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PubMed2000

Racial/ethnic variations of practicing dentists.

BACKGROUND: In recent years, the dental school population has changed from being predominantly white male to a more diverse racial and ethnic makeup. Noting this change in the student population, the American Dental Association undertook an in-depth study of the various racial/ethnic groups. METHODS: Questionnaires were sent to approximately 8,000 dentists nationwide. Samples were drawn for each of the following racial/ethnic groupings: white, black, Hispanic, Native American and Asian. The survey instrument asked questions about personal characteristics, work and private practice issues, household and practice income, and patient characteristics; it also asked for dentists' opinions. A final adjusted response rate of 57.0 percent was achieved. RESULTS: The majority of all dentists responded that they were "very satisfied" with their profession, but the survey found variations in patient mix, employment history and provision of free or discounted care. CONCLUSIONS: The survey examined dentists by race/ethnicity to identify differences and similarities. Cultural and ethnic minorities are the fastest growing segment of the U.S. population. As the profession becomes more diverse, practice patterns will affect the overall dental profession. PRACTICE IMPLICATIONS: Dentists' racial/ethnic backgrounds may change the provision of care as patient mix varies, with each dentist group treating a specific group of patients in regard to family income, racial/ethnic background and subgroups for whom they offer free or reduced-rate dental care.

Career Mobility↗
PubMed1990

Reasons for restoration replacement: differences in practice patterns.

Patients receive varying types and amounts of restorative treatment, depending on the prescribing dentist. The aim of this study was to enhance the understanding of the variation of the restoration replacement practices of dentists. Three dentists in private practice in similar semirural communities with comparable practice demographics were asked to gather data on all restorations they replaced over a period of 1 month. They recorded the tooth number, number of restored surfaces, restorative material being replaced, number of surfaces in the replacement restoration, the replacement restorative material, and the reasons for the replacement restoration. Statistically significant differences were found among the dentists as to the reasons for posterior restoration replacement, replacement materials used, and increase in size of the replacement restorations. Differences were attributed to individual practice philosophies, demonstrating that clinical information was not the sole determining factor as to type of replacement restorations that patients received.

Composite Resins↗
PubMed1992

Dentists' attitudes to cross-infection control.

The wearing of gloves by dentists undertaking clinical procedures has been recommended by many authorities as an essential element of dental surgery cross-infection control. This paper reports an investigation into patterns of glove-wearing by practising dentists, and considers the effect of practice location and practising arrangements on this issue and other aspects of cross-infection control. The results show that these factors, including the type of patient treated, may influence the pattern of glove-wearing by dentists in England and Wales. These findings suggest that groups least likely to follow the recommended infection control procedures should be targeted when assessing dental education requirements.

Attitude of Health Personnel↗
PubMed1992

Personality, self-esteem, stress, and satisfaction among Texas dentists.

Do the personality styles of dentists significantly influence their sense of well-being in their profession? A recent study using the Bi/Polar Inventory of Core Strengths differentiated 218 Texas dentists into eight personality profiles. Patterns VII and V (both risking and practical) as a group reported significantly higher self-esteem, higher ability to cope with stress, lower psychological distress, higher satisfaction with dentistry, and greater likelihood of choosing dentistry again as a career, than did Patterns III and IV (both thinking and theoretical). The results suggest that Patterns VII and V may be the most compatible with dentistry, and Patterns III and IV the least compatible. Also, the practical orientation (preferred by nearly 80% of the Texas dentists sample over the theoretical orientation) may be the single most influential personality trait in terms of compatibility with dentistry. Implications arise in career counseling, dental school admissions committees, and counseling dentists dissatisfied with.

Dentists↗
PubMed1990

Dental treatment needs of elderly patients seen at a university teaching clinic.

There is little data describing the treatment needs of elderly patients seeking dental care at dental school clinics. Such information would be useful in curriculum planning for predoctoral dental programs in order to ensure that students receive a good basic education in the management and treatment of the older dental patient. In this study, the charts of all patients 65 years of age and older, accepted for treatment at the College of Dentistry, University of Saskatchewan, were reviewed. Data was collected from the dental examination chart and the proposed treatment plan. From a total of 156 patients, 41% were found to be edentulous at the time of examination or were treatment planned to become edentulous. A variety of treatment procedures including scaling, individual tooth restorations, fixed prosthodontics, minor periodontal surgery and extractions were found to be required in the dentate patients. The emerging elderly patient will probably retain more teeth and therefore have proportionately more treatment needs than the present elderly generation. Practicing dentists should be aware of these changing patterns of oral diseases. University teaching clinics must ensure the predoctoral dental student's access to an elderly patient pool to allow these students to gain experience in managing the dental needs of this growing sector of the North American population.

