Perceptions of patients' smiles: a comparison of patients' and dentists' opinions

BACKGROUND: Little information has been published regarding the difference between how patients perceive their own smiles and how dentists view them. METHODOLOGY: The authors interviewed 78 consecutively seen patients in a general dental practice in Norway about esthetic features of their faces. The patients were not actively seeking esthetic treatment. Patients rated themselves using a 100-point visual analog scale (VAS), and then two dentists (the patients' regular dentist and an independent periodontist), working with photographs of the patients, used the same VAS in rating the patients' smiles. RESULTS: The average age of the patients was 51.2 years (range, 22-84 years). There were 50 women (average age, 51.5 years; range, 22-84 years) and 28 men (average age, 52 years; range, 30-78 years). Patients' satisfaction with their own smiles reached an average of 59.1 (standard deviation [SD], 21.1; range, 5-100) on the VAS. The dentists' scores (38.6 and 40.7) were significantly lower than the patients' scores. The authors observed poor correlation between the periodontist's scores of dentogingival features and the patients' scores. Patients were most satisfied with the gingiva when smiling and least satisfied with tooth shade. Patients younger than 50 years were most satisfied with their smiles. Patients rated teeth and eyes as the most important features in an attractive face. Women gave teeth and hair significantly higher scores and head shape lower scores than did men. CONCLUSION: Patients' opinions of their own smiles were significantly higher than the two clinicians' assessments of their smiles. Dentists should be aware that patients who seek esthetic services may have different perceptions of their smiles than may patients who do not express such desires.     

Nordic dentists' opinions on the safety of amalgam and other dental restorative materials

The safety of amalgam and other restorative materials has caused concern among dental patients in recent years. The aim of this study was to obtain information on dentists' perceived competence in handling different filling materials and their opinions on the safety of these. A random sample of practising dentists in Denmark, Finland, Norway, and Sweden received a mail question-naire in spring 1990. Answers were received from 1732 dentists (65%). The study showed that the respondents believed that their theoretic knowledge and clinical skills were generally at a high level regarding restorative materials. The risks of the side-effects of gold, ceramic materials, and glass ionomer were considered to be low by about 90% of the respondents. Amalgam was considered to be significantly more hazardous by the Swedish respondents than the others. Interestingly, composite was considered to be associated with a high risk of side-effects by about half of the dentists in all Nordic countries. The dentists' opinions were not found to be greatly influenced by their sex, age, or place of residence but rather by their country and service sector. Against the background of the present lack of scientific evidence on the hazardousness of amalgam or other restorative materials for patients' general health, these findings indicate that dentists are influenced by discussions in the mass media about dental treatment and materials and, of course, by the guidelines given by the health authorities in their own countries. Few dentists were shown to be concerned about occupational risks associated with the use of amalgam, and they had not had their own amalgam fillings replaced. Thus, Nordic dentists seem prepared to continue to use amalgam as one of several dental restorative materials while waiting for technically and biologically more satisfactory ones.     

Patient participation during dental consultations: the influence of patients' characteristics and dentists' behavior

OBJECTIVE: This study examined the influence of the following variables on patients' information-seeking and participating behavior during emergency treatment: patients' preferences for information and participation, patients' coping style, patients' socio-demographic variables, and dentists' communicative behavior. METHODS: The sample consisted of 83 patients receiving emergency care from 13 different dentists. Consultations were videotaped in order to assess dentists' and patients' behavior. Dentists' communicative behavior was coded by means of the Communication in Dental Settings Scale (CDSS); scores for patients' behavior included the number and nature of questions asked during the consultation, attempts to offer diagnoses, and whether or not patients made the decision to undergo treatment themselves. At home, patients filled out a questionnaire that included scales to measure their preference for information and participation and other background variables. RESULTS: Results showed that patients' desire for information and participation, together with other variables, was not reflected in their overt behavior. Furthermore, dentists' communicative behavior was unrelated to patients' information-seeking and participating behavior. CONCLUSIONS: Scores on the CDSS show that still there is a discrepancy between the legal prerequisites of information-giving and emergency dental practice. Therefore, dentists' information-giving behavior should be improved in order to enhance the patients' right to make informed decisions.     

