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Health Services Research Jun 2023To examine the factors that account for differences in dentist earnings between White and minoritized dentists.
OBJECTIVE
To examine the factors that account for differences in dentist earnings between White and minoritized dentists.
DATA SOURCES
We used data from the American Dental Association's Survey of dental practice, which includes information on 2001-2018 dentist net income, practice ZIP code, patient mix between private and public insurance, and dentist gender, age, and year of dental school graduation. We merged the data on dentist race and ethnicity and school of graduation from the American Dental Association masterfile. Based on practice ZIP code, we also merged the data on local area racial and ethnic composition from the American Community Survey.
STUDY DESIGN
We used a linear Blinder-Oaxaca decomposition to assess observable characteristics that explain the gap in earnings between White and minoritized dentists. To assess differences in earnings between White and minoritized dentists at different points of the income distribution, we used a re-centered influence function and estimated an unconditional quantile Blinder-Oaxaca decomposition.
DATA EXTRACTION METHODS
We extracted data for 22,086 dentists ages 25-85 who worked at least 8 weeks per year and 20 hours per week.
PRINCIPAL FINDINGS
Observable characteristics accounted for 58% of the earnings gap between White and Asian dentists, 55% of the gap between White and Hispanic dentists, and 31% of the gap between White and Black dentists. The gap in earnings between White and Asian dentists narrowed at higher quantiles of the income distribution.
CONCLUSIONS
Compared to other minoritized dentists, Black dentists have the largest earnings disparities relative to White dentists. While the level of the explained component of the disparity for Black dentists is comparable to the explained part of the disparities for other minoritized dentists, the excess percentage of the unexplained component for Black dentists accounts for the additional amount of disparity that Black dentists experienced. Persistent income disparities could discourage minoritized dentists from entering the profession.
Topics: Adult; Aged; Aged, 80 and over; Humans; Middle Aged; Dentists; Ethnicity; Hispanic or Latino; Income; United States; White; Minority Groups; Asian; Black or African American; Economics, Dental; Economic Factors; Ethnic and Racial Minorities
PubMed: 36307983
DOI: 10.1111/1475-6773.14095 -
International Dental Journal Apr 2023Dental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients' self-reported dental...
OBJECTIVES
Dental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients' self-reported dental fear and detection of dental fear by the dentists. Another aim was to validate a colour code instrument for estimating dental fear. The influence of COVID-19 on fear and attendance was assessed.
METHODS
A cross-sectional survey was conducted in the primary urgent dental care of Oulu, Finland, in spring 2020 and 2021 after the first (T1) and third waves (T2) of the pandemic. Data were obtained for analyses using the Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a new "traffic light" colour code for dental fear (CCF). The influence of COVID-19 on dental fear and attendance was assessed with structured and open-ended questions. The questionnaires were completed by 273 anonymous participants.
RESULTS
Of the participants, 167 (61.2%) visited dental care during T1 and 106 (38.8%) during T2. Their mean age was 45.1 years. An MDAS score of 19 or above, indicating severe fear, was reported by 10.6% of the participants. Of those with severe dental fear, 87% chose the red colour in the CCF "traffic light" system. The association between dentists' and participants' estimation of dental fear was weak (P < .001) and agreement with the red code was nonexistent (Cohen's kappa value = -0.035). MDAS scores of the younger participants were higher than those of the older ones after the first wave (T1) (P = .021). COVID-19 had the strongest influence on dental attendance and dental fear of those having the most severe self-reported dental fear as measured by the MDAS.
CONCLUSIONS
Colour-coded traffic lights seem valid for screening severe dental fear and are easy and quick to use. They could be useful tools especially since recognising dental fear seems difficult for dentists. The COVID-19 pandemic has complicated dental care for the most fearful individuals.
Topics: Humans; Middle Aged; Dental Anxiety; COVID-19; Cross-Sectional Studies; Pandemics; Surveys and Questionnaires; Dentists
PubMed: 35918206
DOI: 10.1016/j.identj.2022.06.018 -
Stomatologija 2020Studies have shown that dentists are experiencing stress at work and it might have an impact on general health. Dental students have reported negative effect of stress...
OBJECTIVE
Studies have shown that dentists are experiencing stress at work and it might have an impact on general health. Dental students have reported negative effect of stress starting in undergraduate studies period. The various predisposing factors have been identified and determined. The aim of our study was to determine and compare stress among dentists of different specializations.
