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PubMed1991

A useful model for dental practice analysis, budgeting and income projection.

A versatile dental practice financial model, developed and utilized by the author, is presented. The model can be used by the dentist/manager to analyze dental practice financial data in order to identify practice inefficiencies and determine return on investment. It can also be used as a simple method of preparing a dental practice budget and projecting practice profit. Rationale for the model is explained and its use is discussed using hypothetical dental practice situations.

Budgets↗
PubMed2000

Genetic analysis of deciduous tooth size in Australian twins.

Investigations of permanent dental crown size in twins and family groups indicate a high degree of transmissible control, but little is known about the relative contributions of genetic and environmental factors to variation in size of the deciduous (primary) teeth. Here, maximum mesiodistal and buccolingual crown dimensions of maxillary and mandibular primary teeth were measured from dental models of 602 individuals, including 99 monozygous (MZ) twin pairs, 81 dizygous (DZ) same-sex pairs, 41 DZ opposite-sex pairs, and 160 singletons. Data were subjected to univariate genetic analysis with the structural-equation-modelling package, Mx using the normal assumptions of the twin model. A model incorporating additive genetic (A) and unique environmental (E) variation was found to be the most parsimonious for all tooth-size variables. Estimates of heritability for deciduous crown size ranged from 0.62 to 0.91. This study shows that variation in deciduous crown size has a strong genetic component, similar to that observed in the permanent dentition. Further studies are required to determine whether the underlying genetic mechanisms are the same for both deciduous and permanent teeth.

Analysis of Variance↗
PubMedDate not supplied

Application of the human needs conceptual model of dental hygiene to the role of the clinician : part II.

In summary, the theories of Maslow and of Yura and Walsh have been highlighted as background for understanding the human needs conceptual model of dental hygiene. In addition, 11 human needs have been identified and defined as being especially related to dental hygiene care, and a sample evaluation tool for their clinical assessment and a dental hygiene care plan have been presented. The four concepts of client, environment, health/oral health, and dental hygiene actions explained in terms of human need theory, and the 11 human needs related to dental hygiene care constitute the human needs conceptual model of dental hygiene. Within the framework of the human needs conceptual model of dental hygiene, the dental hygiene process is a systematic approach to dental hygiene care that involves assessment of the 11 human needs related to dental hygiene care; analysis of deficits in these needs; determination of the dental hygiene care plan based on identified deficits; implementation of dental hygiene interventions stated in the care plan; and evaluation of the effectiveness of dental hygiene interventions in achieving specific goals, including subsequent reassessment and revision of the dental hygiene care plan. This human needs conceptual model for dental hygiene provides a guide for comprehensive and humanistic client care. This model allows the dental hygienist to view each client (whether an individual or a group) holistically to prevent oral disease and to promote health and wellness. Dental hygiene theorists are encouraged to expand this model or to develop additional conceptual models based on dental hygiene's paradigm.

Body Image↗
PubMed1996

[Implications in terms of costs and manpower of using the Scandinavian dental care model in Brazil].

The implications in terms of dental manpower and costs of applying the Scandinavian system of dental care in Brazil are specified and analysed. Two societies were chosen for study: those of Sweden, in Scandinavia and Santa Catarina, State in southern Brazil. The theoretical analysis of the implications was undertaken on the basis of an estimate of dental and auxiliary manpower required to deal with the high levels of oral disease and needs (caries, teeth needing extraction, periodontal diseases and the need for full dentures) in Santa Catarina. This estimate was undertaken by means of the World Health Organization-Fédération Dentaire Internationale (WHO-FDI) Model "Health Through Oral Health" (1989). The implications in costs, taking the total Swedish expenditure per dentist as a basis, were calculated and applied to the manpower calls for by the WHO-FDI model. The high costs resulting showed that the application of the Swedish model of dental care to Santa Catarina would be unrealistic. The implications in terms of manpower were calculated by applying the manpower ratios considered desirable in Sweden to Santa Catarina. In order to achieve the Swedish dentist: population ration, Santa Catarina would need 85% more dentists that it had in 1990. Regarding auxiliary personnel, the Brazilian State of Santa Catarina would need to train a large number of new personnel in order to attain the Swedish auxiliary: dentist ratio. In the light of the findings of this study, the adoption of the Swedish model of providing dental care by Santa Catarina in terms of costs and manpower is not feasible. Therefore, alternative approaches for the improvement of oral health in Santa Catarina and in the rest to Brazil should be sought. These approaches should take consider political, cultural and socio-economic aspects of Brazilian society into consideration.

