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PubMed2005

[Pastoral psychology, spiritual counseling in dentistry. Review of the literature].

Although there were drastic changes in the XX-th century, still 70% of the Hungarian population believe in God, and 10-15% can be counted as active believer. A percentage of 44% of the hospitalised patients indicated a need of pastoral counseling during the treatment time. In the field of psychiatry and psychotherapy the percentage of the need of religious care (pastoral psychology, pastoral counseling) may be even higher. In the field of dentistry the increasing number of psychosomatic patients justify the introduction of such religious treatment methods into the dental care system as well. In this review authors try to collect the main points of this special, religious type of therapy to help dental professionals working in the field of psychosomatic dentistry in the orientation in this interesting and important field.

Dental Care↗
PubMed2005

[The rubber dam in dental practice: use and practical advice].

Use of rubber dam offers many advantages in endodontic, operative and prosthetic procedures. Rubber dam protects the patient against ingestion or inhalation of instruments or chemical products, the cavity against contamination and the dental practitioner against infections. This article gives technical advice for the easy application of rubber dam.

Dental Instruments↗
PubMedDate not supplied

Availability of dental appointments for young children in King County, Washington: implications for access to care.

PURPOSE: The purpose of this study was to determine the proportion of dental offices in King County willing to provide a new appointment to young children and young children on Medicaid. METHODS: A simulated parent phone call was made to 508 randomly chosen dental offices in King County. Of these, 291 offices provided preventive dental care to children. Data were collected on: (1) youngest age seen (options ranged from less than 1 to older than 5 years); (2) whether Medicaid was accepted; and (3) time to first available appointment. RESULTS: In King County, more than 99% of dental offices providing care to children would see new patients 5 years of age or older, but only 15% of these offices would accept 5-year-olds on Medicaid. Nine percent of dental offices accepted patients younger than 1 for a new preventive visit, but just 3% accepted Medicaid-insured children in this age group. CONCLUSIONS: Adhering to recommendations for early initiation of dental care is difficult, given the limited availability of dental appointments for young and Medicaid-insured children.

Appointments and Schedules↗
PubMed2005

Mandibular third molar removal: patient preferences, assessments of oral surgeons and patient flows.

UNLABELLED: Mandibular third molar removal is one of the most common treatments conducted at oral and maxillofacial surgery clinics in Sweden. During the 1980's and 1990's, 20-25,000 mandibular third molars were removed annually which represents about 60% of the total operation volume. Removals performed in private specialist clinics and general dental clinics are not included in these figures. The aims of the present studies on mandibular third molars were to: 1) study values that reflect patients' preferences about possible outcomes of removal and non-removal; 2) make comparisons between Sweden and Wales with respect to patient's preferences; 3) study assessments of oral surgeons' indications for molars to be removed; 4) describe patient flows in the care process of removal. The multi-attribute utility (MAU) method was used to quantify patients' preferences about outcomes following removal and non-removal. Whilst there were clear cultural and economic differences between the Swedish and the Welsh, there was a high degree of correlation in patients' ranking of the different outcomes for patients from the two countries (rs = 0.93, P<0.001). Generally, situations describing the outcomes of non-removal had a higher ranking than those describing the outcomes of removal i.e. patients seemed to prefer non-removal. Oral surgeons at seven specialist clinics registered data for 666 patients i.e. patient age and sex, the angular position and extent of eruption of the molar and whether or not there was an associated disease related to the molar proposed for removal. The indication for the removal was assessed on a Visual Analogue Scale (VAS), and the recorded results found to show a great variety. The mean VAS for removal of molars without disease was significantly lower than that for molars with associated disease. The differences between the mean VAS for molars with one disease compared with molars with two or three diseases were not significant. The patients' age was the only factor that had a significant effect on the assessment of the indication for molars without disease. The indication was higher for patients of the youngest age group than for patients of the oldest age group (P<0.05). In four specialist units in southern Sweden, the patient flows (the number of visits and what the visits comprise of) was registered for 361 patients. All details were recorded from arrival of the referral to the unit to performed mandibular third molar surgery. Eight different patient flows were found. The number of patient visits varied from one to three. For about 60 percent of the patients, attached radiographs to the referral were considered not appropriate and had to be completed, e.g. to be retaken. For a minority of the patients, the radiographic examination was completed at the radiological clinic included in the specialist unit and, in the oral and maxillofacial clinic for the others. The number of patient visits seemed not to depend on whether the attached radiographs were judged to be appropriate or not. IN CONCLUSION: Patient preferences seem to be more stable than the preferences of oral surgeons across the boundaries. Patients prefer outcomes of third molar non-removal as compared to outcomes following removal. Different patient flows may influence the cost-effectiveness in mandibular third molar surgery.

Adolescent↗
PubMed2005

[The inventory of treatment risks and chance of complications in root canal therapy].

Recently two endodontic case assessment forms have been introduced in the Netherlands. The aim of these forms, the Dutch Endodontic Treatment Index (DETI) and the Endodontic Treatment Classification (ETC), is to differentiate between complicated and uncomplicated endodontic cases. Preceding the treatment procedure, these forms may help general practitioners to assess the difficulty and risks of an endodontic treatment and to decide whether to treat the case or to refer it to a specialist. In which way complications may be prevented by using these risk assessment forms is illustrated with two case presentations. Finally, the frequently asked question is addressed whether the treatment of complicated endodontic cases should be exclusively reserved to specialists.

Decision Making↗
PubMed2004

A comprehensive survey of retention procedures in Australia and New Zealand.

