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Public Health Reports (Washington, D.C.... 1981Denturism, an organized movement by dental laboratory technicians to increase their control over the provision of denture services to the public, has generated a great...
Denturism, an organized movement by dental laboratory technicians to increase their control over the provision of denture services to the public, has generated a great deal of controversy among members of organized dentistry, the National Denturist Association, the Federal Trade Commission, consumer groups, and prepaid dental plans.Denturism is currently legal in Arizona, Colorado, Maine, and Oregon. In the first three States, the denturist must practice under the supervision of a dentist, but in Oregon the denturist is able to enter independent practice.The American Dental Association has held that a denturist is educationally unqualified to provide denture services directly to the consumer, Representatives of organized dentistry have characterized denturists as untrained and unskilled persons who would endanger the public's health and return one phase of dentistry to the apprentice system. They see denturism as constituting a major step backward in health care delivery and having an adverse effect on preventive dental care.The National Denturist Association, however, defines a denturist as a highly skilled person who specializes in the making of full and partial dentures. Denturists maintain that the dentist is an unnecessary middleman in the provision of denture services and is the primary cause of the high cost of dental prostheses. They contend that State dental laws providing that only dentists may render denture services have led to the high cost of these services without contributing significantly to the health and safety of the public.Organized dentistry in the United States has been fighting denturism in a number of ways. One that has met with considerable success has been the establishment of programs to provide people access to dental care, especially denture services, at lower costs. A second alternative under consideration is to license denturists but require them to practice under the supervision of a dentist. A third alternative under discussion is to expand the duties of existing dental auxiliary personnel.The final decision on denturism, however, will not be made by the dental profession or the denturists, but by the voting public and their elected representatives, based on the evidence they have before them.
Topics: American Dental Association; Canada; Dental Auxiliaries; Dentistry; Denturists; Licensure, Dental; United States
PubMed: 7291472
DOI: No ID Found -
International Dental Journal Aug 2016The aim of this study was to analyse the potential health effects of occupational exposure of denturists in the Łódź province.
OBJECTIVE
The aim of this study was to analyse the potential health effects of occupational exposure of denturists in the Łódź province.
METHODS
The survey was performed among 103 denturists working in 24 dental laboratories in the Łódź province using the questionnaire prepared by the authors.
RESULTS
The most common health problems associated with work (occurring daily or at least once a week) were: back pain (69.8%); chronic fatigue syndrome (61.6%); irritation, itching and rashes on the hands (51.2%); restlessness and aggression (43.0%); and watery and itchy eyes (41.9%). Psychosocial and ergonomic hazards associated with work organisation (72.2%) were the most common work environment factors related to the denturist profession.
CONCLUSIONS
Analyses of denturists' occupational exposure in the Łódź province and epidemiological estimates of the health effects suggest the need for preventive measures.
Topics: Accidents, Occupational; Adult; Denturists; Female; Humans; Male; Middle Aged; Occupational Diseases; Occupational Exposure; Poland; Prevalence; Safety Management; Surveys and Questionnaires; Workplace; Young Adult
PubMed: 27000468
DOI: 10.1111/idj.12226 -
Journal (Canadian Dental Association) Aug 2021Occupational characteristics of dental care - including closed environment, proximity to staff and patients and the use of aerosol-generating procedures - put workers at...
INTRODUCTION
Occupational characteristics of dental care - including closed environment, proximity to staff and patients and the use of aerosol-generating procedures - put workers at high risk of COVID-19 exposure and transmission. We describe the frequency of workplace situations that potentially increase the risk of exposure to COVID-19 in dental care compared with other occupations including health care.
METHODS
We conducted a cross-sectional study using sociodemographic and occupational data from the 2016 Canadian census linked to workplace characteristics from the Occupational Information Network (O*NET) dataset. We assessed frequency of workplace indicators using an intensity score from 0 (low) to 100 (high) from O*NET on exposure to infection or disease, physical proximity to others, indoor controlled environments, standard protective equipment and specialized protective equipment.
