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PubMed2003

Dental treatment concepts for pregnant patients--results of a survey.

AIMS AND METHODS: 702 dentists in private practices were surveyed about dental treatments of pregnant patients with an anonymous questionnaire. RESULTS: 61.3% of the dentists indicated that they treat pregnant patients, 35.5% postponed treatment to a postnatal time if possible and 3.4% referred these patients to dental clinics. The most frequently occurring treatments measures were pain and emergency treatments in 53.3% of the cases, followed by restorative treatments (42.9%) and oral hygiene measures (39.7%). Only 9.8% of the dentists performed all necessary treatments, 14% were against using an anesthetic during pregnancy. Less than 50% of the dentists indicated they would not perform a treatment in the first trimester and 8.5% said they would not treat in the second trimester. CONCLUSIONS: The present study shows that only 54.6% of the surveyed dentists felt they were sufficiently informed and educated about the treatment of pregnant patients.

Attitude of Health Personnel↗
PubMed2003

I, too, have a dream.

Explore the source record for details and available documents.

Dentist-Patient Relations↗
PubMed2003

Overservicing in dental practice--ethical perspectives.

Overservicing or the acceptance of unnecessary, inappropriate, excessive or fraudulent treatment is regarded as sanctioned lying, cheating or stealing and thus constitutes unethical conduct and a breach of the integrity of the profession. During the past year the media have repeatedly reported that the private sector is bloated with overservicing: one of the most important factors contributing to the increasing inflation of health care costs. Overservicing is an ethical problem presenting with a conflict situation among the interests of the patient, the provider and the funder. For example, since dentists are in a position to gain financially from their professional recommendations, they are at risk of having a conflict of interest: by overservicing they collect more fees. Low medical aid tariffs, delayed payment of benefits, oversupply of dentists, decreasing business and the spiralling costs of dental materials and equipment are the primary causes of high practice overheads and low cash-flow levels. Dentists may seek alternatives such as overservicing or unnecessary treatment to generate income and to improve their cash flow and/or profit. The main motives for overservicing are economic survival and financial gain. Some dentists may overtreat unintentionally due to out-dated treatment philosophies or where criteria for diagnosis and effective care are not clear, leading to variation in treatment decisions. Some overservicing may be due to patient-initiated demand. Dentists are largely unregulated as to the appropriateness or necessity of treatment decisions because of their professional status. Society trusts that their professionals will put the benefit of those they serve above their own self-interests. The aim of this review is to provide dentists with some guidance to the process of ethical decision making, the ethical principles involved, moral rules, and guidelines for professional standard of care. Business considerations whether profit, financial gain or economic survival should never justify overservicing by the dentist. If the patients' best interests are always considered, the profession of dentistry can ethically exist within a business structure.

Decision Making↗
PubMed2003

The shortened dental arch concept--attitudes of dentists in Tanzania.

OBJECTIVES: The shortened dental arch concept is a problem-oriented strategy to reduce complex restorative treatment in the posterior regions. The aim of this study was to determine the attitude of Tanzanian dentists about this concept. METHODS: A questionnaire was sent to all 77 dentists treating patients in Tanzania. The questionnaire contained items to assess the dentist's opinions such as dentist's judgement about the oral function of subjects with shortened dental arches, the type of treatment (or no treatment) of subjects with shortened dental arches and the reactions of patients to the proposal to shorten the dental arch. A short description about the problem-oriented approach and the shortened dental arch concept was included. RESULTS: Most of the responding dentists judged that shortened dental arches can provide satisfactory or acceptable chewing function (71%) and dental appearance (79%). Most dentists (89%) indicated that the shortened dental arch concept, as an example of a problem-oriented approach, has a useful place in clinical practice. However, most dentists (89%) inserted free-end acrylic partial dentures in these cases. Dentists with experience to apply the concept indicated that most of the patients have no objections after explanation of the proposal to shorten the dental arch. CONCLUSIONS: From this study it is concluded that the shortened dental arch concept is an acceptable strategy for dentists in Tanzania. However, many dentists doubt its implementation in clinical practice.

Attitude of Health Personnel↗
PubMed2000

An investigation of patient management methods used for orthodontic extractions by general dental practitioners in north west England.

OBJECTIVE: To quantify the patient management methods used by dental practitioners for orthodontic extractions and to determine what factors influence their choice of method. DESIGN: Practitioners working in the General Dental Service in the area of the former North West Regional Health Authority were randomly sampled and sent a postal questionnaire. SETTING: General Dental Service in the North West of England. SUBJECTS: 204 completed questionnaires were returned; a response rate of 71.1%. INTERVENTIONS: Practitioners were asked about the patient management methods that they used for orthodontic extractions and what factors were important in choosing to use a general anaesthetic. OUTCOME MEASURES: The mean percentages of patients treated with local anaesthetic alone, general anaesthesia and inhalation sedation with local anaesthesia were calculated for the sample. Factors influencing the choice of method used were scored by the practitioners on a ten point scale. RESULTS: Local anaesthesia alone was used for two thirds of orthodontic extraction patients and general anaesthesia for one third. Inhalation sedation was rarely used. Poor patient cooperation and a nervous patient were the most important factors in choosing a general anaesthetic. CONCLUSIONS: Local anaesthesia is used for the majority of orthodontic extractions. However there remains an overuse of general anaesthesia and an underuse of inhalation sedation.

Anesthesia, Dental↗
PubMed2005

UK dentists' attitudes and behaviour towards Atraumatic Restorative Treatment for primary teeth.

