PubMed Health⌕ Search

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.

At least 289 records · Page 16Linked to original sources
PubMed2000

Optimum bitewing examination recall intervals assessed by computer simulation.

OBJECTIVE: To assess the effect of altering bitewing examination recall intervals on health gain from dental restorative treatment and to determine optimum recall intervals under varying clinical conditions. DESIGN: A computer simulation of the caries process in posterior approximal tooth surfaces. The effect of superimposing restorative treatment, based on diagnoses from bitewing radiological examinations carried out at differing time intervals, was incorporated. Input data included caries attack rates, median survival times of restorations, and sensitivity (Sn) and specificity (Sp) of treatment decision making by a high (A) and a low (B) performing dentist. PARTICIPANTS: A hypothetical population, initially 14-15 years old. INTERVENTIONS: Class II amalgam restorations. OUTCOME: Health gain in utility based units (UBUs) was assessed relative to interim end point UBUs pertaining under 'do nothing scenarios'. RESULTS: One thousand approximal surfaces, designated initially as 920 sound, 51 carious and 29 filled were followed in the model over 10 years. The greatest health gain (39.33 UBUs) was from dentist A (Sn = 0.23, Sp = 0.99, restoration median survival time = 20 years, caries rate = 4.4% per annum, optimal recall interval between bitewing radiological examinations = 7 months). The least was from dentist B (Sn = 0.52, Sp = 0.88, median survival time = 5 years. caries rate = 0.0% per annum, optimal recall interval between bitewing radiological examinations > 120 months) representing a loss of 16.79 UBUs compared with 'do nothing'. CONCLUSIONS: In the best interests of their patients, it would seem that dentists need to exercise considerable caution in making positive decisions to restore approximal tooth surfaces on the basis of bitewing radiographic evidence and that for some dentists current guidelines for bitewing examination intervals would appear to be too permissive.

Computer Simulation↗
PubMed2003

Restorative service patterns in Australia: amalgam, composite resin and glass ionomer restorations.

AIM: To examine the provision of amalgam, composite resin and glass ionomer restorations, and to assess whether these main restorative services varied by patient, visit and oral health characteristics. DESIGN: A cross-sectional survey incorporating a log of service items provided on a typical day. SETTING: Australian private general practice. METHODS: Data on services and patients were collected by a mailed survey from a random sample of dentists from each State/Territory in Australia in 1998-99 with a response rate of 71%. MAIN OUTCOME MEASURES: Rates per visit of amalgam, composite resin and glass ionomer restorations among dentate adults who had received a restoration. RESULTS: Analysis showed older patients had lower amalgam rates but higher glass ionomer rates, composite resin rates were lower at emergency visits, capital city patients had higher amalgam rates but lower composite resin rates, patients with decayed teeth had higher amalgam and composite resin rates, and use of restorative materials varied by clinical problem. CONCLUSIONS: Despite widespread use of alternative materials, amalgam rates remained high in circumstances such as replacement restorations and restorations involving more than one surface. Other restorative materials also had specific applications. Both amalgam and composite resins were provided at higher rates to patients with active caries but composite resins were also used at higher rates for aesthetic problems. Glass ionomer restorations were used at higher rates for initial and one-surface restorations, and for conditions such as root caries and dentinal sensitivity.

Adult↗
PubMed2001

[Intracanal medication used in general dentistry].

In order to investigate the use of intracanal substances during root canal treatment 400 dentists were asked to take part in a questionnaire survey. Questions related to the substances used, the reason for use and the way they were used. Studied were the possible influences by the variables 'year of graduation', 'number of patients in practice', 'dental school'. The results show a general use of sodiumhypochlorite and calciumhydroxide. Also a frequent use of substances with possible systemic side effects was reported. A positive trend is the fewer use of these medicaments by dentists who qualified more recently.

Adult↗
PubMedDate not supplied

The reasons for tooth extractions in adults and their validation.

