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PubMed1994

Cariogenicity tests.

An American Dental Association Scientific Consensus Conference on Methods for the Assessment of the Cariogenic Potential (CP) of Foods was held in San Antonio, Texas, in 1985. The aim was to establish a scientific consensus regarding methods to assess the CP of foods. As a result, a sequential food-testing program was proposed involving Animal Caries, Human Plaque Acidity, and Demineralization/Remineralization Models. Two categories of CP--namely, no CP and low CP--were included. The test protocol has hardly been followed since, primarily because the category of low CP was not considered useful in dietary counseling. It is advocated that research into possible caries-preventive factors of food will be more beneficial for improvements of the oral health of the general population than assessments of low CP.

Animals↗
PubMed1976

Survey of dentists' opinions on issues facing the profession.

Dentists in the Seventh District Dental Society of the State of New York were surveyed for their attitudes toward selected health policy issues to determine the extent of attitudinal consensus in the professional community, the bases of significant differences of opinion, and the agreement of the local dentists with official policies of the American Dental Association. Greatest agreement among dentists was found with respect to the issues of licensure and peer review; some significant differences of opinion were found about the existence of manpower problems, expansion of dental schools, recruitment of minorities, expanded-duty auxiliaries, and fee scheduling. Most dentists favored participation in continuing education courses without examination as a requisite for licensure and even more favored peer review by the local dental society. Agreement between opinions of local dentists and official ADA policies was high on all issues except fee posting, for which local opinion was evenly divided. The formation of national policies with regard to fee posting should proceed carefully.

Adult↗
PubMed1983

Recommendations on administratively required dental radiographs.

The FDA recommendation on administratively required dental X-ray examinations states a principle that has been frequently endorsed by the American Dental Association. This recommendation, developed through a formal review process, reflects the views of dentists, educators, insurance carriers, professional societies, and other interested health professionals. Simply stated, it urges dentists to perform only X-ray examinations that are necessary for the patient's immediate dental needs. Dentists and others are urged to refer to this recommendation when presented with requests for radiographs considered unnecessary for patient care.

Humans↗
PubMed1985

Dental research at the National Bureau of Standards: how it changed the practice of dental health service.

A history of dental research at the National Bureau of Standards since its inception in 1919 is presented. The initial thrust on dental amalgam by the US Army Dental Corps, the assignment of Dr. William Souder to the project, and subsequent developments are traced. Difficulties in obtaining support for the early stages of the program following World War I are described. The involvement of the American Dental Association in 1928, issuance of the first ADA specification on dental amalgam, and the ultimate ramifications on dental (and medical) standards programs throughout the world are described. Benefits to patients, dentists, and taxpayers from support of the dental research program have been calculated as exceeding the combined budgets of the currently supporting institutions--NBS, ADA, and National Institute of Dental Research.

Chemistry, Physical↗
PubMed1986

Dimensional stability of dental impressions after immersion disinfection.

Disinfection of dental impressions via short-term immersion in 0.5% or 1% sodium hypochlorite does not significantly affect the dimensional accuracy of the resultant casts. In addition, immersion in glutaraldehydes, povidone-iodine diluted in water, or halogenated phenol has no apparent effect on the dimensional stability of rubber impression materials. The results of this study support the use of immersion disinfectants for treatment of impressions for study models or removable dental appliances or prostheses. Coupled with the findings of other authors, the data suggest that such disinfection also would be suitable for rubber base and vinyl polysiloxane impressions for cast restorations. Given the need for infection control in the treatment of all dental patients, the results of this study support the recommendations of the American Dental Association for disinfection of dental impressions via immersion in an appropriate disinfectant solution.

Alginates↗
PubMed1997

Dental hygienists in the United States: results of an ADA survey.

The Survey Center of the American Dental Association conducts an annual survey of approximately 5 percent of all private practitioners in the United States. This survey is sent to a randomly selected group of dentists in private practice, including general practitioners and specialists and ADA members and nonmembers. It attempts to collect information on various practice characteristics such as work schedules, patient visits, non-dentist staff employment, expenses and wages. Using information from the 1991 to 1995 Survey of Dental Practice reports, this article examines the employment of dental hygienists.

