Safety of dental restorative materials: a survey of dentists' attitudes.

In order to obtain information from practising dentists in Finland about their experiences of and attitudes to dental restorative materials, a cross-sectional survey was conducted in spring 1990 using a postal questionnaire. The response rate was 73% (454 replies). Virtually all (99%) respondents had faced questions about the safety of dental materials in 1989 and 93% of all questions concerned amalgam. Most respondents assessed their theoretical knowledge and practical experience of amalgam, composite and glass ionomer as good, whereas gold and ceramics as filling materials were less familiar. However, the three latter materials were regarded as safe by most respondents. Composite was believed to pose the highest risk of side-effects. Although few dentists regarded amalgam as hazardous, it was estimated that the use of this material will decrease over the next five years in favour of glass ionomer, ceramic materials and composite. Changing dental fillings at the patient's request without odontological indications was opposed by about 80% of the dentists, even if patients were to bear the total cost themselves. Only 7% of the dentists claimed to be worried about the possible risks to themselves of handling amalgam at work, and 97% reported having amalgam fillings personally.     

Longevity of restorations: survey results of dentists' estimates and attitudes

A cross-sectional survey of 571 clinicians was conducted to obtain information about expected and observed restoration longevity. Clinicians believed that average large amalgam, small amalgam, and cast restorations lasted 6, 11, and 13 years, respectively. Patients were thought to be responsible for 47%, dentists for 30%, and materials used for 23% of restoration failures. The clinicians perceived the restorations that they placed to be more long-lasting than those placed by other clinicians. Clinical measurements of restoration longevity were shown to be influenced by the judgment criteria used by clinicians.     

A survey of Hong Kong dentists' attitudes towards advertising.

OBJECTIVE: To determine the attitudes of dental practitioners in the Hong Kong Special Administrative Region (SAR) of the Peoples' Republic of China towards advertising of dental services by members of the profession, a practice that is currently not permitted by legislation. DESIGN: Self-completion questionnaires were mailed to 400 members of the Hong Kong Dental Association. In addition to being presented with a number of closed questions, respondents were invited to expand on their answers in a more qualitative, open-ended manner. RESULTS: 271 replies were received, representing a response rate of 68%. Respondents were largely against a move towards any deregulation which would result in dentists being allowed to advertise their services in the SAR (57.9% against, 28.0% for), this despite a high proportion of respondents reporting that, in their opinion, the Hong Kong public do not know enough about the services provided by dentists in the SAR (69.7%). CONCLUSIONS: Opinions amongst Hong Kong dentists are divided with a majority feeling that a move to allow advertising would not benefit either the public or the profession. There is, however, a significant proportion of dentists who feel that there is a need for such deregulation.     

Antibiotic use for treating dental infections in children: a survey of dentists' prescribing practices

BackgroundThe authors conducted a study to examine the antibiotic prescribing practices of general and pediatric dentists in the management of odontogenic infections in children.MethodsThe authors relied on a cross-sectional study design to assess the antibiotic prescribing practices of general and pediatric dentists in North Carolina. The survey instrument consisted of five clinical case scenarios that included antibiotic-prescribing decisions in a self-administered questionnaire format. The participants were volunteers attending one of four continuing education courses. The authors invited all pediatric dentists in private practice to participate in the study, as well as general practitioners who treated children in general practice. The authors compared the practitioners&;apos; responses for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry and the American Dental Association.ResultsA total of 154 surveys were completed and returned (55 percent response rate). The mean age of respondents was 47 years, and the mean number of years in practice was 19. Of the 154 overall, 106 (69 percent) were general practitioners and 48 (31 percent) were pediatric dentists. Across the three in-office clinical case scenarios, adherence to professional prescribing guidelines ranged from 10 to 42 percent. For the two weekend scenarios, overall adherence to the professional prescribing guidelines dropped to 14 and 17 percent. Dentists who had completed postgraduate education (n = 73 [51 percent]) were more likely (P < .05) to have adhered to published guidelines in prescribing antibiotics.ConclusionsThe results of this survey show that dentists&;apos; adherence to professional guidelines for prescribing antibiotics for odontogenic infections in children was low. There appears to be a lack of concordance between recommended professional guidelines and the antibiotic prescribing practices of dentists. Clearer, more specific guidelines may lead to improved adherence among dentists.     

