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PubMedDate not supplied

The "metal-free" myth.

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Attitude of Health Personnel↗
PubMedDate not supplied

Behavior management techniques among pediatric dentists practicing in the southeastern United States.

PURPOSE: This study identifies those techniques most often utilized by pediatric dentists practicing in the Southeastern United States. It also assesses how the utilization pattern may have changed within the last five years, and identifies those factors that may have influenced the changes as perceived by the practicing dentists. METHODS: A questionnaire was mailed to 528 pediatric dentists who were members of the American Academy of Pediatric Dentistry, or The Southeastern Society of Pediatric Dentistry, or both. RESULTS: The response rate after one mailing and one reminder was 64%. The majority of dentists utilized less aversive behavior management techniques (e.g., parents in the operatory and nitrous oxide oxygen) and had decreased or discontinued use of such controversial techniques as Hand-Over-Mouth-Exercise (HOME) and Hand-Over-Mouth-With-Airway Restriction (HOMAR). The majority of dentists reported that their reasons for changes in the utilization pattern for most techniques were parental influences and legal and ethical concerns. CONCLUSIONS: Chi square analysis indicated significant differences (P < 0.05) in the frequency of use of behavior management techniques and age of practitioner, American Board of Pediatric Dentistry status, type of specialty training, and type of practice.

Adult↗
PubMed1988

Practice patterns of male and female dentists.

The 1985 ADA Survey of Dental Practice was used to compare practice characteristics of 1,414 males and 110 females who graduated from dental school in or after 1975. Similarities and differences in practice, patient, and productivity characteristics were identified among male and female dentists. Additionally, multivariate analyses showed gender, practice type, and age as significant predictors of productivity.

Adult↗
PubMed2006

Disseminating evidence from health technology assessment: the case of tobacco prevention.

OBJECTIVES: The aims of the present study were to investigate the awareness among dentists and dental hygienists of evidence-based reports and guidelines on tobacco cessation activities and the impact these publications had on clinical practice. METHODS: A questionnaire was mailed to dental hygienists and dentists in Stockholm County, Sweden, and the results were compared with a previous investigation. RESULTS: Among the respondents, awareness of a popular science version of a systematic review on smoking and its effect on oral health was reported by 90 percent of the hygienists and 66 percent of the dentists. The information was used in clinical work by 34 percent of the dentists and 54 percent of the hygienists. Reported changes in patterns of practice were more frequent recommendations to use nicotine replacement therapy and a more widespread use of setting quit dates. Approximately one quarter of the dental professionals reported that they had increased tobacco cessation consultation because of the results from the reports. CONCLUSIONS: Changes in patterns of practice were observed after dissemination of evidence-based information on tobacco cessation. Methods that were proven to be effective in the evidence-based report such as discussing quit dates and recommending nicotine replacement therapy were more commonly used after the publication of the report. Short, popular versions of extensive systematic reviews seem to be useful for implementing evidence-based knowledge and changing clinical practice.

Dental Hygienists↗
PubMed2001

Practice belief scales among private general dental practitioners.

BACKGROUND: Practice beliefs have been related to service rate variation. The aims of this study were to replicate practice belief scales in Australia and investigate associations with dentist and practice characteristics and services. METHODS: A random sample of Australian dentists completed mailed questionnaires (response rate 60.3 per cent). RESULTS: Private general practitioners (n = 345) provided service data from a typical day. Eight practice belief items were recorded on a five-point Likert scale, yielding four factor-based scales. Approximately 85 per cent of responses were on the agreement side of the midpoint for the scales of Information giving and Patient influence, 45 per cent for Preventive orientation and approximately 10 per cent for Controlling active disease rather than developing better preventive advice. Capital city dentists had higher agreement with the Preventive orientation scale, while males and older dentists showed less disagreement with the Controlling active disease item (Mann-Whitney, Kruskal-Wallis P < 0.05). Those agreeing with the scales (that is scores < or = the median) showed (Poisson regression P < 0.05): a higher rate of crown and bridge, a rate ratio (RR) of 1.31, but lower rates of extraction (RR = 0.76) and prosthodontic services (RR = 0.64) for the Information giving scale; a higher rate of restorative (RR = 1.22) and total services per visit (RR = 1.06) for the Preventive orientation scale; a higher rate of preventive services (RR = 1.14), but a lower rate of crown and bridge services (0.78) for the Patient influence scale; and higher rates of crown and bridge (RR = 1.40) and prosthodontic (RR = 1.59) but lower rates of periodontic (RR = 0.60) and extraction services (RR = 0.62) for the Controlling active disease item. CONCLUSIONS: These findings confirm the factor structure of practice beliefs and demonstrate small to moderate associations with variation in service rates.

Adult↗
PubMed2003

Diagnostic and preventive service trends in private general practice: 1983-1984 to 1998-1999.