RESULTS
In 2016, 87 815 Canadians worked in the 5 dentistry occupations of interest: dentists; denturists; dental hygienists and dental therapists; dental technologists, technicians and laboratory assistants; and dental assistants. These occupations were routinely ranked in the top 10 of all occupations examined in terms of exposure to workplace indicators that increase the risk of exposure to COVID-19. Dental hygienists and dental therapists, dental assistants, dentists and denturists, rank as the top 4 occupations, in that order, with the highest exposure to disease or infection and physical proximity to others combined.
CONCLUSIONS
Compared with other occupations, dental care workers are at a higher risk of occupational exposure to COVID-19. These results support the development of workplace guidance to reduce the risk of COVID-19 transmission and enhance the well-being of the dental care workforce.
Topics: COVID-19; Canada; Cross-Sectional Studies; Dental Care; Humans; SARS-CoV-2
PubMed: 34905474
DOI: No ID Found -
Journal of Prosthodontic Research Jul 2022There is little evidence as to what is the appropriate replacement interval for complete dentures. The aim of this study was to determine the longevity of complete...
PURPOSE
There is little evidence as to what is the appropriate replacement interval for complete dentures. The aim of this study was to determine the longevity of complete dentures in a population of publicly insured adults across a 20 year observation period.
METHODS
The records of 187,227 Australian adults who accessed complete denture treatment through public clinics between 2000-2019 were assessed. Time to denture replacement was modelled using a Weibull regression and a competing risk regression to adjust for the competing risk of mortality.
RESULTS
Over a 20-year period, 27.7% of dentures were replaced, with a mean longevity of 6.06 (SD: 3.93) years. Pairs of complete dentures had greater mean longevity than single dentures (p<0.001). Approximately 4.6% of dentures provided were replaced within 2 years; 18.4% were replaced between 2 and 10 years and 4.6% of replacements occurred after 10 years.Over 70% of adults who received a complete denture did not replace it during the observation period. Dentures provided by denturists had higher levels of replacement than those made by dentists. Participants over 80 years of age had lower rates of denture replacement. Low socio-economic status and living outside a major city were associated with reduced rates of replacement for dentures under 10 years of age.
CONCLUSION
Complete dentures were commonly replaced after 6 years of service. Pairs of dentures lasted longer than single dentures.
Topics: Adult; Aged, 80 and over; Australia; Dental Care; Denture, Complete; Denture, Partial, Removable; Humans; Retrospective Studies
PubMed: 34645719
DOI: 10.2186/jpr.JPR_D_20_00323 -
Journal (Canadian Dental Association) Oct 2004To document the trends in expenditures on dental health care services and the number of dental health care professionals in Canada from 1990 to 1999.
OBJECTIVES
To document the trends in expenditures on dental health care services and the number of dental health care professionals in Canada from 1990 to 1999.
METHODS
Information on dental and health expenditures, numbers of dentists, hygienists and dental therapists, and the population of Canada and the provinces were obtained from the Canadian Institute for Health Information; data on numbers of denturists were obtained from regional bodies and from Health Canada. Information on the costs of other disease categories was taken from studies by Health Canada (1993 and 1998). International comparisons were made on the basis of data published by the Organisation for Economic Co-operation and Development (OECD). Indices of change over the decade (in which the 1990 value served as the baseline [100]) were calculated.
RESULTS
By 1999, the supply of all types of dental care providers had increased to 1 for every 904 people. Dental expenditures during the 1990s increased by 64% overall and by 49% per capita, a rate of increase that exceeded both inflation and costs of health care. Although the public share of dental costs decreased from 9.2% to 5.8%, the direct costs of dental care increased to rank second (6.30 billion dollars) after those for cardiovascular diseases (6.82 billion dollars). Among the OECD nations, Canada had the fourth highest per capita dental expenditures and the second lowest per capita public dental expenditures.
CONCLUSIONS
The direct economic costs of dental conditions increased during the 1990s from 4.13 billion dollars to 6.77 billion dollars. Over the same period, the public share for expenditures on dental health care services declined.
