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PubMed1999

Dentists' selection of measures for assessment of oral health risk factors for Finnish young adults.

Dentists' selection of measures for assessing oral health risk factors for young adults, in relation to their oral health status and to those dentists' characteristics, was studied in one administrative unit of the Finnish public oral health service. A random selection (n = 239) was made of all young adults born in the period 1966-71 and clinically examined during 1994. On the original oral health records of those selected, all notes were scrutinized concerning the most recent clinical examination and treatment course; in total 208 (87%) records. We found that assessment of risk factors to oral health was rare. The patient's diet had been recorded as assessed in 7% of all cases, use of fluoride in 8%, and oral hygiene habits in 14%. No salivary tests were performed; nor was patients' use of tobacco assessed. No correlation was detected between measures used by these dentists and their patients' oral health status (DMFT and DT scores, number of approximal incipient lesions, and number of healthy sextants by CPITN). The oral health status impelled only slightly assessments by bite-wing radiographs. Fewer than half (44%) of the dentists performed and recorded any kind of assessment measure; 4% assessed diet, hygiene, and use of fluoride for all their patients in our sample. A dentist's gender showed no correlation with number of measures used; younger dentists tended to perform and record assessments slightly more often than did older dentists, but in all age groups there were those who had not done this. The practice of risk-factor assessment should be more widespread and standardized, contributing to needs-based treatment and allocation of resources.

Adult↗
PubMed1999

Congruence between self-reported and actually provided prosthodontic services among Swedish dentists.

The purpose of this study, comprising two parts, was to investigate the congruence between answers given by general dentists in questionnaires concerning prosthodontic services and the recorded information on the services actually performed by each dentist. In Part I it is investigated whether questionnaire reports of weekly working hours devoted to prosthodontics can be used as indicators of actual prosthodontic production. Part II deals with the dentists' self-reported numbers of single crowns, fixed partial dentures (FPDs), and removable dentures. These reported services are compared with the services actually provided. Part I: A regression analysis indicates a lacking precision for the individual dentist, indicated by a relatively low explained variance (R2 = 0.20). However, a highly significant association is seen between the two production measures (P = 0.000). Part II: The congruence between stated and actually provided services is higher for single crowns and removable dentures than for FPDs. Bivariate regression models are statistically significant for all three services. In Part II, the reported weekly working hours used for prosthodontics covaries significantly with prosthodontic production, but the association is not as strong as in Part I. Although the precision in both Part I and Part II is low for the individual dentist, the questionnaire measure is found to be useful as an indicator in a population of dentists. It is concluded that the questionnaire data can be used as reasonably valid expressions of prosthodontic activity in population-oriented analyses among general dentists.

Crowns↗
PubMed2002

Right- and left-handed dentists using right- and left-sided dental chairs in treatment of calculus.

The aim of the present study was to evaluate the association of hand preference of dentists and the position of dental chairs in treatment of dental calculus. The dentists were last-class students from the School of Dentistry (Erzurum, Turkey). They were directed to dental chairs designed for right- and left-handers (right-sided and left-sided chairs) to remove calculus from the lower anterior teeth in volunteer patients having similar amounts of calculus, which was measured by Calculus index (CI). The right-handed dentists were more successful in right-sided (traditional) chairs than left-sided chairs; the left-handed dentists were more successful on left-sided chairs than right-sided chairs. The highest posttreatment CI (lowest success) was due to the right-handed dentists on the left-sided chairs. The lowest posttreatment CI (highest success) belonged to the left-handers working on the left-sided chairs. The left-handed dentists were better than right-handed dentists in the treatment of the mesial and distal surfaces of teeth, whereas the right-handers were successful only in the treatment of the distal parts of teeth. These results were explained by a better coordination between right and left hands and with higher skill in both hands in left-handers than right-handers.

Adult↗
PubMed1996

Musculoskeletal symptoms among dentists in a dental school.

