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PubMed1997

Survey of oral appliance practice among dentists treating obstructive sleep apnea patients.

PURPOSE: Oral appliances (OAs) are used to treat obstructive sleep apnea (OSA). This study seeks to quantify the patterns of practice of OA use among dentists. DESIGN: Survey mailed to dentists. PARTICIPANTS: Members of the Sleep Disorders Dental Society (SDDS). MEASUREMENTS: Dentists were asked questions regarding number of patients treated, types of OA used, average total OA cost to the patient excluding reimbursement, percentages of patients receiving pretreatment and posttreatment nocturnal polysomnography (NPSG), and whether they believe subjective patient reports alone or nocturnal pulse oximetry alone is an adequate substitute for NPSG to assess OSA treatment response. Summary statistics for the absolute value and percentage data are presented with the median, maximum, and minimum range. RESULTS: Three hundred fifty-five surveys were mailed, of which 124 (35%) were returned. These dentists treat a median of 27 OSA patients with OAs (range, 2 to 300) annually. Patients receive pretreatment NPSG in 95% of cases (range, 0 to 100%), and posttreatment NPSG in 18% of cases (range, 0 to 100%). Only 7% of dentists believe subjective patient reports alone are an adequate substitute for NPSG. Nocturnal pulse oximetry was perceived to be an adequate substitute for NPSG by 37%. Dentists who believe nocturnal pulse oximetry to be an adequate substitute for posttreatment NPSG are less likely to obtain pretreatment or posttreatment NPSG (Mann-Whitney U test, two-tailed; p = 0.001, p = 0.02). CONCLUSIONS: Most SDDS dentists believe subjective reports and nocturnal pulse oximetry are inadequate to assess OA treatment response in OSA patients, yet posttreatment PSG is obtained infrequently.

Humans↗
PubMed1986

The dentist-patient relationship: mutual perceptions and behaviors.

The relationship between patients' characteristics and dentists' perceptions as well as the associations between these dimensions and specific dentist behaviors as perceived by patients are explored. Dentist perceptions of patient sophistication and anxiety were related to several patient characteristics, but perceptions of patient likability were unrelated to patient personal and social characteristics. Perceptions of patient likability were associated with more specific dentist behaviors than were other dentist perceptions noted by patients. The results suggest that dentists' views are influenced primarily by those patient characteristics manifested during treatment. In general, dentists like patients who are dentally sophisticated and not anxious.

Adolescent↗
PubMed1986

Dentists who practice with spouses or relatives: a pilot study of practitioners in Iowa.

Of 130 practicing dentists in Iowa surveyed, 73, or 6% of the practicing dentists in that state, responded that they worked with a total of 108 relatives. Half of the relatives were the dentists' spouses. One to ten relatives worked in each office. Overall, the dentists were satisfied with the associations and expected them to continue. Most dentists had informally defined associations, and 10% had written contracts. Dentists named "office policy and organization" most often and "finances" least often as motives behind the associations and "personal growth" most often and "recognition" least often as a satisfaction with the association. The respondents suggested 567 ideas for other dentists considering such associations.

Dentists↗
PubMed2004

Liver cancer risk in Japanese male dentists: a long-term retrospective cohort study.

It has been speculated that dentists are at high risk for occupational exposure to bloodborne viruses such as hepatitis B and hepatitis C viruses. To assess the risk of the development of liver cancer among Japanese male dentists, we conducted a retrospective cohort study on 3,314 dentists of the Osaka Dental Association who were members between 1964 and 1985, the year before HBV immunization became available. By linking to the Osaka Cancer Registry, we found that during the period of 1964-1997, 36 of the dentists were diagnosed with liver cancer over a mean follow-up of 23.6 yr. The observed number of liver cancer cases was compared with the expected number, which was calculated by multiplying the number of person-years at risk by the corresponding age- and calendar time-specific incidence rate from the Osaka Cancer Registry data. The male dentists had a significantly lower risk of developing liver cancer than the general population of Osaka (O/E=0.71, 95% CI=0.50-0.98). On subcategorical analysis by birth year or duration of follow-up, there was no significantly increased risk of developing liver cancer among the dentists. Contrary to our expectation, our findings indicate that Japanese dentists were not at increased risk of developing liver cancer compared with the general population.

Adult↗
PubMed1990

Symptoms of the neck and upper extremities in dentists.