OBJECTIVES: To investigate the primary reasons for the extraction of permanent teeth in adults and to validate the dentists' reasons for extraction. METHODS: Twenty-one dentists in the Greater Manchester area took part in the study. These dentists provided extracted teeth stored in 10% buffered formal saline together with details of the patient's age, sex, dental attendance pattern and the reason for extraction. In order to validate the reasons for extraction, teeth were examined for the presence or absence of coronal and root caries. A subgroup of 80 teeth, half of which were extracted primarily for caries and half for periodontal reasons were selected, stained and attachment loss measured at six sites per tooth to validate periodontal reasons for extraction. RESULTS: Three hundred and eighty-nine teeth were collected of which 37% were extracted primarily due to caries and 29% due to periodontal disease. Caries was the main reason for extraction in patients under 50 years, whereas periodontal disease was the commonest reason in the over-50 age group. Irregular attenders had more extractions for caries than regular attenders but attendance pattern did not affect the proportion of teeth extracted for periodontal reasons. The mean greatest loss of attachment on teeth extracted for periodontal reasons was 12 mm compared with 6.5 mm for caries. CONCLUSION: In this group of patients caries was the most common reason for extraction of teeth but periodontal disease became a more important reason for extraction after 50 years of age. The study validated the dentists' given reason for extraction.

Adolescent↗
PubMed1999

HIV infection and oral health care in South Africa.

This study determined the knowledge, attitude and practice of oral health care workers in public clinics in South Africa towards HIV/AIDS and investigated the implementation of infection control measures. A total of 727 questionnaires were distributed to dentists, dental therapists, oral hygienists and chairside assistants in the public dental clinics of 9 provinces, of which 276 were returned from 8 provinces, giving a response rate of 38%. The questionnaire covered demographic factors and assessed issues such as knowledge, infection control practices, continuing education, legal, ethical and psychosocial issues and available support for HIV/AIDS. The common oral manifestations seen by respondents were candidiasis, acute necrotising ulcerative gingivitis (ANUG), hairy leukoplakia and Kaposi's sarcoma. Of the 174 who had a previous HIV test, 48% were for insurance purposes and 21% for post-needle-stick injury. Over 10% of the respondents indicated that gloves were not available at all, that there was an inadequate supply of water, and that there was no autoclave in their clinic. Nearly 50% of the clinicians had not had hepatitis B vaccination in the last 3 years. Fifteen respondents (5.4%) were not willing to treat HIV-positive patients. Only 48% had access to a written post-exposure management protocol and post-exposure medication was available to only 36.6%. The vast majority of the respondents clearly expressed a need for additional education on HIV/AIDS. The study demonstrated a need to add knowledge, enhance personal skills and improve the application of universal precautions.

AIDS Serodiagnosis↗
PubMed2002

The use of restraint in the treatment of paediatric dental patients: old and new insights.

OBJECTIVE: This article reviews aspects of the restraint strategies in paediatric dentistry that have been reviewed in recent years and point out those strategies that remain controversial as well as questionable. METHODS: Studies that evaluated demographic and cultural factors that influence dentists' use of restraint, discussion of the rationale behind the use of restraint, the role of parents, informed consent, use of restraints at the undergraduate and at the postgraduate level, and some ethical questions were selected. CONCLUSIONS: Practice location, caries prevalence, and the educational backgrounds of the dentist played a role in the selection of behavioural strategies. Use of these techniques varied depending on the age of the dentist and the dental school from which the dentist had graduated. Parents are one leg of the child/dentist/parent triangle and therefore have a role to play in the determination of treatment strategies. Dentists must select techniques that help to instill a positive dental attitude in the child by performing treatment effectively and efficiently. Dentists must inform parents of all aspects of the applied strategy and must have their approval.

Child↗
PubMed2000

Referral patterns and the referral system for oral surgery care. Part 1: General dental practitioner referral patterns.