Adult↗
PubMed2000

Application of the human needs conceptual model to dental hygiene practice.

The Human Needs Conceptual Model is relevant to dental hygiene because of the need for dental hygienists to be client focused, humanistic, and accountable in practice. Application of the Human Needs Conceptual Model provides a formal framework for identifying and understanding the unique needs of the client that can be met through dental hygiene care. Practitioners find that the Human Needs Conceptual Model can not only help them in assessment and diagnosis, but also in client education, decision-making, care implementation, and the evaluation of treatment outcomes. By using the model, the dental hygienist is able to manage client care humanistically and holistically, and ensure that care is client-centered rather than task-oriented. With the model, a professional practice can be made operational.

Communication↗
PubMed2003

Assessment of the accuracy of a three-dimensional imaging system for archiving dental study models.

OBJECTIVE: The use of stone and plaster study models is an integral part of any dental practice and is required for research. Storage of study models is problematic in terms of space and cost. Ayoub et al.(1) introduced a new technique based on the recent advances in stereophotogrammetry for archiving dental study models in a digital format. However, assessment of the accuracy of the generated three-dimensional (3D) models has not been carried out yet. It was the aim of this study to evaluate the accuracy of this technique. DESIGN: A comparative assessment between direct measurements of dental study models and measurements of computer generated 3D images of the same study models was performed. MATERIALS AND METHODS: Twenty-two dental study models stored at Glasgow Dental Hospital and School for the purposes of research were used in the study. The models were captured in three dimensions using a photostereometric technique and stored in digital format. MAIN OUTCOME MEASURES: Measurements were conducted directly on dental study models and on the computer generated 3D images using Euclidean Distance Matrix Analysis.(2) The difference between the two sets of measurements was statistically analysed using a two-sample t-test. RESULTS: The average difference between measurements of dental casts and 3D images was 0.27 mm. This difference was within the range of operator errors (0.10-0.48 mm) and was not statistically significant (P < 0.05). CONCLUSION: This study shows that it is possible to use 3D imaging to store dental study models for treatment monitoring and research with a satisfactory degree of accuracy.

Archives↗
PubMed1998

Pretherapy dental decisions in patients with head and neck cancer. A proposed model for dental decision support.

OBJECTIVE: The proposed model was designed to function as a tool for the development and testing of evidence-based clinical guidelines for the pretherapy oral screening and dental management of patients with head and neck cancer. STUDY DESIGN: Methods of clinical decision analysis were used to analyze the decision dilemma and construct a decision algorithm and decision tree. The robustness of the model was tested by means of a probabilistic sensitivity analysis with second-order Monte Carlo simulations (n = 10.000). RESULTS: Clinical criteria for evaluating dental pathologic conditions and malignancy- and patient-related conditions were transformed in probability estimates. The tradeoffs between the benefits and drawbacks of the dental intervention were integrated into the model to identify the optimal option for dental intervention. The calculation process of "folding back and averaging out" the decision tree enabled the identification of the optimal options for dental intervention in four different pretherapy risk conditions. CONCLUSIONS: A priori testing of the proposed model with 95% confidence intervals suggests that it has a great potential for solving clinical dilemmas associated with pretherapy dental decision-making. In addition, it seems a useful tool for the development of evidence-based clinical guidelines. A posteriori clinical testing should further validate the model before its assimilation into clinical practice takes place.

Algorithms↗
PubMed2004

Simulation model for dental arch shapes.