Data Collection↗
PubMed1999

Trends in the dental health work force.

BACKGROUND AND OVERVIEW: Using data from various American Dental Association projects (Distribution of Dentists Survey, the Survey of Dental Practice, the Dental Workforce Model, and the Survey of Predoctoral Dental Educational Institutions), the authors analyzed trends and projections for the dental work force. The article presents work-force projections overall and by sex, when available, through the first 20 years of the 21st century. The number of women practicing dentistry has been increasing rapidly, while the increase in the number of male dentists has been more modest. In the future, the number of female dentists is projected to increase while the number of male dentists is projected to decrease. CONCLUSIONS: Estimates based on the ADA census data place the overall growth in the number of active private practitioners at 19.1 percent between 1982 and 1997. This growth signifies a substantial expansion of capacity to produce dental services in the United States. Growth will be slower in the future. PRACTICE IMPLICATIONS: Changes in the dental work-force capacity and demographic distributions merit careful monitoring and analysis, because they no doubt will determine the dental profession's future ability to deliver needed dental services and influence practitioners level of busyness.

Age Distribution↗
PubMed1999

Combining periodic and continuous sodium hypochlorite treatment to control biofilms in dental unit water systems.

BACKGROUND: This study evaluated the efficacy of combined intermittent and continuous treatment with diluted sodium hypochlorite, or NaClO, to improve dental unit water quality in a clinical setting. METHODS: In this prospective study, 10 dental units were fitted with separate water reservoir systems. Dental units were maintained with weekly rinses with 1:10 NaClO. Treatment water consisted of 750 milliliters of tap water and one drop of undiluted commercial bleach. Bacterial contamination in the effluent coolant water was assayed via microbiologic culture on a weekly basis. At the end of the study, scanning electron microscopy of the inner surfaces of the dental unit waterlines corroborated the results. RESULTS: All 10 dental units consistently delivered water with less than 10 colony-forming units per milliliter, or CFU/mL, with a mean bacterial contamination of less than 1 CFU/mL. Baseline scanning electron microscopy demonstrated biofilm formation. Scanning electron microscopy at the end of the study demonstrated the lack of features consistent with biofilm formation. Although tri-halomethanes were detected in output water, all samples were below Environmental Protection Agency limits for drinking water. CONCLUSIONS: Weekly treatment with 5.25 percent NaClO diluted 1:10, and concomitant use of chlorinated treatment water (3 parts per million chlorine) consistently attained the proposed American Dental Association goal of fewer than 200 CFU/mL in the unfiltered output. The effects of continuous treatment on dentin and enamel bond strength may require further evaluation. CLINICAL IMPLICATIONS: The success of this protocol suggests that optimal attainment of dental water quality goals may require a combination of approaches.

Biofilms↗
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↗
PubMed1999

Assessing the clinical effectiveness of an aerosol reduction device for the air polisher.

BACKGROUND: Because of the growing concern of the infectious nature of aerosols produced by air polishers, the Centers for Disease Control and Prevention and the American Dental Association have made recommendations to minimize dental aerosols. In addition, a device was developed in 1997 to reduce the aerosol generated during air polishing. METHODS: The authors conducted a blinded clinical study to determine the effectiveness of an aerosol reduction device during air polishing. All 30 subjects underwent two minutes of air polishing, one with the aerosol reduction device on one side of the mouth and one without the device on the opposite side. Microbial samples were collected on blood agar plates positioned 12 inches from the subject's mouth and from one plate attached to the dental hygienist's face mask. The sample plates were then inverted and incubated for three days at 37 C. RESULTS: Using the paired t-test, the authors found that the air polisher without the aerosol reduction device generated a significantly greater mean quantity of colony-forming units, or CFUs, 12 inches from the subject's mouth (mean +/- standard deviation, 148.00 +/- 145.00 CFUs) than the air polisher with the aerosol reduction device (20.10 +/- 53.90 CFUs) (P < .0001). In addition, the air polisher without the aerosol reduction device generated a significantly greater number of CFUs on the face mask plate (40.90 +/- 33.80 CFUs) than the air polisher with the aerosol reduction device (8.80 +/- 15.10 CFUs) (P < .0001). CONCLUSION: The data suggest that the aerosol reduction device is effective in reducing the number of microorganisms generated during air polishing. CLINICAL IMPLICATIONS: Air polishing with the aerosol reduction device may decrease the potential for disease transmission.

