Dentists' attitudes toward discussing Internet health information with their patients – does professional self‐efficacy matter?

Objective: The present study explored the relation between professional self‐efficacy and the attitudes of dentists toward discussing Internet dental health information with their patients. Methods: Fifty‐seven dentists answered a questionnaire examining professional self‐efficacy and attitudes toward patients wishing to discuss dental health information obtained through the Internet. Results: A correlation was found between professional experience (in years) and professional self‐efficacy [r point by serial (rpb) = 0.27, P < 0.05]. No statistically significant correlation was found between specialty and professional self‐efficacy (rpb = 0.11, P < 0.4), and between professional self‐efficacy and attitudes toward patients who wish to discuss dental health information (rpb = 0.22, P > 0.1). Specialists were more willing to converse with their patients than nonspecialists. Most participants did not find discussing information from the Internet to be time‐consuming. Conclusions: This pilot study's results indicate that a) Specialists in dentistry were more willing to discuss Internet dental health information with their patients than nonspecialists; b) Dentists with high professional self‐efficacy had a positive attitude toward patients who wish to discuss Internet dental health information with them; and c) Further studies are needed to investigate and validate the results of the present study. Practice Implications: High professional self‐efficacy may improve general dentists' attitudes toward patients who wish to discuss Internet dental health information. The dental community should seek to expand the professional self‐efficacy of its members in order to enable them to adequately deal with patients' needs.     

Dental health of dentists' children in Mongolia

Summary. Objectives. To describe the dental health of dentists’ children, to evaluate its association with their dentist‐parents’ background and work‐related characteristics and to compare it with that of children in the general population in Mongolia. Design. Cross‐sectional survey, questionnaire‐based data. Subjects. Dentists’ children, aged 3–13 years. Sample. All dentists (n = 250) actively practising in the capital city of Mongolia. Results. The dentists’ children's dmft ranged from 0 to 12, and DMFT from 0 to 8; 50% were caries‐free. The younger the children, the higher was their total caries experience expressed as the sum of DMFT + dmft scores (r = ?0·22; P = 0·001). Dentist‐parents’ background and work‐related factors were not associated with their children's caries status (P > 0·05). When dentists’ children were compared with their counterparts at the population level, mean dmft for 6‐year‐olds was 2·6 for (urban) dentists’ children, 6·5 for children in the urban population and 0·9 for those in rural population of equivalent age. Mean DMFT for 12‐year‐olds were 1·0, 1·8 and 1·2, respectively, in the same three groups. In general, (urban) dentists’ children in all age groups had better dental health than did their urban counterparts at the population level. Among 5–7‐year‐olds, dentists’ children had worse dental health than did their counterparts in the rural population. Conclusions. Despite the dentists’ knowledge and awareness, their children demonstrated higher rates of dental caries than expected. This suggests that Mongolian dentists may have insufficient preventive orientation. In particular, the primary dentition of younger children seems to be poorly valued. In Mongolia, dentists should have better training and education in modern methods of caries prevention and their advantages. Appreciation and care of the primary dentition need to be improved at all levels of oral health promotion in Mongolia.     

Self‐reported gagging in dentistry: prevalence,psycho‐social correlates and oral health

Although gagging has a profound effect on the delivery of dental care, it is a relatively under‐investigated phenomenon. This study aimed to derive a prevalence estimate of gagging during dental treatment based on patient‐reported information, to determine some socio‐demographic and psychological correlates and to assess the relationship of gagging with self‐reported oral health and avoidance of dental care. Data were collected with a survey among Dutch twin families (n = 11 771). Estimated overall prevalence of gagging during dental treatment was 8·2% (95% CI 7·7–8·7). Patients' self‐report of gagging was found to be significantly associated with female sex, a lower level of education and higher levels of dental trait anxiety, gagging‐related fears (e.g. fear of objects in the mouth), anxious depression and neuroticism. Gagging also appeared to be significantly associated with untreated cavities, gingival bleeding and wearing full dentures, but not with avoidance of dental care. It can be concluded that individuals who report to gag during dental treatment are moderately dentally anxious, fear‐specific situations that can trigger a gagging response and, albeit visiting the dentist equally frequently, report to have a poorer oral health compared to those who do not gag.     