A cross-sectional study of symptoms from the musculoskeletal system among employees in a school of dentistry was performed. A questionnaire was answered by 139 dentists, dental auxiliaries and office workers, e.g. 68% of the employees. The answers from the dentists were compared to the answers from all the other employees. No significant differences in musculoskeletal symptoms between the dentists and the other employees were found. Female dentists reported more musculoskeletal symptoms than did male dentists. No difference was found comparing the occurrence of musculoskeletal symptoms among female dentists and females in the reference group. This indicates that the symptoms are not related to the work as a dentist, but to female working conditions in general or to factors outside work.

Adult↗
PubMed1985

Variation in radiographic interpretation and restorative treatment decisions on approximal caries among dentists in Norway.

Of a random sample of dentists in Norway (n = 741), 83% responded to a questionnaire about their use of radiographs in and their opinions and knowledge about the diagnosis of approximal caries. There was great disparity in criteria for initiation of restorative treatment of approximal caries based on radiographic appearance. Two thirds of the dentists would do restorative treatment of lesions confined to enamel, the others would wait until lesions had reached the dentin before treatment was commenced. The criteria for restoration based on radiographic appearance was best correlated with the dentists' opinions about cavity formation. About 20% of the variation in criteria among dentists was explained by the radiographic appearance dentists associated wih the presence of a cavity. The majority of the dentists believed that approximal caries progressed faster than is indicated by progression studies. The interval between recall examinations using radiographs was not consistently shorter for dentists who decided to carry out operative caries treatment at a relatively advanced stage.

Adolescent↗
PubMed1989

Dental care of HIV-infected patients: attitudes and behavior among Danish dentists.

The aims of the study were to study Danish dentists' attitudes and behavior with regard to providing dental care to HIV-infected persons and to look for explanatory variables for the dentists' attitudes and behavior. Two hundred and twenty-eight Danish dentists responded to a questionnaire on dental treatment of HIV-infected patients and related problems (response rate: 91.2%). The dentists' attitudes differed a great deal from the current national policy as to where HIV-infected patients should be treated and with regard to the possibility of being tested for HIV anonymously. 64% of the dentists favored the idea of referral of HIV-infected patients to special dental clinics for routine dental treatment, and 93% disapproved of the idea that infected individuals themselves should decide whether they wish to inform their dentist or doctor of seropositivity. Older dentists were more reluctant to treat HIV-infected individuals than younger. Other differences with regard to a number of demographic variables were not found. No difference in attitude towards HIV-infected persons was found when compared to that towards HBV-infected individuals. The reluctance towards treatment of HIV-infected persons was present irrespective of any subsidy for an extra cost for treatment of HIV-infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Early screening for orthodontic treatment. Differences in assessments made by a consultant orthodontist and three public health dentists.

The aim of the present study was to compare the differences in the assessments of occlusal and functional features, the need for and timing of orthodontic treatment and the complexity of treatment made by a consultant orthodontist and three public health dentists. The data comprised the examinations of 260 children aged 7-8 yr (87% of total age group of the community) attending the first grade of primary school in a medium-sized town in eastern Finland. The examinations were carried out according to agreed criteria. The main indications for treatment were Class II malocclusion, lateral crossbite and crowding. When assessing treatment need, agreement between the orthodontist and the three dentists was fairly good (agreement in 69%, Kappa statistic 0.51), sensitivity for each dentist ranged from 0.86 to 0.97 and specificity from 0.72 to 0.92. The agreement on the timing of treatment was poor (agreement in 49%, Kappa statistic 0.18). In most cases of disagreement, the dentists would begin the treatment earlier than the orthodontist. The agreement on the complexity of treatment was rather poor (agreement in 61%, Kappa statistic 0.22). In most cases of disagreement, the treatment was regarded as more complex by the orthodontist than by the dentists. When dentists work with a consultant orthodontist, it seems justified to have the dentist screen the children at the age of 7-8 yr for early orthodontic treatment, but the orthodontist should assess the timing and complexity of treatment.

Child↗
PubMed1993

Nordic dentists' opinions on the safety of amalgam and other dental restorative materials.

