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International Journal of Environmental... May 2019To describe the current oral health care needs and the number and category of dental personnel required to provide necessary services in South Africa (SA). This is a... (Review)
Review
To describe the current oral health care needs and the number and category of dental personnel required to provide necessary services in South Africa (SA). This is a review of the current disease burden based on local epidemiological studies and the number of oral health personnel registered with the Health Professions Council of South Africa (HPCSA). In SA, oral health services are rendered by oral hygienists, dental therapists, dentists, and dental specialists. Dental caries remains one of the most prevalent conditions, and much of them are untreated. The majority of oral care providers are employed in the private sector even though the majority of the population access the public sector which only offers a basic package of oral care. The high prevalence of caries could be prevented and treated by the public sector. The infrastructure at primary health care facilities needs to be improved so that dentists performing community service can be more effectively utilized. At present, SA requires more dental therapists and oral hygienists to be trained at the academic training institutions.
Topics: Dental Caries; Dentists; Humans; Malocclusion; Mouth Neoplasms; Oral Health; Periodontal Diseases; South Africa
PubMed: 31091648
DOI: 10.3390/ijerph16101668 -
Journal of the American Dental... Feb 2019In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States.
BACKGROUND
In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States.
METHODS
The authors used geospatial analysis to describe the distribution of periodontists and adults, periodontists vis-à-vis estimated density of adults with severe periodontitis, and their ratios to adults with severe periodontitis. The authors identified locations of 5,415 practicing periodontists through the 2014 National Provider Identifier Registry, linked them with the weighted census number of adults, and estimated the number of adults within a series of circular distance zones.
RESULTS
Approximately 60% of adults 30 through 79 years lived within 5 miles of a periodontist, 73% within 10 miles, 85% within 20 miles, and 97% within 50 miles. Proximity to a periodontist varied widely. In urban areas, 95% of adults resided within 10 miles of a periodontist and 100% within 20 miles. Only 24% of adults in rural areas lived within 10 miles of a periodontist. Most periodontists (96.1%) practiced in urban areas, clustering along the eastern and western coasts and in the Midwest, 3.1% in urban clusters elsewhere, and 0.8% in rural areas. Ratios of fewer than 8,000 adults with periodontitis to 1 or more periodontists within 10 miles were clustered mostly in the Northeast, central East Coast, Florida, West Coast, Arizona, and Midwest.
CONCLUSIONS
In this study, the authors identified wide variations in geographic proximity to a practicing periodontist for adults with severe periodontitis.
PRACTICAL IMPLICATIONS
Dental practitioners may provide preventive care and counseling for periodontitis and referrals for specialty care. Geographic proximity to specialized periodontal care may vary widely by locality.
Topics: Adult; Counseling; Dentists; Humans; Periodontics; Periodontitis; Referral and Consultation; United States
PubMed: 30470389
DOI: 10.1016/j.adaj.2018.09.021 -
The New Zealand Dental Journal Dec 2016
Topics: Dentist-Patient Relations; Dentists; Humans; Male; Professional Role; Suicide
PubMed: 29694761
DOI: No ID Found -
International Journal of Environmental... Apr 2023The advent of new technology has caused significant changes in the field of dentistry, enabling dentists and orthodontists to provide more efficient and effective...
The advent of new technology has caused significant changes in the field of dentistry, enabling dentists and orthodontists to provide more efficient and effective treatments to their patients [...].
Topics: Humans; Dentists; Public Health; Orthodontists; Dental Care; Technology
PubMed: 37047978
DOI: 10.3390/ijerph20075364 -
International Dental Journal Feb 2017Attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice are described in several studies, but the results are... (Meta-Analysis)
Meta-Analysis Review
AIMS
Attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice are described in several studies, but the results are heterogenous. The purpose of this systematic review was to compare the attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice.
