Evidence-based Dentistry, dentists, and dental materials.
Explore the source record for details and available documents.
Advertising↗
SEARCH · PubMed Health
Results for “Practice Patterns, Dentists'”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Patterns of oral care in dental school and general dental practice.
This study compared patterns of oral care provided by predoctoral dental students for patients seeking treatment at the University of Washington (UW) with patterns reported for general dental offices by the Washington Dental Service (WDS). Dental care included about 5 million services provided to 880,317 patients by 2,803 WDS general dentists and about 45,600 dental services provided to 9,488 patients by 155 UW dental students during 1999. There was high fidelity between databases and randomly surveyed patient records for treatment provided in both UW (95 percent) and WDS (97 percent) populations. While patient age patterns were generally similar, UW students completed more procedures for young children and for adults older than seventy-four years but completed fewer procedures for age groups of from thirteen to eighteen and from forty-five to fifty-four than general dental offices. The relative mix of all services completed by UW and WDS providers was similar (ANOVA, P=0.82). Within categories of service, the percentage of total services completed by students compared to those submitted by community dentists to WDS was about the same for examinations, radiographs, fluoride and sealants, amalgams, composites, single crowns, and endodontics. The percentage of total procedures completed showed a greater emphasis by UW students on inlays/onlays, dentures, extractions, and periodontal maintenance, and lesser experience with implants, orthodontics, sedation, and emergency procedures than general dental offices. We conclude that the relative distribution of clinical services provided by UW dental students is comparable to those procedures reported to WDS by dental offices in the adjacent community.
Adolescent↗
Perspective of a practicing dentist on the concept of evidence-based dentistry.
Explore the source record for details and available documents.
Decision Making↗
Do dentists prescribe narcotics excessively?
Dealing with pain is an inevitable sequela to dental treatment. Although several drug regimens primarily involving narcotics have been used in the past, availability of nonsteroidal anti-inflammatory drugs (NSAIDs) has increased recently. A study was conducted to analyze dental prescribing patterns for analgesics. Data analysis of a survey of 130 dentists revealed that respondents still rely on narcotic analgesics for pain relief and generally exceed needed potency and quantities in their prescribing habits. Dentists are treating rather than preventing pain, and NSAIDs are underused.
Analgesics, Opioid↗
Differences in dentists' working postures when adopting proprioceptive derivation vs. conventional concept.
New technologies and changes in dental care, including the proprioceptive derivation (Pd) concept, aimed at providing dentists with greater comfort and better health, were introduced in Thailand. The aim of this study was to investigate the differences in dentists' working postures when adopting different work concepts: Pd and the conventional concept. The results showed differences in dentists' sitting posture, clock-related working positions, and Rapid Upper Limb Assessment (RULA) scores. This implied that Pd helped dentists to discover new ways of positioning themselves, and working comfortably and effectively, which made it possible for them to adopt better working posture and have lower RULA scores. In conclusion, the Pd concept had a positive effect on dentists' working posture.
Adaptation, Physiological↗
Research of importance to the practicing dentist: 2004 ADA research agenda.
Explore the source record for details and available documents.
American Dental Association↗
Tobacco attitudes, practices, and behaviors: a survey of dentists participating in managed care.
Tobacco cessation knowledge, attitudes, and behaviors of dentists participating in a large national managed care dental plan were assessed using a mailed survey. The survey was administered to dentists recruited to participate in an evaluation of a CD-ROM and supportive electronic detailing to promote increased tobacco cessation activities. General dentists who met specific technological criteria, had an active E-mail account, and at least 200 adult patients were eligible to participate in this study. A total of 184 dentists, located in 29 states, agreed to participate. The survey instrument included questions that addressed (a) Ask, Advise, Assess, Assist, and Arrange behaviors, (b) self-efficacy including knowledge, confidence, and success regarding tobacco cessation, (c) success of various tobacco cessation strategies, (d) barriers to tobacco cessation, and (e) demographics including year of graduation, gender, and race/ethnicity. Self-reported baseline tobacco intervention-related behaviors were low, with 28% of dentists reporting that they asked their patients about tobacco or recorded tobacco use in their patients' charts at least 41% of the time. For Advise behavior, approximately half of the dentists advised tobacco-using patients to quit at least 41% of the time. Although self-reported lack of knowledge was high, 71% of respondents indicated that their lack of knowledge was either not a barrier or a slight barrier to incorporating tobacco cessation into their practices. The survey revealed that dentists do not routinely incorporate tobacco cessation into their practices. Newer information-transfer technologies may serve as vehicles for increased smoking cessation activities by dentists.