Topics: Canada; Cost of Illness; Dental Auxiliaries; Dental Care; Dentists; Economics, Dental; Financing, Government; Health Care Costs; Health Expenditures; Humans
PubMed: 15473944
DOI: No ID Found -
Journal (Canadian Dental Association) May 2005Remedies for dental diseases have been in use for as long as 4,000 years, and various materials and methods have been used over the millennia. Dentistry continues to...
Remedies for dental diseases have been in use for as long as 4,000 years, and various materials and methods have been used over the millennia. Dentistry continues to change in response to changes in the age distribution, origins, financial means and health of the population, as well as to changes within the profession itself. The Canadian population is very unevenly distributed geographically and ethnically. Furthermore, it is aging rapidly and life expectancy is increasing. Although the average income of Canadians has increased, the increase was unevenly distributed, and the gap between rich and poor continues to expand. There has been a steady rise in the number of Canadians with dental insurance, although the proportion of the population with insurance varies from one province to another. Not surprisingly, people with dental insurance compared to those without are more frequent users of dental services. The rate of caries attack has diminished in industrialized countries, but people are keeping their teeth longer, so caries will remain a significant public health problem, particularly among elderly people. In addition, smoking tobacco is strongly associated with periodontal disease; thus, there should be more action within the dental community in support of smoking cessation programs. The composition of the dental care community is also changing. The ratios of dentists and dental hygienists to the population have increased, the services offered by dental technicians have expanded greatly, and the services offered by denturists have also increased as these services gain more widespread acceptance. Use of dental services in Canada remains reasonably broad; however, denture-wearers continue to regard uncomfortable dentures as a normal part of aging. The pattern of uneven distribution of disease and access to service remains the major challenge facing the dental profession.
Topics: Aged; Aged, 80 and over; Canada; Dental Care for Aged; Dental Care for Disabled; Dental Caries; Dental Health Services; Emigration and Immigration; Health Services Needs and Demand; Health Transition; Humans; Income; Insurance, Dental; Life Expectancy; Periodontal Diseases; Population Growth
PubMed: 15949255
DOI: No ID Found -
American Journal of Public Health Jun 1980This paper explores the changing realities of dentistry in the 1970s: the development of denturism; the maldistribution of dental practitioners; the growth and...
This paper explores the changing realities of dentistry in the 1970s: the development of denturism; the maldistribution of dental practitioners; the growth and activities of expanded function auxiliaries; the intrusion of the Federal Trade Commission into professional issues resulting in advertising, supermarket and franchise dentistry; and the effect of prepayment plans. These realities are considered in terms of their impact on the profession and the efforts by the individual practitioner and his representative organizations to come to terms with them.
Topics: Advertising; American Dental Association; Attitude of Health Personnel; Dental Auxiliaries; Dentistry; Dentists; Denturists; Government Agencies; Insurance, Dental; Legislation, Dental; Medically Underserved Area; Practice Management, Dental; United States
PubMed: 7377438
DOI: 10.2105/ajph.70.6.619 -
BMC Oral Health Mar 2015The traditional measure for assessing dental treatment needs and workforce requirements based solely on normative need (NN) has major shortcomings. The sociodental... (Comparative Study)
Comparative Study
BACKGROUND
The traditional measure for assessing dental treatment needs and workforce requirements based solely on normative need (NN) has major shortcomings. The sociodental approach (SDA) to assess needs overcomes some of the shortcomings as it combines normative and subjective needs assessments and also incorporates behavioural propensity (Sheiham and Tsakos 2007). The objective of this study was to estimate and compare prosthodontic treatment needs and workforce requirements, using the normative and the sociodental approaches for different skill mix models.
METHODS
A cross-sectional study was conducted on 732 university employees aged 30-54 years. Normative prosthodontic need was assessed using the WHO (1997) method. The SDA includes NN and also considers oral impacts, measured through the OIDP index, and behavioural propensity. Estimates of prosthodontic need and dental workforce requirements using the two methods were compared using McNemar and Wilcoxon Signed Rank test respectively. The dental workforce required for prosthodontic treatment based on NN and SDA approaches were then compared using different workforce skill mix models.