Subjective food intake ability related to oral health‐related quality of life and psychological health

Reduced food intake ability can restrict an individual's choice of foods and might have a significant impact on the individual's quality of life and mental health. The aim of this study was to evaluate the correlations between self‐reported masticatory ability and oral health‐related quality of life (OHRQOL) and psychological health. The study included 72 (26 men, 46 women) adults with a mean age of 26·4 ± 8·6 years. Each participant completed the key subjective food intake ability (KFIA) test for five key foods, the Korean version of the Oral Health Impact Profile‐14 (OHIP‐14K) and three questionnaires for measuring anxiety, depression and self‐esteem. The participants were distributed into two groups by sex (a mean age of 23·9 ± 5·2 for men and 27·9 ± 9·8 for women) and by the median KFIA score. There were no significant differences in any of the variables according to sex. Thirty‐two participants (12 men, 20 women) in the lower KFIA group had a higher total OHIP‐14K (P < 0·001) and depression level (P < 0·05) than the 40 participants (14 men, 26 women) in the higher KFIA group. As the KFIA decreased, OHRQOL worsened (P < 0·001) and depression increased (P < 0·05). Participants with lower KFIA scores were more than 4·3 times as likely as to have a poor OHRQOL than the reference group (odds ratio, 4·348; 95% confidence interval, 1·554–12·170, P < 0·01). Lower subjective food intake ability is associated with a poor oral health‐related quality of life and higher depression level.     

The Level of Anxiety and Pain Perception of Endodontic Patients

Objectives

to compare the level of anxiety reported by patients and assessed by dentists. Also, the expected and actual pain during the treatment perceived by the patient and dentist were assessed.

Methods

sixty six endodontic patients filled in two questionnaires, prior to and after the treatment, so did their therapists. The first set of questions for patients was regarding demographics, the frequency of dental visits, the level of anxiety and expectations about the level of pain. Before the treatment, dentists estimated the level of patients'' anxiety and the expected intensity of pain. After the treatment, the patients evaluated the level of experienced pain and dentists'' empathy during the treatment, while dentists reassessed the intensity of patients'' pain.The data were statistically analysed by t-test for paired samples and by Spearmans''s Rho correlation coefficient at level of significance set at 0.05.

Results

Patients'' expectation of pain intensity was higher than the actual pain during the treatment (t-test=3.540, p=0.001). There was no difference in the level of pain which dentists expected and their perception of pain during the procedure. There was a statistically significant correlation between the patients'' level of anxiety and recognition of it by dentists (Spearman Rho=0.460, p<0.001). A higher level of anxiety increased the expected intensity of pain (Spearman Rho=0.401, p=0.001). Actual intensity of pain was not significantly associated with dental anxiety (Spearman Rho=0.080, p=0.524).

Conclusion

Since the level of dental anxiety was associated with the increased intensity of expected pain, a vicious cycle of pain and anxiety may be terminated by giving positive information to the patient before and during endodontic procedures.     

Counseling on Early Childhood Caries transmission by dentists

Objective: High levels of Streptococcus mutans on teeth of young children are predictive of Early Childhood Caries (ECC). Transmission from mother‐to‐child is common and studies have demonstrated treatment of the mother results in less ECC. The objective of this study was to determine how dentists have adopted the practice of counseling about ECC. Methods: In 2006 as part of a larger study on dental care for pregnant women, we surveyed 829 general dentists in Oregon. The questionnaire contained questions to capture the extent to which general dentists have adopted counseling pregnant women about ECC transmission, to describe personal and practice characteristics, and examine how dentists' views on the ease of adopting of new procedures related to ECC counseling. Multivariate logistic regression was used to identify separate and additive effects of demographic and practice characteristics, attitudes, and beliefs. Results: The adjusted odds of a dentist who strongly believed in the link between mothers and babies and provided ECC counseling were 1.60 (95% CI 1.3‐2.0, P < 0.01). The odds of a dentist who reported discussing ECC with staff members and provided counseling were 2.7 (95% CI 1.7‐4.3, P < 0.01). Male dentists were less likely to counsel patients than female dentists (Adjusted OR = 0.5, 95% CI 0.3‐1.0, p < 0.05). Conclusions: The strongest predictors of counseling patients about ECC were dentists' belief in the evidence of caries transmission and dentists' discussion of ECC during staff meetings.     