MATERIALS AND METHODS
A cross-sectional study was conducted in March-September 2016 among 317 dentists. 151 (48%) form public and 166 (52%) from private clinics. All participants were dental practitioners working in Kaunas, Lithuania. A modified version of Occupational stress questionnaire (Institute of Health, Helsinki, Finland, 1992) was used. Chi-square, Kolmogorov-Smirnov test Mann-Whitney U tests, Student's (t) criterion and logistic regression analysis model served for statistical analysis.
RESULTS
Majority of dentists were women (85%) and 61.8% of all participants were general practitioners. More general practitioners and paediatric dentists specialists were working in public clinics. The most stressful factors were: restrictions, work tension, and responsibility, while least stressful were value of work, work and life satisfaction (p<0.05). The intensive stress (>3) was indicated mostly by general practitioners, pediatric dentists and periodontologists.
CONCLUSIONS
Stress is more experienced by dentists working in public clinic being as a general practitioner or having specialization of periodontologist or pediatric dentist. Dentists should be encouraged to take stress management course to cope with.
Topics: Child; Cross-Sectional Studies; Dentists; Female; General Practitioners; Humans; Lithuania; Professional Role; Surveys and Questionnaires
PubMed: 33242029
DOI: No ID Found -
The Journal of Clinical Pediatric... Apr 2021To develop, validate, and apply an instrument for assessing the children's perception regarding pediatric dentist's appearance, based upon the influence of age, gender,...
OBJECTIVE
To develop, validate, and apply an instrument for assessing the children's perception regarding pediatric dentist's appearance, based upon the influence of age, gender, previous dental experience, and anxiety.
STUDY DESIGN
Images and a nine-item questionnaire were developed. The acceptability, convergent-construct validity, and reliability based on reproducibility and internal consistency were evaluated. The validated instrument was applied in a cross-sectional study, with children (n=120) aged 7-12 years asked to evaluate images of pediatric dentists wearing different dental attire (A:all-white (control); B:printed coat and cap, colorful face mask; C:printed coat, cap and face mask; and D:white coat and cap, printed face mask). Children's age, gender, and previous dental experiences were collected with the guardians. The Children's Fear Survey Schedule-Dental Subscale assessed children's anxiety. Descriptive and inferential statistics were carried out (p<0.05).
RESULTS
The instrument showed excellent acceptability, construct validity with moderate and strong correlations (>0.40), satisfactory reproducibility (ICC >0.70), and internal consistency (Cronbach's alpha coefficient >0.70). Considering only the attire, the children's perceptions were more positive with the use of attire C and D (p<0.05). Intergroup analysis of all the variables did not identify a statistically significant difference (p>0.05). In the intragroup analysis, compared to attire A: younger children have higher perception scores to attire D; girls, children with previous experience and without anxiety favored attire C and D; and children without previous experience showed no difference in comparison to A but did between B and C (p<0.05).
CONCLUSION
The C and D attires promoted a more positive perception of the appearance of a pediatric dentist when compared to A; however, age, gender, previous dental experience, and anxiety did not influence the perception scores.
Topics: Child; Clothing; Cross-Sectional Studies; Dental Anxiety; Dentists; Female; Humans; Perception; Reproducibility of Results; Surveys and Questionnaires
PubMed: 33951165
DOI: 10.17796/1053-4625-45.2.4 -
American Journal of Preventive Medicine Mar 2022It is unknown whether certain dentists account for disproportionate shares of dental opioid prescriptions and high-risk prescriptions. Identifying and characterizing...
INTRODUCTION
It is unknown whether certain dentists account for disproportionate shares of dental opioid prescriptions and high-risk prescriptions. Identifying and characterizing such dentists could inform the targeting of initiatives to improve the appropriateness and safety of dental opioid prescribing.
METHODS
In May 2021, the authors conducted a cross-sectional analysis using the IQVIA Longitudinal Prescription Database, which reports dispensing from 92% of U.S. pharmacies, and 2 provider databases (IQVIA OneKey, National Plan and Provider Enumeration System). Analyses included opioid prescriptions from dentists dispensed in 2019 to patients aged >12 years. High-risk prescriptions were those considered high risk by any of 3 metrics (prescriptions to opioid-naïve patients exceeding a 3-day supply, prescriptions with daily opioid dosage ≥50 morphine milligram equivalents, opioid prescriptions with benzodiazepine overlap). Among all prescriptions and high-risk prescriptions, the authors calculated the proportion accounted for by high-volume dentists -- those with prescription counts in the 95th percentile or higher. Using logistic regression, the characteristics associated with being a high-volume dentist were identified.
RESULTS
In 2019, a total of 141,345 dentists accounted for 10,736,743 opioid prescriptions dispensed to patients aged >12 years; 4,242,634 (39.5%) were high-risk prescriptions. The 7,079 high-volume dentists, a group representing 5.0% of the 141,345 dentists, accounted for 46.9% of all prescriptions and 47.5% of high-risk prescriptions. Male sex, younger age, non‒Northeast location, and specialization in oral and maxillofacial surgery were associated with a higher risk of being a high-volume dentist.
