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Australian Journal of General Practice Sep 2020Oral health and general medical health are intimately linked. However, medical and dental practitioners often work in isolation from each other and have separate...
BACKGROUND
Oral health and general medical health are intimately linked. However, medical and dental practitioners often work in isolation from each other and have separate training, funding, regulatory and administrative systems.
OBJECTIVE
The aim of this article is to explore the history behind the divide between medicine and dentistry, and the challenges this raises.
DISCUSSION
The siloed nature of the two professional groups may be attributed to historical backgrounds, deficiencies in interdisciplinary education, government funding discrepancies and differing models of care. The two professions have evolved with different social drivers and scientific underpinnings, with only a recent appreciation of the many connections between the health of the mouth and the health of the body. Solutions to overcome this divide should be considered in order to ensure better outcomes for patients, the community and perhaps the professions themselves.
Topics: Australia; Dentistry; Dentists; General Practice; History, 19th Century; History, 20th Century; Humans; Professional Role; Schools, Dental
PubMed: 32864667
DOI: 10.31128/AJGP-06-20-5482 -
PloS One 2022This questionnaire-based validation study investigated if the dental examination of children and adolescents with autism spectrum disorder is viewed by dentists with key...
Is examining children and adolescents with autism spectrum disorders a challenge?-Measurement of Stress Appraisal (SAM) in German dentists with key expertise in paediatric dentistry.
OBJECTIVES
This questionnaire-based validation study investigated if the dental examination of children and adolescents with autism spectrum disorder is viewed by dentists with key expertise in paediatric dentistry as a challenge or a threat in terms of transactional stress theory. The Stress Appraisal Measure (SAM) was used for this purpose and it's feasibility and validity was examined as a first part of a multi-stage process for validation in dentistry with a sample of German dentists. It has hardly been investigated how the treatment of children and adolescents with a disorder from the autism spectrum is perceived by dentists.
METHODS
An online-based survey (39 questions) plus the SAM as an add-on as well as a preceding short story of imagination on the topic (appointment for a dental check-up in a special school) were developed. Via e-mail members of the German Society of Paediatric Dentistry (DGKiZ) received a link which enabled interested members to participate. The majority of the members of the DGKiZ have additional qualifications in the treatment of children and adolescents and further training in the area of special needs care in dentistry. The data analysis was based on the SAM and its subscales.
RESULTS
Out of the 1.725 members of DGKiZ 92 participants (11 male, 81 female) fully completed the questionnaire and the SAM. All in all the dentists rated their own psychological and physical stress in course of treating children and adolescents with a disorder from the autism spectrum between less and partly stressful. Although the structure of the SAM could not be fully mapped by means of a factor analysis, the different ratings "challenge" or "threat" could be comprehensibly evaluated after reading the story. The participants rated the situation from the story in general as challenging but not as threatening. Intercorrelations between the subscales of the SAM (e.g threat and centrality) of r = .56 showed that the scales are not clearly independent of one another. According to the transactional stress model, the SAM bases on, stress (perceived stressfulness) arises from appraisal processes (e.g. threat, controllable-by-self) that bring about a comparison between the requirements for the described situation and one's own possibilities in terms of a person-environment-fit. In the hierarchical regression a variance of R2 = .48 could be explained with all six subscales (appraisal processes) to predict perceived stressfulness of the SAM within a sample of dentists.
CONCLUSIONS
Due to the response rate the results of the SAM are not representative for all German dentists, but it offers an insight into topics of special needs dentistry in Germany that have not yet been examined. Overall, the feasibility and validity of the SAM in the context of mapping cognitive appraisal processes and stress could be confirmed. Taking into account the result that the treatment of children and adolescents with autism spectrum disorder is seen as a challenge, it is concluded that there is a need to improve the education of dental students and graduated dentists in Germany in the field of special needs dentistry.
Topics: Adolescent; Autism Spectrum Disorder; Child; Dentists; Female; Germany; Humans; Male; Pediatric Dentistry; Surveys and Questionnaires
PubMed: 35921352
DOI: 10.1371/journal.pone.0271406 -
BioMed Research International 2022The aim was to evaluate the association between the professional training of dentists and their outpatient production (OP) of clinical and collective/preventive...
BACKGROUND
The aim was to evaluate the association between the professional training of dentists and their outpatient production (OP) of clinical and collective/preventive procedures and the total number of procedures registered in a health information system.
METHODS
It included all 19,947 primary dental care units participating in the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB 2nd cycle) and the number of clinical procedures (CP), collective/preventive procedures (PP), and total procedures (TP) registered in the ambulatory information system between November 2013 and July 2014 for each participant oral health team. The outcome was being above the national median of procedures. The main variables related to training were the dentists specialising in family health, the level of training, and participation in permanent education. Effect estimates were calculated by multiple logistic regression.