METHODS
PubMed, AMED and CINAHL were screened by two independent assessors to identify relevant studies. Only quantitative studies that reported the percentages of dentists' and dental hygienists' attitude towards extended scope and independent dental hygiene practice were included. The random-effects model was used to synthesise possible heterogenous influences.
RESULTS
Meta proportions with regard to a positive attitude towards extended scope of practice are 0.54 for dentists and 0.81 for dental hygienists. Meta proportions of a positive attitude towards independent practice are 0.14 for dentists and 0.59 for dental hygienists. A meta analysis with regard to negative attitudes could only be performed on extended scope of practice and did not reveal a difference between the two professions. We obtained homogeneous outcomes of the studies included regarding negative attitudes of dentists . A minority of dentists hold negative attitudes towards extended scope of dental hygiene practice. Study outcomes regarding negative attitudes of dental hygienists were heterogeneous.
CONCLUSIONS
Positive attitudes are present among a majority of dentists and dental hygienists with regard to extended scope of dental hygiene practice, while for independent dental hygiene practice this holds for a minority of dentists and a majority of dental hygienists.
Topics: Attitude of Health Personnel; Dental Hygienists; Dentists; Female; Humans; Male; Oral Hygiene; Professional Role
PubMed: 27678334
DOI: 10.1111/idj.12254 -
Dental and Medical Problems 2021Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) has had drastic effects among healthcare professionals.
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) has had drastic effects among healthcare professionals.
OBJECTIVES
This study aimed to assess knowledge and awareness among dental specialists, general dentists and dental assistants regarding standard patient care guidelines for minimizing the spread of the infection.
MATERIAL AND METHODS
A survey-based cross-sectional study was conducted on a sample of 84 participants. The participants were divided into groups of dental specialists, general dentists and dental assistants. A modified version of a validated questionnaire was used to evaluate knowledge and awareness regarding SARS‑CoV‑2 as per the Centers for Disease Control and Prevention (CDC) guidelines. Data was analyzed using the one-way analysis of variance (ANOVA) and post-hoc Tukey's tests to assess differences in knowledge regarding the SARS‑CoV‑2 guidelines across the 3 groups. The simple linear regression analysis was used to examine factors influencing the knowledge scores.
RESULTS
Among all dental specialists, 13 orthodontists, 9 operative dentists, 8 maxillofacial surgeons, 4 prosthodontists, and 1 periodontist responded to the survey. The mean knowledge scores of dental specialists, general dentists and dental assistants were 10.05 ±2.10, 9.95 ±2.30 and 8.53 ±2.10, respectively. Overall, we found a significant difference (p = 0.02) in the knowledge scores between the groups, and pairwise comparisons showed that there was a significant difference (p = 0.03) in the knowledge scores between dental specialists and dental assistants.
CONCLUSIONS
These findings suggest that hospitals should conduct mandatory workshops, training sessions and seminars to raise the awareness of the novel coronavirus pandemic and disinfection protocols, not only for specialists, but for all staff members.
Topics: COVID-19; Cross-Sectional Studies; Dental Assistants; Dentists; Health Knowledge, Attitudes, Practice; Humans; SARS-CoV-2; Specialization; United States
PubMed: 34463437
DOI: 10.17219/dmp/134964 -
BMC Oral Health Dec 2018Healthcare workers including physicians, dentists, nurses and laboratory workers are considered to be among the groups at the risk of blood-borne pathogen transmission....
BACKGROUND
Healthcare workers including physicians, dentists, nurses and laboratory workers are considered to be among the groups at the risk of blood-borne pathogen transmission. Thus, it is necessary to evaluate the Knowledge, Attitude, and Practices (KAP) of dentists regarding infection control and basic principles.
METHODS
This cross-sectional study recruited 106 dentists in Sanandaj, Iran. The dentists' KAP regarding hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV/AIDS were evaluated. Chi-square test, student's t-test, and one-way ANOVA were used to assess differences between the groups. Data were analyzed in Stata 12.
