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PubMed1996

Perceptions of orthodontic treatment need: Receiver Operating Characteristic analysis.

This study aimed to investigate the variations in dentists' perception of need for orthodontic treatment. Sixteen dentists viewed forty clinical vignettes and recorded their decisions according to the certainty with which they would offer treatment for each case. Receiver Operating Characteristic (ROC) analysis was performed on this data, using the Index of Orthodontic Treatment Need (IOTN) as the "gold standard'. The data suggest that dentists treatment decisions do not concur with current guidelines in use in the UK.

Attitude of Health Personnel↗
PubMedDate not supplied

Children's oral health services: organization and financing considerations.

This article highlights prominent issues concerning children's oral health and provides an overview of the structure, organization, and financing of dental services for children in the United States. The size, composition, characteristics, and distribution of the dental workforce and the arrangements that facilitate the delivery and financing of dental services are discussed. Features of the current dental care delivery system are examined within the context of primary care. Suggestions for creating meaningful change to enhance access through expanded, integrated systems are presented as part of a concluding challenge.

Allied Health Occupations↗
PubMed2005

Dental digital radiography: a survey of quality aspects.

The aim was to evaluate the experiences of Swedish general dental practitioners (GDPs) with digital radiography and their opinion on the same, particularly regarding quality issues. A letter was sent to all GDPs in private care in Region Skåne, Sweden, asking whether they used digital radiography (n=513). The response rate was 79%. The number of private GDPs who replied that they used digital radiography was 106. The Public Dental Service in Region Skåne listed 33 GDPs who worked with digital radiography. Based on these answers, a questionnaire was sent to the GDPs working with digital radiography (n=139). The questionnaire comprised 27 questions about the dentists, the system of intra-oral digital radiography, and the GDPs' experiences of and opinions on issues regarding image quality and quality control. The response rate to the questionnaire was 94%. Almost all, 92%, worked with charge-coupled device (CCD) and complementary metal oxide semiconductor (CMOS) sensors. Most GDPs were satisfied with their digital radiographic system. The majority (65%) experienced problems. Detector failure and trouble with the software were common. The GDPs wrote that they used lower exposure times in digital radiography than traditional film radiography. The estimated reduction in exposure time was said to be between 51% and 75%. Thirty-five per cent continued to use film parallel with digital radiography. The answers indicated that less than half of the equipment (40%) underwent quality control. Quality controls, when conducted, were undertaken once or twice a year, mainly by technicians from the companies that had sold the digital equipment. Based on the results of the questionnaire, there seems to be a need to improve the maintenance and the quality of digital radiography. It is also important that the GDPs become more aware of the problems that can occur when a new technique is introduced and that they develop the skills to handle these problems.

Attitude of Health Personnel↗
PubMedDate not supplied

Practice patterns of board-certified pediatric dentists: frequency and method of cleaning children's teeth.

PURPOSE: The purpose of this study was to assess the periodicity of the recall examination and frequency and most often used technique for cleaning children's teeth. The resulting data were compared to current scientific evidence and recommendations to determine the appropriateness of practices by board-certified pediatric dentists. METHODS: A 28-item questionnaire was mailed to the 1,034 members of the College of Diplomates of the American Board of Pediatric Dentistry residing in the United States. This report describes data pertaining to recall appointment periodicity, frequency and method of cleaning children's teeth, use of auxiliaries in prophylaxis, and instruction in oral hygiene. RESULTS: Six hundred twenty-nine surveys were returned, tabulated, and analyzed. Only 1% of dentists did not have an active recall program, 95% used a 6-month recall interval, and the remaining 5% had an interval ranging from 3 to 18 months. Hygienists were employed in 62% of pediatric dentistry practices. Pumice/rubber cup prophylaxis was employed routinely at recall by 67% of respondents; 24% reported the use of toothbrush and dental floss for cleaning; the other 9% reported no routine method for prophylaxis. The average fee for a pumice/rubber cup prophylaxis was dollar 42.55, and dollar 40.31 for a toothbrush prophylaxis. One hundred percent of pediatric dentists reported providing oral hygiene instruction for their patients. The instruction was directed to both parent and child in 97% of practices, child only in 2% of practices, and the parent only in 1% of practices. CONCLUSIONS: Recall intervals were not based on specific criteria related to individual patient needs. The majority of pediatric dentists employed the pumice/rubber cup prophylaxis method for cleaning children's teeth.

Appointments and Schedules↗
PubMed2006

Antibiotic prescribing practices among Norwegian dentists.

OBJECTIVE: There is little information on antibiotic prescribing habits among dentists in general. In 1992 we reported a study among Norwegian dentists, and the present investigation was undertaken to find out if the patterns of antibiotic prescription had changed since then. MATERIAL AND METHODS: A total of 470 randomly selected dentists (10% of total) received a questionnaire and a letter describing the survey and 313 responded. RESULTS: Results indicated that 35% did not issue any prescriptions in a typical week, while 3% issued > or =5. Fifty percent reported that they might prescribe antibiotics when treating periodontal diseases, but only 3.4% reported the use of microbial diagnosis before selecting an antibiotic; 71% of the respondents reported use of antibiotics occasionally to prevent general complications of dental treatment; 80% prescribed antibiotics for prophylactic use if the patient revealed a history of endocarditis, while 5% reported never doing so. CONCLUSION: These findings are in concert with the results obtained 11 years ago, but indicating that dentists who had attended postgraduate courses on antibiotics prescribed such drugs more frequently. This was not statistically significant. However, it is of great concern that 5% never prescribed antibiotics when treating patients with a history of endocarditis, and that 20% did not know that amoxicillin was a penicillin. Such lack of knowledge may cause fatal results of therapy.