Treatment of obstructive sleep apnoea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists

Obstructive sleep apnoea (OSA) is an increasing problem worldwide. Yet, a large number of patients may remain undiagnosed. Dentists could suspect OSA, but little is known about their knowledge and attitudes towards the topic. An email questionnaire was sent to dentists working in Helsinki Health Centre, Helsinki, Finland (n = 226). It consisted of demographic data, items on dentists' overall knowledge of OSA and factors associated with it, and their possibilities and willingness to take part in the recognition and treatment of OSA patients. Altogether, 70·9% (n = 134) of dentists eligible for the study completed the questionnaire. Of them, 79·1% (n = 106) were general practitioners and 20·9% (n = 28) dentists with specialty training. Continuous positive airway pressure (CPAP) (99·3%) and weight control (99·3%) were both generally acknowledged as effective methods to treat OSA. Regarding the efficacy of other treatment modalities, significant differences were found between general practitioners' and specialists' opinions. For example, mandibular advancement devices (MAD) were less often reported by general practitioners (69·8%) than specialists (89·3%) (P < 0·05). The possible risk factors, signs and symptoms, and consequences of OSA were overall well recognised regardless the years in dental profession, but specialists saw more often that nocturnal sweating (P < 0·01) and snoring (P < 0·05) may signify OSA. Dentists could play an important role in suspecting OSA, but they may need more education to cope with that.     

Psychometric properties of the Dutch version of the Orofacial Esthetic Scale (OES‐NL) in dental patients with and without self‐reported tooth wear

The aim of this study was to test the psychometric properties of the Dutch version of the Orofacial Esthetic Scale (OES) in dental patients with and without self‐reported tooth wear. The English version of the OES was translated into Dutch, following established guidelines for cross‐cultural adaptation of health‐related quality of life measures. The reliability of the resulting OES‐NL was tested in a test–retest study on 343 subjects; its validity was tested with the use of convergent validity on 582 subjects. The test–retest reliability of the OES‐NL showed intra‐class correlation coefficients (ICC) that ranged from 0·76 to 0·82, which can be qualified as excellent. The Cronbach's alpha revealed that the overall internal consistency of the scale was good (α = 0·89). Convergent validity was confirmed by the association between the OES‐NL summary scores and three questions of the Dutch version of the Oral Health Impact Profile (OHIP‐NL). The calculated Spearman's rank correlation coefficients ranged from −0·43 to −0·54 and were all significant (P < 0·001). The Dutch version of the Orofacial Esthetic Scale (OES‐NL) showed good psychometric properties, making it suitable for the assessment of self‐perceived aesthetics in Dutch dental patients with and without self‐reported tooth wear.     

Dentists' attitudes and practices related to diabetes in the dental setting

Objective: The objective of this study was to determine general dentists' attitudes and practices related to patients with diabetes, a major public health issue with oral complications. Methods: This study was a cross‐sectional survey of 265 randomly selected general dentists who were Delta Dental providers in California, West Virginia, and Pennsylvania. Results: Sixty‐one percent of respondents believed that addressing diabetes was important to their role as a dentist, 86 percent advised patients with diabetes about periodontal risks, 18 percent provided diabetic‐related services, 47 percent reported they knew how to assess for diabetes, and 42 percent felt well prepared to intervene with patients with diabetes. Adjusting for number of patients with diabetes and adult patients seen in the past month, dentists' formal training in diabetes assessment and management [odds ratio (OR) = 4.0, P = 0.000, confidence interval (CI) = 1.9, 8.5], and belief in the importance of their role as a dentist to intervene with patients with diabetes (OR = 1.6, P = 0.011, CI = 1.1, 2.3) were both significant factors in providing services for patients with diabetes. Similarly, dentists' formal training (OR = 3.0, P = 0.02, CI = 1.2, 7.3) and belief in the importance of their role (OR = 1.9, P = 0.00, CI = 1.3, 2.6) were both significant factors in advising patients with diabetes about periodontal risk associated with diabetes. Conclusions: Formal training and personal beliefs are important factors related to dentists' behavior toward patients with diabetes in the dental setting.     