OBJECTIVE: To develop a simulation model for dental arch shapes. DESIGN: Analysis of measurements of dental casts to determine a general second degree equation for the dental arches. SETTING: Department of Human Anatomy and School of Computing and Informatics, University of Nairobi. SUBJECTS: The measurement of dental casts, 30 (15M and 15F) each from three Kenyan ethnic groups (Maasai, Kalenjin, Kikuyu), aged 12 years. RESULTS: The arches change their shapes from a parabola to an ellipse, governed by the boundary conditions at the position of the canine tooth, based on the general second degree equation for the conic sections. CONCLUSION: The simulation model graphically confirms the change from parabolic to elliptic shapes of dental arches with boundary conditions at the canine. This could be used to show the changes in dental arches for other ethnic groups.

Child↗
PubMed1986

Dental stress model and assessment questionnaire.

This article presented a new dental stress model, which is based upon "perceived" (psychological) stresses. The model consists of antecedents of stress (stressors) and the resulting job and life stresses which produce psychologic and physiologic stress responses and behavioral consequences. From the proposed model, a stress evaluation questionnaire was constructed to help dental personnel diagnose excessive stressors in their own lifestyles.

Dentists↗
PubMed2005

Fund allocation within Australian dental care: an innovative approach to output based funding.

BACKGROUND: Over the last 15 years in Australia the process of funding government health care has changed significantly. The development of dental funding models that transparently meet both the service delivery needs for data at the treatment level and policy makers' need for health condition data is critical to the continued integration of dentistry into the wider health system. METHODS: This paper presents a model of fund allocation that provides a communication construct that addresses the needs of both policy makers and service providers. RESULTS: In this model, dental treatments (dental item numbers) have been grouped into eight broad dental health conditions. Within each dental health condition, a weighted average price is determined using the Department of Veterans Affairs' (DVA) fee schedule as the benchmark, adjusted for the mix of care. The model also adjusts for the efficiency differences between sectors providing government funded dental care. In summary, the price to be applied to a dental health condition category is determined by the weighted average DVA price adjusted by the sector efficiency. CONCLUSIONS: This model allows governments and dental service providers to develop funding agreements that both quantify and justify the treatment to be provided. Such a process facilitates the continued integration of dental care into the wider health system.

Australia↗
PubMed2000

A 'sufficient cause' model for dental caries.

BACKGROUND: It is generally believed that dental caries is an infectious disease. The occurrence of dental caries is affected by a variety of determinants. In order to estimate the precise extent of the relation between specific determinants and the outcome phenomenon (i.e. the occurrence of dental caries), a coherent disease model is required. This model should also permit multivariate analysis to control for confounders and interactions. Only with such a disease model will it be possible to investigate the relation between the occurrence of a determinant and dental caries, and to estimate the extent of this relation. The known causal models for the explanation of dental caries do not fully meet these requirements. METHOD: Rothman's 'sufficient cause' model has been used as a starting point for the development of a new coherent disease model, to explain the occurrence of dental caries and allow multivariate analysis. RESULTS: The sufficient cause for dental caries comprises three component causes: sufficient microorganisms with cariogenic potential, easily fermentable carbohydrates and teeth. Whether dental caries actually occurs also depends on the influence of independent risk factors that interact with the component causes in a protective, as well as in a risk-increasing manner. These independent risk factors are saliva, fluoride, oral hygiene and diet. CONCLUSIONS: The 'sufficient cause' model for dental caries is a biological model in which distinction between protective and risk-increasing factors has been made, and interaction between factors has been described. With this model, it will now be possible to assess the extent of the relationship between a determinant and dental caries (the outcome phenomenon) using multivariate techniques.

Confounding Factors, Epidemiologic↗
PubMed1998

Oral health-related quality of life: a model for dental hygiene.

During the past decade, dental hygiene has been challenged to develop conceptual models to define the discipline. Such models can provide a common language and infrastructure for the discipline to define the process of care. Health-Related Quality of Life conceptual models have been adopted by many health professions to assist in planning health-related interventions and assessing outcomes to care. Based on the Natural History of Disease Schema, the Wilson & Cleary model, and Neuman's Systems Model, a new conceptual model for dental hygiene is proposed. The Oral Health-Related Quality of Life Model, composed of six primary domains: Health/Preclinical Disease, Biological/Clinical Disease, Symptom Status, Functional Status, Health Perceptions, and General Quality of Life. This model proposes a dynamic relationship among these domains and characteristics unique to individual clients or populations, and may have utility for interdisciplinary communication. As an integrated model, it may serve as a foundation for assessing, planning, implementing, and evaluating outcomes to dental hygiene care. This paper reviews possible application of the model for clinical practice, research, and education.