Symptoms of the neck, shoulders, arms, and hands of 99 dentists and a reference group of 100 pharmacists were studied by means of a telephone interview. Forty-four percent of the dentists and 26% of the pharmacists reported symptoms of the neck [relative risk (RR) 2.1, 95% confidence interval (95% CI) 1.4-3.1]. Symptoms of the shoulder were reported by 51% of the dentists and 23% of the pharmacists (RR 2.2, 95% CI 1.5-3.3). Musculoskeletal symptoms in the forearm were present almost exclusively in the dentists (12 versus 1%). Numbness and paresthesia were more common among the dentists than among the referents (RR 4.2, 95% CI 2.3-7.7). Unilateral Raynaud's phenomenon in the dominant hand occurred in six dentists and one pharmacist. The high frequency of symptoms from the neck, shoulders, and upper extremities of the dentists was probably related to their difficult work positions with cervical flexion and rotation, abducted arms, and repetitive precision-demanding handgrips.

Adult↗
PubMedDate not supplied

Prosthodontic decision making among general dentists in Sweden. I: The choice between crown therapy and filling.

PURPOSE: The purpose of this study was to analyze dentists' evaluations of factors related to the choice between crown therapy and filling and to possibly explain this by social and demographic attributes, job situation, and dentists' attitudes. MATERIALS AND METHODS: Questionnaires were sent to a random sample of 2,059 Swedish dentists. The response rate was 76%. In the questionnaire the choice between crown therapy and filling in a clinical situation was presented. The dentists were asked to mark their assessments of the relative importance of the different items on 14-item visual analogue scales (VAS). Multiple regressions were run for all 14 items. RESULTS: Large individual variations were seen among the dentists regarding the stated importance of the various items. The items rated as the most important were "patient's wish" and "treatment prognosis," and the items rated as least important were "treatment time required" and "number of visits required for treatment." The differences between groups were small, and for no item exceeded 0.7 step on the 8-grade VAS scale. No data reduction was possible using principal components analysis. CONCLUSION: The study showed great variations among individual dentists. The dentist-related factors explained little of the variance. The results indicated that the questionnaire instrument did not fully capture the real influences on the treatment choice between a filling and an artificial crown.

Adult↗
PubMedDate not supplied

Prosthodontic decision making among general dentists in Sweden. II: The choice between fixed and removable partial dentures.

PURPOSE: The purpose of this study was to describe how dentists evaluated various items related to a treatment choice between fixed partial dentures (FPD) and removable partial dentures (RPD), and to determine if the differences could be explained by dentist-related variables ("social and demographic attributes," "job situation," and "attitudes"). MATERIALS AND METHODS: Questionnaires were sent to a random sample of 2,059 Swedish general dentists, with a response rate of 76%. In the questionnaire, the choice between FPDs and RPDs in a clinical situation was presented. The dentists were asked to mark on 14-item visual analogue scales the relative importance he or she gave the different items. The items were analyzed through principal components analysis, where a 3-factor solution was obtained; the factors were labeled as "time," "health," and "comfort." The factors were run as dependent variables in multiple regression analyses. RESULTS: Great individual variations were seen, but the differences between groups of dentists were small. The items evaluated as most important were "patient's wish," "condition of possible abutment teeth," and "prognosis for delivered treatment." Male dentists gave significantly greater importance to the "health" factor compared to female dentists. The attitudinal variable "patient information" showed significant associations with all 3 factors in the multivariate models. CONCLUSION: Great individual differences were seen regarding the importance of the various items. In multiple regression models, several independent variables showed significant associations, most interestingly the attitudinal variable "patient information." Low explanatory (R2) values indicate that it is necessary to capture more variables of importance for the prosthodontic decision-making process.

Age Factors↗
PubMed2000

On composite resin materials. Degradation, erosion and possible adverse effects in dentists.

