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PubMed1999

The role of age- and population-based differences in the attitudes, knowledge and infection control practices of Canadian dentists.

OBJECTIVES: To investigate age- and population-based differences in dentists' infection control practices and willingness and refusal to treat patients with HIV. METHODS: A national mailed survey of a stratified random sample of dentists in Canada (n = 6444) with three follow-up attempts. Pearson's chi-square test and multiple logistic regression were used for data analysis. Predictor variables included population, age, gender, marital status, specialty, number of patients treated per day and continuing education on HIV/AIDS. RESULTS: The adjusted response rate was 66.4%. The best predictors of willingness to treat patients with HIV were younger age (compared with dentists > or = 60 years of age: < 30 years, OR = 8.6, 30-39, OR = 3.4; 40-49, OR = 2.7; 50-59, OR = 1.6), attending continuing education on HIV/AIDS in the past 2 years (> 10 hours, OR = 1.6 compared with zero hours), practicing in small population centres < 10,000 (OR = 1.6 compared with > 500,000) and gender (male OR = 1.3). The best predictors of refusal to treat patients with HIV were older age (compared with dentists < 30 years of age: > or = 60, OR = 6.1; 50-59, OR = 4.1; 40-49, OR = 3.0; 30-39, OR = 2.6); and practicing in population centres > 500,000 (OR = 1.5 compared with < 10,000). However, the latter group also reported treating more HIV patients than respondents in smaller communities. Infection control practices varied significantly with age and population centre. Dentists in communities of < 10,000 were more compliant with HBV vaccination, but less compliant with handwashing after degloving and the use of infection control manuals. Similarly, dentists > 60 years of age were the least compliant with HBV immunization, routine use of barriers and sterilization of handpieces, but reported the highest compliance with handwashing. CONCLUSIONS: Age- and population-based differences need to be considered in planning educational interventions to improve both access to care for patients with HIV and dentists' compliance with recommended infection control procedures.

Adult↗
PubMed2006

Factors related to job satisfaction among South Korean dentists.

OBJECTIVES: The purposes of this study were to investigate the level and distribution of job satisfaction and to explore work environment factors associated with job satisfaction of South Korean dentists. METHODS: A stratified systematic random sample of 1029 dentists was selected from the 10 357 registered dentists in the Korean Dental Association. They were surveyed via a self-administered mail questionnaire. Job satisfaction was measured by a modified version of the Dentist Satisfaction Survey. RESULTS: The response rate was 62.2%. The mean score of overall job satisfaction among South Korean dentists was 3.2 out of 5. In terms of work environment factors, the most satisfying aspect was patient relations (3.7) and the least satisfying aspect was personal time (2.8). Multiple regression analysis identified a model including patient relations, perception of income, personal time, staff, and specialty training that accounted for 35% of variation in overall job satisfaction. The majority of the variance was explained by patient relations. CONCLUSIONS: This study suggests that patient relations, perception of income, personal time, staff, and specialty training are important work environment factors for job satisfaction among South Korean dentists. The findings of this study will be helpful to policy makers to design plans to increase the level of job satisfaction among South Korean dentists.

Adult↗
PubMed2001

Dentists' attitudes and behaviors regarding domestic violence. The need for an effective response.

BACKGROUND: The authors examined the attitudes and behaviors of a national sample of dentists regarding domestic violence and the barriers dentists face in intervening to help victims. METHODS: The authors surveyed a national random sample of 321 dentists by mail from November 1997 to March 1998 about their attitudes and clinical practice behaviors related to domestic violence. Survey items were developed based on the domestic violence and health care literature. The authors used the Total Design Method to maximize the response rate and analyzed data to determine differences between dentists who had received domestic violence education and those who had not. RESULTS: Eighty-seven percent of responding dentists never screened for domestic violence; 18 percent never screened even when patients had visible signs of trauma on their heads or necks. Overall, respondents intervened only minimally to help patients whom they had identified as victims. Respondents reported that the major barriers to screening were the presence of a partner or children (77 percent), lack of training (68 percent), concern about offending patients (66 percent) and their own embarrassment about bringing up the topic of abuse (51 percent). Respondents who had received domestic violence education were significantly more likely to screen for domestic violence and to intervene. CONCLUSIONS: Dentists face many barriers to identifying and helping patients who are abuse victims, yet these data suggest that education about domestic violence could help them overcome some of these barriers. CLINICAL IMPLICATIONS: We suggest that dentists follow the AVDR model when approaching abused patients in their practice: Ask about abuse, provide Validating messages, Document presenting signs and Refer victims to domestic violence specialists.