CONCLUSIONS
In 2019, high-volume dentists accounted for almost half of dental opioid prescriptions and high-risk prescriptions. Quality improvement initiatives targeting these dentists may be warranted.
Topics: Analgesics, Opioid; Child; Cross-Sectional Studies; Dentists; Drug Prescriptions; Humans; Male; Practice Patterns, Physicians'; Prescriptions
PubMed: 35190099
DOI: 10.1016/j.amepre.2021.09.017 -
European Journal of Paediatric Dentistry Mar 2020Choosing a paediatric dentist is an important decision for parents. The mechanisms of this selection have hardly been studied. This study assesses the factors...
AIM
Choosing a paediatric dentist is an important decision for parents. The mechanisms of this selection have hardly been studied. This study assesses the factors influencing parents' decision choosing a specialised paediatric dentist for their child.
MATERIALS AND METHODS
A questionnaire consisting of 30 items that could potentially be relevant to decision-making was sent nationwide in Germany to paediatric dentists to be given to the parents of new patients (n=450). Eighty-nine out of 102 returned questionnaires (response rate=22.7%) were evaluated.
RESULTS
Parent's and children's experience in previous dental visits played an "important" or "very important" role in choosing a paediatric dentist (78.8% and 62.2%, respectively). The most frequently mentioned recommendation for the paediatric dentist was by friends and acquaintances (86.5%). Recommendations from other dentists were often included in the decision making (60.7%), while specialist journals or Internet portals were less important for the respondents (15% and 19%, respectively). Most of the parents used Internet search engines and the practice website to obtain information.
CONCLUSION
Previous negative experience with general dentists was the main reason for visiting a specialised paediatric dentist. Recommendations came mostly from the close social environment and the qualifications were the most important feature for choosing a paediatric dentist.
Topics: Attitude to Health; Child; Child Behavior; Decision Making; Dentists; Humans; Parents; Surveys and Questionnaires
PubMed: 32183534
DOI: 10.23804/ejpd.2020.21.01.15 -
Pediatric Dentistry Jan 2023The purpose of this study was to evaluate practice patterns among dentist anesthesiologists for pediatric patients with autism spectrum disorders (ASD) undergoing...
PURPOSE
The purpose of this study was to evaluate practice patterns among dentist anesthesiologists for pediatric patients with autism spectrum disorders (ASD) undergoing sedation for dental procedures.
METHODS
An electronic nationwide survey was delivered to all members of the American Society of Dentist Anesthesiologists. The survey assessed provider training and comfort in treating pediatric patients with ASD, perioperative procedures for children with and without ASD, and preferred educational resources for the perioperative management of pediatric patients with ASD.
RESULTS
Respondents were 114 dentist anesthesiologists and residents (33.3 percent response rate). Respondents indicated a high comfort level for managing pediatric patients with ASD for sedation (mean equals 91.9±14.74 [SD] percent). The average number of patients with ASD who respondents treat per week was 3.48±2.44). Providers reported making scheduling and staffing accommodations for patients with ASD. More than half of respondents reported no difference between patient groups in medication dosing for sedation and medication regimens used intraoperatively; however, only 43.9 percent of providers indicated using equivalent preoperative medication regimens for both patient groups, and providers reported increased usage of preoperative anxiolytic techniques with patients with ASD. Importantly, 87.7 percent of respondents reported the same incidence of adverse events during the perioperative period between groups.
CONCLUSIONS
Findings from this survey suggest there are both similarities and differences in how dentist anesthesiologists practice with pediatric patients with and without autism spectrum disorders. Additional research is warranted to measure the clinical benefits of modified practices for patients with ASD and identify best practices for this vulnerable population.
Topics: Child; Humans; Anesthesiologists; Autism Spectrum Disorder; Dentists; Social Group; Workforce; Practice Patterns, Dentists'; Dental Care for Children
PubMed: 36879378
DOI: No ID Found -
International Journal of Paediatric... Jan 2021During the period of health emergency linked to the current COVID-19 pandemic, the paediatric dentists' management of oral health problems in children must have as...
BACKGROUND
During the period of health emergency linked to the current COVID-19 pandemic, the paediatric dentists' management of oral health problems in children must have as primary objective the control of the spread of the disease according to specific protocols aimed at minimizing the risk of viral transmission.
