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Health Services Research 1974Definitions and aspects of the concept of access to medical care are reviewed and integrated into a framework that views health policy as designed to affect...
Definitions and aspects of the concept of access to medical care are reviewed and integrated into a framework that views health policy as designed to affect characteristics of the health care delivery system and of the population at risk in order to bring about changes in the utilization of health care services and in the satisfaction of consumers with those services. Indicators are suggested for the measurement of the various relevant aspects of access, with the system and population descriptors seen as process indicators and utilization and satisfaction as outcome indicators in a theoretical model of the access concept.
Topics: Attitude to Health; Consumer Behavior; Delivery of Health Care; Demography; Dentists; Health Facilities; Health Services; Health Workforce; Hospitals; Models, Theoretical; Organization and Administration; Physicians; Population; Socioeconomic Factors
PubMed: 4436074
DOI: No ID Found -
The Journal of Clinical Pediatric... Sep 2023Stainless steel crowns (SSCs) are the preferred restoration of pediatric dentists for children requiring a pediatric dental rehabilitation due to their low cost and...
Stainless steel crowns (SSCs) are the preferred restoration of pediatric dentists for children requiring a pediatric dental rehabilitation due to their low cost and durability. Despite low technique sensitivity SSC placement can be challenging in some clinical situations including when placed on primary canines. Primary canines restored with SSCs often result in premature contacts and posterior open bite making acquiring an "as the patient presented" (ATPP) occlusion difficult when providing a pediatric dental rehabilitation. Opening of the posterior occlusion due to premature canine contact in a dental rehabilitation is often viewed as unavoidable. This technique article describes a simple method to address this clinical situation and reviews basic principles and techniques for placing SSCs.
Topics: Child; Humans; Dentists; Open Bite
PubMed: 37732429
DOI: 10.22514/jocpd.2023.047 -
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 -
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 -
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 -
American Journal of Public Health May 2017
Topics: Attitude of Health Personnel; Dentists; Humans; Medicaid; Social Responsibility; United States
PubMed: 28661812
DOI: 10.2105/AJPH.2017.303780 -
Rural and Remote Health 2014There is a globally observed unequal distribution of dental and other health practitioners between urban and rural areas in OECD countries. Dental practitioners provide... (Review)
Review
INTRODUCTION
There is a globally observed unequal distribution of dental and other health practitioners between urban and rural areas in OECD countries. Dental practitioners provide important primary healthcare services to rural populations. Workforce shortages and stability issues in underserved areas can have negative effects on rural communities. Strategies used to fix the dental practitioner workforce maldistribution need to be investigated.
METHOD
The study had primary focus on Australia and included relevant international literature. Databases used were PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Informit, Web of Science, Scopus and Summon. Search terms included dental practitioner, rural, remote, retention, recruitment and strategies.
RESULTS
Sixteen articles met the inclusion criteria. The articles described a total of eight different positive factors and 12 negative factors towards rural practice. The positive factors related to the nature of the type of clinical work being a 'challenge', close social and professional support networks, enjoyment of rural lifestyle and successful integration into the rural community. The negative factors mentioned included social and professional isolation, workload and type of clinical work, access to further education opportunities, access to facilities, education for children and job opportunities for a partner, and inability to integrate into the rural community. The articles that analysed recruitment incentives described three strategies currently used to influence recruitment, all of which were financial or contractual in nature. Articles mentioning retention factors described seven long-term retention motivators; of these, six of them were personal reasons. The most commonly mentioned motivational factor for recruitment and retention of the rural dental practitioner workforce was the effect of prior rural exposure for dental practitioners.
CONCLUSIONS
The results of this review indicate that the most important influences on rural dental practitioner workforce recruitment and retention were a combination of financial reimbursement and personal reasons. There was also a large influence of rural medical workforce research on untested assumptions and drivers of the rural dental practitioner workforce. The high recruitment rate compared with the low retention rate indicates that current strategies were not effective in addressing rural dental practitioner workforce shortages in the long term.
Topics: Career Choice; Dentists; Humans; Motivation; Personnel Selection; Professional Practice Location; Rural Health Services; Workforce; Workload
PubMed: 25074243
DOI: No ID Found -
Journal of the Royal Society of Medicine May 1978
Topics: Attitude of Health Personnel; Dentistry; Dentists; Research; United Kingdom
PubMed: 650645
DOI: 10.1177/014107687807100503 -
Journal of the American Dental... Feb 2021
Topics: Dentists; Humans; Workforce
PubMed: 33168141
DOI: 10.1016/j.adaj.2020.09.001