RESULTS
The results showed that the majority of the subjects in the study population (53.8%) were female. The mean ± standard deviation (SD) for age and work experience was 39.6 ± 9.80 and 10.6 ± 8.7 years, respectively. The mean ± SD for knowledge, attitude and practices of participants was 37.3 ± 3.01, 22.9 ± 4.80 and 24.07 ± 5.06, respectively. The results also indicated that dentists' higher level of knowledge about HBV, HCV and HIV/AIDS was significantly influenced by work experience (≥10 years; P < 0.001) and graduation year (after 2006: P < 0.001). Positive attitude towards HBV, HCV and HIV/AIDS was considerably influenced by age group (< 30 years: P = 0.021), work experience (≥10 years: P < 0.001), and workplace (dental office: P = 0.016).
CONCLUSIONS
The results of this study demonstrated a satisfactory level of knowledge and attitude of dentists about HBV, HCV and HIV/AIDS infections, but some gaps were observed, suggesting that higher knowledge level of dentists plays a very important role in forming the attitudes and practices regarding patients with HBV, HCV and HIV/AIDS.
Topics: Adult; Cross-Sectional Studies; Dentists; Female; HIV Infections; Health Knowledge, Attitudes, Practice; Hepatitis B; Hepatitis C; Humans; Iran; Male
PubMed: 30563497
DOI: 10.1186/s12903-018-0685-1 -
The Cochrane Database of Systematic... Nov 2013Methods of remuneration have been linked with the professional behaviour of primary care physicians. In dentistry, this can be exacerbated as clinicians operate their... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Methods of remuneration have been linked with the professional behaviour of primary care physicians. In dentistry, this can be exacerbated as clinicians operate their practices as businesses and take the full financial risk of the provision of services. The main methods for remunerating primary care dentists include fee-for-service, fixed salary and capitation payments. The aim of this review was to determine the impact that these remuneration mechanisms have upon primary care dentists' behaviour.
OBJECTIVES
To evaluate the effects of different methods of remuneration on the level and mix of activities provided by primary care dentists and the impact this has on patient outcomes.
SEARCH METHODS
We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 7, 2013); MEDLINE (Ovid) (1947 to 11 June 2013); EMBASE (Ovid) (1947 to 11 June 2013); EconLit (1969 to 11 June 2013); the NHS Economic Evaluation Database (EED) (11 June 2013); and the Health Economic Evaluations Database (HEED) (11 June 2013). We conducted cited reference searches for the included studies in ISI Web of Knowledge; searched grey literature sources; handsearched selected journals; and contacted authors of relevant studies.
SELECTION CRITERIA
Primary care dentists were defined as clinicians that deliver routine or mainstream dental care in a primary care environment. We included randomised controlled trials (RCTs), non-randomised controlled clinical trials (NRCTs), controlled before-after (CBA) studies and interrupted time series (ITS) studies. The methods of remuneration that we considered were: fee-for-service, fixed salary and capitation payments. Primary outcome measures were: measures of clinical activity; volume of clinical activity undertaken; time taken and clinical session length, or both; clinician type utilised; measures of health service utilisation; access and attendance as a proportion of the population; re-attendance rates; recall frequency; levels of oral health inequalities; non-attendance rates; healthcare costs; measures of patient outcomes; disease reduction; health maintenance; and patient satisfaction. We also considered measures of practice profitability/income and any reported unintended effects of the included methods of remuneration.
DATA COLLECTION AND ANALYSIS
Three of the review authors (PRB, JP, AMG) independently reviewed titles and abstracts and resolved disagreements by discussion. The same three review authors undertook data extraction and assessed the quality of the evidence from all the studies that met the selection criteria, according to Cochrane Collaboration procedures.