AIM
This paper examines the possible clinical conditions that may require intervention by the paediatric dentist, distinguishing clinical situations that fall into the category of paediatric dental emergencies from conditions of oral pathologies that normally do not represent an emergency. The definition of rigorous and highly effective infection control protocols in the dental settings must therefore be complemented by the development and strengthening of remote communication techniques with the parents, who must be adequately educated on preventive and palliative measures for the management of their children's oral health, with the aim of postponing clinical attendance to when the circumstances become favourable.
CONCLUSIONS
The experience gained with these approaches and models of treatment, where remote interaction techniques play a central role, will hone the communication skills of the paediatric dentist and will retain its usefulness even at the end of the current emergency period.
Topics: COVID-19; Child; Dentists; Humans; Oral Health; Pandemics; SARS-CoV-2
PubMed: 33012056
DOI: 10.1111/ipd.12737 -
International Journal of Environmental... Jul 2022Utilization of a dentist is influenced by many factors. The aim of this study is to present the factors relating to how patients become aware of a dentist, according to...
What Counts for the Old and Oldest Old?-An Analysis of Patient Criteria for Choosing a Dentist-Part I: Awareness and Selection Criteria, Infrastructure, and Dental Office Equipment.
Utilization of a dentist is influenced by many factors. The aim of this study is to present the factors relating to how patients become aware of a dentist, according to which criteria they select the dentist, and which factors in the infrastructure, equipment of dental offices, and human interactions are important for patients. A telephone survey with 466 participants (female 59.9%) in three age groups (ag 1: 35−50 years, ag 2: 70−84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to age, gender, and place of residence. Hardly any differences in the selection of the dentist and the selection criteria applied were found between the sexes, the age groups, or the places of residence. Recommendation seems to be the major aspect regarding how patients become aware of or select their dentist (n = 278, 65.6%), while modern technologies, e.g., the internet, play a subordinate role (n = 31, 7.3%). The unimportance of modern technologies increases significantly with the increase in age. As age increases, factors such as infrastructure (e.g., elevator available (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p < 0.001, ag 1 and ag 3 p < 0.001, and ag 2 and ag 3 p = 0.009); accessibility by wheelchair (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p = 0.006; and ag 1 and ag 3 p < 0.001); etc.) and dental office equipment become significantly important and influence the choice of dentist, while the importance of good parking facilities significantly decreased with age (ANOVA p = 0.003; Bonferoni correction: significant differences between ag 1 and ag 3 p = 0.004, and ag 2 and ag 3 p = 0.023). With increasing age, e.g., the importance of a television in the waiting room (ANOVA p = 0.012; Bonferoni correction: significant differences between ag 1 and ag 3 p = 0.014; and ag 2 and ag 3 p = 0.011), a modern waiting room (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 3 p < 0.001; and ag 2 and ag 3 p < 0.001) or the possibility to visualize the oral situation on a screen decreases significantly (ANOVA p < 0.001; Bonferoni correction: significant differences between ag 1 and ag 2 p < 0.001; ag 1 and ag 3 p < 0.001, and ag 2 and ag 3 p < 0.001). If dentists want to welcome and treat older people, they should adapt the accessibility, infrastructure and equipment of their practice to the needs of older people in order to be able to guarantee continuous lifelong dental care regardless of the need for assistance or care.
Topics: Adult; Aged; Aged, 80 and over; Delivery of Health Care; Dental Offices; Dentists; Female; Humans; Middle Aged; Patient Selection
PubMed: 35886163
DOI: 10.3390/ijerph19148307 -
The Angle Orthodontist Jan 2022To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those...
OBJECTIVES
To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those characteristics that are most negatively and positively rated.
MATERIALS AND METHODS
A smiling photograph of a female dental student was selected and digitally manipulated to create changes in different microesthetic parameters. These altered images were rated by the following five groups: 120 orthodontists, 45 periodontists, 49 prosthodontists, 130 general dentists, and 172 laypersons. Smile esthetics scores were calculated, and comparisons between groups were performed using the univariate general linear model.
RESULTS
The presence of black triangles between the upper incisors was the most negatively rated, and the ideal smile was the most positively rated. Significant differences were detected in the rating scores among the different study groups (P < .05). Orthodontists, prosthodontists, and general dentists scored the presence of a black triangle in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.
CONCLUSIONS
The ideal smile and that with black triangles between the upper incisors were rated as the most and the least attractive smiles, respectively. Orthodontists, prosthodontists, and general dentists scored the presence of black triangles in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive smiles, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.
Topics: Attitude of Health Personnel; Attitude to Health; Dentists; Esthetics, Dental; Female; Gingiva; Humans; Smiling
PubMed: 34520516
DOI: 10.2319/020521-108.1