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British Dental Journal May 2020
Topics: COVID-19; Career Mobility; Dental Care; Dentists; Humans; SARS-CoV-2
PubMed: 32444710
DOI: 10.1038/s41415-020-1696-2 -
Dental Press Journal of Orthodontics 2021This study aimed to assess the knowledge, attitudes, and aspects of the clinical practice of orthodontists and periodontists, regarding lower fixed orthodontic retainers. (Observational Study)
Observational Study
OBJECTIVE
This study aimed to assess the knowledge, attitudes, and aspects of the clinical practice of orthodontists and periodontists, regarding lower fixed orthodontic retainers.
METHODS
The orthodontists (n=502) and periodontists (n=269) who participated in this cross-sectional observational study received, via e-mail, questions related to the type of lower fixed retainer, dental biofilm accumulation, oral hygiene, and potential periodontal changes. The data were subjected to chi-square and Fisher's exact tests, at 5% significance level.
RESULTS
Both orthodontists (72.3%) and periodontists (58.7%) reported that hygienic retainers accumulate more dental biofilm (p< 0.05), and 64.1% of orthodontists and 58.7% of periodontists considered that modified retainers may lead to periodontal changes (p< 0.05). There was no significant difference between the dental specialties, regarding the type of lower fixed retainer considered the easiest for the patient to perform hygiene (p> 0.05), whereas 48.6% of professionals chose the modified type.
CONCLUSION
The modified retainer accumulates a greater amount of dental biofilm and, in the perception of orthodontists and periodontists, it may cause periodontal changes.
Topics: Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Humans; Orthodontic Appliance Design; Orthodontic Retainers; Orthodontists
PubMed: 34468561
DOI: 10.1590/2177-6709.26.4.e2119276.oar -
Journal of Dentistry Oct 2023Dentists in Australia are the second largest prescriber group, and are generally not formally taught how to prescribe. The objective of this review is to describe the... (Review)
Review
OBJECTIVES
Dentists in Australia are the second largest prescriber group, and are generally not formally taught how to prescribe. The objective of this review is to describe the Prescribing Competencies Framework and its relevance to dentistry.
DATA
The four-model stage of prescribing by Coombes and colleagues, and the seven competencies within the Prescribing Competencies Framework devised by the Australian National Prescribing Service MedicineWise, are discussed and applied to dentistry.
SOURCES AND STUDY SELECTION
Each of the seven competencies are analysed and detailed in the context of clinical dental practice. Competencies 1-5 describe the skillset and tasks required by dentists to safely prescribe, whereas Competencies 6 and 7 describe the clinical environment and recommended resources to support dentists to prescribe safely and effectively.
CONCLUSIONS
The Prescribing Competencies Framework provides an overview of safe and effective prescribing. Prescribing is a process, and a separate skillset to clinical dentistry. The process involves information gathering, clinical assessment, effective communication and review of the patient. Access to timely and appropriate resources and relevant electronic sources of health information for clinicians are important to provide the support required for better informed prescribing decisions. The framework describes a patient-centered prescribing process, and ultimately prescribing should be a shared decision between the dentist and the patient.
CLINICAL SIGNIFICANCE
Safe and effective prescribing is an integral part of dentistry and dentists are the second largest prescriber group. However, dentists display high rates of inappropriate and unnecessary prescribing, and to minimise errors, the Prescribing Competencies Framework has been established. This article details how the Framework applies to clinical practice dentistry.
Topics: Humans; Australia; Dentistry; Dentists
PubMed: 37574106
DOI: 10.1016/j.jdent.2023.104654 -
Journal of Dentistry Jun 2024Primary care dentistry is the first point of contact that someone has with the dental system and is predominantly focused on the treatment and prevention of dental... (Review)
Review
INTRODUCTION
Primary care dentistry is the first point of contact that someone has with the dental system and is predominantly focused on the treatment and prevention of dental caries and periodontal disease. The aim of this paper was to review the Australian primary dental care system.
METHODS
This paper reviews the primary dental care system in Australia, drawing on data reporting on the dental workforce, funding sources for dental care, oral health outcome measures and dental visiting patterns.
RESULTS
Primary dental health care in Australia is predominantly provided by dentists working in private practice, with the number of dentists per 100,000 people in Australia increasing from 46.9 in 2000 to 65.1 in 2022. However, there has been a gradual shift over the past twenty years towards greater service provision by other members of the dental team who now represent one quarter of the dental workforce, and some expansion of publicly funded dental care. Despite this dentistry remains isolated from the rest of primary health care, and the lack of government funding means that many people continue to miss out of necessary dental care, particularly those living in regional and rural Australia and from low-income groups.
