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PubMed1996

Dentists' perceptions and management of pain experienced by children during treatment: a survey of groups of dentists in the USA and Finland.

Dentists' perceptions and management of the pain experienced by children during treatment were examined in surveys of 198 American and 230 Finnish dentists. Two pain management areas were studied: communication and the use of anaesthetics and sedation. Neither group of dentists routinely questioned children about pain, but encouraging the child to report pain during treatment was more common; the USA dentists asked about pain more often than the Finnish dentists, whereas the Finnish dentists more often encouraged children to report pain. Finnish dentists were much less likely to use local anaesthetics during restorative treatment of either primary or permanent teeth than USA dentists. Neither group of dentists routinely prescribed nitrous oxide sedation, or premedication, or post-operative pain medications. Regarding the dentists' perceptions of pain experienced by children during dental treatment, neither group rated dental treatment procedures as particularly painful or unpleasant. Most dentists found the pain reports of children credible, yet a sizeable minority (up to 67% of the USA dentists and 21% of the Finnish dentists) did not find them strongly credible. There was little relationship between the dentists' pain management behaviour and their perceptions of the pain experienced by their patients.

Adult↗
PubMed1986

Planned change and the future of the dental education system.

Dentistry today faces an environment that clearly requires changes in dental education. Future dentists must be prepared to deal with new patterns of dental disease, revised manpower requirements, and new developments in the nature of dental practice. The dental education system can best adapt to this situation by initiating a process of planned change. A well-developed literature in this area provides both a theoretical framework and a practical approach that the dental education system can follow in its planning process. In this paper, the principles of planned change are interpreted in the context of dental schools' characteristic structure, goals, leadership, and communication mechanisms. The traits of successful change and specific strategies for achieving it are offered as a means for the dental education system to build with confidence a productive and healthy future.

Decision Making↗
PubMed1994

Restorative decision making by Ontario dentists.

One-half of the dentists in general practice in Ontario were randomly selected for a survey in June 1992 to determine their practices and decision-making regarding some aspects of restorative dentistry. Using patient scenarios to describe clinical situations, respondents stated the threshold at which a restoration should be placed in various tooth surfaces of persons of different ages, according to the severity of the carious lesion and the usual restorative procedure for different case situations. A total of 1,276 (52 per cent) dentists responded to a detailed mail questionnaire. Data were entered into a personal computer (PC) and analyzed using frequencies and chi-square with the SPSS/PC+ statistical package. Multivariate analyses were undertaken to examine what characteristics of dentists independently explained variations in their usual restorative procedures for approximal and occlusal caries. With approximal lesions, as seen on bitewing radiographs, 60 per cent of the dentists indicated that they would place a restoration in a 12 year old with an enamel lesion that had not reached the dentino-enamel junction, whereas with 30- and 55-year-old patients, 28 and 20 per cent, respectively, would do so. At each patient age, there was a tendency for significantly younger dentists to restore enamel-only lesions more often than other dentists (p < .01). Variations in proposed treatment for an adult patient with above average oral hygiene, but with a small (1-1.5 mm diameter) occlusal cavity that had penetrated through the dentino-enamel junction, were also observed. In this case, 23 per cent of the dentists would prepare a conventional cavity extending to include all fissures, and restore the tooth with amalgam or composite; 45 per cent would prepare a cavity just larger than the outline of the lesion and restore it in the same way; 32 per cent would prepare a small cavity and place a preventive resin restoration. Significant differences in cavity design were also observed between graduates of the University of Toronto and the University of Western Ontario with respect to restoring approximal carious lesions. A number of the dentists' characteristics were significantly associated (p < .01) with these variations in procedures. These included the dentists' gender, year and university education and type of practice. The documentation and explanation of these large variations in restorative practices have important implications for continuing dental education.

Adult↗
PubMed1995

Private dental practitioners in South Africa--a professional profile.