OBJECTIVE: To investigate current GDP oral surgery referral patterns given the anticipated change since the introduction by the General Dental Council of the specialty of surgical dentistry. DESIGN: Postal questionnaire. SETTING: 400 GDPs in Greater Manchester. RESULTS: 84% participation rate. 69% of dentists made a referral because of anticipated difficulty of surgery and 49% because of the complex nature of the patients' medical history. Practitioners who had undergone some oral surgery postgraduate training were more likely to undertake more surgery in their practices (P < 0.01) and to refer more patients for specialist care (P < 0.05). While female practitioners rated their own surgical confidence less highly than male practitioners (P < 0.001), and younger practitioners less than their older colleagues (P < 0.05), there was no significant difference in the number of referrals made. CONCLUSION: The most common reasons for referral were the anticipated difficulty of surgery and patient medical compromise. There was a wide variation between practitioners in the number of patients referred for specialist care. Postgraduate oral surgery training was identified as a factor contributing to this variation. Other practitioner variables, such as sex, experience and type of practice were not found to contribute.

Adult↗
PubMed2003

Changes in restorative caries treatment in 15-year-olds in Oslo, Norway, 1979-1996.

OBJECTIVES: To examine changing patterns regarding restorative treatment criteria for dental caries. METHODS: A representative sample (n = 215) was drawn from all 15-year-olds receiving dental treatment in the Public Dental Service (PDS) in Oslo, Norway for each of the years 1979, 1989, 1993 and 1996. Information from clinical records and bitewing radiographs on caries treatment was collected. The results presented in this paper pertain to 198, 201, 209 and 208 subjects in each group. RESULTS: The results revealed dramatic changes in the use of restorative treatment criteria. Only 16% of tooth surfaces were treated in 1996 according to the criteria from 1979. The number of sound surfaces was found to have increased by 39% whereas the number of filled surfaces was reduced by 92%. In spite of more stringent criteria for restorative treatment, the number of D4 lesions did not increase. CONCLUSION: The practice of change in restorative treatment continued during the 17 years of study. Though the number of decayed surfaces appeared to be stable during the period, in reality, there was a reduction in caries occurrence during the first 10-year period (1979-1989). A conceptual model of dentists' caries-related treatment decisions outlined by Bader & Shugars may be used to explain parts of the rapid change in the criteria used in the PDS in Oslo.

Adolescent↗
PubMed2006

Root canal treatment in a population-based adult sample: differences in patient factors and types of teeth treated between endodontists and general dentists.

OBJECTIVE: The purpose of this study was to identify in a population-based study the differences between general dentists and endodontists with regard to types of teeth treated, fees, and patient characteristics. BASIC RESEARCH DESIGN: The "Florida Dental Care Study" was a prospective cohort study using a representative baseline sample of 873 dentate adults. In-person interviews and clinical examinations were conducted at baseline, 24 months, and 48 months, with 6-monthly telephone interviews between those times. Dental record information was abstracted afterward. RESULTS: A total of 100 root canals were performed in participants during the study period. While generalists performed the majority of endodontic procedures in all teeth, the percentage of molars treated by endodontists was significantly higher than the percentage of anterior teeth and bicuspids treated by endodontists. Data on fees were available in 85 of the cases. The trend was for endodontists fees to be higher, but the difference in fees was statistically significant only for molars. There were no statistically significant differences between generalist and specialist patients with regard to income, fear of pain, and frustration from previous dental care. However, a significantly higher percentage of patients treated by endodontists had dental insurance. CONCLUSIONS: Although the number of teeth ultimately treated in this representative sample of a dentate population was small, results do suggest that endodontists' fees were higher, they performed a higher percentage of molar root canals, and their patients were more likely to have dental insurance, as compared to general dentists who did root canals.

Chi-Square Distribution↗
PubMedDate not supplied

Children's utilization of dental care in the NC Medicaid program.