RESULTS
In the final model, controlled by contextual factor work process, family health specialists had higher chances (odds ratio (OR) = 1.13, 95% CI: 1.00; 1.27) of producing above the national median of CP than nonspecialists, OR = 1.06 (0.96; 1.18) for PP and OR = 1.17 (1.08; 1.27) for TP. Dentists taking permanent education had higher chances than those not taking it of producing above the national median for CP, PP, and TT, respectively, with OR = 1.40 (1.20; 1.62), OR = 1.24 (1.09; 1.40), and OR = 1.28 (1.18; 1.39).
CONCLUSION
Training in family health performs more procedures in primary care settings than those without training. However, this OP is influenced by variables related to the municipality and the work process, especially for PP. If the highest production observed is a consequence of training, then public health managers can not only encourage training policies such as permanent education policies to expand the use of services.
Topics: Dentists; Family Health; Humans; Oral Health; Outpatients
PubMed: 35355824
DOI: 10.1155/2022/5365363 -
International Dental Journal Oct 2018
Topics: Dentists; Humans; Occupational Diseases; Respiratory Tract Diseases
PubMed: 30255940
DOI: 10.1111/idj.12438 -
International Dental Journal Feb 2023The aim of this work was to determine dentists' ability to accurately estimate patients' anxiety level during dental treatment (ie, "empathic accuracy") and to determine...
OBJECTIVES
The aim of this work was to determine dentists' ability to accurately estimate patients' anxiety level during dental treatment (ie, "empathic accuracy") and to determine the strength of the association between empathic accuracy and patient-reported reassurance.
METHODS
A cross-sectional study was conducted amongst 177 adult patients who underwent different invasive dental procedures (ie, extractions or procedures requiring injections and drilling) performed by 10 different dentists from 3 dental offices in the Netherlands. Patients reported their anxiety level during treatment and the extent to which they felt reassured by the dentist using a visual analogue scale (VAS). Simultaneously, the dentists estimated patients' anxiety level. Empathic accuracy was calculated as an absolute difference between patient-reported anxiety (100-point VAS) and dentist estimation of anxiety (100-point VAS).
RESULTS
Agreement between dentists' assessment of patients' anxiety and patient-reported anxiety proved good, intraclass correlation coefficient (177) = 0.63; 95% confidence interval [CI], 0.53-0.71. A small to medium-sized positive correlation, r (177) = 0.15; 95% CI, 0.00-0.29, was found between dentists' empathic accuracy and patient-reported reassurance. A negative correlation was found between empathic accuracy and patients' anxiety scores, r (177) = -0.23; 95% CI, -0.38 to -0.09.
CONCLUSIONS
Given that greater empathic accuracy was associated with higher patient-reported reassurance during treatment, training young dental professionals in empathic accuracy might help patients feel reassured. Importantly, our results also suggest that with elevated levels of patient anxiety it is increasingly challenging for dentists to recognise this emotion, and thus support the patient in anoptimal manner.
Topics: Adult; Humans; Cross-Sectional Studies; Anxiety; Dentists; Patient Reported Outcome Measures; Netherlands; Surveys and Questionnaires
PubMed: 35896426
DOI: 10.1016/j.identj.2022.06.009 -
Journal of Dentistry Jun 2024Dental practice is based upon dentists' cognitions, knowledge being foundational. Knowledge is attained through education and perception. Although knowledge is modulated... (Review)
Review
OBJECTIVES
Dental practice is based upon dentists' cognitions, knowledge being foundational. Knowledge is attained through education and perception. Although knowledge is modulated by beliefs, attitudes, preferences, and behaviors, it is essential to evidence-based practice. Cross-sectional studies uniformly demonstrate that community NSRCT is of sub-optimal quality worldwide, is lack of knowledge a problem? Our purpose was to measure dentists' knowledge of root canal treatment (NSRCT).
DATA
Quantitative and qualitative data were extracted: purpose, topics assessed, authors cited knowledge sources, number of dentists studied, number of questions, authors descriptors of knowledge level,% correct answers by question, authors recommendations.
SOURCES
OVID Medline, EMBASE, Web of Science, and hand-searching.
STUDY SELECTION
Studies which had measured dentists' knowledge of non-surgical root canal treatment that was valuable, reliable, and had practical implications which could be implemented. A total of 51 papers from 19 countries measured the knowledge of 15,580 dentists using 445 questions on 29 root canal treatment topics.