Attitude of Health Personnel↗
Dentists and oral cancer prevention in the UK: opinions, attitudes and practices to screening for mucosal lesions and to counselling patients on tobacco and alcohol use: baseline data from 1991.
OBJECTIVE: To investigate the opinions, attitudes and practices towards oral cancer prevention among UK dentists as a baseline from which to measure the need for continuing education efforts in this area. DESIGN AND METHOD: Postal questionnaire survey carried out in August 1991. A questionnaire with 13 test items was piloted at continuing education courses then distributed to all subscribers of the British Dental Journal with a postage paid return envelope. The aspects inquired into were recent attempts by dentists at updating their knowledge on oral cancer, their practical approaches to screening for oral mucosal diseases and follow-up actions after oral screening, their questions to patients regarding the major risk factors for oral cancer, their efforts towards behavioural counselling for patients and any constraints felt or experienced in this regard. RESULTS: The questionnaire was circulated to 15,836 dentists. The response rate of 16% was poor but due to the many dentists circulated, 2519 responses were available for analysis. This large sample, though presumptively biased towards those interested in professional matters, showed an encouraging 84% claiming to perform screening of the oral mucosa routinely. Among these, 74% reported referral of screen detected cases to a hospital for further attention and only 4% would adopt a wait and see policy. Disturbingly, half of the respondents did not enquire about risk habits related to oral cancer and, among the other half who claimed to make such enquiries, only 30% routinely provided brief health education advice concerning these. Seventy-one percent agreed that giving advice against tobacco use is desirable but major constraints were identified, notably a lack of training, and frustration regarding patient compliance. There was even greater reluctance on the part of the respondents to enquire into the alcohol use of their patients and to provide advice on alcohol moderation. CONCLUSIONS: Most of this large but unrepresentative sample of UK dentists were carrying out screening of the oral mucosa as a part of their prevention activities in 1991. However, the survey indicated a considerable need for improvement in the manner and extent of provision of health advice in respect of the major risk factors for oral cancer: such a substantial need amongst the presumptively better motivated implies that the need amongst the practitioner population at large is even greater.
Alcohol Drinking↗
Research in dental practice: a 'SWOT' analysis.
Most dental treatment, in most countries, is carried out in general dental practice. There is therefore a potential wealth of research material, although clinical evaluations have generally been carried out on hospital-based patients. Many types of research, such as clinical evaluations and assessments of new materials, may be appropriate to dental practice. Principal problems are that dental practices are established to treat patients efficiently and to provide an income for the staff of the practice. Time spent on research therefore cannot be used for patient treatment, so there are cost implications. Critics of practice-based research have commented on the lack of calibration of operative diagnoses and other variables; however, this variability is the stuff of dental practice, the real-world situation. Many of the difficulties in carrying out research in dental practice may be overcome. For the enlightened, it may be possible to turn observations based on the volume of treatment carried out in practice into robust, clinically related and relevant research projects based in the real world of dental practice.
Attitude of Health Personnel↗
Adoption of innovative caries-control services in dental practice: a survey of Washington State dentists.
To assess the adoptability of the medical model for caries control, the authors surveyed general dentists about their use of four caries-control services among adult patients: salivary functioning tests, fluoride varnishes, chlorhexidine rinses, and pit-and-fissure sealants. Responses indicated that leaders in the dental community and those with a wider network of professional colleagues were likely to adopt new services more quickly than other dentists. Earlier adopters also had more correct information about these services than later or nonadopters. Overall, the knowledge base of the services studied in this survey was not uniform, making adoption of the medical model for caries control premature.
Adult↗
The American Dental Association's oral cancer campaign: the impact on consumers and dentists.
BACKGROUND: The ADA conducted a public service campaign in late 2001 to raise awareness of oral cancer and of the dentist's role in early detection. METHODS: To gather information about the impact of this campaign, the ADA undertook two surveys. A telephone survey was conducted among 1,270 adult consumers, and a second survey was mailed to a national sample of 2,500 dentists. RESULTS: The majority of the consumers did not recognize the fact that dentists are responsible for examining their patients for oral cancer and that oral cancer claims more lives than melanoma or cervical cancer. The majority of dentists was aware of the ADA campaign and agreed that it helped raise the public's awareness of oral cancer and the importance of early detection. As a result, more dentists said that they are likely to educate their patients about early detection, adjust their own practice routines to include discussion about the disease, and look more closely for small oral lesions and test them with the brush biopsy test. CONCLUSIONS: The results of the survey of dentists demonstrated that the oral cancer awareness initiative sponsored by the ADA resulted in positive behavioral changes targeted toward the early detection of oral cancer. CLINICAL IMPLICATIONS: Continued efforts to provide health education and health promotion interventions aimed at consumers and dentists invariably will result in the detection of oral cancers at early and curable stages.
