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At least 1,063 records · Page 59Linked to original sources
PubMed1992

Early childhood tooth decay. Pediatric interventions.

Pediatricians in the greater Chicago area were surveyed to probe their awareness and approaches to management of dental caries in early childhood. A total of 298 pediatricians (21% of those surveyed) responded to the questionnaire. Ninety-five percent of the respondents stated they examined their patients' teeth; 85% considered dental examinations part of their responsibility for children under 3 years of age. However, our data suggest that many pediatricians are unaware of the decay and the dietary patterns associated with tooth decay in early childhood. Although 96% of the respondents referred patients to a dentist when decay was diagnosed, analysis of diet and dietary counseling were performed by only 61% and 65% of the respondents, respectively. Recommendations for preventive measures that can be adopted by pediatricians are offered.

Bottle Feeding↗
PubMed1993

Physical evaluation and the prevention of medical emergencies: vital signs.

It was assumed that dentists employ a complete system of physical evaluation for all new patients in their dental practices. Results of a survey of 1,588 dentists demonstrated that the use of a written medical history questionnaire was commonplace; however, recording of blood pressure and heart rate and rhythm on all new patients was quite limited. A greater percentage of dentists monitored blood pressure when there was a history of cardiovascular disease or high blood pressure. Monitoring of the heart rate and rhythm, even in patients with cardiovascular disease or high blood pressure, was severely limited in scope. A significant number of dentists still employ racemic epinephrine impregnated gingival retraction cord, and of these, 40% had observed "epinephrine-reactions."

Blood Pressure Determination↗
PubMed2001

Dental work force strategies during a period of change and uncertainty.

Both supply and demand influence the ability of the dental work force to adequately and efficiently provide dental care to a U.S. population growing in size and diversity. Major changes are occurring on both sides of the dental care market. Among factors shaping the demand for dental care are changing disease patterns, shifting population demographics, the extent and features of third-party payment, and growth of the economy and the population. The capacity of the dental work force to provide care is influenced by enhancements of productivity and numbers of dental health personnel, as well as their demographic and practice characteristics. The full impact of these changes is difficult to predict. The dentist-to-population ratio does not reflect all the factors that must be considered to develop an effective dental work force policy. Nationally, the dental work force is likely to be adequate for the next several years, but regional work force imbalances appear to exist and may get worse. Against this backdrop of change and uncertainty, future dental work force strategies should strive for short-term responsiveness while avoiding long-term inflexibility. Trends in the work force must be continually monitored. Thorough analysis is required, and action should be taken when necessary.

Delivery of Health Care↗
PubMed1980

Periodontal examination.

With the exception of gingival indices, it is evident that there have not been great changes in the methods used in clinical practice. Rather, the changes made are in the categories of integration of methods and interpretation of data. We know that the extent of periodontal disease cannot be ascertained from any single diagnostic aid alone. The date obtained from the many diagnostic methods described must be evaluated together before an accurate diagnosis can be achieved. A periodontal examination should include a periodontal probing, a radiographic analysis, a gingival index, mobility charting, and an evaluation of the amount of attached gingiva. These clinical exercises require simple instrumentation and a minimal amount of clinical calibration on the part of the examiner. These exercises, however, do not eliminate the need for a general examination that includes the location of caries, plaque index, and medical and dental history. Probing is still considered the single most important examination method in detecting periodontal disease and evaluating therapy. However, probing becomes a great deal more meaningful when combined with data from a gingival index and radiographic analysis. Because the significance of the pocket depth depends not only on the height of the alveolar bone but also on the degree of gingival inflammation, a gingival index should be used as an integral part of a routine examination. A radiographic examination supplements probing by providing information on root length and shape and width of the periodontal ligament space, and aids in determining the configuration of a bony defect. Yet radiographic analysis is of little value without the knowledge of the pocket depths, position of the gingival margin, and mobility patterns. Many forms of sophisticated instrumentation and indices for a periodontal examination have been introduced in the past decade. Unfortunately, many of these new instruments are not practical for clinical practice in their present form. Future trends will no doubt be directed toward simplifying these instruments and indices so that they can be more easily adapted to the clinical practice of periodontics, by both the general dentist and the specialist.