Adult↗
PubMed2004

The American Dental Association's oral cancer campaign: the impact on consumers and dentists.

BACKGROUND: The ADA conducted a public service campaign in late 2001 to raise awareness of oral cancer and of the dentist's role in early detection. METHODS: To gather information about the impact of this campaign, the ADA undertook two surveys. A telephone survey was conducted among 1,270 adult consumers, and a second survey was mailed to a national sample of 2,500 dentists. RESULTS: The majority of the consumers did not recognize the fact that dentists are responsible for examining their patients for oral cancer and that oral cancer claims more lives than melanoma or cervical cancer. The majority of dentists was aware of the ADA campaign and agreed that it helped raise the public's awareness of oral cancer and the importance of early detection. As a result, more dentists said that they are likely to educate their patients about early detection, adjust their own practice routines to include discussion about the disease, and look more closely for small oral lesions and test them with the brush biopsy test. CONCLUSIONS: The results of the survey of dentists demonstrated that the oral cancer awareness initiative sponsored by the ADA resulted in positive behavioral changes targeted toward the early detection of oral cancer. CLINICAL IMPLICATIONS: Continued efforts to provide health education and health promotion interventions aimed at consumers and dentists invariably will result in the detection of oral cancers at early and curable stages.

Adult↗
PubMedDate not supplied

Dentist-patient communication and patient satisfaction in prosthetic dentistry.

PURPOSE: Dentist-patient verbal communication dimensions on patient satisfaction were investigated in a prosthodontic context, controlling for the age and gender of patients and dentists and the amount of delivered prosthodontic treatment. Two concepts of satisfaction were defined, one for the single visit (satisfaction with care), and one for the overall result (satisfaction with treatment outcome). MATERIALS AND METHODS: Audio recordings of 61 patients meeting 15 dentists were made in three specialist clinics of prosthetic dentistry. The prosthodontic treatment periods with fixed tooth- or implant-supported prostheses, on average 20 months, were monitored by questionnaires. One visit near the end of each treatment period was audio recorded. The recorded verbal communication was analyzed with the Roter Interaction Analysis System-Dental. RESULTS: Bivariate analysis showed that patients of female dentists were more satisfied in the long-term perspective than patients of male dentists. In logistic multivariate regression models, the verbal communication dimensions "information-dentist horizon" and "information-patient horizon," together with the mouth involvement of the prosthodontics, influenced patient satisfaction with treatment outcome. CONCLUSION: Patients undergoing extensive prosthodontic rehabilitation should be given the opportunity to ask and talk about their dental health, and dentists should minimize their question-asking and orientating behavior during the encounters to help improve patient satisfaction with treatment outcome.

Adult↗
PubMed2004

Gender impact on the socioprofessional identification of women dentists in Bulgaria.

Women comprise 73 percent of all dentists in Bulgaria. Almost all of them started their careers as salaried, and now they are self-employed. The purpose of this study was to show how female dentists in Bulgaria met the challenges of the social and health reforms during the period of transition from totalitarian to democratic rule. A field sociological survey was carried out between October 1996 and June 1997, involving a sample of 842 dentists. The questionnaire was designed to give information on dental demography trends, pattern of participation and practice of female dentists, and their career development. The data were treated statistically using an SPSS package. Results show that for the period 1991-96 women dentists owned more than 50 percent of the newly opened private practices in Bulgaria. They were more interested in improving their qualifications and more successful in obtaining specialty status than male dentists. Dentists in Bulgaria by the late 1990 s, with no gender difference, tend to identify themselves as liberal practitioners within the pluralistic model of dental services delivery. The volume of services delivered and profile of women in professional practice and their social and professional mobility are highly competitive, despite the growing problems of maternity leave coverage and funding to re-enter the profession.