MAIN RESULTS
Two cluster-RCTs, with data from 503 dental practices, representing 821 dentists and 4771 patients, met the selection criteria. We judged the risk of bias to be high for both studies and the overall quality of the evidence was low/very low for all outcomes, as assessed using the GRADE approach.One study used a factorial design to investigate the impact of fee-for-service and an educational intervention on the placement of fissure sealants in permanent molar teeth. The authors reported a statistically significant increase in clinical activity in the arm that was incentivised with a fee-for-service payment. However, the study was conducted in the four most deprived areas of Scotland, so the applicability of the findings to other settings may be limited. The study did not report data on measures of health service utilisation or measures of patient outcomes.The second study used a parallel group design undertaken over a three-year period to compare the impact of capitation payments with fee-for-service payments on primary care dentists' clinical activity. The study reported on measures of clinical activity (mean percentage of children receiving active preventive advice, health service utilisation (mean number of visits), patient outcomes (mean number of filled teeth, mean percentage of children having one or more teeth extracted and the mean number of decayed teeth) and healthcare costs (mean expenditure). Teeth were restored at a later stage in the disease process in the capitation system and the clinicians tended to see their patients less frequently and tended to carry out fewer fillings and extractions, but also tended to give more preventive advice.There was insufficient information regarding the cost-effectiveness of the different remuneration methods.
AUTHORS' CONCLUSIONS
Financial incentives within remuneration systems may produce changes to clinical activity undertaken by primary care dentists. However, the number of included studies is limited and the quality of the evidence from the two included studies was low/very low for all outcomes. Further experimental research in this area is highly recommended given the potential impact of financial incentives on clinical activity, and particular attention should be paid to the impact this has on patient outcomes.
Topics: Adult; Capitation Fee; Child; Dental Care; Dentists; Fee-for-Service Plans; Humans; Randomized Controlled Trials as Topic; Remuneration; Salaries and Fringe Benefits
PubMed: 24194456
DOI: 10.1002/14651858.CD009853.pub2 -
International Dental Journal Oct 2018
Topics: Dentists; Humans; Occupational Diseases; Respiratory Tract Diseases
PubMed: 30255940
DOI: 10.1111/idj.12438 -
Australian Dental Journal Mar 2020To examine the efect of age and gender on dental services provided by dentists in Australia, and compare with previous estimates across the period 1983-1984 to 2013-2014.
OBJECTIVES
To examine the efect of age and gender on dental services provided by dentists in Australia, and compare with previous estimates across the period 1983-1984 to 2013-2014.
METHODS
Data were collected by mailed survey from a random sample of Australian dentists. Private sector dentists were the focus of the analysis. Data were weighted to the age and sex distribution of Australian practising dentists.
RESULTS
The analysis was based on service logs collected from n = 211 dentists. Adjusted results (rate ratio, 95% CI) showed male dentists had higher endodontic rates (1.7, 1.0-2.9) than female dentists. Dentists aged 40-49 years had higher restorative rates (1.6, 1.1-2.2) but lower preventive rates (0.5, 0.3-0.9) than those aged 20-29 years. Diagnostic services were lower for dentists aged 40-49 to 60+ years (0.8, 0.6-0.9), while denture services were higher for dentists aged 40-49 (11.1, 2.5-48.5) to 60+ years (6.4, 1.2-33.3). Crowns were higher for dentists aged 40-49 (2.4, 1.0-5.6) and 50-59 years (2.9, 1.3-6.6). Diagnostic and preventive services were consistently higher across 1983-1984 to 2013-2014.
CONCLUSIONS
Younger dentists provided higher rates of diagnostic and preventive services. Over a 30-year period, there was a consistent trend towards higher provision of diagnostic and preventive services.
Topics: Adult; Australia; Crowns; Dental Care; Dentists; Dentists, Women; Female; General Practice, Dental; Humans; Male; Middle Aged; Practice Patterns, Dentists'; Sex Distribution; Surveys and Questionnaires; Young Adult
PubMed: 31814141
DOI: 10.1111/adj.12741