Anti-Bacterial Agents↗
PubMed2000

Service provision patterns by main diagnoses and characteristics of patients.

Service provision patterns may be influenced not only by clinical oral health status leading to a diagnosis and treatment plan, but also by other variables such as patient characteristics. The main aim of this study was to investigate whether associations between services provided and patient factors would persist after controlling for the main presenting diagnosis or condition. A random sample of dentists surveyed in 1993-94 provided a response rate of 74%. Private general practitioners recorded service provision data from logs of 1-2 typical days of practice. Caries (26.5%) was the most prevalent diagnosis, followed by recall/maintenance care (19.0%), pulpal/periapical infection (10.9%), and failed restorations (10.4%). Diagnoses were associated with variation in the percentage of patients receiving services in main areas of service, and also with insurance status, sex and age distributions of patients, and type of visit (chi-square; P< 0.05). Logistic regressions of receipt of services indicated statistically significant associations with patient characteristics and diagnosis categories. Controlling for diagnosis, uninsured patients and those visiting for emergencies had less favourable service patterns (e.g., higher odds of extractions, but lower odds of preventive and crown and bridge services) compared to patients who had dental insurance or visited for check-ups or other non-emergency dental problems. The influence of these factors on services provided has implications of public health importance in terms of appropriateness of care and social inequality.

Adolescent↗
PubMed2006

Dentists' and dental hygienists' role in smoking cessation: an examination and comparison of current practice and barriers to service provision.

ISSUE ADDRESSED: Dentists and dental hygienists are important but under-used professionals in the delivery of smoking cessation services. This study compared confidence and barriers among dentists and dental hygienists and analysed the impact of barriers on smoking cessation activities. METHODS: Participants were surveyed on their confidence, perceived barriers, level of smoking cessation activity and practice and demographic factors. RESULTS: Fifty-eight dental hygienists (83% response rate) and 334 dentists (54% response rate) practising in South Australia responded to the survey. Participants indicated high rates of advising patients to quit smoking, but low rates of assisting and referring patients. Hygienists reported greater levels of activity and confidence, fewer barriers and longer consultation times. Confidence, system barriers, and practitioner barriers emerged as the most important predictors of service provision for both dentists and hygienists. Reported levels of smoking-specific education and training were very low (dentists 4%, hygienists 6%). CONCLUSIONS: There is potential to increase dentists' and dental hygienists' rates of smoking cessation activity, particularly for the more proactive strategies such as assisting patients to quit and arranging referrals.

Adult↗
PubMed1996

[Defensive behavior in medical care. A lesson for the dentist?].

Defensive behaviour in medical care is defined as a clear deviation from the physicians (dentists) usual behaviour and from what he/she considers to be good practice in order to prevent problems in the contact with patients and their families. General practitioners behave defensively in substantial proportion of their referrals to a specialist (15%) and of their ordering diagnostic tests (25%). In both instances varying (clinical and non-clinical) reasons can prompt the physician to refer or to test. Defensive considerations can play an equally varying role within all these reasons, which shed more light on the nature of the daily work in primary care. It is concluded that no reason exists to presume that Dutch dentists are more free either from non-clinical considerations and from defensive behaviour when they treat their patients than general practitioners.

Attitude of Health Personnel↗
PubMed2005

[Oral care delivery and top-class sports. Relationships according to dentists who are top-class sportsmen].

The aim of this qualitative study was to determine the opinions of eight top-class sports dentists, two women and six men, about the possible relationship between their performance of top-class sports and their oral care delivery as a general practitioner. Seven of the eight dentists interviewed, indicated a connection between their performance of top-class sports and their oral care delivery. In particular, it concerns aspects as working very disciplined and systemicly, the pursuit of perfection, having the capability to concentrate very much, and working with an achievement-oriented attitude, such as the repeated search for challenges and always being active in exercising. Furthermore, some dentists interviewed stated that in delivering oral care, on the one hand they are trying to back frontiers, and on the other hand they have experienced their limitations. In the discussion, the questions are pointed out how quality of oral care delivery can be assessed, if there is any top-class oral care, and if so, which the personal characteristics are of dentists delivering this top-class care.

Delivery of Health Care↗
PubMed2006

A 20-year study of dentists' and dental hygienists' assessment of dental caries lesions in bite-wing radiographs.

Epidemiological data reveal that the prevalence of dental caries in western countries has decreased in recent decades. The aim of this study was to investigate how dentists and dental hygienists assess dental caries lesions in bite-wing radiographs between 1983 and 2003. All dentists and dental hygienists in Public Dental Health in Uppsala County were offered to take part in the study. The participants assessed manifest and initial caries lesions in eight bite-wing radiographs from three patients individually. An X-ray viewer and binoculars were used. The assessments were repeated in the same radiographs every five years, a total of five times, between 1983 and 2003. In the different test occasions 80-103 dentists and 11-48 dental hygienists participated. The registration of dental caries changed between 1983 and 2003. The number of manifest lesions registered by dentists decreased between 1983 and 1988, but were stable after 1988. Dental hygienists showed no changes in the registration of manifest lesions during the study. Initial lesions registered by dentists and dental hygienists increased between 1988 and 1998. Assessments of initial caries lesions displayed a wider range than manifest lesions. Increasing age and more years in the profession resulted in fewer registered initial caries lesions. Dental hygienists had a tendency to register less caries than dentists. In conclusion, the result of the study indicate that inclusion of initial caries lesions in epidemiological reports should lead to a reduction in reliability. The changes in assessments of manifest caries lesions that took place in the 19805s should be considered when epidemiological data are evaluated.

Adult↗