Temporomandibular disorders in adolescents. Epidemiological and methodological studies and a randomized controlled trial

The aim of the present thesis was to investigate different aspects of temporomandibular disorders (TMD) and pain such as prevalence, diagnostics, and treatment among adolescents. The reliability of a questionnaire and the clinical examination and diagnoses according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were assessed. Overall, we found it possible to assess and diagnose TMD in adolescents in a reliable way. The prevalence of TMD pain, gender differences, and the need for treatment were investigated among 864 adolescents from a Public Dental Service clinic. Seven percent of the subjects received a pain diagnosis according to the RDC/TMD, and the prevalence was higher among girls than boys. More subjects with TMD pain reported school absence and analgesic consumption compared to controls. Approximately every second subject who reported TMD pain also perceived a need for treatment. In an evaluation of psychosocial and dental factors, the following were found to play an important role in adolescents with TMD: stress, somatic complaints, and emotional problems. Three treatment methods were compared in a randomized controlled trial: brief information only, brief information and occlusal appliance, and brief information and relaxation therapy. In the brief information and occlusal appliance group, 60%--significantly more than in the other two groups--experienced a reduction of at least 50% in TMD pain. The influence of somatic and emotional stimuli was evaluated, and we found that adolescents with TMD pain were significantly more sensitive to not only aversive somatic but also pleasant somatic stimuli compared with healthy controls. The results suggest that not only nociceptive but also cognitive processes are implicated in chronic pain states in young TMD subjects. In conclusion, TMD pain is more common in girls than in boys and affects daily life. TMD pain in adolescents can best be improved by traditional treatment with occlusal appliance combined with brief information.     

Temporomandibular disorders among Brazilian adolescents: reliability and validity of a screening questionnaire

Temporomandibular disorders (TMD) screeners assume significant item overlap with the screening questionnaire proposed by the American Academy of Orofacial Pain (AAOP).

Objective

To test the reliability and validity of the Portuguese version of AAOP questions for TMD screening among adolescents.

Material and Methods

Diagnoses from Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were used as reference standard. Reliability was evaluated by internal consistency (KR-20) and inter-item correlation. Validity was tested by sensitivity, specificity, predictive values, accuracy and receiver operating characteristic (ROC) curves, the relationship between the true-positive rate (sensitivity) and the false-positive rate (specificity). Test-retest reliability of AAOP questions and intra-examiner reproducibility of RDC/TMD Axis I were tested with kappa statistics.

Results

The sample consisted of 1307 Brazilian adolescents (56.8% girls; n=742), with mean age of 12.72 years (12.69 F/12.75 M). According to RDC/TMD, 397 [30.4% (32.7% F/27.3% M)] of adolescents presented TMD, of which 330 [25.2% (27.6% F/22.2% M)] were painful TMD. Because of low consistency, items #8 and #10 of the AAOP questionnaire were excluded. Remaining items (of the long questionnaire version) showed good consistency and validity for three positive responses or more. After logistic regression, items #4, #6, #7 and #9 also showed satisfactory consistency and validity for two or more positive responses (short questionnaire version). Both versions demonstrated excellent specificity (about 90%), but higher sensitivity for detecting painful TMD (78.2%). Better reproducibility was obtained for the short version (k=0.840).

Conclusions

The Portuguese version of AAOP questions showed both good reliability and validity for the screening of TMD among adolescents, especially painful TMD, according to RDC/TMD.     

Changing dentists' knowledge, attitudes, and behaviors relating to AIDS: a controlled educational intervention

The efficacy of an educational intervention designed to improve dentists' knowledge, attitudes, and behaviors about acquired immune deficiency syndrome (AIDS) was tested. The intervention had three components: computerized feedback comparing participants' own knowledge, attitudes, and behaviors with those of fellow participants and with an ideal; periodic bulletins; and telephone conference calls with experts. The group receiving the educational package had better scores than a control group on outcomes of willingness to treat persons with AIDS; identification of human immunodeficiency virus lesions; knowledge of AIDS; and completeness of both intraoral and extraoral examinations. It was concluded that intervention is one approach to increasing dentists' positive response to the AIDS epidemic.     

AIDS and infection control in dental practice: dentists' attitudes, knowledge, and behavior

A random sample of 541 dentists in California was surveyed to determine the dentists' attitudes toward AIDS and their role in relation to AIDS, their knowledge about AIDS, their behaviors in regard to screening for AIDS, and their use of infection-control measures. The survey results showed that dentists believe they have a responsibility to care for patients with AIDS but preferred not to do so; were moderately knowledgeable about AIDS and AIDS-related issues; and were inconsistent in their use of infection-control measures.     