Adult↗
Oral and pharyngeal cancer: knowledge and opinions of dentists in British Columbia and Nova Scotia.
Oral and pharyngeal cancers are largely preventable and can be successfully treated when diagnosed at an early stage. Dentists in British Columbia and Nova Scotia were surveyed regarding their knowledge and opinions about oral and pharyngeal cancer. In February 1998 a pretested 41-item survey was mailed to a random sample of dentists in British Columbia and the population of dentists in Nova Scotia. A reminder postcard and one additional mailing were sent to nonrespondents. Of the 670 dentists supplying usable responses (response rate 55.2%) only 56.7% agreed that their knowledge of the subject was current. Most dentists correctly identified tobacco use (99.4%) and alcohol use (90.4%) as risk factors, but fewer correctly identified factors such as the use of spicy foods (57.0%) and poor oral hygiene (46.3%) as not being risk factors. Only 42.5% identified both erythroplakia and leukoplakia, in that order, as the conditions most likely associated with oral cancer. Indices of risk and diagnostic knowledge were constructed by summing the number of correct responses to items in each domain. On 16 risk factors the mean correct score was 9.2, and on 14 diagnostic procedures the mean correct score was 10.0. Only 38.5% of dentists had consistent levels of knowledge on both indices. Differences between the provinces were statistically significant (p < 0.01) for only 2 knowledge items. About three-quarters of all dentists (77.0%) were interested in taking continuing education courses. Dentists in British Columbia and Nova Scotia could benefit from undergraduate and continuing education courses to increase their knowledge of risk and diagnostic factors for oral cancer.
Adult↗
Dental education and care for underserved patients: an analysis of students' intentions and alumni behavior.
The U.S. surgeon general's report on oral health stressed the importance of providing dental care to underserved patients. The objectives of this study were to explore a) dental students' intentions and dentists' behavior concerning treating underserved patients, b) their perceptions of their education concerning these patients, and c) the relationship between dental education and their attitudes and behavior. Data were collected from 328 dental students (response rate: 77.5 percent) and 234 alumni (response rate: 43.7 percent). Only 67.4 percent of the students and 38 percent of the alumni indicated that their education had prepared them well to treat patients from different socioeconomic backgrounds; 71.3 percent of students and 55.2 percent of alumni responded that they had been well educated to treat patients from different ethnic/racial groups. The findings showed a positive relationship between the degree of curriculum focus on the importance of treating patients from all aspects of society and students' and alumni intentions to provide inclusive patient care to patients from diverse backgrounds. The more students agreed that their dental education had prepared them well to treat patients from different ethnic backgrounds, the more likely they were to report that they intended to treat these patients (r=.12; p=.033). In a similar manner, the more the alumni agreed that their dental education had prepared them well to treat patients in different communities, the more likely they were to treat patients from different socioeconomic backgrounds (r=.18; p=.009). In conclusion, these findings showed that access to oral health care for underserved patients could potentially be increased if dental students were more overtly educated about the importance of treating patients from all segments of society.
Adult↗
A quality assurance review of the patient referral process and user satisfaction of outpatient general anaesthesia services for dental treatment.
In many parts of the United Kingdom the Community Dental Service (CDS) receives a consistently high level of referrals for general anaesthetic (GA) provision from general dental practitioners (GDPs), predominantly for the treatment of pain in young children. To provide a safe and effective service it is essential to have an appropriate and satisfactory referral process. As part of the established quality assurance programme in the East Kent CDS two surveys utilising self-complete postal questionnaires were conducted, the first to assess GDP's opinions and to examine their referral procedure, the second to gauge user satisfaction with the overall care provided by the CDS-GA service. The main findings suggested a lack of effective communication both between health professionals and with their patients. Over 80 per cent of the GDPs considered either the existing CDS referral guidelines needed clarification or did not even know such guidelines existed. Parents of referred children reported a high level of satisfaction with the service provided by the CDS, but some were critical of a lack of immediate access for children in pain. The finding of greatest concern was that 50 per cent of the parents stated their child's GDP did not explain the possible risks of general anaesthesia prior to referral and 70 per cent were offered no alternative form of treatment to a general anaesthetic. The results of this study should be fed into the continuing quality assurance programme to enable the effective and appropriate development of the CDS-GA service.
