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PubMed2001

Epidemiological evaluation of the outcomes of nonsurgical root canal treatment in a large cohort of insured dental patients.

Selected outcomes following initial nonsurgical root canal treatment (NSRCT) procedures were retrospectively assessed using an insurance company database of 110,766 nonsurgical root canal procedures that were completed by endodontists and their referring general dentists. A subset of 44,613 cases, with a minimum required follow-up time of 2 yr, showed incidences of extraction, retreatment and periradicular surgery equal to 5.56%, 2.47%, and 1.41%, respectively. The incidence of subsequent extraction increased with patient age. Teeth that were not restored after root canal therapy were significantly more likely to undergo extraction than restored teeth. Although the practice pattern for endodontists consisted of a significantly higher proportion of molars (48% more; p < 0.001) and a smaller proportion of anterior teeth (43% less; p < 0.001) than general dentists, both groups of providers had comparable rates of untoward events. These data strongly support the hypothesis that the specialist practice provides similar rates of clinical success compared with other providers, even when treating significantly more complex NSRCT cases. Overall, 94.44% of nonsurgical root canal treated teeth remained functional over an average follow-up time of 3.5 yr. These results are an important indication of the benefits of endodontic treatment when provided in an integrated health care delivery system of endodontists and their referring general dentists.

Adolescent↗
PubMed1977

An outreach cancer education program: a model for continuing education in the dental office.

During the period 1970-1973, only 2.5 percent of the dentists practicing in Kentucky attended cancer continuing education courses offered by the University of Kentucky College of Dentistry. In the fall of 1973 a different approach to cancer education was launched: Learn about Oral Cancer in Your Office. Self-instructional materials, developed in the College of Dentistry, were taken to the dentist's office on an appointment basis. This method had great appeal and significantly increased the number of dentists involved in cancer continuing education. Other positive results of this approach were a greater awareness on the part of the dentist of his role in cancer detection, a desire amont the participants to alter the pattern of practice to include cancer detection techniques, and exposure of dental auxiliary personnel to cancer education material.

Dental Offices↗
PubMed1995

Role of prophylactic antibiotics in the prevention of late infection of prosthetic joints. Results of a questionnaire and review of the literature.

A postal survey has revealed wide variation in attitudes towards the need for prophylactic antibiotics in patients with implants who develop intercurrent infections, or who undergo surgical procedures. The available evidence is insufficient to reach any firm conclusions, however any patient who has an implant should receive swift treatment for intercurrent infections.

Anti-Bacterial Agents↗
PubMed1992

Restorative treatment thresholds and agreement in treatment decision-making.

It has been recognised for many years that treatment decision-making among dentists often shows wide variation. This study sought to examine the effect of dentists' stated treatment thresholds as a source of variation between them. Twenty dentists made 360 treatment decisions about the approximal surface of extracted teeth seen in simulated bitewing radiographs. They also stated their personal treatment thresholds, i.e. the depth of lesion which they intended to restore. One hundred and ninety pairwise comparisons of treatment decisions showed that only 16% of the dentist pairs showed substantial agreement. Dentist pairs who reported that they held the same interventive threshold achieved exactly the same mean level of agreement in treatment decision-making as dentist pairs who disagreed about the appropriate threshold for restorative intervention. The study suggests that restorative thresholds which are reported to be used by dentists may be poorly correlated with the number of positive treatment decisions actually made.

Adolescent↗
PubMed2001

Building community support for a school dental sealant program.

Children from low-income families experience more dental caries and are less likely to receive dental treatment than children from middle- and high-income families. An overwhelming amount of scientific evidence supports the effectiveness of pit and fissure sealants in deterring the development of dental caries. The authors describe a unique component of the Multnomah County, Oregon, sealant program in which local dentists volunteer to conduct dental screenings in schools. This program, which began in 1989, targets elementary schools with 40% or more of students on free or reduced-cost lunch programs. During the 1999-2000 school year, volunteer dentists screened 5,252 second- and third-grade students in 64 schools and other community programs. As a result of the screenings, dental hygienist/dental assistant teams placed a total of 11,087 dental sealants on 3,866 children (a mean of 2.87 per child). The dentists who conducted the screenings were asked to evaluate the dental sealants placed during the previous school year. The program is one example of how a school dental sealant program can be staffed to optimize the resources of a state or county public health department. An added benefit of this staffing pattern is that it builds linkages in the dental community and a foundation for collaboration between private-practice dentists and public health programs. This type of collaboration is essential to the practice of public health. Furthermore, the involvement of private dentists in a local school sealant program can contribute to the long-term oral health of low-income children.

