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PubMed2000

Dentists' participation in capitation and preferred provider organization dental plans.

BACKGROUND: In 1998, the American Dental Association Survey Center conducted a telephone and mail survey of U.S dentists in private practice in an effort to determine the extent of dentists' participation in capitation and preferred provider organization, or PPO, dental plans and the characteristics of dentists who participate in those plans. METHODS: An initial phone screening survey was conducted with a random sample of 11,550 dentists in private practice. Dentists who indicated that they participated in capitation or PPO dental plans received a follow-up mail survey asking specific questions concerning these two types of dental plans. RESULTS: Almost one-half of responding dentists indicated that they participated in either capitation or PPO dental plans. However, far more dentists reported participating in PPO dental plans than in capitation dental plans. The majority of participating dentists' patients were reported to be fee-for-service patients. CONCLUSIONS: Dentists' participation in PPO dental plans generally increased from that indicated in previous surveys, though participation in capitation plans declined. There was some regional and demographic variation in participation in these dental plans, but such differences were not large. Pricing and concerns about quality of care continue to be the primary concerns of nonparticipating dentists. PRACTICE IMPLICATIONS: Dentists reporting participation in PPO dental plans are becoming more common, but such plans still do not cover the majority of participating dentists' patients. A large percentage of nonparticipating dentists cite pricing and concerns about quality care as reasons for not joining these plans.

American Dental Association↗
PubMed2005

Plaque removal efficacy of a prototype manual toothbrush versus an ADA reference manual toothbrush with and without dental floss.

OBJECTIVE: The objective of this study was to compare the plaque removal efficacy of a prototype manual Deep Clean toothbrush versus an American Dental Association (ADA) manual toothbrush and the ADA manual toothbrush in conjunction with floss. METHODS: This study was a randomized, examiner-blind, six-period cross-over, single-center study conducted in 60 adult subjects that examined plaque removal with a prototype Deep Clean manual toothbrush, an ADA reference manual toothbrush, and an ADA reference manual toothbrush followed by floss. During the course of this study, subjects used each treatment two times. Plaque was scored before and after brushing using the Rustogi Modification of the Navy Plaque Index. A mixed model analysis of covariance (ANCOVA) for a crossover design with baseline plaque score as the covariate was applied to the baseline minus one-minute post-brushing differences in average whole-mouth plaque scores. Supplemental analyses were also performed using the ANCOVA model separately for average gingival margin scores and for average interproximal scores, using the appropriate baseline score as the covariate. All comparisons were two-sided at the 0.05 level of significance. RESULTS: The prototype Deep Clean manual toothbrush delivered an adjusted (via ANCOVA) mean difference between baseline and post-brushing plaque scores of 0.245, while the ADA manual toothbrush plus floss delivered an adjusted mean difference of 0.207 versus 0.196 for the ADA manual toothbrush alone. The prototype Deep Clean manual toothbrush demonstrated a statistically significantly greater reduction in plaque than the ADA manual toothbrush plus floss (p<0.001), which in turn had a statistically significantly greater reduction in plaque than the ADA manual toothbrush alone (p<0.001). The prototype Deep Clean manual toothbrush group had, on average, 25.2% and 18.3% greater plaque removal scores than the ADA manual toothbrush alone and the ADA manual toothbrush plus floss groups, respectively. Results for the interproximal and gingival margin regions also demonstrated statistically significantly (p<0.001) greater plaque removal for the prototype Deep Clean manual toothbrush group relative to the other groups. CONCLUSIONS: The prototype manual Deep Clean toothbrush was found to deliver greater plaque removal by 25.2% and 18.3% compared to the control manual toothbrush group (ADA reference manual toothbrush) and ADA manual toothbrush plus floss group.

Adult↗
PubMedDate not supplied

The impact of concentration in dental insurance markets on dental reimbursement in Minnesota.

The following article has been prepared by the American Dental Association (ADA) at the request of the Minnesota Dental Association (MDA). The article is the culmination of a rigorous national study by the ADA to measure the concentration of dental insurance in major dental marketplaces around the country. Five Metropolitan Statistical Areas (MSA's)from Minnesota were compared to other MSA's around the country. The results of this study are very significant for dentists and dental patients in Minnesota. Minnesota' practicing dental community may find the results of the study to be somewhat disturbing. Nevertheless, the MDA believes that it is important to share the results of this study with MDA members and others in the Minnesota dental community. It is important to consider both the study's short-term ramifications, as well as its long-term implications, as we attempt to better understand Minnesota's dental marketplace. It is also important for MDA members to know that the ADA brought the results of this study as they relate to the Minnesota Dental Marketplace to the appropriate federal agencies. The ADA believed that these agencies might choose to develop it into an anti-trust case. After reviewing the matter and working with the ADA over a long period of time, these agencies decided that they would not proceed with a Minnesota-based anti-trust case; additional information beyond what the ADA was legally able to provide was needed by the federal agencies in order for them to proceed. The MDA will continue to analyze and respond to these dental marketplace developments.

