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Australian Dental Journal Dec 2018The management of medical emergencies is widely considered a requisite skill for all dentists. Timely intervention of an emergency can significantly alter the outcome... (Review)
Review
The management of medical emergencies is widely considered a requisite skill for all dentists. Timely intervention of an emergency can significantly alter the outcome for a patient's morbidity and possible mortality. This scoping review examines the prevalence of medical emergencies in dental practice, as well as dentists' attitude, confidence, and competence, of medical emergency management within a dental setting. Key findings include a lack of preparedness towards medical emergencies, despite a universal recognition of the importance and desire to improve key medical skills.
Topics: Attitude of Health Personnel; Clinical Competence; Dentists; Emergencies; General Practice, Dental; Humans; Practice Management, Dental; Prevalence
PubMed: 30169909
DOI: 10.1111/adj.12649 -
General Dentistry 2015Elite athletes strive to attain superior levels of health and fitness; however, many have high levels of oral disease. Oral screenings detect disease and need for...
Elite athletes strive to attain superior levels of health and fitness; however, many have high levels of oral disease. Oral screenings detect disease and need for treatment and identify opportunities for preventive interventions. Many dentists volunteer their time with sports organizations, but their scope of practice and needs are unknown. The purposes of this study were to gather baseline data about attitudes, practice behaviors, and needs of team dentists and to assess dental services provided, including the type and frequency of oral screenings conducted on athletes and any associated barriers to those screenings. This descriptive study utilized an original online survey, comprising 37 supplied-response questions, that was pilot tested for face and content validity. All dentist members of the Academy for Sports Dentistry were invited to participate (n = 491), and 150 responded, yielding a 31% response rate. The survey format allowed respondents to skip questions, and some respondents chose not to answer some questions. Quantitative data collected included level of athletes, league affiliation, scope of services provided, and types of oral screening performed. Dentists' attitudes regarding athletes' treatment and preventive needs, practice behaviors, and self-identified needs were assessed. Descriptive statistics were used to analyze the data. Results revealed that 116 of 146 respondents (80%) had a league affiliation. Among 112 dentists who reported providing services to athletes, the most frequently provided services were emergency treatment (96%), mouthguards (96%), restorative treatment (79%), oral hygiene instruction (63%), prophylaxis (61%), periodontal charting (61%), and dental charting (60%). Most team dentists (80%; n = 90/112) performed oral screenings for the athletes. Among 87 respondents who performed screenings and reported the type of screening they provided, 36 (41%) screened all athletes prior to the season and then provided individualized follow-up examinations as needed. The most commonly cited barrier to screenings was lack of awareness of the importance of oral health. Additional education for athletes, coaches, owners, schools, and leagues is needed to increase the value placed on oral health.
Topics: Attitude of Health Personnel; Dental Care; Dentists; Health Services Needs and Demand; Humans; Mouth Protectors; Oral Health; Sports Medicine; Surveys and Questionnaires; Tooth Injuries; United Kingdom
PubMed: 26545277
DOI: No ID Found -
International Dental Journal Oct 2022In many countries, periodontal surgery is mainly provided by periodontists. This specialty is not recognised in France, where periodontal care and treatment are...
AIM
In many countries, periodontal surgery is mainly provided by periodontists. This specialty is not recognised in France, where periodontal care and treatment are principally the responsibility of general dentists (GDs). The objective of this study was to investigate the periodontal care provided and factors associated with the treatment of periodontal diseases, including periodontal surgery, by GDs in France.
METHODS
A national cross-sectional survey of GDs practicing in the French metropolitan area was conducted in 2019. A self-administered questionnaire was sent by mail to the GDs selected by stratified simple random sampling. It included questions on respondents' sociodemographic characteristics and their periodontal practice. A multivariate logistic regression model was employed to identify the factors associated with the practice of periodontal surgery by GDs.
RESULTS
Three hundred eighty-five GDs responded (response rate, 23.4%). Their mean age was 45.2 years; 51.2% were male and 83.6% were in private practice. They reported performing selective periodontal examinations such as pocket probing on average for 34.2% of their patients, but only 5.5% of them performed them systematically. Several variables were significantly associated with the provision of periodontal surgical procedures such as the gender of the GDs, full mouth periodontal probing, implantology practice, insufficient fees, or uncertainty about treatment procedure. This survey confirmed the referral of patients for periodontal surgery by a minority of practitioners. It also highlighted insufficient screening and diagnostic procedures for periodontal diseases by GDs.