BACKGROUND: Aggregate trends have indicated increases in the provision of diagnostic and preventive services but there have been few reports based on their component sub-categories. The aims of this study were to investigate time trends in the provision of sub-categories of diagnostic an preventive services across a 15-year period. METHODS: A random sample of Australian dentists was surveyed by mailed questionnaire in 1983-1984, 1988-1989, 1993-1994 and 1998-1999 (response rates 71-75 per cent). Data were weighted to provide representative estimates for the age by sex distribution of private general practitioners in 1983, 1988, 1993 and 1998. RESULTS: Rates per visit were higher, Poisson regression, P<0.05, in 1998-1999 compared to baseline for examinations, radiographs, prophylaxis and topical fluoride. Diagnostic and preventive service rates varied by age of patient: compared to patients aged 65+ years, examinations were higher among children aged <5 years to adults aged 25-44 years, radiographs were lower among children <5 years and 5-11 years but higher among adults aged from 18-24 years to 45-64 years, prophylaxis services were lower among children <5 years but higher among adolescents 12-17 years to adults aged 45-64 years, while topical fluoride was higher among children 5-11 years and adolescents 12-17 years. CONCLUSIONS: Examination, radiograph, prophylaxis, and topical fluoride rates increased over the study period. While examination rates increased for both children and adults, and prophylaxis rates increased for adolescents and adults, rates for radiographs and topical fluoride only increased for adults. Age-specific changes in service rates over time indicate the effect of changing oral health status and population demographics on service provision.

Adolescent↗
PubMedDate not supplied

How tough is that root canal?

It is not uncommon to be faced with difficult treatment planning decisions when a patient presents with an endodontic problem during a routine day in the practice of general dentistry. Signs and symptoms of pulpal or periapical disease dictate the need for decision-making, and frequently the result of that decision is magnified by the patient experiencing severe pain. Our purpose is to present a link between case selection based on risk factors and the self-assessment of the dentist regarding his or her ability or motivation to treat a given case.

Attitude of Health Personnel↗
PubMed1997

What do we know about how dentists make caries-related treatment decisions?

A conceptual model of dentists' treatment decision-making is discussed. The model suggests that dentists do not use a hypothetico-deductive process for the diagnosis of caries. Rather, caries is identified through a process of pattern recognition that in most instances is inextricably linked to intervention decisions. Individual dentists have inventories of caries scripts that, when matched by a particular clinical presentation, lead to decisions to treat. The scripts comprise salient factors that are dependent on individual dentist's characteristics and biases, and thus vary substantially across dentists. The scripts tend to be complex, highly visual, and difficult to describe. All of these characteristics suggest that efforts to improve dentists' caries-related treatment decisions should acknowledge this knowledge structure and be designed to change the salient factors or interpretations of salient factors within the context of the caries script.

Attitude of Health Personnel↗
PubMed2006

Endodontic treatment outcome: survey of oral health care professionals.

This study assessed the opinion of oral health care professionals regarding the predictability of initial endodontic treatment, expected long-term outcome and the importance of placing a coronal coverage after completion of treatment. An eight-item questionnaire was distributed among oral health care professionals. There were 49% of participants who responded that the expected retention rate of teeth 5 to 10 yr after endodontic treatment was more than 90%, whereas 44% responded that such retention rate was between 70 to 80%. The majority of the participants also responded that the need for additional treatment, such as retreatment, apical surgery or extraction, was expected to occur within the first 3 yr after endodontic treatment if initial treatment has failed. About 87% of participants responded that placing coronal coverage after completion of endodontic treatment in premolars and molars was very important for long-term tooth retention and 92% responded that overall, endodontic treatment was a predictable procedure with long-term tooth retention rate. Statistically significant associations were found between years of experience and expected rate of retention for both the total group of respondents (p < 0.001) and for general practitioners when examined separately (p < 0.002). Statistically significant associations were only found for general practitioners between years of experience and their responses regarding the need for additional treatment (p < 0.05) and overall predictability of endodontic treatment (p < 0.02). A trend was found between the professionals' years of experience and their opinion regarding the importance of coronal coverage. Of the group who had more than 20 yr of experience, about 87% considered coronal coverage to be very important for long-term tooth retention. In conclusion, it appears that most clinicians participating in this study consider endodontic therapy to be a predictable procedure with long-term tooth retention rate. Their opinions also reflect the variations that currently exist in the literature regarding the reported outcome of endodontic treatment.

Adult↗
PubMed1996

Reasons for dentists' acceptance or rejection of microbiological root canal sampling.

Microbiological root canal sampling (MRS) has been found to be used by only a few Swedish general dentists. The present study addresses the reasons for their acceptance or rejection of the technology. A questionnaire was mailed to 240 general dentists practising within the city of Göteborg. The questionnaire concerned certain practice characteristics and attitudes to MRS. The data showed that MRS is mainly performed by dentists working with adult patients in private practice. The technology is rarely used routinely, but is applied in selected cases. The main reason for non-adoption seems to be a perceived lack of relative advantage over conventional treatment strategies. Furthermore, opinions regarding the complexity and observability of the technology appear to influence acceptance significantly.

Attitude of Health Personnel↗