CONCLUSIONS
'Gold standards' were from literature, external bodies, or expert consensus in 47, 31, and 2 papers respectively. Levels of knowledge by percentage correct answers among studies were poor to moderate and varied considerably. The mean, for the 50 studies where overall study percentages could be calculated, was 57 %, standard deviation 17 %, and a range of 16 % to 82 %. Authors' adjectives describing knowledge levels were generally negative. Additional education was advised in 49 papers, but without evidence that education was inadequate; 6 papers recommended increased use of protocols; only 5 papers advocated research on the cause of lack of knowledge.
CLINICAL SIGNIFICANCE
Dentists' root canal treatment knowledge was found to be poor to moderate, as well variable. This may constrain quality of care. However, provision of information without attention to dentists' cognitions and motivations may not be successful. Educational strategies and goals should be re-evaluated. Evidence-based practice faces many barriers.
Topics: Humans; Root Canal Therapy; Dentists; Health Knowledge, Attitudes, Practice; Clinical Competence; Evidence-Based Dentistry; Practice Patterns, Dentists'
PubMed: 38580057
DOI: 10.1016/j.jdent.2024.104975 -
PloS One 2022Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective...
Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective of this study was to develop a virtual learning environment for antibiotic prescription and to determine its impact on dentists' awareness, attitudes, and intention to practice. First, the learning content on multimedia resources was developed and distributed into three challenges that participants had to overcome. Then, a quasi-experimental study was performed in which the virtual learning environment was implemented on dentists from seven Colombian cities. The median of correct answers and the levels of awareness, attitudes, and intention to practice were compared before, immediately after, and 6-months post-intervention. Wilcoxon signed-rank and McNemar's tests were used to determine the differences. A total of 206 participants who finished the virtual learning environment activities exhibited a favorable and statistically significant impact on the median of correct answers of awareness (p < 0.001), attitudes (p < 0.001), and intention to practice (p = 0.042). A significant increase occurred in the number of participants with a high level of awareness (p < 0.001) and a non-significant increase in participants with high levels of attitudes (p = 0.230) and intention to practice (p = 0.286). At 6 months, the positive effect on the median of correct answers on awareness and intention to practice persisted (p < 0.001); however, this was not evident for attitudes (p = 0.105). Moreover, there was a significant decrease in the number of participants who showed low levels of awareness (p = 0.019) and a slight increase in those with high levels of the same component (p = 0.161). The use of a virtual learning environment designed for dentists contributed to a rapid improvement in awareness and intention to practice antibiotic prescription; however, their attitudes and information retention need reinforcement.
Topics: Anti-Bacterial Agents; Colombia; Dentists; Education, Distance; Female; Health Knowledge, Attitudes, Practice; Humans; Intention; Male; Non-Randomized Controlled Trials as Topic; Practice Patterns, Dentists'; Prescriptions; Surveys and Questionnaires
PubMed: 35089952
DOI: 10.1371/journal.pone.0262731 -
Journal of Health Organization and... Dec 2021The purpose of the paper is to describe the current state of leadership and leader-member exchange (LMX) theory in dentistry and develop a novel conceptual model of LMX... (Review)
Review
PURPOSE
The purpose of the paper is to describe the current state of leadership and leader-member exchange (LMX) theory in dentistry and develop a novel conceptual model of LMX to guide future research and highlight the importance of enhancing leadership training for new dentists.
DESIGN/METHODOLOGY/APPROACH
A literature review exploring leadership in dentistry and LMX in dentistry was completed. The findings were analyzed with framework analysis to develop a novel conceptual model of LMX specific to dentistry.
FINDINGS
LMX theory was applied to leadership in dentistry, including a focus on new dentists, senior dentists, other dental team members and the patient. A new conceptual model of the New Dentist LMX Quartet, which is unique and specific to new dentist teams, was developed.
RESEARCH LIMITATIONS/IMPLICATIONS
The study identifies the need for research in LMX in dentistry, contributes a new conceptual model for LMX theory and identifies future research.
PRACTICAL IMPLICATIONS
Practitioners, policymakers and educators can utilize this information to explore concepts in leadership and improve training and dental practice.
ORIGINALITY/VALUE
No other studies specifically exploring LMX in dentistry for new dentists exist. The current literature review and conceptual paper begins the conversation on developing understanding of leadership in dentistry through further research.
Topics: Communication; Dentists; Humans; Leadership
PubMed: 34951297
DOI: 10.1108/JHOM-05-2021-0192 -
Journal of Dental Research Sep 2023The dental profession has endured unprecedented disruption amid COVID-19. Novel stressors have included a high risk of occupational exposure to COVID-19, financial...