Aged↗
PubMed1990

Age differences in the stress patterns of dentists.

The present study is a comparison of the stress patterns of older and younger dentists in private practice. Dentists responded to a questionnaire which sought to elicit their responses to a number of situations and events that typically occur in their professional lives. These included financial difficulties, patient-management problems, time issues and uncertainty about their professional status. The groups compared were dentists over 54 years (n = 36) with dentists below the age of 35 years (n = 41), where both the frequency and intensity of their responses were measured. The findings suggested that overall, the older dentists are less stressed than their younger counterparts. Some issues, those concerned with finance and patient-management, appear to affect both groups more or less equally, which suggests that these issues are of global, rather than specific concern. From a theoretical point of view, the findings tend to contradict the generally-held belief that getting older is automatically accompanied by degeneration and problems of adaptation to life changes. On the contrary, seemingly favourable adaptation and low levels of stress are evident in most of the older respondents.

Adult↗
PubMed1995

Professional attitudes to specialisation and minor oral surgery in general dental practice.

A questionnaire was distributed to the general dental practitioners of Grampian Region to investigate their perception of the need, the advantages and disadvantages, qualifications and location, of a 'specialist' or 'specialist' practice in minor oral surgery. A 92% response rate was achieved. Nearly nine out of ten practitioners believed there was a need for such a 'specialist' with 85% being willing to refer to one. Up to 48% would refer more patients for minor oral surgery than they do at present. They envisaged reduced patient waiting and improved convenience as the main advantages of such a service. The patient paying for treatment and post-operative complications are perceived as the major disadvantages. The type of procedures that the practitioners expect a 'specialist' to undertake is as expected, although only 75% expect implants to be undertaken. Most practitioners, 86%, would prefer if the 'specialist' worked in a 'specialist' only practice. Other alternative venues would be viewed favourably with the 'specialist' working in another dental practice being the least favourable. Nearly nine out of ten practitioners believe that a qualification is necessary for such a 'specialist' and if a minor oral surgery qualification was introduced 73% of practitioners would regard it as the most appropriate qualification. Many practitioners in principle would attempt to gain it, 82% of practitioners would refer their private patient to a specialist with this qualification.

Attitude of Health Personnel↗
PubMed1995

Caries diagnosis and risk assessment. A review of preventive strategies and management.

The scientific basis for caries risk assessment, prevention and treatment on an individual patient basis requires further development, specification and continuing validation. Still, current technologies and techniques, taken together, can provide enhanced capabilities over those that have been employed traditionally. Undoubtedly, the clinical tools for carrying out these responsibilities will be refined and expanded in the future in response to the changing clinical profile of caries in the population. For example, bacteriologic testing methods have become easier and more reliable, and will become more widely used. Other effective methods to detect the early, pre-cavitation stage of caries also should become more available in the future. Practitioners will be continually challenged and responsible for evaluating the effectiveness and value of emerging technologies in their practices and in light of their patients' needs. But how can this be accomplished best? Effectiveness claims will be made for new drugs and devices that come onto the market. There are several sources of information to assist the practitioner in making such decisions. The American Dental Association acceptance programs (voluntary) and the U.S. Food and Drug Administration compliance programs (law) provide standards and guidance as to product safety and effectiveness. Without such determinations, the practitioner must judge independently product claims and clinical studies. Marketing materials by themselves (advertisements, videos, pamphlets) may not be sufficient evidence of effectiveness particularly when scientific references supporting claims either are not provided or are inadequate. Peer-reviewed scientific literature in publications of the major scientific and professional associations can be viewed as generally reliable. Changing the way dental caries is managed in clinical practice will require integrating new scientific information and technology into workable clinical procedures. Dental education and third-party reimbursement issues must be addressed also but are beyond the scope of this document. Given that disease patterns are always changing in the population, dentists need to modify practice decisions using risk assessment. Ultimately, the goal for dentistry is that adult patients also will enjoy the same low level of caries experience that many children enjoy today.

Adolescent↗
PubMed1992

Restoration longevity in an Australian Defence Force population.

Replacement of restorations comprises a considerable portion of the work of most dentists. Consequently, factors that affect restoration longevity can influence the pattern of dental practice in a given community. Based on the results of research into treatment provision in the General Dental Service in Scotland, it was considered possible that factors such as the frequency with which patients were examined, and the frequency with which they changed dentists, might influence restoration longevity in other populations. Therefore, the present study was initiated to investigate the effects of these two factors in a population of 100 long-term members of the Royal Australian Air Force. No statistically significant relationship could be found between examination frequency, or frequent changes in dental practitioner, and restoration longevity. It is proposed that the large differences found in restoration longevity between this study and the Scottish study upon which it was based, may be due in part to the differing modes of remuneration of the dentists in the two studies.