CONCLUSIONS
Australians should be able to access primary dental care services when and where they need it with adequate financial protection, from services that are well integrated into the broader primary health care system to ensure they are able to achieve optimal oral and general health. For many Australians, this is not currently the case.
CLINICAL SIGNIFICANCE
Australia is at a crossroads with respect to access to dental care, and there is a need for stronger advocacy from stakeholders to improve oral health outcomes and reduce inequalities.
Topics: Humans; Australia; Primary Health Care; Health Services Accessibility; Dental Care; Oral Health; Dentists; Dental Caries; Private Practice; Workforce
PubMed: 38621524
DOI: 10.1016/j.jdent.2024.104996 -
Indian Journal of Dental Research :... 2023Noncooperative behaviour faced by a paediatric dentist is the most common attribution towards behavioural manifestations of anxiety in children, and it had been observed... (Review)
Review
Noncooperative behaviour faced by a paediatric dentist is the most common attribution towards behavioural manifestations of anxiety in children, and it had been observed that these relationships are long-deterministic and form part of the aforementioned belief system of the child. Forehead and Long in their study found that most uncooperative behaviour of the child is due to their strong will and these children are generally confident, persistent and independent. A fruitful method to deal with strong willed children is to violate the causal relationship by some magic tricks from preventive via curative to his/her follow ups visits. Tricks can be applied at three levels of their visit. Level 1 is preoperative tricks, which includes the preventive measures that teach and educate children for good oral health. Level 2 is operative tricks, which involves child preparedness for successful dental procedures. Level 3 is postoperative tricks, which involve positive reinforcement for regular follow ups. The purpose of this review is to make paediatric dentists think like magicians by using the science behind the magic and applying it in their practice for creating a positive attitude of a child toward dentistry and better procedural experience.
Topics: Child; Humans; Dentists; Oral Health; Pediatric Dentistry; Dental Anxiety
PubMed: 38197355
DOI: 10.4103/ijdr.ijdr_986_22 -
AMA Journal of Ethics Jan 2022Dental treatment is contraindicated by some health conditions. As patients live longer and dentists treat more patients with underlying disease, patients often need...
Dental treatment is contraindicated by some health conditions. As patients live longer and dentists treat more patients with underlying disease, patients often need general medical care before dental care can proceed. For US patients without access to health care and their dentists, lack of medical-dental integration can generate inequity, poor outcomes, and ethical questions. Individual dentists should advocate for patients who need general health care prior to dental care, but the professions of dentistry and medicine must also respond to macro-level health system gaps and failures.
Topics: Attitude of Health Personnel; Contraindications; Delivery of Health Care; Dentists; Health Status; Humans
PubMed: 35133722
DOI: 10.1001/amajethics.2022.6 -
BMC Oral Health Jun 2023This study is to investigate the referral pattern and treatment modality of dentists in the management of peri-implant diseases between periodontists and...
OBJECTIVES
This study is to investigate the referral pattern and treatment modality of dentists in the management of peri-implant diseases between periodontists and non-periodontist dentists (NPDs).
MATERIALS AND METHODS
A total of 167 validated questionnaires were obtained from periodontists and NPDs, who had experience of placing implants for at least one year. Question I to IV asked how the dentist would respond if a patient came for treatment of their peri-implant diseases with four different scenarios according to resource of patient and disease severity. For each Scenario, dentists also replied which treatment procedures they would use if they decide to treat the patient.
RESULTS
Periodontal training, resource of patient, and disease severity were shown to significantly influence the referral pattern and treatment modality in the management of peri-implant disease (p < 0.05). Periodontists were more likely to use variable treatment procedures, including occlusal adjustment (OR = 2.283, p < 0.01), oral hygiene instruction (OR = 3.751, p < 0.001), topical antiseptic agent (OR = 2.491, p < 0.005), non-surgical mechanical therapy (OR = 2.689, p < 0.001), surgical therapy (OR = 2.009, p < 0.01), and remove implant (OR = 3.486, p < 0.001) to treat peri-implant diseases, compared to NPDs.
CONCLUSION
The periodontal specialty training, resource of patient, and disease severity significantly influenced the referral pattern and treatment modality of dentist treating an implant diagnosed with peri-implant disease. This study also highlighted the importance of educating basic periodontal and peri-implant disease-related knowledge to all dentists regularly performing dental implant treatments.
CLINICAL RELEVANCE
Peri-implant diseases are highly prevalent among patients with dental implants. Periodontal specialty training could enhance using variable treatment procedures to treat peri-implant diseases for dentists.