The dental profession has endured unprecedented disruption amid COVID-19. Novel stressors have included a high risk of occupational exposure to COVID-19, financial losses, and stricter infection prevention and control requirements. The present study investigated the longitudinal impact of COVID-19 on the stress and anxiety levels of a cohort of Canadian dentists ( = 222) between September 2020 and October 2021. Salivary cortisol was selected as a biomarker of mental stress, and 10 sets of monthly saliva samples (2,131 in total) were self-collected, sent to our laboratory in prepaid courier envelopes, and analyzed by enzyme-linked immunosorbent assay. To assess COVID-19 anxiety, 9 monthly online questionnaires were administered, comprising a general COVID-19 anxiety instrument and 3 items regarding the impact of dentistry-related factors. Bayesian log-normal mixed effect models were fitted to estimate the longitudinal trajectory of salivary cortisol levels and their association with the disease burden of COVID-19 in Canada. After accounting for age, sex, vaccination status, and the diurnal rhythm of cortisol secretion, a modest positive association was found between dentists' salivary cortisol levels and the count of COVID-19 cases in Canada (96% posterior probability). Similarly, the self-reported impact of dentistry-related factors, such as fear of getting COVID-19 from a patient or coworker, was greatest during peaks of COVID-19 waves in Canada; however, general COVID-19 anxiety decreased consistently throughout the study period. Interestingly, at all collection points, the majority of participants were not concerned about personal protective equipment. Overall, participants reported relatively low rates of psychological distress symptoms in relation to COVID-19, a result that should be reassuring for the dental community. Our findings strongly suggest a link between self-reported and biochemical measurements of stress and anxiety in Canadian dentists during the COVID-19 pandemic.
Topics: Humans; COVID-19; Hydrocortisone; Pandemics; Bayes Theorem; Canada; Anxiety; Surveys and Questionnaires; Dentists
PubMed: 37317840
DOI: 10.1177/00220345231178726 -
International Journal of Circumpolar... Dec 2018The eight Arctic States exhibit substantial health disparities between their remote northernmost regions and the rest of the country. This study reports on the trends... (Comparative Study)
Comparative Study
BACKGROUND
The eight Arctic States exhibit substantial health disparities between their remote northernmost regions and the rest of the country. This study reports on the trends and patterns in the supply and distribution of physicians, dentists and nurses in these 8 countries and 25 regions and addresses issues of comparability, data gaps and policy implications Methods: We accessed publicly available databases and performed three types of comparisons: (1) among the 8 Arctic States; (2) within each Arctic State, between the northern regions and the rest of the country; (3) among the 25 northern regions. The unit of comparison was density of health workers per 100,000 inhabitants, and the means of three 5-year periods from 2000 to 2014 were computed.
RESULTS
The Nordic countries consistently exceed North America in the density of all three categories of health professionals, whereas Russia reports the highest density of physicians but among the lowest in terms of dentists and nurses. The largest disparities between "north" and "south" are observed in the Northwest Territories and Nunavut of Canada for physicians, and in Greenland for all three categories. The disparity is much less pronounced in the northern regions of Nordic countries, while Arctic Russia tends to be oversupplied in all categories.
CONCLUSIONS
Despite efforts and standardisation of definitions by international organisations such as OECD, it is difficult to obtain an accurate and comparable estimate of the health workforce even in the basic categories of physicians, dentists and nurses . The use of head counts is particularly problematic in jurisdictions that rely on short-term visiting staff. Comparing statistics also needs to take into account the health care system, especially where primary health care is nurse-based. List of Abbreviations ADA: American Dental Association; AHRF: Area Health Resource File; AMA: American Medical Association; AO: Autonomous Okrug; AVI: Aluehallintovirasto; CHA: Community Health Aide; CHR: Community Health Representative; CHW: Community Health Worker; CIHI: Canadian Institute for Health Information; DO: Doctor of Osteopathic Medicine; FTE: Full Time Equivalent; HPDB: Health Personnel Database; MD: Doctor of Medicine; NOMESCO: Nordic Medico-Statistical Committee; NOSOSCO: Nordic Social Statistical Committee; NOWBASE: Nordic Welfare Database; NWT: Northwest Territories; OECD: Organization for Economic Co-operation and Development; RN: Registered Nurse; SMDB: Scott's Medical Database; WHO: World Health Organization.
Topics: Arctic Regions; Dentists; Health Personnel; Healthcare Disparities; Humans; Physicians; Workforce
PubMed: 29968514
DOI: 10.1080/22423982.2018.1492825