CONCLUSIONS
There is a need to improve French GDs' periodontal skills and knowledge and to address other barriers that currently limit their ability to deliver comprehensive periodontal care.
Topics: Cross-Sectional Studies; Dentists; Female; France; General Practice, Dental; Humans; Male; Middle Aged; Periodontal Diseases; Practice Patterns, Dentists'; Surveys and Questionnaires
PubMed: 35422317
DOI: 10.1016/j.identj.2022.02.002 -
Journal of Endodontics Feb 2018The aim of this study was to investigate changes in treatment planning decisions among different practitioner groups over 7 years for teeth with apical periodontitis...
INTRODUCTION
The aim of this study was to investigate changes in treatment planning decisions among different practitioner groups over 7 years for teeth with apical periodontitis and a history of endodontic treatment.
METHODS
A Web-based survey was sent to dentists in Pennsylvania in 2009 consisting of 14 cases with nonhealing periapical lesions and intact restorations without evidence of recurrent caries. Participants selected among 5 treatment options: wait and observe, nonsurgical retreatment (NSRTX), surgical retreatment (SRTX), extraction and fixed partial denture, or extraction and implant (EXIMP). In 2016, the identical survey was resent to the original 2009 participants.
RESULTS
In 2009, 262 dentists participated in the survey. Two hundred one participants were general practitioners (GPs: 76.7%), 26 endodontists (ENDOs: 9.9%), and 35 other specialists (prosthodontics, periodontics, and oral surgery [SPECs]: 13.4%) (n = 262). EXIMP, NSRTX, and SRTX were fairly equally selected but with great variation between practitioner groups (χ = 173.49, P < .05). A subset group of 104 participants (SUB) (39.7% of the original participants) retook the survey in 2016 (69 GPs [66.3%], 15 ENDOs [14.0%], and 20 SPECs [19.7%]). Comparisons among practitioner groups were significantly different in SUB (n = 104) for 2009 (χ = 95.536, P < .05) and 2016 (χ = 109.8889, P < .05). Intragroup reliability between 2009 and 2016 revealed no significant differences between the overall treatment planning choices for all practitioners (GPs, ENDOs, or SPECs). Intrapractitioner reliability showed many treatment planning decision changes on an individual level. Chances that individuals changed their original decision were 47.8% (95% confidence interval, 45.2%-50.4%) and were significantly different among the 3 practitioner groups (GPs > SPECs > ENDOs [χ = 11.2792, P < .05]). No significant changes were observed in the decision for tooth saving versus replacement treatment options (P = .520).
CONCLUSIONS
No significant differences were noted between current and past treatment planning decisions in regard to tooth preservation by endodontic retreatment versus tooth extraction and replacement. However, individual practitioners lacked consistency in their decision making over time.
Topics: Adult; Decision Making; Dentists; Female; Humans; Male; Middle Aged; Oral and Maxillofacial Surgeons; Orthodontists; Periapical Periodontitis; Root Canal Therapy; Specialties, Dental; Surveys and Questionnaires; Tooth, Nonvital
PubMed: 29254814
DOI: 10.1016/j.joen.2017.09.004 -
Australian Dental Journal Mar 2022This study aimed to investigate the perceptions and opinions of orthodontists and periodontists on the management of gingival recession in orthodontic patients.
BACKGROUND
This study aimed to investigate the perceptions and opinions of orthodontists and periodontists on the management of gingival recession in orthodontic patients.
METHODS
An online survey was sent to 29 periodontists and 80 orthodontists registered and currently practising in New Zealand. All participants answered questions about the timing and clinical indications of mucogingival surgeries in orthodontic patients diagnosed with mucogingival deformities.
RESULTS
Most periodontists and orthodontists believed that gingival grafts should ideally be performed after orthodontic treatment. In clinical practice, 40% of periodontists indicated that they would receive referrals after completion of orthodontic treatment. However, 29.6% of orthodontists indicated that they would refer to a periodontist before orthodontic treatment in clinical practice. The most crucial factor that affected periodontists' decision-making was 'evidence-based guidelines' (35.0%), followed by 'clinical experience' (30.0%) and 'patient concerns' (15.0%). All four factors of 'gingival phenotype', 'presence of gingival recession', 'amount of keratinised tissue' and 'planning specific tooth movements' were equally considered by orthodontists regarding their decision-making.
CONCLUSIONS
The majority of the surveyed New Zealand periodontists and orthodontists expressed a belief that the ideal timing for the management of gingival recessions would be after the completion of orthodontic treatment.