PURPOSE: The aims of this thesis were: 1. To study the effect of water and pH on composite resin materials in vitro by assessing sorption, solubility, monomers eluted and flexural properties. 2. To study adverse effects on the skin in dentists possibly caused by acrylic resin-based materials. MATERIALS AND METHODS: Proprietary composite resin materials were used for the in vitro experiments. The tests were performed according to the ISO 4049 (1988) with the exception of McIlvaine's solution used in Study II and the storage times. The analysis of eluted monomers was performed using HPLC. The flexural properties were tested in a three-point bending equipment. The secant modulus and deflection at break were calculated for description of the viscoelastic behaviour of the material tested. To study the adverse effects on skin in dentists, a questionnaire was sent to 3500 randomly selected Swedish dentists. A response rate of 88% was achieved and the data were statistically analysed and compared with the results of two studies on skin symptoms among the general Swedish population. Dentists living in the three main cities in Sweden who had experienced hand eczema during the last 12 months were invited to a clinical examination in which a patch test was included. RESULTS: A wide range in sorption and solubility over the test period was found, with low sorption values observed for materials containing hydrophobic matrix monomers. A maximum concentration of monomers eluted was found after 7 days of storage, and TEGDMA was the main monomer released. pH affected the sorption and solubility behaviour for two of the three materials tested. The flexural strength and modulus of the composite resin material were lowered after water storage and the secant modulus and deflection at break could describe the viscoelastic behaviour. The prevalence of dry skin and hand eczema was high in dentists compared to two age-matched general population samples investigated using identical questions. The most important predictor for adult hand eczema was found to be childhood eczema. At the clinical examination, irritant contact dermatitis was the predominant diagnosis. Seven per cent reported skin symptoms when working with acrylic resin-based material but the true prevalence of hand eczema caused by acrylates was below 1%. Contact allergy was diagnosed, however, in 50% of the dentists, mainly due to other allergens such as nickel, perfumes or rubber chemicals. CONCLUSIONS: The matrix composition was shown to be important for the sorption and solubility behaviour of the composite resin materials tested and a maximum release of monomers occurred after 7 days of storage. pH affected the water sorption and solubility behaviour. Calculation of the secant modulus and the deflection at break allowed the plasticising effect of water on composite resin material to be observed. The prevalence of hand eczema was high among dentists, with irritant contact dermatitis as the predominant diagnosis. Childhood eczema was the most important predictor for adult hand eczema. The prevalence of hand eczema owing to acrylates was below 1%.

Adsorption↗
PubMed2002

PGD training and its impact on general dentist practice patterns.

This study compares the practice patterns of general dentists with and without formal advanced training in AGED or GPR programs. The UCLA School of Dentistry surveyed a random selection of dentists from graduating years 1989, 1993, and 1997 as part of a Health Resources Services Administration (HRSA)-supported evaluation of the impact of federal funding on postgraduate general dentistry (PGD) programs. Using a sample drawn by the American Dental Association (ADA), 6,725 dentists were surveyed about their practice, advanced training, patients served, and services provided. Of the 2,029 dentists (30 percent) who responded, 49 percent were practicing dentists with no formal advanced training in general dentistry or one of the eight ADA specialties; 7 percent had Advanced Education in General Dentistry (AEGD) experience; 20 percent trained in a General Practice Residency (GPR); and 24 percent were specialists. Additionally, 7 percent of respondents had PGD training and a clinical specialty. GPR-trained dentists were significantly more likely to be on a hospital staff and to treat medically compromised patients even after ten years of practice. PGD dentists were less likely to seek specialty training. Major reasons for seeking PGD training were increasing treatment speed, learning to treat medically compromised patients, and wanting hospital experience. Primary reasons for not selecting training were starting a practice and having a great practice opportunity. Our conclusion is that PGD training has an enduring impact on practice patterns and improves access to dental care for underserved populations.

Analysis of Variance↗
PubMed2005

Brazilian dentists' restorative treatment decisions.

PURPOSE: To investigate the pattern of decision-making by southern Brazilian dentists regarding the use of restorations in the treatment of dental caries. MATERIALS AND METHODS: A cross-sectional survey involving 840 dentists, randomly selected in three southern Brazilian states, was performed. Telephone interviews were conducted by three previously trained dentists, in which clinical situations with different-depth radiolucencies, based upon bitewing radiographs, were described. Two other situations, including dark fissures and white spots, were also described. The main outcome measures were the tendency in clinical decision-making in comparison with the number of years elapsed since qualification and attendance on postgraduate courses. RESULTS: The overall response rate was 89.4%: 31.5% of dentists would restore cavities in the outer half of the enamel; 54.5% when the cavity reached the inner half of the enamel, but not the enamel-dentine junction (EDJ); 79.0% when cavities reached the EDJ; and 96.9% when cavities reached the outer half of the dentine. Furthermore, 21.8% of dentists would restore dark fissures without signs of demineralization. Dentists qualified for less than 10 years and those who had attended postgraduate courses were less interventionist. CONCLUSION: It was concluded that dentists have an interventionist attitude in the making of treatment decisions for dental caries and may be over-treating in several situations.

Adult↗
PubMed1992

Fear of amalgam: dentists' experiences in the Nordic countries.

