Use of online sources of information by dental practitioners: findings from The Dental Practice‐Based Research Network

Objective: Estimate the proportion of dental practitioners who use online sources of information for practice guidance. Methods: From a survey of 657 dental practitioners in The Dental Practice‐Based Research Network, four indicators of online use for practice guidance were calculated: read journals online, obtained continuing education (CDE) through online sources, rated an online source as most influential, and reported frequently using an online source for guidance. Demographics, journals read, and use of various sources of information for practice guidance in terms of frequency and influence were ascertained for each. Results: Overall, 21 percent (n = 138) were classified into one of the four indicators of online use: 14 percent (n = 89) rated an online source as most influential and 13 percent (n = 87) reported frequently using an online source for guidance; few practitioners (5 percent, n = 34) read journals online, fewer (3 percent, n = 17) obtained CDE through online sources. Use of online information sources varied considerably by region and practice characteristics. In general, the four indicators represented practitioners with as many differences as similarities to each other and to offline users. Conclusion: A relatively small proportion of dental practitioners use information from online sources for practice guidance. Variation exists regarding practitioners' use of online source resources and how they rate the value of offline information sources for practice guidance.     

The Enforcement of Regulations Restricting Expanded Duties by Dental Auxiliaries: an Analysis of the Recent Disciplinary Actions of the Texas State Board of Dental Examiners

The issue of delegation of dental procedures (expanded duties) to auxiliaries continues to be controversial. Although it has been shown that these practices are usually beneficial to the public, many states continue to maintain laws prohibiting expanded duties. In Texas, auxiliaries are not allowed to perform many simple functions, and dentists who supervise these acts are tried and sentenced by the Texas State Board of Dental Examiners. Although one might expect that more serious categories of offenses would be treated in a harsher manner, this study indicates that this is not the case in Texas. The disciplinary actions of the Texas State Board of Dental Examiners were analyzed, and the rate of conviction and severity of penalty for three types of offenses: supervising auxiliaries in the performance of unauthorized expanded duties, malpractice/negligence, and drug offenses were compared. The results revealed that dentists who were convicted for unauthorized auxiliary expanded duty use were assigned harsher penalties than those given to dentists convicted for other classes of offenses (P = .02, Fisher's exact test). This study indicates that, at least for the dentists of Texas, the punishment may not always fit the crime.     

Concordance between patient satisfaction and the dentist's view: Findings from The National Dental Practice-Based Research Network

ObjectivesIn this study, the authors examined the dentist's view of the patient's experience and concordance with the patient's rating of satisfaction.MethodsPractitioners from 197 practices in The National Dental Practice-Based Research Network recruited consecutively seen patients who had defective restorations that were replaced or repaired. At the end of the dental visit, the treating dentist and 5,315 patients completed and returned a survey that asked about the patient's satisfaction.ResultsMost dentists viewed their patients as having been satisfied with the treatment experience (n = 4,719 [89 percent]) and as having perceived them as friendly (n = 5,136 [97 percent]). Dentists had less strong feelings about whether patients had a preference for the restorative material (n = 2,271 [43 percent]) or an interest in obtaining information about the procedure (n = 1,757 [33 percent]). Overall, patients were satisfied, and most of the time dentists correctly predicted this outcome. Among patients who were less than satisfied, there was a substantial subset of cases in which dentists were not aware of this dissatisfaction.ConclusionFor improved patient-centered care, dentists should assess patients' desires, expectations and perceptions of the dental care experience and then manage or correct the expectations and perceptions as needed.Practical ImplicationsBy taking a patient-centered approach, dentists should seek to understand how patients evaluate and rate the services provided, thereby enabling them to focus on what each patient values most.     

Impression evaluation and laboratory use for single-unit crowns: Findings from The National Dental Practice-Based Research Network

Background

Objectives were to determine the likelihood that a clinician accepts an impression for a single-unit crown and document crown remake rates.