A questionnaire submitted to dentists in private practice was part of the first National Oral Health Survey 1988/89. The questionnaire investigated demographic and professional characteristics. Completed questionnaires were returned by 2224 dentists (69.5 per cent). Most respondents were located in the 5 main metropolitan areas. There was a paucity of Black and Coloured dentists. Male dentists dominated the profession with almost 74 per cent under 50 years of age. General practitioners made up over 90 per cent of the profession and orthodontists were the largest group of specialists. Conservation was ranked as the most frequently practised service and preventive procedures were ranked low. Medical aid systems were seen to have some disadvantages. Fees and working conditions were felt to be better in private practice than in the public sector.

Adult↗
PubMed1991

Gender trends in dental practice patterns. A review of current U.S. literature.

This paper reviews three recent reports of national gender trends in dental practice patterns. Although the three independent cross-sectional studies were conducted at different points in time, used different sampling strategies, and used similar but independent survey instruments, findings were consistent across studies. In summary: Women dentists are less likely to be married and have fewer children. Women are more likely to assume child rearing and household responsibilities. Women are less likely to be practice owners. Women worked slightly fewer hours per week and weeks per year, and were more likely to take a leave of absence for illness or child rearing. However, women dentists demonstrate a far greater professional work commitment than was previously reported in the literature. Women earn significantly less income from the practice of dentistry, even after controlling for age, practice ownership, hours worked per week, and other personal characteristics. The most current "Gender Wage Gap" estimates range from 57.7% for specialists to 75.4% for general practitioners (8). delta.

Data Collection↗
PubMed2001

An evaluation of attitudes of Midlands female dentists to general dental practice: will it impact upon the future delivery of primary dental care?

INTRODUCTION: Both anecdotal evidence and research indicate that there is a developing manpower shortage in the delivery of dental care in the UK. With the predicted increase in registered female dentists, it is possible that future changes in work patterns might occur. If they are occurring, it is important to understand the needs of these female dentists in order to maximise efficient delivery of dental care. The aim of the study was to identify any gender differences that might exist in attitudes to the delivery of primary dental care within general dental practice in the Midlands. METHOD: A Likert-style questionnaire was sent to all private and registered NHS GDPs who worked within the areas covered by three Midland health authorities. RESULTS: The results indicated that the clinical practice of female GDPs appears to involve less private work than their male counterparts and they seem less inclined than male GDPs to proactive development of private practise. Females were less likely than males to be principals and also less likely than males to employ other dentists. Female GDP attitudes towards management, net income and stress at work appears to differ to those of their male counterparts. There was little difference in gender attitude towards professional ethics and maintenance of clinical standards.

Adult↗
PubMed1988

Private practice of periodontics. Past patterns, future prospects.

The private practice of periodontics has grown in a comparatively short time from a handful of clinicians to a significant factor in the overall practice of dentists. Periodontics has matured into a specialty that interfaces with every aspect of dentistry. Patient awareness demands it service. With the changes taking place in the health delivery system, there has emerged insurance and capitation programs that have influenced the private practice of periodontics. Along with these changes have come economic factors that have encouraged many periodontists to seek new avenues of revenue such as implantology. The dental awareness of the public and the continuance of the high standards of periodontics will prevail. If this is the case, then the future prospects of the private practice of periodontics is ensured.

Delivery of Health Care↗
PubMed1989

A survey of Canadian pediatric dentists: practice characteristics and views on dental education.

The success of caries prevention in the developed countries has resulted in a marked decline in dental disease, especially in pediatric divisions of dental faculties, where an acute problem is finding patients to provide students with the clinical experience they will require in practice. It has become apparent that this changing disease pattern should be accompanied by a re-thinking of educational strategies and objectives to mirror the times and projected trends. While changes in educational strategies will likely be initiated from within the dental faculties, debate and discussion should include those in private practice as well as the academic field. With this in mind, 85 pediatric dentists nation-wide were surveyed regarding their views on educational matters as well as characteristics of their practice and their general profiles. There was widespread agreement on the need for changes in educational strategies and suggestions were made regarding the directions these changes should take.