Dental Hygienists↗
PubMed1998

Comparison of exposed dentinal surfaces resulting from abrasion and erosion.

The aim of this study was to compare the shape of exposed dentinal surfaces caused by abrasion and erosion with a view to developing a diagnostic clinical test. The study material consisted of 80 natural teeth and 129 dental models obtained from Australian Aborigines known to display considerable dental abrasion due to their diet, and dental models of 37 Caucasians diagnosed with dental erosion through detailed history and dietary analysis. Polyvinyl siloxane impressions were obtained of all occlusal surfaces with dentinal scooping in both the 'abrasion' and 'erosion' groups. All impressions were sectioned buccolingually through the deepest point of the scooped dentine, and then the profiles were photocopied at x2 magnification. The breadth and depth of dentinal profiles were measured to an accuracy of 0.1 mm, enabling ratios of depth:breadth to be determined, and the position of the deepest part of each scooped surface was recorded. The mean depth:breadth ratio of scooped dentine was significantly greater in the Aboriginal natural teeth (0.19 +/- 0.06, mean +/- SE) than in the Aboriginal dental models (0.15 +/- 0.04). Both Aboriginal natural teeth and models with abrasion showed significantly smaller ratios (p < 0.05) than the Caucasian models showing erosion (0.33 +/- 0.07). Furthermore, in the abrasion samples, the deepest region of the scooped dentine tended to be lingually placed more often in maxillary teeth but buccally placed more often in mandibular teeth (p < 0.05). These results indicate that scooped dentine on abraded occlusal surfaces of teeth displays significant differences in shape compared with that caused mainly by erosion.

Adolescent↗
PubMed2006

Metrological validation for 3D modeling of dental plaster casts.

The contribution of this paper is twofold: (1) it presents an automatic 3D modeling technique and (2) it advances a procedure for its metrological evaluation in the context of a medical application, the 3D modeling of dental plaster casts. The motivation for this work is the creation of a "virtual gypsotheque" where cumbersome dental plaster casts can be replaced by numerical 3D models, thereby alleviating storage and access problems and allowing dentists and orthodontists the use of novel and unprecedented software tools for their medical evaluations. Modeling free-form surfaces of anatomical interest is an intriguing mixture of open issues concerning 3D modeling, geometrical metrology, and medicine. Of general interest is both the fact that a widespread use of 3D modeling in non-engineering applications requires automatic procedures of the kind presented in this work and the adopted validation paradigm for free-form surfaces, rather useful for practical purposes. In this latter respect, the metrological analysis we advance is the first seminal attempt in the field of 3D modeling and can be readily extended to contexts other than the medical one discussed in this paper.

Computer Simulation↗
PubMed1996

The effect of steam sterilization on the properties of set dental gypsum models.

The aim of this study was to investigate the viability of autoclave sterilization of set dental gypsum models. The effects of autoclaving on the strength, surface hardness and dimensions of specimens of plaster, stone and diestone were investigated. In addition, sodium succinate was used to minimize any changes produced by autoclaving. It has been shown that dental gypsum casts can be successfully steam sterilized. The results showed that for fully-dried gypsum products, autoclaving at 132 degrees C for 5 minutes rendered the casts unacceptable for use. Autoclaving at 121 degrees C for 16 minutes had less effect although casts were still not satisfactory, with the main problems being excessive expansion for plaster and significant strength and surface hardness loss for stone and diestone. The effect of three additional treatment procedures was examined and the least degradation was observed when the casts were soaked in 1 per cent sodium succinate solution and dried prior to autoclaving, then soaked in water immediately after. Using this procedure the average change in properties for plaster, stone and diestone respectively were: loss of strength 36, 21 and 28 per cent, loss of surface hardness 34, 21 and 33 per cent, and linear expansion 0.05, 0.09 and 0.13 per cent. Further refinement may improve the procedure.

Calcium Sulfate↗