PURPOSE: To characterize the patterns of dental care in the North Carolina (NC) Medicaid Program for three- and eight-year-old children who began dental treatment in the 1985-86 and 1990-91 groups. We also compared the children's patterns of care by provider (general dentists versus pediatric dentists). METHODS: Our extensive data set included claims, enrollment, and provider data. Children were assigned to one of five categories or patterns of care as follows: complete care, general anesthesia care, sporadic care, emergency only care, and no care. Statistical comparisons of the variables age, cohort year, and provider groups were made. RESULTS: The use of Medicaid dental services by both age groups was severely limited in both yearly cohorts. Pediatric dentists tended to provide more complete and less sporadic care for both age groups and both yearly cohorts. CONCLUSIONS: Financing dental care through Medicaid results in very low levels of complete care among enrollees, and any plan that limits referral to pediatric dentists might adversely affect the number of enrollees who receive complete care.

Age Factors↗
PubMedDate not supplied

Board certification status and pediatric dentists' practice characteristics.

PURPOSE: Board certification is often used as a surrogate indicator of provider competence and quality of care, although few studies have demonstrated its validity. The aim of this study was to assess the relationship between board certification status and a set of quality characteristics of pediatric dental practice. METHODS: A 30-item questionnaire was developed that collected information regarding practice characteristics in the areas of: (1) professional growth/practice management; (2) emergency readiness; (3) treatment guidelines utilization; (4) patient pool selection; (5) safety; and (6) behavior management. The questionnaire was mailed to 250 board-certified and 250 noncertified pediatric dentists paired by year and program of graduation. RESULTS: Overall, respondents-irrespective of pairing by program and year of graduation-tended to answer affirmatively or largely positively to most questions. Maintaining hospital privileges and having routinely CPR-certified staff were significantly related to the board certification status. When year of graduation and residency program attended was considered, however, this significance disappeared. In categories of treatment guidelines utilization, patient pool selection, safety protocols and behavior management, there was no significant difference between board certified and nonboard certified pediatric dentists (P > .05). CONCLUSIONS: Generally, pediatric dentists independent of certification status, practice at a high level of quality, as measured in this study.

Certification↗
PubMedDate not supplied

Determining when to refer periodontal patients--clinical guidelines.

As part of the examination and evaluation of the patient, it is the dentist's responsibility to evaluate the periodontal tissues for the presence or absence of periodontal disease. If the practitioner finds that periodontal disease is present and is unwilling or unable to accurately diagnose and/or treat the type or extent of the disease, the dentist must offer the patient the opportunity to be evaluated by a practitioner who can complete the examination and diagnostic process.

Decision Making↗
PubMed1998

The use of systemic antibiotics in dental practice.

Clinical dental practice is immersed in the primary treatment and corrective management of infectious bacterial diseases of the oral and peri-oral region. Systemic antibiotics play a key role in achieving either therapeutic and/or prophylactic treatment goals. There are a number of theoretical considerations associated with the use of systemic antibiotics in dental practice. These are related to the principles of infection management, microbiology and host response, and the pharmacology of the particular agent. In the clinical setting, these principles are modulated by a number of factors. These factors need to be understood to ensure appropriate prescribing of antibiotics. Minimizing the occurrence of antibiotic misuse and abuse has global implications for the containment of resistant bacterial strains. This paper discusses some of the current understanding of prescribing practices by dentists. Also presented is an outline of the factors that may be considered in the use of antibiotics.

Administration, Oral↗
PubMed2004

Survey of dental prophylaxes rendered by pediatric dentists in New England.