Preferences of dental care providers in maintaining compromised teeth in relation to their professional status: implants instead of periodontally involved maxillary molars?

Aim: The purpose of this study was to evaluate the dentists' decision making in the maxillary molar region to find out how it is influenced by general practitioners' and specialists' characteristics as well as by the external evidence. Material and methods: A questionnaire was developed containing clinical cases and statements to assess practitioners' opinions on the treatment of periodontally involved maxillary molars and implant therapy with sinus grafting. Data were analysed with respect to the dentists' age and speciality. Results: Three hundred and forty questionnaires were evaluated (24% from universities, 76% from educational courses, overall response rate 35.1%). Forty six per cent of all participants indicated they had specialised, 52% placed dental implants, while 33% performed sinus grafting and 64% periodontal surgeries. Forty six per cent were against or were indecisive about having sinus grafting performed on themselves. The treatment proposals given for the clinical cases revealed a preference among older dentists and general practitioners for regenerative treatments even when these were not evidence based in through‐and‐through furcation involvements. Resective therapies were most often selected by periodontists. Prosthodontists tended to prefer more invasive treatment options with extractions and augmentations. More experienced general practitioners favoured conventional fixed dental prostheses in free‐end situations or no treatment rather than the complicated augmentation procedures, which were preferred by younger dentists. Conclusions: Implant placement seems to be widely accepted by almost all subjects, who may either place implants themselves or refer patients. More information seems to be needed on the indications for regenerative therapies for furcation involved maxillary molars, and guidelines required for decision making in complex clinical situations. To cite this article:
Zitzmann NU, Scherrer SS, Weiger R, Lang NP, Walter C. Preferences of dental care providers in maintaining compromised teeth in relation to their professional status: implants instead of periodontally involved maxillary molars?.
Clin. Oral Impl. Res. 22 , 2011; 143–150.
doi: 10.1111/j.1600‐0501.2010.02062.x     

Self‐reported Bruxism ‐ associations with perceived stress,motivation for control,dental anxiety and gagging*

Summary To examine possible associations between self‐reported bruxism, stress, desirability of control, dental anxiety and gagging. Five questionnaires were distributed among a general adult population (402 respondents): the Perceived Stress Scale (PSS), Desirability of Control Scale (DC), Dental Anxiety Scale (DAS), Gagging Assessment Scale (GAS), and Bruxism Assessment Questionnaire. A high positive correlation between DAS and GAS (R = 0·604, P < 0·001) was found. PSS was negatively correlated with DC (R = ?0·292, P < 0·001), and was positively correlated with GAS (R = 0·217, P < 0·001) and DAS (R = 0·214, P < 0·001). Respondents who reported bruxing while awake or asleep showed higher levels of GAS, DAS and PSS than those who did not. There were no differences between the bruxers and the non‐bruxers (sleep and aware) with regard to the DC scores. The best predictors of awake bruxism were sleep bruxism (OR = 4·98, CI 95% 2·54–9·74) and GAS (OR = 1·10, CI 95% 1·04–1·17). The best predictors of sleep bruxism were awake bruxism (OR = 5·0, CI 95% 2·56–9·78) and GAS (OR = 1·19; CI 95% 1·11–1·27). Self‐reported sleep bruxism significantly increases the odds for awake bruxism and vice versa. Tendency for gagging during dental care slightly increases the odds of both types of self‐reported bruxism, but desirability of control is not associated with these phenomena.     