A Profile of Black and Hispanic Subgroups'' Access to Dental Care: Findings from the National Health Interview Survey

This study examined which black and Hispanic minority subgroups were least likely to obtain dental care and why, based on logistic regression analyses of the 1986 National Health Interview Survey. Blacks and Hispanics were less apt to have private dental insurance coverage, to be knowledgeable about the purpose of fluoride, to have been to a dentist in the past year, and, when they did go, were more apt to have gone in response to symptoms rather than for preventive reasons, compared to whites. Logistic regression analyses for adults 18 years of age and older and for children and adolescents 2 to 17 years of age showed that the following individuals had the lowest probability of having been to a dentist in the past year: males, members of larger families, adults who were unemployed or in blue-collar jobs, those who lived in the South or nonmetropolitan areas, people who perceived their health to be fair or poor, and those with no private dental insurance. Mexican-Americans were least likely to have been to a dentist regardless of their income or education. In general, the findings confirmed the importance of dental insurance, as well as suggesting a need for more school-based dental programs and public health clinic-based dental health education and outreach efforts for targeting minority children and adults.     

Practitioner, patient and carious lesion characteristics associated with type of restorative material: findings from The Dental Practice-Based Research Network

BackgroundThe authors conducted a study to identify factors associated with the materials that dentists in The Dental Practice-Based Research Network (DPBRN) use when placing the first restoration on permanent posterior tooth surfaces.MethodsA total of 182 DPBRN practitioner-investigators provided data regarding 5,599 posterior teeth with caries. Practitioner-investigators completed an enrollment questionnaire that included the dentist’s age, sex, practice workload, practice type and number of years since graduation. When patients who had provided informed consent to participate in the investigation sought treatment for a previously unrestored carious surface, the practitioner-investigator recorded patient and tooth characteristics.ResultsPractitioner-investigators used amalgam more often than they used direct resin-based composite (RBC) for posterior carious lesions. Practitioner and practice characteristics (years since graduation and type of practice); patient characteristics (sex, race, age and dental insurance status); and lesion characteristics (tooth location and surface, preoperative and postoperative lesion depth) were associated with the type of restorative material used.ConclusionsSeveral practitioner and practice, patient and lesion characteristics were associated significantly with use of amalgam and RBC: geographical region, years since dentist’s graduation, patient’s dental insurance status, tooth location and surface, and preoperative and postoperative lesion depth.Clinical ImplicationsDespite advances in esthetic dentistry, U.S. dentists still are placing amalgam on posterior teeth with carious lesions. Amalgam was used more often than RBC in older patients, who may have had deeper carious lesions.     

Differences in male and female dentists' practice patterns regarding diagnosis and treatment of dental caries: findings from The Dental Practice-Based Research Network

BackgroundA number of articles have addressed differences in productivity between male and female dentists, but little is known about differences between the sexes in practice patterns regarding caries management.MethodsIn this study, the authors surveyed general dentists who were members of The Dental Practice-Based Research Network (DPBRN) and who practiced within the United States. The survey included questions about dentists’, practices' and patients' characteristics, as well as prevention, assessment and treatment of dental caries. The authors adjusted the statistical models for differences in years since dental school graduation, practice model, full-time versus part-time status, and practice owner or employee status before making conclusions about sex differences.ResultsThree hundred ninety-three male (84 percent) and 73 female (16 percent) dentists participated. Female dentists recommended at-home fluoride to a significantly larger number of their patients than did male dentists, whereas male dentists had a preference for using in-office fluoride treatments with pediatric patients. Female dentists also chose to use preventive therapy more often at earlier stages of dental caries. There were few differences between the sexes in terms of diagnostic methods, time spent on or charges for restorative dentistry, and busyness of the practice.ConclusionsFemale DPBRN dentists differ from their male counterparts in some aspects of the prevention, assessment and treatment of dental caries, even with significant covariates taken into account.Practice ImplicationsThe practice patterns of female dentists suggest a treatment philosophy with a greater focus on caries prevention.     

Utilization of the Danish Youth Dental Care Scheme among 1655 16–22-year-old males and females

The present study attempts to establish operational criteria which can be used in the evaluation of the Youth Dental Care Scheme (YDCS) established in Denmark in 1965. The utilization of the YDCS is studied in a population of 1655 16-22-year-old males and females all of whom had attended the Public Child Dental Care in the municipality of Aarhus. Data on enrollment and use of the YDCS were collected using an official data base established with the purpose of administering the YDCS and by a mailed questionnaire. The study showed that enrollment rate was approximately 80% for those individuals who had just left Public Child Dental Care. For individuals who had left Public Child Dental Care 4-5 years earlier, the enrollment rate was 74%. Enrollment rate at a given time did, however, prove not to be a valid measure for the utilization. The study thus showed that only 65% of the individuals had been constant users for 4-5 years after they had left Public Child Dental Care. Women were more frequently constant users than men. Individuals from the higher social groups were more frequently constant users than individuals from the lower social groups.