The safety of amalgam and other restorative materials has caused concern among dental patients in recent years. The aim of this study was to obtain information on dentists' perceived competence in handling different filling materials and their opinions on the safety of these. A random sample of practising dentists in Denmark, Finland, Norway, and Sweden received a mail questionnaire in spring 1990. Answers were received from 1732 dentists (65%). The study showed that the respondents believed that their theoretic knowledge and clinical skills were generally at a high level regarding restorative materials. The risks of the side-effects of gold, ceramic materials, and glass ionomer were considered to be low by about 90% of the respondents. Amalgam was considered to be significantly more hazardous by the Swedish respondents than the others. Interestingly, composite was considered to be associated with a high risk of side-effects by about half of the dentists in all Nordic countries. The dentists' opinions were not found to be greatly influenced by their sex, age, or place of residence but rather by their country and service sector. Against the background of the present lack of scientific evidence on the hazardousness of amalgam or other restorative materials for patients' general health, these findings indicate that dentists are influenced by discussions in the mass media about dental treatment and materials and, of course, by the guidelines given by the health authorities in their own countries. Few dentists were shown to be concerned about occupational risks associated with the use of amalgam, and they had not had their own amalgam fillings replaced.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1987

Comparison of dentists' treatment and management of normal and handicapped patients.

Forty-eight of 120 dentists (40%) responded to a survey using a two-questionnaire time-series design. Responding dentists with a median age of 36 years and 9.5 years in practice had received education in care of the handicapped mainly in dental school (42%) and continuing education (40%). They were asked to make the same treatment and practice management decisions for both normal and handicapped patients. No significant differences were found between normal and handicapped patients in the amount of time dentists spend on diagnosis, treatment, planning, or recall (p less than 0.05). For both normal and handicapped patients, the dentists as a group always chose the same option as treatment of choice for both normal and handicapped patients most frequently from a list of treatment or management options. Individual dentist consistency between normal and handicapped patients in treatment and management was good, with four out of five dentists choosing the same first treatment of choice for both normal and handicapped patients for similar circumstances. Only about one out of six dentists maintained a consistent priority sequence for both normal and handicapped patients when asked to rank a list of four or five possible treatment or management choices.

Adult↗
PubMed1993

The influence of social, economic, and professional considerations on services offered by dentists to long-term care residents.

Many studies have focused on the disabilities and behavior of the elderly population in an attempt to explain the frequent reports of poor oral health among residents of long-term care (LTC) facilities, but little attention has been given to the experiences and opinions of dentists relating to the problem. This study was conducted to discover how dentists feel about older patients and about working in LTC facilities. A response to a questionnaire was obtained from 334 (55%) of the 603 dentists in Vancouver who treated adults. The responses were subjected to bivariate and multivariate analyses. Three models were constructed from factors that might interest a dentist in attending a patient in a facility; the factors in each model were ranked in order of importance. Interest was associated significantly with lack of concern for time lost in practice, with training in managing medically compromised patients, and with a positive attitude toward elderly patients. Dentists with fewer years in practice were attracted by the economic potential of the service, while the older and busier dentists were less involved because of the disruption to their practice and leisure. Dentists who made home visits also were more likely to be interested. The model based on professional considerations was superior to either the social or economic model in explaining an interest in the service.

Adult↗
PubMed1993

Comparison of oral health ratings by dentists and dentate elders.

Previous studies suggest a discrepancy between the way dentists and patients measure oral health. The purpose of this study was to determine the relationship between a dentist's rating of an older dentate person's oral health and the patient self-rating using a single-item indicator, and to compare the clinical (i.e., number of teeth, caries, etc.) and subjective (problems with function, pain, etc.) factors that influence the rating. The study sample consisted of 776 older dentate people. Results showed that dentists judged subjects' oral health significantly more positively than the self-ratings. Approximately 30 percent of the elders rated their oral health identically to the dentist and half rated their oral health lower than the dentist. Bivariate comparisons showed that similar clinical and subjective variables were associated with the dentist and patient ratings. Multiple regression findings, however, highlighted differences in the factors that influenced the ratings. In addition, the proportion of variance accounted for by the clinical factors as opposed to the subjective factors was greater for the dentist rating (R2 = .28 of .33) than the subject self-rating (R2 = .18 of .43).