Dental Instruments↗
PubMed2003

Service provision trends among Australian private general dental practitioners: 1983/84 to 1998/99.

AIM: To investigate time trends in service provision. DESIGN: Four cross-sectional surveys across a 15-year period. SETTING: Australian private general practice. PARTICIPANTS: A random sample of dentists. METHODS: Dentists were surveyed by mailed questionnaire in 1983, 1988, 1993 and 1998 (response rates 71%-75%). Data were weighted to provide representative estimates for the age by sex distribution of private general practitioners in 1983, 1988, 1993 and 1998. MAIN OUTCOME MEASURES: Services per visit, annual services per dentist, annual services per patient. RESULTS: Total services per visit increased over the study period from 1.78 to 2.14 (Poisson regression; p < 0.05). However the annual number of services provided per dentist did not vary significantly, reflecting a trend among dentists to supply fewer patient visits per year. The annual number of services provided per patient increased over the period from 3.47 to 5.22 (OLS regression; p < 0.05), reflecting both the increased service rate per visit and increased numbers of visits by patients. Dentists provided less restorative, prosthodontic and extraction services per year, but more endodontic and crown and bridge services. The pattern of annual care received per patient also included more endodontic and crown and bridge services but differed from the dentist pattern through increased service rates over the study period in areas such as restorative, diagnostic and preventive. CONCLUSIONS: While dentists are providing a similar number of services annually, the content of their workload has changed to include less emphasis on removal and replacement of teeth and more effort on maintenance and retention of natural dentitions.

Adult↗
PubMed1990

Use of non-sterile gloves in clinical practice.

This paper reviews the use of non-sterile gloves in dental practice. It is now considered to be normal practice to wear gloves for all dental procedures and although there is considerable controversy regarding patterns of glove use, there is increasing evidence to the effect that single patient use is indicated. Careful use of gloves and proper hand care are key components to effective cross-infection control in clinical practice.

Attitude of Health Personnel↗
PubMed2000

The building blocks of evidence-based dentistry.

The practice of dentistry is becoming more complex and challenging. Changing socio-demographic patterns, patients as knowledgeable health care consumers, rapid technical advances and the information "explosion" all place greater demands on clinical decision making. The need for reliable information and the electronic revolution have come together to allow the "paradigm shift" towards evidence-based health care to progress swiftly. Evidence-based dentistry closes the gap between clinical research and real world dental practice and provides dentists with powerful tools to interpret and apply research findings. Central to evidence-based practice is the systematic literature review, which synthesizes the best evidence and provides the basis for clinical practice guidelines.

Dental Care↗
PubMed2006

[Bulimia nervosa].

Bulimia nervosa is characterized by episodes of binge eating and compensatory behaviours (self-induced vomiting, laxative misuse, dietary restriction). It has a complex aetiology and is mostly found in young women. Bulimia leads to substantial physical and psychosocial morbidity. Bulimia nervosa needs specialized psychotherapeutic treatment. In most cases outpatient treatment is sufficient, but comorbidity with other psychiatric disturbances has to be taken into account. Additional psychopharmacological interventions might be helpful. After 5 to 10 years about 50% of the patients show complete remissions, 30% partial remissions and about 20% a chronic course of the illness. General practitioners, dentists and gynaecologists should be informed about typical signs of the disorder that is often hidden by the patients.

Bulimia↗
PubMed1991

Glove use in clinical practice: a survey of 2000 dentists in England and Wales.

Attitudes to glove wearing by dentists practising within the NHS Regulations were tested by means of a questionnaire distributed to 2000 dentists in England and Wales. The response was 76.5%. The results indicate that 68% of the respondents wore gloves routinely for all patients and procedures, 3% never wore gloves, while the remainder (29%) wore gloves for only selected patients or selected procedures. Reasons given for not wearing gloves routinely included problems of comfort, loss of tactile sensation and the risk of cross-infection, which was perceived to be small. Of the routine glove wearers, only 12% changed gloves between patients, cost being considered to be a factor by 57% of respondents who used gloves for more than one patient. The results indicate that the respondents practising and personal details had an influence on the pattern of glove wearing, with single-handed practitioners and those who graduated before 1979 being less likely to wear gloves routinely. Comparison with the findings of earlier studies of similar type suggest that there is increased awareness in the dental profession of the necessity for glove wearing, but that there is still a need to encourage routine glove use, especially amongst certain groups of GDPs.