Bulgaria↗
PubMed2006

Increasing dentists' capacity for secondary prevention of eating disorders: identification of training, network, and professional contingencies.

The incidence of eating disorders has increased substantially over the last forty years. Primary care physicians and dentists share a parallel challenge for secondary prevention of anorexia nervosa and bulimia nervosa. The dentist, in particular, has a uniquely important and valuable role with respect to assessment of oral and physical manifestations, patient communication, referral, case management, and restorative care. Despite this crucial role, few dentists are engaged in eating disorder-specific secondary prevention. The purpose of this study was to explore beliefs, attitudes, and experiences of general dentists regarding eating disorder-specific secondary prevention behaviors using focus group methodology. Three ninety-minute focus groups were conducted with twenty-one general dentists (seventeen male, four female) recruited from the 2004 Academy of General Dentistry Leadership Conference. Data from the focus groups were analyzed to identify two over-arching themes and associated subthemes with regard to supports and barriers to eating disorder-specific secondary prevention practices. Analysis of data revealed that training, network, and dental professional contingencies emerged as places of influence for increasing capacity among dentists with regard to secondary prevention of eating disorders. This exploratory assessment identifies leverage points where strategic interventions including curriculum development, policies, and practices can be developed to support and sustain secondary preventive clinical behaviors among dentists.

Attitude of Health Personnel↗
PubMed1991

Perceptions of dentists' chairside behavior in a military dental care system.

A dental questionnaire was developed to assess patients' perceptions of dentists' chairside behavior in the military dental care system at Fort Carson, CO. Patients' perceptions of military and civilian dentists were found to be generally positive. No significant difference was found on the perceptions of civilian and military dentists in six of eight categories of personal behaviors involved in the chairside dentist-patient relationship. However, patients felt more rushed with civilian dentists and questioned more the necessity of dental work by civilian dentists. Nevertheless, patients appear to make minimal distinctions between these two groups, simply perceiving them as "the dentist."

Adult↗
PubMed2006

Development of a questionnaire to assess dentists' knowledge, opinion, education resources, physician cooperation, and clinical practice regarding obstructive sleep apnea (OSAQ-D).

This report describes the construction of a questionnaire to assess dentists' knowledge, opinion, education resources, clinical practice, and physician cooperation regarding obstructive sleep apnea (OSA) based on the PRECEDE-PROCEED model. The scale development included such steps as generating an item pool, expert review of initial item pool, pilot test, and final test. After the expert review, a total of 78 items made up the pilot test instrument including five demographic (age, year graduated from dental school, gender, years in practice dentistry, and membership of the Academy of Dental Sleep Medicine), 22 knowledge, 15 opinion, 11 education resources, 10 physician cooperation, and 15 clinical practice questions. The pilot test samples were third or fourth year dental school students and dentists from the University of Florida. Nineteen dentists and 26 students returned the survey. Based on the results of item analysis and content review, a total of 70 questions were remained for the final test. The final questionnaire was mailed to 450 dentists who were randomly selected from a list of 10,838 dentists with a Florida license and also delivered to 65 dental school students and postgraduates of the University of Florida. A total of 163 participants including 112 dentists and 51 students and postgraduates responded. The average age was 42.87 years, and most of them are males (77.8%). Only one dentist was a current member of the Academy of Dental Sleep Medicine. The item analysis was performed for five scales. 8 items with poor item difficulty, lower item discrimination, or having big effect on the item consistency were removed from the instrument, and 62 questions were kept for the further evaluation. The reliability coefficient alpha of knowledge, opinion, education resources, physician cooperation, and clinical practice scales was 0.77, 0.86, 0.67, 0.75, and 0.86, respectively. According to the standard from DeVellis (Scale development: theory and applications, Sage, Thousand Oaks, 2003), they were acceptable, or respectable, or even very good.