Age Factors↗
PubMed1996

Dentists' stated restorative treatment thresholds and their restorative and caries depth decisions.

OBJECTIVE: This study examines the relationships between stated restorative treatment thresholds of 16 dentists and both their restorative decisions and caries depth determinations for approximal tooth surfaces based on bitewing radiographs. METHODS: Sixteen dentists independently examined 15 pairs of experimental bitewing radiographs. They separately recorded restorative and dental caries depth decisions for 4,864 unrestored approximal tooth surfaces, 304 identical surfaces per dentist. In addition to caries depth and restorative decision data, these dentists provided their restorative thresholds using a five-point scale. RESULTS: Three dentists stated it would be appropriate to restore enamel lesions, nine would wait until caries had reached the dentinoenamel junction, and four would wait until caries extended into the dentine. Although dentists stating an enamel restorative threshold intended definitely or probably to restore relatively more surfaces and recorded relatively more surfaces with dentinal caries, ANOVA analyses revealed that the differences among the restorative and the depth means according to the restorative thresholds were not significant. Considerable variation existed in both the restorative and depth decisions among the dentists in each threshold group. CONCLUSION: Although interesting trends occurred in the restorative and depth decisions relative to the stated thresholds, this study suggests, like others in Europe, that these thresholds cannot be taken at face value to explain restorative decisions.

Analysis of Variance↗
PubMed2002

Provision of care to the underserved populations by National Health Service Corps alumni dentists.

OBJECTIVE: This study examined factors associated with dentists continuing to provide care to the underserved populations beyond their National Health Service Corps (NHSC) obligation period. METHODS: Self-administered questionnaires were mailed in 1998 to 404 dentists who had completed their service obligation between 1980 and 1997. The outcome variable was dentist self-report of continuing to work with the underserved population past NHSC obligation. RESULTS: Among 249 respondents (62% response rate), 46 percent of alumni dentists continued to work with an underserved population. Multivariate analyses found that being an African American (odds ratio [OR] = 3.2), higher final salary during the NHSC assignment (OR = 1.2), and higher altruistic motivation to work with the underserved populations prior to entering NHSC (OR = 1.1) were significantly associated with continued service to the underserved populations. CONCLUSIONS: A small number of factors were associated with alumni NHSC dentists' decisions to continue to provide care for the underserved populations. Targeting African-American students and students interested in caring for the underserved may improve the long-term commitment of dentists to provide care for the underserved populations. Attention will also need to be given to increased salary as a potential intervention to increase the numbers of dentists who continue to serve the underserved populations.

Adult↗
PubMed2001

Effects of perceived patient attributes on dentist communication behavior.

The current study was designed to assess the relationship between dentists' communication behavior and their perception of patient attributes such as likeability, manageability, and prognosis. Six AEGD residents were videotaped, and their verbal and nonverbal communication behavior was analyzed in the manner described. Each resident was administered a 20-item questionnaire to determine his/her perception of patient attributes. For overall dentist nonverbal behavior, perception of the patient and the amount of recognized interruptions that the dentist allowed were significantly correlated (r = 0.28, p < 0.05). When the three dentist perception subcategories--Likeability, Manageability, and Prognosis--were analyzed, verbal and nonverbal communication leads were significantly correlated with the dentists' perceptions of patient attributes in each. The hypothesis of a relationship between patient communication behavior and the dentists' perceptions of patient attributes was supported. The results suggest that dentists alter their communication behavior depending on their assessment of various patient qualities. Whether training in interviewing techniques and communication behavior would have an effect on this process is unknown and should be addressed.

Attitude of Health Personnel↗
PubMed1996

Factors affecting the amount of long-term restorative dental treatment provided to 100 patients by 20 dentists in 3 Adelaide private practices.