Cities↗
PubMed2000

Comparison of gingivitis and plaque efficacy of a battery-powered toothbrush and an ADA-provided manual toothbrush.

This examiner-blind clinical study evaluated the efficacy of a new battery-powered toothbrush with oscillating head (Colgate Actibrush) on established gingivitis and plaque at 15 days and again at 30 days, as compared to a control manual toothbrush (American Dental Association [ADA]-provided toothbrush, full head, soft bristles). A total of 63 participants completed the study. They were stratified into two balanced groups according to their mean baseline prebrushing plaque scores and were randomly assigned to use the battery-powered test toothbrush or the manual control toothbrush. Participants were instructed to brush their teeth twice daily (mornings and evenings) for 1 minute with their assigned toothbrush for the 30-day duration of the study. Gingivitis and plaque (pre- and postbrushing) examinations were conducted by the same dental examiner at baseline, after 15 days, and again after 30 days. The Colgate Actibrush demonstrated a significantly greater reduction of plaque (46.53%) and gingivitis (18.57%) when compared to the ADA-provided toothbrush after 30 days of use. Additionally, a comparison of the plaque scores for the battery-powered toothbrush at 15 and 30 days shows a continued reduction in plaque of more than 25% for a cumulative difference from baseline of 73%. These results support the conclusion that the new battery-powered toothbrush is clinically superior in plaque removal efficacy and gingivitis efficacy to the manual toothbrush, and continues to significantly improve plaque scores even up to 30 days of use.

Adolescent↗
PubMed1997

A 5-year retrospective analysis of employer-provided dental care for Finnish male industrial workers.

The treatment-mix, treatment time, and dental status of 268 male industrial workers entitled to employer-provided dental care were studied. The data were collected from treatment records of the covered workers over the 5-year period 1989-93. Treatment time was based on clinical treatment time recorded per patient visit, and the treatment procedure codes were reclassified into a treatment-mix according to American Dental Association categories, with a modification combining endodontics and restorative treatment. The mean number of check-ups followed by prescribed treatment (treatment courses) during the 5 years was 3.7 among those who had entered the in-house dental care program prior to the monitored period (old attenders). Their treatment time was stable, 57-63 min per year, while the first-year mean treatment time (170 min) of those who had entered the program during the study period (new attenders) was significantly higher (P < 0.01) than the 5-year mean of the old attenders (61 min). Over the first 2 years, the treatment-mix of the new attenders showed a rise in diagnostic and preventive procedures from one-third to about one-half of all procedures, as it was for the old attenders. The new attenders' mean number of carious teeth (2.7), registered at the initial check-up visit, paralleled the mean recently demonstrated in the similar non-covered population. It was significantly higher than the 5-year mean of the old attenders (0.5) (P < 0.001), but declined to the same level after the first year of treatment. It was concluded that the studied program seemed to contribute to a stabilization of treatment-mix, and to the establishment of a shorter annual treatment time within the first 2 years of treatment.

American Dental Association↗
PubMed2002

A review of the science regarding dental unit waterlines.

BACKGROUND: The National Institute of Dental and Craniofacial Research, or NIDCR; the American Dental Association, or ADA; and the Organization for Safety & Asepsis Procedures, or OSAP, sponsored a workshop on the topic of dental unit waterlines, or DUWLs, on Sept. 29, 2000, at the National Institutes of Health in Bethesda, Md. These organizations invited a group of experts from the ADA, NIDCR, OSAP, the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention, the U.S. Department of Defense, academia and private industry to participate. TYPES OF STUDIES REVIEWED: The sponsors asked the participants to critically review the scientific literature on the subject in an attempt to determine the evidence basis for management of DUWL contamination and potential health risks, if any, in dental procedures. The ultimate goal of the workshop was to determine if a research agenda in the area of DUWLs should be pursued and what questions such an agenda should involve. RESULTS: The workshop yielded four questions that need to be addressed in future research: What is the safest and most effective agent(s)/device(s) for achieving microbial levels of no more than 200 colony-forming units per milliliter, or CFU/mL, in the effluent dental water? How should these products be evaluated and by whom? What are the adverse health effects, if any, of chronic exposure to dental bioaerosol or to the agents introduced into the dental unit to treat the waterlines for both dental staff members and patients? How could these health issues be evaluated? CLINICAL IMPLICATIONS: Developing evidence-based parameters for the management of biofilm contamination that are efficacious and cost-effective will allow clinicians to meet in proposed ADA standard of no more than 200 CFU/mL of effluent water.