Adult↗
PubMed2000

Characteristics of dentists participating in capitation and Preferred Provider Organization dental plans.

BACKGROUND: In 1998, the American Dental Association Survey Center conducted a telephone and mail survey of U.S. dentists in private practice in an effort to determine the extent of dentists' participation in capitation and preferred provider organization, or PPO, dental plans and the characteristics of dentists who participate in those plans. METHODS: An initial telephone screening survey of a random sample of 11,550 dentists in private practice was conducted to identify dentists who participated in PPO or capitation dental plans. Dentists who participated in either of these plan types then were asked to complete a mail survey on their plan participation. RESULTS: The majority of dentists participating in either type of dental plan reported having never left a dental plan. Dentists who belonged to more than one PPO or capitation plan reported that a larger percentage of their patients were enrolled in these plans and that more of their practice's gross income came from the plans. Participation in PPO and capitation plans has had a positive impact on the practices of many of the responding dentists, particularly with regard to expanding their patient base. CONCLUSIONS: The authors found that the majority of dentists participating in PPO dental plans found it to be a positive experience overall. Dentists participating in capitation plans were less satisfied; more than 50 percent of capitation plan participants reported some level of dissatisfaction with the plans. The majority of dentists participating in a PPO plan expected to renew participation when their current contract expired; a much smaller percentage (though still a majority) of responding capitation-plan participants indicated the same. PRACTICE IMPLICATIONS: Responding dentists' overall indication of satisfaction with their current PPO plan participation probably indicates further growth for these dental plans. On the other hand, capitation plan participants seem much less satisfied with their plans. PPO plans, therefore, seem much more likely to be the type of plan that dentists will choose in the future.

Capitation Fee↗
PubMed2001

Prevalence of carpal tunnel syndrome and median mononeuropathy among dentists.

BACKGROUND: The authors undertook a study to determine the prevalence in dentists of abnormal sensory nerve conduction and/or symptoms of carpal tunnel syndrome, or CTS, the most common nerve entrapment syndrome. METHODS: In a cross-sectional study, dentists (n = 1,079) were screened during the American Dental Association's Annual Health Screening Program in 1997 and 1998 by means of standard electrodiagnostic measures in the dominant hand and a self-reported symptom questionnaire. The authors diagnosed a median mononeuropathy from a 0.5- or 0.8-millisecond, or ms, prolongation of the median sensory-evoked peak latency compared to the ulnar latency. They diagnosed CTS if the subject also had accompanying symptoms of numbness, tingling or pain. RESULTS: Thirteen percent of screened dentists were diagnosed with a median mononeuropathy (using a 0.5-ms prolongation as the criterion), but only 32 percent of these had symptoms consistent with CTS (4.8 percent overall). When the 0.8-ms prolongation was used as the electrodiagnostic criterion, only 2.9 percent (overall) were diagnosed with CTS. People with diabetes, rheumatoid arthritis and obesity were more likely to have a median mononeuropathy. CONCLUSIONS: The prevalence of symptoms consistent with CTS in the dominant hand among dentists was higher than the prevalence in the general population. However, when electrodiagnostic confirmation is added, the prevalence of CTS was nearly the same as that among the general population. CLINICAL IMPLICATIONS: Early recognition of CTS can lead to more effective management. Education regarding ergonomic risk factors can be an effective preventive measure.

Adult↗
PubMed2002

Clinical effect of a new liquid dentifrice containing triclosan/copolymer on existing plaque and gingivitis.