RESULTS
The proportion of subjects needing prosthodontic treatment was lower by more than 90% when the SDA was used compared to NN. The number of dentists required for prosthodontic treatment per 100,000 people were 98.8 using NN compared to 2.49 using SDA. Using a skill mix approach, the requirements for dentists per 100,000 people decreased slightly when more denture procedures were delegated to dental therapists.
CONCLUSION
There were very much lower levels of prosthodontic treatment needs and workforce requirements when using the sociodental approach compared to normative methods.
Topics: Activities of Daily Living; Adult; Attitude to Health; Clinical Competence; Cross-Sectional Studies; Delegation, Professional; Dentists; Denture, Complete; Denture, Partial, Fixed; Denture, Partial, Removable; Dentures; Denturists; Female; Health Behavior; Humans; Malaysia; Male; Middle Aged; Needs Assessment; Oral Health; Quality of Life; Time Factors
PubMed: 25887142
DOI: 10.1186/s12903-015-0015-9 -
Journal (Canadian Dental Association) Jun 2006A national interdisciplinary strategy is needed to address the comprehensive oral health care needs of frail elderly people residing in long-term care facilities....
A national interdisciplinary strategy is needed to address the comprehensive oral health care needs of frail elderly people residing in long-term care facilities. Reasonable care within the social and personal context of frailty encompasses active prevention of disease augmented by necessary restorative treatment, provided with sensitivity to a person"s propensity to seek care. Typically, dental emergencies are managed quite well in longterm care facilities, either by treating the resident on site or by transporting the resident to a local clinician. In addition, facility administrators are usually well aware of their legal responsibilities to provide diagnostic services to residents before disease or dysfunction causes irreparable damage. Consequently, many facilities have arrangements with dental hygienists, dentists or denturists for periodic clinical assessment of all residents, or they seek help at the first sign of trouble. On the other hand, effective, widely accepted strategies for assisting frail residents with daily oral hygiene are lacking, and in many regions across the country it is overly difficult for frail residents with severe oral impairment or dysfunction to receive appropriate care and treatment. A cooperative effort from many disciplines will be needed to provide these missing links in Canadian health services and to realize the principle of providing maximum benefit to the least advantaged in society.
Topics: Aged; Aged, 80 and over; British Columbia; Canada; Dental Care for Aged; Dental Caries; Ethics, Dental; Frail Elderly; Health Services Needs and Demand; Humans; Nursing Homes; Oral Hygiene; Patient Acceptance of Health Care; Periodontal Diseases; Quality of Life; Social Justice
PubMed: 16772066
DOI: No ID Found -
American Journal of Public Health Oct 1995Dental services use by two cohorts under the universal dental plan for the elderly in Alberta, Canada, was examined. (Comparative Study)
Comparative Study
OBJECTIVES
Dental services use by two cohorts under the universal dental plan for the elderly in Alberta, Canada, was examined.
METHODS
Two birth cohorts 65 to 69 years old at entry who used the plan from 1978 to 1979 (n = 17,816) or from 1985 to 1986 (n = 27,474) were analyzed over 6 successive years for differences in dental services use and costs.
RESULTS
The 1985/86 cohort received 24% more visits per patient than the 1978/79 cohort. Their inflation-adjusted expenditures increased by 19% mainly as a result of increases in denturists' expenditures (33%) (dentists' expenditures increased just 4% because of lower plan fee increases). The 1985/86 cohort received relatively many more periodontal and fewer denture services. Annual attendance over 6 consecutive years was high, especially for the 1985/86 cohort and dentists' patients; 55% of the 1985/86 cohort who used dentists did so in 5 or all 6 years.
CONCLUSIONS
Differences in plan expenditures per patient between the birth cohorts and dentists and denturists, along with the high continuity of care for dentists' patients, have important implications for planning and administering dental plans for the elderly. The large expenditure decreases for removable dentures and the large increases for periodontal services to the 1985/86 cohort are noteworthy.
Topics: Aged; Alberta; Cohort Studies; Dental Care for Aged; Denturists; Health Care Costs; Health Expenditures; Health Services Research; Humans; Insurance, Dental
PubMed: 7573626
DOI: 10.2105/ajph.85.10.1408