如何保持民营口腔诊所的可持续发展状态

2000年,国务院体制改革办公室、国家计委、国家经贸委、卫生部等8个部委发布了《关于城镇医药卫生体制改革的指导意见》,明确提出“建立新的医疗机构分类管理制度”,“将医疗机构分为非盈利性和盈利性两类进行管理”。此后,我国民营口腔诊所进入了有法可依的发展时期,各地的民营口腔诊所如雨后春笋般涌现。     

Survey of dentists' opinions on issues facing the profession.

Dentists in the Seventh District Dental Society of the State of New York were surveyed for their attitudes toward selected health policy issues to determine the extent of attitudinal consensus in the professional community, the bases of significant differences of opinion, and the agreement of the local dentists with official policies of the American Dental Association. Greatest agreement among dentists was found with respect to the issues of licensure and peer review; some significant differences of opinion were found about the existence of manpower problems, expansion of dental schools, recruitment of minorities, expanded-duty auxiliaries, and fee scheduling. Most dentists favored participation in continuing education courses without examination as a requisite for licensure and even more favored peer review by the local dental society. Agreement between opinions of local dentists and official ADA policies was high on all issues except fee posting, for which local opinion was evenly divided. The formation of national policies with regard to fee posting should proceed carefully.     

Caries experience of adults attending private and public dental clinics in Australia

Objectives: In Australia, the majority of dental patients attend the private sector, while those with means tested eligibility for government assistance may attend the public sector. The aims of this study were to compare dental caries among persons who last visited private and public clinics, controlling for age, sex, reason for visit, and income. Methods: Data were collected in 2004‐06, using a three‐stage, stratified clustered sample of Australians aged 15+ years, involving a computer‐assisted telephone interview (CATI), oral examination, and mailed questionnaire. Results: A total of 14,123 adults responded to the CATI (49 percent response) of whom 5,505 (44 percent of those interviewed) had an oral epidemiological examination. Multivariate regression analysis controlling for age, sex, reason for visit, and income showed (P < 0.05) that persons attending public clinics had higher levels of decayed (β = 0.33) and missing teeth (β = 0.83), but lower levels of filled teeth (β = ?1.09) compared with the reference category of private clinics. Conclusions: Persons who attend for dental care in the public sector have worse oral health than adults who visit private dental clinics, in addition to an independent effect of socioeconomic disadvantage.     

Oral health and family characteristics of children attending private or public dental clinics

Abstract The City of North York Public Health Department (NYPHD) operates a school-based dental programme that provides preventive and treatment services to children according to evidence-based practice guidelines. This programme and private dental practices (PDP) represent the only sources of dental care for children in North York. The purpose of our study was to compare the oral health and family characteristics of clients from the NYPHD and PDP using a dental examination and a parent interview. Results showed that NYPHD and PDP clients had similar levels of lluorosis, calculus, and periodontal health, but NYPHD clients had experienced greater levels of decay. Clients of the NYPHD and PDP also had significantly different family characteristics, many of which were significantly associated with the presence of one or more decayed primary or permanent teeth. Multivariate logistic regression identified mother's immigration history, past caries experience, and parents' rationale for scheduling their child's dental appointments as the principle risk makers for dental decay. When compared with PDP clients, the NYPHD serves higher-needs children who otherwise might not receive care.     