Topics: Humans; Gingival Recession; Orthodontists; New Zealand; Dentists; Tooth Movement Techniques
PubMed: 35527478
DOI: 10.1111/adj.12914 -
BioMed Research International 2021To evaluate the association between dentists' profile and health work management with the performance of primary care dental teams in the Brazilian National Health...
To evaluate the association between dentists' profile and health work management with the performance of primary care dental teams in the Brazilian National Health System, both nationally and regionally. Secondary data analysis from a Brazilian National Programme that evaluated 18,114 Brazilian dental teams, working in the public sector, between 2013 and 2014. Twenty-four independent variables taken from dentists' profile and dental team management characteristics were analysed to assess their influence on reported "dental team performance." An estimated score was generated from their performance on 20 dental procedures by an item response theory model. Multiple linear regression models were performed for each Brazilian geographical region, separately and for the whole of Brazil. values ≤ 0.05 were considered significant. Two variables related to dentists' profile, "having graduate studies" ( = 0.151) and "undertaking continuing professional development training" ( = 0.101), were associated with enhanced dental team performance in all five Brazilian geographical regions and nationally. The dental team management variables of "having a flexible dental appointment list" ( = 0.218) and "monitoring oral health indicators" ( = 0.132) also contributed to improve team performance in each of the regions and nationally. Dentists' profile influenced the performance of dental teams from south region more than the other regions. The findings suggest that continuing professional development, including postgraduate education, and strategic management characteristics are important for primary dental care performance and should be reflected in health policy initiatives in support of quality care. Regional factors could be considered for health care management.
Topics: Attitude of Health Personnel; Brazil; Dentists; Health Personnel; Health Workforce; Humans; Oral Health; Practice Patterns, Dentists'; Primary Health Care; Professional Competence; Quality of Health Care; Surveys and Questionnaires
PubMed: 34778459
DOI: 10.1155/2021/8843928 -
Journal (Canadian Dental Association) Jan 2021Government-funded and pro bono dental care are important to populations with limited means. At the same time, dentistry is experiencing a gender shift in the practising...
BACKGROUND
Government-funded and pro bono dental care are important to populations with limited means. At the same time, dentistry is experiencing a gender shift in the practising profession. As a result, we aimed to determine the factors associated with the provision of government-funded and pro bono dental care and whether there are gender differences.
METHODS
We conducted a secondary data analysis of the results of a 2012 survey of a representative sample of Ontario dentists. Descriptive, bivariate and multivariable analyses were carried out.
RESULTS
The 867 survey respondents represented a 28.9% response rate. On average, Ontario dentists reported that 15.7% of their practice consisted of government-funded patients and they provided $2242 worth of pro bono care monthly. Male and female dentists reported similar levels of both (p > 0.05). Being a practice owner and having more pediatric patients influenced levels of government-funded patients. Being internationally trained, of European ethnicity, single, and income status affected levels of monthly pro bono care. Gender-stratified analysis revealed that, among female dentists, household responsibilities was a unique factor associated with the proportion of government-funded patients, as was international training, personal income and ethnic origin for levels of pro bono care.
CONCLUSION
Overall, male and female dentists are similar in the provision of government-funded and pro bono care, but various factors influence levels of each in both groups.
Topics: Child; Dentists; Dentists, Women; Female; Government; Humans; Male; Ontario; Sex Factors; Surveys and Questionnaires
PubMed: 34343072
DOI: No ID Found -
PloS One 2020Clinical decision-making is a complex process influenced by clinical and non-clinical factors. The aim of this study was to investigate the association between provider,...
Clinical decision-making is a complex process influenced by clinical and non-clinical factors. The aim of this study was to investigate the association between provider, patient, and practice factors with clinical decision-making among dentists in Ontario, Canada's most populated province and its largest dental care market. This was a cross-sectional, self-administered survey of a random sample of general dentists in Ontario (n = 3,201). The 46-item survey collected demographic, professional, and practice information. The outcome (treatment intensity) was measured using a set of clinical scenarios, which categorized dentists as either relatively aggressive or conservative in their treatment decisions. Associations were assessed using bivariate analysis and logistic regressions. One thousand and seventy-five dentists responded (33.6% response rate). Age (p = 0.001), place of initial training (p<0.001), number of dependents (p = 0.001), number of hygienists employed (p = 0.001), and perceptions of practice loans (p = 0.020) were associated with treatment intensity. Dentists who were <40-years old (OR = 2.06, 95% CI:1.39-3.06, p<0.001), American-trained (OR = 2.48, 95% CI:1.51-4.06, p<0.001), and perceived their practice loans as large (OR = 1.57, 95% CI:1.02-2.42, p = 0.039), were relatively more aggressive in their treatment decisions. Various non-clinical factors appear to influence the clinical decision-making of dentists in Ontario.