Adult↗
PubMed2003

Views of practicing dentists regarding a mandatory fifth year of training.

As part of a U.S. Health Resources and Services Administration-funded evaluation of the impact of federal funding on postgraduate general dentistry programs, a random sample of 6,725 dentists graduating in 1989, 1993, and 1997 were surveyed regarding practice patterns, advanced training, populations served, services provided, and their position on a mandatory fifth year of training. Responses (1,965) showed 48 percent supporting a mandatory year and 52 percent not supportive. Open-ended comments were provided by 1,626 respondents. The main reasons for supporting a mandatory fifth year were the need for more instructional time and need for a transition year. Individual choice, no value in a fifth year of dental school, mentoring available elsewhere, and cost were cited in opposition. The following respondents were significantly more likely than other respondents to support a mandatory fifth year: individuals who had completed an AEGD, GPR, or specialty program; were Asian; held salaried positions in a community clinic, nursing home, or hospital; or described themselves as a consultant. Graduates in 1993 and 1997 were less supportive of a mandatory fifth year than were 1989 graduates. Significant differences in the reasons offered in support of respondents' positions on the issue were observed among AEGD, GPR, specialists, and nonspecialists and the three cohort years.

Attitude of Health Personnel↗
PubMedDate not supplied

Evolving demographic patterns and potential for pediatric dental practice.

The Bureau of the Census has reported changes in the projected number of children. These changes, as well as the decreases in the number of dentists and a changing awareness of the needed care for children are considered in terms of the potential for pediatric dental practice. Evolving demographic patterns are an important factor in practice location; ten years after the late 1970s, conditions and forecasts now have become far more favorable for the profession.

Adolescent↗
PubMed1990

A survey of dentists practicing implant dentistry in Israel.

Due to the increasing interest in the field of implant dentistry, a first survey of dentists in Israel who used implants was conducted. Out of a total of 312 dentists questioned, 97 reported using dental implants in their practice. In spite of the team approach advocated in the literature, 40% of the dentists in the survey conducted both the surgical and the prosthetic phases of treatment. Over 60% of the respondents had less than 3 years' experience in the field, which is in keeping with the worldwide trend. A smaller number than expected regarded red gingival color and bone resorption based on radiographic findings as grounds for implant failure. In the view of at least 10 respondents, pain, discomfort, exudate, and fistulization did not indicate unsuccessful implants. A disparity was revealed between the dentists' practice methods and their hypothetical choice of self-treatment. Although the Core-Vent method was the most widely employed, only 50% of those using this system preferred it for themselves. Even fewer (25%) of those using blade implants considered it their self-treatment of choice. In contrast, although only 10% of the dentists had used the Branemark method, 30% preferred it for their own treatment.

Attitude of Health Personnel↗
PubMed1995

Radiographic examination of children. A survey of prescribing practices of general dentists.

OBJECTIVE: The purpose of this article was to assess the radiographic prescribing practices of a sample of general practitioners for the pediatric dental patients in relation to current guidelines. STUDY DESIGN: Questionnaires were mailed to a sample of 963 dentists. The adjusted response was 80%. RESULTS: For the new patient under age 6, slightly more than two thirds of respondents reported the use of selective radiography. For ages 6 to 14 years, a slight majority chose a protocol of survey radiography. Of those who used a predetermined protocol, 69% chose "bite-wings only" for the child under 6 years, whereas for the child 6 to 14 years, the protocol of choice was a complete radiographic survey, predominantly the panoramic/bite-wing. For recall patients in both age groups, less than 1% of dentists used survey radiography. CONCLUSION: From our results, we concluded that the majority of dentists followed the guideline for children under 6 years. However, for children in the transitional dentition years, our respondents choices were divided between selective or survey radiography. The ambiguity in the wording or interpretation of the guideline for this age group may have contributed to this result.

Adolescent↗
PubMedDate not supplied

Ethical issues encountered by dentists in the care of institutionalized elders.

Increasing numbers of institutionalized elders have very poor oral health. It has been suggested that ethical problems may influence dentists who attempt to provide oral care for these people, but little attention has been given to research in this area. A qualitative interview method was used to investigate the the views and experiences of dentists working with institutionalized elders. Particular attention was given to the ethical difficulties encountered and how the dentists resolved them. Ten dentists experienced in long-term care were interviewed individually by means of open-ended questions. Thematic analysis identified ethical problems focused on the difficulty of identifying the wishes of patients or predicting the outcome of treatment. The participants reported few difficulties in making clinical decisions in this setting. However, analysis revealed that the ethical perspectives of the dentists varied substantially. Variation was notable particularly in their preference for ideal or practical treatment and in their preference for autonomy of beneficence.

Aged↗