Ambulatory Care↗
Developing a treatment philosophy.
Developing a philosophy is an excellent way to begin a dental career. Many dentists reading this column already are well into practice and may have developed a philosophy without realizing it. It is important to reflect on that philosophy and even write it down to clarify the direction you would like your practice to take. Our experience in consulting to more than 7,500 practices has shown that many dentists completely change the direction and vision for their practice when the philosophy is clearly established and documented. This change often gives these dentists greater profitability and the opportunity to retire at an earlier age.
Humans↗
Antibiotic prescribing by general dental practitioners in the Greater Glasgow Health Board, Scotland.
OBJECTIVE: To investigate antibiotic prescribing patterns by general dental practitioners (GDPs) in the Greater Glasgow Health Board Area, Scotland. STUDY DESIGN: A 10% sample of prescriptions were selected at random from 35,545 prescriptions written by GDPs over a 6-month period. MAIN OUTCOME MEASURES: Absolute and relative frequencies were used to describe the different classes of antibiotics used and the variations in prescribing practice. RESULTS: GDPs prescribed a wide range of antibiotics. Seventeen different antibiotics were prescribed with amoxycillin, metronidazole and penicillin V accounting for almost 90% of the prescriptions. In general the antibiotics were prescribed at the British National Formulary (BNF) recommended doses. There were, however, wide variations in the frequencies and durations of the prescriptions for all antibiotics. CONCLUSIONS: The present study provides evidence of sub-optimal prescribing of antibiotics by dentists in Scotland, with considerable variation from the recommended frequencies and doses.
Anti-Bacterial Agents↗
General dental practitioners' experiences of a collaborative clinical audit on antibiotic prescribing: a qualitative study.
OBJECTIVE: To evaluate general dental practitioners' experiences of a multi-collaborative antibiotic prescribing audit. DESIGN: Qualitative analysis of compulsory post-audit group report data collection forms and individual practitioners' post-audit evaluation forms. SUBJECTS: Information was collected from 175 general dental practitioners in the North West of England who participated in the audit. METHOD: The general dental practitioners were divided into groups of 8-10 to undertake the audit. Information from compulsory post-audit group reports was transcribed and analysed. The information was categorised into a number of areas including changes in practice, patients' expectations, training and quality of service. On completion of the audit individual practitioners were asked to complete an evaluation form on the audit process. RESULTS: 141 (80.5%) individual evaluation forms were returned. Over 90% of GDPs felt that the audit process was easily understood and the majority of the practitioners thought the audit was worthwhile. Approximately 69% of participants felt that the audit had helped to change their antibiotic prescribing practices. Analysis of the post-audit group report data collection forms revealed more than 100 statements. The most common areas were changes required in practice, patients' expectations, increased training and quality of service. CONCLUSION: The collaborative clinical audit project was seen to be a worthwhile learning experience by the participating general dental practitioners. The audit encouraged GDPs to change their antibiotic prescribing practices and thereby improve patient care. GDPs also highlighted the need for continuing education in the prescribing of antibiotics.
Anti-Bacterial Agents↗
Knowing how to help tobacco users. Dentists' familiarity and compliance with the clinical practice guideline.
BACKGROUND: A U.S. Public Health Service-sponsored clinical practice guideline urges all health care providers to make tobacco-use cessation counseling a routine part of clinical practice. This study assessed practices of dentists in east Texas, their adherence to the guideline and barriers to adherence. METHODS: A cross-sectional survey mailed September 2003 through January 2004 assessed demographic characteristics and knowledge, attitudes and activities of 783 dentists. The survey focused on familiarity with the guideline, adherence to the recommended steps (including the "5 A's" for tobacco users willing to quit and the "5 R's" for tobacco users unwilling to quit), perceived barriers and time spent counseling. RESULTS: Most dentists were unfamiliar with the guideline and usually did not follow its recommended steps. Less than 20 percent of dentists spent three or more minutes per patient on counseling. Knowledge of and training in using the guideline were significantly associated with adherence and time spent counseling. Lack of training was cited as the greatest barrier. CONCLUSIONS: Most dentists in east Texas are unaware of the clinical practice guideline. Lack of training is a major barrier to adherence. Practice Implications. Opportunities for improving patients' health through brief counseling interventions are missed. Measures are needed to increase dentists' familiarity with and adherence to the guideline.
Adult↗