Patients' and dentists' perception of dental appearance

The purpose of this study was to compare the patients' and dentists' perception of dental appearance. Based on internationally accepted guidelines about dental esthetics, a questionnaire was developed to measure “dental appearance” (QDA). Eleven items defined a QDA sum score (0 = “absolutely satisfied”, 44 = “absolutely dissatisfied”). The QDA was completed by 16 patients (eight women, eight men, mean age 63 ± 9 years) before and after a complete oral rehabilitation. Forty-two dentists evaluated the esthetics before and after rehabilitation on a visual analog scale (VAS, 0 = “absolutely unesthetic”, 100 = “absolutely esthetic”). The patients' quoting showed a significant esthetic improvement (QDA sum score) from 22 before treatment to 3.5 after treatment (P ≤ 0.001). Although most of the dentists judged an improvement in most of the patients dental appearances, no significant correlation could be found between patients' and dentists' judgment regarding dental appearance (r = −0.13–0.53, P > 0.05). When evaluating the influence of age, gender, and experience on rating dental appearance, no significant differences (P > 0.05) could be found.     

Analysis of attendance rates at Soweto dental clinics 1995-2002.

BACKGROUND: Patient attendance rates at Soweto dental clinics increased during the year after the implementation of free primary oral health care in 1995. OBJECTIVE: This study was performed to examine if the attendance rates continued to increase between April 1995 and March 2002. MATERIALS AND METHODS: Monthly clinic records were used to record casual (pain and sepsis treatment) and booked patient attendance (restorative, prosthetic and orthodontic treatment) and number of dental operators in the nine primary health care clinics and one hospital clinic in Soweto. Data were analysed with SAS and Prism software. RESULTS: Total patient attendances in the primary health care clinics significantly increased from 6,161 in 1995 to 10,519 in 2002 (P<0.05) due to an increase in casual patients Booked patients decreased and patients treated per operator increased. In the hospital clinic the casual patient attendances decreased but booked patients significantly increased (P<0.005). CONCLUSIONS: Patient attendance rates increased between 1995 and 2002 with an increase in dental operator workload.     

Use and quality of bitewing films in private dental offices

Patient records (387) were obtained from twenty-five dentists in private practice in Rochester, New York. The number and types of radiographs taken at each recall examination in the most recent 10-year period were recorded. Bitewing radiographs were taken at 50.5% of the recalls with size 2 film used most frequently (83.7%). The average recall interval was 8.4 months overall and 18.0 months for bitewing recalls. Of all proximal surfaces available on the bitewing films, 68.2% were judged adequately separated for diagnostic purposes. For individual surfaces, the highest percentages were recorded for the mesial surface of the maxillary second premolar (89.9%) in the permanent dentition and for the distal surface of the mandibular second molar (83.7%) in the deciduous dentition. Taking four bitewing films instead of two improved the percentage of adequately separated proximal surfaces at a given recall by 2% to 25%. The percentage of unreadable proximal surfaces caused by overlapping or distortion on the bitewing radiographs, when excluding the canines, ranged from 6.3% to 39.5% in the permanent dentition and from 12.5% to 24.9% in the deciduous dentition.     

Sealants and dental caries: dentists' perspectives on evidence-based recommendations

BackgroundThe authors conducted a study to survey the perspectives of dentists regarding the 2010 American Dental Association (ADA) recommendation to seal non-cavitated carious lesions (NCCLs) in children and young adults.MethodsThe authors mailed a questionnaire to a randomly selected sample of 2,400 general dentists (GDs) and pediatric dentists (PDs) in the United States. The sample was chosen by the ADA&;apos;s Survey Center. The questionnaire included two photographs of NCCLs (permanent first molar and premolar) in a 12-year-old child. Respondents were provided with radiographic findings and asked to choose from several management options.ResultsIn the absence of radiographic evidence of caries, 37.4 percent and 42.3 percent of GDs and PDs, respectively, indicated that they would seal the NCCL in the molar. For the premolar, a significantly lower percentage of GDs than of PDs indicated that they would seal the NCCL. With radiographic evidence of caries in dentin, less than 4 percent of all dentists surveyed indicated that they would seal the NCCLs, and more than 90 percent indicated that they would remove the caries and place restorations. Less than 40 percent of dentists indicated that they sealed NCCLs in their practice.ConclusionsThe U.S. dentists surveyed have not adopted evidence-based clinical recommendations regarding the sealing of NCCLs.Practice ImplicationsNew educational and dissemination programs should be developed regarding these evidence-based caries management approaches.     