The purpose of the present investigation was to study Nordic dentists' experiences with patients concerned about the possible adverse effects of dental restorations, their perceived ability to deal with this problem and their views as to the suitability of amalgam as a filling material. A random sample of practising dentists in Denmark, Finland, Norway and Sweden were sent a questionnaire in spring 1990. Responses were received from 1732 dentists (65 per cent). In 1989, virtually every dentist had seen patients concerned about possible adverse effects of their dental restorations. The reported mean number of such patients per dentist per year was 80.5 (SD = 128.1) in Denmark, 39.3 (SD = 68.4) in Finland, 83.3 (SD = 194.1) in Norway, and 124.4 (SD = 210.3) in Sweden. Ninety-two per cent of the patients' questions concerned amalgam fillings. About 70 per cent of the dentists believed that inexplicable symptoms associated with amalgam fillings had a psychosomatic background. Only about a fifth of the respondents felt able to examine such patients without seeking medical expertise. In the absence of oral or medical indications, 65 per cent of the respondents in Sweden and 77 per cent in the other countries considered that dentists should advise patients against having their amalgam fillings replaced. About 5 per cent of the respondents were ready to stop using amalgam in the near future.

Attitude of Health Personnel↗
PubMed2005

Barriers to the provision of oral health education among Mongolian dentists.

PURPOSE: To study barriers to providing oral health education (OHE) to their patients among Mongolian dentists. SUBJECTS AND METHODS: A questionnaire survey was carried out in 2000 among practising dentists (n = 250) in the capital city of Mongolia. The response rate was 98%. Barriers to OHE were measured by six statements describing problems that might interfere with dentists' OHE activities and attitudes towards it by a statement about its importance; all answers were rated on a 5-point Likert scale (strongly agree-strongly disagree). Self-perceived competency in providing OHE was measured by means of a 4-point scale of competency (very to not at all competent) and preventive knowledge by 14 statements related to preventive dentistry. Dentists' work-related backgrounds were work experience in years, type of practice (state or private) and field of practice (general practice or speciality field). Statistical evaluation was carried out by chi-square test and logistic regression analysis. RESULTS: Poor appreciation of OHE by patients (85%) followed by insufficient teaching materials (73%) and time constraint due to the huge demand for curative care (59%) were the most commonly agreed-upon barriers. Concerning their attitudes towards and competency in providing OHE, 88% of the dentists agreed that OHE should be statutory, and 85% perceived themselves at least quite competent. Dentists' years of work experience were positively, but preventive knowledge score negatively associated with their agreeing about barriers to OHE activities. CONCLUSION: Despite appreciation of OHE, Mongolian dentists seem to face practical barriers to providing OHE activities.

Adult↗
PubMed1991

Occupational cervico-brachial disorders among dentists. Analysis of ergonomics and locomotor functions.

The aim of the investigation was to compare dentists with and without occupational cervicobrachial disorders with regard to the mobility of the neck and shoulders and the static endurance of the shoulder muscles. Further, differences in working position and the task performance on a stimulated case were to be analysed. The investigation was carried out during a visit to the workplace of 143 dental officers in the Public Dental Service in Malmöhus District and the Municipality of Malmö. Of these dentists, 96 had signs of cervico-brachial disorders and discomfort while 47 had not. The ergonomic examination showed, that significantly more dentists without symptoms of pain applied a wedge cushion under the upper part of the back of the patient to get an optimum view (p less than 0.05). It was also found that significantly more dentists without symptoms were aware of and utilised the naturally arising pauses in their work than dentists with pain and discomfort. Further dentists with cervico-brachial disorders kept their head sidebent and rotated to a greater extent than dentists without symptoms (p less than 0.01). No significant difference was found between the two groups concerning mobility of the neck and shoulders. Significant differences were found between women with and without cervico-brachial systems.

Adult↗
PubMed1990

Use of gloves among dentists in Sweden.

This study among 191 public and private dentists in the Malmöhus County of southern Sweden showed that 77% of the community dentists (n = 167) and 54% of the private dentists (n = 24) used gloves regularly as infection precaution during extraction. For surgery these figures were 90% and 54% respectively. These were low figures considering the several general recommendations from both the Swedish National Board of Health and Welfare and local community authorities to dental personnel to use gloves regularly during procedures with known risk of blood contact. The survey showed that 61% (n = 167) of the public dentists and 4% (n = 24) of the private dentists used gloves regularly during all patient treatment. High cost for gloves was no major obstacle for not using them regularly but rather discomfort and old habits (79% of the answers). 21% of the dentists had experienced local infections of their hands due to patient contact, puncture wounds being the most common cause. Most of the dentists using gloves had been influenced by the general HIV/AIDS discussion in news media (65%; n = 114).

Adult↗
PubMedDate not supplied

Dentists' outlook toward their profession.