BACKGROUND: Dentifrices traditionally have been formulated as pastes or gels. However, liquid varieties recently have become available The authors conducted a study to determine whether a fluoridated liquid product with added triclosan and a polyvinyl methyl ether/maleic acid, or PVM/MA, copolymer delivery system is efficacious for the control of supragingival plaque and gingivitis. METHODS: The authors conducted a six-month, double-blind, parallel, stratified clinical study in accordance with American Dental Association guidelines for the clinical evaluation of antiplaque/antigingivitis products. Subjects who qualified with a suitable amount of existing plaque and gingivitis were given one of two dentifrices: an "experimental" liquid dentifrice containing 0.3 percent triclosan, 2.0 percent PVM/MA copolymer and 0.243 percent sodium fluoride, or NaF, in a silica base; or a "placebo" dentifrice containing 0.243 percent NaF in a silica base. The authors collected subjects' plaque and gingival index scores at baseline, three months and six months. RESULTS: The results of the study indicate that the use of the experimental liquid dentifrice provided a significant reduction in existing levels of plaque and gingivitis as compared with the placebo standard dentifrice. At six months, the experimental group demonstrated a 34.9 percent reduction in plaque formation and a 25.7 percent reduction in gingivitis as compared with the placebo group (P < .001). CONCLUSIONS: When compared with the placebo, the experimental dentifrice had a significantly better ability to reduce plaque and gingivitis. When compared with results reported in the literature, this new form of dentifrice achieved results comparable in efficacy to those of traditional dentifrice pastes with matching active ingredients. CLINICAL IMPLICATIONS: This study confirms that a liquid dentifrice containing a triclosan/copolymer/NaF delivery system is efficacious in its ability to reduce existing plaque and gingivitis.

Adult↗
PubMed2002

Computer-assisted analysis of oral brush biopsies at an oral cancer screening program.

BACKGROUND: Dentists and dental hygienists attending a health screening program were screened for oral cancer. Select oral epithelial lesions were evaluated by oral brush biopsy with a computer-assisted method of analysis (OralCDx, OralScan Laboratories Inc., Suffern, N.Y.). METHODS: After those who had oral epithelial lesions were identified, the clinical characteristics of each lesion were recorded. Participants with abnormal oral brush biopsy results ("positive" and "atypical") subsequently underwent incisional biopsy of their lesions by an oral surgeon. RESULTS: A total of 930 dentists and dental hygienists were screened over a four-day period at each of the American Dental Association's 1999 and 2000 annual sessions. Eighty-nine people (9.7 percent) with 93 oral epithelial lesions were identified and evaluated by brush biopsy. Seven of the 93 oral lesions-all benign appearing in their clinical appearance-were determined to be "atypical" or "positive." Of these, three were diagnosed as precancerous by scalpel biopsy and histologic evaluation. CONCLUSIONS: Computer-assisted brush biopsy analysis is a valuable adjunct to the oral screening examination. The identification of three innocuous-looking precancerous lesions in this low-risk group of dentists and dental hygienists underscores the necessity of evaluating all oral lesions of unknown etiology. CLINICAL IMPLICATIONS: As 9.7 percent of the screened dentists and dental hygienists had epithelial oral lesions, general dentists most likely routinely encounter an even higher percentage of oral lesions in their patients. The minimally invasive brush biopsy lets general dentists evaluate these lesions. Like Pap smears and mammograms, this tool can help identify precancers and potentially curable cancers.

Adult↗
PubMed2003

Access to dental care for children in the United States: a survey of general practitioners.

BACKGROUND: In response to concern that inadequate dental school training may create a barrier to access to care for children, the authors conducted a survey concerning general practitioners' practice patterns involving child patients. METHODS: The authors requested a list of 4,970 randomly chosen general practitioners from the American Dental Association Survey Center. They then sent those dentists a written survey asking whether and in what numbers they treat children; the ages and caries levels of any children they do treat; their perceptions of their educational experiences in pediatric dentistry, and their perceived needs for continuing education in pediatric dentistry. They analyzed data using chi2. RESULTS: Ninety-one percent of the general dentists surveyed treated children, but those younger than 4 years of age, with high levels of caries, and whose care is funded by Medicaid were represented in very low numbers. The types of patients treated and procedures performed by the respondents were significantly (P < or = .05) associated with the intensity of the respondents' educational experiences, except for the number and types of Medicaid patients they treated. CONCLUSIONS: These data indicate that the vast majority of general practitioners treat children in their practices, but there still are groups of children for whom access to dental care is a problem. PRACTICE IMPLICATIONS: Very young children, children with high levels of caries and Medicaid-covered children have difficulty finding dental care in the general practice community.

Chi-Square Distribution↗