American Dental Association↗
PubMed2000

Comparative efficacy of Colgate Actibrush battery-powered toothbrush and Colgate Plus (manual) toothbrush on established plaque and gingivitis: a 30-day clinical study in New Jersey.

The objective of this 30-day clinical study, conducted in harmony with American Dental Association guidelines, was to evaluate the efficacy of a new battery-powered toothbrush (Colgate Actibrush) relative to a manual toothbrush (Colgate Plus Diamond Head Toothbrush, Full Head, Soft Bristle) in the control of supragingival plaque and gingivitis. A total of 110 adult men and women from the Northern New Jersey area were entered into the study and stratified into 2 balanced groups according to baseline plaque and gingivitis scores. Participants were instructed to brush twice daily (morning and evening) for 1 minute with their assigned toothbrush and a commercially available toothpaste (Colgate Cavity Protection Great Regular Flavor Fluoride Toothpaste). Examinations for plaque and gingivitis were conducted by the same dental examiner at baseline, after 15 days, and again after 30 days of product use. All 110 participants complied with the protocol and completed the 30-day clinical study. At the 30-day examinations, the group using the Colgate Actibrush battery-powered toothbrush exhibited a statistically significant greater reduction in plaque (26.7%) and in gingivitis (25.8%) than did the group who used the Colgate Plus Diamond Head Toothbrush. The results of this 30-day clinical study support the conclusion that the Colgate Actibrush battery-powered toothbrush provides a clinically superior level of efficacy for the control of supragingival plaque and for the control of gingivitis when compared with a manual toothbrush.

Adolescent↗
PubMed2005

[Use of questionnaires in screening for risk factors in the dental care of elderly patients].

The medical and dental history is one of the crucial part of the routine dental practice. According to a survey performed in 2001 27% of the total Hungarian population was above the age of 60. The prognosis forecasts an increasing tendency in life expectancy and an even higher percentage of elderly population in the foreseeable future. Due to the increasing life expectancy the risk for complications of common dental treatments is also increasing. More care and attention should be paid to anticipate the occurrence of sudden complications during dental treatment that might also be a life threatening condition. In 1941 the American Dental Association drew up a questionnaire based on the risk groups established by the American Society of Anaesthesiologists (ASA). In 1993 K.J.M. de Jong et al. presented the results of their experience with the clinical application of these questionnaires. Based on their studies the Dental Working Group of the Health Committee of the European Council recommended the European application of this questionnaire. The major objective of our investigation was to evaluate how this questionnaire--developed by ASA--can assist the proper registration of the medical history in dental practice. Our survey also investigated how the risk groups distributed among the subjects. The data of 207 randomly selected individuals from the patient pool of the Dental Faculty of Semmelweis University were processed. The data of risk groups distribution is outlined here: ASAI:35,8%, ASAII:24%, ASAIII:17%, ASAIV:23,2%. In the age group 60+ the following distributions were obtained: ASAI:20,9%, ASAII:13,2%, ASAIII:24,2%, and ASAIV:41,7%. The results of this survey also confirmed that the occurrence of ASAIII and ASAIV risk scores increased in the age of 60+. Consequently the number of patients whose treatment plan should be modified due to health risk factors is also increasing. It can be stated that the ASA classification is appropriate to inform the dentist about the general physical status and health problems of the patients that may influence the dental treatment.

Aged↗
PubMed1994

Paul Sheppard Burnham, DDS (1903-1987).

A search via databases and indexes, as well as the American Dental Association package library collection, yielded no evidence of participation by American dentists in outboard motor or hydroplane inboard motor boat racing. There may be or have been such participants, but the contributions of Paul Sheppard Burnham, DDS are noteworthy and quite probably unique. Competing always as an amateur, his racing ability was respected; on many occasions he outraced professional drivers. Dr. Burnham led an interesting life. In his 83 years, he operated and soon thereafter traded automobile after automobile (a total of 49)--satisfying his love for fast and unusual cars. While practicing dentistry most of his adult life, he managed to become an integral part of the Rehoboth Beach, DE beach patrol, serving for ten years as captain of lifeguards and, in a few of his senior years, as chief. As the 20th century comes to a close, a good deal is written and spoken about those identified as unusual, vibrant, daring, spirited, competitive, self-confident, and colorful--travelers in the fast lane. Paul S. Burnham, DDS spent a great part of his life in the fast lane, with very few in front of him.