Given the dramatic changes presently occurring in the practice of dentistry, it was the purpose of this research to examine the outlook held by practicing dentists toward their profession. Through use of a mailed questionnaire, a national sample of general and pediatric dentists was surveyed. A 12-item Likert scale was used to measure dentist outlook. Additionally, dentists responded to questions dealing with conditions of their practice. Respondents were most positive about the professions' accomplishment in reducing caries by promoting the use of fluorides. The majority also felt that decreased time spent providing restorative services would lead to increased time spent providing other services, that greater use of auxiliaries would produce increased income, that the ADA's proposed marketing plan would have a positive effect on the public, and that research findings were relevant to the private practice of dentistry. Three items received negative responses. These items related to the oversupply of dental manpower, the detrimental effects of the increase in competition among dentists, and the decrease in professional autonomy. Additionally, four practice variables were found to be related to dentist outlook. Outlook became more favorable with increasingly more positive income change over the prior year, with increasing numbers of employees, and with increasing practice business. Finally, the longer a dentist had been out of dental school, the more positive his or her outlook was likely to be.

Attitude of Health Personnel↗
PubMed1989

Urinary mercury concentrations in Finnish dentists.

During the past few years the safety of amalgam as a dental filling material has been the subject of general public discussion. So far there has been no agreement of whether micromercurialism, a term for the symptoms caused by minute amounts of mercury released from dental fillings, exists or not. Dentists may take mercury into their bodies from amalgam in their dental fillings and from handling it while working. We therefore included determination of urinary mercury concentrations in a comprehensive medical examination programme involving 136 dentists from South-Western Finland. We investigated factors possibly related to observed levels of mercury. The factor most closely related to high urinary mercury levels was use of amalgam by the dentist. Dentists who did not use amalgam had urinary mercury concentrations similar to those in Finns not occupationally exposed to mercury. Their "normal" excretion of mercury into the urine reflected the numbers of their dental fillings made from amalgam. The urinary concentrations of mercury of the dentists who used amalgam in their work were statistically highly significantly elevated. None of the values observed was close to the upper level for safety set by the WHO. However, since only one dentist in eight who used amalgam in their work had urinary mercury levels similar to those in Finns non-exposed to mercury at work, our findings suggest that every dentist should constantly take due care when using amalgam.

Adult↗
PubMed1989

Are Texas dentists burned out?

Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do "people work" of some kind. Health care providers, including dentists, are at high risk for burnout because their occupation often requires intense interaction with fearful, demanding patients on a daily basis. The purpose of this study was to assess the prevalence of burnout among Texas dentists using a standardized measurement device, the Maslach Burnout Inventory (MBI). Dentists attending the 1989 Texas Dental Association Annual Session were surveyed using the MBI. The respondents' results were analyzed and compared to each other as well as to the norms of medicine and to society (human service workers nationwide). Among the Texas sample, male dentists scored significantly higher for emotional exhaustion and depersonalization than did female dentists. When compared to the norms of medical workers, Texas dentists scored higher burnout in the depersonalization subscale, but lower burnout for personal accomplishment. The Texas sample again scored lower for burnout in the personal accomplishment subscale when compared to societal norms. At no time did the Texas sample fall into the high range of experienced burnout as defined by the survey instrument. Texas dentists did not appear "burned out" as a group and actually demonstrated an increased sense of personal accomplishment in their profession.

Adult↗
PubMed1978

Hepatitis and hepatitis B surface antigen and antibody in dentists.

Dentists were surveyed regarding a history of hepatitis and the presence in the blood of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) to determine whether they were at high risk of exposure to hepatitis B virus. Of 288 Canadian dentists 5.2% gave a history of hepatitis after graduation. This proportion is similar to that for 1462 Ontario dentists (6.3%) and that for 3162 accountants (5.1%) who had previously completed a mailed questionnaire. One dentist (0.3%) was HBsAg-positive and 42 (14.6%) were anti-HBs-positive. Of 210 healthy volunteer blood donors matched for age, sex and ethnic origin with the group of dentists none was HBsAg-positive and 2.9% significantly fewer (P less than 0.005), were anti-HBs-positive. Among Ontario blood donors 0.3% were HBsAg-positive and 3% were anti-HBs-positive. Thus, in Canada, dentists are not at increased risk of acquiring clinical hepatitis or becoming carriers, but they are more likely than other groups to have anti-HBs in the blood. Among dentists from outside Canada a higher proportion had a history of hepatitis (10.3%) and were HBsAg-positive (1.6%), but approximately the same proportion were anti-HBs-positive (15.9%).

Antibodies, Viral↗