Adult↗
PubMedDate not supplied

Occupational risk for hepatitis C virus infection among New York City dentists.

Health-care workers have an occupational risk of infection with hepatitis C virus (HCV). However, neither the magnitude of this risk nor the practices associated with it have been defined. Since dentists have numerous patients and are exposed to blood, they are likely to have the maximum risk. Therefore, we have assessed occupational risk for HCV infection among dentists in the New York City area. Individuals who admitted present or previous intravenous drug use or (men) who were homosexual or bisexual were excluded. Demographic, occupational, and behavioural data were recorded, and sera were tested for antibodies to HCV (anti-HCV). Anti-HCV was found in 8 (1.75%) of 456 dentists compared with 1 (0.14%) of 723 controls (odds ratio [OR] 12.9, 95% confidence interval [CI] 1.7 to 573). Anti-HCV was found in 4 (9.3%) of 43 oral surgeons compared with 4 (0.97%) of 413 other dentists (OR 10.5, 95% CI 1.9 to 58). Seropositive dentists claimed to have treated more intravenous drug users in the week (p = 0.04) or month (p = 0.03) before the study than did seronegative dentists. Our findings show that dentists are at increased risk for hepatitis C infection. All health-care workers should regard patients as potentially infected with a communicable bloodborne agent.

Adult↗
PubMed1993

Patterns of dentist location: Lansing, Michigan 1950-1991.

Most literature on the location and distribution of medical professionals, particularly in the U.S., has concentrated on the locational patterns of physicians, even though dentists are also important providers of health care. During the last 40 years, dentists in Lansing, Michigan have moved their offices away from traditional downtown locations to other areas of the city, primarily along commercialized arteries leading out of the city core. The changes in dentist location have mainly been the result of older dentists retiring from the downtown area and new, presumably younger dentists locating in other sections. Dentists, like physicians, tend to cluster together, particularly in buildings occupied by other medical and dental professionals. Lansing dentists do not appear to locate their offices on the basis of population characteristics. It is suggested that future research consider the effects of city size on the distributional patterns of all health care professionals.

Dentists↗
PubMed2006

Treatment concepts for restoration of endodontically treated teeth: A nationwide survey of dentists in Germany.

STATEMENT OF PROBLEM: Opinions concerning proper restoration of endodontically treated teeth (ETT) vary. A variety of techniques and materials for post-and-core restorations are available. The rationale for post placement performed by German dentists was unknown. PURPOSE: The purpose of this study was to determine current opinions, applied techniques, and materials for the restoration of ETT in Germany. MATERIAL AND METHODS: A nationwide questionnaire-based survey containing 18 multiple choice questions regarding treatment philosophies, favored post type, and materials for core foundations was mailed to 36,500 German general dentists. A total of 6029 questionnaires (16.5%) were returned. Data were evaluated in terms of the dentists' occupational experience and the frequency of post placement. Descriptive statistics were used to analyze the data. RESULTS: Irrespective of their occupational experience, 52% of the surveyed dentists consider post placement for almost every postendodontic restoration of ETT. The majority of dentists (54%) believe that a post reinforces ETT. Cast posts and cores are used by 55% of all dentists, whereas 34% use prefabricated posts exclusively. Screw posts are the most popular prefabricated post type (47%). Composite resin (51%) is preferred for core foundation, followed by glass ionomer cements (GICs) (26%). Amalgam is seldom used (0.5%). Posts are placed primarily with zinc phosphate cement (51%), followed by GIC (38%). CONCLUSION: The treatment philosophy of German dentists is not in complete agreement with recommendations found in the literature. The belief that a post would reinforce an ETT might explain the high frequency of post placements. Due to the partially inconsistent responses, it is difficult to derive a generalized treatment concept.