Topics: Humans; Peri-Implantitis; General Practice, Dental; Dental Implants; Dentists; Referral and Consultation
PubMed: 37370067
DOI: 10.1186/s12903-023-03135-3 -
JAMA Network Open Jul 2022Evaluating the availability of dentists to provide dental care services to children is important for identifying interventions for improving access.
IMPORTANCE
Evaluating the availability of dentists to provide dental care services to children is important for identifying interventions for improving access.
OBJECTIVE
To assess dental care availability for children in the US by public insurance participation, rural-urban setting, and dentist taxonomy (general, pediatric, or specialized).
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study analyzed the availability of dentists from matching 3 data sets: the 2020 National Plan and Provider Enumeration System, the 2019-2020 State Board of Dentistry information acquired from each state, and the 2019 InsureKidsNow.org database. Data on active dentists in most states (including the District of Columbia [combined hereinafter with states] and excluding Hawaii and Washington) were included in the analysis. The study was conducted from January 2019 to March 2022.
MAIN OUTCOMES AND MEASURES
The number and percentage of dentists participating in public insurance programs (Medicaid and/or Children's Health Insurance Program [CHIP]) were aggregated at the dental office and stratified by the rurality of their practice and taxonomy. State-level comparisons were derived between this study and reports from the Health Policy Institute of the American Dental Association, along with maps and summary statistics disseminated through a data portal and state reports.
RESULTS
Among 204 279 active dentists, participation in public insurance varied widely across states, especially for the states that manage the Medicaid and CHIP programs separately. Participation rates in Medicaid and CHIP varied substantially from those of the Health Policy Institute of the American Dental Association. Participation in Medicaid and CHIP was lowest among urban dentists (Medicaid, 26%; CHIP, 29%) and highest among rural dentists (Medicaid, 39%; CHIP, 40%), while urban dentists accounted for most of the dentist population (urban, 84%; rural, 5%). Similarly, participation in Medicaid and CHIP was substantially lower among general dentists (Medicaid, 28%; CHIP, 29%) vs pediatric dentists (57% in both programs), while each state's dentist population consisted of notably more general (84%) than pediatric (3%) dentists. Nearly half of the states revealed wide variations in Medicaid and CHIP participation between counties, ranging from no participation (21 states) to full participation (22 states).
CONCLUSIONS AND RELEVANCE
The findings of this study suggest that disparities in the availability of dentists for pediatric dental care are extensive, particularly for Medicaid- and CHIP-insured children, those living in rural communities, and those receiving specialized care. Lack of dentist availability for Medicaid- and CHIP-insured children appears to deter access to receiving dental care.
Topics: Child; Cross-Sectional Studies; Dentists; Health Services Accessibility; Humans; Insurance; Medicaid; United States
PubMed: 35816300
DOI: 10.1001/jamanetworkopen.2022.21444 -
Inquiry : a Journal of Medical Care... 2022Dentists in Spain reached equal gender representation in 2012 and the number of female dentists has continued to grow (until 57.3% in 2020). This study aims to increase...
Dentists in Spain reached equal gender representation in 2012 and the number of female dentists has continued to grow (until 57.3% in 2020). This study aims to increase evidence about the gender distribution on the high responsibility positions and opinion leaders of the dental profession and academia. Composition of the executive comities of the main dental institutions of Spain (regional professional associations, national dental association, and scientific societies), members of the Faculty of Dentistry of the University of Granada in 2020 and speakers of the main dental congresses of 2019 (due to the lack of congress in 2020) were recorded and analyzed by genders using chi-squared test ( < .05). Mean representation of female dentists in executive committees of professional associations was 35.6%. More than 70% of presidents and vice-presidents of professional colleges and more than 60% of these positions in scientific societies were occupied by male dentists. None of dental congresses of 2019 reached equal gender participation, being 81.3% of lecturers presenting on main auditoriums male dentists. Although dental workforce in Spain is slightly overrepresented by females, leadership positions and figures among Spanish dentists doesn't seem to reflect the gender distribution of the collective. There is a lack of women occupying high-level positions in dentistry that proves the existence of the so-called "glass ceiling effect" on the profession. Further studies about sociodemographic aspects of dental workforce are needed to develop evidence-based policies for the collective.
Topics: Dentistry; Dentists, Women; Female; Humans; Leadership; Male; Spain; Universities
PubMed: 35912432
DOI: 10.1177/00469580221109970 -
Journal of the American Dental... Feb 2021
Topics: Dentists; Humans; Workforce
PubMed: 33168141
DOI: 10.1016/j.adaj.2020.09.001