Attitude of Health Personnel↗
PubMed1996

Criteria of good dental practice generated by general dental practitioners and patients.

A survey was carried out asking patients to evaluate the criteria of good dental practice proposed by patients and dentists. A total of 344 patients from 4 different general dental practices in South East England evaluated 16 criteria of good dental practice. Eight criteria were generated by 30 general dental practitioners and the other eight by 30 patients. Questionnaires containing the 8 pairs of criteria randomly assigned by a computer were drawn up, with each pair containing one patient and one general dental practitioner criterion. Patients were asked to indicate their preference. The number of times each criterion was preferred was scored and ranked. The three highest ranked criteria were explanation of procedures, sterilisation/hygiene and dentist's skills (all criteria proposed from patients), whilst the three lowest ranked criteria were up-to-date equipment, pleasant decor and surroundings and good practice image (all criteria proposed from dentists). Overall the criteria proposed by patients as a group scored significantly more highly than those proposed by dentists as a group. There was variation in rankings relating to the sex, age, pattern of attendance and social class of the respondents.

Adolescent↗
PubMed1985

The implications of changing patterns in oral health for the general practice of dentistry.

Recent reports from several developed countries have shown reductions in caries prevalence, especially amongst children. As a result of these changes, dental practice surveys show that dentists now work fewer hours at the chairside and see fewer patients. There has been a decline in the time patients have to wait for appointments. There is anxiety amongst general dental practitioners that their income is reducing. The school dental service in the developed countries would be the first casualty of the caries-free society, and the reduction in demand for the services of school dental nurses has led to the closure of some training institutions. If the caries decline persists, the volume of restorative work will fall and there will be a shift of emphasis to periodontal care and geriatric dentistry. A change of attitude to the utilization of dental auxiliaries is predicted. In the developing countries, a restorative strategy is no answer to the increasing prevalence of dental caries, as most developing countries cannot afford the armamentarium required or its maintenance. The use of dental auxiliaries, especially dental hygienists, may not cope with the worsening picture of oral disease. It is proposed that volunteers recruited from the urban and rural areas be trained as lay health advisors. The prospects for the dentist in most developing countries are those of excessive work load, high cost of dental services and the continued neglect of preventive dental care.

Adult↗
PubMed1995

Cross-infection compliance of UK dental staff and students.

OBJECTIVES: The objectives of the study were to determine the compliance of a group of dental health care workers and students in aspects of cross-infection control. DESIGN: The dentists and dental students working in a dental clinic were observed by a 'hidden' ceiling-mounted video camera. Procedures were recorded onto videotape and the actions of the observed clinicians and students assessed by two suitably qualified assessors. SETTING: An emergency Oral Medicine clinic in a dental hospital. SUBJECTS: Seventy nine dentists and 35 dental undergraduates. METHODS: The action of staff and students were recorded on videotape and assessed retrospectively. MAIN OUTCOME MEASURES: Degree of compliance with recognised infection control policies. RESULTS: Compliance with recommended guidelines for control of cross-infection was poor. In only 56% of health care worker-patient contacts were protective gloves changed between patients. Facemasks and protective eyewear were only worn in 38% and 29% of such contacts respectively. CONCLUSIONS: Compliance with cross-infection control measures are poor in dentistry--even when clinicians are provided with appropriate facilities.

Attitude of Health Personnel↗
PubMedDate not supplied

African-American physicians' and dentists' perceptions of smoking cessation: solo versus HMO practices.