Cementation↗
PubMed2002

Private dental visits per dentist in Spain from 1987 to 1997. An analysis from the Spanish national Health Interview Surveys.

OBJECTIVES: In view of the sharp increase in the number of dentists in Spain, the aim of the present study was to analyse changes in the private dentist workload in Spain over the period 1987-97. METHODS: Data were taken from censuses of the population and of dental practitioners, and from the Spanish National Health Interview Surveys. The percentage of people that had visited the dentist in the 3 months prior to the survey was calculated, and of these, the percentage whose last visit was private. The total number of visits made by those people was taken as the estimate of total private visits in Spain during 3 months. Total private activity in 1 year was derived by multiplying this estimate by four. Annual private activity was then divided by the number of dentists. RESULTS: From 1987 to 1997, the Spanish population grew 2.5% (from 38.7 to 39.7 million) and the number of dentists increased by 136.1% (from 6373 to 15,044). The total annual number of private dental visits (+/-SE) was 35.7 +/- 1.0 million in 1987, and 48.9 +/- 2.0 million in 1997 - a 36.8% increase. Thus, the mean number of private dental visits per dentist decreased 42.0% (from 5610 +/- 152 to 3251 +/- 133). CONCLUSION: A significant reduction in private dental visits per dentist is taking place in Spain.

Data Interpretation, Statistical↗
PubMed2003

Gender differences in burnout among Dutch dentists.

OBJECTIVES: Differences between the sexes in the manifestation of burnout have been reported for different occupational groups. Although some gender-specific explanations for this finding have been forwarded, there is a paucity of studies in which the relation with other work-related gender differences is examined. The objective of this study was to analyze gender differences in burnout among dentists and to identify possible concomitant factors. METHODS: Male (n = 411) and female (n = 81) Dutch dentists filled out the Dutch version of the Maslach Burnout Inventory (MBI) together with several health and work-related questionnaires. RESULTS: Results showed male dentists to report a higher score on the depersonalization dimension of the MBI than did female dentists. No gender differences were found on the other dimensions (i.e. emotional exhaustion and personal accomplishment). Moreover, no gender-related differences in experienced work-stress or health-related aspects were found. It was found, however, that male dentists put in working hours and see more patients per week when compared to female dentists. Also, a difference in mean age was found. Our main finding was that the difference in depersonalization disappears when controlling for working hours and age. CONCLUSIONS: Gender differences in burnout among dentists do exist. However, our results indicate that underlying factors, such as working hours, have a profound effect on these differences. These results can have direct practical consequences, for instance, in distinguishing between groups concerning the way burnout scores should be interpreted.

Achievement↗
PubMed2001

Who has difficulty in registering with an NHS dentist?--A national survey.

AIMS: The aims of this paper are first, to determine the extent of difficulties the public are experiencing in obtaining a dentist undertaking NHS dental care. Second, to describe the personal and socio-demographic details of these groups using data from a national study. METHOD: The vehicle for this study was the Office for National Statistics Omnibus Surveys, undertaken in June and July of 1999. A random probability sample of 5,385 addresses was selected from the British Postcode Address File. Respondents were interviewed in their homes about how difficult they found it to obtain an NHS dentist. RESULT: A total of 3,739 adults took part in this study and the response rate was 69%. Nineteen per cent (705) claimed they found it difficult to get an NHS dentist. Bivariate analysis revealed that difficulty in obtaining an NHS dentist [excluding those who claimed they did not seek NHS dental care (781) and those who refused to answer or did not know (66)] was associated with age group (P < 0.01), gender (P < 0.05), social class (P < 0.01) and area of residency (P < 0.01). Moreover, difficulty in obtaining NHS dental care was also associated with time since last dental visit (P < 0.01), method of payment for last dental visit (P < 0.01) and use of 'out of hours' emergency dental services (P < 0.01). Further analysis revealed that among the socio-demographic variables, area of residency emerged as the most important factor in determining difficulty in obtaining an NHS dentist. Those who lived in the South of England (London, South-East or South West) were more than twice as likely to experience difficulty in obtaining an NHS dentist, OR = 2.40, 95% CI 2.00-2.88 compared with those who lived elsewhere in Great Britain. CONCLUSION: One in five adults in Britain claim that they are experiencing difficulties in finding a dentist who will provide NHS dental care. In particular, those using private dental services and residents of the South of England have experienced such difficulties.