Apart from the effects of the frequency of patient attendance for dental examination, and of a change of dentist, little is known of those factors which may influence the amount of treatment provided in dental practice. The present study investigated during 1992 the effects of seven factors on the amount of treatment provided for 100 adult patients treated by 20 male dentists over many years in three selected Adelaide private practices. The amounts of particular types of restorative treatments provided were significantly related to patient age, gender and frequency of attendance, and to practice location, change of dentist and number of changes of dentist, and to the experience or time since graduation of the dentist. These factors were of special significance for the number of crowns provided, most of which were placed in older patients by more experienced dentists. But, there was no evidence of increased numbers of direct placement restorations being received by patients who attended more frequently or who changed their dentists.

Adult↗
PubMed2004

Canadian dentists' willingness to be involved in dental research.

BACKGROUND: Building a collaborative research network reuniting dentists and academics constitutes a solution in order to bridge the gap between dental research and patient care. The purpose of this study was to identify the kind of clinicians willing to be involved in research and to determine their research priorities. METHODS: A questionnaire was mailed to all registered dentists in Canada in December 2001. This questionnaire comprised sociodemographic variables and questions on research utility, research results availability and dental research priorities. The statistical analyses were performed with 2,595 questionnaires completed by dentists working in a clinical setting. RESULTS: 27% of respondents were willing to be involved in dental research, 23% did not know and 50% did not want to be involved. A multiple logistic regression model shows that being open to participate (Yes and Don't know) is associated with: younger age (OR = 2.83), perception that research has a very big impact on the oral health of the population (OR = 1.93), perception that dental research results are not easily available to dentists (OR = 1.47), practice as a specialist (OR = 1.45) and French spoken as a first language (OR = 1.45). A large majority (80%) of dentists who would like to be involved in research think that effectiveness of techniques and treatments are a very high priority. CONCLUSIONS: There is a significant group of dentists who wish to be involved in research. This information could be used to reunite dentists and researchers in a collaborative network.

Adult↗
PubMed1991

Occupational cervico-brachial disorders among dentists. Psychosocial work environment, personal harmony and life-satisfaction.

The aim of the investigation was to compare dentists with and without occupational cervico-brachial disorders with regard to some psychosocial variables (work environment, personal harmony and life-satisfaction) and professional position. The investigation is based on a questionnaire sent to 143 randomly selected official dentists in Malmöhus District and the Municipality of Malmö. Of these, 96 dentists had symptoms while 47 had not. Dentists with symptoms showed less satisfaction with their work environment than dentists without. Those with symptoms experienced their work load as being more unsatisfactory, were more burdened by anxiety, had poorer psychosomatic health and less confidence in the future than dentists without symptoms. These differences were significant between the groups. It was found that specialists, both with and without cervico-brachial symptoms, were more satisfied with their psychosocial work environment than general practitioners, especially regarding their personal control over their work and the stimulation of their work. The specialists also had more self-confidence and experienced less anxiety than general practitioners and head dentists.

Adult↗
PubMed2000

Too few dentists? Workforce planning 1996-2036.

The development and use of forecasting models can stimulate the debate on workforce planning for dentists by improving the quality of the data available, by providing a framework within which the debate can be conducted and by providing a means whereby the effects of different trends and policy options can be measured in a consistent way. The number of dentists on the Dentists Register aged under 60 years may well fall over the 40 years between 1996-2036, while the proportion of female dentists is likely to grow from under 30% to almost 50%. If the present gender differences in dentists' output persist, the effective 'whole-time equivalent' (WTE) size of the dentist workforce could fall by 15%. While future patterns of disease and the efficacy of future treatments are difficult to predict, the demand for dentistry is very likely to increase, given the forecast ageing of the UK population. The number of people aged 65-74 years could increase by 50% to eight million and those over 75 years by 70% towards seven million. Further, almost of all of this greatly increased older population will have retained some of their own teeth. The edentulous adult population was 37% in 1968 and might fall to less than 5% by 2036. These trends taken together could increase the number of courses of treatment per WTE dentist by as much as 40% over these 40 years. Such modelling can help to reduce the degree of uncertainty in future workforce planning.

Adult↗