Automobiles↗
PubMed1977

Diagnostic and preventive services in a national incremental dental plan for children.

A modelling exercise was carried out to examine the potential expenditure in a national incremental dental program for children aged six to 13. Using Relative Value Units (RVUs) as a proxy for dollars, the relative expenditures for care per child in fluoridated and fluoride-deficient areas were assessed. Dental treatment requirements were taken from existing data as far as possible. Arrangements for the delivery of care were based on existing pocicies of the American Dental Association, an services delivered were based on the recommendations of the American Academy of Pedodontics and the American Society of Dentistry for Children. Orthodontic care was limited to space maintainers and simple interceptive care. Children were assumed to receive initial care at age six, and annual maintenance care from ages seven to 13. The results showed that although restorative care would be 49.8 percent less expensive for children in fluoridated areas, total care would be only 11.9 percent less expensive. The major reason for this difference was the high proportion of annual maintenance-care costs that would be absorbed by diagnostic and preventive services using UCR fees. The necessity for much of this care is questioned under the conditions of this model, and some methods by which the dental profession might control the relatively high cost of diagnostic-preventive services are suggested.

Adolescent↗
PubMed2001

The comparative anticaries efficacy of a dentifrice containing 0.3% triclosan and 2.0% copolymer in a 0.243% sodium fluoride/silica base and a dentifrice containing 0.243% sodium fluoride/silica base: a two-year coronal caries clinical trial on adults in Israel.

The purpose of this two-year clinical study was to provide a comparison of the anticaries efficacy associated with two commercially available, American Dental Association-accepted dentifrices: Colgate Total Toothpaste, which contains 0.3% triclosan and 2% copolymer in a 0.243% sodium fluoride/silica base; and Crest Cavity Fighting Toothpaste with Fluoristat, which contains 0.243% sodium fluoride in a silica base. The study was conducted in harmony with the published 1988 American Dental Association guidelines for studies geared toward the comparison of fluoride dentifrices. The study employed a double-blind parallel-group design, and involved adults living in communities throughout Israel. Qualifying subjects were randomly assigned to the two treatment groups, with multiple subjects in the same household all assigned to the dentifrice randomly allocated to the first among them. Caries examinations were conducted in accordance with U.S. Food and Drug Administration guidelines for the clinical evaluation of drugs to prevent dental caries. Two calibrated examiners performed all of the measurements. After treatment assignment, study participants were instructed to brush their teeth at home with their assigned dentifrice at least twice daily. Brushing instructions were reinforced by indoctrination in proper oral hygiene techniques by dental professionals, supplemented by pamphlets supplied by the sponsor and yearly mailings to participants, emphasizing good oral hygiene and the need to ensure compliance with the study. Post-baseline examinations were performed after one year of product use, and again after two years of product use. Three-thousand, three-hundred and ninety-two (3,392) subjects completed this two-year study. For these subjects, the mean caries scores (DFS, decayed or filled surfaces) at baseline were 21.96 for the Colgate Total Toothpaste group, and 21.49 for the Crest Cavity Fighting Toothpaste with Fluoristat group. For caries increment after one year, the respective means were 1.37 for the Colgate Total Toothpaste group, and 1.56 for the Crest Cavity Fighting Toothpaste with Fluoristat group. After two years, the mean caries increments were 1.46 for the Colgate Total Toothpaste group, and 1.75 for the Crest Cavity Fighting Toothpaste with Fluoristat group. No statically significant difference was indicated between the treatment groups at baseline. However, for both the one-year and two-year increments, there was a statistically significant difference between treatment groups. Relative to the Crest Cavity Fighting Toothpaste with Fluoristat group, the Colgate Total Toothpaste group presented a 12.2% reduction in caries increment scores at one year, and a 16.6% reduction in caries increment scores at two years. In accordance with the procedures and standards provided by the published guidelines of the American Dental Association for the comparison of the anticaries efficacy of fluoride dentifrices, the results of this study support the conclusion that Colgate Total Toothpaste provides a superior level of coronal anticaries efficacy compared to Crest Cavity Fighting Toothpaste with Fluoristat.

Adult↗