Scottish dentists' preferences for remuneration and their opinions on the scope of General Dental Service treatment

A questionnaire was sent to a list of what was considered to be all dentists currently in practice in the General Dental Service (GDS) and Community Dental Service (CDS) in Scotland; 72% responded. The dentists were asked to indicate the general method by which they would prefer to be paid, given a choice of fee for item-of-service, salary or capitation. Opinion was split among the GDS respondents, between fee for item-of-service (34.9%), a salaried system of payment (32.6%), or a service based on differing remuneration systems for the dental care of adults and children (22.5%). Only 22.6% of GDS respondents said they would prefer a capitation system for the treatment of child patients. Most CDS respondents said they preferred to be salaried. Dentists in both services were asked if they felt there was a need to extend the range of treatment items which are currently permitted in the GDS; most felt that there was. About 80% of all respondents felt that there was a need to allow payment for various items of preventive dental care within the GDS. Almost a third of GDS respondents also mentioned various items of restorative dental treatment which they felt should be funded (a concern which fewer CDS respondents (6.7%) mentioned). Few respondents suggested any other additional types of treatment items.     

Canadian dentists' view of the utility and accessibility of dental research

As part of a major reorganization of health and health care research in Canada, a study was performed to investigate the views of Canadian dentists on the utility and accessibility of the results of dental research. A cross-sectional survey design was used. Questionnaires and a postage-prepaid reply envelope were mailed with the December 2001 issue of the Journal of the Canadian Dental Association (JCDA) to all registered Canadian dentists. No second mailing occurred. Of 17,648 questionnaires distributed, 2,797 were returned representing a 15.8 percent response rate. In this sample, 64.3 percent found research findings easily available, 88.8 percent found research findings useful, and 95.8 percent had already changed one or more aspects of their clinical practice due to research findings. Significant differences in preferred means of learning the results of research and preferred formats for written reports of research findings were evident between generalist/clinicians and specialist/researchers. These results suggest that Canadian dentists are interested in the results of research and apply them to their practice, but that there are two main groups (generalist/clinicians and specialist/researchers) with different needs for learning the results of that research.     

Dentists'' and patients'' opinions of the dental condition at moment of full clearance

Reasons for full mouth extraction in an urban and a rural area in The Netherlands (dentist-patient ratio 1:2500 and 1:5700 respectively) have been studied. Patients who participated in this combined sociodental research project were those who received full mouth extractions over a period of 1 yr. The combined patient response was 75% and the overall dentist response 90%. In the urban and the rural areas respectively 137 and 237 cases of full mouth extraction were recorded. When comparing the dentists' diagnoses with the conditions of the dentitions there appeared to be a fair degree of agreement in most of the cases, although some striking deviations were also found. In the relationship between the patient's opinion and the condition of the dentition some unexplained discrepancies were found: 37% of the dentitions in which the teeth and attachment were in a healthy condition were perceived as bad by the patients. Dentists and patients agreed in their perceptions of the dental conditions in 60% of the cases. In 27% there was a strong disagreement. In most of the discrepancies found plausible explanations could be given. In some cases this was not possible. As this involves a substantial minority of cases, dentists should be aware of reasons other than the clinical condition in the disabling treatment of full clearance.     

患者对口腔专业实习医师满意度和信任度的调查分析

目的:了解患者对口腔专业实习医师的满意度和信任度,探讨提高患者对实习医师满意度和信任度的对策。方法:对118例口腔科就诊患者进行问卷调查,主要涉及患者对实习医师的满意度和信任度,对结果进行分析。结果:95.24%的患者对实习医师评价良好,84.13%的患者认为实习医师比自己预想的好,51.09%的患者愿意接受实习医师诊疗,47.83%的患者在被实习医师诊治时存在各种担心,而28.26%的患者则不存在顾虑。结论:出于各种原因,患者对实习医师有不同程度的抵触情绪,不愿配合临床教学,医院、学校、教师、学生应共同努力,提高患者对实习医师的满意度和信任度,提升临床实习的质量和效率。