OBJECTIVES: This survey aimed to identify consistencies in retention procedures. METHODS: Three hundred Australian orthodontists and 70 New Zealand orthodontists were randomly selected for the study. A questionnaire gathered their views regarding the most commonly used retainers, wire types and sizes of bonded retainers, factors influencing the design of retainers, duration of regular retention, definition of permanent retention, percentage of cases that needed permanent retention, factors influencing the decision to use permanent retention, changes in retention protocols over the last five years, and reasons for such changes. RESULTS: Upper invisible and lower canine-to-canine bonded retainers were the most commonly used retainers. Pretreatment tooth position was the major factor influencing the design of retainers, and most respondents preferred bonded retainers. The majority preferred multistrand stainless steel wire for bonded retainers. The most common wire size was 0.0175 inch. Orthodontists more commonly recommended a regular retention period of more than two years, and defined permanent retention as "lifetime". Orthodontists applied permanent retention to either a very high or very low percentage of their cases. A high percentage of respondents made changes to their retention protocols over the past five years. There was no relationship between factors influencing the design of retainers and the preferred type of retainer. There was no consensus on the major factor influencing the decision to use permanent retention. CONCLUSIONS: Retention procedures are variable and dependent largely on personal preferences. There does not seem to be any consistent pattern in the application of retention methodologies.

Australia↗
PubMed2006

Scope of practice comparison: a tool for curriculum decision making.

The proportion of claims filed for specific dental procedures (ADA codes # 05110, 05120, 03320, 03330, 04260, 02150) between January 1, 2000 and June 30, 2004 by Texas general practitioners participating in a preferred provider network was compared to the proportion of these procedures performed by students graduating from the three Texas dental schools during the same period. Analysis of the data revealed that Texas dental students provide class two amalgam restorations in permanent teeth (02150) at approximately the same frequency as Texas general practitioners. Both groups provide periodontal osseous surgery (04260) at an extremely low frequency (<0.02% of total procedures). Bicuspid endodontic procedures (03320) were performed at a slightly higher frequency by students (0.43% of all procedures) than by general practitioners (0.36% of all procedures), and molar endodontic procedures (03330) were performed at a slightly higher frequency by general practitioners (0.65%) than by students (0.36%). Significant discrepancies between the groups were noted for the two complete denture procedures (05110, 05120). Students provided these procedures at frequencies fifteen times (05110) and twenty-five times (05120) greater than general practitioners. Dental schools should use data provided by scope of practice analyses to help determine an appropriate breadth and depth for their educational programs.

American Dental Association↗
PubMed2006

[Relaxation techniques in dentistry].

In the field of dentistry the increasing number of psychosomatic patients justify the introduction of psychological treatment methods into the dental care system. In this review authors try to collect the main points of the theoretical background and clinical principles of relaxation techniques. Some aspects of the concept of mental hygiene is also discussed to help dental professionals working in the field of general and psychosomatic dentistry in the orientation in this interesting and important field.

Dental Care↗
PubMedDate not supplied

Dental therapeutic practice patterns in the U.S. I. Anesthesia and sedation.

For this first of a two-part article, anesthetic treatment modalities and specific drugs administered for third molar extractions were assessed to determine current office-based therapeutic practices. Questionnaires were mailed to a random national sample of 850 practicing oral surgeons. Survey design and pilot testing was conducted to assure clarity of questions and usefulness of responses. To maximize the response rate, two follow-up letters were sent to non-responders after the initial mailing. Completed questionnaires were returned by 563 practitioners (66.2% response rate). Practicing oral and maxillofacial surgeons were estimated to have performed an average of 52.7 third molar extraction surgery cases per month, using either general anesthesia (46.3%), intravenous conscious sedation (33.4%), nitrous oxide sedation (5.8%), oral sedation (1.7%), or local anesthesia alone (12.9%). For intravenous conscious sedation, a three-drug technique using midazolam, fentanyl, and propofol was reported most commonly. The most frequently selected local anesthetic formulations were 2% lidocaine, 1:100,000 epinephrine for surgical anesthesia and 0.5% bupivacaine, 1:200,000 epinephrine for postoperative pain management.

Anesthesia, Dental↗
PubMed2006

A historical perspective on the University of Nebraska Medical Center's College of Dentistry Class of 1961.

We conducted a retrospective analysis of the University of Nebraska Medical Center (UNMC) College of Dentistry (COD) Class of 1961 to glean information that might be useful in the design of dental education programs in Nebraska and elsewhere. We scanned annual class newsletters, demographic statistics for students entering the UNMC dental program for each decade from 1961 to 2001, and UNMC COD alumni data for patterns and themes among thirty-two dental professionals. Eighty-four percent of those contacted provided responses to a survey. We found that, like current dental cohorts nationwide, the UNMC COD Class of 1961 is mostly of European ancestry (non-Hispanic) and male. But in contrast to current dental college graduates, the UNMC Class of '61 were able to rely upon self-employment and spousal and/or military support (GI Bill) to cover the costs of their dental education. They also were more likely to enter dental school before completion of an undergraduate degree and have a substantial work history before entering the UNMC dental program. Although the most common reason for attending dental school related to independence and financial security, "time with family" and "family vacations" were the next most important reasons cited for becoming dental professionals. Among '61 graduates, the average number of years spent in the dental profession is thirty-seven years. Despite the notable changes in dental technology and the continual need for updating knowledge and skill, eight members of the UNMC COD Class of 1961 continue to practice dentistry. Most maintain contact with other class members, providing support to former classmates and maintaining an identity with their alma mater, the University of Nebraska.

Cohort Studies↗