BACKGROUND: Atraumatic Restorative Treatment (ART) was introduced a decade ago as a minimal intervention treatment for caries in unindustrialised countries, but UK general dental practitioners (GDPs) may also be using this technique. OBJECTIVE: This study aimed to determine the materials and techniques used by a group of UK GDPs to treat caries in primary teeth. METHOD: A questionnaire, designed to determine GDPs' use of materials and techniques in the restoration of caries in primary teeth, was distributed to 600 GDPs in Scotland and England, with an explanatory letter and reply-paid envelope. The questionnaire included colour illustrations of two carious cavities in primary molar teeth and a request that respondents draw the cavity outline that they would use on the illustrations. The cavity outlines were assessed independently by two examiners. All other data were collated and analysed. RESULTS: 390 usable replies were received, a response rate of 65%. Of the respondents, 99% treated child patients and 42% of respondents were aware of ART. For treatment of a small Class II cavity, 37% drew a cavity outline without extension beyond removal of caries and a majority suggested use of an adhesive material (51% glass ionomer, 13% compomer). For cavity preparation, 47% of respondents used a drill, 10% an excavator and 41% used both. For treatment of a large occluso-lingual cavity, again most used an adhesive technique (44% glass ionomer, 12% compomer) for its restoration, while 50% used a drill, 7% an excavator and 42% used both for cavity preparation. CONCLUSION: Most respondents used adhesive materials for restoration of caries in primary molars, but, despite 42% of respondents stating that they were aware of the treatment, "true" ART was adopted by fewer than 10% of respondents.

Attitude of Health Personnel↗
PubMed2006

Smoking cessation as a dental intervention--views of the profession.

OBJECTIVE: To undertake a questionnaire-based survey to determine the attitudes and activities of dental professionals in primary care in the Northern Deanery of the UK in relation to providing smoking cessation advice. METHODS: Questionnaires for dentists, hygienists and dental nurses were sent to hygienists to distribute to other members of the team. The information collected included: smoking status of the professionals and the practice; roles of the dental team in giving smoking cessation advice; levels of training received; and potential barriers to giving this brief intervention. RESULTS: Over 90% of practices were smoke-free environments and significantly more dental nurses (23%) were smokers compared to dentists (10%) and hygienists (7%) (p<0.01). The majority of dentists and hygienists enquired about smoking status of their patients and all three groups believed that hygienists and dentists should offer brief smoking cessation advice. Potential barriers to delivering smoking cessation advice were identified: lack of remuneration; lack of time; and lack of training. CONCLUSION: Dental teams in primary care are aware of the importance of offering smoking cessation advice and, with further training and appropriate remuneration, could guide many of their patients who smoke to successful quit attempts.

Analysis of Variance↗
PubMed2003

Business orientation and the willingness to distribute dental tasks of Dutch dentists.

AIM: Dentists have a dual professional role: they have to focus on good oral health in their patients and, at the same time, they have to organise their practices. The aim of this analysis was to assess the extent to which dentists can be seen as business-oriented and/or willing to delegate to dental team members and others, and to investigate which personal and practice characteristics of dentists can be regarded as determinants for these two aspects of their professional role. METHOD: The data were collected in 2000 by means of a written questionnaire sent to a random stratified sample of 790 dentists. RESULTS: 607 (77 per cent) dentists responded. Multivariate regression analysis showed that business oriented dentists distinguish themselves by having larger practices and a higher level of professional satisfaction. Furthermore, although to a lesser extent, on a regular basis, they treat patients from colleagues in the practice. There are proportionately fewer women dentists in this category. Dentists oriented on task distribution can also be typified by working in larger practices, but in addition they have a greater preventive treatment philosophy and have more hours of support provided by oral hygienists. CONCLUSION: Among Dutch dentists there exist clear differences in the way they take on their role as dentists with regard to business orientation and their willingness to distribute dental tasks.

Attitude of Health Personnel↗
PubMed2001

[Manpower problems in dentistry].

In this special issue the historic and future development of the dentist population in the Netherlands is outlined. With regard to the current supply of demand a picture is given of the regional variation in the supply of dentists. The future developments of the dentist population are put into perspective by three papers on developments in professional groups neighbouring dental general practice: oral hygienists, maxillofacial surgeons and orthodontists. These papers are supplemented by a paper on the expectations patients have regarding their dentists, both now and in the future. Finally, the consequences of changes in the tasks performed by dentists for the academic dental education, are discussed.

Adult↗
PubMed1999

Recommendations for endodontic referral among practitioners in a dental HMO.

This study assessed the effect of patients' presenting conditions on general practitioners' (GPs') self-reported endodontic referral patterns, and compared GPs' perceived indications for referral with those of endodontists. The study was based on a self-administered, confidential survey distributed to 79 GPs and 7 endodontists who provide care to members of one Dental HMO in the Pacific Northwest. GPs were most likely to recommend referral for teeth they felt needed surgical retreatment, but GPs and endodontists did not always agree on indications for referral. Compared with GPs, endodontists were more likely to recommend referral for patients with complex problems, but not necessarily technically difficult teeth. Compared with those with less experience, GPs with more than 10 yr both in dentistry and at this HMO were more likely to recommend (a) referring difficult cases rather than performing endodontic therapy themselves and (b) extracting perforated or root-fractured teeth prior to obturation rather than continuing treatment. Indications for referral that maximize favorable dental outcomes need to be identified.

Attitude of Health Personnel↗