Child↗
PubMed1995

Dentists' perceptions of orthodontic services.

In this investigation the orthodontic referral patterns of the dentists working within two FHSA areas in the north of England were surveyed. A sub-sample of 149 of the dentists was selected and they were sent a postal questionnaire directed at their perceptions of the service provided and factors influencing their choice of orthodontist. One hundred and twenty one questionnaires (90%) were returned. It was found that 26.4 of the dentists did not refer an orthodontic patient and 51% referred to only one type of treatment provider. The most important factors governing their choice of orthodontic treatment provider were the length of treatment waiting list (62%) and the standard of treatment provided (66.9). In addition, the dentists' perceptions of the roles of the orthodontic services were not in concordance with those of the orthodontic treatment providers. They also expressed a degree of dissatistfaction with the orthodontic services.

Attitude of Health Personnel↗
PubMed1996

Utilization of personal protective equipment in general dental practice.

The principles of universal precautions are central to infection control. These principles form the basis or current guidelines for the use of personal protective equipment (PPE) in dental practice. This study, which examined the patterns of use of PPE in general dental practice, was based on a postal survey of 250 dentists in Brisbane (41 per cent of the total private general practitioners in the region). Routine use of PPE was commonplace (gloves, 84-6 per cent; masks, 55.7 per cent; eyewear, 77.6 per cent), but complete compliance with current acommendations for glove handling and hand care had not been achieved. Potential problem areas in terms of attitudes to PPE were identified, as were inconsistencies in the use of PPE in both clinical and non-clinical settings. These findings emphasize the need for further educational campaigns in practical infection control measures.

Attitude of Health Personnel↗
PubMed1981

Dental providers in international perspective.

This paper describes the dental provides in six study areas. The data were collected through interviews with samples of dentists who participated in the World Health Organization/US Public Health Service International Collaborative Study. Comparisons between dental providers in the different areas focus upon their personal characteristics, characteristics of their practices, their work patterns, the way they used their time, their professional activities and their satisfaction with dentistry. These descriptive data are related to consumer survey data obtained in another section of the International Collaborative Study.

Adult↗
PubMed2002

Attitudes and trends of primary care dentists to continuing professional development: a report from the Scottish dental practitioners survey 2000.

OBJECTIVES: To describe the current and intended continuing professional development activity of dentists in general and community practice. DESIGN: A cross-sectional survey by postal questionnaire. METHODS: A semi-structured questionnaire was sent to all general practice and community dentists identified from the dental practices division as being in practice in Scotland. The issues addressed included personal demographics, current working patterns and job satisfaction, training and professional development and finally career and working intentions. RESULTS: Of the 1,917 questionnaires sent to general dental practitioners (GDPs), 1,357 were returned useable (70% response rate); 212 of the 283 questionnaires to community dental practitioners (CDPs) were returned giving a 75% response rate. Of the responders, 89% of GDPs (1,188) and 95% of CDPs (178) reported participating in some form of CPD in the preceding year. One sixth of GDPs (211) and one third of CDPs (62) had a further qualification. Short courses such as Section 63 were very popular with over 90% of GDPs, but more than half the respondents did not think that further qualifications would enhance their career prospects. The most commonly identified barriers to further qualifications were heavy clinical commitments (78%), with 73% citing the substantial cost with no additional benefit. Over a third of GDPs under the age of 30 indicated they intended to sit a postgraduate qualification, but this fell to 12% for those aged over 30. The number of dentists identified on a career break was low (18). CONCLUSION: Two years before implementation of the General Dental Council's mandatory revalidation scheme, over 90% of Scottish primary care dentists reported active participation in continuing professional development. Future initiatives must be sufficiently sophisticated to fulfil the educational needs of different age groups, and to focus on part-time and career break dentists as well as full-time practitioners. It is important to establish career pathways in dental primary care. Part-time modular courses such as Masters degrees in primary care based dentistry may be one solution. An increased number of part-time posts for primary care dentists in secondary dental care may increase the skill base and also increase service provision in secondary care establishments. These pathways should create an opportunity to adequately reward those who continue to develop the knowledge and skills necessary for a technically demanding healthcare profession.

Adult↗
PubMed1990

Patterns of sealant delivery under variable third party requirements.