General dentists' attitudes toward delegation, information, and patient influence in a prosthodontic context

PURPOSE: The aim of this study was to investigate attitudes among general dentists in Sweden in relation to gender, age, prosthodontic activity, and dental delivery system (private or public). MATERIALS AND METHODS: Questionnaires were sent to a random sample of 2,059 dentists, and a response rate of 76% (1,567 dentists) was achieved. Among those who responded, 50% were private practitioners and 50% were publicly employed practitioners; 42% were female and 58% were male. The questionnaire contained 10 statements aimed at measuring attitudes. Their dimensionality was analyzed using principal components analysis. The resulting factors were related to delivery system (public or private), gender, age, job satisfaction, and weekly working hours used for prosthodontics in multiple regression models. RESULTS: There was a wide variation in the answers to the statements, indicating great individual differences in opinions among dentists. Several distributions differed with respect to gender and delivery system, but the mean differences between various groups of dentists were small. The most affirmative attitude was shown for delegation of impression taking to auxiliaries (mean 6.7; SD 1.8), and the most negative attitude was shown for close cooperation between dentists (mean 1.8; SD 1.4). The factor analysis gave 3 factors, with a variance explanation of 57%. Regression models for the 3 attitude dimensions ("patient influence," "delegation," and "patient information") showed that female dentists felt more positive about delegation and information than male dentists. The explained variance was very low for all 3 models and varied from 0.01 to 0.05. CONCLUSION: Although the differences in attitudes between various groups of dentists were statistically significant, these differences were small in relation to the large variation in attitudes among individual dentists.     

Norwegian dentists' knowledge, attitudes, and behavior concerning the HIV

Abstract— Knowledge about routes of HIV transmission and attitudes to HIV antibody testing was studied in a group of Norwegian dentists. Personal protection by gloves was also recorded. Eighty-three of 120 (69%) dentists in Bergen (private practitioners) completed a postal questionnaire. More than half of these considered themselves to be in potentially infectious situations daily. Overall knowledge was good, although one fifth gave wrong answers about the relation between antibody status and infectivity. About half the respondents had attitudes to antibody testing not consistent with Centers for Disease Control (CDC) guidelines. These dentists scored significantly lower on the knowledge questions. Seventy-five (92%) reported consequent use of gloves. A low knowledge score was found among non-users. The present study indicates that lack of knowledge is related to non-recommended attitudes and behavior. The study underlines the need for continuous education and information about HIV.     

Norwegian dentists' knowledge, attitudes, and behavior concerning the HIV

Knowledge about routes of HIV transmission and attitudes to HIV antibody testing was studied in a group of Norwegian dentists. Personal protection by gloves was also recorded. Eighty-three of 120 (69%) dentists in Bergen (private practitioners) completed a postal questionnaire. More than half of these considered themselves to be in potentially infectious situations daily. Overall knowledge was good, although one fifth gave wrong answers about the relation between antibody status and infectivity. About half the respondents had attitudes to antibody testing not consistent with Centers for Disease Control (CDC) guidelines. These dentists scored significantly lower on the knowledge questions. Seventy-five (92%) reported consequent use of gloves. A low knowledge score was found among non-users. The present study indicates that lack of knowledge is related to non-recommended attitudes and behavior. The study underlines the need for continuous education and information about HIV.     

Temporomandibular joint disorders: a diagnostic challenge

During the past decade much interest has been focused on disorders of the TMJ. The etiology appears to be multifactorial, with signs and symptoms difficult to evaluate and radiologic investigations insufficient. This review attempted to analyze current diagnostic tools. The recent introduction of various techniques promises optimism for this diagnostic and therapeutic challenge.     

Temporomandibular joint sounds in adolescents: a longitudinal study

A 2-year longitudinal study on signs and symptoms of mandibular dysfunction was performed with 285 17-year-old adolescents living in a certain geographic area in Skellefte?, Sweden. Crepitation was neither reported nor recorded in any subject. Both reports and recordings of TMJ clicking sounds fluctuated with time. The 2-year period prevalence was 24%, and 5.8% consistently reported TMJ clicking sounds. The corresponding figures for clinically recorded clickings were 36% and 9.3%, respectively. Both reported and recorded joint sounds were significantly more frequently found in 19-year-old girls than in boys. No consistent pattern of relationships between reported and recorded clicking sounds and single factors obtained by the questionnaire or clinically recorded variables could be found. Palpation tenderness in three muscle sites was to a varying degree related to both reports and recordings of clicking. Each year, significant relationships were found between reports of TMJ sounds and symptom indices. Recorded sounds were significantly related to a clinical index in the two oldest age groups. The prevalence of TMJ clicking sounds increases with age, and girls are more prone to have them than boys. In view of the natural longitudinal fluctuations, most clickings only need to be supervised, and when there is a demand for treatment, reversible methods are advocated in adolescents.