In vitro determination of the forceps level for extraction of teeth for periodontal reasons

Abstract The aim of the present study was to validate dentists' periodontal reasons for extraction by comparison with the in vitro periodontal status of extracted teeth. A national systematic random sample of Norwegian dentists (n= 500) was requested to record primary, secondary and tertiary reasons for tooth extraction for a period of 2 weeks in 1988. The response rate was 70%. The extracted permanent teeth from the first 2 patients of each dentist were collected. Of the 365 teeth, 329 satisfied the criteria for assessment of periodontal attachment after staining. Using a dissecting microscope (10 ×), 4 to 8 linear measurements were recorded per tooth. 159 of the 329 teeth had loss of periodontal support. Of the 93 teeth for which the dentists' reason for extraction included periodontal considerations, 1% had 1–10% loss of attachment, 59% had 11-50% loss and 40% had 51–76% loss of periodontal support. There was a significant correlation between in vitro measurements of attachment loss and a ranking of teeth on a scale from 1 to 3 based on the dentists' emphasis on periodontal reasons for extraction (The Spearman Rs = 0.29, p<0.01). The results suggest that the forceps level for removal of teeth for periodontal reasons was set at a relatively early stage of the disease process by Norwegian dentists, and that there was a weak association between attachment loss and the dentists' emphasis on periodontal reasons for extraction.     

Earlier depression and later‐life self‐reported chewing difficulties: results from the Whitehall II study

This study aimed to assess, whether depression in adulthood was associated with self‐reported chewing difficulties at older age, and examine whether the strength of the association differed according to the number of depression episodes in earlier adult life. We used Whitehall II study data from 277 participants who completed a questionnaire in 2011. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES‐D) in 2003 and 2008. The association between CES‐D depression and self‐reported chewing ability was assessed using regression models adjusted for some socio‐demographic factors. Participants with depression at some point in their earlier adulthood had an odds ratio (95% CI) of 2·01 (1·06, 3·82) for reporting chewing difficulties in older adulthood, compared to those without depression. The respective odds ratios were 1·42 (0·66, 3·04) for individuals with depression in only one phase, but 3·53 (1·51, 8·24) for those with depression in two phases. In conclusion, while further research is required, there was an association between depression and chewing difficulty that was independent of demographic and socio‐economic characteristics. Furthermore, this increased odds for chewing difficulties was primarily among adults that experienced two episodes or a prolonged period of depression.     

Assessing oral cancer early detection: clarifying dentists' practices

Objective: This study explores new methods for assessing in greater detail what dentists do when they perform oral cancer early detection examinations. It clarifies practice behaviors and opens opportunities to identify factors that facilitate thorough early detection examinations by clinicians and to assess the relative effectiveness of different examination procedures. Methods: A 38‐item survey instrument was e‐mailed to dentists in a western US, multistate dental practice group. Questionnaires were received by 241 dentists, and 102 responded. An Oral Cancer Knowledge scale (0 to 14) was generated from correct responses on oral cancer general knowledge. An Oral Cancer Examination Thoroughness scale was calculated from the two dimensions of reported usage and frequency of procedures in oral cancer examinations. Results: Nearly all responding dentists were in general practice (90%), with a median year of graduation from dental school of 1994. The Oral Cancer Knowledge scores ranged from 5 to 14 with a mean of 10.4. The mean Thoroughness of Examination score was 11.34 (range 0 to 20). The two scales were not statistically correlated (r = ?0.015, P = 0.883). Statistically, recency of continuing education was significantly associated with knowledge (P = 0.0284) and appears to be marginally associated with thoroughness (P = 0.075). Conclusions: This study documents considerable variability in dentists' knowledge and thoroughness of examinations. The scales provide tools for future studies for improving understanding of early detection of oral cancer in clinical practice.     

Evaluating factors that affect the shade-matching ability of dentists,dental staff members and laypeople