Age Factors↗
PubMed2003

[Clinical evaluation of the occlusion of young Senegalese].

The dental occlusion is a basic phase of mastication moreover it is an everlasting concern for the dentist during therapeutic and prevention of dento-maxillo-facial disorders. Senegal is a country of recent dental practice and dental problems are frequent in it. We led this clinical assessment of occlusion on a sample of 30 young Senegalese people aged 18 to 35 years and we tried to evaluate the consequential effects on teeth and periodontal tissues with intent to use this study as pattern of prevalence evaluation of occlusion disorders. Taken at random in the consultation at the Institute of Odontology and Stomatology, these people have been selected by excluding any obvious cause of occlusal disorders. 76.67% of our sample are students and the average patient of the study is à 24 years man, wolof, student dwelling in Dakar. He has an avoid face, is in normocclusion or prognathia and presents a tooth affection which can be related to malocclusion and defective hygiene. 67% of examined teeth are in contact during maximal occlusion and 33% are in entire lack of posterior contact during protrusion meanwhile 73 to 80% present group function. In 70% of studied cases, the superficial periodontium is affected and 30% representing the deep periodontium, are quite safe. This word is a first attempt of prevalence evaluation. It has to be led in multicentric study and at a larger scale in order to have more exact sight of young Senegalese occlusal disorders.

Adolescent↗
PubMed1990

Dental practitioner attendances at postgraduate courses in a dental school.

The attendance pattern of dental practitioners who resided in the West Midlands and attended postgraduate courses at Birmingham University Dental School was studied. Data were collected from the participants as to their name, the location of their practice and the type of course that they attended. Other information such as their qualifications or their attendance at other postgraduate courses was sought from appropriate records. The percentage of West Midlands' dentists who attended postgraduate courses at Birmingham University Dental School was found to be 41%, although this figure was higher amongst Birmingham (53%) and Wolverhampton (51%) practitioners. It is known that practitioners participated in other types of continuing educational activities elsewhere. The majority of dentists attending courses had been qualified for less than 15 years. There were multiple attendances from participants who were already involved in other postgraduate activities such as the MGDS. This study also highlighted the important role of university employed staff in providing postgraduate education for general dental practitioners.

Attitude of Health Personnel↗
PubMed1992

A survey of complete denture prosthetics for the elderly, the handicapped and difficult patients.

A survey was carried out to establish information on the facilities and management of the elderly and the handicapped and to evaluate the treatment of the difficult edentulous patient in general dental practice. A postal questionnaire was sent to a total of 1090 dentists in three regions of England and Wales. There was a 50.4% response. Ninety-nine per cent of practitioners were able to treat the ambulant elderly, whereas only 72% offered treatment if the patient was wheelchair dependent. Ninety-six per cent of all respondents undertook domiciliary visits. All practitioners provided prosthetic treatment (complete and partial dentures) for the elderly, whereas fewer felt able to treat the physically and the mentally handicapped. There was less conservative and periodontal treatment provided than prosthetic treatment. A similar pattern was obtained in all three regions. Forty-seven per cent preferred to treat difficult complete denture patients privately, 44% under the NHS and 6% not at all. There were regional variations in the referral patterns of these difficult denture cases. The majority of respondents considered that there should be more opportunities for postgraduate education in prosthetic dentistry.

Aged↗
PubMed2002

Evaluation of patients by private general practitioners: associations with patient, visit, and service characteristics.

