The international migration of dentists: directions for research and policy

In 2010, the World Health Organization Global Code of Practice for International Recruitment of Health Personnel (the WHO Code) was adopted by the 193 Member States of the WHO. The WHO Code is a tool for global diplomacy, providing a policy framework to address the challenges involved in managing dentist migration, as well as improving the retention of dental personnel in source countries. The WHO Code recognizes the importance of migrant dentist data to support migration polices; minimum data on the inflows, outflows and stock of dentists are vital. Data on reasons for dentist migration, job satisfaction, cultural adaptation issues, geographic distribution and practice patterns in the destination country are important for any policy analysis on dentist migration. Key challenges in the implementation of the WHO Code include the necessity to coordinate with multiple stakeholders and the lack of integrated data on dentist migration and the lack of shared understanding of the interrelatedness of workforce migration, needs and planning. The profession of dentistry also requires coordination with a number of private and nongovernmental organizations. Many migrant dentist source countries, in African and the South‐Asian WHO Regions, are in the early stages of building capacity in dentist migration data collection and research systems. Due to these shortcomings, it is prudent that developed countries take the initiative to pursue further research into the migration issue and respond to this global challenge.     

Do various degrees of tooth decalcification affect orthodontists', general dentists' and laypersons' ratings of smile esthetics?

ObjectivesTo compare the effect of various degrees of decalcification after orthodontic treatment (white spot lesions) on orthodontists'', general dentists'', and laypersons'' ratings of smile esthetics.Materials and MethodsEight photographs representing incrementally altered tooth decalcification lesions of maxillary anterior teeth ranging from mild to severe were shown randomly to the study participants. Photographs were rated by a matched sample of orthodontists (N = 42), general dentists (N = 52), and laypeople (N = 58). A visual analogue scale (VAS) was used to assess perceptions of smile esthetics.ResultsThe three groups of raters could distinguish between different decalcification levels. Raters gave more negative scores as the decalcification level increased.ConclusionsThe three groups of raters were able to distinguish between various degrees of decalcification lesions. General dentists were the most critical of all groups when rating decalcification lesions.     

How willing are dentists to treat young children?: A survey of dentists affiliated with Medicaid managed care in New York City, 2010

BackgroundDespite recommendations for children to have a dental visit by the age of 1 year, access to dental care for young children, including children enrolled in Medicaid, remains limited. The authors conducted a survey to assess the availability of dentists to see young children enrolled in Medicaid managed care (MMC) in New York City (NYC), to determine barriers to the provision of dental care to young children and, within the context of MMC, to identify strategies to facilitate the delivery of dental care to children.MethodsThe authors mailed a survey to assess the provision of dental services to young children and perceived barriers and facilitators to 2,311 general dentists (GDs) and 140 pediatric dentists (PDs) affiliated with NYC MMC. A total of 1,127 surveys (46 percent) were received. The authors analyzed the responses according to provider type, youngest aged child seen, provider’s ability to see additional children and practice location. The authors compared responses by using the χ² test.ResultsFewer than one-half (47 percent) of GDs saw children aged 0 through 2 years. Provider type, years in practice and percentage of Medicaid-insured patients were associated significantly (P χ .005) with youngest age of child seen. Among respondents seeing children aged 0 through 2 years, PDs were significantly more likely to provide preventive therapy (P = .004) and restorative treatment (P χ .001). Additional training and access to consulting PDs were identified by GDs as potential facilitators to seeing young children.ConclusionA high proportion of NYC GDs affiliated with MMC do not see young children.Practice ImplicationsNinety-four percent of NYC MMC– affiliated dentists are GDs, but 53 percent of GD respondents did not see children aged 0 through 2 years in their practices. Improving access to dental care for young children requires changes in GDs’ practices, possibly by means of additional training and access to consulting PDs.     

Perception of Saudi dentists and lay people to altered smile esthetics

Aim

To evaluate and compare the perceptions of Saudi dentists and lay people to altered smile features.

Methods

Thirty-six digital smile photographs with altered features were used. Altered features included the following: crown length, width, gingival level of the lateral incisors, gingival display, midline diastema, and upper midline shift. The photographs were presented to a sample of 30 dentists and 30 lay people with equal gender distribution. Each participant rated each picture with a visual analogue scale, which ranged from 0 (very unattractive) to 100 (very attractive).

Results

Dentists were more critical than lay people when evaluating symmetrical crown length discrepancies. Compared to lay people, Saudi dentists gave lower ratings to a crown length discrepancy of >2 mm (P < 0.001), crown width discrepancy of ⩾2 mm (P < 0.05), change in gingiva to lip distance of ⩾2 mm (P < 0.01), and midline deviation of >1 mm (P < 0.01). There was no significant difference between dentists and lay people towards alterations in the gingival level of the lateral incisors or towards a space between the central incisors. No significant sex difference was seen across the groups.

Conclusion

In this sample, Saudi dentists gave significantly lower attractiveness scores to crown length and crown width discrepancies, midline deviations, and changes in gingiva to lip distance compared to Saudi lay people.