BackgroundThe authors conducted a study to evaluate the influence of dentists' and nondentists' experience, age, sex, eye color and use of eyeglasses or contact lenses on tooth shade–matching ability.MethodsThe authors included 120 participants in this study conducted in Istanbul (periodontists, oral and maxillofacial surgeons, orthodontists, endodontists, pediatric dentists, prosthodontists, restorative dentists, general dentists in private practice, dental technicians, dental assistants, dental assistant students and laypeople). The authors assigned participants to one of three groups: group 1 was composed of prosthodontists, restorative dentists and dental technicians; group 2 consisted of other dental specialists and general dentists; and group 3 included dental assistants, dental assistant students and laypeople. The authors asked participants to match the shades of three artificial maxillary right central incisors (Vitapan acrylic teeth [shades 2L1.5, 1M2, 2R1.5], Vita Zahnfabrik, Bad Sa?ckingen, Germany) by using a shade guide system (Vita Toothguide 3D-Master, Vita Zahnfabrik). They calculated shade matching for the three color components (value, hue, chroma) and analyzed the results by using a χ² test.ResultsThe rate of success in matching the shade for IM2 was 53.3 percent for participants in group 1, 30 percent for participants in group 2 and 20 percent for participants in group 3 (P = .017). However, there were no significant differences between the three groups for shades 2L1.5 and 2R1.5. Professional experience (P = .003) and age (P = .027) were associated with shade-matching success for tooth shade 2L1.5 only. The results showed no statistically significant differences with respect to sex, eye color or use of eyeglasses or contact lenses.ConclusionsDental care professionals who routinely performed restorative procedures matched the shades better than did participants in other groups. Professional experience was associated positively with the outcome, while sex, eye color and use of eyeglasses or contact lenses did not have any effect on shade-matching results.Clinical ImplicationsTo improve shade-matching skills, clinicians should participate in hands-on courses, continuing education classes and other training programs.     

Associations among temporomandibular disorders,chronic neck pain and neck pain disability in computer office workers: a pilot study

Neck pain is the most common musculoskeletal complaint among computer office workers. There are several reports about the coexistence of neck pain and temporomandibular disorders (TMD). However, there are no studies investigating this association in the context of work involving computers. The purpose of this study was to verify the association between TMD and neck pain in computer office workers. Fifty‐two female computer workers who were divided into two groups: (i) those with self‐reported chronic neck pain and disability (WNP) (n = 26) and (ii) those without self‐reported neck pain (WONP) (n = 26), and a control group (CG) consisting of 26 women who did not work with computers participated in this study. Clinical assessments were performed to establish a diagnosis of TMD, and craniocervical mechanical pain was assessed using manual palpation and pressure pain threshold (PPT). The results of this study showed that the WNP group had a higher percentage of participants with TMD than the WONP group (42·30% vs. 23·07%, χ² = 5·70, P = 0·02). PPTs in all cervical sites were significantly lower in the groups WNP and WONP compared to the CG. Regression analysis revealed TMD, neck pain and work‐related factors to be good predictors of disability (R² = 0·93, P < 0·001). These results highlighted the importance of considering the work conditions of patients with TMD, as neck disability in computer workers is explained by the association among neck pain, TMD and unfavourable workplace conditions. Consequently, this study attempted to emphasise the importance of considering work activity for minimising neck pain‐related disability.     

Dentists' variability in restorative decisions, microscopic and radiographic caries depth

Abstract Restorative and dental caries depth decisions were recorded for 5168 unrestored approximal tooth surfaces by 17 dentists who worked in the school dental clinics of the North York (Ontario) Public Health Department. Each dentist examined 15 pairs of experimental bitewing radiographs for which true caries depth had previously been determined by microscopy of the sectioned teeth following production of the radiographs. The dentists independently recorded their restorative decisions and radiographic caries depth perceptions. The relationship between the variation in the dentists' restorative decisions and their perceptions of caries depth based on a re-reading of the bitewings on the one hand, and true caries depth on the other was also examined. The percentages of total variability in each dentist's restorative decisions attributable to radiographic and to microscopic caries depth were estimated using regression analyses. Large variations were found among the 17 dentists' distributions of overall restorative and depth decisions. The relationship between microscopic caries depth and the dentists' restorative decisions was, understandably, less strong than that of the dentists' radiographic perceptions of caries depth and restorative decisions. Relative to true caries depth, high numbers of false positive and false negative restorative decisions were made. Overall, 50% of the variability in the dentists' restorative decisions was explained by their perceptions of radiographic caries depth; however, among individual dentists, the range was from 29% for one dentist to 69% for another. A much lower percentage of the overall restorative variation was explained by microscopic depth, 18%. Like the findings of the only two previous European studies that quantified the role of radiographs on clinical decisions, this study demonstrated that dentists' perceptions of dental caries depth using bitewing radiographs play a major but variable role in their restorative decisions for approximal tooth surfaces.