all previous studies in this area, with the exception of one that did identify such transmission.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Infection control among dentists in private practice in Durban.

The general fear, superstition and alarm surrounding HIV/AIDS warrant that the highest standards of care be available to our patients. A survey on infection control was undertaken in Durban to assess the current state of infection control procedures among dentists in private practice. A self-administered 44-item questionnaire was hand-delivered to a random sample of 75 dentists (31.3%)--see comments in Methods--in private practice. The response rate was 90.7% (68 dentists). The routine use of gloves, masks, and protective eyewear was reported by 97.1%, 82.4% and 52.9% of dentists respectively. Although 89.7% of dentists had autoclaves in their practices, only 45.2% autoclaved their high speed handpieces and 39.7% their slow handpieces. Almost 60% of dentists did not use rubber dam at all whilst 46.3% did not disinfect impressions before sending them to the laboratory. Approximately 6% of respondents reported re-using local anaesthetic cartridges and 1.5% re-used needles. Needlestick injuries in the previous six months were reported by 13.8% of dentists but two thirds of them did not follow any specific protocol after injury. Almost 90 per cent of dentists were immunised against Hepatitis B but more than 60% of their staff were not. The results of the study showed that adherence to universally accepted guidelines for infection control remain low amid a climate of an ever-increasing HIV pandemic.

Adult↗
PubMed1992

[Projected supply and geographic distribution of dentists in Taiwan for the year 2000].

Using the data from the Dentist Masterfile of the Department of Health, Executive Yuan, and the reports from all Colleges of Medicine in Taiwan and the Ministry of Defense, this study projected the future supply of dentists as well as their geographic distribution. The components of projection included studying current supply, future increment and loss. The results of this study showed that there would be 7897 active dentists in Taiwan by the year 2000, or 36 dentists per 100,000 population. It also showed the poor geographical distribution of dentists will not substantially ameliorate in response the rapidly increasing supply of dentists. The 14 to 1 ratio of the highest to the lowest (Taipei city V.S. Penghu county) in terms of dentist-population will remain in the coming decade. Finally, this study discussed the projection process as well as the implications for dentist manpower policy in Taiwan.

Adult↗
PubMedDate not supplied

The dentist's communicative role in prosthodontic treatment.

PURPOSE: Dentist-patient verbal communication is important for patient satisfaction. The aim of this study was to investigate the dentist's role in the provider-patient relationship as to verbal communication and patient satisfaction with the treatment outcome in prosthetic dentistry. The dentist-specific properties were analyzed in random coefficient modeling. MATERIALS AND METHODS: Sixty-one dentist-patient pairs were followed through 61 prosthodontic treatment periods. The treatment performed was fixed prosthodontic restorations on teeth or implants. One encounter at the end of each treatment period was tape recorded. The verbal communication on the recordings was analyzed using an interaction analysis instrument. Various measures of communication were used, summarizing the variational pattern of verbal interaction. Two different aspects of the patient satisfaction concept were used as dependent variables: cure (overall patient satisfaction with prosthodontic treatment), and care (patient satisfaction with a particular dental encounter during the prosthodontic treatment period). RESULTS: In the multilevel model for care, the dentist variance was mostly explained by the communication variables. In the cure model, there was no dentist variance. The communication patterns used by the dentists thus influenced patient satisfaction in a short-term perspective but not in an intermediate perspective. CONCLUSION: Patient evaluation of the care during an encounter is dependent on the dentist's verbal communication activity during the encounter, but this communication has no impact on the patient evaluation of overall prosthetic treatment outcome in the intermediate time perspective.

Adult↗
PubMed2006

Computer and Internet usage by Canadian dentists.

OBJECTIVES: To determine the frequency of computers in Canadian dental offices and to assess their use; to evaluate Internet access and use in Canadian dental offices; and to compare use of computers and the Internet by Canadian dentists, by the general public and by other dental groups. METHODS: An anonymous, self-administered survey of Canadian dentists was conducted by mail. A potential mailing list of 14,052 active Canadian dentists was compiled from the 2003 records of provincial regulatory bodies. For each province, 7.8% of the general dentists were randomly selected with the help of computer software. The surveys were mailed to this stratified random sample of 1,096 dentists. RESULTS: The response rate was 28%. Of the 312 respondents, 4 (1%) were in full-time academic positions, 15 (5%) were not practising, and 9 (3%) provided incomplete data. Therefore, 284 survey responses were available for descriptive analysis. Two hundred and fifty-seven (90%) of the respondents had a computer in their primary practice. Computers were used mainly for administrative tasks (accounting, bookkeeping and scheduling) rather than clinical tasks. Internet access was common (185/250 or 74%), and high-speed Internet access (93/250 or 37%) was increasingly common, judging from the results of previous studies on computer use. The main reasons given for not having in-office Internet access were security or privacy concerns and no reported need for or interest in the service. CONCLUSIONS: Computer use was high in this sample of Canadian dentists, but a small proportion of dental offices remained without computers. Canadian dentists" use of the Internet was greater than that of American dentists, private enterprise and the North American public in general.

Canada↗
PubMedDate not supplied

Strategies used by dentists in Victoria, Australia, to manage children with anxiety or behavior problems.

Two hundred and sixty-seven Australian dentists from the State of Victoria, representing members of the Australian Society of Dentistry for Children (AusSDC) and randomly selected practitioners, responded to a survey on attitudes and practices in the management of anxious children or children with behavior problems. The most common strategies used by dentists in this study were: permitting the child to exercise some form of control over terminating the treatment, if they were experiencing difficulties; furnishing waiting areas with play materials; and using a Tell-Show-Do approach to the provision of dental care. Members of the Australian Society of Dentistry for Children differed from general dentists by more frequently teaching anxious children a technique of relaxation and also by more frequently using a mouth prop or rubber dam during the delivery of care. Younger dentists tended to use behavioral strategies more frequently than older practitioners. Women dentists more frequently than male dentists, used strategies including: spending more time with the child before entering the operatory; setting shorter appointment sessions; and permitting the child to hold a toy or a mirror during dental treatment. In contrast to North American studies, few of the Australian dentists used the Hand-Over-Mouth technique to control hysteria. Australian dentists appeared to rely more frequently than their North American colleagues on setting shorter appointment sessions as a major strategy in managing children with anxiety or other behavioral difficulties.

Adult↗