This study sought to assess the differences in smoking cessation (SC) patient practices and attitudes of physicians and dentists by type of practice (i.e. solo versus group or health maintenance organization [HMO]). Few studies have compared demographics, attitudes, and practices between solo and group providers. The results from this survey of African-American (AA) physicians and dentists provide insights into the perceptions of SC by AA health-care providers in a Southern metropolitan area. Approximately 373 physicians and 90 dentists were mailed questionnaires along with a letter describing the purpose of the study and elements of confidentiality. Dentists and physicians reported nearly the same percentage of smoke-free offices. Physicians were more likely to report that they record information on patients' smoking status and that they counsel patients to quit. Measuring attitudes and current practices among physicians and dentists with regards to SC is essential if health promotion efforts are to have an impact among the AA population.

Adult↗
PubMed2001

The reasons for the extraction of various tooth types in Scotland: a 15-year follow up.

OBJECTIVES: The aim of this survey was to investigate the reasons for extraction of the various tooth types in Scotland. This study replicated one which was undertaken 15 years earlier. A further aim, therefore, was to identify any changes in the frequency of extraction of each tooth type in the 15 years between the two studies. METHODS: The names of every fourth dentist on the list of the Scottish Dental Practice Board were obtained. Four hundred and twenty-five general dental practitioners were asked to record permanent tooth extractions for 1 week. Data requested for each extraction were: the patient's age, gender and dental attendance pattern, the type of tooth removed and the reason for the extraction. RESULTS: Three hundred and fifty-two dentists participated (a response rate of 82.8%). There were 25% fewer teeth extracted per patient and 30% fewer per dentist than in the 1984 study. In 1999, more teeth of most types were extracted from regular attenders whereas, in 1984, more teeth of all types were extracted from irregular attenders. Premolars and first and second molars were the tooth types most frequently extracted in both surveys. In 1999 premolars were the teeth most commonly removed below 21 years of age, accounting for 57.5% of extractions in this age range. Molars accounted for 33.8% of extractions in this age range compared with 52% in 1984. Overall, caries was found to be the principal reason for loss of all tooth types apart from lower incisors which were extracted mainly for periodontal reasons. However, below 21 years, 84.5% of premolar extractions were performed for orthodontic purposes. CONCLUSIONS: Over the last 15 years, the overall number of extractions has reduced and the proportion of extractions from regular attenders has increased. Proportionately more premolars and fewer molars were extracted from under-21-year-olds. This observation can be explained by an increase in orthodontic extractions or a decline in extractions for caries in this age group. However, when extractions from the population as a whole are considered, caries and its sequelae remains the principal reason for loss of all tooth types other than lower incisors which are extracted mainly for periodontal reasons.

Adolescent↗
PubMed1994

Prescribing endodontic retreatment: towards a theory of dentist behaviour.

The large variations observed in dentists' management of periapical lesions in endodontically treated teeth suggest that disease concepts used in clinical practice should be investigated. In the present study it was hypothesized that dentists regard various periapical conditions as different stages on a health continuum. Variations could then be regarded as the result of the individuals selection of differing cut-off points for prescribing retreatment. The hypothesized decision-making model was tested using dental students in Amsterdam (Holland), Gothenburg (Sweden) and Pavia (Italy). The students were shown six simulated cases among which the quality of root filling seal and presence of post and crown were systematically varied. For each case, management of five periapical conditions was assessed. Five options were offered: no therapy, wait-and-see, nonsurgical retreatment, surgical retreatment, and extraction. For each examiner and case a 'retreatment preference score (RPS)' was established. The investigation showed large interindividual variations in RPS. A statistically significant higher mean RPS was seen among students in Pavia compared with students in Amsterdam and Gothenburg. Among all observers and cases it was found that if retreatment was proposed for a certain size of lesion, retreatment was subsequently selected for all larger lesions. The experiment gave evidence in support of the proposed hypothesis. The data also suggest that the choice of retreatment criterion is affected by values, costs of retreatment and technical quality of the original treatment.

Adult↗
PubMedDate not supplied

Israeli dentists: a survey of infection control office practices and care of medically compromised patients.