Adolescent↗
PubMed1994

Barriers to the provision of complex dental treatment for dentate older people: a comparison of dentists' and patients' views.

The majority of older people live active lives and more are retaining their teeth. These people rely for their dental care on general dental practitioners. However, many find that the service they are offered falls short of their desires, and this study examined this problem from the points of view of the public and the dentists. Qualitative group discussions were conducted among 61 middle-aged and elderly people and 20 dentists, followed by a quantitative study involving 20 dentists and 57 of their patients. The aim was to discover what, if any, differences there may have been between their expectations of dental treatment. There were no significant differences between middle-aged and older peoples' views on barriers to the receipt of dental care. However, dentists assumed that their older patients would have significantly greater negative dental attitudes than their middle-aged patients. Dentists considered that ability to pay would be a significantly greater barrier for their working-class rather than their middle-class patients. However, among the patients themselves there was no significant difference. The comparison of dentists' and patients' views on barriers to treatment showed that dentists significantly overestimated their older patients' reluctance to receive dental treatment.

Aged↗
PubMed1998

Work place characteristics, work stress and burnout among Dutch dentists.

Work stress among dentists has been described several times, indicating a diversity of causes of stress. Professional burnout among dentists has been the subject of empirical study only occasionally. The aim of the present study was to investigate which occupational factors are related to levels of burnout among Dutch dentists. A distinction was made between actual work place characteristics and experienced pressure from specific aspects of dental work. With a response rate of 75%, a representative group of 709 Dutch general dental practitioners responded to a questionnaire containing a Dutch version of the Maslach Burnout Inventory (MBI-NL), the Dentists' Experienced Work Stress Scale (DEWSS), and a collection of items on work place conditions. No actual work place condition could be demonstrated to be correlated with high burnout levels. Lack of career perspective appeared to be the stress factor most strongly related to burnout. Mean burnout levels of all dentists were found to be favourable in comparison with Dutch norm scores: dentists showed less Emotional Exhaustion, less Depersonalization, and more Personal Accomplishment. It is concluded that the relation between lack of career perspective and burnout should stimulate serious attention for career planning among dentists.

Adult↗
PubMed2003

Oral health in relation to wearing removable dentures provided by dentists, denturists and laboratory technicians.

The aim of this study was to evaluate the oral health of elderly Finnish men wearing removable dentures supplied either by dentists, denturists or laboratory technicians. From a sample of 550 men, 362 subjects were both interviewed and clinically examined. The subjects were asked a range of questions related to their oral health and dentures. Clinical examinations were carried out by one dentist using well-defined criteria and without knowing the information the respective subjects had given in the interview. The 242 denture wearers had a higher frequency (P < 0.001) of mucous membrane lesions (78.7%) than the 120 non-wearers (27.5%). Differences between the denture providers were small, although subjects with dentures provided by dentists had less often most of the recorded mucous membrane lesions than other denture wearers. Coating of tongue and cheilitis angularis were the most commonly encountered lesions. High levels of yeast growth were observed more frequently (P < 0.02) among subjects who had obtained their dentures from dentists (41.3%) than from either denturists (17.1%) or laboratory technicians (18.2%). Among dentate subjects, the average number of remaining teeth was higher (P < 0.05) among those who had obtained their dentures from dentists (8.7) than among subjects wearing dentures from denturists (5.9) or laboratory technicians (6.2). Subjects wearing dentures supplied by dentists had slightly better oral health than other denture wearers. The observed differences can be at least partly explained by dentists' patients having higher number of remaining teeth and also more frequent check-up visits.

Dental Care for Aged↗