Despite evidence indicating dental sealants to be effective in preventing caries on the pit and fissure surfaces of teeth, only 8 percent of school-aged US children had received sealants as of 1986-87. While many rationales have been suggested and scientifically answered for this low level of utilization, issues of cost and cost effectiveness remain considerable barriers to many insurers and public programs. This study reports dentist behavior when sealants were added with few restrictions as a new benefit to an existing third party system of care. Results are compared to another third party program with stricter reimbursement policies. Overall, sealants were provided in a reasonable fashion to both groups of patients, relative to teeth selected for sealing and costs. Only a small proportion of patients receiving sealants were under age six or above age 19. Even under the most liberal program, sealants were predominantly targeted to teeth at highest risk to decay. Still, for both groups, a significant proportion of the sealants were placed in teeth at points in time quite distant from expected eruption patterns and, thus, their periods of highest risk to decay. Overall, dentists appeared to use sealants only minimally in their practices. These data suggest that sealants can be added to third party dental programs with little overall risk of inappropriate use or abuse. They also suggest that specific efforts are merited to educate providers as to the most effective times at which to provide sealants for preventing the maximum amount of decay in a population.

Adolescent↗
PubMed1995

A survey of the pattern of private general dental practice in Queensland, 1992.

In 1987 all non-specialist ADA member private practitioners in Queensland were invited to participate in a survey to determine the number of the various types of permanent restorations placed in one week and the percentage breakdown of the time they devoted to the various areas of dentistry. Results of that survey were published in 1989. The survey with a few minor changes was repeated in 1992. Results show that there has been little change in the pattern of practice over the five years with restorative dentistry still taking a very large proportion of respondents' time and similar materials being used. The dental workforce appears to be relatively stable with low rates of overseas and interstate migration. There is evidence of an increasing number of women dentists in the workforce and this is emphasized by a breakdown of the current undergraduate enrolment.

Adult↗
PubMed1992

Education in dental anesthesia in the United Kingdom.

This paper describes the present system of education and training for doctors and dentists providing general anesthesia or conscious sedation for dental treatment in the United Kingdom. The changing pattern of practice in these areas is outlined in the context of a changing medicolegal climate, together with the possibilities for future development.

Anesthesia, Dental↗
PubMed1995

Factors influencing the wearing of protective gloves in general dental practice.

The present study was undertaken to explore the factors that influence decisions regarding wearing of gloves in the setting of private general practice. A survey of 250 dentists in Brisbane, Australia (41% of the total private general practitioners in the region), was conducted. Routine use of gloves was commonplace (84.6%); however, many dentists experienced skin problems related to glove use. Years of experience and unsolicited patient comments regarding glove wearing were significantly associated with patterns of glove use, while other factors examined did not exert a significant effect (practice profile, practice location, frequency of treating patients known to have an infectious disease, rate of sharps injuries, choice of glove material, and frequency of adverse mucosal and cutaneous reactions). These results revealed the need for further educational campaigns in practical infection-control measures for all practitioners, regardless of their level of experience. An educational approach used by the authors is described.

Attitude of Health Personnel↗
PubMed1982

Primary care practice patterns.

An interview survey of the primary care practices of a class of dental school graduates was conducted in 1977 as a part of a longitudinal study that was begun 11 years earlier, when these individuals entered dental school. Primary care was defined by the variety of dental treatment procedures used by the dentist and by his or her participation in interdisciplinary aspects of health care. The study showed that: (1) the urban or rural location of the practice was not associated with primary care; (2) the dentists' position in the practice (sole practitioner, group owner, and so forth) was associated with the variety of treatment procedures used; (3) predental school values, dental aptitudes, and dental school achievement were significant predictors of primary care practices; and (4) the two measures of primary care were uncorrelated, and there were several patterns of primary care being practiced.

Adult↗
PubMed1986

Sero-epidemiological study on hepatitis A and B virus infection among dentists in the Philippines.

Dentists in the Philippines were surveyed for evidence of past hepatitis A and B virus infections. Of the 234 dentists examined, 201 (85.9 per cent) were found to have been infected by HA virus and 137 (58.5 per cent) had been infected by HB virus. The proportion with evidence of past HB virus infection increased as the years in dental practice increased. This increment with age was not found in the general population of the Philippines. It is considered that the incremental pattern could be attributed to the summation of risk during many years of providing dental treatment. Comparing the proportion of dentists with HBV antibodies (anti-HBs/c) in the Philippines, Japan, USA and Denmark, the Philippine dentists were found to be more frequently infected than dentists in the other countries. However, the increment in the proportion positive for HBV as the years in practice advanced was consistent with that found in Japan. The prevalence of post HA virus infection in Philippine dentists was higher than the proportion for dentists in Japan but in both countries it is probable that dentists are infected at the same rate as the general population.

Adult↗