A survey was conducted by interviewing a randomly selected sample of practicing dentists in Israel in 1991. The aim of this study was to evaluate methods of infection control in current use and to learn about the access to care for medically compromised patients. One hundred seventeen dentists were interviewed. This group represented a majority of graduates from Israeli schools (66). With respect to infection control, only 28% of the population surveyed routinely uses gloves, but 43% use steam autoclave, and 70% use dry-heat sterilization. A very high percentage (87%) took a verbal medical history, while a small minority (27%) had their patients fill out a written questionnaire. Only occasionally was the name of the patient's physician requested or recorded, implying a flaw in interprofessional communications. Only 26% of the dentists said they would treat patients with hepatitis and/or AIDS. Only about half the dentists accepted patients on chemotherapy or radiotherapy or those who were taking anticoagulant drugs. Physical access for dental patients in wheelchair or stretcher was markedly limited, with referral to regional hospitals the routine for these patients.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Oral cancer knowledge and practices of dentists along the Texas-Mexico border.

BACKGROUND: The study assessed the knowledge and clinical practices of Texas-Mexico border dentists in oral cancer prevention and early detection. METHODS: A pretested, self-administered questionnaire was mailed to all 398 dentists registered to practice along the Texas-Mexico border. RESULTS: Inadequacies and ambivalence in respondents' oral cancer knowledge and practices were evident. Performance of oral cancer examinations was associated with positive perception of undergraduate oral cancer training (P =.02). Most respondents (81%) were interested in oral cancer continuing education (CE). CONCLUSIONS: More emphasis on oral cancer training for dental students as well as provision of oral cancer CE to respondents are recommended.

Adult↗
PubMed1976

Dentists and sub-bachelor's degree allied health manpower.

The responses of 176 randomly selected dentists to a written questionnaire were used to assess the attitudes and perceptions of dentists toward subbachelor degree allied health workers. Particularly, demographic characteristics of dentists who employ allied health workers, the patterns of how the dentists utilize the allied health workers, and the dentists' attitudes toward aspects of allied health training were the main points covered. Findings indicate that practicing dentists have a mixed view of the role that paramedical workers can have in increasing dentists' productivity. Although most surveyed dentists agress that auxiliary personal are useful in filing nondental roles, many dentists also are delegating dental functions to these workers.

Allied Health Personnel↗
PubMed2006

[The questionnaire survey to clarify correspondence of medical doctors and dentists in Fukuoka City, Japan, for warfarin therapy at the dental extraction].

PURPOSE: The questionnaire survey was performed in order to clarify correspondence of medical doctors and dentists working at hospital service for warfarin therapy at the dental extraction. METHODS: For 17 senior dentists in 17 hospitals and 142 senior physicians in 82 hospitals in Fukuoka City, we investigated using the questionnaire whether they supported dental extraction under warfarin therapy or not in patients having warfarin treatment with past history of cardioembolic stroke due to non-valvular atrial fibrillation (NVAF). Specialty and experience of stroke after withdrawal of warfarin were also asked in medical doctors. RESULT: The reply was obtained from 14 dentists (82.4%) and 66 doctors (46.5%). The number of dentists and doctors who pull out a tooth under warfarin treatment continuation were 12 persons (85.7%) and 32 persons (48.5%), respectively. The rates in doctors whose specialty was stroke, cardiovascular disease, and others were 78.6% (11/14), 36.0% (9/25), and 44.4% (12/27), respectively. The rate in stroke specialists was significantly higher than that in cardiovascular disease specialists (p = 0.019). The stroke specialists had experience of stroke after withdrawal of warfarin more frequently than the cardiovascular disease specialists (57.1% vs. 20.0%, p = 0.033). CONCLUSION: The rates of acceptance in tooth extraction under warfarin treatment continuation of the dentist were high in Fukuoka city, while that of the medical doctors were not. Rate of doctor's acceptance differed according to the specialties, and may be affected by experience of stroke after cessation of warfarin therapy.

Anticoagulants↗