Topics: Adult; Clinical Decision-Making; Cross-Sectional Studies; Dentists; Female; Humans; Male; Middle Aged; Ontario; Practice Patterns, Dentists'; Surveys and Questionnaires
PubMed: 32502170
DOI: 10.1371/journal.pone.0233652 -
Dental and Medical Problems 2020Coronavirus Disease 2019 (COVID-19) has been declared a global public health emergency that is affecting people across the globe.
BACKGROUND
Coronavirus Disease 2019 (COVID-19) has been declared a global public health emergency that is affecting people across the globe.
OBJECTIVES
The aim of this study was to assess the Knowledge, Attitudes and Practices (KAP) of dental practitioners regarding the Coronavirus Disease 2019 (COVID-2019) pandemic.
MATERIAL AND METHODS
An online questionnaire was distributed among dentists across the globe using a combination of convenience and snowball sampling. The questionnaire was divided into 4 sections: the 1st one contained personal information, whereas the 2nd, 3rd and 4th sections assessed knowledge (11 questions), attitudes (6 questions) and practices (7 questions) of the dentists. The data was subjected to the Shapiro-Wilk test, one-way analysis of variance (ANOVA), multivariate linear regression, and Pearson's correlation; 95% confidence interval (CI) was calculated and odds ratio (OR) was obtained. The analysis was done using IBM SPSS for Windows, v. 21.0.
RESULTS
The total number of the responses received (860) was divided with regard to various continents (Asia, Americas - North and South, Europe, Africa, and other - Australia and Antarctica). The largest number of dentists came from the Asian continent (264; 30.7%). Most dentists had a degree of MDS (Master of Dental Science) (301; 35.0%), followed by BDS (Bachelor of Dental Surgery) (282; 32.8%) and DDS (Doctor of Dental Surgery) (226; 26.3%). High/Good knowledge and practice scores were observed among 92.7% and 79.5 % of the dentists, respectively. Good knowledge scores were significantly associated with qualifications (p = 0.04) and years of practice (p = 0.02); good practice scores were associated with qualifications only (p = 0.03).
CONCLUSIONS
The dentists were found to have good knowledge and practice scores, which is important to combat COVID-19. They are advised to follow the Centers of Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines in their clinics, and sensitize their staff so that no stone is left unturned in defeating this pandemic.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Dentists; Health Knowledge, Attitudes, Practice; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2; Surveys and Questionnaires; Time Factors
PubMed: 32307930
DOI: 10.17219/dmp/119743 -
The Journal of Contemporary Dental... Sep 2022The aim of this study was to assess the opinions and practices of different dentists about the cervical margin relocation (CMR) concept.
AIM
The aim of this study was to assess the opinions and practices of different dentists about the cervical margin relocation (CMR) concept.
MATERIALS AND METHODS
A total of 432 general dentists, advanced general dentists (AGDs), periodontists, restorative dentists, and prosthodontists practicing in Saudi Arabia were approached in person or asked to complete an electronic survey (Google Forms) assessing demographic data and their opinions and practice of CMR. Differences between groups were assessed using the Chi-squared test, and binary regression models were constructed to identify predictors of opinions and practice of CMR.
RESULTS
About half of the surveyed dentists practiced CMR when indicated, but many felt that it represents an invasion of the biological width and might affect crown survival. Participants had several, often concurrent concerns about CMR. The opinions and practices of CMR were influenced by several factors including educational degree, work setting, country of clinical training, years of experience, and specialty.
CONCLUSION
The relatively conservative attitude of dentists towards CMR is justifiable, as it is a relatively new concept with little long-term clinical data. Clinical trials with sufficient follow-up periods are now needed to evaluate outcomes from CMR to provide further confidence to dentists to implement the procedure.
CLINICAL SIGNIFICANCE
Deep proximal carious lesions extending subgingivally is a common clinical scenario. Assessing the opinion and practice of dentists towards conservative treatment with CMR provides the basis for encouraging practitioners to use the procedure both clinically and in clinical trials.
Topics: Humans; Crowns; Dentists; Practice Patterns, Dentists'; Saudi Arabia; Surveys and Questionnaires; Root Caries; Crown Lengthening
PubMed: 36259305
DOI: No ID Found