BACKGROUND: The objective of this anonymous postal survey was to assess the provision of dental prophylaxis by pediatric dentists in New England. METHODS: The questionnaire survey was sent by first class mail in September, 2001 to all 217 American Academy of Pediatric Dentistry (AAPD) members in active private practice in the six New England States of Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, and Vermont. A self-addressed, stamped envelope was provided to facilitate the returned response. RESULTS: The survey had a response rate of 70%. Most practitioners (93%) routinely recommended dental prophylaxis for their recall patients. The proportion of practitioners who considered the following indications for recommending dental prophylaxis was: plaque, stain, and/or calculus removal - 99%; caries prevention - 75%; prior to topical fluoride application - 82%; prior to sealant application - 58%; and for behavioral modification - 68%. Almost two thirds of the practitioners (62%) defined dental prophylaxis as referring to both rubber cup pumice prophylaxis as well as to toothbrush prophylaxis. However, only one in four practitioners (26%) had modified her/his clinical practice to substitute toothbrush prophylaxis in lieu of rubber cup pumice prophylaxis. CONCLUSION: Pediatric dentists in New England routinely provide dental prophylaxis to their recall patients.

Behavior Therapy↗
PubMed1997

Variation in the use of crowns and their alternatives.

The use of crowns and their alternatives for the restoration of compromised posterior teeth is of interest to educators, purchasers, and patients. Considerable curricular time is devoted to learning these techniques, substantial amounts of money are spent on these procedures, and differences in the outcomes of these treatments may have consequences for tooth survival. To begin to understand more about the actual use of these procedures, the provision rates of these services in a sample of U.S. dental practices were examined. This study reports on the extent to which utilization patterns and subsequent costs of crowns and their alternatives were associated with certain patient and practice characteristics. Insurance claims for dental services submitted by general dental practices through an electronic claims clearinghouse were used. Crown ratios (crowns/crowns plus alternatives) were calculated for dental practices to evaluate relationships with available explanatory variables. Findings indicated that older patients were significantly more likely to receive crowns than those in younger groups, resulting in as much as a 33 percent increase in the mean per tooth cost of treatment in the oldest group. Regional variation existed in the provision of crowns and resulted in up to a 31 percent difference in the mean per tooth treatment cost between regions. Crown ratios exhibited variation beyond that accounted for by patient and practice factors, thus raising questions about the consistency of treatment recommendations among dentists. These findings support the need to examine further the consistency of crown use among general dentists and to modify current approaches for teaching treatment planning in predoctoral restorative curricula.

Adolescent↗
PubMed2001

Ethics and dentistry: 2. Ethics and risk management.

The previous paper explored the meaning of ethics, especially its relationship to dentistry. Here, we examine a practical application for solving ethical problems. Together, the two articles should provide dentists with a core of relevant knowledge about ethics and a ready guide to the daily relevance of ethics.

Bioethical Issues↗
PubMed2006

Patients with special health care needs in general and pediatric dental practices in Ontario.

The objective of this study was to determine the involvement of Ontario's general and pediatric dentists in providing care to patients with special health care needs (PSHCNs). A questionnaire was developed and sent to a randomly selected sample of general dentists and to all pediatric dentists in Ontario; response rates were 52% and 90%, respectively. Most general dentists and all pediatric dentists reported that they provided a full range of dental services to PSHCNs. Most (80%) general dentists treat PSHCNs of all ages, whereas 60% of pediatric dentists report only treating PSHCNs up to the age of 18 years. A majority of both groups report treating PSHCNs whose dental care is paid through various government-funded programs. Most general dentists received training in the treatment of PSHCNs in undergraduate dental school, and 40% reported taking continuing education courses in this area. Most pediatric dentists received this training during their advanced dental specialty training, and 29% reported taking continuing education courses in this area. The results of this survey appear to demonstrate that general and pediatric dentists in Ontario provide a full range of dental services to PSHCNs, treat patients with a variety of disabilities and of all ages and are interested in pursuing continuing education that focuses on the delivery of dental care to PSHCNs. However, the results may be inaccurate because of question design flaws and responder bias among the 52% of surveyed general dentists who returned their questionnaires.

Adolescent↗