OBJECTIVE: To examine evaluations of patients by dentists, and analyse these by patient, visit and service characteristics. BASIC RESEARCH DESIGN: Mailed questionnaires collected from a random sample of Australian dentists in 1997-98 (response rate = 60.3%; n = 345 private general practitioners provided service data). MAIN OUTCOME MEASURES: Three factor-based sub-scales ('payment', 'no problems', and 'knowledge') and an overall scale ('evaluation') were derived from a 5-item battery. Scale and sub-scale scores ranged between I and 5. Lower scores indicated better evaluation ratings. RESULTS: Nearly 60% of patients had better ratings (scores < or = 2) on the 'payment' and 'no problems' sub-scales, 39.9% on the 'knowledge' sub-scale, and 36.4% on the 'evaluation' scale. Better ratings on all sub-scales and the overall scale were associated with dentate patients, non-emergency visits, insurance, and no decayed teeth (chi2; P<0.05). Those with better 'evaluation' scale ratings (scores < or = 2.0), had higher [Poisson regression, P < or = 0.05; RR=Rate ratio] preventive (RR = 1.30), and crown and bridge rates (RR = 1.88), but lower extraction rates (RR = 0.52). CONCLUSIONS: Desirable characteristics of patients were associated with more favourable evaluation scores by their dentists. Patients with better evaluation scores received a more favourable service pattern.

Adolescent↗
PubMed1988

Simple application of anterior jig or leaf gauge in routine clinical practice.

Utilization of either of the two described methods by dentists is recommended as a simple means to routinely record or provide centric relation closures. The leaf gauge (1 to 6 mm thick) can be made from plastic or x-ray film or it can be purchased. The anterior acrylic resin jig can be made in a few minutes directly in the mouth by the dentist or an assistant or by a technician using mounted casts. Both methods avoid adaptive mandibular closure patterns and dentist-guided jaw closure as well as other commonly unrecognized errors in assessing occlusal contacts.

Dental Instruments↗
PubMed1992

A review of methods to forecast restorative treatment needs.

Decision makers in the areas of health policy, resource allocation, and manpower requirements rely implicitly on estimations of treatment needs on which to base their forecasts. The less specific the treatment-need estimate, the less precise the forecast. In previous decades, high caries rates were so prevalent that the dental profession could risk having inexact projections because overwhelming need and demand existed. However, rampant decay is no longer a common occurrence. Decay levels are declining in our nation's children and adults have fewer missing teeth. Therefore, restorative treatment needs and patterns in adult populations are transforming at a time when health care costs are spiraling and budget analysts at all levels of government are questioning the priority of continued support of dental care, dental education, and dental research at current levels. The purpose of this review is to present the existing methods of forecasting restorative treatment needs and to postulate the development of a new method based on the collective experiences of practicing dentists nationwide, an empirical method, to convert surface-specific oral health status data to restorative treatment need information. Need estimations based on empirical data would more accurately reflect the actual distribution of services that practicing dentists provide.

Adult↗
PubMed2002

Work.

The very nature of work is changing because of rapid social change, a culture of abundance, and the ability to substitute information for equipment, inventory, and other material aspects of value creation. In America, we are experiencing an erosion of the concept of a "job," a dramatic shift to service and information as the basis for value added, market commercialism, and the importance of the self-managed career. In some of these areas, dentistry has been consistent with the patterns of innovation--even being a model in some cases. There are also areas where dentistry is moving in contrary directions.

Attitude of Health Personnel↗
PubMedDate not supplied

The use of behavior management techniques by dentists across practitioner type, age, and geographic region.

The purpose of this project was to describe the behavior management procedures employed for child dental patients based on practitioner type (general dentist vs. pediatric dentist), age, and geographic location. A survey of practice characteristics, which included questions relating to child behavior management, was mailed once to a national random sample of 3000 dentists--2000 general dentists and 1000 pediatric dentists. The pediatric dentists who responded employed a broader spectrum of management techniques than did the general dentists. Significant regional and practitioner age differences were reported in the use of behavior management techniques. The use of sedation and general anesthesia was reported more frequently in the western regions. Of the five age groups, the 40- to 49-year-old age group reported using the broadest spectrum of behavior management techniques. The survey revealed practitioner type, age, and regional differences in the child behavior management procedures employed by dentists.

Adult↗